Abstract
What truly counts as labour found within the general aftermaths of post-Fordist global market restructuring? More specifically, how can labour in the bioeconomy be defined? That is, who labours and in what way? These are critical questions that Melinda Cooper and Catherine Waldby ask in their remarkable book. In the process, we get a refreshing analysis of the bioeconomy itself.
The bioeconomy sits alongside other sectors (service, finance, information), which have all innovated value creation. First emerging in the 1980s, the bioeconomy was a result of the financialization of the pharmaceutical industry (where foremost, investment companies institute pressures on the drug industry to make high rates of short-term gains in return for finance capital). One result is the drug industry’s increasing dependency on clinical labour – the invisible research volunteers and those who donate biological material to perpetuate life in multiple, value-creating ways. As the authors beautifully analyse, these are labourers that go unacknowledged as actual workers. Their labour does not require the interface of body and mind with machine. Rather, it requires human corporeal ‘flesh and blood’, used and modified as the raw material that initiates a value chain – what Cooper and Waldby refer to as embodied labour.
While volunteers have long participated in the research process, there are two new turns that the authors elucidate. First, they analyse shifting forms of labour: one within biological reproduction and the other within the realm of economy. While feminist scholars have extensively interrogated the relationship between markets and reproduction, Cooper and Waldby show how reproductive labour itself is now intrinsic to the bioeconomy. Tracing an important genealogy from American slavery and social class, the authors emphasize that the new turn pertains to socio-technical assemblages that contribute to establishing global surrogacy, stem cells, in vitro fertilization, reproductive tissues and gametes markets. These markets are essentially cross-border fertility chains located in California, the European Union and India, to name a few, and they cater to reproductive tourists (buyers) and women living at the margins of society (sellers), giving rise to what Cooper and Waldby refer to as ‘reproductive arbitrage’.
A second turn pertains to an exponential expansion of clinical trial labour that has emerged with the simultaneous processes of financialization and post-Fordist deindustrialization. In terms of the former, the result is the globalization of clinical trials as an industry unto itself. The name of the game for the pharmaceutical industry is rationalizing new profits by shortening the research process and adding more trial subjects who are treatment naïve and less costly than those in traditional (mostly US) public health care settings. At the same time, deindustrialization and the restructuring of global markets have directly transformed what was once formalized labour into precarious and/or undocumented life. Those marginalized within these, at times, massive dispossessions, find occasional, informal and contractual livelihoods as clinical trial volunteers. The authors illustrate this by detailing the dynamics of clinical trial offshoring to the growing national economies of India and China. The clinical trials industry relies upon the post-socialist state (e.g. for its relatively intact medical expertise and health infrastructures), while at the same time drawing on increasingly uninsured Chinese citizens who are highly motivated to seek out trials as an alternative to health care access. In the process, multiple forms of risk exposure have become, in the words of the authors, a tradable service.
The expanding labour force that is not acknowledged as such, growing inside these new markets, raises new questions about research ethics. Bioethics has long established a set of principles that cast research subjects as altruistic volunteers. This purpose was to protect volunteers from the commodification of risk as well as also setting guidelines for an imagined scientific objectivity in the research process. Yet, as Cooper and Waldby very convincingly analyse throughout the book – from tort law to informed consent – the question of risk has always been intrinsic to the clinical trial (as opposed to Fordist practices that sought to eliminate risk within the production process). When inserted into the bioeconomy, intrinsic risk neatly maps onto other logics of livelihood risks found in economies that provide no social safety nets. This is not simply an unfortunate outcome of current day research practices. Rather, the clinical trial relies upon risk-bearing labour for value extraction. As such, bioethics gets absorbed into normative legal and research infrastructures that are internal – even necessary – to the political economy of the life sciences.
This is a brilliant book that extends, if not challenges, both Marxist and post-Fordist renderings of labour. It is necessary reading for scholars of labour studies, feminist studies, bioethics, political economy, global health, medical anthropology, medical humanities, and science and technology studies. It freshly frames longstanding debates on gendered labour as well as international political economy. I suspect it will be well cited in years to come.