Volunteering for Free Is Dead, Long Live Reciprocity? Revisiting the Gift Relationship

Abstract

Having critiqued voluntarism and altruism to situate healthy volunteering as an economic exchange and thus a form of labour, I now turn attention to the idea of the ‘gift relationship’ (Titmuss 1971) as applied to human involvement in clinical drug trials. I engage with literature on alturism in the blood donation context and how it relates to debates on human involvement in clinical drug trials. Arguing that while healthy volunteers gave altruism as their motivation in some cases, it is important for altruism in clinical drug trials to be considered in a critical manner. Appeals to altruism obscure power relations and inequality in clinical drug trials in that volunteering tends to attract people who are in financially disadvantaged situations. The use of altruism as motivation or explanation for involvement in clinical drug trials suggests the availability of willing participants who come forward with abandon to take part. Such a view negates how acts of altruism and voluntarism are shaped by the sociopolitical, sociocultural, and socioeconomic contexts in which they take place and that many healthy volunteers in clinical drug trials are actually coerced to take part in clinical drug trials.