Paper short abstract:

Conceptions of vulnerability in healthy volunteer trials tend to use medical definitions of vulnerability. This paper argues for a broader view of vulnerability to include wider socio economic structures in which clinial trial subjects take part in such studies.

Paper long abstract:

Debates about healthy volunteers and risk in clinical trials abound, especially in light of high profile clinical trial that have gone wrong such as the 2006 Northwick Park incident (Hedgecoe 2013) and more recently in January 2016 Rennes France (Mwale 2016). Bioethical debates in response to such disasters tend to focus on healthy volunteers as rational and capable actors. Bioethical and socio-economic understandings of individuals as actors draw on medical understandings of vulnerability and rationalism as the guiding principles of human thought and action (Hale 2007). In this context, healthy volunteers, as adults and free of mental and physical impairment, are seen as capable of rational thought, thus able to understand the contracts they sign to take part in clinical trials. Here, information provision is seen as a solution to ethical dilemmas in human involvement in clinical trials. Drawing on a qualitative research on healthy volunteer involvement in clinical trials, this paper interrogates medical conceptions of vulnerability in first in human clinical trials. Extending Butler's (2014) conceptionalisation of vulnerability, I argue that understanding healthy volunteers as life giving subjects needs to take into account the socio-economic and political contexts in which such acts of volunteerism take place. Specifically, the paper interrogates the limits of vulnerability when linked purely to medical definitions, and asks if healthy volunteers in commercial clinical as life giving su/objects, are made to bear more responsibility than they are capable of.