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When Experiments Travel:
Clinical Trials and the Global Search for Human Subjects
Adriana Petryna

Book Description | Reviews
Introduction [HTML] or [PDF format]

TABLE OF CONTENTS:

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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File created: 7/11/2014

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