This paper explores social relations within the 'trial community' (staff and volunteers)
of a Malaria Vaccine Trial (MVT), implemented by the Medical Research Council (MRC)
in The Gambia between 2001 and 2004. It situates ethical concerns with medical research
within the everyday life of scientific fieldwork. Based upon discussions with volunteers
and staff, we explore processes of mediation between scientific project and study
population, and between formal ethics, local ethical debates and everyday practice.
We observe that material contact and substantial transactions, notably of blood and
medicine, are central to the construction of the MVT. These transactions are guided
by a concrete and relational form of ethics, which contrasts with the abstract and
vertical formal ethical principles underwriting the scientific study protocol. The
success of the MVT owed much to these kinship-like ethics. One possible conclusion
from these observations is that research ethics should be understood, not just as
a quasi-legal frame but also as an open, searching movement, much in the same way
that kinship is not merely a juridical institution and a prescriptive frame of rules,
but a network made through relational work. However, this conclusion raises new problems:
by contrasting formal, abstract principles to intimate, immediate relations, and economic
justice to personal morality, we accept that the order of medical research is moved
further out of the public and political, and into the domains of either quasi-legal
claims or of private morality. Irrespective of the undeniable importance of clear-cut
rules and of good face-to-face relations, a third essential foundation of medical
research ethics is the democratically constituted public sphere, including equitable
health services, and transparent institutions to facilitate open debate and regulate
particular interests. Ultimately, the ethics of global science can rely neither on
principles nor trust but requires citizenship and democratic government.