A new study exploring the concepts of undue inducement and coercion was conducted in top 60US institutions as ranked by National Institute of Health (NIH). The study, titled ‘How IRB view and make decisions regarding coercion and undue inducement’, interviewed 46 chairs, coordinators and members of US IRBs via telephone which lasted on average 2 hours.
The interviews were transcribed and themes identified, which included, ‘how much to give the subject’, ‘when to compensate subjects’, ‘what’ and ‘who to compensate’, ‘whether and how to inform subjects about compensation’ and lastly ‘underlying tensions’.
Interviewees expressed difficulty in deciding the amount of monetary compensation for research participation. Some interviewees believed subjects should not enroll with the sole aim to acquire money but for altruistic motives. So research participation does not involve monetary gains or conflict of interests. According to the study, IRBs commonly used the terms coercion and undue inducement interchangeably indicating a lack of standardized definitions of both among interviewees. In addition, members debated whether the money paid to participants be different according to the income each subject earns or agree on a fixed compensation to all participants regardless of their incomes.
Deciding on compensation in the developing country seems to be a challenge as well, since this depended on the economic level of the country and its budget for research. The compensation given in developing country covers only transportation expenses and some interviewees expressed concerns of exploitation. Though, IRB resort to seeking advice of local IRBs in addressing the local context of undue inducement and coercion, some of these local IRBs may not fully understand these concepts.
Compensating pediatric age group was addressed in the study. It is agreed that minors should not take money in return for research participation but compensating students in the form of academic credit was practiced. However, interviewees questioned the real motives behind such practice. is it for teacher’s or student’s benefit?
IRB also addresse whether to tell participants of compensation value in recruitment flyer or not. The decision mostly depended on the amount of money proposed. Some interviewees preferred to advertise a compensation in the form of a gift card than to mention a set monetary value.
There is variability in addressing issues regarding coercion and undue inducement among IRBs in the US. The definitions of the terms are not clear to many interviewees and /or misused. Measures need to be taken to resolve such shortcomings and standardize the language and practice among IRBs.