Labourers or lab tools? Rethinking the role of lab animals in clinical trials JoNAThAN L . CLARk
In The Professional Guinea Pig, an account of an anarchist community in Philadelphia whose members support themselves by participating in clinical trials, Roberto Abadie (2010) argues that human subjects enrolled in phase one trials should be classified as workers. A phase one trial is designed to test the safety, as opposed to the efficacy, of an experimental drug; its main objectives are to discover any side effects and to better understand how the body metabolizes the drug. Unlike participants in later phases, who typically stand to benefit from the drug, participants in phase one trials do it mainly for the money, often because they have few other options, their involvement constituting not so much an instance of altruistic volunteering as an “economic draft” (Weinstein 2010: 122; see also Elliott 2010; 2008; Elliott and Abadie 2008). Drawing on Marx’s critique of the legal fiction of the labour contract, which presumes that workers with nothing left to sell but their labour-power choose freely to part with it, Kaushik Sunder Rajan (2007: 83) reminds us that the very purpose of the informed consent form that human subjects typically sign is to establish, as a legal matter, that they are not “coerced guinea-pigs”, even if, as Melinda Cooper (2008: 88) puts it, they have “nothing left to sell but exposure itself ”. Increasingly, the pharmaceutical industry is outsourcing clinical trials to such places as China, India, and Eastern Europe, where there is a surplus of economically desperate people whose bodies are said to have the added advantage, from the perspective of the industry, of being relatively free of other drugs that might interact with the experimental drug, an advantage that presumably stems, in many cases at least, from their inability to afford such drugs (Cooper 2008; Petryna 2009; Prasad 2009; Rajan 2007).1 In the United States and countries with similar laws, participation in clinical trials is not classified as work, at least not insofar as labour laws are concerned. In response to this lack of labour rights, several scholars have argued that participating in phase one trials should be regarded as a form of “experimental or clinical labour” (Cooper 2008: 73; see also Abadie 2010: 165-166; Carney 2011: 180; Elliott 2008; Rajan 2007; Waldby and Cooper 2010, 2008). “Guinea-pigging”, as it is often called, is a peculiar kind of work; instead of doing things it mainly entails having things done to you (Elliott 2008: 41; see also Abadie 2010: 2; Carney 2011: 180). With a few notable exceptions, such as
the long history of physicians experimenting on themselves (but also on family members), human experimentation has been a more-or-less coercive relationship involving slaves, prisoners (both in penal institutions and, most infamously, in the Nazi concentration camps), soldiers, the poor, the mentally ill, racial minorities, children, women, and other vulnerable groups (see, e.g. Guerrini 2003; Lederer 1995; Washington 2006). And as the term “human guinea pig” suggests, this is a vulnerability that human subjects share, at least in some respects, with their nonhuman counterparts. “[W]hat generates our moral response to animals and their treatment”, Cary Wolfe (2008: 11) writes, “is our sense of the mortality and vulnerability that we share with them, of which the brute subjection of the body – in the treatment of animals as mere research tools, say – is perhaps the most poignant testament” (see also Acampora 2006: 130). Whether this subjection is achieved through economic coercion, as in the case of many human subjects in phase one trials, or, as in the case of the nonhuman animals on whom drugs are tested, through physical confinement and restraint, it is the reduction of the body to a mere object of labour that strikes such a powerful ethical chord (Acampora 2006: 97-103; Greenhough and Roe 2011). Indeed, it was the recognition of this shared vulnerability that helped give rise to the movement against human experimentation in the United States (Lederer 1995). In the early twentieth century, Susan Lederer explains, it was the antivivisection movement, a movement concerned primarily with the plight of nonhuman animals, that led the charge against what it called “[h]uman vivisection”, or non-therapeutic experimentation on vulnerable human groups (Lederer 1995: xiv, italics omitted). “That investigators would treat human subjects like laboratory animals was precisely what antivivisectionists feared”, Lederer (1995: 123) writes. In the US, the UK and countries with similar laws, before a drug may legally be tested on humans in phase one trials, it must first be tested for toxicity on nonhuman animals in what is called the pre-clinical phase. The purpose of preclinical toxicity testing is to reduce the risk to which human subjects in phase one trials are subjected. The connection between human and nonhuman subjects raises an intriguing question: if human guinea pigs are engaged in clinical labour, what about actual guinea pigs? To date, scholars working on the concept of clinical labour have had little to say about nonhuman lab animals, and most of the scholars who have written about these animals have classified them as part of the means of production, or “living laboratory equipment”, not as labourers (Birke 2003: 213; see also Cetina 1999: 138-158; Kohler 1994: 6-8). Yet a close reading of some of these accounts reveals another way of thinking about lab animals, one that affords them greater agency. For example, in his history of the fruit fly as a model organism, Robert Kohler describes the flies most often as lab tools; occasionally, however, they figure as the scientists’ “co-worker[s]” in the lab, though Kohler does not develop this theme in any depth (Kohler 1994: 1, see also 23; for other examples, see Pemberton 2004; Russell 2004). Picking up on this theme, this chapter examines the question of whether it makes sense, both analytically and politically, to regard the participation of nonhuman animals in pre-clinical toxicity testing as a form of clinical labour.