1. De Santis, Joseph PhD, ARNP, ACRN

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Children always have been considered among the most vulnerable populations. After the Industrial Revolution, which resulted in changes to child labor laws and statutes that focused on the prevention of exploitation of children, a need to protect such a vulnerable population was given precedence in the United States. This obligation to protect the vulnerable nature of children is the foundation of my opinion that children generally should not be compensated financially for participation in research studies.


This statement is more meaningful if it can be compared to the current position on children consenting for surgical or medical procedures. Legally, children are not given the right to consent for themselves for medical care until they are 18 years of age, excepting emancipated minors. Children must rely on their parents or caregivers to make medical decisions for them based on the assertion that children lack the cognitive capabilities to comprehend the risks versus benefits of the care. This fact also pertains to participation in research studies, because children do assent to participate but legally cannot participate in the study without parental consent.


Although it is an acceptable practice to offer compensation to children for research participation (Sales & Folkman, 2000), the premise that children generally should not be compensated for research participation is intended to prevent coercion on the part of researchers. If monetary or material compensation is provided for participation, children may participate only to claim the compensation, being blinded of the risks versus benefits of study participation. Compensation in the form of money may exert an undue influence over economically disadvantaged parents. Economically disadvantaged children and families necessitate additional safeguards to prevent coercion, especially when these children are members of ethnic minority groups. Coercion notwithstanding, nurse researchers also must consider the influence or impact that compensation may have on the study's integrity. Previous research has demonstrated that research participants may respond to research questions in a manner that the participants believe to be socially acceptable to the researcher. Using compensation to reward participation may, in essence, cause participants to respond in this manner in an effort to please researchers, thereby skewing the results of the study (Rice & Broome, 2004). Children are often easily influenced by adults, especially those in a position of authority. The innate desire to please an authority figure may result in invalid responses from children under the influence of the adult's authority and the compensation.


This is not to say that children should never be compensated for participation in research studies but rather that guidelines should be developed to prevent a general standard that requires compensation for all children who participate in research. Although it is generally accepted that parents are compensated for lost wages and travel expenses when allowing their children to participate in research studies, the compensation directly to children must be addressed separately. One of the defining principles for the development of guidelines for compensation of children is the developmental age of the child. It is generally accepted that children have developed a grasp of abstract thinking and comprehension at about 9 to 12 years of age. Children younger than age 9 are unable to appreciate the value of compensation, whereas older children generally have developed an understanding of both the value and meaning of compensation. This fact was demonstrated in a relatively small study of 42 children aged 4 to 16 years who were asked hypothetical questions about compensation for research participation (Bagley, Reynolds, & Nelson, 2007).


In order to protect the vulnerability of children, safeguard against coercion, and protect study integrity, nurse researchers may need to develop institutional policies and procedures to guide compensation for children who participate in research studies in an effort to avoid the practice of blanket compensation. If compensation is justifiable, then monetary compensation should be avoided if at all possible. Second, the developmental age of a child should be considered when planning for compensation, and nonmonetary compensation in the form of modestly priced books or games should be offered. Finally, any compensation that must be offered should be made available to the child, not the child's parents (Rice & Broome, 2004).


Protecting children during all phases of the research process is imperative for nurse researchers. The general practice of offering compensation to all children who participate in research studies should not be customary practice. If compensation is required, standards to prevent potential exploitation of children and their families should be adopted and implemented.




Bagley, J. S., Reynolds, W. W., & Nelson, R. M. (2007). Is a wage payment model for research participation appropriate for children? Pediatrics, 119, 46-51. [Context Link]


Rice, M., & Broome, M. E. (2004). Incentives for children in research. Journal of Nursing Scholarship, 36, 167-172. [Context Link]


Sales, B. D., & Folkman, S. (Eds.). (2000). Ethics in research with human participants. Washington, DC: American Psychological Association. [Context Link]