Academic journal article The Hastings Center Report

Biomedicine and Technocratic Power

Academic journal article The Hastings Center Report

Biomedicine and Technocratic Power

Article excerpt

Current developments in biomedicine promise a genetically engineered and better future.(1) A "genetic future" would mean incorporating more high technology medicine into the habits of everyday life. The order of the body, that is, the sense of how we should look, act, and perform, would become the domain of conventional medicine, and we would look to medicine to intervene in human performance, ability, and even character when we thought these were less than they should be. Our willingness to accept medicine in this capacity would require the deeper conviction that technological developments and scientific discoveries are proper measures of human progress.(2)

Such attitudes are not remote from contemporary values. We live in an era in which many personal and social problems are treated as if they were matters capable of technical solution-the interventionist response to infertility through in vitro fertilization is an example. Such a belief system conceals from us the probability that advanced technology will not successfully solve the complex social problems we think it should. Moreover it grants to advanced technology, and those who own and control it, a high social value. Indeed, so highly valued is technical knowledge that it can supersede moral considerations and argument in providing a base upon which therapeutic and research decisions are taken. For example, the widespread use of amniocentesis and chorionic villus sampling, which foretell the sex, health, parentage, and future diseases of the fetus, has the immediate appeal of decreasing the numbers of damaged and defective newborns by indicating the "need" to terminate a pregnancy but, simultaneously, the same technology has the latent function of determining which human lives are more valuable, or in utilitarian terms, which individuals are potential welfare burdens to the community in the long term.

Measuring the future capacities of a fetus is a form of human accounting that estimates the individual's future costs or contribution to the society. As early diagnostic and screening procedures become technically commonplace, a classification of human traits deemed suitable for remediation is simultaneously coming into effect. In the future, as more of our genetic abilities and characteristics are foretold by technically sophisticated probes, we would look to medicine to intervene to ensure that our physical appearance and capacities are in accord with current standards of normalcy.(3) In these circumstances, the practices of biomedicine have the latent function of social engineering.

Michel Foucault has argued that this is characteristic of medicine in the West, whose development is coterminus with an account of how social power is accumulated by an elite profession through its increasingly esoteric technical base.(4) The rapid increase in the medicalization of various human conditions has served to promulgate the view that medicine can perfect human life. Many of the current well publicized developments in medicine such as genetic testing, transgenic engineering, organ transplants, and so on, promise a perfected human in a future bio-utopia where debilitating diseases and degeneration have been effectively eliminated.(5) In such a future, our dependence on medicine to specify and regulate how we should live and behave has the effect of indenturing us to the professional ambitions of medicine. The point must be emphasized that medicine has not been greatly successful in raising the standards of health across the community. On the contrary, history has shown a different view.(6) However, the image and status of medicine are such that its promises to rid us of this disability and that discomfort have seemed immediately plausible. Thus, the elite position of the profession is assured and many opportunites for further expansion are gleaned from its promissory image of a bio-utopian future.

Viewing medicine through a Foucauldian perspective is to be less concerned with social consequences that may result from specific biomedical achievements and more aware of the pan that the medical technocrat plays in directing social and government policy in matters that affect the individual's general life chances. …

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