chapter  6
20 Pages

‘Transport to Where?’: Reflections on the problem of value and time à propos an awkward practice in medical research

WithP. Wenzel Geissler

Based upon Kenyan ethnography, this article examines the gap between the bioethics aversion to

value transfers in clinical trials, and research participants’ and researchers’ expectations of these.

This article focuses upon so-called ‘transport reimbursement’ (TR): monetary payments to

participants that are framed as mere refund of transport expenses, but which are of considerable

value to recipients. The interest in this case lies not so much in the unsurprising gap between

regulatory norms and poor study subjects’ lives, but in the way in which this discrepancy between

bioethical discourse and materialities of survival is silenced. In spite of the general awareness that

TR indeed is about the material value of research, about value calculation, and expectations of

return, it is not publicly discussed as such unless ironically, in jest, or in private. This doubleblindness around ‘reimbursement’ has provoked discussions among ethicists and anthropologists,

some of which propose that the work that generates scientific value should be recognised as

labour and participants, accordingly, paid. Here, this paper argues that such a re-vision of trial

participation as work rather than as a gift for the public good, risks abrogating the possibility of

‘the public’ that is not only a precondition of public medical science, but also its potential product.

The supposedly radical solution of tearing away the veils of misrecognition that ‘free’ gifting

ideology lays upon the realities of free labour, though analytically plausible, fails to recognise the

utopian openings within clinical trial transactions that point beyond the present towards larger forms of social association, and towards future alignments of scientific possibilities and

human lives.