My Virtual Presentation to philoSOPHIA, June 3, 2022: Disaster Ableism, Assisted Suicide, and Bioethics

The land on which I am currently located and from which I am joining this philoSOPHIA conference is the traditional ancestral territory of the Haudenosaunee and Anishnaabeg, covered by the Upper Canada Treaties and directly adjacent to Haldimand Treaty territory. My presentation today is an expression of my commitment to engage in active solidarity with Indigenous peoples of so-called Canada and other settler states who, for thousands of years, have held sacred the land, water, air, and sky, as well as their inhabitants and have struggled, for centuries, to protect them from the ravages and degradation of colonization and expropriation.

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DISASTER ABLEISM, ASSISTED SUICIDE, AND BIOETHICS

By

Shelley Tremain, Ph.D.

Presented in “Philosophy of the Limit: Risk, Disaster, and Infrastructure”

A Virtual Panel

Although disability bioethicists insist that Peter Singer’s claims about disabled people are morally reprehensible, their critiques do not extend to the subfield of bioethics itself. Rather, disability bioethicists (as they refer to themselves) aspire to improve the field of bioethics by revising the discriminatory biases and assumptions about disabled people that they perceive to currently condition contributions to the field. For disability bioethicists such as Joe Stramondo and Joel Reynolds, the governmental and eugenic character of the values and beliefs about disability and disabled people that bioethics promotes are accidental features of the enterprise rather than its defining characteristics and the impetus for its very existence.

For disability bioethicists, that is, ableism is a problem within bioethics which they assume can be rectified with the development of better approaches to bioethical inquiry; that is, disability bioethicists frame the relation between power and the subfield of bioethics in (neo)liberal, juridical terms, with critical reference to the unsavory arguments of certain bioethicists, the eugenic consequences of certain practices, and misapplication of certain normative principles, such as autonomy and quality of life, all of which frames of reference effectively individualize the institutional and structural injustices of bioethics.

In On Being Included (2012), Sara Ahmed argues that institutional racism is individualized in this way and points out the cost of this individualization. Ahmed writes:

[R]acism should not be seen as about individuals with bad attitudes … because such a way of thinking underestimates the scope and scale of racism, … leaving us without an account of how racism gets reproduced….The argument can be made in even stronger terms: the very identification of racism with individuals becomes a technology for the reproduction of racism of institutions. (Ahmed 2012, 44; emphasis in Ahmed)

My argument is that the eugenic impetus of bioethics conceals its own origins in this way, that is, the very identification of eugenic ableism in bioethics—for example, with individual bioethicists (such as Singer)—is a technology that enables the reproduction of eugenic ableism as a fundamental condition of possibility for the field of bioethics. In short, disability bioethicists fail to recognize that the subfield of bioethics is an expanding mechanism of institutionalized ableism, assuming instead that bioethics is merely an arena in which occasional instances of ableism manifest. Such tendentious and indeed wishful constructions of the subfield of bioethics as an unmotivated enterprise, an innocuous, if not progressive, field of inquiry, are instrumental to (what I call) “the mystique of bioethics.”

I use the term mystique of bioethics to refer to, first, the technology by which the eugenic impulse of bioethics is concealed; second, the structural gaslighting that enables this concealment, casting bioethics as the domain of a specialist knowledge that renders bioethicists uniquely qualified to evaluate a purportedly distinct set of questions and concerns; and third, the technology of this supposedly specialist knowledge whereby, through practices and strategies of mystification vital to the apparatus of disability, systemic social and political problems are naturalized, individualized, and medicalized. Indeed, the profession-wide ableist contract to quash or at least ignore comprehensive external critiques of the subfield of bioethics is the most consequential, entrenched, and obfuscated scandal in philosophy with respect to academic freedom.

In this presentation, I draw upon Kyle Whyte’s work on “epistemologies of crisis” (2021) and Naomi Klein’s writing about “disaster capitalism” (2007) to elaborate my claim that bioethics is a neoliberal technology of government. Whyte uses the term epistemologies of crisis to refer to colonialist narratives and ways of knowing that characterize certain situations and states of affairs as unprecedented and urgent, while disregarding the history of colonization to do so. Klein coined the term disaster capitalism to describe elements of neoliberalism that variously produce, exploit, and aggravate economic, political, environmental, and social disasters and crises in ways that expand unregulated economic markets.

In this presentation, I extend my previous arguments about bioethics as a technology of neoliberal eugenics by introducing the term disaster ableism to refer to strategies and practices that produce, exploit, and aggravate perceived and actual economic, political, environmental, and social disasters and crises in ways that advance ableist agendas and eugenic goals.

In Foucault and Feminist Philosophy of Disability (2017), I assert that bioethics emerged as a technology of government to resolve the problem that the production of disability poses for the neoliberal management of societies. In the book, I argue, furthermore, that the eugenic impetus of bioethics according to which the appropriate responses to disability are prevention, correction, and elimination, contributes considerably to the antagonistic environment that disabled philosophers confront in philosophy, reproducing our exclusion from the profession and the marginalization of critical philosophical work on disability from the discipline.

My antipathy with bioethics constitutes a distinct departure from other critiques of it. For my argument is that the subfield of bioethics—including disability bioethics and feminist bioethics—is a neoliberal mechanism and technology of biopower whose increasing institutionalization and legitimation in the university, in the discipline of philosophy, and in public policy consolidate and conceal the fundamental role that this field of inquiry plays in biopolitical strategies of normalization and hence the government of populations and individuals.

The field of bioethics, I maintain, is increasingly a premier arena for the adjudication of biopower’s capacity to make live and let die, as Foucault put it; that is, the subfield of bioethics constitutes and comprises a set of strategic discursive practices that work in the service of normalization and the government of conduct to eliminate impairments that medical, juridical, and administrative discourses are claimed to discover and manage, while simultaneously enabling these discourses to enlarge the scope of the broad outlines of the category of impairment itself. As a technology of racism against the abnormal (to use Foucault’s insight), bioethics is a modern form of race science. Thus, efforts to decolonize philosophy must recognize bioethics as foundational to the persistence of colonialism, racism, and ableism within philosophy, in the university, in medicine, law, public policy, and society more generally.

In so-called Canada, bioethicists have played a formative role in the creation of a culture of eugenics within the discipline of philosophy and in the Canadian milieu at large, both influencing the development and promulgation of the ableist, racist, and classist legislation that I discuss in this presentation and ensuring that disabled specialists in philosophy of disability do not enter the ranks of professional philosophy in Canada.  In short, bioethicists act as gatekeepers for philosophy, shielding the profession from an influx of disabled people and guarding the discipline from the incursion of philosophy of disability.

Indeed, disabled philosophers of disability confront a wave of epistemic injustice and ridicule if they criticize bioethics too loudly and in ways that contest the very consolidation and status of the subfield itself. Exceptions to this exclusion—exemplified by practitioners of so-called disability bioethics—are admissible and serve to disguise and legitimize the subfield of bioethics, typifying the polymorphic character of neoliberalism from which bioethics has emerged and enabling philosophy to proceed under the guise of political neutrality, objectivity, and disinterest.

Insofar as bioethics is an instrument and mechanism of neoliberalism, which aims to normalize populations in ways that make them cost effective and governable, an understanding of the operations of neoliberalism can help us identify and resist the power relations that animate bioethics and enable its governmental strategies to proliferate. If we wish to learn how the episteme of neoliberalism produces values, norms, and practices that capitalize on disasters and crises, we should look to the analysis that Klein develops in her landmark book, The Shock Doctrine: The Rise of Disaster Capitalism.

In The Shock Doctrine, Klein sets out to show how capitalism variously produces and exploits disasters and crises as a means to radically change economies and governments. For Klein, the wizard of this social movement was economist Milton Friedman who wrote the instruction manual for the contemporary global economy whose mobility steadily outstrips geopolitical borders through policies of deregulation and a race to the bottom with respect to workers’ wages and other benefits. For example, as Klein explains, Friedman used Hurricane Katrina and the flooding of New Orleans in 2005 to facilitate the privatization of the city’s public education system. As Friedman put it: “Most New Orleans schools are in ruins… This is a tragedy. It is also an opportunity to radically reform the educational system” (Friedman, in Klein 2007, 5).

Friedman’s “radical” idea was that the Louisiana government should distribute vouchers to families that they could in turn spend at state-subsidized, private, charter schools, many of which are run for profit. He emphasized, furthermore, that this elemental change in the way that education in New Orleans is financed should be regarded as a “permanent reform” rather than merely a temporary stop-gap measure. Indeed, less than two years after the levees were breached, privately-run charter schools had almost entirely replaced the New Orleans public school system and all of the members of the New Orleans teacher’s union had been fired. For Klein, this dismantling of the New Orleans public school system post-Katrina exemplifies “disaster capitalism,” which she defines as “orchestrated raids on the public sphere in the wake of catastrophic events, combined with the treatment of disasters as exciting market opportunities” (Klein 2007, 6).

My argument is that all levels of government in so-called Canada, as well as various academics, journalists, think tanks, corporations, and foundations have seized upon the COVID-19 pandemic as an opportune occasion to engage in (what I call) “disaster ableism,” that is, have exploited the pandemic and the circumstances that surround it to cultivate norms, values, and beliefs that promote eugenic goals and ableist agendas. In particular, the current Liberal federal government and the bioethicists to whom Canadian politicians regularly defer and appeal employed disaster ableism to usher into law legislation—namely, Bill C-7—that significantly expands neo-eugenics in Canada.

During the height of a global pandemic, when the residents of Canada were losing their loved one’s, their dwellings, and their incomes due to COVID-19; were living in situations of fear, misinformation, and confusion; and were increasingly distracted and isolated, the Canadian federal government bypassed adequate public consultation, usurped international treaties, disregarded the objections of Indigenous community leaders, manipulated parliamentary procedure, and made a mockery of disabled experts at its legislative proceedings on Bill C-7, in order to ensure passage of legislation that would make sweeping changes to existing Canadian laws on medically assisted suicide.

In other words, the same neoliberal government which, throughout the pandemic, has consistently failed to provide financial and other social supports to disabled people and has allowed thousands of them to die of COVID-19 and neglect in nursing homes and other congregate settings in which disabled people are confined, instituted a sinister new way to (in the words of Friedman) “permanently reform” distribution to disabled people, namely, by providing them with easier access to premature death rather than providing them with the means to live their lives.

Canadian bioethicists, law professors, politicians, and some very privileged white disabled people claim that Bill C-7 promises greater equality for disabled people by further enshrining their rights to autonomy and self-determination; however, poor, racialized, Indigenous, trans, and queer disabled people recognize that Bill C-7 constitutes a threat to their collective existence, in addition to the threats that the legislation poses to their respective personal safety, sense of belonging, and self-respect.

Canadian bioethicists, law professors, and politicians claim that Bill C-7 was a unique corrective to past legislative mistakes and, in addition, that arguments to the contrary amount to fallacious slippery slope reasoning; however, disabled people in Canada persistently argue that Bill C-7 is part of a long and treacherous Canadian history of eugenic policies and practices directed at disabled people and Indigenous people (among others) that the incremental normalization of the policies and practices depoliticizes and erases. Indeed, the arguments that Canadian bioethicists, law professors, and politicians advance about Bill C-7 and medically assisted suicide in general are typical of the colonialist presentism that is characteristic of epistemologies of crisis.

Recall that Whyte uses the term epistemologies of crisis to refer to colonialist narratives and ways of knowing that characterize certain situations or states of affairs as unprecedented and urgent, ignoring histories of colonization and traditional teachings of Indigenous communities to do so. Epistemologies of crisis, Whyte writes, involve knowing the world such that a certain present is experienced as new. In other words, crisis epistemologies are presentist in their narrative orientation: they assume a certain conception of the unfolding of time as means to the achievement of power or the protection of privilege. In particular, presentist orientations favour experiences of time that presume unprecedentedness and urgency; that is, presentism is an exercise of colonial power that effaces the historical realities and conditions of this colonial power. As Whyte notes, Indigenous Studies scholars have given considerable attention to the temporal assumptions on which settler colonial power relies, critically exposing the liberal assumptions about the primacy of individual autonomy and the settler state that are embedded in national origin stories (Whyte 2021, 53).

In this regard, Whyte refers to Audra Simpson who, noting that the “settler colonial present” is one of “purported newness,” writes that the settler colonial present is “revealed as the fiction of the presumed neutrality of time itself, demonstrating the dominance of the present by some over others, and the unequal power to define what matters, who matters, what pasts are alive and when they die” (Simpson 2017: 21, in Whyte 2021). In this way, Whyte points out, one becomes so preoccupied with the present crisis as new that one questions neither one’s own perspective nor the social origins from which the perspective may derive (Whyte 2021, 54-55). In short, the sense of imminence that accompanies presentism leads people to obscure or minimize how their actions relate to the persistence of colonialism, capitalism, ableism, racism, and other forms of power (57).

I contend that the events, justifications, and rationale surrounding the creation and passage of Bill C-7 have been framed within a presentist narrative. By framing Bill C-7 as a unique and urgent new procedural corrective, Canadian bioethicists, law professors, journalists, and politicians have, again, reconfigured and obfuscated the incremental normalization of eugenic practices in precisely the way that Whyte describes, that is, according to the presentist orientation of an epistemology of crisis. This presentist orientation positions the notions of personal autonomy and quality of life as existing outside of any temporal location, as timeless and universal, and in doing so, conceals the historically contingent and culturally specific character of these politically motivated ideals, as well as the way that these constructs emerged from and reproduce the liberal settler state itself.

Indeed, both the incremental normalization of eugenic bioethical practices and the apparatus of disability from which the strategies of this mechanism derive have their origins in colonialism and the liberal settler state.

References

Ahmed, Sara. 2012. On Being Included: Racism and Diversity in Institutional Life. Durham and London: Duke University Press

Klein, Naomi. 2007. The Shock Doctrine: The Rise of Disaster Capitalism. Toronto: Vintage Canada.

Simpson, Audra. 2017. “The Ruse of Consent and the Anatomy of ‘Refusal’: Cases from Indigenous North America and Australia.” Postcolonial Studies 20: 18–33.

Tremain, Shelley L. 2017. Foucault and Feminist Philosophy of Disability. Ann Arbor:  University of Michigan Press.

Whyte, Kyle. 2021. “Against Crisis Epistemology.” In Routledge Handbook of Critical Indigenous Studies, 52-64. Brendan Hokohitu, Aileen Moreton-Robinson, Linda Tuhiwai-Smith, Chris Andersen, and Steve Larkin, eds. New York and London: Routledge.

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