Because of the decline in willing volunteers, the AMA has decided that volunteer participation in vaccination trials should become a thing of the past. They said:
"If progression of promising vaccines from the lab to the clinic is to remain unaffected and financial inducement is an ethically unacceptable solution to the recruitment shortage, other strategies need to be considered. Compulsory involvement in vaccine studies is one alternative solution that is not as outlandish as it might seem on first consideration. Many societies already mandate that citizens undertake activities for the good of society; in several European countries registration for organ-donation has switched from "opt-in" (the current U.S. system) to "opt out" systems (in which those who do not specifically register as non-donors are presumed to consent to donation, and most societies expect citizens to undertake jury service when called upon."