Home Ethical Issues Institutional Integrity Issues Appropriate Incentives

Appropriate incentives

What incentives are appropriate? Access to research quality tissue is an incentive in collaborations for institutional researchers. Local researchers often rely on local tissue banks which are of varying quality and inventory or request tissue from pathology colleagues. Price breaks and access to a large inventory of high quality tissue is a major advantage for many local researchers working on grants with small budgets for purchase of tissue. This does not suggest a direct conflict of interest as long as those who cut the tissue or conduct informed consent processes with prospective donors are not also potential users of the tissue in their own research.

Equipment, supplies, and overhead may not be incentives so much as necessary investments in building the infrastructure at a medical center so that it can function appropriately as a collection site. Should these incentives exceed the actual operating costs, they would begin to constitute a conflict of interest.

It is important to shield surgeons who cut the tissue from any direct incentives so that there is no reason for them to deviate from usual diagnostic protocols and remove more tissue for their own gain (e.g. build a state-of the-art doctors conference room, purchase private parking spaces, or lavishly decorate their offices). It is helpful to insulate surgeons from tissue-banking and pathologists who manage the daily operations of tissue collection from those who deal directly with repository officials. Repository managers may pressure those at the collection site to increase volume in ways that may not be appropriate. It is important that the financial managers of repositories do not dictate local collection operations in this regard. Repositories may indicate that they will close collections at a particular medical center if their collection quotas are not met. As long as the incentives to medical centers are relatively small, medical centers should be able to easily resist pressures to compromise their own principles.