Callahan, Brown, and Ideology

This one goes out on a theoretical limb...

The pairing of Callahan's article on ideology and Brown's article on politicization is an interesting one, in that the subject of Brown's article (politicization) is -- at least partially -- the enactment of the subject of Callahan's article (ideology).

Early on in his article, Brown comments:

"To say that something has been “politicized” implies that it was previously not political. [...] To some extent, of course, the meaning of controversial concepts like politics and politicization are essentially contestable, and so any generic definition is inevitably subject to challenge. What counts as political often becomes a political question itself." (Brown, 2 - emphasis added)

Brown has introduced an interesting schism here, one that can perhaps be best understood in terms of a divide between ontology and epistemology. The nature of the political (or, the political nature of something -- for example, bioethics) itself becomes a political question, thus forcing us to reflexively examine the manner in which we know the political. After acknowledging this problem, however, Brown abandons it -- to his argument's loss, I think.

Here Callahan points the way. It is at this divide between the ontological and the epistemological -- between definitions of the political and understanding how we arrive at these definitions -- that ideology functions. If we apply this conception to bioethics, then the problematization of the politicization of bioethics can be understood as a distinctly ideological phenomenon. That is to say, a change in the ontological status of the politics of bioethics (i.e. politicization) is only problematic if there is some sort of disjunction between the change and how we conceive of the change. This disjunction -- this gap -- is ideology.

As Callahan suggests, the study of ideology would then focus on both the gaps (negative masking) and their complement, the "bridges" between ontology and epistemology (positive masking) -- things that seem to be problematic but aren't necessarily so, and things that don't seem to be problematic but aren't necessarily so. Thus, the critique of ideology cuts far deeper than Brown's engagement, which (perhaps necessarily so, given his disciplinary situation) takes certain political terms/structures/processes for granted as his "building blocks". In turn, this limits Brown's ability to engage with the quickly changing reality of biotechnology (and by extension, the demands for new bioethics). What Callahan suggests is a much deeper critique -- a critique of the "building blocks" themselves. Given the rapidity of change within biotechnology, it seems likely that ideological critique is or will soon be a necessity for bioethics.

Bioethicists do not want to be stuck trying to build Notre Dame with Legos.

The Middleman

Towards the end of "Life, Science, and Biopower", Raman and Tutton comment on what they see to be the future of STS research on biopower:

"...biopower, to use Foucault’s language, is characterized by the molecular and the population as ‘‘two poles of development linked together by a whole intermediary cluster of relations.’’ The work that is required, therefore, for scholars in STS and related fields is the tracing and understanding of this cluster of relations." (Raman & Tutton, 19)

But what particular relations make up this cluster? Or, to phrase the question differently: In the context of the "power from above" vs. "power from below" debate, who and/or what constitutes the "middle"? The answers, of course, are many, but one of the more interesting "middle" figures is the general medical practitioner -- that is, the figure who, for most people, serves as an interface between the complicated, technical world of biological/medical innovation and the lay person's existence. As trained professionals, they are by necessity more in touch with and more able to make sense of advances in biotechnology than the average citizen; but at the same time, most general practitioners are decidedly not specialists in the field of biotechnology. General practitioners stand, in a sense, with a leg in each world.

This means that GPs are often the real-world focal points for the legal and ethical dilemmas that are regularly debated by bioethicists. It is GPs who negotiate the balance between promoting length of life and quality of life (for example: should one administer chemotherapy to the exceptionally elderly? i.e. possibly extend their life by a couple years, but at the cost of greatly reducing their quality of life?).

Although GPs are often the site at which biopower and biopolitics comes in contact with the average citizen (for example, a GP urging his or her patient to quit smoking is a tangible enactment of an increasingly normative push for a certain kind of health-oriented behavior), it is also important to remember that GPs are as much subject to the forces they enact as are their patients. GPs are members of a (disciplinary) profession. This means that ethical injunctions (initiated by the new development of technologies) quickly become professional/legal requirements for GPs. Since the work of biopolitics is necessarily a procedure of normalization, subjective judgments with regard to health are necessarily tossed aside. The "goal" of medicine -- whatever it may be -- must be standardized. To return to the chemotherapy example, an extensive biopolitics/biopower simply cannot leave the use of chemotherapy up to the patient's discretion; increasingly, the GP, to protect him or herself legally (and the legal is always connected to the discretion of the profession), is obligated to encourage a particular treatment, precisely because of the standardizing and normalizing effects of biopower/biopolitics. In other words, the middle level is increasingly obligated to obligate the lesser level.

This chain of obligation seems to run parallel with Raman and Tutton's critique of Rabinow and Rose's work. If the middleman is constrained, the how much more so are those down "below"?