The human capacity to reflect and decide: Bioethics and the reconfiguration of the research subject in the British biomedical sciences

This article examines how a fundamental element of the British bioethical assemblage – the literature on informed consent published between 1980 and 2000, a period when bioethics became a powerful force in the UK – has influenced contemporary understandings of the research subject. Drawing on Foucault, the article argues that this corpus of texts has created a sphere of possibilities in which research subjects can imagine themselves as human beings who reflect and decide whether they want to participate in medical experimentation. In particular, it shows how the narratives found in these texts portray relationships between researchers and their human subjects as ‘paternalistic’, and calls for their replacement by new, more ethical relationships characterized by both ‘dialogue’ and ‘respect’ and articulated around subjects who can ‘think and take decisions’. It also discusses the different strategies – using patient information sheets, a list of possible questions and invitations to take time to reflect – which the bioethical literature has developed in order to realise these new, ethical relationships. As the article suggests, these narratives and strategies provide researchers and research subjects with models and examples of how to interact with each other that are very different from the ones that prevailed before the emergence of bioethics.