‘Pay-to-play’: Why current policies restrict payments by participants

We expect patients and the general public to pay, or co-pay, for a number of valuable health services, including clinical care. Yet, in research contexts, MOH and IRB policies generally restrict such payments. This includes ensuring participants do not need to pay for medical expenses incurred as a result of adverse events from study interventions, which normally would come from participant insurance with often some out-of-pocket cost.

This talk will outline the policies against ‘pay-to-play’ research in Singapore, and the ethical justifications behind them. In essence, the research context differs substantially from clinical settings due to the primary purpose: in clinical care, to benefit the patient; in research, to generate generalisable knowledge. Because research interventions are designed not primarily for patient benefits, it is not a fair distribution of burdens to expect them to pay financially when something goes wrong in the study.