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Finder''s fees are offers of money to physicians, nurses, or other health professionals in reward for their referral of patients eligible for research participation (that is, they represent payment for referrals, over and above reasonable remuneration for services rendered). The general view on finder''s fees as reflected in various ethics guidelines is straightforward: they are deemed unacceptable. That said, finder''s fees are in reality rarely clearly indicated as such. They are, rather, most often integrated into the budgets of clinical trials, usually described only as payment of "administrative costs." Since existing guidelines generally allow researchers and research personnel to be compensated for extra time spent on research, finder''s fees can easily be hidden among bona fide expenses. Moreover, significant incentives can be independent of what is provided through the budget of a trial, and thereby doubly hard to directly associate with the recruitment of subjects. Researchers who have been successful in recruiting patients may, for example, be rewarded not with fees, but with equally valuable invitations to make well-paid presentations of research findings, or to participate in prestigious seminars at interesting locations,s Financial interests and concomitant feelings of obligation to sponsors can also be generated through the appointment of researchers to lucrative positions on sponsors'' scientific advisory boards and specialized committees, or through paid consulting relationships. (9) Strong sponsorship ties between researchers, research institutions, and industry may also come with the pressure of sponsors'' expectations of better access to the patient populations of the institution.

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