Why Do Disability Bioethicists and Feminist Bioethicists Sustain the Status Quo of the Apparatus of Disability?

This past weekend, I wrote a comment on a Twitter thread according to which disability bioethicists extend the biopolitical normalization of the apparatus of disability rather than challenge it, sustaining the status quo. It would have been more astute for me to have written, as I have in a few places (including here), that disability bioethicists (and feminist bioethicists) legitimate the ways in which bioethics operates in the service of biopolitical normalization. In order to go some distance to ameliorate these remarks and illuminate my broader position, therefore, I have copied below a draft excerpt from a chapter that I have written for The Bloomsbury Guide to Philosophy of Disability, the pathbreaking collection that I’m editing which will be published in Spring 2023.

The excerpt is part of my broader critique of the subfield of bioethics as a technology of government. Thus, some of the excerpt may be familiar to readers and listeners of BIOPOLITICAL PHILOSOPHY. A post of the excerpt seems timely, nevertheless, given the recent publication of The Routledge Handbook of Feminist Bioethics which includes a chapter on medically assisted suicide authored by Jocelyn Downie, the leading proponent of the practice in Canada (outside of a Canadian philosophy department). In this regard, I have written a number of posts on BIOPOLITICAL PHILOSOPHY about feminist support for Downie’s efforts. For instance, here and here. My thanks to BIOPOLITICAL PHILOSOPHY blogger Mich Ciurria who alerted me to “Philosophy as a Profession” (1975), the article by Alison Jaggar that I cite in the excerpt.

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Excerpt from “Disaster Ableism: Epistemologies of Crisis and the Mystique of Bioethics”

Bioethics is a profession unto itself, as well as an academic subfield of philosophy and other disciplines. Hence, many bioethicists are both employees of universities and paid consultants to governments, pharmaceutical companies, TV shows, hospitals, the nursing-home industry, and so on. Insofar as bioethics is a profession, bioethicists are deeply attentive to the norms of their profession and the maintenance of these norms, which–through processes of structural gaslighting and mystification–involve attribution to the profession of a distinctly unique expertise and ethical authority, policing the borders of the profession, and reinforcing it internally (Jaggar 1975). As members of a profession, that is, a primary allegiance of bioethicists–including disability bioethicists–is to other members of the profession, in addition to the commitment of bioethicists to the status and prestige of the profession itself.

Furthermore, the status and prestige of the profession of bioethics have looping effects that confer recognition and expertise upon individual members of the profession, increasing their odds of success with respect to employment, funding, publication, and promotion, as well as improving the odds that the universities that employ them will be successful in securing corporate sponsorships, philanthropic endowments, and government grants. Thus, insofar as (disabled) philosophers identify themselves as disability bioethicists and their work on disability as bioethics, they benefit, both personally and professionally, from this status and prestige, even though their work may, in many respects, closely resemble the work of (disabled) philosophers of disability who do not benefit from these privileges and the opportunities that they afford.

Bioethicists (including disability bioethicists and feminist bioethicists), who are, in general, extremely protective of their lucrative profession/subfield and its interests, reject my critique of bioethics and dutifully foster the mystique of the bioethics project. With few exceptions, for example, bioethicists will not acknowledge that their profession effectively enables the steadily expanding production and rationalization of biopolitical normalization and its social harms, but rather explain the genealogy of their profession and its steady expansion in terms of discrete events (such as the decades-long complicity of medical ethicists in the Tuskegee Study), casting this expanding governmentality as the necessary antidote to disruptions in the history of an otherwise noble endeavor which strives to ensure that the methodologies and practices of biomedicine and biomedical science uphold the highest ethical standards (for example, The Hastings Center, n.d.).

Yes, even the critiques of bioethics that so-called disability bioethicists and feminist bioethicists articulate implicitly (and, at times, explicitly) authorize the bioethics agenda by assuming the self-understandings and self-image that the profession/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, all of which critiques are cosmetic fixes to the profession of bioethics that leave unexamined the historical conditions of possibility for the overall enterprise of bioethics and enable the profession of bioethics itself to be reinforced.          

My antipathy with bioethics constitutes a distinct departure from other critiques of it. For my argument is that 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, in law, and in public policy (among other contexts) consolidate and conceal the fundamental purpose that this field of inquiry serves in biopolitical strategies of normalization and hence the government of populations and individuals. In short, the field of bioethics is a premier arena for the adjudication of biopower’s governmental capacity to make live and let die, as Foucault put it; that is, bioethics is founded on the rationalization of eugenics. 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 ways in which bioethics is instrumental to the persistence of colonialism within philosophy, in the university, in medicine, law, and public policy.

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