Research Participants as Laborers: Political Solutions to Exploitation in Medicine

• In Event: Power, Politics, and Critical Theory

Abstract

The world of work amidst and post-Covid has featured heightened attention to the problem of exploitation in labor. This includes for workers across various industries, such as Amazon warehouse packers and public school teachers, drivers in the gig economy and even software engineers in Silicon Valley. Moral concerns of exploitation also feature prominently in the field of medicine, particularly when considering paying research participants in clinical trials or for other medical services and parts.

In my paper, I argue that the definitions and applications of three prominent formulations of exploitation (vulnerability, instrumentalization, and unfairness) and are each insufficient to fully encapsulate the wrongs and harms we worry about in the ethics of exploitative medicine.
To resolve these insufficiencies, I offer a fourth formulation, drawn from the world of political philosophy of Karl Marx, of exploitation as the extraction of surplus labor. This allows us to more fully explore the rights and justice-based demands of research participants and patients on the medical system.

In so doing, I argue that the exploited are the best knowers and epistemic agents of their own exploitation, and can make demands, often in the form of increased payment and greater access to healthcare benefits, rather than less or banning certain research or behavior, as is often the policy remedy to concerns of exploitation. Similarly, this requires a democratic insight into the need for deliberation and testimony giving amongst those we are most concerned with, rather than proscribing for them top-down policies.

Author

• Naomi Scheinerman, Ohio State University