Paper short abstract:

In this paper I propose to analyze the multiple logics underlying the signature of the agreement between the clinical trial as an institution and the HIV-AIDS patients recruited. Instead of deconstructing these logics and experiences in insisting on what seems to oppose them, I want to highlight how different actors play a role in the setting up of the Ethical process and in doing so articulate matter of facts and concerns. The ethical procedures appear as a fiction opening the way for the association to happen.

Paper long abstract:

To adopt a realistic attitude would be to recognize that in the encounter of researchers and subjects within clinical trials, there is no strict opposition of matters of fact and concern, but rather an articulation of the two. This articulation (or association) is based on the staging of an agreement grounded on the multiplicity and economy of registers _ fact, concern. Even so the terms of the agreement seem to give precedence to fact, the different parties do not ignored concern of both parties. But the signature of the agreement is not a place of revelation of an absolute truth neither about why parties do sign nor about what they "carry"; it is a place of staging of the trial where actors accept to collaborate knowing that while signing they both have other "matter of concerns". We will discuss this issue from the experience of subjects enrolled in a clinical trial in Ivory Coast looking at early antiretroviral treatment against HIV and AIDS. Analyzing the conditions and experiences of inclusion of different patient-subjects, I propose to discuss the staging of this agreement and its consequences on what is the ethical protocol within clinical trials.