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The reduction of bioethical problems to the level of individual persons and the transactional relationship between them—between a medical practitioner and patient or researcher and subject—has in turn led to an overemphasis on individual autonomy, personal sovereignty, and informed consent. Furthermore, the focus on the individual risks ignoring the social reality of groups. Part V of the book focuses explicitly on patients as consumers within this marketplace that increasingly commoditizes health as something controllable through individual consumer choices.
Precision genetic medicine claims to tailor medical care to individual genetic characteristics, but who develops, controls, and profits from the infrastructure and flows of bioinformation in the age of genetic databases and biobanks remains a serious ethical concern. What bioethics has been slow to do is address how social, economic, and political forces work upon the seemingly unmediated choices of individuals.
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On the other hand, the very kinds of bodies we stigmatize as pathological or undesirable equally expose the ways in which science naturalizes social or cultural views. This is particularly evident in genetics. While bioethics emerged out of the aftermath of the Nazi regime, the field has been slow to confront the enduring legacy of eugenics. To this end, the biopolitical take on these biotechnologies attends not only to which bodies are ensured life but also what and how social groups and populations marked for death.
Beyond Bioethics mobilizes critiques from feminist, disability, and critical race studies to confront this new eugenic imaginary that increasingly pathologizes marginalized groups under the guise of improving health outcomes. For Obasogie and Darnovsky, such a shift in bioethics toward biopolitics reorients the field toward social justice and human rights-based concerns at a moment when we need it most.
I want to speculate more about the theoretical payoffs of pivoting toward biopolitics as a means by which we might reimagine what bioethics can do 8, I was immediately reminded of two recent essay collections that share the same title: Beyond Biopolitics.
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The greater social justice project of Beyond Bioethics would greatly benefit from greater engagement with these ongoing debates in studies of post-Foucault biopolitics on the topics of sovereignty and governance. How do states, by framing these new biotechnologies as the management of risk down to the molecular level, enable vast forms of exclusion and violence for the preservation of the life capacities of certain populations? Could bioethical principles of patient justice be in turn applied to the unique forms of biopolitical governance of life and death?
How can we take a bioethical approach to temporality within such conditions of persistent crisis and shifting economies of risk? Given the culture of speed surrounding the research and development of biotechnologies, an ethics of such speediness seems particularly urgent. He is currently working on a book project on the British history of vaccination and the rise of national health and health security. His research interests include eighteenth- and nineteenth-century British literature, the history of medicine, and disability studies.
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Bibliography in: Death and security
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