The ethics of paying drug users who participate in research: a review and practical recommendations

THE PAYMENT OF RESEARCH PARTICIPANTS raises ethical and empirical questions that have special importance in addictions research involving drug-dependent participants. Despite a now large literature on human subjects payment, what is still needed is practical guidance for investigators and ethics committees. This paper reviews the literature on: current payment practices and guidelines; defining features of undue and due incentives and fair reimbursement; and the significance of risks and harms that may arise from paying drug using participants. We conclude that research payments are ethically acceptable in most circumstances of addictions research, but should be closely scrutinized in situations where these may exacerbate existing harms or create additional risks for participants and investigators. General principles, key questions and procedural options are highlighted for an applied approach to ethical research payments. Future research directions are identified.

Investigating the dilemmas of ethical social research

The author’s work with a university ethics committee and field research in Pacific New Caledonia is used as a basis to problematise the biomedical research models used by universities in Australia for assessing social research as ethical. The article explores how culturally specific Western emotional bases for ethical decisions are often unexamined. It expresses concerns about gaps in biomedical models by linking the author’s description of field interactions with research participants to debates about the creation of knowledge.

The policy and ethical implications of genetic research on attention deficit hyperactivity disorder

Objective: To review the policy and ethical implications of recent research on the molecular genetics of attention deficit hyperactivity disorder (ADHD). Method: MEDLINE and psycINFO database searches were used to identify studies on the genetics of ADHD. The implications of replicated candidate genes are discussed. Results: The findings for most genes have been inconsistent but several studies have implicated the genes in the dopaminergic pathway in the aetiology of ADHD. Conclusions: The current evidence on the genetics of ADHD is insufficient to justify genetic screening tests but it will provide important clues as to the aetiology of ADHD. Genetic information on susceptibility to ADHD has the potential to be abused and to stigmatize individuals. Researchers and clinicians need to be mindful of these issues in interpreting and disseminating the results of genetic studies of ADHD.

Ethical issues in social research

There are numerous ethical issues that one must consider when developing a research project; however, much discussion about ethics in health research has focused on experimental studies such as clinical trials. As a result, there remains some ambiguity as to the ethical issues that need to be considered in health-related social research. This paper outlines a number of important ethical issues that CAM researchers should be aware of when developing, running and writing up social research. Maintaining high ethical standards is extremely important in social research as it protects participants and researchers, improves the quality of the data retrieved and ensures that future researchers will have access to participants within the community. (C) 2005 Elsevier Ltd. All rights reserved.

Ethics and health systems research in 'post'-conflict situations

Although considerable attention has been given to ethical issues related to clinical research in developing countries, in particular related to HIV therapy, there has been limited focus on health systems research, despite its increasing importance in the light of current trends in development assistance. This paper examines ethical issues related to health systems research in 'post'-conflict situations, addressing both generic issues for developing countries and those issues specific to 'post'-conflict societies, citing examples from the author's Cambodian experience. It argues that the destruction of health infrastructure results in a loss of structures and processes that would otherwise protect prospective research subjects who are part of vulnerable populations. It identifies the growth of health systems research as part of a trend towards sectoral and programmatic development assistance, the emergence of 'knowledge generation' as a form of research linked to development, and the potential for conflict where multilateral and bilateral donors are both primary funders and users of health systems research. It also examines the position of the health system researcher in relation to the sponsors of this research, and the health system being analysed.

Using pharmacogenetics and pharmacogenomics in the treatment of psychiatric disorders: some ethical and economic considerations"

Current pharmacotherapies for psychiatric disorders are generally incompletely effective. Many patients do not respond well or suffer adverse reactions to these drugs, which can result in poor patient compliance and poor treatment outcome. Adverse drug reactions and non-response are likely to be influenced by genetic polymorphisms. Pharmacogenetics holds some promise for improving the treatment of mood disorders by utilising information about genetic polymorphisms to match patients to the drug therapy that is the most effective with the fewest side effects. Pharmacogenomics promises to facilitate the development of new drugs for treatment. However, these technologies raise many ethical, economic and regulatory issues that need to be addressed before they can be integrated into psychiatry, and medicine more generally. We discuss ethical and policy issues arising from pharmacogenetic testing and pharmacogenomics research, such as informed consent, privacy and confidentiality, research on vulnerable persons and discrimination; and economic viability of pharmacogenetics and pharmacogenomics. We conclude with recommendations for the regulation and distribution of pharmacogenetic testing services and pharmacogenomic drugs.

Shoot first, ask questions later: Ethnographic research in an online computer gaming community

For researchers investigating online communities, the existence of the internet has made the activities and opinions of community members visible in a public domain. FPS gaming culture is a highly literate culture - members communicate and represent themselves in textual forms online, and the culture makes use of a wide variety of communication and publishing technologies. While a significant amount of insider knowledge is required to understand and interpret such online content, a large body of material is available to researchers online, and sometimes provides more reliable and enlightening information than that generated by more traditional research methods. While the abundance of data available online in some ways makes research far easier, it also creates new dilemmas and challenges for researchers. What extra knowledge is required of the researcher? How can one ensure that one's interpretations of member statements are made with an understanding of meaning within that culture? What responsibilities does the researcher have in their representation of the culture under examination? What ethical issues must be considered?

Reflecting on ethical and legal issues in wildlife disease

Disease in wildlife raises a number of issues that have not been widely considered in the bioethical literature. However, wildlife disease has major implications for human welfare. The majority of emerging human infectious diseases are zoonotic: that is, they occur in humans by cross-species transmission from animal hosts. Managing these diseases often involves balancing concerns with human health against animal welfare and conservation concerns. Many infectious diseases of domestic animals are shared with wild animals, although it is often unclear whether the infection spills over from wild animals to domestic animals or vice versa. Culling is the standard means of managing such diseases, bringing economic considerations, animal welfare and conservation into conflict. Infectious diseases are also major threatening processes in conservation biology and their appropriate management by culling, vaccination or treatment raises substantial animal ethics issues. One particular issue of great significance in Australia is an ongoing research program to develop genetically modified pathogens to control vertebrate pests including rabbits, foxes and house mice. Release of any self-replicating GMO vertebrate pathogen gives rise to a whole series of ethical questions. We briefly review current Australian legal responses to these problems. Finally, we present two unresolved problems of general importance that are exemplified by wildlife disease. First, to what extent can or should 'bioethics' be broadened beyond direct concerns with human welfare to animal welfare and environmental welfare? Second, how should the irreducible uncertainty of ecological systems be accounted for in ethical decision making?

A cross-cultural study of the role of religion in consumers' ethical positions

Purpose - Previous studies have looked at how socio-economic and political factors play a role in consumers' ethical positions, but few have considered the role of religion which is a major driver of ethics. This paper seeks to address this. Design/methodology/approach - From a survey of over 700 consumers this paper explores the similarities and differences between consumers' ethical positions in three different religions namely; Christian (from three countries), Islam, and Buddhism. Findings - It was found that a reduced item scale measuring the two factors of Forsyth's idealism and relativism was applicable in all five religions, but variations were seen because of religious teachings. In particular, Austrian Christians were significantly less idealistic and relativistic than all other religions, even other Christians from the United States and Britain. Research limitations/implications - The results have implications for measuring ethical positions internationally and for developing ethically based marketing messages and products. Originality/value - The paper shows for the first time how ethical positions are affected by religions and should be of interest to marketers involved in ethics research and ethical marketing.

Does pharmacogenomics provide an ethical challenge to the utilisation of cost-effectiveness analysis by public health systems?

Pharmacogenomics promotes an understanding of the genetic basis for differences in efficacy or toxicity of drugs in different individuals. Implementation of the outcomes of pharmacogenomic research into clinical practice presents a number of difficulties for healthcare. This paper aims to highlight one of the Unique ethical challenges which pharmacogenomics presents for the utilisation of cost-effectiveness analysis by public health systems. This paper contends that pharmacogenomics provides a challenge to fundamental principles which underlie most systems for deciding which drugs should be publicly subsidised. Pharmacogenomics brings into focus the conflict between equality and utility in the context of using cost-effectiveness analysis to aid distribution of a limited national drug budget.

Ethical perspectives of the Australian live export trade

Objective To examine the ethical perspectives of the Australian live export trade. Design and method The perspectives of farmers and other industry personnel, overseas consumers, the Australian public, veterinarians and the assumed interests of transported animals are compared in relation to the ethical consequences. Animal welfare, societal, personal and professional ethics are identified and the ratification of different perspectives considered. Results and conclusions There are positive and negative aspects of the trade for each stakeholder group, and the overall position adopted by any individual reflects their perspective of the balance of these components. The debate as to whether Australia should continue with the trade will be best served by consideration of the interests of all parties in the trade, including the consumers and animals, which are among the most affected by the trade. There is a need for further research to address the major welfare problems for the animals, an openness to inspection on the part of the trade and balance in media reporting.