Final Chapter 9 explains why ‘free’ market competition under regulatory capitalism underlies widespread unrecognized regulatory violence and argues that the cultivation of competitive desire (cf. Girard 2000) succeeds at the expense of what have become ‘sacrificeable’ patients. After a discussion of suggestions of altering the social contract between science and publics, and the observation of the prevalence of competitive desire in the context of political debate in the UK, I explain how, instead of regulatory capitalism based on competitive desire, a vision of caring solidarity applying the generative principle of creative desire (Adams 2000) would be more conducive to policies aimed at medical and public-health targets. I argue that guidelines rooted in ‘caring solidarity’ can largely prevent the violence of regulatory competition that has become endemic to regulatory capitalism. By avoiding high-risk strategies that are oriented on one-size-fit-all solutions expected to generate high-profit margins, the proposed vision of caring solidarity is more conducive to sustainable health. The rudiments of such a model, I suggest, would use the generative principle of creative desire, building on local notions of wisdom incorporating virtue ethics of prudence and justice.

Chapter 8 asks how various forms of regulatory brokerage (informal; with state-support; deregulation; international; and, global) are interrelated, and how they have emerged across time in the field of regenerative medicine. A distinction between opportunistic (profiting from discrepancies between jurisdictions to forge collaborations) and active forms of regulatory brokerage (involving activities directed at the creation of regulations) helps to show how awareness of regulation as capital has spread. Extending from individual science-entrepreneurs to larger organisations, including universities, companies, state institutions and international organisations, regulatory brokerage has become part of the entrepreneurial culture of science management. To remain competitive, countries strategically follow the regulatory reforms of competitors, culminating in a cascade of regulatory adjustments and accompanied by the proliferation of regulatory violence. National discussions on regulatory trends in regenerative medicine, suggest that, though differently expressed, competitive desire tends to be an important driver of regulatory reform. But, at the same time, in some countries trends emerge that do not centre on competitive desire but on solidarity and concern for care.

Introductory and regulatory capitalism, and it outlines the methodology and the chapters. On the basis of a discussion of the notion of ‘regulatory violence’ in the context of various relevant legal, political, philosophical and criminological literatures on regulation and violence, I propose to define regulatory violence as the forseeable and possibly preventable violence that obtains when regulation is created and applied for reasons that are illegitimate. In the field of regenerative medicine, this means that when research regulation is developed for reasons other than patient safety and scientific development, it is likely to cause foreseeable harm to patients, the development of science and the public at large. Although in a world dominated by regulatory capitalism, regulatory competition is a main driver of regulatory adjustments, regulatory violence is not unavoidable: some countries manage to change regulation by prioritising patient needs and high-quality science. The Chapter also discusses the challenges involved in regulating the safety and scientific quality of clinical research and the marketing of new regenerative therapies and the main arguments for moving from ‘competitive desire’ to ‘caring solidarity’.