At the time of this writing, a widely publicized, waived-consent trial is underway. Sponsored by Northfield Laboratories, Inc. (Evanston, IL) the trial is intended to evaluate the emergency use of PolyHeme®, an oxygen-carrying resuscitative fluid that might prevent deaths from uncontrolled bleeding. The protocol allows patients in hemorrhagic shock to be randomized between PolyHeme® and saline in the field and, still without consent, randomized between PolyHeme® and blood after arrival at an emergency department. The Federal regulations that govern the waiver (...) of consent restrict its applicability to circumstances where proven, satisfactory treatments are unavailable. Blood - the standard treatment for hemorrhagic shock - is not available in ambulances but is available in hospitals. The authors argue that the in-hospital stage of the study fails to meet ethical and regulatory standards. (shrink)

In the policy discourses of the Organization for Economic Cooperation and Development and European Commission, modern biotechnology and the life sciences are represented as an emerging “bioeconomy” in which the latent value underpinning biological materials and products offers the opportunity for sustainable economic growth. This articulation of modern biotechnology and economic development is an emerging scholarly field producing numerous “bio-concepts.” Over the last decade or so, there have been a number of attempts to theorize this relationship between biotechnologies and their (...) capitalization. This article highlights some of the underlying ambiguities in these conceptualizations, especially in the fetishization of everything “bio.” We offer an alternative view of the bioeconomy by rethinking the theoretical importance of several key economic and financial processes. (shrink)

In 2003 the UK National Blood Service introduced a policy of ‘male donor preference’ which involved women’s plasma being discarded following blood collection. The policy was based on the view that data relating to the incidence of Transfusion-Related Acute Lung Injury (TRALI) was linked to transfusion with women’s plasma. While appearing to treat female donors as equal to male donors, exclusion criteria operate after donation at the stage of processing blood, thus perpetuating myths of universality even though only certain ‘extractions’ (...) from women are retained for use in transfusion. Many women in the UK receive a plasma-derived product called Anti-D immunoglobulin which is manufactured from pooled male plasma. This article examines ways in which gender has significance for understanding blood relations, and how the blood economy is gendered. In our study of relations between blood donors and recipients, we explore how gendered bodies are produced through the discursive and material practices within blood services. We examine both how donation policies and the manufacturing and use of blood products produces gendered blood relations. (shrink)

The issue of what is proper to nature, or life itself, is central to critical accounts of biomedicine and its complex interrelations with social, political and economic forces. These engagements, namely biopolitical accounts of medical practices and ethical-political critiques of biomedical discourse, grapple with the indistinction between the political and biological that biomedicine enacts. Making a significant contribution to both literatures, Ed Cohen’s A Body Worth Defending argues that the emergence of the concept of biological immunity signals the entry of (...) politics into life itself and, as such, constitutes a concrete example of biopolitics. This article examines Cohen’s account of how the political becomes biological, and the view of life it assumes. Seeking to open up the question of biology, it draws on the work of Georges Canguilhem, and New Materialist accounts of matter–meaning entanglement, to offer a reading of knowledge and life, or politics and biology, as ontologically entangled. (shrink)

The proliferation of for-profit enterprises offering stem cell storage services for personal use illustrates one of the ways health is increasingly governed through uncertainty and speculative notions of risk. Without any firm guarantee of therapeutic utility, commercial stem cell banks offer to store a range of bodily tissues, signalling the further transformation of the living body into an accumulation strategy within biotechnology capitalism’s ‘tissue economies’. This article makes two related claims: first, it suggests that specifically gendered forms of identification with (...) the leading edge of the bioeconomy are embedded in the speculative practices of commercial stem cell banking and are particularly visible in the recent creation of a banking service for endometrial tissue marketed directly to women. Second, the article offers a novel analytic through which to explore the commercial banking of one’s own bodily tissues (or ‘autologous’ banking) through Marx’s discussion of money hoarding. The aim of the article is to thus further the conceptual claims linking emergent forms of economic and biomedical subjectivity to transformations in biotechnology capital. (shrink)

Umbilical cord blood has become the focus of intense efforts to collect, screen and bank haematopoietic stem cells in hundreds of repositories around the world. UCB banking has developed through a broad spectrum of overlapping banking practices, sectors and institutional forms. Superficially at least, these sectors have been widely distinguished in bioethical and policy literature between notions of the ‘public’ and the ‘private’, the commons and the market respectively. Our purpose in this paper is to reflect more critically on these (...) distinctions and to articulate the complex practical and hybrid nature of cord blood as a ‘bio-object’ that straddles binary conceptions of the blood economies. The paper draws upon Roberto Esposito’s reflections on biopolitics and his attempt to transcend the dualistic polarisations of immunity and community, or the private and the public. We suggest that his thoughts on immunitary hospitality resonate with many of the actual features and realpolitik of a necessarily internationalised and globally distributed UCB ‘immunitary regime’. (shrink)

Blood supplies have become indexes of national security and the public good. While blood shortages can provoke anxiety, controversies continue to erupt in many countries over proper donor screening, especially with reference to HIV. This article sketches these dynamics in several global settings, focusing especially on activist efforts by gay men to reform exclusionary blood donor guidelines. The contours of the debate recall familiar conflicts between the putative demands of public health and the rights of individuals in the era of (...) AIDS. However, if gay activists marshal a discourse of individual rights vis-a-vis forms of institutional exclusion, they also seek a broader shift in social and cultural understandings of gay identity. To capture this complex interplay of citizenship and sociality, risk and responsibility, the article introduces the notion of `vital publics' to refer to the peculiar associational form represented by blood supplies. Vital publics are kinds of embodied association elicited through the generalized exchange of body — in this case, blood. Hailed to `give life' by the jargon of the pervasive social marketing of varied blood service systems, activists seek to contribute to the life of the `vital public' that transfusion medicine calls into being. (shrink)

At the time of this writing, a widely publicized, waived-consent trial is underway. Sponsored by Northfield Laboratories, Inc. (Evanston, IL) the trial is intended to evaluate the emergency use of PolyHeme®, an oxygen-carrying resuscitative fluid that might prevent deaths from uncontrolled bleeding. The protocol allows patients in hemorrhagic shock to be randomized between PolyHeme® and saline in the field and, still without consent, randomized between PolyHeme® and blood after arrival at an emergency department. The Federal regulations that govern the waiver (...) of consent restrict its applicability to circumstances where proven, satisfactory treatments are unavailable. Blood—the standard treatment for hemorrhagic shock—is not available in ambulances but is available in hospitals. The authors argue that the in-hospital stage of the study fails to meet ethical and regulatory standards. (shrink)

U.S. Food and Drug Administration policy prohibits blood donation from men who have had sex with men even one time since 1977. Growing moral criticism claims that this policy is discriminatory, a claim rejected by the FDA. An overview of U.S. blood donation, recent donor deferral policy, and the conventional ethical debate introduce the need for a different approach to analyzing discrimination claims. I draw on an institutional understanding of injustice to discern and describe five features of the MSM policy (...) and its FDA context that contribute to its discriminatory effect. I note significant similarities in the 1980s policy of deferring Haitians, suggesting an historical pattern of discrimination in FDA deferral policy. Finally, I point to changes needed to move toward a nondiscriminatory deferral policy. (shrink)