Re-making the clinical subject in war times: Reflections on continuing and expanding pharmaceutical innovation under martial law

Abstract (English)

The plasticity built into commercial and non-commercial scientific experiments that provides ‘a way to bridge research and public health needs’ (Petryna 2009) is the epistemological premise of this practice-focused and future-oriented inquiry into the social reality of conducting clinical trials under martial law in Ukraine. Our guiding question asks what happens when clinical research subjects search for participation in trials, as opposed to the ‘classic’ trajectory in the global search for human subjects. Specifically, we take issue with the actual and perceived challenge of displaced cancer patients enrolled in trials seeking treatment continuation elsewhere. Theoretically, we combine the conceptual notions of ‘Making’ (Ingold 2014) and ‘Marking Time’ (Rabinow 2008) to elucidate and discuss from a legal and anthropological vantage point opportunities for reworking hardline views of the ‘ancestral’ participation criteria of modern bioethics to protect vulnerable population groups in crises, including armed conflict and war. A critical engagement with the notion of ‘compassionate use’ in the legislation of the European Union and Ukraine (an EU candidate state), and acceptance, reluctance, or resistance to embrace this term in the national legislation (e.g., Poland), facilitates the discussion of a pharmaceutical dilemma to which the unfolding wartime refugee crisis draws attention. A commitment to what may be stretched and changed in extraordinarily sensitive situations with vast implications for the pharmaceutical nexus (Petryna, Lakoff; Kleinman (eds) 2006) informs and guides this contribution that problematises clinical trial dislocation with a cluster of barriers, especially trial continuation and expansion in precarious times.