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126 Early in 2005, I received a message on my answering machine. The call was from a company specializing in clinical trials on healthy human subjects and was part of a general recruitment campaign for their facility in the southwestern United States. The woman calling reminded me that I could earn money by enrolling in any of the company’s active recruiting studies: This message is for Jill Fisher. We are [a clinical trials company], calling just to advise you of current studies we have available that you are qualifying for. They are very good studies currently running, and it’s good, easy, fast money to make for the New Year. If you want further information, feel free to give us a call. Our number is 1–888–xxx–xxxx. Thank you. Several weeks later I received a postcard from the same company. The card wished me a happy birthday, and it offered me an additional $25 for screening for any one of their studies during the month of my birthday. The card informed me that studies pay up to $3,200 in exchange for my participation. I had become part of the company’s database a year earlier when I had tried to enroll in a study for the purposes of participant observation.1 The study for which I passed the phone screening—meaning that I met the basic qualifications of age, weight, and so on—was a three-week, in-patient, randomized , double-blind, placebo-controlled study to test the “pharmacokinetics , safety, and tolerability of multiple dosing regimes in Healthy Subjects of an investigational drug being studied to treat rheumatoid arthritis” with Chapter 6 Recruiting Human Subjects Recruiting Human Subjects 127 a $3,000 stipend.2 The clinic was located in the most impoverished part of the city, known for its predominantly Latino population. I arrived at the appointed time as one of two hundred screening to fill forty-two study slots, and found that I was one of very few women (about 20 percent) and one of the few who spoke English. Informed consent was done in groups based on language, and the English-speaking consent group was significantly less than half of the total. After being weighed, measured, and having my vitals checked, I was sent to the phlebotomist’s station. It was at this point—unfortunately for my research3 —that I was disqualified from the study because my veins, I was told, were not good enough for research. The phlebotomist explained that they need to take blood samples in sixty seconds or less, from tying the tourniquet to applying the final Band-Aid. Because they have more people who are interested in studies than they can enroll, she said they did not need to bother with cases of more difficult veins. Indeed, they had 25,000 participants in their database, of whom nearly 10,000 individuals screen for healthy subject clinical trials each year. More than 3,000 enroll in studies at this in-patient facility with over one hundred beds. In my case, my veins were labeled as uncooperative, I failed the screening visit, and I was told to go home. Who participates in pharmaceutical clinical trials? How are they recruited? How do the demographics of participants differ depending on the types of clinical trials (for example, type of illness, healthy subject, and so on)? And what are the reasons that people give about why they enroll in drug studies at all? Human subjects’ decisions to participate in clinical trials are influenced primarily by their need for medical treatments or income. Although there are important differences based on the race, class, and gender of subjects, the clinical trials industry takes advantage of disenfranchised groups by offering them “access” to the medical establishment or large stipends in exchange for access to their bodies to test new drugs. Political and Economic Contexts of Human Subject Recruitment Since the late 1970s, the period in which neoliberal political and economic policies began to infiltrate the provision of health care in the United States, poverty rates and health insurance coverage have shifted. According to a U.S. census report, in the second half of the 1970s, the poverty rate was roughly 12 percent (25 million Americans). By 1983, that rate peaked at 15.2 percent (35.3 million Americans). Over the next twenty years, the poverty rate fluctuated up and down, but in 2002, it returned to its 1970s average at 12.1...

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