Clinical investigators must engage in just subject recruitment and selection and avoid unduly influencing research participation. There may be tension between the practice of keeping payments to participants low to avoid undue influence and the requirements of justice when recruiting normal healthy volunteers for phase 1 drug studies. By intentionally keeping payments low to avoid unduly influenced participation, investigators, on the recommendation or insistence of institutional review boards, may be targeting or systematically recruiting healthy adult members of lower socio-economic groups (...) for participation in phase 1 studies. Investigators are at risk of routinely failing to fulfill the obligation of justice, which prohibits the systematic targeting and recruiting of subjects for reasons unrelated to the nature of the study. Insofar as we take seriously the obligation to engage in just subject recruitment and selection, I argue that we must acknowledge the implications low payments might have for subject recruitment and selection and examine the effect of low payments. If low payments de facto target the less well-off for phase 1 studies, we must defend the priority ranking of the obligation to avoid undue influence over the obligation of justice or adopt an alternative recruitment approach. This paper identifies a number of alternatives to the current system of low-value payments to research participants. (shrink)

Mercenaries are the target of moral condemnation far more often than they are subject of moral concern. One attempt at morally condemning mercenaries proceeds by analogy with prostitutes; mercenaries are ?the whores of war?. This analogy is unconvincing as a way of condemning mercenaries. However, careful comparison of mercenarism and prostitution suggests that, like many prostitutes, some mercenaries may be vulnerable individuals. If apt, this comparison imposes a consistency requirement: if one thinks certain prostitutes are appropriate subjects of moral concern (...) in light of their vulnerability, then one must think that mercenaries who are likewise vulnerable are also appropriate subjects of moral concern. In this paper I elucidate the relevant, morally significant sense of ?vulnerability?, and present evidence suggesting that at least some mercenaries are vulnerable in this sense. (shrink)