Discursive dialects of bioethics: Understanding the institutional embeddings of human stem cell experimentation in India

Abstract

Experimental stem cell therapy (ESCT) as a mode of therapeutic treatment is widely available in India in spite of regulatory prohibition of such practice and little scientific evidence in support of its medical efficacy. In our view, it is especially the varied institutional set-ups and modes of functioning of therapeutic service-providing centres that make ESCT a lucrative enterprise. But very little is known about how such providers circumvent scientific and regulatory frameworks and are able to successfully sustain and expand this enterprise. In this article we argue that such providers thrive through ‘bionetworking’− informal forms of socio-scientific and entrepreneurial liaison − in the context of their institutional embeddings. In contrast with moral and generalising explanations for the spread of stem cell therapies in India in terms of neoliberal pressures, we illustrate how variable institutional embeddings motivate therapy providers to actively create and mobilise dialects of a dominant bioethics discourse. We categorised the therapy providers into three groups: public, private and independent practitioners. The differences show that institutional embeddings are crucial to the understanding of the diverse motivations, therapeutic practices and patient recruitment strategies that we analyse on the basis of various economic values, entrepreneurial logics and bioethical discursive dialects.