The Professional Guinea Pig: Big Pharma and the Risky World of Human Subjects

199 Pages·2010·0.868 MB·English

by  Roberto Abadie

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Big Pharma and the Risky World of Human Subjects
Duke University Press
Durham and London
2010
∫ 2010 Duke University Press
All rights reserved.
Printed in the United States of America on acid-free paper $
Designed by Heather Hensley
Typeset in Whitman by Keystone Typesetting, Inc.
Library of Congress Cataloging-in-Publication Data appear
on the last printed page of this book.
In loving memory of my mother Susana

CONTENTS
A NOTE ON METHOD ix
ACKNOWLEDGMENTS xi
INTRODUCTION A Guinea Pig’s Wage: Risk, Body Commodification,
and the Ethics of Pharmaceutical Research in America 1
1 Guinea-Pigging: The In/Formal Economy of
Phase I Clinical Trials in Philadelphia 21
2 Market Recruitment, Identity, and Resistance among
Professional Guinea Pigs 45
3 Local Knowledge and Risk Management among
Professional Guinea Pigs 65
4 Big Pharma and hiv Clinical Trials: A Case Study 85
5 Strategies of Survival: hiv Clinical Trials and the
Fight for Their Lives 97
6 From Prisoners to Professionals: A Brief History
of the Clinical-Trial Enterprise 121
7 Ethics and the Exploitation of the Poor in Clinical Trials Research 137
CONCLUSION Living in/o√ the Mild Torture Economy as Trial Subjects 157
EPILOGUE Following Up: Robert Helms, Frank Little,
Dave Onion, and Spam One Last Time 167
BIBLIOGRAPHY 171
INDEX 181

A NOTE ON METHOD
To protect informants I have chosen to identify them by pseudonyms. An
exception is Robert Helms, who asked me to identify him by his real name.
Anonymity is particularly important to avoid retaliation in cases when
paid subjects are still active in clinical trials. The Community-Based Trial
Organization (cbto) is also a fictitious name. Despite my e√orts, those
knowledgeable about the aids institutional landscape in Philadelphia
might be able to uncover the real site behind cbto. I hope that nothing
in this book compromises the mission of the organization. I could have
gone further, concealing the identity of Philadelphia by referring to it only
as a Northeastern city, but doing so would have deprived the reader of the
full sociohistorical context in which this research is deeply embedded.