Economic Exchanges? Healthy Volunteering as a Form of Labour

Abstract

While the previous two chapters question the idea of autonomy in healthy volunteering, here I interrogate the notion and discourse of altruism that permeates discussions of healthy volunteering in clinical drug trials. Drawing on accounts of healthy volunteers’ experiences in clinical drug trials, this chapter challenges the tendency to situate healthy volunteers as willing and altruistic in their actions. I argue that healthy volunteering is infact a form of economic exchange in which the body is exchanged for the financial rewards on offer and it is in fact a form of passive labour. The history of healthy volunteering as an exchange can be traced to post-war changes in the regulation, organisation, and practice of clinical drug trials, which led to the birth and subsequent growth of CROs. Today, CROs pride themselves at being effective and efficient in recruiting the right kind of trial participants and being competent in managing studies. Consequently, recruitment of participants has become a lucrative business for the CROs. The increasing numbers of CROs have intensified competition in the national and global search for healthy volunteers and has resulted in an increase in amounts of monetary rewards offered to healthy volunteers for participating in clinical drug trials.