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Journal of Health Politics, Policy and Law 2003 28(2-3):473-508; DOI:10.1215/03616878-28-2-3-473
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Duke University Press

Part 3—New Sources of Change?

No Exit and the Organization of Voice in Biotechnology and Pharmaceuticals

Donald W. Light
University of Medicine and Dentistry of New Jersey

Ramón Castellblanch
San Francisco State University

Pablo Arredondo
Stanford University Law School

Deborah Socolar
Boston University School of Public Health

Abstract.

Although leadership is typically seen as coming from the leaders of governments and major institutions, a strong case can be made that concerned citizens first articulate important issues and policies that official leaders then pick up and promote. In a market-based society dominated by large corporations, Hirschman's framework of exit, voice, and loyalty can be used to relate consumer and grassroots movements to markets, when participants believe there is no exit and loyalty (or acquiescence) is not an option. While "voice" is usually applied to the individual or consumer level, this article develops the concept of organized voice and illustrates how it has exhibited leadership in the controversial relations between the biotech and pharmaceutical industries and society as a whole. The essay concludes by urging more research on organized voice as a source of leadership and by outlining some important dimensions for researchers to consider.




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