Our Bodies, Our Selves
The Politics of Life Itself: Biomedicine, Power, and Subjectivity in the Twenty-First Century. Nikolas Rose. xvi + 350 pp. Princeton University Press, 2007. Cloth, $65; paper, $24.95.
Those wishing to orient themselves in today's vast landscape of biomedical advances may want to consult The Politics of Life Itself, a study of 21st-century biomedicine by sociologist Nikolas Rose. The book provides a comprehensive description of the latest biological and medical interventions in human life. Rose proposes to steer a course between the negativity of social critics and the naive enthusiasm of scientific puffery. Instead, he promises a dry-eyed assessment of our new biomedical capacities to wield power and to shape the way we relate to ourselves as "somatic individuals."
Because Rose's study helps to map this largely uncharted terrain, he calls it a "cartography of the present," emphasizing continuities more than changes and sources of innovation more than causes for critique. He situates his work within "ethopolitics"—a revival of attention to human responsibilities and potentials in this era of pervasive attention to all aspects of "life itself."
The 21st century is characterized not by the "politics of health" typical of the 18th and 19th centuries or by the "thanapolitics," or politics of death, that dominated the modern era, he argues, but by "our growing capacities to control, manage, engineer, reshape, and modulate the very vital capacities of human beings as living creatures." Taken together, these capacities require "a politics of 'life itself.'"
Rose acknowledges that he developed the notion of "life itself" in conversation with the anthropologist Sarah Franklin, who explored the concept in an essay he read in draft form. The volume in which the essay ultimately appeared, Global Nature, Global Culture (2000), might usefully be read as a companion to Rose's study, because it provides an alternative route through the vital territory covered by these two major scholars, who are now colleagues at the Bios Centre of the London School of Economics. Although both Franklin and Rose draw from the works of Michel Foucault in their formulations of "life itself," Franklin and her coauthors, Celia Lury and Jackie Stacey, explore the reconfiguration of nature and culture under the rubric of globalization at scales ranging from the cell to the blue planet. At stake is an alternative world of relationships, collective actions and shared strategies for protecting a vital commons.
In contrast, Rose's volume is oriented toward policy. He focuses on what he calls "advanced liberal democracies," where citizens are subjected to "marketization, autonomization, and responsibilization" and are thus required to choose from the diverse market of interventions in human health and reproduction. Within that neoliberal social realm, he argues, this politics of life itself has given rise to distinctly new practices and identities.
Rose selects for special attention five areas in which, as he puts it, "significant mutations are occurring." He gathers them under the rather forbidding labels molecularization, optimization, subjectification, somatic expertise and economics of vitality. All those who have participated in a "run for the cure" or logged on to a patient advocacy Web site will be aware of the new ways of thinking about human selfhood, character, rights and responsibilities that are emerging from the new definitions of risk, susceptibility and illness Rose examines. They will have heard about, if not explored, the diverse markets where therapies are available. And finally, they are likely to have personally experienced the new emphasis on diagnosis and treatment of illness (or susceptibility to illness) at the molecular or submolecular level, as well as the new possibilities for optimizing health and well-being.
These new modes of managing human life on levels from the gene to the population are mapped in the eight chapters of Rose's study. They include the rise of a "molecular-genetic identity"; the emergence of a flexible ethical calculus for gauging questions of risk, susceptibility, enhancement and optimization; the creation of "pastoral experts" who help individuals navigate the thicket of knowledge sources and choices relating to their specific "somatic identities"; the consolidation of a new market for biovalue, comprising individual tissues and organs as well as national genetic features; the increasing use of racial and ethnic categorizations in medical research, health care management and pharmaceutical marketing; the increasing reliance on brain-based psychiatric diagnosis and on intervention before a diagnosis has been made; and the growth of a new biological criminology based on technologies of genetic and neurological screening.
Along the way Rose provides provocative new perspectives on some familiar issues—for example, the observation that genetic research in Iceland has led to the identification of genes linked to alcoholism, schizophrenia and manic depression: "In the age of genomics such conditions, once seen as burdens on the national population and its health service, have become potentially valuable resources," Rose says. "The national population has become a resource not only for understanding particular pathologies, but also for profitable biomedical exploitation."
Rose encourages us to see the linking together of genomics, race and medicine not as a deterministic state-based strategy for legitimating inequality, but rather as testament to "the economy of hope that characterizes contemporary biomedicine." And with similar, if unsettling, optimism, he differentiates contemporary biological criminology from both eugenics and genetic determinism, situating it instead "in the same thought style as the rest of contemporary molecular biology and molecular neuroscience, involving the logic of susceptibility, prediction, and prevention." Yet he also offers the cautionary insight that bioethics has "become an essential part of the machinery for . . . facilitating the circuits of biological material required for the generation of biocapital."
No map is neutral, and Rose's is no exception. Scholars looking for "the familiar tropes of social critique" will be surprised by the relative lack of depth of the analysis and criticism in this book. Rose presents himself as refraining from any authoritative summation: "Where so many judge, however, I have tried to avoid judgment, merely to sketch out a preliminary cartography of an emergent form of life and the possible futures it embodies." While promising to avoid "breathless epochalization," the book makes a central claim—that "the new style of thought that has taken shape in the life sciences has so modified each of its objects that they appear in a new way, with new properties, and new relations and distinctions with other objects."
Despite his argument that "we are seeing the emergence of a novel somatic ethics," Rose's prose suggests continuities of which he seems unaware. Consider, for example, his metaphor for the new ways of negotiating vitality the book discusses: He describes them as "significant mutations" in an "emergent form of life." The rhetorical effect is telling—Rose positions those new political and social practices in the same category as bodies subject to the medical, biological, neurological and criminological interventions that he addresses. Although Rose may intend to show us the full range of politics at play in our current socioeconomic, biomedical and cultural negotiations with life, his chosen metaphor risks restricting the scope of his analysis to the realm of biology. Framing social practices as biological entities, his description smuggles in judgment, establishing the discursive boundaries of his map without debate.
Indeed, Rose's recourse to the metaphor of cartography in a book on human embodiment recalls those early modern anatomists who, as Jonathan Sawday notes in his 1995 book The Body Emblazoned, compared their scientific studies of the human body to "the triumphant discoveries of the explorers, cartographers, navigators, and early colonists." Sawday observes that "in the production of a new map of the body, a new figure was also to be glimpsed—the scientist as heroic voyager and intrepid discoverer." The gendered and raced effects of that particular mapping, with which we are all too familiar, suggest some troubling limits to Rose's analysis of the politics of life itself.