Bioethics De-Mystified

In “Bioethics as a Technology of Government,” the fifth chapter of my monograph, Foucault and Feminist Philosophy of Disability, 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 particular, disability is constituted as a problem for a central mechanism of neoliberal capitalism, namely, biopower, which operates primarily through the exercise of productive forms of coercion and control to maximize the conditions conducive to “life:” the “life” of the species and the “life” of the individual. Note, however, that although the subfield of bioethics emerged to provide intellectual resources for the resolution of the problem of disability, it is simultaneously implicated in the very constitution of disability (and its naturalized foundation, impairment) as a natural deficit and disadvantage. In the fifth chapter, I argue, furthermore, that the eugenic impetus of bioethics, an impetus according to which the appropriate responses to disability are thereby prevention, correction, and elimination, contributes considerably to the antagonistic environment that disabled philosophers confront in philosophy, reproducing both our exclusion from the profession and the marginalization of our critical philosophical work on disability from the discipline.

        Bioethics operates as an area of philosophy whose guiding assumptions and discursive practices are tremendous obstacles to both acknowledgement that the questions which the apparatus of disability raises are genuinely philosophical and recognition that disabled philosophers who investigate these questions are credible philosophers and worthy colleagues. Thus, disabled philosophers of disability confront a wave of epistemic injustice and ridicule if they criticize bioethics too loudly and do so in ways that contest the very consolidation and status of the subfield itself. In short, the subdiscipline of bioethics, which relies on an epistemology of domination, 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. Foucault’s remarks about the three major forms that technologies of government take in their development and history can serve as an apt characterization of the emergence of bioethics as a subfield of philosophy: first, a given technology of government takes the form of a dream or utopia; then, the dream of the technology of government develops into actual practices or rules to be used in real institutions; finally, the practices and rules of the technology of government become consolidated in the form of an academic discipline (Foucault 1988, 145–62; see also Hall 2015, 166–69; Hall 2016).         

        Bioethicists, many of whom are extremely protective of their lucrative subfield and its interests, generally eschew the aforementioned critique of bioethics and dutifully foster the mystique of the bioethics project. For example, most bioethicists continue to depict infamous medical and scientific abuses as disturbing relics of days gone by, that is, as disruptions in the history of an otherwise principled endeavour that strives to ensure that methodologies and practices in biomedicine and biomedical science uphold the highest ethical standards. Even the critiques of bioethics that feminist bioethicists and so-called disability bioethicists articulate implicitly (and, at times, explicitly) authorize the bioethics agenda by assuming the self-understandings and self-image that the subfield of bioethics represents; hence, the direction and scope of these critiques are, for the most part, limited to individualized arguments against a certain biomedical practice or technology, the claims of a certain bioethicist, or a particular application of certain normative principles, leaving the historical conditions of possibility for the overall enterprise of bioethics unexamined and reinforced. In short, my antipathy with the subfield of bioethics constitutes a distinct departure from these other critiques of it. For my argument is that the subfield of bioethics (including disability bioethics and feminist bioethics)—as a concerted enterprise—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 (among other contexts) 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.

       I contend that the field of bioethics is a premier arena for the adjudication of biopower’s capacity to make live and let die, as Foucault put it. For example, the subfield of bioethics rationalizes the proliferation and use of biotechnologies such as prenatal testing and stem cell research and, in doing so, bioethics effectively contributes to the constitution of impairment (among other so-called natural anomalies) through the very identification, evaluation, assessment, classification, and categorization of it, thereby expanding the purview of the apparatus of disability and extending its reach. The subfield of bioethics, I maintain, 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 claim 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 take account of the central role that the subfield of bioethics plays in the persistence of colonialism within philosophy, in the university, in medicine, law, and public policy.

         Philosophers mistakenly regard bioethics as the most suitable domain in philosophy for considerations about disability, as the persistent lack of job opportunities in philosophy of disability and the concurrent proliferation of jobs in bioethics and cognate fields indicate. In so-called Canada, for example, philosophers and bioethicists have played a fundamental 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 ableist legislation and ensuring that disabled specialists in philosophy of disability do not enter the ranks of professional philosophy in Canada. Canada now has the most permissive euthanasia and assistive-suicide legislation in the world thanks in no small part to Canadian bioethicists and other philosophers (Coelho 2022). In addition to the ways in which these bioethicists and philosophers prop up the neoliberal eugenicist arguments of Canadian politicians, they repeatedly generate–in high-profile bioethics journals, on popular bioethics blogs, and in their attentive bioethics classrooms–caricatures and sloppy renditions of the arguments that disabled philosophers who oppose the legislation advance in order to dismiss and quash these arguments. An example of this phenomenon is a feature article that Canadian bioethicist Udo Schüklenk and Canadian law professor Jocelyn Downie (2021) published in a recent issue of Journal of Medical Ethics in which they allegedly substantiate–with a single citation to a 1999 article that an American disabled author wrote–their skewed claims about the arguments that opponents of MAiD in Canada currently advance.

         Indeed, a growing number of bioethicists, both in Canada and abroad, dedicate considerable effort to the task of reconfiguring bioethics in ways that preserve their own disciplinary, professional, and institutional jurisdiction over philosophical claims about disability. 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. The effectiveness of this gatekeeping and complicity with it throughout the profession can be identified, for example, in a variety of diversity and inclusiveness reports compiled by nondisabled philosophers who express either unwarranted satisfaction or optimism with the current situation for disabled philosophers or skepticism about claims that I and other disabled philosophers of disability make according to which disabled philosophers are excluded from philosophy. 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 pretence of political neutrality, objectivity, and disinterest. In other words, the allegedly transformative area of inquiry called “disability bioethics” enhances mainstream bioethics from which it appears to distinguish itself, sustaining the field of bioethics in general and enabling bioethics to enlarge its influence by refashioning itself in the practice of autocritique.

        Philosophy of disability is, by contrast, a categorically insurgent discourse that neither intersects with bioethics nor is derivative of it. Thus, budding philosophers of disability should conceive their work as oppositional to bioethics and as a form of resistance to its eugenic impetus and medicalizing gaze, both of which phenomena increasingly implicate philosophy in the government of disabled people’s lives, while purportedly illuminating and informing their putatively self-actualizing choices. Philosophy of disability is motivated to identify the intellectual materials and practices that consolidate the field of bioethics, are produced by it, and enable it to foster popular acceptance of eugenic normalization in certain contexts, to achieve certain aims. For example, philosophy of disability tracks how the consolidation of the field of bioethics has been enabled by, and is reinforced through, the neoliberal touchstones of autonomy (construed as self-governance) and freedom (construed as individual choice), that is, how bioethics both legitimizes and is grounded in neoliberal assumptions about freedom and autonomy that effectually operate by guiding and limiting the actions of subjects in accordance with their capacity to choose from a highly circumscribed set of possible actions.

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