Work, welfare, and the values of voluntarism: Rethinking Anscombe’s “action under a description” in postwar markets for human subjects

Abstract

This paper documents an exchange for healthy human subjects of medical experiments brokered and carried out by a labor union (The United Mine Workers of America) and the federal government (The US National Institutes of Health). The organizations legally established the exchange in a 1960 contract; jobless people took part in the exchange throughout the decade; and the exchange served as a “prototype” for additional exchanges between NIH and organizations in blue-collar communities. The exchange was successful because the organizations negotiated two “dissonant descriptions” of the same action to manage two different audiences – one legal, one vernacular. The case engages three issues in cultural sociology. First, the episode illustrates how philosopher GEM Anscombe’s concept of “action under a description” solves a puzzle embedded in studies of culture-in-action and offers a way to more systematically study symbolic action. Second, it demonstrates precisely how organizations, paradoxically, use the language of voluntarism to accomplish market goals. Third, it illuminates the terms of engagement with new commodities and markets in the age of biocapital and in doing so helps deepen understandings of moral markets.

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Notes

  1. 1.

    Memo from Associate Director of the Clinical Center [Clifton Himmelsbach] to Medical board members. 16 Sept 1960. Administrative files of the Patient Recruitment and Public Liaison Office, National Institutes of Health, Building 61, Bethesda, Maryland. (Hereafter PRPL).

  2. 2.

    The audio and transcripts of interviews, as well as images, documents, and other materials from former “normal controls,” and the materials included in the FOIA release are archived in the Vernacular Archive of Normal Volunteers (VANV) publicly available online through Harvard University’s Countway Library of Medicine. <https://dataverse.harvard.edu/dataverse/vanv>.

  3. 3.

    Meeting minutes. 14 Feb 1956. Folder Meetings 3-1-4, Box 31. RG 511(NIH), NARAII. (Also MedBoard).

  4. 4.

    Meeting minutes. 14 Feb 1956. Folder Meetings 3-1-4, Box 31. RG 511(NIH), NARAII. (Also MedBoard).

  5. 5.

    Himmelsbach to Masur. 15 Aug 1960. Memo “Conversation with Mr. Harold Mayers of United Mine Workers Association on August 9, 1960.” PRPL.

  6. 6.

    Cordon memo. 22 June 1960. PRPL. This memo specifies that the men would be living on the fourth floor and the exam rooms were on the third and second floors. “Two special rooms off the unit—one on 2-West and one in 3 N-250—are frequently used at present, because they are equipped with one-way vision mirror, and adjoining rooms contain non-portable electronic analyzing and recording equipment.” Szára et al (1966) also states the men were telling each other about the effects of the drug being studied since they received the drug one at a time.

  7. 7.

    Himmelsbach to Masur. 15 Aug 1960. Memo “Conversation with Mr. Harold Mayers of United Mine Workers Association on August 9, 1960.” PRPL.

  8. 8.

    Himmelsbach to Masur. 15 Aug 1960. Memo “Conversation with Mr. Harold Mayers of United Mine Workers Association on August 9, 1960.” PRPL.

  9. 9.

    Himmelsbach to Billstone. 22 Aug 1960. “I do hope that some member of the group will see fit to document the history of its development as we go along, and later report it as the ‘Johnstown plan.’ I am sure that with the inevitable growth of clinical research throughout the country, the need for guidance in obtaining normal volunteers is going to be substantial.” PRPL.

  10. 10.

    Meeting minutes. 14 Sept 1960. Folder: Minutes of the medical board April 14 1959 – March 28 1961. Box 1. Accession 0791, Clinical Center Office of Medical Services, 1953–87. National Library of Medicine, Bethesda, Maryland. (Hereafter MedBoard).

  11. 11.

    See also the Peace Collection at Swarthmore College archives.

  12. 12.

    Hardy (Information Officer, CC) to Kliewer (Information Services, MCC). 2 August 1954. Folder: National Institutes of Health, 1954. Series: MCC correspondence, IX-6-3. Mennonite Central Committee Archives, Goshen, Indiana.

  13. 13.

    Memo. 18 Oct 1960 attached to Feb 1965 meeting minutes. Folder: October 13 1964–Jan 25, 1966. Box 1. MedBoard. NIH administrators only systematically required written consent in the 1960s (as opposed to oral or tacit consent), and the audit of 1957 records was retrospective. “A recent review of 52 records of normal control patients discharged from July 1, 1956, to May 11, 1957, disclosed infrequent evidence of such informed consent…As a matter of fact, there is evidence that occasionally normal controls are started on new studies without notification or explanation of any kind.”

  14. 14.

    Recruitment flier, 195[4], US National Institutes of Health. Clinical Center Collection. Office of NIH History, NIH. Bethesda, Maryland.

  15. 15.

    The Medical Board tracked, reported and discussed in meetings news stories on the Clinical Center, e.g., Meeting minutes, 1965 April 27. Folder: October 13 1964–Jan 25, 1966. Box 1. MedBoard.

  16. 16.

    Meeting minutes. 14 Sept 1960 Folder: Minutes of the medical board April 14 1959–March 28 1961. Box 1. MedBoard.

  17. 17.

    Himmelsbach Memo. 9 August 1960. “Subject: Possible Normal Controls From Johnstown, Pennsylvania.” PRPL.

  18. 18.

    Himmelsbach to Berret. 10 Aug 1960 PRPL Himmelsbach offered to visit and to bring Maginnis. Himmelsbach told Berret also that he hoped “it will be possible for you to visit the Clinical Center and become acquainted first-hand with our facilities, personnel, and programs.”

  19. 19.

    US Census data for 1960. Accessed Dec 26, 2014. I thank Erin Kelly for locating these data. Poverty rates in 1960 census:

    • Cambria County, PA: 25.63 percent (51,000/200,000)

    • PA poverty rates in 1960 census: 16.99 percent

    • US poverty rates in 1960 census: 22.10 percent.

  20. 20.

    “Report: Supporting paper for proposed Appalachian regional hospital budget for period July 1 1965 to June 30, 1966.” No date. Folder: Appalachia. Box 1: “Absence from office” through “budget.” Entry: Subject Files, 1965–1969. RG381: Office of Economic Opportunity. National Archives and Research Administration, College Park, MD.

  21. 21.

    Memo “gainful employment of conscientious objector volunteer patients.” 3 Jan 1955. PRPL See also Meeting Minutes. 1 Sept 1956. MedBoard: “Information for Normal Control Patients.—It was reported that a question had been raised as to whether or not the proposed document on the ‘Information for Normal Control Patients’ should include a statement of our policy with regard to conscientious objector volunteer patients accepting gainful employment while patients at the Clinical Center. The Medical Board at its meeting on December 14, 1954 recommended not to allow Normals to work outside of the Clinical Center.”

  22. 22.

    Meeting minutes. 14 Sept 1960. MedBoard.

  23. 23.

    Himmelsbach to Billstone, Dir City-Co Clinic Johnstown. 12 Aug 1960. PRPL.

  24. 24.

    Memo from Himmelsbach. 23 August 1960. “Report of Trip to Johnstown, Pennsylvania by Dr. C. K. Himmelsbach and Mr. W.W. Maginnis.” PRPL.

  25. 25.

    Page 3. Memo from Himmelsbach. 23 August 1960. “Report of Trip to Johnstown, Pennsylvania by Dr. C. K. Himmelsbach and Mr. W.W. Maginnis.” PRPL.

  26. 26.

    Page 3. Memo from Himmelsbach. 23 August 1960 “Report of Trip to Johnstown, Pennsylvania by Dr. C. K. Himmelsbach and Mr. W.W. Maginnis.” PRPL. Allegheny Airlines Flight 302 was scheduled to leave at 12:23 pm and return Flight 106 was scheduled to leave at 7:12 pm.

  27. 27.

    Himmelsbach “Memo for the record” 16 September 1960. PRPL. The memo states that “At the request of Mr. Laurie Billstone, I met with the Board of Trustees of the City-County Clinic, Inc., Johnstown, Pennsylvania for the purpose of describing to them the normal control program and encouraging them to react favorably to the proposal that the City-County Clinic serve as the sponsor for normal volunteers from the Johnstown area.”

  28. 28.

    Memo from Associate Director of the Clinical Center [Himmelsbach] 16 September 1960. “Report of Trip to Johnstown, Pennsylvania, on September 9.” PRPL.

  29. 29.

    Memo from Associate Director of the Clinical Center [Himmelsbach] 16 September 1960. “Report of Trip to Johnstown, Pennsylvania, on September 9.” PRPL.

  30. 30.

    Memo from Associate Director of the Clinical Center [Himmelsbach] 16 September 1960. “Report of Trip to Johnstown, Pennsylvania, on September 9.” PRPL.

  31. 31.

    Arestad to Ghizzoni. November 28, 1960. UMWA District Two collection. Indiana University of Pennsylvania. Special Collections, Indiana, PA.

  32. 32.

    John Ghizzoni to “To the board members (sic) of district 2, United Mine Workers of America.” 1 December 1960. UMWA District Two collection. Indiana University of Pennsylvania. Special Collections, Indiana, PA.

  33. 33.

    Broad evidence of this claim is available in VANV, which includes letters and other documents from the time period with more than 100 former participants in the Normal Volunteer Patient Program and scientists who experimented on them, as well as retrospective oral history interviews I conducted with them. I have been unable to locate any Johnstown miners, but the archive does include materials from other research participants and scientists who knew the Johnstown miners. See specifically the individual collections of Carson Good, Lawrence Rockland, and Steven Szára: <https://dataverse.harvard.edu/dataverse/vanv>.

  34. 34.

    NVPP annual report 1965. PRPL. See also FOIA release materials included in VANV.

  35. 35.

    Meeting minutes. 14 Sept 1960. Folder: Minutes of the medical board April 14 1959–March 28 1961. Box 1. MedBoard.

  36. 36.

    NVPP hand written draft “fiscal year report, July 1, 1964-June 30, 1965.” PRPL. FOIA.

  37. 37.

    NVPP annual report 1965. PRPL. See also FOIA release materials included in VANV: <https://dataverse.harvard.edu/dataverse/vanv>.

  38. 38.

    Scholars have also shown how poverty itself serves as a corporate resource, for example, by developing “the precariat” as consumers of financial instruments like microloans that drive and perpetuate the economic systems that create poverty (Elyachar, 2012; Roy, 2012; Standing, 2011).

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Acknowledgements

I am grateful to my colleague-friends for their feedback on earlier drafts of this article: Dominique Béhague, Angela Creager, Aimi Hamraie, Sarah Igo, Sally Kohlstedt, Ken MacLeish, Terry Maroney, and Alistair Sponsel. Ruha Benjamin, Jill Fisher, and other audience members offered invaluable feedback during the “Science at the margins” session, organized by Logan Williams, at the 2016 annual meeting of American Sociological Association. I benefited enormously from a summer fellowship and feedback on this research from scholars in Division II at the Max Planck Institute for History of Science. The editors of this journal and two anonymous reviewers also gave me generous and apt advice on earlier versions of this article. To complete this research, I received much-needed research support from Vanderbilt University as well as an invaluable research leave AY 2013–14. Laura Farris provided, as always, exceptional research assistance. In the archives, Jim Quigley (Penn State) and Harrison Wick (Indiana University Pennsylvania) gave generously of their time and expertise. At NIH’s Office of Patient Recruitment, Dinora Dominguez and Mandy Jawara provided gracious and important help. Finally, I am grateful to the more than one hundred scientists and former human subjects who donated their own personal “vernacular archives” and oral histories to this research.

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Stark, L. Work, welfare, and the values of voluntarism: Rethinking Anscombe’s “action under a description” in postwar markets for human subjects. Am J Cult Sociol 5, 181–224 (2017). https://doi.org/10.1057/s41290-016-0022-6

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Keywords

  • Anscombe
  • inequality
  • employment
  • welfare
  • War on Poverty
  • volunteer
  • economy
  • UMWA
  • moral markets
  • labor unions
  • NIH
  • human subjects