Washington, D.C.–June 2, 2025–Sixty-four global experts across disciplines spanning philosophy, law, medicine, policy, public health, patient advocacy, and research ethics have published a forceful open letter in The American Journal of Bioethics, calling for a reexamination of entrenched attitudes toward payment for clinical research participation. The letter challenges the widespread but largely unsubstantiated fear that monetary compensation necessarily exerts “undue influence” on participants, a concern that results in pervasive underpayment for participants’ valuable contributions to society.
Organized by 1Day Sooner, the open letter titled “Pursuing Fair and Just Compensation for Research Participants: An Open Letter to the Research Ethics Community” urges institutional review boards/research ethics committees (IRB/RECs) to reconsider payment conservatism, which often defaults to low or no compensation out of a misguided abundance of caution.
The signatories state:
- Undue Influence is Rare: Decades of empirical research suggest that payments, even in the range of thousands of dollars, do not impair informed consent or lead to irrational choices by participants. This holds true across populations and geographies, including studies conducted in low-income countries.
- Underpayment is Harmful: Compensation ceilings often result in the disproportionate enrollment of individuals with greater financial need, unfairly shifting research burdens to socioeconomically disadvantaged groups. Insufficient compensation also restricts participation among underrepresented communities.
- IRBs/RECs Should Reconsider Motivating Factors: Regulators themselves, including the U.S. Office for Human Research Protections, have acknowledged that fears over undue monetary influence are exaggerated. The letter calls on IRBs/RECs to critically evaluate whether concerns about payment reflect a deeper issue with study design or inadequate informed consent—rather than the payment itself.
- Fair Payment is a Sign of Respect: Generous compensation acknowledges participants’ contributions, promotes trust and reflects the social value generated by research. In many cases, payment may be ethically required, particularly when involving vulnerable populations.
The letter also notes that while efforts to improve participant compensation are critical, they must be pursued alongside broader reforms, such as implementing systems for compensating research-related injuries in countries like the U.S., where such systems are currently lacking.
Read the full open letter in The American Journal of Bioethics.
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About 1Day Sooner
1Day Sooner, a U.S.-based nonprofit, is dedicated to accelerating the development and deployment of life-saving medical research and policy interventions. For more information, visit www.1daysooner.org or follow them on LinkedIn, X, and Bluesky.
Media Contact:
Leigh Minnier
leigh.minnier@1day-sooner.org
201-841-5768