The patient‐worker: A model for human research subjects and gestational surrogates

• Published in: Developing world bioethics Vol. 18; no. 4; pp. 310 - 320
• Main Authors: Ryman, Emma, Fulfer, Katy
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.12.2018
• Subjects: Beneficiaries; commercial surrogacy; Feminism; fiduciary relationships; Globalization; Health care; Health services; Human subjects; Innovations; Medical innovations; Medical personnel; Medical research; medical research ethics; Moral dilemmas; Patients; Research ethics; Research subjects; Workers; Workers' rights; commercial surrogacy; medical research ethics; fiduciary relationships
• ISSN: 1471-8731; 1471-8847; 1471-8847
• DOI: 10.1111/dewb.12141

We propose the ‘patient‐worker’ as a theoretical construct that responds to moral problems that arise with the globalization of healthcare and medical research. The patient‐worker model recognizes that some participants in global medical industries are workers and are owed worker's rights. Further, these participants are patient‐like insofar as they are beneficiaries of fiduciary relationships with healthcare professionals. We apply the patient‐worker model to human subjects research and commercial gestational surrogacy. In human subjects research, subjects are usually characterized as either patients or as workers. Through questioning this dichotomy, we argue that some subject populations fit into both categories. With respect to commercial surrogacy, we enrich feminist discussions of embodied labor by describing how surrogates are beneficiaries of fiduciary obligations. They are not just workers, but patient‐workers. Through these applications, the patient‐worker model offers a helpful normative framework for exploring what globalized medical industries owe to the individuals who bear the bodily burdens of medical innovation.