Below is a lightly edited, AI-generated transcript of the “First Opinion Podcast” interview with Jake Eberts and Jill Fisher. Be sure to sign up for the weekly “First Opinion Podcast” on Apple Podcasts, Spotify, or wherever you get your podcasts. Get alerts about each new episode by signing up for the “First Opinion Podcast” newsletter. And don’t forget to sign up for the First Opinion newsletter, delivered every Sunday.
Torie Bosch: Jake Eberts did not die of dysentery. But he did catch it for science. How much would you have to be paid to risk a bout with a disease that most Americans associate with the Oregon Trail?
Welcome to the “First Opinion Podcast.” I’m Torie Bosch, editor of First Opinion. First Opinion is STAT’s home for big, bold ideas from health care providers, researchers, patients, and others who have something to say about medicine’s most important and interesting topics.
Today I’m speaking with Jake Eberts, who serves on the board of directors of the nonprofit 1Day Sooner, and Jill Fisher, a professor of social medicine at the University of North Carolina Center for Bioethics. After a quick break, I’ll bring you our conversation about healthy volunteers in medical research and how to pay them fairly.
So, Jill and Jake, you both recently wrote an op-ed for STAT arguing that people who take part in medical research deserve to get paid more. Let’s start with a really super basic question, our listeners probably already know, but what is a clinical trial exactly and why do we have to pay people to take part sometimes?
Jill Fisher: Yeah, so a clinical trial is a type of research study in which generally speaking you’re comparing an investigational new drug or an existing therapy to something else. And so for the most part, a lot of these clinical trials are taking place in order to get new products approved for the for the market. And why they have to be paid, it depends on the type of study. But oftentimes if you want to incentivize somebody to participate, you have to either compensate them for their time or the inconvenience of participating.
Bosch: How does payment look right now, generally speaking? Like what sorts of dollar numbers are we talking about?
Fisher: So I think that really depends on the clinical trial that we’re looking at. Jake and I are particularly interested in studies that recruit healthy volunteers for studies, and those often pay substantially more than studies that enroll patients. The average amount for a healthy volunteer trial is probably about $3,000.
Jake Eberts: Yeah, but it does vary pretty immensely across institutions, across time, even among institutions. The most I’ve seen, I think, in the D.C. area where I live is one that was recruiting for about $15,000-$16,000. And that included like a month of inpatient stays and pretty intensive follow-up visits and things like that. But they can really run anywhere from a couple hundred dollars or sometimes less for, you know, studies that aren’t particularly intensive or time-consuming, or ones that really, really do reach out there in the in the five figures.
Bosch: So for $3,000, say, let’s take the average, what does that require of the healthy volunteer generally?
Fisher: So oftentimes what it really means is that somebody has to consent to a clinical confinement as part of the study. So for the most part, healthy volunteer trials are run in such a way that people check into a research facility at the beginning of the study and they stay for some length of time. Then oftentimes they’re let out and then there might be a follow-up visit or two after that. But for a study that’s paying $3,000, you’d expect that they’re spending maybe a week, maybe two weeks in that facility.
Bosch: Yeah, so $3,000 might seem like a lot of money, but you know, as you say, you’re giving up a fair amount of your time and also, let’s be clear, taking some chances with your health.
Fisher: Absolutely. If we look at the data about Phase 1 trials or trials with healthy volunteers, they are pretty safe. That’s not to say that people don’t experience adverse events or side effects as part of the trial. Some meta-analyses show that some type of adverse event is going to be really common. Like, you know, two-thirds of participants are going to experience some kind of physiological change during the study, but that’s generally not something that would be coded as a serious adverse event.
Bosch: So Jake, when you two were writing your op-ed, the first draft had one of the wildest throwaway lines I’ve ever seen in an opinion essay, which was about how you once got dysentery for science. So speaking of those adverse effects that Jill just mentioned, can you tell us a little bit about how that happened?
Eberts: Yeah. So Professor Fisher and I come at this from very, very different angles. You know, I live and work in D.C. and don’t have a formal any formal training in bioethics or medicine. I signed up for what is called a human challenge study, which is a very particular type of healthy volunteer trial. A challenge here is an interesting little scientific euphemism for “to deliberately infect.” And so this can be done in safe and controlled ways. It’s actually quite common for some diseases like malaria, where there are reliable treatments and rescue therapies or diseases that are not particularly virulent, like the common cold among healthy adults.
But I signed up for shigellosis, which is caused by the Shigella bacteria. It causes dysentery, easily treatable with antibiotics, but still kills hundreds of thousands of people every year, particularly in the developing world where access to antibiotics is not a guarantee. And there’s no vaccine.
So I signed up for this kind of on a whim. I was working at another job and they were perplexed but were OK with me taking advanced sick leave and some time off to work remotely. I spent 10 days inpatient. We had two experimental vaccinations, which had already gone through the Phase 1, which kind of initial safety and immunogenicity testing. And so that’s how we got kind of introduced to this. So I was I was paid about $7,300 in total that involved like about 10, 11 days inpatient. I did in fact contract dysentery pretty aggressively. I joked that I was one of the overachievers in the cohort.
Bosch: Really quickly, do you get extra money for having actually contracted dysentery?
Eberts: No, because that would create some weird incentives for people to fake it. Dysentery is hard to fake, I will say. But it was both a really rewarding experience in in a long-term sense in that I became kind of acutely aware of the intensity with which we test pharmaceuticals, particularly vaccines, lifesaving vaccines, and also how deeply uncomfortable and really painful and awful dysentery was. And it’s a disease, frankly, I kind of thought of as … actually the ad that got me on Instagram was really quite clever. It was “The Oregon Trail,” you know, “you have died of dysentery, help us prevent dysentery by joining this vaccine study.” That was the kind of process for me, and I tweeted about it, it went viral. It was a whole thing, and that’s how I kind of came into this advocacy space. Through discussions with the investigator and then some sleuthing on my own because I learned that in Maryland any IRB meeting minutes can be publicly accessed if you ask nicely.
Bosch: Sorry, let me hop in there. Can you explain an what an IRB is and what they have to do with this?
Eberts: So the IRB are the ethics police. The institutional review board is what they’re called in the United States. What I learned from this process was that IRBs often have a very finicky relationship with compensation. And like I said, I was paid about $7,300. This was not a life-changing sum of money for me, but I was in my early, mid-20s, and it was certainly not nothing. And I learned from discussions with the investigator and IRB records that there had been originally been offering much less money, I think about half. And they had a really hard time recruiting.
And even then there was concern about what we talk about in this op-ed, undue influence or undue inducement. Namely this idea that there’s, you know, the money being offered is so large or so enticing as to like risk overriding the rational ability for participants to, as adults, assess the risk and benefit of participation.
It occurred to me that by creating a cap, or … if we’re worried about undue influence or undue inducement by money, it’s, you know, institute what may be a de facto maximum wage where we say things like, well, $7,000 is too much for this. If you’re still gonna run the study, you just push this problem down the socioeconomic ladder. So people like me might not, I might be quote unquote protected because it no longer makes sense for me to participate economically.
But there are people in my cohort who were irregularly employed who for whom I imagine that $3,000 or $4,000 would have been enough. And so in this alternate world, maybe we’ve protected me, but those people are still unquote, unprotected and also just make less money to begin with.
Bosch: So Jill, Jake just touched on a lot of the great reasons why the system isn’t working. As an expert in social medicine, what do you think about the system and what should be changed?
Fisher: Yeah, so I agree with everything Jake said that the system really is set up in such a way that it’s kind of this conservative approach to protecting participants in research and there has been this concern that’s very long standing about paying people to enroll in research.
And I think that the only way that really makes sense is to kind of think about the fact that medical researchers, maybe researchers in general want participants to be altruistic, and some are, and Jake already talked about how part of his motivation was also altruistic.
But you know, we can’t have a system of medical research that is relying on people to be purely altruistic because medical research takes a substantial amount of time for those who are enrolling in studies. We talked about healthy volunteers who have to check into these research facilities and stay there. So that’s a really great example of how much time and inconvenience being in a clinical trial might be.
But even for patients who are enrolled in studies, a lot of these studies are really asking a lot of participants and to think that everybody could just do it for free, I think really undermines the system and it also potentially affects the diversity of clinical trial participants because as Jake was saying, you start seeing groups kind of dividing out based on what’s possible and what kinds of incentives might be necessary to get them into research. But as Jake was saying, IRBs are typically very conservative. They’re very anxious about offering too much money. And so as a rule, I think that has really reduced the amount that’s being offered to participants.
Bosch: Yeah, I mean you know when I think about the idea of taking advantage of participants, I think of the sort of cliche of the college student or the single parent who enrolls in multiple studies to try to get the bare minimum. I’m sure there was an episode of “House” about it, for instance. Can you talk a little bit more about how pay can take advantage of people if it’s too low?
Fisher: I spent about 10 years of my career researching healthy volunteers and you know who they are, why they’re motivated to participate in this research. And you know, you mentioned the college student, and of course, there are some college students that enroll in clinical trials, but that’s largely a myth. When I started this research, that’s what I believed too. I expected that I would go to these research facilities and mostly see white college students who were doing it for some extra money for beer. And when I got there, that’s not at all what I saw. In fact, the vast majority of participants were in their 30s, they were mostly people of color. And that kind of changed based on the the area of the country that I was doing the research in. In the Northeast, they were mostly Black men, in the Midwest, mostly Black, and then in the Southwest, mostly Hispanic or Latino men. So, you know, there is this hand-wringing in medical research about how we’re not recruiting diverse research participants, but in this world of healthy volunteers, that’s actually flipped on its head where we actually see more people of color enrolling in these studies.
And I think it’s absolutely because of the social and economic inequalities in the U.S. and that these studies are offering money to participate. So there’s this real tension there, as Jake was saying, with how much are we going to offer? Because if people are already doing this for the money, and they are, we really have to be cautious not to exploit their financial situations by offering them insubstantial or amounts that are not really respecting the time that they’re giving to this enterprise.
Bosch: So you both make a great case that we should be paying people more money for doing this kind of research. What are the concerns about paying too much exactly? And you talked about undue influence, but can you sort of articulate what the concern is?
Eberts: Yeah, I can talk about too. Yeah, so undue influence is interesting because in the United States, it’s not well defined in federal regulations. And so it’s kind of the federal regulations point to it basically saying, you know, IRB should ensure that compensation doesn’t cause undue influence and then kind of rely on IRBs to interpret what that means.
And so there’s, you know, the penumbra of academic literature and conference talks and think pieces that kind of like define this, and they often define it in sometimes different ways. But yeah, like I said earlier, the core concern is that like you, you know, and again, this makes intuitive sense if we think about it. You know, if I dangle a million dollars in front of you, or some, you know, insert life-changing sum of money, are you going to do something that is in reality against your best interests? And am I basically, you know, people use the word coercion, which is I think a separate issue involving threats of force.
But people often say, you know, I’m worried I’m going to coerce someone into doing something that’s bad for them. And that’s kind of the core issue. I do think there are other reasons, you know, high compensation can be problematic sometimes. I think what like and requires thought. Like you know, a lot of compensation can incentivize deception, like I mentioned earlier, this idea that if, you know, if I know I’m gonna get paid more because I’m gonna contract dysentery, then maybe I’m just gonna right before I go into the study just eat stuff out of the garbage can out back and hope I get, you know, [dysentery]. … There are other problems there that IRB would need to balance, but that’s definitely a little bit different from this idea of we take undue influence as, you know, again, the core definition of it being, you know, overriding the rational sense of risk and benefit for an adult who is otherwise able to consent, then the compensation issue does, yeah, there’s still some ways that it falls apart.
Fisher: And when I was interviewing healthy volunteers about this exact issue, you know, I asked them what they thought about how the money was actually influencing their participation. And of course, there’s, you know, they told me, “I’m enrolling in these studies because I’m getting paid. I wouldn’t do it without getting paid.” And so I asked them the question of, you know, what do you think of this idea that institutional review boards are protecting you by limiting how much they pay for you to do these studies? And, you know, for the most part, people said that, “Yeah, there are a lot of people who would do crazy things for the money. But if the risk isn’t changing, like if this is an appropriate study, I don’t understand, like, what are they protecting me from?” That they should be looking at whether the study is too risky or not. And if it’s not, then “I should be paid, you know, an amount that is commensurate with what it’s requiring me to do.” So, you know, healthy volunteers were really very thoughtful about this issue and trying to grapple with what exactly are they being protected from.
Bosch: Is it entirely the IRBs that are pushing back on this idea of paying more? You know, do companies creating these vaccines or medicine, would they love to be able to pay more, for instance?
Eberts: In my experience harassing people about this issue as a nonprofit advocate from the nonprofit advocacy world, I think the actors in their in their interests vary pretty widely. Broadly speaking, I’d be very interested in hearing Jill’s perception of this as well. My conception is that academic IRBs are much more likely to definitely slow-walk high compensation. And particularly in universities, which are, you know, highly bureaucratic, lots of, you know, boxes to check and bureaucratic rules to follow. You might have institutional guidelines on what can and cannot be paid. For instance, you know, every hour at check-in is worth $15 or like every, you know, blood draw is X dollars. This is what we see in both in the United States and the United Kingdom.
And so a lot of times the IRB will say this is too much, or someone will be like, “We’re worried about this.” And if it’s only one person, you know, an IRB is a deliberative body and it might not be worth it to … no one really wants to go to bat and, you know, push for maybe $5,000 as opposed to $4,000. It might be easier to just ask the investigator to bump it down a bit.
And I think what often happens, though, is investigators just know, you know, repeat interactions happen with the IRB. They kind of know what their IRB roughly accepts, and they’re gonna preemptively not, you know, push something higher.
But I do think sometimes investigators can shield themselves under the undue influence banner or the desire to avoid undue influence. They can maybe take money that they otherwise would have used to pay participants and buy a fun, fancy new machine in the laboratory sort of thing. I think this is probably rarer because professor principal investigators like to recruit people to their studies because that’s necessary. But I do think there’s also a way that this you know very nebulous concept can be used to push around wages from the other side. I think this is probably true of sponsors as well. Although again, it does seem often that the people who run the studies or sponsor the studies have an interest in paying more oftentimes because that generally, all else being equal, you know, and this varies massively depending on the type of study too, but generally you can assume will result in more recruitment and higher retention rates. And they want that. So I think IRBs are often the principal obstacle, but it really does depend.
Bosch: So it’s really down to the principal investigator and the IRB to determine the pay. Is that right?
Eberts: Generally speaking, the principal investigator will propose, you know, as part of their protocol, “here’s what we’re gonna pay, here’s how we’re gonna pay it.” And the IRB is then to review. They don’t set — in the United States, at least, they don’t assign a monetary value per se. There might be institutional guidelines, but the ultimate money, the dollar value, is coming from the investigator.
Bosch: So some investigators might be a little cheaper than others.
Eberts: I think that’s possible, yes. That’s that’s my perception.
Fisher: And I think, you know, depending on who is sponsoring the research, that also makes a really big difference. Because if somebody, let’s just say, is a university faculty member who’s a PI on a study and they’re using internal funds, they probably don’t have access to the same kind of budget as a study that’s being sponsored by Pfizer, for instance. So there are going to be these other factors that are part of it.
But I completely agree with Jake that what we typically see at universities is much less being offered in terms of payment. And I think that’s partly because of more conservative IRBs that are located at universities, but also probably because there’s in in general less contract research that’s happening as well. So it might be more studies that are funded by the NIH, for instance.
Eberts: And that’s frustrating, I will say, for me as an altruistically motivated participant, at least in part, to watch how often universities doing incredibly important basic research shortchange themselves in participants. I was in a Zika human challenge study, which was very well run by a very prestigious institution that did a good job with it overall, but was definitely hamstrung by their inability to pay more. And this is an IRB issue. And that created problems down the road as well.
This is one of the things that really got me set off on this competition issue was watching how prohibitions against bonus completion bonuses, which are pretty common because the idea of, you know, again, intuitively, if you dangle the entire sum at the very end of the trial and someone has a legitimate reason where they have to drop out, it seems unfair that you wouldn’t pay them for, you know, doing 90% of it. But the prohibition on, you know, quote unquote too large sums of money at the end meant that people just kind of dropped off after the first part of the study, the inpatient study. And that was really bad for data gathering and also because the study, the Zika study was, you know, safe and but the primary concern was actually the weeks after Zika infection and after the initial kind of inpatient period, where there was a very small chance of neurological conditions developing. It was really important that people come in for their check-ins. That was a really good example of how this incentivizing created problems down the road for like it also made participants less safe overall.
Bosch: Now did you contract Zika that time?
Eberts: This was an interesting human challenge study. This was basically kind of the forerunner challenge study where they figure out the dosing and you know, is this strain of the virus or these strains of the virus, in this case, you know, safe and what does it look like and characterizing the infection. So there’s no vaccine and that meant there was also a sham, like a placebo control sort of. And so they didn’t tell us I just got a saline injection, but I did still spend 10 days inpatient and had to do a bunch of samples and things like that, got bitten by mosquitoes and a cup, which was super interesting. So I got the stolen valor and then I can say I like signed up for Zika, but I did not actually get it.
Bosch: Zika plus dysentery would be —
Eberts: A lot anyway for one body. To be clear, not simultaneously. That might have been a little much. I don’t think they tend to mix and match these sort of things, whether it’s drug investigations or human challenge. Just trying to pile them on and chop each other. Usually it’s more one at a time.
Fisher: I wanted to follow up on the point that Jake was making about completion bonuses, because they are really common, especially in healthy volunteer trials. And so, you know, essentially what this is is that there’s a certain total amount that’s being offered for the clinical trial, and it’s not prorated across the study — that larger sum is saved for the end. And as Jake was saying, it’s to incentivize completion of the trial.
But there’s a flip side to it, too. So, like Jake mentioned, you know, the risk of not offering enough completion bonus at the end could make some people drop out. And because they’re not necessarily committed to the research, they’re not concerned about not finishing the study. But there is this other effect, too. So for participants who, you know, think their lives are still happening in the background while they’re in these clinical trials. And so, one example that springs to my mind of a participant who was in one of my studies, and my study is social science research, so I’m not actually doing clinical trials, just studying the healthy volunteers who are in clinical trials. But while he was in a study, his very young son, I think he was 4 years old, pulled a pot off of the stove and it fell down on him and burned the the whole front side of his body. So it was second-degree burns, and he got a call from his son’s mother saying, you know, “I’m taking him to the hospital. Please meet us there.” And this gentleman had to make this decision about whether or not he should leave the study and forfeit the money that he was there to earn, especially knowing that he was going to forfeit the completion bonus too. So ultimately he decided to stay in the study because, you know, he felt like “that’s really why I’m here. I’m here to earn this money for my family.” But it also really shows that there’s not a lot of flexibility for healthy volunteers. They really are giving up things in order to do these studies. And in that instance, the money did have this effect where he would have absolutely made a different decision if he could have.
Bosch: So yeah, we’ve talked a bit about how uneven all of this is. I mean, is your thinking that there should be like some formula that’s used across the country, some sort of standardization? What would you like things to look like?
Eberts: I am very anti-formula. I think many very smart people have tried to make many formulas and they publish them and it’s, you know, congrats, now we have a dozen formulas. Trying to do that even within an institution where cost of living is the same for everybody theoretically is just a really is a very difficult task. And I think it risks compressing things in ways that are pretty just counterproductive.
I joke that people don’t like the word, but the market-oriented kind of approach, which is to say, I think the best way to determine what is fair payment, at least you know, initially, is if you set a threshold for a study that is otherwise approved as ethical and scientifically valid by an IRB, and you’re just not recruiting anybody or you’re getting like one or two recruits, that’s a sign that you’re not paying enough. And that you should up it.
And I think that that disconnect between recruitment and payment is something that the IRB often does not see and that investigators might complain about, but is something that the IRB doesn’t generally check on, and so that creates this problem. But I think that the it’s just so difficult to capture the enormous complexity, because I mean, Jill and I are only talking right now about, you know, healthy volunteer trials. My focus is on this very specific type of, you know, deliberate disease infection human challenge trial. And even within those, there are so many, there’s so much variation. Like malaria ones, for instance, are often outpatient because you just have someone come in every day. And for some people that might be more intensive than just staying inpatient for three days. There are ones that are pretty chill, like you may not have any symptoms. There are ones like dysentery at the other end. And so even just within these single types of of niche studies, there’s so much variation that it seems that trying to account for all of the factors involved there is just really so complex that it’s gonna inevitably shortchange somebody and make things just inefficient overall.
Fisher: Yeah, and I think as a rule too, you want to make sure that people are not losing money because of being in a clinical trial. And that’s both as a healthy volunteer but also as patients. I mean, I think this comes up really often when it comes to patient clinical trials, that it shouldn’t cost them anything to be in medical research. And yet we see that happening all the time. You know, just reimbursing somebody from parking is really not enough when we think about how much they are investing in these clinical trials. I think the question of how much do we pay healthy volunteers is a very difficult question because you’re gonna see wages across a spectrum. And as Jake said, if we really want to incentivize people who are better off to participate, then it should be those higher amounts. But I think he’s right that there’s really no great way to do a formula for this.
Eberts: What I’ve heard too is and I will say like people have approached this, for instance, like indexing it to the minimum, you know, to the median wage of unskilled labor. That’s one that I think I take particular issue with and does seem to be pretty common because it rests on the assumption that, you know, wages for unskilled labor are in a market area are inherently just. And particularly today with cost of living so high in major cities where these studies tend to occur, that’s just like pretty flatly not true and not the case. And so I have had well-intended, I’ve discussions with many, many well-intended ethicists and IRB members who kind of default to this position, I think, and maybe recognize it’s a little bit fraught, but still ultimately just seem most comfortable tethering something because it’s a number. You can look at the Bureau of Labor Statistics and be like, “this is how much an unpaid laborer or an unskilled laborer is paid in, you know, the D.C. or Baltimore area or the Michigan or you know, the Detroit area,” and it’s a safe number you can kind of hang your hat on. But again, I think it sidesteps questions of true value and a worth for participants in a way that is true probably for a lot of kind of formula-based compensation schemes.
Bosch: And now how does this research work in other countries? Is this another case of the U.S. system being wildly different than overseas?
Fisher: So it depends on the country, of course. I mean, I think the way that the U.S. stands out is that one, we don’t have a system of automatic compensation for harm for research. So that’s a big issue in the U.S. because we don’t have a one-payer system. So if somebody’s harmed in a clinical trial, it’s very difficult to know what’s gonna happen to them, who’s gonna pay for their care. So that’s very different, especially compared to Western Europe, let’s say.
As far as compensation in terms of like actual monetary incentive for participation, most countries are going to have to pay, especially healthy volunteers, to participate. That again, like we’re gonna have the same issue no matter where we are in the world. If you want healthy people to enroll in medical research, you’re gonna generally speaking have to incentivize them to do so. There are some exceptions where maybe altruism will be more important, maybe in in the in the case of a global pandemic, for instance. But countries definitely regulate it differently. So France, for instance, actually has a maximum amount of money you can pay healthy volunteers not only per trial, but in in a given year. So no one could make earn more than that that amount in a given year. So definitely countries are doing this differently.
Eberts: It’s actually interesting too that you mentioned that because the institution that developed the vaccine that I tested or that was tested on me, rather, for shigellosis was Institut Pasteur in France. And doing the mental math right now, I would guess that with there, I think it’s like 6,000-ish euros in a given calendar year is the maximum. So it’s about $7,000 or so, depending on exchange rates, like that already hits you at the maximum. And so maybe that is part of the reason that they had the study done. And you see relatively few of these really intensive long-term inpatient studies in France. I know in Colombia, for example, it’s totally illegal. Brazil has heavy restrictions on compensation, so it does depend. But Jill’s right, the big difference is the United States lacks a universal comprehensive health care system. Some studies occasionally, I think, require health insurance, but that’s not the norm. And so this underlying issue, which really is a separate conversation entirely, is like the ethics of running these studies when institutions aren’t willing to to pick up for you pick up the tab for the rare but sometimes serious side effects that occur, whether you’re a a patient participant or a healthy participant.
Bosch: Well, last question before we wrap this up. Jake, do you plan to do another challenge study at any point?
Eberts: I have tried. I joke with my friends that if I get three, I, you know, fill out the punch card and get a fourth one for free. But I did actually try to do one for malaria. That one was canceled quite late in the process because of a unrelated manufacturing issue. But I’m open to it. But it is a time thing more than anything else. It is an incredibly serious time commitment and one that I want to take seriously as well. But it is there’s nothing in the cards right now. I’ve looked at hookworm potentially, I’ve looked at malaria. The D.C. area has a lot of institutions that run them, more so than most other areas of the country and the world, really. So it’s I’m really lucky that I can just have a menu at any given time.
Bosch: Is your family horrified by this?
Eberts: No, my father was a doctor and so very pro-vaccine family and high trust, I would say, in the kind of the medical system in general. After I called my mom about it, she was definitely bemused and worried in the way that you would expect. But you know, I sent her the materials and the form consent document, and she’s like, “OK, this clearly is something that is not just ‘we’re pulling people random people off the street and injecting them with random substances and diseases.’” It was, you know, very well thought out. And so she was very proud of me.
My family was pretty broadly supportive, which I’m very grateful for because as Professor Fisher has talked about, you know, there is stigma that is involved in these. And I was able to kind of parlay the privilege I have in terms of class and race to say, look at this really cool, great thing that I did that makes me look, you know, as a really fun story to talk about on podcasts and parties. But for a lot of people who participate it is often quite stigmatized. And so that’s another reason I think that like the if you’re gonna make people do stigmatized work, then you might as well pay them more for it so that helps cover some of that stigmatization, so to speak.
Bosch: Jake Eberts and Jill Fisher, thank you so much for coming on the “First Opinion Podcast” today.
Eberts: Thank you.
Bosch: And thank you for listening to the “First Opinion Podcast.” It’s produced by Hyacinth Empinado. Alissa Ambrose is the senior producer, and Rick Berke is the executive producer. If you’ve got an opinion about the show, please email me at first.opinion at statnews.com and leave a review or rating on whatever platform you use to get your podcasts. Until next time, I’m Torie Bosch, and please don’t keep your opinions to yourself.
