Opposition to inducement payments for research subjects is an international orthodoxy amongst writers of ethics committee guidelines. We offer an argument in favour of these payments. We also critically evaluate the best arguments we can find or devise against such payments, and except in one very limited range of circumstances, we find these unconvincing.

The paper defends the permissibility of paying inducements to research subjects against objections not covered in an earlier paper in Bioethics. The objections are that inducements would cause inequity, crowd out research, and undesirably commercialize the researcher‐subject relationship. The paper shows how these objections presuppose implausible factual and/or normative claims. The final position reached is a qualified defence of freedom of contract which not only supports the permissibility of inducements but also offers guidance to ethics committees in dealing with practical (...) problems that might arise if inducements are offered. (shrink)

The moral and political thought of Herbert Spencer is usually associated with some form of evolutionism. This is unsurprising, since Spencer himself thought of his ideas as founded on evolutionary theory. But it is regrettable, because no one believes in Spencer's form of evolutionism any more, and even if they did, they would not think that it supported his views in the way that he confidently believed. And so Spencer has been largely neglected since his death. His libertarianism is thought (...) to be without foundation, and so few have thought it worth study. But in this paper I try to show that Spencer's moral and political conclusions can be based on some of the non-evolutionary arguments that he offered. Although these arguments are not entirely compelling, they have force in a way that his evolutionary claims do not. (shrink)

There is strong opposition in bioethics to paying research subjects. This paper, building on earlier work, gives arguments on behalf of the permissibility of payment. It develops an analogy between payment to research subjects. And payment and regulation in the labour market Few seriously oppose payment in the labour market, and the reasons to allow payment carry over to payment to research subjects. The paper then considers and rejects an alleged disanalogy, that research is special in that it involves subjects’ (...) bodies. At greater length, it assesses the argument from the gift relationship: that the value of giving is good reason not to extend market norms into research. This argument has some force in pointing out the unattractiveness of some market motivations, but those who offer it usually overlook the coordination advantages of the market. Still, the gift relationshp argument against payment has something going for it, which is more than can be said for virtually all the other major anti-payment arguments. (shrink)

Zusammenfassung Im illegalen Nierenhandel werden Verkaufer oft uber den Tisch gezogen, sie werden genotigt, es wird ihnen angemessene medizinische Betreuung vorenthalten und sie werden uber die Gefahren und die Illegalitat der Nierenentnahme in die Irre gefuhrt. Die Empfanger bezahlen oft fur qualitativ schlechte Operationen sowie ungesunde oder unpassende Nieren. Einige Autoren argumentieren, es sei die Illegalitat, die dieses Leid und dieses Unrecht verursachen, nicht der Handel an sich. Sie argumentieren, die Legalisierung von Nierenverkaufen wurde das Leid verringern. Dieses Leidensverringerungsargument ist (...) es, das in diesem Aufsatz entwickelt und untersucht wird. Es werden zunachst die ethischen und empirischen Bestandteile einer utilitaristischen Version von Leidensverringerung dargelegt. Und es wird erklart, wie eine Legalisierung das Leiden auf Schwarzmarkten vermutlich verringern wurde, aber auch, warum wir nicht wissen, wie die Legalisierung das Angebot an Organen oder die Anzahl leidvoller Transaktionen auf ‘weisen Markten’ beeinflussen wurde. Kurz gesagt, wir konnen nicht sicher sein, dass seine Legalisierung das Leiden insgesamt verringern wurde. Dennoch versucht dieser Aufsatz zu zeigen, dass die Argumentation zugunsten von einer Legalisierung gestarkt werden kann, wenn man dem utilitaristischen Hauptanliegen des aggregierten Wohlergehens etwas hinzufugt. Den besonderen Anliegen der am schlechtesten Gestellten und dem Unrecht des Verkaufsakts kann man durch Legalisierung besser gerecht werden als durch Kriminalisierung. Das Leidensverringerungsargument entscheidet diese Debatte uber die Legalisierung des Organhandels zwar nicht, aber es ist entscheidender als Kritiker bislang zugestehen wollten. (shrink)