The connection between health and productivity manifests in biopolitical control over subjectivity and neoliberal ethos of utility

[Nikolas, “The Politics of Life Itself,” Theory, Culture, and Society, Vol. 18, No. 6, December 1, 2001, Pg. 20-22]

Biological identity practices do not, as some critics have suggested, lead to passivity in the face of biological fate. Quite the reverse. In advanced liberal democracies, biological identity becomes bound up with more general norms of enterprising, self-actualizing, responsible personhood (Novas and Rose, 2000). As knowledges and beliefs about one's biological and genetic complement become integrated into the complex choices that prudent individuals are obliged to make in their life strategies, biological identity generates biological responsibility (see Rapp, 1999 for a superb study of the enactment of such responsibility in amniocentesis). While many critics see the new biomedicine as individualizing, we can already see new forms of collectivization emerging. Choices about marriage, procreation, financial planning, inheritance, career and much more are made in a web of entanglements involving actual and potential kin, employers, partners and children. And 'at risk' individuals are joining into groups and organizations, not merely demanding public provision and rights, but making their own claims on the deployment of biomedical technologies and the direction of biomedical research — as, for example, in the case of families of those with muscular dystrophy, Huntington's disease or breast cancer (cf. Rabeharisoa and Callon, 1998). Paul Rabinow (1996b) has termed this 'biosociality'. Individuals who identify themselves and their community through their biology challenge the vectors that lead from biological imperfection or abnormality to stigmatization and exclusion. They use their individual and collective lives, the evidence of their own existence and their vital humanity, as antagonistic forces to any attempt to re-assemble strategies of negative eugenics within a new exclusionary biopolitics. They demand civil and human rights for those whose lives, previously, were deemed less worthy of life. They call for recognition, respect, resources, research, control over medical and technical expertise. As somatic individuals engage with vital politics, a new ethics of life itself is taking shape. Within this new ethics, the human vital order has become so thoroughly imbued with artifice that even the natural has to be produced by a labour on the self - natural food, natural childbirth and the like. Even choosing not to intervene in living processes becomes a kind of intervention. This requires us to question the distinction, proposed most clearly by Georges Canguilhem, between vital norms and social norms. Canguilhem (1978) argued that vital norms arose from and manifested the normativity of life itself, of the organism as a living being, of its adaptability to its environment. Social norms, on the other hand, manifested only adaptation to a particular artificial order of society and its requirements for normativity, docility, productivity, harmony and the like. Some suggest that the new politics of life has once more mistaken social norms for vital ones, for example that the molecular politics of psychiatry, with its claims to be able to manipulate and transform personality and emotion, has incorporated the social into the vital, and has taken key features of vitality itself - for example sadness - as errors open to correction in the name of a social, not a vital, norm of health. But, at least as far as human life is concerned, the social and the vital have never been so distinct. Our very ideas of what it is to be a normal human being have been made possible by historically specific institutional and technical developments, not least by biopolitics itself. Thus, new norms of human capacities and longevity were born in the sanitization and hygienization of urban existence in the 19th century; new norms of recovery and cure were born in the clinical hospitals; new ways of posing the relations between fate, life and health were born in the development of epidemiological knowledges of the distributions of disease and their social correlations. Our contemporary vital norms are no less, but no more, shaped by their conditions of formation than those of previous generations. On the one hand, our very personhood is increasingly being defined by others, and by ourselves, in terms of our contemporary understandings of the possibilities and limits of our corporeality. On the other hand, our somatic individuality has become opened up to choice, prudence and responsibility, to experimentation, to contestation - and so to a 'vital polities'. Michel Foucault pointed out long ago that, from at least the time of the birth of clinical medicine, 'medical thought [has been] fully engaged in the philosophical status of [wo]man' (Foucault, 1972: 198). Medical thought has also been fully engaged in the ethical question of how we should live — of what kinds of creatures we are, of the kinds of obligations that we have to ourselves and to others, of the techniques which we can and should use to improve ourselves, and the kinds of persons we should strive to be. I do not think that, today, the most far-reaching ethical innovations concerning our relations to ourselves are being made in the deliberations of the bioethicists and moral philosophers — they are being made within medical and biomedical thought and technique itself. Indeed, the individualized humanism of bioethicists and medical philosophers emerged alongside the 19th-century individualization of the living body within clinical medicine. But this humanism now encounters human life whose very meaning is being altered by biology, biomedicine and biotechnology. 'The philosophical status' - indeed the very ontology - of human beings is being reshaped through the decisions of entrepreneurs as to where to invest their capital and which lines of biomedical research and development to pursue. It is being shaped by geneticists taking all those small decisions about which family lineages to investigate, which markers to choose, which genes to hunt by which methods. It is being refined by clinicians working in alliance with their own patients to test out and explore the new potentials of gene therapy or reproductive technology. And it is being developed and contested by all those individuals and groups who are themselves active participants in the new ethics of normalcy — whether as subjects at risk of illness or early death, consumers governing ourselves though diets, selves reshaping ourselves by sculpting our bodies, potential parents deliberating over screening and genetic counselling, gay couples using artificial reproduction to have children.I have argued that life, today, is not imagined as an unalterable fixed endowment, biology as destiny, where the reproduction of individuals with a defective constitution is to be administered by experts in the interests of the future of the population. No longer are judgements organized in terms of a clear binary of normality and pathology. Of course, there are many practices where identification of high risk plus biological incorrigibility can switch the affected individual — or potential individual — onto the circuits of exclusion: whether that be via therapeutic abortion for a severely damaged foetus or preventive detention - or the death penalty in some states in the United States — for those thought to have a biological propensity to violence or sexual predation. But the dream - of doctors, geneticists, biotech companies and many 'afflicted individuals' and their families - is of that pre-symptomatic diagnosis followed by technical intervention at the biological level to repair or even improve the sub-optimal organism. For the political vocation of the life sciences today is tied to the belief that in most, maybe all cases, if not now then in the future, the biological risky or at risk individual, once identified and assessed, may be treated or transformed by medical intervention at the molecular level. In the process, the familiar distinction between illness and health has become problematic and contested. As claims are made to identify the genetic bases of 'normal' variability in aspects of vitality — from sexuality to longevity — the line of differentiation between interventions targeting susceptibility to illness or frailty on the once hand, and interventions aimed at the enhancement of capacities on the other, is beginning to blur.I have suggested in this article that, in and through such developments, human beings in contemporary Western culture are increasingly coming to understand themselves in somatic terms - corporeality has become one of the most important sites for ethical judgements and techniques. Two modes of such a 'biological ethics' are particularly striking. On the one hand, human rights now have a biological dimension and, partly in consequence, have gained a new kind of 'species universality'. Legal, political and social rights were first linked to the capacities and obligations of individuals who were elements of a political association. But now, it seems, each human being has such rights, simply by virtue of their existence as beings of this human kind. Individuals seem to have acquired a kind of biological citizenship - a universal human right to the protection, at least, of each human person's bare life and the dignity of their living vital body. In the geopolitics of famine, drought, war and ethnic cleansing, in the vociferous anti-capitalist and anti-globalization movements, and in the local politics of health, it is now possible for human beings to demand the protection of the lives of themselves and others in no other name than that of their biological existence and the rights and claims it confers. Such arguments suggest that biological ethics ascribes each human life equal worth. But our practices and techniques show us that, on the contrary, the biological lives of individual human beings are recurrently subject to judgements of worth. We do not have to look to the controversies over euthanasia or the rights to life of severely damaged neonates to see this — each session of genetic counselling, each act of amniocentesis, each prescription of an anti-depressant is predicated on the possibility, at least, of such a judgement about the relative and comparative 'quality of life of differently composed human beings and of different ways of being human. As biomedical technique has extended choice to the very fabric of vital existence, we are faced with the inescapable task of deliberating about the worth of different human lives - with controversies over such decisions, with conflicts over who should make such decisions and who cannot, and hence with a novel kind of politics of life itself. In this article, I have argued that this politics is not one in which authorities claim - or are given - the power to make such judgements in the name of the quality of the population or the health of the gene pool. On the one hand, in the new forms of pastoral power that are taking shape in and around our genetics and our biology, these questions about the value of life itself infuse the everyday judgements, vocabularies, techniques and actions of all those professionals of vitality: doctors, genetic counsellors, research scientists and drug companies among them, and entangle them all in ethics and ethopolitics. And, on the other hand, the politics of life itself poses these questions to each of us - in our own lives, in those of our families, and in the new associations that link us to others with whom we share aspects of our biological identity.