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The biopolitics of life
Perspectives
Book The biopolitics of life
The Politics of Life Itself: Biomedicine, Power, and Subjectivity in the Twenty-First Century Nikolas Rose. Princeton University Press, 2007. Pp 350. US$25·95. ISBN 978-0-691-12191-8.
708
It is hard to doubt that developments in biotechnology in the past decades have profoundly affected our lives, but it is even harder to say exactly what these effects have been. The iconic marker of these changes was perhaps the successful completion of the Human Genome Project. Although there have been expressions of disappointment that this did not immediately usher in an era of new cures for major diseases, and it is only beginning to be widely understood that this was the beginning rather than the end of a scientific project, it is surely an event of great ideological importance. Perhaps paradoxically, at least for those who have appreciated the complexity of life processes that contemporary biotechnology has begun to disclose, the Human Genome Project can also be seen as a demystification of life. Whatever the practical obstacles to understanding the details of life processes, there is nothing ultimately incomprehensible: the inexorable march of molecular biology has finally disposed of the ghosts in machines and élans vitals that might have kept these processes forever beyond the reach of science. This intelligibility implies a possibility of control and suggests unlimited possibilities for intervention in life processes. And this, finally, leads to the most intriguing general thesis of Nikolas Rose’s The Politics of Life Itself, that the medical goal of normalisation has been replaced by a goal of optimisation. In place of a sharp boundary between health and disease, a much more obscure and contestable objective is provided of optimising the quality of a life. Although it can be argued that health and illness were always normative notions, the cases of illness that until recently were reasonable targets of medical intervention were not generally especially controversial. Optimisation,
by contrast, is a clearly normative concept from the start. A major contributor to the move from illness to optimisation is the increasing emphasis on risk, and especially on genetic susceptibility, that itself blurs the distinction between health and illness. As the spectrum from fatal monogenomic diseases
“…the medical goal of normalisation has been replaced by a goal of optimisation” with varying ages of onset, through genetic flaws that provide high probabilities of illness at some point in life, to susceptibility genes that increase relatively low risks of disease is increasingly expanded at the low risk end, the question of what constitutes illness becomes more problematic. The existence of such questions is part of what underlies the epidemic of bioethicists or, as Rose would prefer it, the growing importance of biopolitics. Bioethicists and biopoliticians are not, however, in Rose’s vision primarily involved in directing a passive citizenry paternalistically towards their objective best interests. Rather, these developments must be seen in the context of a certain kind of contemporary western individualism. Within this context, it is the responsibility of the “biological citizen” to create a life project that incorporates responses to the possibilities that biomedicine offers or is expected soon to offer. Plastic surgery, preimplantation genetic diagnosis, and performanceenhancing drugs, are among the kinds of resources that citizens can increasingly draw on in making their particular life plans. And this perception of a degree of autonomy among the “biological citizens” to whom these emerging technologies are giving rise, is one reason why Rose is generally, although not universally, optimistic
about the changes he describes. On the spectrum between the deep fears of dehumanisation expressed by, for example Jurgen Habermas (The Future of Human Nature) and the enthusiastic embrace of biotechnology by writers such as Nicholas Agar (Liberal Eugenics: In Defence of Human Enhancement), Rose is much closer to the latter end of the spectrum. A somewhat surprising source of Rose’s optimism is the increasing contemporary focus on genetic susceptibilities over simple monogenetic disease. It is true, as Rose emphasises, that this emphasis should contribute to dispelling traditional worries about genetic determinism, reductionism, and so on. Susceptibilities, for Rose, are a central part of the context that generates “the obligation to live one’s life as a project, generating a range of ethical conundrums about the ways one might conduct one’s life, formulate objectives, and plan for the future in relation to genetic risk”. If this is a new phenomenon it is because of the individualisation of these risks. This increasing emphasis on susceptibilities can be seen—rightly, I think—as reflecting a problem for the philosophical argument for genetic determinism, yet the connection is subtle, and it is far from clear that genetic determinism has declined in the general public consciousness. In the end, no doubt only history will tell us whether we are seeing a fundamental change in our conception of what it is to be human. My own hunch is that this has changed continuously throughout human history, and it would be premature to suppose that there was anything exceptional about the changes happening at this particular historical moment.
John Dupré [email protected]
www.thelancet.com Vol 372 August 30, 2008
Book The biopolitics of life
The Politics of Life Itself: Biomedicine, Power, and Subjectivity in the Twenty-First Century Nikolas Rose. Princeton University Press, 2007. Pp 350. US$25·95. ISBN 978-0-691-12191-8.
708
It is hard to doubt that developments in biotechnology in the past decades have profoundly affected our lives, but it is even harder to say exactly what these effects have been. The iconic marker of these changes was perhaps the successful completion of the Human Genome Project. Although there have been expressions of disappointment that this did not immediately usher in an era of new cures for major diseases, and it is only beginning to be widely understood that this was the beginning rather than the end of a scientific project, it is surely an event of great ideological importance. Perhaps paradoxically, at least for those who have appreciated the complexity of life processes that contemporary biotechnology has begun to disclose, the Human Genome Project can also be seen as a demystification of life. Whatever the practical obstacles to understanding the details of life processes, there is nothing ultimately incomprehensible: the inexorable march of molecular biology has finally disposed of the ghosts in machines and élans vitals that might have kept these processes forever beyond the reach of science. This intelligibility implies a possibility of control and suggests unlimited possibilities for intervention in life processes. And this, finally, leads to the most intriguing general thesis of Nikolas Rose’s The Politics of Life Itself, that the medical goal of normalisation has been replaced by a goal of optimisation. In place of a sharp boundary between health and disease, a much more obscure and contestable objective is provided of optimising the quality of a life. Although it can be argued that health and illness were always normative notions, the cases of illness that until recently were reasonable targets of medical intervention were not generally especially controversial. Optimisation,
by contrast, is a clearly normative concept from the start. A major contributor to the move from illness to optimisation is the increasing emphasis on risk, and especially on genetic susceptibility, that itself blurs the distinction between health and illness. As the spectrum from fatal monogenomic diseases
“…the medical goal of normalisation has been replaced by a goal of optimisation” with varying ages of onset, through genetic flaws that provide high probabilities of illness at some point in life, to susceptibility genes that increase relatively low risks of disease is increasingly expanded at the low risk end, the question of what constitutes illness becomes more problematic. The existence of such questions is part of what underlies the epidemic of bioethicists or, as Rose would prefer it, the growing importance of biopolitics. Bioethicists and biopoliticians are not, however, in Rose’s vision primarily involved in directing a passive citizenry paternalistically towards their objective best interests. Rather, these developments must be seen in the context of a certain kind of contemporary western individualism. Within this context, it is the responsibility of the “biological citizen” to create a life project that incorporates responses to the possibilities that biomedicine offers or is expected soon to offer. Plastic surgery, preimplantation genetic diagnosis, and performanceenhancing drugs, are among the kinds of resources that citizens can increasingly draw on in making their particular life plans. And this perception of a degree of autonomy among the “biological citizens” to whom these emerging technologies are giving rise, is one reason why Rose is generally, although not universally, optimistic
about the changes he describes. On the spectrum between the deep fears of dehumanisation expressed by, for example Jurgen Habermas (The Future of Human Nature) and the enthusiastic embrace of biotechnology by writers such as Nicholas Agar (Liberal Eugenics: In Defence of Human Enhancement), Rose is much closer to the latter end of the spectrum. A somewhat surprising source of Rose’s optimism is the increasing contemporary focus on genetic susceptibilities over simple monogenetic disease. It is true, as Rose emphasises, that this emphasis should contribute to dispelling traditional worries about genetic determinism, reductionism, and so on. Susceptibilities, for Rose, are a central part of the context that generates “the obligation to live one’s life as a project, generating a range of ethical conundrums about the ways one might conduct one’s life, formulate objectives, and plan for the future in relation to genetic risk”. If this is a new phenomenon it is because of the individualisation of these risks. This increasing emphasis on susceptibilities can be seen—rightly, I think—as reflecting a problem for the philosophical argument for genetic determinism, yet the connection is subtle, and it is far from clear that genetic determinism has declined in the general public consciousness. In the end, no doubt only history will tell us whether we are seeing a fundamental change in our conception of what it is to be human. My own hunch is that this has changed continuously throughout human history, and it would be premature to suppose that there was anything exceptional about the changes happening at this particular historical moment.
John Dupré [email protected]
www.thelancet.com Vol 372 August 30, 2008