In what seems a season of special issues, Body & Society has a special double issue (Sept. and Dec. 2012) entitled “Medicine, Bodies, Politics: Experimentation and Emergence”. Editors Mike Michael and Marsha Rosengarten’s extensive introduction alone makes the issue valuable, to say nothing of the compelling six articles and afterward that follow it.
The following are the abstracts for the introduction and articles, as well as a link to the afterward.
Mike Michael and Marsha Rosengarten
In this introduction, we address some of the complexities associated with the emergence of medicine’s bodies, not least as a means to ‘working with the body’ rather than simply producing a critique of medicine. We provide a brief review of some of the recent discussions on how to conceive of medicine and its bodies, noting the increasing attention now given to medicine as a technology or series of technologies active in constituting a multiplicity of entities – bodies, diseases, experimental objects, the individualization of responsibility for health and even the precarity of life. We contrast what feminist theorists in the tradition of Judith Butler have referred to as the question of matter, and Science and Technology Studies with its focus on practice and the nature of emergence. As such we address tensions that exist in analyses of the ontological status of ‘the body’ – human and non-human – as it is enacted in the work of the laboratory, the randomized controlled trial, public health policy and, indeed, the market that is so frequently entangled with these spaces. In keeping with the recent turns toward ontology and affect, we suggest that we can regard medicine as concerned with the contraction and reconfiguration of the body’s capacities to affect and be affected, in order to allow for the subsequent proliferation of affects that, according to Bruno Latour, marks corporeal life. Treating both contraction and proliferation circumspectly, we focus on the patterns of affects wrought in particular by the abstractions of medicine that are described in the contributions to this special issue. Drawing on the work of A.N. Whitehead, we note how abstractions such as ‘medical evidence’, the ‘healthy human body’ or the ‘animal model’ are at once realized and undercut, mediated and resisted through the situated practices that eventuate medicine’s bodies. Along the way, we touch on the implications of this sort of perspective for addressing the distribution of agency and formulations of the ethical and the political in the medical eventuations of bodies.
It is a commonplace of the critical innovation literature that experiment has replaced mass production as the driving force of accumulation. But while many theorists have explored the politics and dynamics of such economies of experiment under the rubric of ‘immaterial’, cognitive or affective labour, few have examined the intersection of labour, experiment and the speculative in the clinic. Taking the clinic as representative of contemporary transformations in the commodity-form, labour and innovation, this article will look at recent attempts to reform the clinical trial, arguing that these developments represent a far-reaching shift in our understanding of medicine. First, I investigate recent efforts (associated with the discourse of ‘translational medicine’) to rethink the interface between experimental lab-based science and the clinic. I also look at closely associated efforts to reintroduce an element of experimental surprise into the clinical trial process itself, through the adoption of novel trial designs. If the randomized controlled trial was conceived essentially along the lines of a product testing procedure, recent efforts have attempted to reintroduce surprise into the testing process itself – in other words, to invent a trial process capable of producing unexpected events as leads for further innovation. I then move from the experimental clinic to what I call the distributed experiment. Here I focus on efforts to outsource pharmacological innovation to a distributed public of patients through the use of social networking software. These platforms allow drug developers to escape the limits of the conventional clinical trial by tracking the experimental practices taking place in the distributed clinic of unregulated drug consumption.
In the wake of Foucault, the debate on biopolitics has focused on the tensions of bíos and zoé, community and immunity, generation and thanatopolitics. What remains obscure in these accounts is the experiential aspect of life – its unfolding and entanglement with the ageing process. This is true both of approaches that emphasize the ethical implications of the life sciences and those that explore the biopolitical workings of wider social processes. In the contemporary capitalist formation, life’s unfolding is caught up in global flows of information, finance and labour. The organization of the human faculties, the general preconditions for knowledge and communication, becomes central to value creation. And the human body, like fixed capital for Marx, becomes a cost to be amortized as quickly as possible. Investigating these processes with regard to transformations in practices of care provides a means for reassessing current debates regarding the ageing of people and populations.
This article examines how the formation of markets in bottled water has relied on assembling a particular subject: the subject of hydration. The discourse of hydration is a conspicuous feature of efforts to market bottled water, allowing companies to appeal to scientifically framed principles and ideas of health in order to position the product as an essential component in self-health and healthy lifestyles. Alongside related principles, such as the ‘8 × 8 rule’, hydration has done much to establish new practices of water drinking and consumption in which the consumer appears to be always at risk of dehydration and must engage in practices of ‘frequent sipping’. This article traces the emergence of the concept of hydration from its origins in exercise science and explores its circulation, contemporary uses and purchase. I argue that the appeal to biomedical languages and concepts found in the discourse of hydration connects with much broader ways of conceiving and acting upon the self that have become prevalent in contemporary society – what Rose and Novas call ‘biological citizenship’ – indicating how the ensemble of hydration participates in wider-ranging transformations in forms of rule. The story of hydration reveals how biomedical techniques of the self can be made to double up as ‘market devices’ by offering specific procedures for assessing the self and calculating the body’s needs. In order to grasp these developments, I position the health sciences, and health and fitness in particular, as a potent site of popular culture in which bodies learn to be affected by the procedures of scientific experiment. A critical grasp of this context is best enabled, I argue, by situating the producers and consumers of scientific principles and commercial products as embodied and looking at their interconnection in processes of emergence. Through these means, we can begin to develop a fully materialized account of the question: how have we become so thirsty?
Annie Pfingst and Marsha Rosengarten
This photo-essay highlights the ways in which medicine features in the Occupied Palestinian Territories (OPT) and uses it to reflect on the nature of ethical obligation set out by Judith Butler in her work on state-achieved precarity. Although medical infrastructure of even the most basic type is tragically lacking and in some areas shockingly absent in the OPT, it is the particular way in which medicine comes to be needed that we focus on. Leaving aside the rhetoric that has claimed authority over what can or cannot be said of the Occupation, we focus on its geo-technological arrangements. By placing photos and case studies of medical obstruction within an analysis of the Occupation, we forge an encounter between reader and the Occupation to raise questions about the use of medicine in this context and the manner in which conventional ethics can give legitimacy to this use. On the basis of what we show through visual and textual documentary material, we propose ethics be understood as inherent to the geo-technological arrangements that make life possible or, as in this case, undermine, obstruct or deliberately take life. Hence the ethical obligation that Butler calls upon is reiterated in ways that encompass the everyday features of occupation including those active in the emergence of medicine as a tactic of war.
This article explores the development of a novel biomedical research organism, and its potential to remake the species and spaces of translational medicine. The humanized mouse is a complex experimental object in which mice, rendered immunodeficient through genetic alteration, are engrafted with human stem cells in the hope of reconstituting a human immune system for biomedical research and drug testing. These chimeric organisms have yet to garner the same commentary from social scientists as other human–animal hybrid forms. Yet, they are rapidly being positioned as central to translational medicine in immunological research and pharmaceutical development. This article explores the complex relations between species and spaces they seek to enact. Humanizing mice simultaneously moves these animal forms towards the intimate geographies of corporeal equivalence with humans and the expansive geographies of translational research. These multiple trajectories are achieved by the way humanized mice function as both uncertain ‘epistemic things’ and as expansive ‘collaborative things’, articulating mouse genetics with other research, notably stem cell science. In the context of post-genomics, their indeterminacy is critical to their collaborative value; their expansive potential follows as much from their biological openness as from specific expectations. Yet, these new research organisms have both accumulative and disruptive capacities, for there are patterns of interference between these trajectories, remaking boundaries between experimental practices and clinical contexts.
What role do nonhuman animals play in the construction of medical knowledge? Animal researchers typically claim that their use has been essential to progress – but just how have animals fitted into the development of biomedicine? In this article, I trace how nonhuman animals, and their body parts, have become incorporated into laboratory processes and places. They have long been designed to fit into scientific procedures – now increasingly so through genetic design. Animals and procedures are closely connected – animals in science are disassembled and reassembled in various ways. Indeed, biomedical knowledge can be said to rest on a large pile of animal bodies and body parts. The process of producing animal body parts to order has implications for how we conceptualize the body (human or nonhuman), which I discuss in the final section.