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The phenomenal growth of global pharmaceutical sales and the quest for innovation are driving an unprecedented search for human test subjects, particularly in middle- and low-income countries. Our hope for medical progress increasingly depends on the willingness of the world's poor to participate in clinical drug trials. While these experiments often provide those in need with vital and previously unattainable medical resources, the outsourcing and offshoring of trials also create new problems. In this groundbreaking book, anthropologist Adriana Petryna takes us deep into the clinical trials industry as it brings together players separated by vast economic and cultural differences. Moving between corporate and scientific offices in the United States and research and public health sites in Poland and Brazil,When Experiments Traveldocuments the complex ways that commercial medical science, with all its benefits and risks, is being integrated into local health systems and emerging drug markets.Providing a unique perspective on globalized clinical trials,When Experiments Travelraises central questions: Are such trials exploitative or are they social goods? How are experiments controlled and how is drug safety ensured? And do these experiments help or harm public health in the countries where they are conducted? Empirically rich and theoretically innovative, the book shows that neither the language of coercion nor that of rational choice fully captures the range of situations and value systems at work in medical experiments today.When Experiments Travelchallenges conventional understandings of the ethics and politics of transnational science and changes the way we think about global medicine and the new infrastructures of our lives.
Adriana Petryna is associate professor of anthropology at the University of Pennsylvania. She is the author of the award-winning Life Exposed: Biological Citizens after Chernobyl (Princeton) and the coeditor of Global Pharmaceuticals: Ethics, Markets, Practices.
Table of Contents
|Introduction: Experimental Fields||p. 1|
|The Search for Human Subjects||p. 1|
|Anthropology and the Global Clinical Trial||p. 5|
|Ethical Variability||p. 10|
|Why Are Clinical Trials Globalizing?||p. 10|
|Treatment Saturation||p. 19|
|Ethics as "Workable Document"||p. 33|
|Floater Sites and Hidden Harms||p. 41|
|The Aftermath of Clinical Trials||p. 44|
|Arts of Drug Development||p. 47|
|Study Mills||p. 47|
|Drug-Development Services||p. 53|
|From Vulnerable to Professional Subjects||p. 61|
|The Pharmaceutical Boom and Everyday Research||p. 68|
|Engineering Out Harm||p. 77|
|The Scientific Plateau and the New Safety Paradigm||p. 85|
|The Global Clinical Trial||p. 89|
|How Many Clinical Trials Are Being Carried Out Worldwide?||p. 89|
|The Polish Market and the "Nonexistent" Patient||p. 98|
|Clinical Research Frontiers||p. 106|
|Collaborations in Global Science||p. 109|
|Akademia Kliniczna||p. 116|
|The Work of Slack||p. 119|
|"Our society was not competitive"||p. 127|
|Pivotal Countries||p. 130|
|Insurance and Legal Protection||p. 132|
|Pharmaceuticals and the Right to Health||p. 139|
|Reclaiming Patients and the Evidence Base of Drugs||p. 139|
|"Pharmaceuticals are the new gold"||p. 142|
|Health Technology Assessment in Brazil||p. 146|
|The Judicialization of Health||p. 150|
|Alternative Treatment Guidelines||p. 153|
|The Clinical Research Unit||p. 156|
|When a Country Is a Pharmacy||p. 160|
|A Public Health Experiment||p. 165|
|What Happens When Clinical Trials End||p. 167|
|The Values Patients Bring||p. 173|
|Information Asymmetry and Agency||p. 179|
|Conclusion: The Future of Global Medicine||p. 186|
|Scientific Evidence and Value||p. 186|
|Drugs as Public Goods||p. 190|
|Global Health Markets||p. 192|
|Table of Contents provided by Ingram. All Rights Reserved.|