A Note on Method ix

Acknowledgments xi

Introduction. A Guinea Pig's Wage: Risk, Body Commodification, and the Ethics of Pharmaceutical Research in America 1

1. Guinea-Pigging: The In/Formal Economy of Phase I Clinical Trials in Philadelphia 21

2. Market Recruitment, Identity, and Resistance among Professional Guinea Pigs 45

3. Local Knowledge and Risk Management among Professional Guinea Pigs 65

4. Big Pharma and HIV Clinical Trials: A Case Study 85

5. Strategies of Survival: HIV Clinical Trials and the Fight for Their Lives 97

6. From Prisoners to Professionals: A Brief History of the Clinical-Trial Enterprise 121

7. Ethics and the Exploitation of the Poor in Clinical Trials Research 137

Conclusion. Living in/off the Mild Torture Economy as Trial Subjects 157

Epilogue. Following Up: Robert Helms, Frank Little, Dave Onion, and Spam One Last Time 167

Bibliography 171

Index 181

Winner, 2011 British Sociological Association Sociology of Health and Illness Book Prize

“[A] groundbreaking ethnography. . . .” — Martin Tolich, Qualitative Health Research

“Abadie gives readers a look behind the curtain of phase I clinical trials sponsored by major pharmaceutical companies. . . . Recommended.” — J. H. Barker, Choice

“Abadie has conducted illuminating research into this topic and the reader is left with the hope that the author continues in this area and offers more detailed insight into the experience of research participants outside his core group for this book, including the issue of clinical trials conducted in the developing world, which has become a increasingly frequent site for drug trials, forming a new and very problematic ethical dimension in drug development research.” — Rachel Barrett, t Sociology of Health and Illness

“Abadie’s absorbing ethnography takes us into the broader lives and artful subjectivities of these diverse professional guinea pigs. The ethnography also delivers the reader into the somewhat antiseptic world of clinical trials and pharmaceutical testing, laying out the terrain and the sore points of this strangely evolving relationship.” — Donna M. Goldstein, American Ethnologist

“Insights gained from Abadie’s work hold benefits for researchers, IRB members, government regulators, and human subjects themselves. With de-individuation of human subjects too frequently the norm, the faces which Abadie describes for us are important reminders that real risks exist and real people may be harmed.” — Ann Hamilton, Journal of Empirical Research on Human Research Ethics

“Roberto Abadie penetrates the professional corps of human test subjects in his book The Professional Guinea Pig to uncover often shocking accounts of the lives of professional and semiprofessional test subjects. . . . It is a treat to read an observant and thoughtful account by someone who has escaped the traditional halls of academia, to delve into the world inhabited by the test subjects at the centre of his research.” — Alan Cassels, Canadian Medical Association Journal

“This book is an important contribution to understanding of current issues related to clinical research. Moreover, it is an invitation to further the public debate and develop policies that are better suited for research subject protection.” — Elita Poplavska, Social Forces

“The Professional Guinea Pig gives voice to volunteers skeptical of the current ethical protections in phase 1 trials, even as they endure the risks of those trials. . . . Readers will learn something about a fascinating counterculture. . . .” — Deborah R. Barnbaum, Nature Medicine

“The Professional Guinea Pig tells a fascinating story at the entrepreneurial and pharmaceuticalized heart of neoliberal medicine. . . . It is a riveting read and makes important contributions to the anthropologies of neoliberalism, pharmaceuticals, and the body.” — Anne Pollock, American Anthropologist

“[A]disturbing account. . . . The Professional Guinea Pig raises important questions.” — Meredith Wadman, Nature

“[An] intriguing and worrying book.” — Scott McLemee, Inside Higher Ed

“Roberto Abadie has written an absorbing ethnographic study of clinical trials that focuses not on the clinic or the clinicians, the science or its development, but the research participants in phase one trials (the first stage of testing in humans). . . . [A] fascinating description of the subculture of regular drug-trial volunteers.” — Nathan Emmerich, Times Higher Education Supplement

“The book makes a compelling argument for why test subjects in the US should be given more protection - and I take my hat off to the author for arguing the case.”
— Clint Witchalls, New Scientist

Winner, 2011 British Sociological Association Sociology of Health and Illness Book Prize

“[A] groundbreaking ethnography. . . .” —Martin Tolich, Qualitative Health Research

“Abadie gives readers a look behind the curtain of phase I clinical trials sponsored by major pharmaceutical companies. . . . Recommended.” —J. H. Barker, Choice

“Abadie has conducted illuminating research into this topic and the reader is left with the hope that the author continues in this area and offers more detailed insight into the experience of research participants outside his core group for this book, including the issue of clinical trials conducted in the developing world, which has become a increasingly frequent site for drug trials, forming a new and very problematic ethical dimension in drug development research.” —Rachel Barrett, t Sociology of Health and Illness

“Abadie’s absorbing ethnography takes us into the broader lives and artful subjectivities of these diverse professional guinea pigs. The ethnography also delivers the reader into the somewhat antiseptic world of clinical trials and pharmaceutical testing, laying out the terrain and the sore points of this strangely evolving relationship.” —Donna M. Goldstein, American Ethnologist

“Insights gained from Abadie’s work hold benefits for researchers, IRB members, government regulators, and human subjects themselves. With de-individuation of human subjects too frequently the norm, the faces which Abadie describes for us are important reminders that real risks exist and real people may be harmed.” —Ann Hamilton, Journal of Empirical Research on Human Research Ethics

“Roberto Abadie penetrates the professional corps of human test subjects in his book The Professional Guinea Pig to uncover often shocking accounts of the lives of professional and semiprofessional test subjects. . . . It is a treat to read an observant and thoughtful account by someone who has escaped the traditional halls of academia, to delve into the world inhabited by the test subjects at the centre of his research.” —Alan Cassels, Canadian Medical Association Journal

“This book is an important contribution to understanding of current issues related to clinical research. Moreover, it is an invitation to further the public debate and develop policies that are better suited for research subject protection.” —Elita Poplavska, Social Forces

“The Professional Guinea Pig gives voice to volunteers skeptical of the current ethical protections in phase 1 trials, even as they endure the risks of those trials. . . . Readers will learn something about a fascinating counterculture. . . .” —Deborah R. Barnbaum, Nature Medicine

“The Professional Guinea Pig tells a fascinating story at the entrepreneurial and pharmaceuticalized heart of neoliberal medicine. . . . It is a riveting read and makes important contributions to the anthropologies of neoliberalism, pharmaceuticals, and the body.” —Anne Pollock, American Anthropologist

“[A]disturbing account. . . . The Professional Guinea Pig raises important questions.” —Meredith Wadman, Nature

“[An] intriguing and worrying book.” —Scott McLemee, Inside Higher Ed

“Roberto Abadie has written an absorbing ethnographic study of clinical trials that focuses not on the clinic or the clinicians, the science or its development, but the research participants in phase one trials (the first stage of testing in humans). . . . [A] fascinating description of the subculture of regular drug-trial volunteers.” —Nathan Emmerich, Times Higher Education Supplement

“The book makes a compelling argument for why test subjects in the US should be given more protection - and I take my hat off to the author for arguing the case.”
—Clint Witchalls, New Scientist

“Roberto Abadie has given us a deep, complex, and profoundly disturbing investigation into the dark underside of the clinical trials industry. The Professional Guinea Pig is not just ethnography. It is a call to action.” — Carl Elliott, author of, Better than Well: American Medicine Meets the American Dream

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