Background: There is general consensus internationally that unfair distribution of the benefits of research is exploitative and should be avoided or reduced. However, what constitutes fair benefits, and the exact nature of the benefits and their mode of provision can be strongly contested. Empirical studies have the potential to contribute viewpoints and experiences to debates and guidelines, but few have been conducted. We conducted a study to support the development of guidelines on benefits and payments for studies conducted by the (...) KEMRI-Wellcome Trust programme in Kilifi, Kenya. Methods: Following an initial broad based survey of cash, health services and other items being offered during research by all programme studies (n = 38 studies), interviews were held with research managers (n = 9), and with research staff involved in 8 purposively selected case studies (n = 30 interviewees). Interviews explored how these ‘benefits’ were selected and communicated, experiences with their administration, and recommendations for future guidelines. Data fed into a consultative workshop attended by 48 research staff and health managers, which was facilitated by an external ethicist.FindingsThe most commonly provided benefits were medical care (for example free care, and strengthened quality of care), and lunch or snacks. Most cash given to participants was reimbursement of transport costs (for example to meet appointments or facilitate use of services when unexpectedly sick), but these payments were often described by research participants as benefits. Challenges included: tensions within households and communities resulting from lack of clarity and agreement on who is eligible for benefits; suspicion regarding motivation for their provision; and confusion caused by differences between studies in types and levels of benefits. Conclusions: Research staff differed in their views on how benefits should be approached. Echoing elements of international benefit sharing and ancillary care debates, some research staff saw research as based on goodwill and partnership, and aimed to avoid costs to participants and a commercial relationship; while others sought to maximise participant benefits given the relative wealth of the institution and the multiple community needs. An emerging middle position was to strengthen collateral or indirect medical benefits to communities through collaborations with the Ministry of Health to support sustainability. (shrink)

As a relatively young profession, public relations seeks a realistic ethics foundation. A continuing debate in public relations has pitted journalistic/objectivity ethics against the advocacy ethics that may be more appropriate in an adversarial society. As the journalistic/objectivity influence has waned, the debate has evolved, pitting the advocacy/adversarial foundation against the two-way symmetrical model of public relations, which seeks to build consensus and holds that an organization itself, not an opposing public, sometimes may need to change to build a productive (...) relationship. A similar battle between adversarial advocacy and symmetry occurred during the emergence of rhetoric in the Athens of the 4th century B.C. Plato and Aristotle favored adversarial/advocacy rhetoric, whereas Isocrates favored a symmetrical rhetoric. Four criteria of comparison of those rhetorics are examined: success of the respective schools, success of the respective graduates, the evaluation of later Roman rhetoricians, and the impact on the future of education. History shows that Isocrates's symmetrical rhetoric clearly was more effective than its adversarial/advocacy rivals. Recent studies of the two-way symmetrical model concur, indicating that it may well be the most effective foundation for public relations ethics. (shrink)