When experiments travel : clinical trials and the global search for human subjects
著者
書誌事項
When experiments travel : clinical trials and the global search for human subjects
Princeton University Press, c2009
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注記
Includes bibliographical references (p. [225]-247) and index
内容説明・目次
内容説明
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 Travel" documents 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 Travel" raises 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 Travel" challenges 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.
目次
Abbreviations ix INTRODUCTION: EXPERIMENTAL FIELDS 1 The Search for Human Subjects 1 Anthropology and the Global Clinical Trial 5 CHAPTER ONE: ETHICAL VARIABILITY 10 Why Are Clinical Trials Globalizing? 10 Treatment Saturation 19 Experimentality 26 Ethics as "Workable Document" 33 Floater Sites and Hidden Harms 41 The Aftermath of Clinical Trials 44 CHAPTER TWO: ARTS OF DRUG DEVELOPMENT 47 Study Mills 47 Drug-Development Services 53 From Vulnerable to Professional Subjects 61 The Pharmaceutical Boom and Everyday Research 68 Engineering Out Harm 77 The Scientific Plateau and the New Safety Paradigm 85 CHAPTER THREE: THE GLOBAL CLINICAL TRIAL 89 How Many Clinical Trials Are Being Carried Out Worldwide? 89 The Polish Market and the "Nonexistent" Patient 98 Clinical Research Frontiers 106 Collaborations in Global Science 109 Akademia Kliniczna 116 The Work of Slack 119 Patient-Consumers 124 "Our society was not competitive" 127 Pivotal Countries 130 Insurance and Legal Protection 132 CHAPTER FOUR: PHARMACEUTICALS AND THE RIGHT TO HEALTH 139 Reclaiming Patients and the Evidence Base of Drugs 139 "Pharmaceuticals are the new gold" 142 Health Technology Assessment in Brazil 146 The Judicialization of Health 150 Alternative Treatment Guidelines 153 The Clinical Research Unit 156 When a Country Is a Pharmacy 160 A Public Health Experiment 165 What Happens When Clinical Trials End 167 The Values Patients Bring 173 Information Asymmetry and Agency 179 CONCLUSION: THE FUTURE OF GLOBAL MEDICINE 186 Scientific Evidence and Value 186 Drugs as Public Goods 190 Global Health Markets 192 Innovation 195 Acknowledgments 201 Notes 205 References 225 Index 249
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