Contracting Health: Procurement Contracts, Total Institutions, and the Problem of Virtuous Suffering in Post-war Human Experiment

Summary

The American medical research industry seemed poised to collapse in the wake of the US civil rights movement because of sudden, sharp restrictions on access to human subjects for medical research. Yet research on healthy people continued to expand, eventually taking a new organizational form with the rise of Contract Research Organizations. This surprising outcome emerged because a set of private religious organizations during the 1950s aligned with the US National Institutes of Health (NIH) to produce the legal possibility of a sustained, large-scale civilian market for human subjects and, simultaneously, to create the living reality of that market. NIH made novel use of the government 'procurement contract' mechanism, and the churches offered a logic of suffering to 'volunteers' to make sense of their experiences. Together, they enabled the formal exchange of money for human subjects that anchors medicine in the present day and invites critique beyond the conventional categories of bioethics.

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