My argument is that the academic discipline of bioethics relies on an epistemology of domination and is an institutionalized vehicle for the biopolitics of our time, that is, bioethics is a technology of government that provides intellectual resources designed to facilitate the “strengthening” (read: fitness) of a certain population and the elimination of others. I submit, furthermore, that the implicit and explicit governmental tenor of bioethical inquiries and discussions contributes substantially to the hostile environment that disabled philosophers confront in philosophy.--Shelley L. Tremain (2017) Foucault and Feminist Philosophy of Disability (University of Michigan), 160-161.
As the quoted passage suggests, Tremain diagnoses two kinds of inductive risks from the way bioethics is practiced: (i) it is eugenic in character: it promotes the "elimination" of populations with characteristics thought undesirable; (ii) it creates a hostile work environment for disabled philosophers within professional philosophy. Today's post is focused on (i). For on her view, it is constitutive of bioethics to "posit conceptions of the normal from which the possibility and probability of deviations are measured and classified in order to prevent and control their actualization." (169) Within the discipline, the normal is taken to be an objective feature of reality (often understood as something statistical or species functional), and the deviations -- in particular below the norm -- are treated as objective defects or harms (or costly). Following Foucault, Tremain treats the disciplinary articulation of this conceptualization a step in what she calls 'normalization.'
For the articulation of these conceptualizations and their understanding as objective (social) facts constitute a field of inquiry and creates a discursive power with normative authority in the university, the hospital, and in wider society. More subtly, Tremain argues that normalization shapes, by various looping effects (Hacking's terminology) the self-conception of ordinary agents in society and the possibilities available to them as they make, what they take to be, autonomous choices. Such normalization becomes eugenic once it becomes constitutive of (autonomous) reproductive choices by individual would-be-parents and by social (and sometimes legally mandated) technologies of risk-management and prevention to facilitate the creation of populations without characteristics thought abnormal (defective, costly, or not conducive to full participation/cooperation in society, etc.).
Before I offer some critical reflections on Tremain's position, I want to note two things: first, I agree with Tremain that until quite recently contemporary bioethics (both in its Rawlsian and Utilitarian guise) is eugenic in character and that it has badly theorized -- mostly by ignoring -- the inductive risk of its own activity. In fact, while it councils 'do-no-harm' to medicine and patient autonomy, it has been long reluctant to explore the possible harm that is the possible effect of social and institutional uptake of normative theorizing. For most of my adult life, analytic applied ethicists simply disparage those disciplines (Critical X) where inductive risk is taken seriously (recall my criticism of Heath). In so far as it is agreed that normative theory has possible bad social effects that's never due to the theory itself, but only due to bad people or bad social implementation. The character of the foreseeable uptake of a theory is not treated as a legitimate (professional) evaluative feature of the theory.
Second, and only a partial aside, while Tremain uses a Foucauldian framework (and linguistic register) to analyze these features, it converges with the decidedly non-Foucauldian treatment of the development of applied ethics offered by Katherine Forrester's In the Shadow of Justice: Postwar Liberalism and the Remaking of Political Philosophy (recall here; here; and here). In particular, I want to highlight a structural feature of applied ethics, the significance of which only became clear to me while reading Tremain. Forrester notes that:
Applied ethics soon also encompassed medicine, law, and business. But the fact that moral thinking about war, with all its extremities and appeals to necessity, was one of the first test cases for applied ethics had a wider impact on the development of moral and political philosophy. Its focus on dramatic and extra ordinary moral choices was soon imported into other realms of inquiry. Crucially, it was imported back into the realm of domestic politics, which was turned into a case of its own: public morality.--Forrester In the Shadow of Justice, pp. 74-75 (emphasis added)
Appeals to the necessity of choosing function as a mechanism to prevent the development of questions about the proper form of thought and its institutional embeddedness. The focus on existential social choice facilitates the rise of casuistry without thinking through what the structure of the demand for casuistry does to the supply of ethical theory (as the worth having). (An analogous problem shows up in normative decision theory.) To simplify greatly, we saw the after-effects of this in the most recent pandemic: bioethicists were primed to discuss the rationing of medical care and the justification of vaccine requirements, but had little guidance to offer on how to think about the integration of many different kinds of fast moving (and sometimes still immature) sciences and the complex trade-offs of major social policies.
Now, let me return to Tremain's analysis; it is important to recognize that normalization (mediated by various social and governmental practices) produces "people with certain kinds of subjectivities, that is, these practices have constituted subjects whose actions are governed through the exercise of their own capacity to choose in accordance with the norm(al)." (190) And while the structure of Tremain's argument is akin to an ideology critique, she recognizes that there is no sense in which she can claim that these subjects have "been duped by the ideological forces of some distant and overarching external power," nor is she in a position (as she admits) to claim "these subjects make morally bad personal decisions." (190)
Tremain is a very clear writer, and she puts her assumptions and commitments transparently on the table: she is a nominalist, a historicist, and a relativist. And she makes clear that the problem with ("epistemological and ontological assumptions" embedded in) disciplinary practices that are invested in normalization is that "the potentially detrimental effects for disabled people" is ignored. (192; this is also true of embryo research.) Part of these detrimental effects are the widespread uptake of the thought that the disabled have "diminished lives" and so nudge (and legally facilitate) abortion, infanticide, and euthanasia of them. (200)*
I hinted above that I would offer a criticism. The problem is that acknowledging, even internalizing detrimental effects in a (bioethical) theory is neither necessary nor sufficient to undermine such a theory. Again, I draw on Forrester and the implication of appealing to necessity. It is characteristic of applied ethics to use "abstract, personal, and interpersonal modes of justification to explore the most concrete of existential questions of life, death, and killing— questions that continued to remain at the core of applied ethics." (82) To put the point starkly: the 'heroisms' of applied ethics is precisely its willingness to face up to the existential nature of its questions.** That something is eugenic and has harmful externalities is certainly something that -- once pointed out -- has to be faced, but with theoretical equanimity.
I'll put the dilemma facing Tremain and her partisans as follows: because she is unwilling to develop a normative theory of her own that can meet contemporary applied ethics on its own terms (I almost wrote 'ethical battlefield' there), merely stating and naming, even unmasking, an inductive risk is not sufficient to change a disciplinary practice. If anything, once it is domesticated as inductive risk her insights can feed into other technologies of biopower. (So she may well rightly object to this whole post.) And because such domestication is always a live risk, Tremain is probably prudential in avoiding the development of a normative theory of her own. But as her own analysis shows, society will confer authority on normative theory (and as Forrester shows it will create all kinds of rewards for those who develop it 'best'), so avoiding the contamination of normative theory seems to consign oneself to political and professional wilderness. But that conclusion would be victim blaming, and to understand that we need to look more closely at (ii), the marginalization of disabled philosophers in the profession. To be continued.
*The looping effect of this idea may also risk constituting the subjectivity of the disabled, and so contributing to depression, bad self-images, etc..
**Undoubtedly, there is a gendered element lurking here in how the field was thought 'manly' despite not being 'core.'
Please pardon the naivete of the question, but I'm a bit lost. Doesn't there have to be some underlying, presupposed, or unstated normative "theoretical" position that supports something's having "detrimental" effects on the disabled, including disabled philosophers? How does one even make sense of the "risk" involved, absent such a foundation?
Posted by: ajkreider | 04/12/2022 at 08:24 PM
Sure. What's the problem?
Posted by: ERIC SCHLIESSER | 04/12/2022 at 08:29 PM
That she hasn't really avoided contamination of normative theory, whether it is formalized or not. If Tremain really is brutally honest with herself (I haven't read the book), that would include stating her normative commitments - and perhaps rationally reconstructing a theory about them.
Maybe that's just your point, but it seems odd to laud a failure to do this as prudential. Clearly, she thinks she's providing insights that show weakness in the prevailing views - that those aren't the best (not sure why you have scare quotes there). Ok, bring that to the fore.
Posted by: ajkreider | 04/12/2022 at 11:00 PM
That she hasn't really avoided contamination of normative theory, whether it is formalized or not. If Tremain really is brutally honest with herself (I haven't read the book), that would include stating her normative commitments - and perhaps rationally reconstructing a theory about them.
Maybe that's just your point, but it seems odd to laud a failure to do this as prudential. Clearly, she thinks she's providing insights that show weakness in the prevailing views - that those aren't the best (not sure why you have scare quotes there). Ok, bring that to the fore.
Posted by: ajkreider | 04/12/2022 at 11:02 PM
You conflate two things: (i) one is a first order normative theory in bio-ethics--she is not offering that as far as I can tell. (ii) She is making a normative claim about normative theory of bio-ethics (and a whole range of disciplinary practcies)--that it has bad consequences. You can do (ii) without doing (i) without contradiction or bad faith. (You could even do (ii) as a reductio of (i), but that's not what she is doing.)
Posted by: ERIC SCHLIESSER | 04/12/2022 at 11:05 PM
I think I see what may be confusing you. You read me as suggesting that Tremain is a critic of normative theorizing as such. But she is not a normative skeptic (she is a relativist). And her criticism of the disciplinary practice is ethical in character (without engaging in the disciplinary practice itself).
Posted by: ERIC SCHLIESSER | 04/13/2022 at 12:21 AM