 Financial conflicts of interest in clinical research point to a tension between relying on profits to motivate research versus insulating drug development and testing from the profit motive as a way of protecting research participants and future patients (Psaty and Kronmal 2008). Finally, if a company can make billions of dollars a year from a single drug, one wonders what constitutes an appropriate response to the participants who were vital to its development. On a standard definition, whether a given transaction is fair depends on the risks and burdens that each party to the transaction bears and the extent to which others benefit from the party’s participation in the transaction (see entry on  exploitation).  A series of clinical research studies can result in a company earning tens of billions of dollars in profits. Recognizing that a fair level of benefit is a complex function of participants’ inputs compared to the inputs of others, and the extent to which third parties benefit from those inputs, it is difficult to see how one might fill in the details of this scenario to show that the typically minimal, or non-existent compensation offered to research participants is fair.