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Book Reviews
The Professional Guinea Pig: Big Pharma and the Risky
World of Human Subjects. Roberto Abadie. Durham, NC:
Duke University Press, 2010. x +184 pp.
DONNA M. GOLDSTEIN
University of Colorado
The Spanish conquistadors had their “first contact” with
guinea pigs (Cavia porcellus) over 400 years ago in Peru
(Morales 1995). The Incas bred them for food; the conquis-
tadors took them back to Europe, where they became ex-
otic pets among the upper classes and royalty. The first bio-
logical experimentation with these animals occurred in the
17th century, and at least 23 Nobel Prizes have used guinea
pigs in their medical experiments. Their “docile nature”
made them a popular pet as well as a “model organism”
for experimentation. So it is that guinea pig, as a term for
the test subjects of scientific experimentation, has become
a widely cited, powerful, and deeply descriptive metaphor.
Roberto Abadie’s illuminating ethnography The Pro-
fessional Guinea Pig: Big Pharma and the Risky World
of Human Subjects transports its readers to the city of
Philadelphia and into the complex world of human exper-
imentation that, despite its proximity, is invisible to most
of us. Philadelphia is a city well known for its hospitals
and medical research facilities, and for its difficult-to-fix,
neoliberally enhanced poverty problems. Home to some
of the most prominent pharmaceutical testing sites in
the nation, Philadelphia is the first stop in the arduous
process of drug approval required by the Food and Drug
Administration (FDA).
Abadie introduces the reader to two distinct “pop-
ulations” that are deeply embedded in forms of human
experimentation connected to the pharmaceutical in-
dustry: the first is a freethinking and highly self-aware
anarchist community, many of whose white male members
have chosen to become regular paid volunteers in phase 1
clinical trials (experiments that are testing a drug’s safety in
its move from animals to humans), as well as phase 2 and
phase 3 pharmaceutical trials (experiments for safety and
efficacy of a drug). The second population is made up of
people who are HIV-positive and who are connected to a
Community Based Trial Organization (CBTO) that cooper-
ates with sympathetic and expert doctors to take advantage
of innovations in HIV/AIDS treatment. In this environment,
clinical trials can offer an expanded package of health care
assistance as well as the opportunity to observe new and
improved drug performance (including new combinations)
on the human body among willing participants.
These two populations thus offer us a broad set of ex-
periences through which we can evaluate this “risky world
of human subjects.” The anarchist volunteers are highly
conscious guinea pigs who are sought after for their healthy
bodies and their willingness to allow pharmaceuticals to
flow through their veins in return for payment and the
freedom gained from earnings acquired in a relatively short
timeframe. They are also deeply reflexive, and some of
them have contributed to an entertaining and informative
zine, Guinea Pig Zero (later published as an edited volume,
Helms 2002). The zine offers advice and solidarity to fellow
guinea pigs, explaining how to maneuver and procure bet-
ter wages within the system and, even more importantly,
how to avoid potentially dangerous or uncomfortable
experiments. In addition to conducting fieldwork among
these professional healthy guinea pigs of the anarchist
bent, Abadie provides the life histories of those who par-
ticipate in clinical trials in the context of the CBTO. These
patients embody a completely different mindset from the
healthy anarchist volunteers we meet in the first half of
the book: they are the generation that saw HIV/AIDS be-
come a chronic survivable illness and are the beneficiaries
of the potent activism that demanded cooperation from a
number of actors in the health sector, including doctors,
institutional review boards (IRBs), and Big Pharma. In spite
of this legacy, however, as Abadie makes clear, even an insti-
tution of this kind exactly depends on thoughtful medical
practitioners, conscientious leadership, and trustworthy
review boards that can make clear-eyed decisions about
potential benefits and risks to patients without succumbing
to the wanton influence of Big Pharma.
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 relation-
ship. As Abadie explains, it was not too long ago that this
sort of human experimentation for the advancement of
AMERICAN ETHNOLOGIST, Vol. 39, No. 4, pp. 835–866, ISSN 0094-0496, online ISSN 1548-1425. C
2012 by the American Anthropological Association.
All rights reserved. DOI: 10.1111/j.1548-1425.2012.01398.x
American Ethnologist Volume 39 Number 4 November 2012
scientific knowledge was effectively carried out on prison
populations (up until 1980), a fact that clarifies why prison
populations now receive “special” protection in the context
of IRBs. Abadie sketches the history of the development of
informed consent in the context of clinical trials, hitting
the landmarks—Tuskegee, Belmont, and the evolution
of protocol within contemporary IRBs—but his goal is to
bring us closer to the participants of these experiments in
the present. Abadie shows us their distinct subjectivities,
rationales, and approaches to navigating their bodies and
informing themselves, to varying degrees, about the risks
of becoming professional guinea pigs. He thus brings his
readers to the thorny issues surrounding the notion of
“informed consent.” This all occurs in a society in which
“being paid to test drug safety has become an essential
part of the clinical drug trial enterprise” a place where we
have created “a mild torture economy in which bodily pain,
boredom, and compliance are exchanged for money” (p. 2).
Abadie’s critique of these forms of guinea pig sub-
jectivity in relation to Big Pharma is different for each of
his case studies. He recommends a more rigorous form
of informed consent: for instance, he suggests that the
participation of paid, healthy volunteers should be placed
in a centralized registry so that subjects can be tracked for
effects and protected from their own desires to expose their
bodies repeatedly to medical experimentation. This would
prevent potentially dangerous short- and long-term drug
interactions and other long-term toxicity and synergistic
effects, as well as restrict the overall number of trials any
one individual could join. He also advocates for the elimi-
nation of industry-hired and industry-skewed IRBs with the
ideal of more accurately evaluating the participation of par-
ticular individuals in industry trials. Abadie thus draws our
attention to the structurally violent aspects of guinea pig
participation, noting that “pharmaceutical research feeds
on a mass of destitute citizens who realized that clinical
trials offered a better opportunity than jobs at McDonald’s
and similar dead-end options at the bottom of the new,
service-oriented economy” (p. 161). Further, he points out
that even in the very patient-friendly arms of the CBTO,
much of the ability of those institutions to refuse trials from
Big Pharma has to do with the composition of a politically
insightful IRB composed of individuals sympathetic to the
dilemmas of experimentation for human subjects.
In offering us yet another case where bodies are com-
modified before the promise of biomedical research and
ethics, Abadie introduces us to the structural issues and
lack of regulation that promotes this form of contemporary
volunteerism, as well as to the strides made by Big Pharma’s
collaboration with the highly conscious descendants of
HIV/AIDS activism. This eloquent and insightful ethnog-
raphy motivates the reader to think deeply about human
guinea pigs in the context of late capitalism and promises
to inspire a great deal more inquiry into the ethics of
pharmaceutical capitalism, the commodification of bodies,
and informed consent.
References cited
Helms, Robert, ed.
2002 Guinea Pig Zero: An Anthology of the Journal for Human
Research Subjects. New Orleans: Garrett County Press.
Morales, Edmundo
1995 The Guinea Pig: Healing, Food, and Ritual in the Andes.Tuc-
son: University of Arizona Press.
Cultivating Global Citizens: Population in the Rise of
China. Susan Greenhalgh. Cambridge, MA: Harvard Univer-
sity Press, 2010. 156 pp.
ARIANNE M. GAETANO
Auburn University
This latest book by distinguished anthropologist Susan
Greenhalgh, which consists of three lectures originally
presented in 2008 at Harvard University’s Fairbank Center
for Chinese Studies, is a welcome addition to scholarship
on modern China. The concise and tightly organized
volume distills Greenhalgh’s extensive research—spanning
three decades—on China’s “one-child policy” to situate the
controversial and complex policy within a broader context
of “population politics,” which she argues has been central
to the construction of the post-Mao Chinese state and to
securing China’s place in the globalizing world. Population
politics involves more than just population statistics. It
encompasses a range of health, population, and social poli-
cies; bureaucracy and institutions to support the policy;
science and technology; as well as discourses, norms, and
values. Viewing the Chinese state since 1949 through the
optic of population politics challenges the narrow “master
narrative,” pervasive in U.S. and Western discourse on
China since the Cold War, of a coercive totalitarian state.
True, in the early 1980s, and again in the early 1990s, the
“one-child policy” was especially draconian in its aims and
effects, but forceful campaigns were never the whole story
and have since been succeeded by more humane methods.
Significantly, throughout the post-Mao period, population
politics has been a most fecund arena for expanding
governing capacity, shoring up the party’s legitimacy, and
innovating techniques of social governance. Greenhalgh
emphasizes that the United States and other nations must
have an accurate understanding of China’s population
politics and its centrality to China’s national objectives
to adequately respond to China’s rise as a new global
power. Focusing on population politics also contributes
to anthropological study of modern Chinese society and
individuals, suggesting that the recent emergence of “the
self-optimizing, self-governing subject is rooted not only in
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