A history of colonization inflicts psychological, physical, and structural disadvantages that endure across generations. For an increasing number of Indigenous Australians, environmental epigenetics offers an important explanatory framework that links the social past with the biological present, providing a culturally relevant way of understanding the various intergenerational effects of historical trauma. In this paper, we critically examine the strategic uptake of environmental epigenetics by Indigenous researchers and policy advocates. We focus on the relationship between epigenetic processes and Indigenous views of (...) Country and health—views that locate health not in individual bodies but within relational contexts of Indigenous ontologies that embody interconnected environments of kin/animals/matter/bodies across time and space. This drawing together of Indigenous experience and epigenetic knowledge has strengthened calls for action including state-supported calls for financial reparations. We examine the consequences of this reimagining of disease responsibility in the context of “strategic biological essentialism,” a distinct form of biopolitics that, in this case, incorporates environmental determinism. We conclude that the shaping of the right to protection from biosocial injury is potentially empowering but also has the capacity to conceal forms of governance through claimants’ identification as “damaged,” thus furthering State justification of biopolitical intervention in Indigenous lives. (shrink)

The aim of the article is to intervene in debates about the digital and, in particular, framings that imagine the digital in terms of epochal shifts or as redefining life. Instead, drawing on recent developments in digital methods, we explore the lively, productive and performative qualities of the digital by attending to the specificities of digital devices and how they interact, and sometimes compete, with older devices and their capacity to mobilize and materialize social and other relations. In doing so, (...) our aim is to explore the implications of digital devices and data for reassembling social science methods or what we call the social science apparatuses that assemble digital devices and data to ‘know’ the social and other relations. Building on recent work at CRESC on the social life of methods, we recommend a genealogical approach that is alive to the ways in which digital devices are simultaneously shaped by social worlds, and can in turn become agents that shape those worlds. This calls for attending to the specificities of digital devices themselves, how they are varied and composed of diverse socio-technical arrangements, and are enrolled in the creation of new knowledge spaces, institutions and actors. Rather than exploring what large-scale changes can be revealed and understood through the digital, we argue for explorations of how digital devices themselves are materially implicated in the production and performance of contemporary sociality. To that end we offer the following nine propositions about the implications of digital data and devices and argue that these demand rethinking the theoretical assumptions of social science methods: transactional actors; heterogeneity; visualization; continuous time; whole populations; granularity; expertise; mobile and mobilizing; and non-coherence. (shrink)

Current debates in science and technology studies emphasize that the bio-economy—or, the articulation of capitalism and biotechnology—is built on notions of commodity production, commodification, and materiality, emphasizing that it is possible to derive value from body parts, molecular and cellular tissues, biological processes, and so on. What is missing from these perspectives, however, is consideration of the political-economic actors, knowledges, and practices involved in the creation and management of value. As part of a rethinking of value in the bio-economy, this (...) article analyzes three key political-economic processes: financialization, capitalization, and assetization. In doing so, it argues that value is managed as part of a series of valuation practices, it is not inherent in biological materialities. (shrink)

We live, according to some, in the century of biology, where we now understand ourselves in radically new ways as the insights of genomics and neuroscience have opened up the workings of our bodies and our minds to new kinds of knowledge and intervention. Is a new figure of the human, and of the social, taking shape in the 21st century? With what consequences for the politics of life today? And with what implications, if any, for the social, cultural and (...) human sciences? These are the issues that are discussed in this article, which argues that a new relation is requred with the life sciences, beyond commentary and critique, if the social and human sciences are to revitalize themselves for the 21st century. (shrink)

In the policy discourses of the Organization for Economic Cooperation and Development and European Commission, modern biotechnology and the life sciences are represented as an emerging “bioeconomy” in which the latent value underpinning biological materials and products offers the opportunity for sustainable economic growth. This articulation of modern biotechnology and economic development is an emerging scholarly field producing numerous “bio-concepts.” Over the last decade or so, there have been a number of attempts to theorize this relationship between biotechnologies and their (...) capitalization. This article highlights some of the underlying ambiguities in these conceptualizations, especially in the fetishization of everything “bio.” We offer an alternative view of the bioeconomy by rethinking the theoretical importance of several key economic and financial processes. (shrink)

During the past few years considerable debate has arisen within academic journals with respect to the use of smart drugs or cognitive enhancement pharmaceuticals. The following paper seeks to examine the foundations of this cognitive enhancement debate using the example of methylphenidate use among college students. The argument taken is that much of the enhancement debate rests upon inflated assumptions about the ability of such drugs to enhance and over-estimations of either the size of the current market for such drugs (...) or the rise in popularity as drugs for enhancing cognitive abilities. This article provides an overview of the empirical evidence that methylphenidate has the ability to significantly improve cognitive abilities in healthy individuals, and examines whether the presumed uptake of the drug is either as socially significant as implied or growing to the extent that it requires urgent regulatory attention. In addition, it reviews the evidence of side-effects for the use of methylphenidate which may be an influential factor in whether an individual decides to use such drugs. The primary conclusions are that neither drug efficacy, nor the benefit-to-risk balance, nor indicators of current or growing demand provide sufficient evidence that methylphenidate is a suitable example of a cognitive enhancer with mass appeal. In light of these empirically based conclusions, the article discusses why methylphenidate might have become seen as a smart drug or cognitive enhancer. (shrink)

Although it is usually assumed that in Michel Foucault’s work biopolitics is a politics which has life for its object, a closer analysis of the courses he gave at the Collège de France on this topic, as well as of the other seminars and papers of this period, shows that he took a quite different direction, restricting it to the regulation of population. The aim of this article is to return to the origins of the concept and to confront the (...) issue of life as such. This implies four shifts with respect to Foucault’s theory: Politics is not only about the rules of the game of governing, but also about its stakes. More than the power over life, contemporary societies are characterized by the legitimacy they attach to life. Rather than a normalizing process, the intervention in lives is a production of inequalities. The politics of life, then, is not only a question of governmentality and technologies, but also of meaning and values. The discussion is grounded on a series of empirical investigations conducted in France and South Africa on how life and lives are treated in our world. (shrink)

We bring together recent discussions on data capitalism and biocapitalization by studying value flows in consumer genomics firms—an industry at the intersection between health care and technology realms. Consumer genomics companies market genomic testing services to consumers as a source of fun, altruism, belonging and knowledge. But by maintaining a multisided or platform business model, these firms also engage in digital capitalism, creating financial profit from data brokerage. This is a precarious balance to strike: If these companies’ business models consist (...) of assetizing the pool of genomic data that they assemble, then part of their work has to revolve around obscuring to consumers any uncertainties that would potentially impinge on these processes of assemblage. We reflect on the nature of these practices and the market relationships that enable them, and we relate this reflection to debates around alternative market arrangements that would potentially mitigate the extractive tendencies of these and other digital health firms. (shrink)

This article explores Foucault’s two different notions of power: one where the subject is constituted by power–knowledge relations and another that emphasizes how power is a central feature of human action. By drawing out these two conceptualizations of power, Foucault’s work contributes three critical points to the formation of medicalized subjectivities: the issue of medicalization needs to be discussed both in terms of both specific practices and holistically ; we need to think how we as human beings are “disciplined” and (...) “subjectivated” through medicalization, as discourses, practices, and institutions are all crystallizations of power relations; and we need to reflect on how we can “resist” this process of subjectification, since “power comes from below” and patients shape themselves through “technologies of the self.” Ultimately, Foucault’s work does not merely assist us in refining our analysis; rather, it is essential for conceptualizing medicalization in contemporary society. (shrink)

Social theory is developing in response to the coronavirus (COVID) crisis. Fundamental questions about social justice in the relationship of individuals to society are raised by Delanty in his review of political philosophy, including Agamben, Foucault and Žižek. However, the focus on the libertarian critique of authoritarianism is not enough. The social democratic critique of neoliberalism lies at the centre of the contesting responses to the COVID crisis. A social democratic perspective on public health, democracy and state action is contrasted (...) with the anti-statists of left and right. This is addressed in debates on the relationship between science and governance, the place of crisis in theories of change and the conceptualisation of alternative forms of social formation. The crisis initiated by the pandemic, cascading through society, from health to economy, to polity and into violence, includes a contestation between social democratic and neoliberal visions of alternative forms of society. (shrink)

As befits an emerging field of enquiry, there is on-going discussion about the scope, role and future of the medical humanities. One relatively recent contribution to this debate proposes a differentiation of the field into two distinct terrains, ‘medical humanities’ and ‘health humanities,’ and calls for a supersession of the former by the latter. In this paper, we revisit the conceptual underpinnings for a distinction between ‘the medical’ and ‘health’ by looking at the history of an analogous debate between ‘medical (...) geography’ and ‘the geographies of health’ that has, over the last few years, witnessed a re-blurring of the distinction. Highlighting the value of this debate within the social sciences for the future development of the medical humanities, we call for scholars to take seriously the challenges of critical and cultural theory, community-based arts and health, and the counter-cultural creative practices and strategies of activist movements in order to meet the new research challenges and fulfill the radical potential of a critical medical humanities. (shrink)

This article revises Foucault's account of biopolitics in the light of the impact of the molecular and digital revolutions on `the politics of life itself'. The confluence of the molecular and digital revolutions informationalizes life, providing an account of what it is to be a living thing in terms of complex adaptive and continuously emergent, informationally constituted, systems. Also revisiting Foucault's The Order of Things and its interrogation of the modern analytics of finitude, the article argues that our contemporary politics (...) of life is therefore distinguished by the quasi-transcendentals that now distinguish informationalized life: circulation, connectivity and complexity. Here, too, the article argues, the figure of Man, which once united the quasi-transcendentals of life, labour and language, is replaced by the contingency that now unites circulation, connectivity and complexity. Observing that a life of continuous emergence is also one in which production is continuously allied with destruction, such a life is lived as the continuous emergency of its own emergence. This account of contemporary biopolitics, together with its emergency of emergence, contrasts, in particular, with that offered by Agamben in his appropriation of Schmitt. (shrink)

This paper explores a novel philosophy of ethical care in the face of burgeoning biomedical technologies. I respond to a serious challenge facing traditional bioethics with its roots in analytic philosophy. The hallmarks of these traditional approaches are reason and autonomy, founded on a belief in the liberal humanist subject. In recent years, however, there have been mounting challenges to this view of human subjectivity, emerging from poststructuralist critiques, such as Michel Foucault's, but increasingly also as a result of advances (...) in biotechnology itself. In the face of these developments, I argue that the theoretical relevance and practical application of mainstream bioethics is increasingly under strain. Traditionalists will undoubtedly resist. Together, professional philosopher-bioethicists, public health policymakers, and the global commercial healthcare industry tend to respond conservatively by shoring up the liberal humanist subject as the foundation for medical ethics and consumer decision-making, appealing to the familiar tropes of reason, autonomy, and freedom. (shrink)

It is useful on the occasion of the 21st anniversary of the ‘Cyborg Manifesto’ not only to reconsider its lessons in the context of what is frequently described as the re-engineering of ‘life itself’, but to look at Haraway’s earlier work on embryos. In this article I begin with Haraway’s analysis of embryology in the 1970s to suggest her cyborg embryo was already there, and has, if anything, gained relevance in today’s embryo-strewn society. I argue further, as the title suggests, (...) that the cyborg embryo has been crucial in defining our path to what I am calling here, building on Haraway’s notion of trans from Modest_Witness, ‘transbiology’ - broadly meaning stem cell research, cloning, tissue engineering and regenerative medicine. To illustrate this argument I draw on recent ethnographic fieldwork in a new stem cell derivation facility in the UK built adjacent to an IVF surgery. Using this example, I explore the important and paradoxical role of IVF in the emergence of stem cell science, cloning and transbiology, suggesting that Haraway’s analysis remains crucial to understanding the ironic and contradictory, and unexpectedly generative, circumstances through which the IVF-stem cell interface - the door to transbiology - came into being. (shrink)

Foucault’s argument that a major break occurred in the nature of power in the European Eighteenth century—an unprecedented socialization of medicine and concern for the health of bodies and populations, the birth of biopolitics—has become since the 1990s a dominant narrative among sociologists but is rarely if ever scrutinized in its premises. This article problematizes Foucault’s periodization about the politics of health and the way its story has been solidified into an uncritical account. Building on novel historiographic work, it challenges (...) the modernist bias of histories of biopolitics and public health and considers an earlier and more plural history of collective practices of health of which the story told by Foucault is just one important episode. Finally, it discusses the implications of this revised model for wider sociological debates on the link between modernity, health and the body. (shrink)

This article looks at the strong links between Deleuze's molecular ontology and the fields of complexity and emergence, and argues that Deleuze's work implies a ‘philosophy of technology’ that is both open and dynamic. Following Simondon and von Uexküll, Deleuze suggests that technical objects are ontologically unstable, and are produced by processes of individuation and self-organization in complex relations with their environment. For Deleuze design is not imposed from without, but emerges from within matter. The fundamental departure for Deleuze, on (...) the basis of such an ontology, is to conceive of modes of relating to the evolution of technology. In this way Deleuze, along with Guattari, provides the basis for an ethics and a politics of becoming and emergent control that constitutes an alternative to the hubris of contemporary reductionist accounts of new areas such as nanotechnology. (shrink)

It is argued that the social significance of nanotechnologies should be understood in terms of the politics and ethics of uncertainty. This means that the uncertainties surrounding the present and future development of nanotechnologies should not be interpreted, first and foremost, in terms of concepts of risk. It is argued that risk, as a way of managing uncertain futures, has a particular historical genealogy, and as such implies a specific politics and ethics. It is proposed, instead, that the concepts of (...) contingency and of finitude must be central to any understanding of the ethical significance of nanotechnologies, as these concepts can be used to understand the basis of recent work in science and technology studies, and the sociology of knowledge more widely, which details the multi-dimensional social nature of technological uncertainty. (shrink)

Discussions of the framework and terminology associated with the right to health tend to treat the indeterminacy of ‘health’ as conceptual noise that the construction of effective policy must not focus on, but find ways of bracketing out. On this basis, the right to health is broadly regarded as a social and economic, rather than a civil and political right. This article draws critically on literature about the implications of developments in medical biotechnologies, to argue that a positive acknowledgement of (...) the indeterminate character of health should transform, rather than simply hinder, the quality of debate over what is to be understood and expected in connection with a right to health. A focus on indeterminacy allows for the perception and the formulation of health-related demands that may not stem from the scarcity of material resources or technical means, but from the misplaced authority of particular voices in defining what possibilities are to be seriously envisaged. This proposition only becomes politically effective, it is argued, when ‘indeterminacy’ (and the capacity for normativity) is referred to life itself and not merely to social and moral judgements about life. Although more immediately pertinent to the concerns of relatively privileged populations, the focus on indeterminacy provides a key to generating a certain symmetry and complementarity of interest, across the privileged/underprivileged divide, in promoting health as a (human) right. (shrink)

Canguilhem’s contemporary relevance lies in how he critiques the relation between knowledge and life that underlies Kantian rationality. The latter’s Critique of Pure Reason and Critique of Judgment represent life in the form of an exception: life is simultaneously included and excluded from understanding. Canguilhem’s critique can be grouped into three main strands of argument. First, his reference to concepts as preserved problems breaks with Kant’s idea of concepts regarding the living as a ‘unification of the manifold’. Second, Canguilhem’s vital (...) normativity represents life as the potential to resist normative orders that judge the living, relegating Kant’s ‘lawfulness of the contingent’ to a ‘mediocre regularity’. Third, Canguilhem’s introduction of the environment as a ‘category of contemporary thought’ decentres the living/knowing subject and introduces contingency. His idea of the ‘knowledge of life’ leads to the conclusion that life is the condition of possibility of rationality, rather than rationality’s ‘blind spot’. (shrink)

In the mid-1970s, the biomedical model of medicine gave way to the biopsychosocial model of medicine; it was billed as a more comprehensive and compassionate model of medicine. After more than a century of disentangling medicine from religion, the medicine and spirituality movement is attempting to bring religion and spirituality back into medicine. It is doing so under a biopsychosociospiritual model. I unpack one model for allowing religion back into medicine called the RCOPE. RCOPE is an instrument designed to categorize (...) religion and spirituality as psychological coping mechanisms. I explore how such instruments are related to the history of statistical measurement and demonstrate the political impetus that governs such enterprises. The biopsychosociospiritual medicine is billed as a more holistic and comprehensive model. This new model of medicine offers total care. However, I demonstrate how this total care becomes totalizing, indeed totalitarian, admitting religion and spirituality back into the fold of medicine under a new secularized medical control. (shrink)

This article offers an analysis of marketing as an ideological set of practices that makes cultural interventions designed to infuse social relations with biopolitical injunctions. We examine a contemporary site of heightened attention within marketing: the rise of online communities and the attendant profession of social media marketing managers. We argue that social media marketers disavow a core problem; namely, that the object at stake, the customer community, barely exists. The community therefore functions ideologically. We describe the ideological gymnastics necessary (...) for maintaining momentum behind a practice that barely exists and we ponder why such ideologies are necessary, and what they allow the marketer to do. Working with such concepts as ‘the wild’, ‘communicative capitalism’, and ‘biopolitical marketing’, we explore a genre of popular business literature that proselytizes for online customer communities and we reflect on the broader implications. (shrink)

The making and taking of psychotropic drugs, whether on medical prescription or as self-medication, whether marketed by pharmaceutical companies or clamoured for by an anxious population, has been an integral part of the twentieth century. In this modern era of speed, uncertainty, pleasure and anguish the boundaries between healing and enhancing the mind by chemical means have been redefined. Long before Prozac would become a household name for an ‘emotional aspirin’ did consumers embrace the idea and practice of taking psychotropics (...) not only to treat mental illness but also to make them feel better about living in a modern world. The Freudian promise that each individual can remake him- or herself in the pursuit of health and happiness was helpful in promoting and legitimizing the idea and practice of seeking wellness on prescription. We will argue that the modern consumer-driven political culture of medicine will continue to transverse the boundaries of therapy and enhancement of the mind into the largely unexplored territories of human cognition and behaviour. However exciting, this endeavour will come at the cost of further widening the problem of iatrogenic addiction in the age of happiness pills as ‘botox’ for the mind. (shrink)

An analysis of theological and philosophical understandings of debt and its role in contemporary capitalism. Max Weber’s account of the rise of capitalism focused on his concept of a Protestant ethic, valuing diligence in earning and saving money but restraint in spending it. However, such individual restraint is foreign to contemporary understandings of finance, which treat ever-increasing consumption and debt as natural, almost essential, for maintaining the economic cycle of buying and selling. In The Debt of the Living, Elettra Stimilli (...) returns to this idea of restraint as ascesis, by analyzing theological and philosophical understandings of debt drawn from a range of figures, including Saint Paul, Schmitt and Agamben, Benjamin and Marx, Nietzsche and Freud, and Foucault. Central to this analysis is the logic of “profit for profit’s sake”—an aspect of Weber’s work that Stimilli believes has been given insufficient attention. Following Foucault, she identifies this as the original mechanism of a capitalist dispositif that feeds not on a goal-directed rationality, but on the self-determining character of human agency. Ascesis is fundamental not because it is characterized by renunciation, but because the self-discipline it imposes converts the properly human quality of action without a predetermined goal into a lack, a fault, or a state of guilt: a debt that cannot be settled. Stimilli argues that this lack, which is impossible to fill, should be seen as the basis of the economy of hedonism and consumption that has governed global economies in recent years and as the premise of the current economy of debt. Elettra Stimilli is research fellow of theoretical philosophy at Scuola Normale Superiore in Pisa, Italy. Arianna Bove is the translator of many books, including Factory of Strategy: Thirty-Three Lessons on Lenin, by Antonio Negri. (shrink)

Medical and non-medical experts increasingly argue that individuals, whether they are diagnosed with a specific chronic disease or condition or not (and whether they are judged at minimal risk of these consequences or not), have an obligation to make ‘healthy’ food choices. We argue that this obligation is neither scientifically nor ethically justified at the level of the individual. Our intent in the article is not simply to argue against moralization of the value of prudential uses of food for nutritional (...) health, but to situate nutritional advocacy in the context of Western liberal democracy that values free choice. We have two objectives: (i) to untangle and examine the substance of discourses on ‘healthy’ food choice that simplify nutrition science and place a moral obligation on individuals and (ii) to establish a more comprehensive view of the relationship among food, ethics and health. Although critical of certain features of the liberal political and moral tradition, we argue that John Stuart Mill’s notion of experiments in living provides fertile ground for an improved ethical understanding of individual obligation and of the interconnections among food, health and well-being. (shrink)

This article addresses the relations between ‘nature’ and ‘culture’ (and those characteristics associated with ‘the natural’ and ‘the cultural’) in the context of the debates about Prozac. Following Marilyn Strathern, I focus specifically on the contested issue of enablement - that is, on what Prozac does or does not enable, and on the relation between enablement and enhancement, normality and pathology. I argue that the implications of the model of the brain that accompanies explanations of Prozac are such that commentators (...) are obliged to address not only the nature of normality but also the nature of nature itself. Through a close analysis of these debates, I suggest that critiques of Prozac should be understood not as objections to reductionism - to a biology that closes things down - but rather to one that opens things up: that opens up the relations between nature, culture, biology and the individual, relations that are now cross-cut and thrown about by artificiality. Objections to Prozac, then, might be characterized as an attempt to put these concepts back into their ‘proper’ positions, to re-establish the relationality between them. In conclusion, I argue that the biology put forward by proponents of psychopharmacology, regardless of the desirability of the latter, challenges not only the frequent assumptions that are made about the claims of materialist science, but also some of the terms and concepts that are commonly deployed in the social sciences. (shrink)

In this paper we explore the rise of ‘the breast cancer gene’ as a field of medical, cultural and personal knowledge. We address its significance in the Norwegian public health care system in relation to so-called biological citizenship in this particular national context. One of our main findings is that, despite its claims as a measure for health and disease prevention, gaining access to medical knowledge of BRCA 1/2 breast cancer gene mutations can also produce severe instability in the individuals (...) and families affected. That is, although gene testing provides modern subjects with an opportunity to foresee their biological destiny and thereby become patients in waiting, it undoubtedly also comes with difficult existential dilemmas and choices, with implications that resonate beyond the individual and into different family and love relations. By elaborating on this finding we address the question of whether the empowerment slogan, which continues to be advocated through various health, BRCA and breast cancer discourses, reinforces a naïve or an idealized notion of the actively responsible patient: resourceful enough to seek out medical expertise and gain sufficient knowledge, on which to base informed decisions, thereby reducing the future risk of developing disease. In contrast to this ideal, our Norwegian informants tell a different story, in which there is no apparent heroic mastery of genetic fates, but rather a pragmatic attitude to dealing with a dire situation over which they have little control, despite having complied with medical advice through national guidelines and follow-up procedures for BRCA 1/2 carriers. In conclusion we claim that the sense of safety that gene testing and its associated medical solutions allegedly promise to provide proved illusory. Although BRCA-testing offers the potential for protection from adverse DNA-heritage, administered through possibilities for self-monitoring and self-management of the body, the feeling of ‘being in good health’ has hardly been reinforced by the emergence of gene technology. (shrink)

The emergence of a new tissue economy raises issues for the governance of risk and concepts of the body and self. This article explores the development of autologous cell therapies as a form of tissue engineering and considers how and why autologous applications are seen as less risky and more socially and politically acceptable. In a careful analysis of contemporary debates around the need for new international policies to regulate these technologies, we critically assess the discursive strategies employed to support (...) ideas of the body as a natural entity. Central to these debates are assumptions that autologous applications do not threaten the moral or corporeal integrity of the individual and that they are ‘an ethics-free zone’. Analysis reveals that concepts such as intercorporeality need to be refined if they are to assist our understanding of these cell-based therapies. We consider the biopolitics of Autologous Chondrocyte Implantation (ACI) in order to show the linkages between the culturing of cells, regulation and the reproduction of the self. (shrink)

Bioethics as a distinctive field is undergoing a critical turn. It may be a quiet revolution, but a growing body of scholarship illustrates a perceived need for a rethink of the scope of the field and the approaches and priorities that have carried bioethicists through many heady years of success. Few areas of bioethical practice have been left unexamined, ranging from questions as to the sustainability of the discipline in its current form to the “expertise” of its practitioners; the legitimacy (...) of bioethics in the realms of policymaking; its relationship to philosophy; the purchase of empirical and interdisciplinary method; the relationship of bioethics to the real world; bioethical understandings of the concept of “health” ; its agenda, priorities, and inclusiveness right up to what might be the overarching question: “What is bioethics all about?” Unsurprisingly, these questions elicit varied responses. Scholars from various disciplines have critiqued fundamental tenets of the “ethics” business, albeit as claims of its “conservatism,” “corruption,” and its questionable “usefulness” suggest, not always with a charitable or constructive eye. But quite crucially and often overlooked, bioethics itself has not shied away from the question as to what bioethics is and what it should become; increasingly apparent is that this kind of self-conscious and reflexive theorizing is regarded as a key priority for taking contemporary ethics forward. (shrink)

In this article, we argue that contemporary biomedicine is shaped by two, seemingly incommensurable, organizational logics, the ‘regime of truth’ and the ‘regime of hope’. We articulate their features by drawing on debates sparked by the recent clinical trial of a new approach to the treatment of Parkinson’s Disease. We also argue that the ‘self’ is configured in the very same process whereby these two organizational logics interlock and become mutually dependent, so that the ‘self’ might be said to be (...) the effect of a ‘parasitic’ relationship between the regimes of ‘truth’ and ‘hope’. We then bring these two arguments to bear on the contrasting views of the relationship between embodiment and political subjectivity articulated by Michel Foucault and Giorgio Agamben, on the one hand, and Paul Rabinow and Nikolas Rose, on the other hand. (shrink)

In this paper, we explore how the definition of life takes on an essential character in the ethical debates around health technologies, with life thus being manufactured in the tensions and conflicts around the use of such artefacts and devices. We introduce concepts from science and technology studies (STS) to approach bioethics, overcoming the dualistic conception that separates the natural and the technological and questioning the dominant rationality that divides life into dualities. Drawing on two research projects in which we (...) have been involved in recent years, one regarding biobanks and the other regarding social care robots, we explore how the ethical discussions about biobanks and robots imply particular notions of life. We argue that the contemporary epistemic category of life is a manufactured life in which various rationalities coexist: one rationality based on a separation between the technological and the human, focused on pragmatism and functionalities that tend towards a dualized notion of life divided into qualified and non-qualified life, and another rationality based on a non-essentialist ontology, focused on the mediating role of health technologies, that entails a distributed life appearing as a precarious effect of a network. Each of these rationalities allows the emergence of different issues and ethical concerns, thus enriching the bioethical debate. (shrink)

Despite their common core in statistics, insurance and epidemiology propel two different forms of solidarity. In insurance, the collective is a source of protection, thanks to the pooling of risks; in epidemics by contrast, the group remains the source of danger for the individual. The aim of this paper is to highlight the conceptions of community and solidarity at play in epidemics in contradistinction to insurance, with a focus on the shift introduced by big data and algorithms. Paradoxically, while the (...) new technologies and epidemiology share a common view on the relation between the individual and the collective, tracing apps were not widely adopted in the Covid-19 crisis. This reluctance to use current technologies for the sake of epidemic containments highlights, beyond legitimate interrogations, a confusion between two imaginaries of the social: insurance solidarity where the interdependence is a source of rights, and epidemic solidarity that imposes duties. (shrink)

This article explores the relationship between medicine’s history and its digital present through the lens of the physician-patient relationship. Today the rhetoric surrounding the introduction of new technologies into medicine tends to emphasize that technologies are disturbing relationships, and that the doctor-patient bond reflects a more ‘human’ era of medicine that should be preserved. Using historical studies of pre-modern and modern Western European medicine, this article shows that patient-physician relationships have always been shaped by material cultures. We discuss three activities (...) – recording, examining, and treating – in the light of their historical antecedents, and suggest that the notion of ‘human medicine’ is ever-changing: it consists of social attributions of skills to physicians that played out very differently over the course of history. (shrink)

In 2004, prenatal risk assessment (PRA) was implemented as a routine offer in Denmark, in order to give all pregnant women an informed choice about whether to undergo prenatal testing. PRA is a non-invasive intervention performed in the first trimester of pregnancy and measures the risk of a fetus having Down's syndrome or other chromosomal disorders. The risk figure provides the basis for action, i.e. the decision about whether or not to undergo invasive fetal testing via the maternal route (amniocentesis (...) or chorionic villus sampling), which, however, involves the risk of inducing a miscarriage. On the basis of ethnographic fieldwork in an ultrasound clinic in Denmark and interviews with pregnant women and their partners, this paper investigates how ideals such as autonomy and non-directiveness are practised in processes of decision-making. We view such ideals as forming social practice rather than neutral instruments to reach a certain goal. Focusing on one couple's trajectory through the clinical practices of PRA and the process through which a decision is reached, we call into question the assumption that more choice and more objective information is a source of empowerment and control. We make evident how decisions are made through a complicated process of meaning-making, which emerges through the relationship between professionals, the clinical setting and the social life of the couples. In the face of complex risk knowledge, PRA users are reluctant to make choices and seek to re-install authority in the health professionals. However, when assumptions about autonomy and self-determination are inscribed into the social practice of PRA, authority is transferred to the couple undergoing PRA and a new configuration of responsibility evolves between the couple and their relationship to the fetus. It is argued that PRA performs a form of government that works not through compulsion or persuasion but through choice. An ethic of a shared responsibility for PRA and its outcome between pregnant women and health professionals would be more in agreement with how decisions are actually made. (shrink)

Many scholars have historicized biopolitics with reference to the emergence of sovereign nations and their colonial extensions over the 18th, 19th and 20th centuries. This article begins to conceptualize and trace the history of biopolitics beyond the nation, arguing that the history of world health - the great 20th-century reach of 19th-century health and hygiene - should be understood as a vital politics of population on a newly large field of play. This substantive history of world health and world population (...) is analysed as sites for thinking about global bio-politics; and the article looks seriously at the interwar period as a point at which ‘the world’ (or Hardt and Negri’s ‘Empire’) was already challenging the idea of ‘inter/national’. (shrink)

While human genetic research promises to deliver a range of health benefits to the population, genetic research that takes place in Indigenous communities has proven controversial. Indigenous peoples have raised concerns, including a lack of benefit to their communities, a diversion of attention and resources from non-genetic causes of health disparities and racism in health care, a reinforcement of “victim-blaming” approaches to health inequalities, and possible misuse of blood and tissue samples. Drawing on the international literature, this article reviews the (...) ethical issues relevant to genetic research in Indigenous populations and considers how some of these have been negotiated in a genomic research project currently under way in a remote Aboriginal community. We consider how the different levels of Indigenous research governance operating in Australia impacted on the research project and discuss whether specific guidelines for the conduct of genetic research in Aboriginal and Torres Strait Islander communities are warranted. (shrink)

Angelaki, Volume 17, Issue 2, Page 169-176, June 2012.

Michel Foucault's ethics of embodiment, focusing upon care of the self, has motivated feminist scholars to pursue promising models of embodied resistance to disciplinary normalization. Cressida Heyes, in particular, has advocated that these projects adopt practices of “somaesthetics,” following a program of body consciousness developed by Richard Shusterman. In exploring Shusterman's somaesthetics proposal, I find that it does not account for the subjective challenges of resisting normalization. Based on narrative theories of subjectivity, the role narrative plays in normalization, and a (...) commitment to developing concrete, feminist practices of embodied ethics, I develop a model of “narrative somaesthetics” based on an updated consciousness-raising model that emphasizes group heterogeneity and narrative conflict that deals with these challenges. Through an analysis of interviews with self-identified femme lesbians and a “female to femme” transition support group featured in the documentary film, FtF: Female to Femme, I argue that narrative somaesthetics enables the analytical, genealogical work required to identify and weaken normalization's constraints on embodied feminist ethics. (shrink)

The bioeconomy is becoming increasingly prominent in policy and scholarly literature, but critical examination of the concept is lacking. We argue that the bioeconomy should be understood as a political project, not simply or primarily as a technoscientific or economic one. We use a conceptual framework derived from the work of Karl Polanyi to elucidate the politically performative nature of the bioeconomy through an analysis of an influential Organization for Economic Cooperation and Development initiative, The Bioeconomy to 2030. We argue (...) that this initiative is a response to some of the most acute challenges facing the current neoliberal-capitalist accumulation regime, which seeks to protect and extend that regime, through both what it occludes and what it promotes. Rather than taking the bioeconomy as a description of some subset of economic activity, we regard it as a promissory construct that is meant to induce and facilitate some actions while deterring others; most explicitly, it is meant to bring about a particular set of political–institutional changes that will shape the parameters of possible future action. The bioeconomy concept highlights the potential dangers of failing to situate ethnographic examinations of horizontal micro-relations within a political–economic macro-context that enables and constrains. Scholarly work in science and technology studies and elsewhere that does not recognize the wider politics of the bioeconomy risks unintentionally contributing to the legitimation of this political project. (shrink)

This article is about the recent and profound changes in the conceptualization of dementia, especially the turn towards prevention. The main argument is that more attention needs to be paid to “situated prevention” — the framing of internationally circulating data on the “new dementia” in different contexts. After introducing some of the more problematic issues related to the “new dementia,” a first comparison of major preventive clinical trials in Europe and in North America will be provided. The major insight stemming (...) from situating the global message of preventing dementia is recognition of the responsibility researchers and policy makers bear with respect to the implicit and potential moral narratives in emerging scientific landscapes. (shrink)

This paper examines processes of translation through which molecular genetic technologies and practices are incorporated into environmental health research and regulation. Specifically, it considers how scientists, risk assessors, and regulators have used genetically modified mouse models to translate across scientific disciplines, articulate emergent molecular forms, standards, and practices with the extant? gold standard,? and establish roles for molecular knowledge in risk assessment and regulation. Noting variation both within and between regulatory agencies in responses to data from these models, the article (...) describes also the role of public-private networks and their effects on professional and institutional imperatives which shape regulators? responses to the potential applications of these models. The conclusions address the importance of translation for understanding the wider implications of the molecularization of environmental health science. (shrink)

Based upon flyers and advertisements for the contraceptive pill from 1961 until 2005, this paper discusses the ways in which the drug and its female users were represented in the marketing of two West European countries, France and the German Federal Republic. As my analysis suggests, national differences are only discernible in the marketing until the end of the 1970s. In West Germany, the pill was depicted from early on as a contraceptive, whereas, due to the restrictive legal situation, in (...) France the pill was marketed as a multi-purpose drug. Nevertheless, the sources in both countries emphasized the safety of the drug. Likewise the representations of women changed from the notion of the married mother to a more diverse image, including young, modern and active women. From the early 1980s on, French and German materials conformed to one another. Now more classification systems were developed, emphasizing the differences between types of pills and types of women. Lifestyle, leisure and fun became increasingly central topics. Correspondingly, the female user was often portrayed in a sexualized way and represented as an active consumer with individual needs and wishes. (shrink)

Contributing to both ageing research and queer-feminist scholarship, this article introduces feminist philosopher Margrit Shildrick’s queer notion of the monstrous to the subject of ageing and the issue of dealing with frailty within ageing research. The monstrous, as a norm-critical notion, takes as its point of departure that we are always already monstrous, meaning that the western ideal of well-ordered, independent, unleaky, rational embodied subjects is impossible to achieve. From this starting point the normalizing and optimizing strategies of ageing research (...) – here exemplified through the concept of successful ageing and the treatment of Alzheimer’s disease – can be problematized. The notion of the monstrous instead suggests a view on ageing and ‘monstrous’ embodiment which provides room for other, different ways of being recognized as an embodied subject, and for dealing with difference, vulnerability and frailty. (shrink)

This paper argues that Foucault’s genealogy of racism deserves appreciation due to the highly original concept of racism as biopolitical government. Modern racism, according to Foucault, is not merely an irrational prejudice, a form of socio-political discrimination, or an ideological motive in a political doctrine; rather, it is a form of government that is designed to manage a population. The paper seeks to advance this argument by reconstructing Foucault’s unfinished project of a genealogy of racism. Initially, the paper situates the (...) genealogy of racism within the context of Foucault’s work. It belongs to a period of transition between the mature and the late part of Foucault’s work, more specifically a period of transition from discipline to governmentality. The paper proceeds by reading closely key passages from the 1976 lectures at Collège de France in which Foucault proposes to rethink racism as a form of biopolitical government. While Foucault’s genealogy of racism remains an incomplete project, lacking for example any substantial treatment of European colonialism, the paper proposes to expand the Foucauldian analysis by linking it to the pan-German discourse between 1890 and 1914. Finally, the paper reflects on some of the implications of the Foucauldian analysis, in particular attempts to understand and counter contemporary forms of racism. Foucault’s genealogy of racism, in short, shows us the constructedness of our racialized world and challenges us to develop new and more effective strategies to change it. (shrink)

In a range of digital creative productions and digital culture, questions of how to deal with finitude are on the rise. On the one hand, sectors of the digital entertainment industry – specifically computer games developers – are concerned with the question of how to manage `death' digitally. On the other hand, death and suicide have become the impetus for humorous artistic expression. This article tracks the emergence of a digital ethos that is cognizant of consequence, finitude and even death. (...) Rather than pit a 1990s `will to life' against an emerging `death drive', I argue that the shift to an ethos in which dark consequences ensue from digital actions must be understood by working through digital code's technicity and unfolding this relation of technics to both ethics and politics. Although Bernard Stiegler's analysis of technicity goes some way toward unfolding a political analysis of the aesthetics of digital code, his articulation of noopolitics fails to provide us with a way to conduct ourselves digitally in an era of cognitive capitalism. I look to critical software practices and their provisional networked publics, with potential lines of flight for contemporary technoculture via novel digital `codings'. (shrink)