Institutions, such as genetics/biology, naturalize the relationship between subjects (the pathologic) and discourse (health), rendering these bodies of knowledge ahistorical and therefore appearing immune to struggle and transformation. Under biopolitics and bioethics, social control and power function through discourses of health and science, in which the body is ascribed with a truth of self (Roberts 2010). Discourse generates accessible and inaccessible knowledge about certain bodies and practices; one’s engagement in practices is no longer simply what one does but who one is. Individuals take precautions to manage the identities they construct or present through a ceaseless process of self-regulation; they adapt and modulate their behavior by inhabiting or repelling subjectivities that not only regulate but produce power. When situated in the current era of neoliberalism, bodies have become exploited and transformed into profitable markets through discourses of health. Ascriptions of morality are embedded in the bodies and practices of individuals and applied on classed, raced, and gendered lines. Economic and social benefits are awarded through the adoption of discourses, such as the lowering of insurance rates for those who engage in regulatory health practices (Roberts 2010).
This discourse of health, in combination with advancements in technology, has created a “biological citizenship”. Dubious in nature, it places more medical authority in the hands of individuals and facilitates an affinity towards notions of “normality” achieved through genetic engineering (accessible along raced, classed, and gendered lines). “Biotech advocates deploy the priority of good health to deflect the concerns about the power of these technologies to reinforce race, gender, and other social inequities” (Roberts 2010: 68). There is a dogged focus on the promotion of “good health” rather than the social, political and economic conditions that produce it. “Biological citizenship” holds genes to be a primary determinant of one’s health status, disregarding social causes. Through individualization of health conditions, the responsibility for resolution is ultimately placed in the hands of individuals rather than public institutions (evincing neoliberal motivations). Privatization of medical institutions and practices increasingly require capital investment, leaving one to question the extent of the retrenching welfare state. (Roberts 2010).
In their book “Clinical Labor”, Cooper and Walby seek to undermine the dominant conception of participation in clinical, experimental or reproductive research as selfless and voluntary acts, asserting them to be a form of labor obscured under the markets of capitalism (Cooper & Walby 2014). Their Marxist analysis repositions clinical, experimental, and reproductive subjects as laborers who are commodified through the ascription of market-determined value (exchange-value). As individuals assume they are engaging with the use-value of products determined by their material uses and the human needs they fulfill, this is replaced by an exchange value that engenders alienation from the product. Market control is maintained through the accruement of surplus value, accumulating profit as workers are paid less than the use-value of their labor (Cooper & Walby 2014). If we fail to societally recognize clinical, experimental, and reproductive research participants as laborers, neither will the market, and they will continue to be significantly underpaid for their contributions to medicine and science. Research participants risk their health in the name of science and society, often receiving some form of compensation, which raises the critical question of who is in need of compensation and how that affects participant demographics (Cooper & Walby 2014). There is a value judgment imposed on the lives of those of lower socioeconomic status when they are put in the position of opting to jeopardize their health in exchange for monetary compensation.
Race is not a biological concept but rather a weapon of domination, socially constructed to justify the exploitation and subjugation aligned with imperialist and capitalist policies. “There may be no way to ask about the inherent biological differences between groups of human beings without constructing race, and no way to construct race without invoking racism” (Katz Rothman 1998:57). Scientific principles, such as social Darwinism, the eugenics movement, and intelligence testing, were utilized to support racist beliefs in a time when rapidly advancing scientific knowledge was regarded as prestigious, ahistorical, and irrefutable (Katz Rothman 1998). Through the application of weak research methodologies, lacking reliability and consumed with bias, any evidence contradicting societal preconceived racist convictions was manipulated or suppressed.
The eugenics movement played a prominent role as a basis for scientific racism. Developed by Francis Galton (1822-1911),[DB1] eugenics is a theory of innate character qualities including the conviction that nature, not nurture, determines hereditary ability. This ideology completely disregards the influence of an individual’s environment, and declares poverty, criminality, and laziness to be heritable traits associated with certain racial groups. This theory led to the belief that the human race could be improved through selective breeding, providing an even stronger foundation for acts of racial domination and belief in the intrinsic inferiority or superiority of certain racial groups (Katz Rothman 1998).
Through application of a loosely based interpretation of Charles Darwin’s theory of natural selection to imperialist societies, Herbert Spencer coined the term “social Darwinism” asserting racial conflict to be a “natural” means of evolutionary progress. Natural selection has been used to promote and validate the superiority of white individuals, classifying their success as an inevitable demonstration of natural selection in action, rather than a result of their subjugation of others (Katz Rothman 1998). The theory of evolution states that there are inherent limitations on species improvement and that each species eventually encounters a predetermined point beyond which it is unable to progress. This concept was applied in Social Darwinism; systemic prevention of social mobility led to the belief that a group or species’ position in society is fixed or has minimal capacity for improvement.
Health discourses assert an objective notion of human nature and its ideal functioning, rendering those who do not meet the standards set forth to be of inferior personhood. This framework suggests that there are objectively desirable capacities for thinking, acting, and forming relationships. In actuality, these are simply normatively defined qualities and not inherent to humans. This mode of thinking has historically proven problematic, used in medical and scientific discourse as a means to develop a scale of humanness by which individuals can be categorized. Society will not value nor promote the livelihood of people who medicine and science have deemed unworthy. Through analyzing medicine and healthcare as systems of power, we can avoid furthering the eugenics movement and hyperindividualism that cause physical and emotional harm, take lives, delegitimize individuals, and deter the community building necessary for collective action.
References
Cooper, M. and Catherine Walby. 2014. Clinical Labor: Tissue Donors and Research Subjects in
the Global Bioeconomy. Durham, N.C.: Duke University Press.
Katz Rothman, B. 1998. “Mapping the Past: The Macroeugenics of Race.” Pp. 45-107 in
Genetic Maps and Human Imaginations: The Limits of Science and Understanding Who We Are. New York, NY: W.W Norton & Company.
Metzl, J. and Anna Kirkland. 2010. “The Social Immorality of Health in the Gene Age: Race,
Disability, and Inequality.” Pp. 61-71 in Against Health: How Health Became the New Morality, edited by Dorothy Roberts. New York, NY: New York University.
