Research staff recruits teens and parents to participate in focus groups to develop a curriculum module to educate teens about the consequences of substance use and abuse. The focus groups are tasked with identifying knowledge content (i.e., what teens need to know). Each study participant will be paid $20 at the end of each session. After lively discussion at the first focus group sessions, the researchers were surprised that only 20% of parents and 10% of teens returned for the second session. When they phone the no-shows, the researchers learn that several participants are concerned that sharing their knowledge about the local drug scene and drug use may suggest that they are too involved for comfort and may get into trouble with authorities. The researchers promise confidentiality, urge the continuation of the study and double the incentive to $40. The investigators phone the no-shows again a day before the third scheduled focus group meeting. They make it clear that they have the option of dropping out but repeat that discussions are confidential and consider input from people who know the teen's drug use and the local community important to developing an excellent educational program on drug use and abuse.

Ethical questions to reflect on:

How many times should investigators ask subjects to continue in a study; explain and support your answer.

Are the researchers improperly coercing the participants; explain and support your answer.

In this example, can confidentiality be assured; explain and support your answer.