Inclusion: The Politics of Difference in Medical Research

By Steven Epstein | Go to book overview

CHAPTER TWELVE
Whither the Paradigm?

Where might the inclusion-and-difference paradigm be heading? Having explored the history of its emergence and consolidation, and having investigated its consequences and implications, we can now ask: What is its likely future? In this chapter, I take up three issues that are central to assessing that trajectory. First, I examine the degree to which these reforms establish a model that can be extended to other groups: aside from women, people of color, children, and the elderly, who else will “qualify” as full biopolitical citizens under its framework? And to the extent that such extensions may be resisted, what accounts for the opposition? As part of this discussion, I pay special attention to attempts by lesbian, gay, bisexual, and transgender (LGBT) health advocates to jump on the inclusion-and-difference bandwagon—so far with limited success.

Second, I consider the durability of the paradigm in hostile political climates, as well as the internal tensions that hostile scrutiny may bring to light. Is the inclusion-and-difference paradigm necessarily dependent on politically liberal defenders? Finally, I consider the paradigm's likely capacity to “travel” across international borders. Are other countries adopting, or are they likely to adopt, these particular ways of thinking about biomedical identity and difference? Together, these analyses suggest the staying power of this means of administering and ministering to bodies and groups, but they also point out some of the practical limits on its extension.


DOMAIN EXPANSION

Who gets to become a “special population”? Once particular ways of conceiving of biomedical difference are institutionalized, to which kinds

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