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Contemporary Issues in Bioethics and Biopolitics (CIBB Project)


This project, entitled 'Contemporary Issues in Bioethics and Biopolitics', was launched in February 2011, is funded by the Leverhulme Trust and based at the philosophy department of the University of Warwick.

Miguel de Beistegui, Bill Fulford, Claudia Stein and two research fellows, Marjorie Gracieuse and Giuseppe Bianco, will work on this project for a period of three years during which three international two-day workshops will be organised in relation to contemporary issues in bioethics and biopolitics (for the workshops schedule, see our 'workshops' section).

The aim of this research project is to understand, delimit, investigate, and assess the specificity of the problem of life today. To say that life is a problem is to recognise that it is constituted by a series of internal tensions, the ethical and political consequences of which we intend to analyse and question. In each case, and at every stage of their various evolutions, those tensions produce and/or open up specific modes of knowledge and regimes of power. Such is the reason why the philosophical approach, which governs this research project, intersects with that of the historian, the epistemologist, and the clinician.

Contact: normalpathological@gmail.com


Presentation of the research project: Contemporary Issues in Bioethics and Biopolitics


What are the bio-tensions in question?


1. The first tension is that between life as I experience it from within, the life that I feel and am ("my" life), and life as an object of analysis, intervention, and manipulation. Human life is first and foremost the site of a tension between the life that is mine, intimate, and the life that I share with all living things. My life is in a relation of continuity and discontinuity in relation to Life . From a philosophical perspective, the problem of illness can be seen to emerge from this tension between the subjective and objective dimensions of life. On the one hand, illness is irreducible to an objective fact, as if independent of the subjectivity which it affects; on the other hand, it is irreducible to a mere signification, and cannot be understood independently of its inscription within a living organism, its relation to an environment, and even the effort, on the part of other living beings, to know and treat it. Illness is a qualitative and individual experience that takes place within human life itself. Once we recognise the specificity of illness in those terms, can we not arrive at an understanding of life, and the normal, on the basis of the pathological, and not as what is simply threatened and, ultimately, annihilated by it? Similarly, should medicine not recognise in care (and its latin etymology cura ) the ethical implications of the internal tension of life and not isolate the pathology from the subjectivity in which it is rooted?

Far from being of interest only to biology and medicine, then, the question of the normal andthe pathological implicates our perception of life as a whole, in all its forms. Pathology is at the source of all questioning concerned with life. It's only on the basis of suffering and distress, which are the signs of illness, that every question regarding life, or what living human beings consider normal at a given stage of their history, and the conditions under which such a state can be maintained, becomes possible. "Health is life in the silence of the organs," wrote Leriche. This means that all discourse of life on life spring from that obscure moment when, confronted with an obstacle, life "speaks" or seeks to speak. To the extent that our purpose is to ask about life, we need to begin by asking about life's relation to the pathological, and the epistemological, ethical and political implications of such a relation.

In antiquity, the conception of illness in relation to the normal state of the individual was essentially oppositional. On the one hand, an ontological conception saw illness as an external aggression directed towards the "normal" organism. As a result, the cure consisted in eliminating the pathogenic agent. On the other hand, a more dynamic approach saw illness as introducing an imbalance in the forces at play in the "normal" organism. As a result, the cure was seen as reestablishing the natural order, which medical knowledge itself was thought to imitate.

The separation between the normal and the pathological states was eventually reconfigured in the Enlightenment. To the extent that, in order to succeed, a technical intervention on a given disease presupposes some knowledge of the various relations that the disease has with the normal state, and which it seeks to restore, the difference between the two states cannot be as radical as previously thought. The evolution of the conception of the relations between the normal and the pathological which was largely determined by key discoveries in various areas of medicine, such as anatomy and physiology, but also by the economic and social transformations of modernity - lead to a conception in which pathological phenomena were seen as a purely quantitative variation of the corresponding physiological phenomena. In the 18th and the 19th centuries, the pathological state was considered homogeneous to the normal state, and the patient seen as something "more" or "less" than a normal individual, simply by virtue of the fact that his organism contained something more or less than a normal organism. The positivists of the 19th century extended and radicalised this (largely unquestioned) paradigm. Broussais, Bernard, Comte and Ribot contributed significantly to its dissemination and "normalisation," in areas of culture and knowledge as diverse as psychology, literature, philosophy and, most significantly perhaps, politics. Various metaphors and concepts moved between biology, medicine, and political theory. In the ontological conception, illness was seen as an "invader;" in the dynamic conception, it was seen as an "insurrection." Later on, political theory adopted the categories of medicine, legitimizing along the way those institutions aimed at maintaining or reestablishing, often through coercion, a supposedly "normal" state of society. Politics and medicine, the doctrines of the biological body and the social body became increasingly entangled. Their fate accompanied that of capitalism which, today, tends to govern life in all its forms.

It's only after WWII that, in Germany and France especially, the life sciences and philosophy began to call into question the positivist paradigm. In that respect, the work of Georges Canguilhem remains seminal. According to him, if we assume that living beings cannot be reduced to a mere assemblage of mechanisms, then it is no longer possible to speak of a "normal" state: normality consists solely in the statistical frequency of a series of comportments, or norms, and in their fixation at a given moment and in a given space. Yet such a temporary norm is the result of the essentially transformative activity of a life form subjected to a given number of challenges within its environment. Consequently, pathology comes to be understood only as the organism's inability to create norms of a particular type, but not as the inability to generate norms as such. Pathology is just another type of norm, qualitatively different from the previous one. Similarly, there isn't an ontologically "normal" society, but only a series of different normative choices and institutions, which mirror the reaction of human organs when confronted with new challenges.

This simple assumption generated a considerable critical force in the last century: it rooted physiology in pathology and the latter in the lived experience of the individual. It enabled critical analyses of concepts and institutions, such as hospitals or prisons. Such a critical force was especially effective in its ability to counter the dissemination and institutionalisation of the positivist model, the catastrophic historical and political consequences of which manifested themselves fully in the 20th century. On the one hand, the specialists in public health and hygiene, who were the true inheritors of that positivist tradition, carried out an operation of medicalisation of life as a whole by relying on an abstract model of normality. They promoted a bio-politics that was no longer concerned with ruling over death and letting live, as the sovereign power had done hitherto, but with supporting life and letting die. We have yet fully to understand the consequences of such a paradigmatic shift for our society, and the new forms it is currently taking. On the other hand, the vitalist mythology of race, specific to fascism, overlapped with such a paradigm and promoted a thanatopolitics aimed at excluding and eradicating the forms of life considered as abnormal, or pathological. Ultimately, this paradigm turned out to be auto-immunitarian. Indeed, auto-immunitarian diseases presuppose an excess of defences on the part of the organism, which defends itself against itself, eventually causing its own death. As Derrida emphasised shortly before his death, this paradigm can still be detected in the current state and evolution of neoliberalism.

We are convinced that it is possible, and indeed necessary, to extend and adapt the reflection of the philosophy of pathology we have just sketched in the light of the new challenges emerging from the evolution of society and the life sciences. In the era of bio-power, the norms have become independent of the normative power of the human being, determining its comportments and excluding those considered pathological. To what extent is it possible to emphasise and promote the normative activity of human life in the face of a system that declares in advance, and down to the most minute details, what is normal? What paradigm of normality and health can we develop as an alternative to auto-immunisation, this disease caused by the excess of concern for health? What critical space is left, or can be generated, in an epoch in which the life sciences make it possible for the human being to intervene on itself, on other living beings, and determine their identity? Is it still possible to develop a normative critique that would not be rooted in the naturalistic paradigm?

2. The second tension, internal to life itself, is very close to the first, and cannot be thought independently from it: it is the tension between life (or birth) and death. From the start, then, we need to recognise, from a subjective standpoint, that life stretches between birth and death, but in such a way that death is not simply opposed and external to life, but accompanies it from the start. Human life is mortal life. This ontological claim, in turn, presupposes an epistemological, ethical, and political revolution: if death is not simply outside life, but creates a tension within life itself, then death itself needs fully to be integrated within our lives, private and public, individual and political. There needs to be a politics of birth, death and ageing, as well as an epistemology of life. This is precisely the point at which the stakes of biopolitics emerge. Life itself falls within structures of power and becomes a political object as soon as it becomes a question of preserving it from its other, namely, death. In order to better preserve and protect individual and species’ life, an increase and extension of governmentality is required.

It is under these conditions that the ‘politics of life’ tend to become both bio-politics and thanatopolitics. The intrinsic risk is one in which, in order to address those problems, biopowers need to decide and legislate on what can be considered as ‘truly’ alive, and establish a rigid and normative hierarchy, with human life in its actual existence at the top of the scale, and other living beings as inferior forms of life. This situation generates questions of ethics and jurisprudence that deserve to be explored in depth. Life itself becomes ‘sacred,’ and its sacred character emerges as a new form of transcendence, in the name of which the multiplicity of forms of life can be judged and selected. Life finds itself evaluated in the name of superior values, the human origin of which, however well intentioned, might in fact not be deprived of political, economical and moral interests. We will need, therefore, to investigate the implications of the growing idea of the “sacredness” of life and focus, after Giorgio Agamben, on its very ambiguous ancient meaning (the Latin “sacer” originally meant both blessed and damned) . Thus, the dangers of thanatopolitics and biopolitics, if they are to be prevented, must be carefully faced and explored anew, without falling back into or, worse still, generating new, forms of extremism or obscurantism. The goal, on the contrary, would be to help clarify the chances and dangers of bionormativity. A close analysis of the derridian notion of survie would help us shed light on a new way of treating those problems, avoiding both the bio and thanatho-political paradigms which, we believe, are intimately linked. Indeed, the notion of survie can provide us with a new articulation of death and life, absence and presence, illness and health. For what is essential and original in life is the paradoxical fact of being at once more and less than life itself: life is both survival, or less than life, and more than life (sur-vie ). It is with this paradox, closely bound up with the growing exigency for human beings to be aware of the potentially dangerous ambivalence and excessiveness of their desire that we must start if we are to renew our vision of life and death. For what is ultimately at stake in the problem of the relation between life and death concerns the question of the possibility of a pedagogy of desire as the sole way for philosophy to find a crucial legitimacy in contemporary society.

3. The third and final tension, on which we intend to focus, follows from the second. For the life that, from the start, we have called ours, is one that, from the start also, finds itself confronted with what is always a specific form or regime of power, which marks and shapes our bodies and minds,through the institutions, procedures and mechanisms of government it creates. In other words, life is also the site of a tension between the way in which it is governed (as a result of the previously mentioned tensions) and the way in which it aspires to, or simply can , govern itself. It is the site of a tension between a life that is institutionalised and a life that aims to transcend and invent itself, between a life that is codified and regulated, and a life that creates itself and invents new forms of life. It is the life that is caught between specific regimes of power, which it has internalised, and its own power to engage critically and creatively with them. It is within this tension that the specific status of desire and pleasure will be investigated. We will aim to show that they do not constitute a mere example, or a marginal phenomenon, but the very testing or battle ground on which this ethical and political tension is being played out. We will also aim to show how philosophy itself is at stake in such a tension, how it is itself an instance of life that exceeds life, a creative enterprise that seeks to produce the conditions for a free and happy life.

Indeed, at the heart of this pair of concepts lies the question of happiness, which Aristotle already saw as the ultimate goal of the ethical and political life (bios ), and which he distinguished from (mere) animal life (zoe ). Much of western history, especially in its late Greek and early Christian period, and throughout the Middle Ages, saw desire, whether as concupiscence or, more generally, as striving for worldly possessions and recognition, in a negative light. The virtuous life, which presided over that of the state itself, was inspired by an ideal of suspension of desire and pursuit of the only real satisfaction (distinct from earthly pleasures), the life in God (Augustine). In Hobbes, the intervention of the sovereign, and thus of the political order, is made necessary by the unlimited, and essentially destructive, nature of human desire in its natural state, which the sovereign is designed to channel and manage, but not suspend: the law transforms an unlimited and destructive desire into a legitimate interest. Progressively, though, and especially with the growing importance of commerce, money, and the economics of prosperity in the early renaissance, desire, the realm of passions, and the pursuit of happiness (understood as pleasure), were given an increasingly prominent position. Helvetius, for example, saw man’s actions as directed by the quest for pleasure and the avoidance of suffering. This process culminated in the utilitarianism and the liberalism of the 19th century, which continues to define our time. It is not an exaggeration to say that our time is that of the endless production of desires, and unbridled enjoyment (“enjoy, now, unreservedly!” is the new categorical imperative). However, it could also be argued that the desire in question, as many early philosophers had recognised, Mandevilleincluded, cannot lead to a sustained form of happiness, but only to a form of hedonistic frenzy. In light of such a situation, we intend to revisit the concepts of desire and pleasure: can we think of a concept of desire that is not born of a form of lack (without being the negation of life), and not oriented towards a form of pleasure? Can we think of a type of pleasure that is not bound up with the economics of neoliberalism, and this means with a form of desire that is essentially individualistic and negative? Our hypothesis is that desire and pleasure, which have been united in so many ways, need to be entirely dissociated, and distinguished, before they can be brought back together. But this hypothesis is not purely theoretical: it is a question of laying out the foundations for a practice – an ethics and a politics – of desire and pleasure, and of delimiting another libidinal economy.

Deleuze and Guattari’s work from the 1970s can be seen as a crucial stage on the way to such a radical theoretical and practical programme. Desire, they argue, designates the vital powers that characterise human life. By associating desire with a structural deficiency, and thus by understanding human nature negatively, a long metaphysical tradition has consistently inhibited those vital forces, which now need to be liberated. To do so, it is necessary to understand desire in purely positive terms, as a vital force that creates new forms of life, and to dissociate it from pleasure, which is only ever fleeting, and cannot produce genuine happiness. At roughly the same time, and towards the end of his life, Foucault was developing an ethics of the self, or a “hermeneutics of the subject,” rooted in the concept and practice of pleasure: “[T]here is no first or final point of resistance to political power,” Foucault says in The Hermeneutics of the Subject , “other than in the relationship of self to self.” Whilst lecturing on liberalism and biopolitics at the Collège de France, Foucault was also beginning to investigate technologies of the self, or ascetic disciplines, which presupposed and required a type of desire and pleasure other than that of utilitarianism, and its philosophical anthropology of lack and satisfaction. In a way that mirrors Deleuze and Guattari’s approach, he sought to dissociate pleasure from desire, that is, from the way in which pleasure had been understood as (only) the completion and satisfaction of desire. It is our conviction that Foucault’s problematic of pleasure is ultimately compatible with Deleuze’s conception of desire, and together they can enable us to redefine the contours of human nature and its place in the current historical context.

In short, and by way of summary, we intend to focus our research on three tensions internal to life which can be characterised as epistemological, ontological, and anthropological - yet with a view to extracting their ethical and political implications. We intend this project to amount to a substantial contribution to the field of bio-ethics and bio-politics.