Views & Reviews Review of the Week

Paid to participate in a “mild torture economy”

BMJ 2011; 342 doi: (Published 04 May 2011) Cite this as: BMJ 2011;342:d2550
  1. Boleslav Lichterman, researcher, The Burdenko Neurosurgery Institute, Moscow, Russia

Why do people participate as paid so called volunteers in clinical trials? Boleslav Lichterman reviews a book that considers participants’ motivations and the potential problems

In his recent interview for a Russian medical periodical (Meditsinskaya Gazeta 18 March 2011:19) Evgeny Chazov, a director of a Moscow research centre for cardiology and a former health minister of the Soviet Union, praised the healthy volunteers who regularly participate in testing new drugs, risking their health for token payments.

“We are ready to award them merit certificates,” he said.

The Professional Guinea Pig provides a view on those who volunteer for cash that suggests less altruism. The book is adapted from the doctoral thesis of US anthropologist Roberto Abadie, who presents the results of ethnographical research into paid participation in clinical trials conducted in Philadelphia in the early 2000s. This is a study “of how bodies became commodified and integrated into market economy.” It is based on a semistructured survey of 18 healthy volunteers, aged from 18 to 45, who earn their living by enrolment in phase I clinical trials. Usually such trials are aimed at studying the toxicity of new drugs and involve 30 to 100 participants.

Most of the participants in Abadie’s research were unemployed or partially employed anarchists, with flexible schedules and no family. Their main motivation was “easy, quick money.” The income from so called …

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