What could be more fitting for a Valentine’s Day Taboo Trades class than some readings on commodification of the body? For today’s class I chose:
(1) Martha Nussbaum, Sex and Social Justice, Taking Money For Bodily Services, pp. 276-298
(2) Carl Elliott, Guinea-Pigging, The New Yorker
(3) Cari Romm, The Life of A Professional Guinea Pig, The Atlantic (2015)
The concept of guinea pigging is one that I’ve written about here before, in Medical Research Subjects: Guinea Pigs, Laborers, Or Altruists? According to the Oxford English Dictionary (as discussed by Romm), the first use of the word “guinea pig” as “human subject of an experiment” was in 1913, when George Bernard Shaw decried “the ... folly which sees in the child nothing more than the vivisector sees in a guinea pig: something to experiment on with a view to rearranging the world.”
As used here, guinea pigs are healthy, professional medical research subjects who make money primarily through Phase 1 clinical trials (the trials meant to assess the safety and possible side effects of medications, rather than their efficacy). As noted by Romm, “The members of this group call themselves guinea pigs, or lab rats. They also call themselves professionals.” This notion, of course, flies in the face of the preferred ethicists’ understanding of human subjects research, which likes to conceive of subjects as motivated by altruism. As noted by Elliott:
Of course, ethicists generally prefer that subjects take part in studies for altruistic reasons. Yet, if sponsors relied solely on altruism, studies on healthy subjects would probably come to a halt. The result is an uneasy compromise: guinea pigs are paid to test drugs, but everyone pretends that guinea-pigging is not really a job.
Kieran Healy and I make a similar point about egg donors in our forthcoming paper, Repugnance Management and Transactions in the Body (forthcoming, American Economic Review: Papers & Proceedings 2017, 107(5)). As we say there:
The fact that egg donor compensation occurs within a gift-based cultural account poses other problems as well. Payments of up to $10,000 are hard enough to square with a gift narrative, but participants managed it. Egg donation is physically risky, after all, and there was a general consensus that egg donors deserved something for their efforts. Besides, all market participants recognized that without some compensation there would be very few egg donors. But once incentives enter the picture they threaten to undermine gift framing entirely. Would fertility centers and patients compete for the most desirable egg donors? How do you square extremely large payments that vary with the donor’s beauty, intelligence, or race with the notion that payments to egg donors are mere thank-you gestures or a token in recognition of physical discomfort? (emphasis added)
So, how does Nussbaum’s chapter on prostitution fit into all this? In some years, I opt to assign Nussbaum’s chapter together with readings on sex work, but in some ways I find it a better fit with the human guinea pigs readings because Nussbaum makes her points about prostitution by analogizing to the commodification of the body more generally. Many readers, for example, will be familiar with Nussbaum’s famous example of the “colonoscopy artist,” who “gets paid for having her colon examined with the latest instruments, in order to test out their range and capability.”
When considered in this light, the job of guinea pig and that of prostitute (as with all cases of bodily commodification) share some similarities – and some differences as well. In the end, Nussbaum is skeptical of commodification critiques, concluding that:
We need to scrutinize all our social views about money making and alleged commodification with extra care, for they are likely to embed class prejudices that are unjust to working people.
My dad had it right in 1972 when I asked him why Mercedes Benz automobiles had shoulder belts in its back seats when our Chevrolet did not. He bellowed, "Just like the God Damned war, the rich always pay the poor to die for them." What was true for Viet Nam is true for today.... No, I am sorry, actually worse given our exploitive so called President.
Posted by: Captain Hruska Carswell, Continuance King | February 14, 2017 at 02:43 PM
Cap -- from the Elliott article: "And, because so many guinea pigs are uninsured, they are testing the safety of drugs that they will probably not be able to afford once the drugs have been approved. “I’m not going to get the benefit of the health care that is developed by this research,” Helms says, “because I am not in the economic class to get health insurance.”
To be clear, Elliott does not consider this a reason to worry about the commodification of medical subjects. Instead, it is an argument for recognizing their work as the labor it is and providing for them accordingly (and possibly for a better public health care system, though that's not the point of the article)
Posted by: Kim Krawiec | February 14, 2017 at 02:48 PM
Uninsured means poor. No money. He's tossing them a bone, in other words.
Posted by: Captain Hruska Carswell, Continuance King | February 14, 2017 at 04:38 PM