Monoclonal antibodies are revolutionizing cancer treatments, but come at an increasingly problematic price for health services worldwide. This leads to pressing demands for access, as in the case of Kadcyla. In 2015, patients in the United Kingdom invoked the sovereign rights of the Crown in order to demand access to this expensive yet potentially life-saving medicine that had prior been de-listed due to price. This article interprets this campaign as an act of sovereign reassertion against a fundamental exclusion, which, however, ultimately fails to challenge the concrete mechanism enabling this exclusion—intellectual property (IP). By connecting this example to other declarations of molecular sovereignty, the article argues that the use of sovereignty can perpetuate further exclusion. Drawing on the notion of biocoloniality (Schwartz-Marín and Restrepo 2013) it points out that the intellectual property regime contains a deeply embedded fiction of the world as terra nullius, a blank uninhabited canvas ripe for discovery and appropriation. This decontextualised vision of life as property works to exclude populations and patients from playing a significant role in determining the use of technologies and treatments. Instead of countering this fundamental exclusion, the concept of sovereignty further entrenches this assumption and merely contests the assignation of this property.

单克隆抗体正在彻底改变癌症治疗，但对全球卫生服务而言，其代价越来越大。这导致了对访问的迫切需求，例如Kadcyla。2015 年，英国的患者援引王室的主权，要求获得这种昂贵但可能挽救生命的药物，该药物之前因价格原因被除名。本文将这场运动解释为对基本排斥的主权重申行为，然而，它最终未能挑战实现这种排斥的具体机制——知识产权（IP）。通过将这个例子与其他分子主权声明联系起来，文章认为主权的使用可以使进一步的排斥永久化。借鉴生物殖民性的概念（ Schwartz-Marín 和 Restrepo 2013），它指出知识产权制度包含一个根深蒂固的虚构世界，即无主地，一块空白的无人居住的画布，已经成熟，可以发现和挪用了。这种将生命视为财产的去语境化愿景旨在排除人群和患者在确定技术和治疗的使用方面发挥重要作用。主权概念并没有反对这种基本的排斥，而是进一步巩固了这一假设，只是对这一财产的分配提出了质疑。