Martial Metaphors and Medical Justice: Implications for Law, Crime, and Deviance
Arrigo, Bruce A, Political and Military Sociology
The extent to which military metaphors are contained in medical discourse is largely unexamined This study is an effort to provisionally address this phenomenon. In short, the author teases out some of the implicit messages and hidden assumptions embedded in the text of medicine. Further, by relying on the deconstructive philosophy and methodology of Jacques Derrida, the author demonstrates how binary oppositions such as war/peace, disease/health, violence/serenity underscore militarized medical metaphors. Moreover, the author reserves these hierarchies and explains how the Derridean notions of community and hospitality, as linked to martial rhetoric in medicine, impede prospects for making peace with dis-ease and subject all manifestations of "difference" to medicine's normalizing, sanitizing, unifying power. The author concludes by offering several speculative observations on the nature of law and the control of crime/deviance in society; given the overlapping effects of the military and medical models.
The presence of martial metaphors and war-making discourse embedded within the national psyche are well documented (e.g., Sherry, 1995). America's preoccupation with militarization eclipses many facets of institutional life and human social behavior. Some noteworthy examples include the social construction of: (1) women, gender, and sexuality (Higgonet et al., 1987); (2) lesbian and gay identities (Berube, 1990, Murphy and Poirier, 1993); (3) race and ethnic history (Takaki. 1998; Natty, 1986); (4) economics, science, and technology (Markusen et al., 1991; Lotchin, 1992; Mendelsohn et al., 1988); and (5) political culture (Gillis, 1989; Gibson, 1994; Hunter, 1991). Interestingly. we know little about the presence of martial metaphors in the construction of medicine (cf. Sontag, 1989 on AIDS and attitudes toward the state). Moreover, we know even less about the impact of these metaphors for medical justice2
This deficiency in the literature is significant. As Ericson (1994:153) warns, "the military model is as pervasive as the medical model in efforts to colini[z]e the control of crime and other forms of deviance." If his cautionary observation is remotely correct, what does it portend for our understanding of medicine and medical justice, particularly when these social realities are anchored by martial images and saturated in war-making discourse? Arguably, the implications for the control of crime/deviance are considerably recast as the overlapping and interdependent effects of the medical and military models fashion alienating, marginalizing, and oppressive meanings for citizens who are "combating forms of dis-ease."
This essay is an attempt to shed light on this under-examined question, One access point for an assessment of martial metaphors, medicine, and justice is found in the postmodern, deconstructive methodology of Jacques Derrida (1976, 1978, 1981, 1992, 1997). Derrida's contributions to this enterprise are significant on two fronts. First, as Young (1990: 98-99) explains, deconstructive analysis allows us to unveil the structures, embedded in discourse, that deny and repress difference.3 This is what Derrida (1976) calls the "metaphysics of presence." Second, deconstruction directs us to the "free play of the text" (Milovanovic. 1994: 102). In other words, once a narrative (such as the discourse of medicine) is constructed, the story "insists" and is forever incomplete (Derrida, 1973). This insistence is a recognition that the narrative always signifies more than what is intended. Teasing out several of the implicit meanings and unstated assumptions within the text on military rhetoric and medicine will help advance our investigation of the effects these meanings and assumptions have for the construction of law, and the control of crime and deviance.
In part one of this essay, selected insights from Derrida's deconstructive philosophy are outlined. In part two, Table 1 is presented. The Table lists several everyday martial metaphors and then demonstrates how these images have found their way into the discursive text of medicine. Several observational comments concerning the manifest meanings for these warmaking metaphors in medicine are offered. In other words, the surface level intent is identified so that a coherent narrative can be constructed (Jackson, 1991). In part three, a Derridean critique of war text is presented, based on the previously delineated deconstructive principles and mindful of the underlying, unstated messages and/or values embedded in the text. Table 2 facilitates this investigation. In part four, the implications this deeper textual analysis holds for the nature of law and the control of crime/deviance are provisionally described. In order to situate the overall study, however, some general comments on the genealogy of martial rhetoric and medical justice are warranted.
ON FOUCAULT, THE SOCIAL CONTROL THESIS, AND PUBLIC HYGIENE
It is difficult to say with precision the point at which commentary on war-making discourse in medicine was first examined with any degree of precision or depth. This notwithstanding, the insights of Michel Foucault (e.g., 1965. 1972, 1973, 1977, 1990) are perhaps, if nothing else, the most illuminating and most critically inspired.
Foucault's investigation of disciplinary institutions (e.g., the penal, the psychiatric) was a deliberate effort at de-bunking the purpose of confinement. In short, he reasoned that institutionalization was a form of controlling (or isolating) the socially undesirable, that is, it was a state-sponsored method of "policing public hygiene" and ridding society of difference (Foucault, 1990: 134, 1965, 1977). Although his comments are somewhat limited to the policing of difference through psychiatry and penology (cf. Foucault, 1973 on medical perception), his notions have implications for the archeology of medical justice and military metaphors in general.
According to Foucault, the medical function of psychiatry (i.e., public hygiene) was linked to the management function of policing (i.e., social control and order). This union enabled medicine to advance its "true vocation;" namely, cleansing public morality (Foucault, 1990:180). This "assault" on immorality gave rise to the founding of psychopathic hospitals. These corrective treatment facilities sanitized, de-pathologized, and normalized maladaptive behaviors through sustained psychotherapeutic interventions (Arrigo and Williams, 1998:5). As a result, all problems of social hygiene were "captured within the medicalized psychiatric web of stabilization and homogeneity" (Foucault, 1965:34).
Foucault's (1965, 1973) examination of medicine and the mentally "diseased" resonate with his study of crime and criminality (Foucault, 1977). "The arrival of psychiatry into criminality- provided a new direction for the examination of mental illness and crime... where attention could be focused on the individual; that is, the criminal, as opposed to the crime itself" (Arrigo and Williams, 1998:6). Much of the analysis on criminal pathology explored the question of "dangerousness." This is what Foucault (1990) refers to as the "psychiatrization of criminal danger" (p. 128). In this exploration, Foucault contends that insanity, that is, the irrationality of the minds of crazy people, became the justificatory cause celebre for medicine's policing and controlling of difference. Indeed, as Foucault (1990) explains:
[Insanity] is hidden; it represents a danger in that it is beyond the actor's responsibility; beyond his control because he is frequently unaware of it .... [Psychiatry] has invented an entirely fictitious entity, a crime which is insanity, a crime which is nothing but insanity (p. 132).
Thus, following Foucault, medicine's introduction into the study of criminality created a new crime: "the unpredictable and latent danger of the insane constituted a crime in itself" (Arrigo and Williams, 1998:7). In the wake of this perceived public threat, medicine's responsibility was to it supervise...whatever was in a state of disorder, whatever presented a danger" (Foucault, 1990: 188). Confinement of individuals followed the identification of dangerousness, though not necessarily because of a clear act of criminality. In this regard, dangerousness functioned as a metaphor (Arrigo, 1996) where the police and psychiatry amounted to "institutions intended to react to danger" (Foucault, 1990:188). Absent proof that one was a threat to another, one could still be confined, institutionalized, as a danger to one's self (Arrigo, 1993: 7-27), As Arrigo and Williams conclude (1998:7): "Thus, any form of danger [became] justification for involuntary (criminal/civil) confinement. Accordingly, psychiatry [became] a 'social police.'"
There is one more dimension to Foucault's critique worth noting for purposes of our investigation on military metaphors and medical justice. Underpinning his assessment of disciplinary institutions is a rich and provocative theory on the inextricable relationship shared among power, knowledge, and truth (Foucault, 1980). Space limitations do not permit a more detailed examination of these notions; however, some comments are warranted.
Medicine became an all-encompassing, monolithic expression of power "not because it embraced everything but because it came from everywhere" (Foucault, 1980: 93, 1973). For example, "psychiatry was a legitimated form of disciplinary control through the instrumentality of scientific discoveries and medical breakthroughs" (Arrigo and Williams, 1998:8). Indeed, society's comprehension of mental illness, disease, incompetence, dysfunction, dangerousness and the like, as connected to insanity, was "inventively transformed into clinical and psychopharmacological strategies of social control" (Ibid). These strategies of control, of policing public hygiene, operated as "weapons of attack and defense in the relations of power and knowledge" (Sarup, 1993:66; emphasis added). The presumed truth of psychiatry, as a weapon of attack, justified and legitimated the deprivation of citizen liberties. As Sarup (1993) notes:
Whereas we might normally regard knowledge as providing us with power to do things that without it we could not do, Foucault argues that knowledge is a power over others, the power to define others. In his view knowledge ceases to be a liberation and becomes a mode of surveillance, regulation, and discipline (p. 67; emphasis added).
Foucault's (1972) archeology of knowledge, particularly when applied to medicine, demonstrates how medical justice, "speaks a [certain) truth, exercises power accordingly-, and produces a disciplinary society in which people [a]re normalized and de-pathologized" because of their differences (Arrigo, 1993: 49, 135). Indeed, the new, inventive technologies of epidemiology, forensic psychiatry, neuroscience. and the like, as state-endorsed emblems of power, harness knowledge and truth giving way to the homogenization of morality and to the policing of public hygiene.
Thus, following Foucault, we see how military metaphors play a prominent role in describing his genealogical methodology. Notions of policing, strategies of surveillance, practices of defense and attack are important dimensions to his treatment of medicine and medical justice. Although Foucault's more historical comments are instructive for suggesting some of the linkages between the military and medical models, his treatment of this phenomenon is sketchy at best. The core of Foucault's critique centered on the sedimented and oppressive function of disciplinary institutions. In order to advance the analysis on martial rhetoric, medical justice, and their implications for law, crime, and deviance, the insights of Derrida are useful. The principles descried below are perhaps the most rudimentary for understanding Derrida's deconstructive methodology. However, they are sufficient for purposes of examining how war-making metaphors operate in medicine.
ON DERRIDA AND DECONSTRUCTION; SOME BASIC PRINCIPLES
For purposes of my investigation, this section will describe three overarching tenets contained in Derrida's deconstructive philosophy. Although these tenets are presented in summary fashion, their applicability to the overlapping effects of the military and medical models are easily discernible. These principles include: (1) the reversal of hierarchies; (2) differance; and (3) the trace. In subsequent sections of the article, reference to additional Derridean concepts will facilitate a more thorough analysis of the text on martial rhetoric and medical justice.
Reversal of Hierarchies - In written or spoken texts, terms or words take on value. This valuation is always in relation to the term's position or opposition to other terms. "One [term] becomes dominant, the other repressed" (Milovanovic, 1994: 101). For Derrida (1973, 1978, 1976) this is the manifestation of "the metaphysics of presence" In other words, given every opposition, some terms are dominant, privileged, active, and present while others are subordinate, devalued, passive, and absent. This creates hierarchies (e.g., good/bad, right/wrong, objective/subjective, fact/fiction, health/disease). Hierarchies are fundamental to all phenomena.
According to Derrida (1976, 1973), however, everything is a "text;" that is, a story or narrative that unfolds. A text can be twisted, contorted, and "reversed" to reveal the oppositions embedded in words. Reversing the hierarchies allows one to understand what is present and absent, what is empowered and disempowered, what is privileged and de-valued in the written or spoken word.
Differance - Moreover, through the deconstruction of a text, the interdependent quality of these oppositions can be made explicit (Balkin, 1987: 746-751). This interdependence is expressed in how terms (oppositions) both "differ" from and "defer" to one another (Derrida, 1973, Sarup, 1989).' This is what is meant by the neologism differance. Indeed, within any hierarchy (e.g., man/woman), although the two terms are different from one other, each defers to the other, implies the other term, while, at the same time, deferring to the other. thus demonstrating dependence on the other term (Milovanovic, 1994: 101, Henry and Milovanovic, 1996: 83).
The Trace - We note, then, that within any opposition, differance also implies the mark of the other, the trace of the other word, in the hierarchy. "Within each term of a hierarchy, one ...contains the hidden trace of the other" (Milovanovic, 1994: 101). The trace is what maintains the value position relationship between the two terms. Indeed, following Derrida (1973), we can say that the articulation of any term (presence) implies the hidden term (absence), and that meaning "insists" through the interdependence of each. As Sarup (1989) explains: "Each sign in the chain of meaning is somehow scored over or traced through with all the others, to form a complex tissue which is never exhaustible" (p. 36).5
For a Derridean deconstructive methodology to be effective one must discern the term that is absent and de-valued in a hierarchy; that is, the repressed, hidden word that sustains the term that is felt as present. This deconstructive reversal requires that one make visible that which is concealed, As Balkin (1987) indicates:
"[a]ny social theory must emphasize some human values over others. Such categorizing necessarily involves a privileging, which in turn can be deconstructed. But the goal of deconstruction is not the destruction of all possible social visions, By recalling the elements of human life relegated to the margin in a given social theory, deconstructive readings challenge us to remake the dominant conceptions of our society" ((p.763; emphasis added).
ON MARTIAL METAPHORS AND MEDICINE: A PRELIMINARY ANALYSIS
Table 1 identifies a limited series of popular military metaphors and juxtaposes each against their medical model counterparts. This listing is not exhaustive and is based on popular media images (Barak, 1994). The chronicling of metaphors is an extension of my prior work on medicine, law, and crime (e.g., Arrigo, 1993, 1996). The comments that follow Table 1 represent a surface level analysis on the power of martial rhetoric to shape, in part, our understanding of medicine and medical justice.
Although somewhat contrived, these ten sets of metaphors reveal how war-making discourse and militarism inform our understanding of medicine and, by extension, medical justice. In what follows, five interpretive statements are made about how martial rhetoric contributes to our knowledge of medicine. While these observations are speculative and provisional, they demonstrate how the military and medical models in fact collapse into one another. Indeed, as I present my summary statements, consider how different these comments are from the mission and function of the military in American society.
1. Disease and contagion are identifiable, knowable, and controllable. It is possible to combat various forms of illness and pathology.
2. Disease is debilitating and life threatening. It invades the human body and must be eliminated or neutralized, otherwise it will take over one's life. 3. If it is not curtailed or stopped, disease can be destructive not only to our bodies but to the public health of society.
4. Controlling disease requires constant vigilance; that is, it requires a policing of public hygiene through the gathering of clinical studies and testable data conducted by trained physicians and other doctors.
5. Based on the available medical information, illness can be treated, arrested, cured, and the war against disease can be won even if an operation by a specialist is required.
It is worth noting that even on the basis of a surface level analysis, there are several very revealing aspects of war-making discourse in medicine. Clearly, if we were to substitute, for example, the words "disease" or "illness" with the words "enemy" or "foe" throughout the summary statements presented above, the conclusions we would reach would be quite applicable to the generally agreed upon purpose and operation of the military.
Further, the ease with which the military model can be collapsed into the medical model (and vice versa), given the brief listing of metaphors as chronicled above, lends credibility to Ericson's (1994) warning concerning the pervasiveness of their capacity to control crime and other forms of deviance. Indeed, although not specifically identified in the Table, the presence of martial rhetoric in medicine represents a potent force by which strategies for surveillance, notions of defense and attack, and practices of policing can be legitimately enacted and enforced (Foucault, 1965, 1973, 1977).
Finally, and perhaps most speculatively, the text of medicine and militarism represents an established defense, indeed a "community," whose primary purpose is to identify what is right and wrong, what is safe and unsafe, what is good and bad for our individual and collective health. This message suggests that medicine knows how to correct, control, and treat, the illnesses that afflict us so that we can be restored, made well, and can shed our disease.
DECONSTRUCTING MARTIAL RHETORIC AND MEDICAL JUSTICE
By returning to the essential Derridean principles previously outlined and by applying them to Table 1, a more detailed sequencing of comments concerning medical justice is possible. Although these observations are also preliminary, they do set the stage for our assessment on the nature of law and the control of crime/deviance given the presence of martial rhetoric in medical discourse. In order to provide a more systematic deconstructive evaluation, I examine how each tenet relates to particular facets of Table 1.
Reversal of Hierarchies
Given the presence of martial rhetoric in the medical model, it remains to be seen what terms are present and what terms are absent in the text constituting the "medical metaphors" of Table 1. Following Derrida's deconstructive philosophy, by reversing the hierarchies one can decipher several oppositions embedded in the metaphors, thus learning more about what is valued and what is devalued in the text in question. Although this process is inexhaustible (Sarup, 1989) and undecidable (Derrida, 1973), several noteworthy oppositions are discernible. Table 2 lists several medical terms/phrases that assume metaphorical dimensions. These metaphors are the most prominently featured in Table 1. Table 2 also includes their opposites.
Overt images of war and violence, and covert images of death and destruction underscore the medical metaphors. These impressions both saturate and conceal the more absent and repressed terms embedded in the hierarchies. The opposites listed in Table 2 include such notions as peace, health, well-- being, and rest. These more hidden value positions differ substantially from the privileged terms; however, their absence helps maintain the terms that are felt as present, active. dominant. Further, by sustaining the images of war, violence, disease or, conversely, by focusing on the reversal of hierarchies (i.e., peace, serenity, health) we see how the valued and de-valued terms in the hierarchy defer to one another.
Thus, we acknowledge the interdependence of the terms in each hierarchy. Meaning insists in the present/absent terms constituting each hierarchy. The military rhetoric embedded in the medical metaphors described above has value insofar as the trace (or the mark) of these terms contains their opposites.
To illustrate the reversal of hierarchies, differance, and the trace function, let us look more specifically at one metaphorical term. The suggestion that one's "body is under siege" implies that the soma, as a fortified place, is encircled by an opposing armed force intending to take it, usually in some violent way. This siege of the body is persistent; that is, the intent is to gain control and to overtake the body. The absence of the body's siege is to displace control, to be at rest with the soma, to let go of one's fortification, to allow the body to experience its own peace, to simply be without insistence. Both descriptions are embedded in each other's value position, though they differ considerably. To speak deconstructively of the body under siege we must speak of its tranquility as well. Each term is the trace of the other and their respective articulations reveal the interdependence of both in the hierarchy.
MILITARY METAPHORS IN MEDICAL JUSTICE: IMPLICATIONS FOR LAW, CRIME, AND DEVIANCE
Given our provisional deconstructive analysis on martial rhetoric and medicine, the questions remains: what effects do these meanings and assumptions have for the construction of law and the control of crime and deviance? To address this matter, I examine Derrida's notion of community and hospitality and link them to the problem of difference and power as previously delineated in my Foucauldian genealogical critique.
This Special Issue contains a series of articles examining the militarization of crime and its control (see also, Kraska, 1996, Kraska and Cubellis, 1997; Kraska and Kappeler, 1997). The present article, however, more subtlely canvasses this terrain by examining the interdependent and overlapping effects of the military and medical models for purposes of justice. Both disciplinary "regimes" are institutions. As such, they are analogical to Derrida's (1997) notion of community. Derrida displays an antipathy for the notion of community. Essentially, the word connotes "fusion" and "identification" (Weber, 1995: 46). More specifically, though, Derrida's etymological examination of the word suggests the following:
[C]ommunio is a word for military formation and is a kissing cousin of the word 'munitions': to have a communio is to be fortified on all sides, to build a 'common' (com) 'defense' (munis), as when a wall is put up around the city to keep the stranger or the foreigner out. The self-- protective closure of 'community,' then, would be just about the opposite of ..preparation for the incoming of the other, 'open' and 'porous'to the other. ... A 'universal community' excluding no one is a contradiction in terms; communities always have an inside and an outside (as cited in Caputo, 1997: 108).
Thus, the word community implies a more negative effect. "it suggests injustice, inequality, and an 'us' versus 'them' orientation" (Arrigo ad Williams, 1999:8). Medical and military communities, then, are designed to exclude some others. Following our Derridean deconstruction of medical metaphors, these others represent those who are different in some respect; that is, those who experience dis-ease. Disease represents the common foe of the military/medical community. Disease seizes the body and must be policed and combated. Disease is that against which the militarized medical community wages war.
This war, however, is a fight against that difference which disease signifies (e.g., the mentally ill, the physically disabled, the elderly) (Arrigo, 1996). And, to the extent that martial rhetoric informs medicine, this war proceeds through hospitality to the other. This hospitality is what Derrida (1997:110) terms the "welcoming of the other; the invitation to the stranger." But how does the community of militarized medicine host the difference of the other, the difference that is the dis-ease of the stranger?
According to Derrida (1997), the etymology of hospitality is also problematic.
The word hospitality derives from the Latin hospes, which is formed from hostis, which originally meant a 'stranger' and came to take on the meaning of the enemy or 'hostile stranger' (hostilis) + pets (polis, poles, potentia) to have power (pp. 10- 111).
The military and medical communitys' hosting of the other's difference is a display of power. Thus, "being 'hospitable' is an effort to welcome the other while maintaining or fortifying the mastery the host has over the domain" (Arrigo and Williams, 1999:9). Under these conditions, hospitality is never truly hospitable. Derrida (1997:112) refers to this predicament as the "impossibility, of hostil-pitality" (emphasis added). The community that is medicine, informed by military metaphors, can never truly host that difference which disease embodies. The "common defense" of medicine is fashioned around the notion of inhospitality or hostilpitality. The power that this community represents, vanquishes those whose difference challenges its authority.
Thus, the nature of law and the control of crime and deviance in medicine, given the presence of martial rhetoric, functions to advance the policing of public hygiene consistent with the power/knowledge claims of privileged science. Following Foucault (1965, 1973, 1977), medical science is the avatar of truth and, as such, law defers to its pronouncements to advance the episteme of medical justice (Arrigo, 1996: 47-93). The control of crime and deviance in militarized medicine is transformed into the surveillance and discipline of disease through the corrective regime of medicine. All forms of illness symbolize disunity, disorder, pathology, and they are brought under the hospitable and normalizing force of medicine. Accordingly, the health hazards of crime, drugs, and violence, in short, the war against disease, is arrested. This arresting is the injustice that is done to those who are the strangers, the enemies (i.e., those excluded from) the community because of their insistence on being who they are; namely, different.
Derrida (1997) reminds us that "pure unity... is a synonym of death" (p, 13). The presence of military metaphors underscoring medicine and medical justice, have significant implications for the control of disease. Simply put, the difference that disease signifies is policed, patrolled, surveillanced, and corrected. The intent of this article was not to suggest that all forms of such disciplinary regulation are or are not appropriate, rather, the fundamental question provisionally examined here goes to the force and scope of militarized medical discourse to cleanse that which does not already fit into its normalizing, unifying logic.
Clearly certain expressions of dis-ease ought not be subjected to the corrective power of medicine. What remains uncertain, however, is whether it is possible to strip the medical and military models of their capacity to colonize the control of crime, the nature of law, and the presence of deviance. This is the project that awaits. This is a project whose time has come. Perhaps it is possible not only to except some manifestations of difference, some forms of dis-ease, some expressions of social undesirability, but to revel in the disunity that they represent. This may very well be the only way to forestall the "death" that militarized medicine would otherwise inflict upon us. It may very well be the pathway to peace, health, serenity.
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BRUCE A. ARRIGO, PH.D.1
California School of Professional Psychology - Fresno
'Direct all correspondence to: Bruce A. Arrigo, Ph.D. Professor and Director. Institute of Psychology. Law, and Public Policy, 5130 E. Clinton Way. Fresno. CA 93727. (209) 456-2777 Ext. 2290. Email: firstname.lastname@example.org…
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Publication information: Article title: Martial Metaphors and Medical Justice: Implications for Law, Crime, and Deviance. Contributors: Arrigo, Bruce A - Author. Journal title: Political and Military Sociology. Volume: 27. Issue: 2 Publication date: Winter 1999. Page number: 307+. © Dr. George Kourvetaris Winter 1996. Provided by ProQuest LLC. All Rights Reserved.
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