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anarchist_critic wrote

Anarchism means being against all hierarchy, or at least all formal hierarchy. Being against "unjust hierarchy" is liberalism.

The answer to the question would look quite different depending if the future anarchist society consists of ancoms, primmies, egoists, or some other variety. Ancoms are quite happy to use general assemblies with mass votes, or even democratic systems with delegates provided the delegates are elected and recallable (and probably mandated by the voters as to how to vote). Primmies are opposed on principle to large-scale projects, as division of labour and technological complexity are believed to lead to hierarchy. Egoists believe it is possible to create a "union of egoists" for a common purpose, only if the autonomy of each actor within the project is respected.

This text: https://theanarchistlibrary.org/library/george-barrett-objections-to-anarchism written in 1921 doesn't directly discuss large-scale projects, but includes a lot of consideration of matters like roads, bridges and sewage systems. Answers 5, 12, 13, 15, and 23 all relate indirectly to the quesion

Ursula LeGuin's novel The Dispossessed involves a more-or-less ancom society with a regulated industrial economy. To avoid hierarchy, regulative functions are performed randomly by computer algorithm.

Generally a large-scale project can be broken down into smaller-scale projects assigned to subgroups which function like affinity groups. Each group would focus on its own small area without hierarchy.

I'm not sure why you mention medical research, as most medical research is carried out by small research teams or individuals. Are you thinking of clinical trials? In this case, an anarchist society would just need volunteers. For groups other than primmies, there's nothing objectionable about a researcher or research team putting out a call for 15,000 volunteers who give consent to take part in a predesigned study. The researcher has authoritative status but they don't have command authority as the participants give informed consent. Also in the news today: https://anarchistnews.org/content/meet-anarchists-making-their-own-medicine

By the way, there's a lot of examples of large-scale processes which are organised as emergent or swarm systems, without leadership or hierarchy.

The anti-capitalist protests of 1999-2001 mobilised hundreds of thousands of people without formal leadership or command power.

The Tupi-Guarani people (who were not entirely anarchist as they had gender hierarchies, but they did not have any central power structure) were able to put out armies of tens of thousands against the Spanish conquistadors.

The Open Source/Free Software movement has managed collaborative projects involving significant numbers of researchers without formal hierarchy.

These are just a few examples. There's more in Colin Ward's "Anarchy in Action", Barclay's "Societies without the State" and Gelderloos's "Anarchy Works!"