Bioethics (De)Mystified: A Foucauldian Argument For Why Bioethics Must Be Abolished

In “Bioethics as a Technology of Government,” the fifth chapter of 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 (Tremain 2017, pp. 159-202). 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 (Foucault 1978). Note, however, that although bioethics emerged as a technology of government to provide intellectual resources for the resolution of the problem of disability, it is simultaneously implicated in the constitution of disability (and its naturalized foundation, impairment) as a self-evident and, hence, philosophically uninteresting, natural deficit and disadvantage.

Indeed, the subdiscipline of bioethics, which relies on an epistemology of domination, is an institutionalized vehicle for the biopolitics of our time, that is, the intellectual resources that bioethics provides 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 biopolitical 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, pp. 145–62; see also Hall 2015, pp. 166–69; Hall 2016). In the fifth chapter of my monograph, I use Foucault’s identification of biopolitical technologies of government as a manual to trace a genealogy of the introduction and growth of the subfield of bioethics.       

The representation within bioethics (and philosophy in general) of disability as an inherently disadvantageous personal characteristic and the eugenic impetus of bioethics that is co-constitutive with this representation–an impetus according to which the appropriate responses to disability are thereby prevention, cure, and elimination–contribute 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. That is, bioethics operates as an arena 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. Disabled philosophers of disability thus 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.

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 bioethicists are members of the bioethics profession, they are deeply attentive to the preservation and maintenance of the norms that guide this profession, including norms that–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 the profession of bioethics, 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 raise the status and prestige of the profession itself.        

Both these loyalties deserve mention because one of the two co-editors of Bioethics, the flagship journal of the profession/subfield of bioethics–namely, Canadian bioethicist Udo Schüklenk–is the most prominent proponent of medically assisted suicide (MAiD) in Canadian philosophy, a state of affairs that significantly conditions the contents of the journal and the shape of philosophy worldwide. In this regard, note, furthermore, that the status and prestige of the profession of bioethics have looping effects that confer recognition and expertise upon individual bioethicists themselves, improving their odds of accomplishment with respect to employment, publication, funding, 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 the status and prestige conferred upon the profession of bioethics, 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 and even though their work is likely, given professional norms of bioethics, less original and innovative than the work that philosophers of disability produce.

Bioethicists (including disability bioethicists and feminist bioethicists) are, in general, extremely protective of their lucrative profession/subfield and its interests and thus reject my critique of bioethics, dutifully fostering the mystique of the bioethics project. For example, bioethicists will not acknowledge that the expansion of their profession coincides with and enables the steadily expanding production and rationalization of biopolitical normalization and its social harms; instead, bioethicists explain the genealogy of their profession and its steady expansion in terms of discrete events–such as the decades-long involvement 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 Timeline Committee, n.d.).

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; thus the purposes and scope of these critiques are, for the most part, limited to individualized arguments against a certain biomedical practice or technology, the arguments 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 its internal reinforcement. In other words, the professional norms of bioethics induce disability bioethicists and feminist bioethicists to comply with the apparatus of disability and the neoliberal eugenics that impels it. For example, disability (and feminist) bioethicists largely remain silent about the grievous arguments to promote MAiD that Schüklenk and other prominent bioethicists articulate.

Therefore, I want to underscore that my antipathy with the subfield of bioethics constitutes a distinct departure from the reformist critiques of bioethics that disability bioethicists and feminist bioethicists produce. 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 contributes to the constitution of impairment (among other so-called natural anomalies) through the very identification, evaluation, assessment, classification, and categorization of it, thereby enlarging the purview of the apparatus of disability and extending its reach.

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 allege 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 ways in which bioethics is instrumental to the persistence of colonialism within philosophy, in the university, in medicine, law, and public policy (Pitts and Tremain 2022). Robin Kelley, referencing the lessons of various disabled authors, has pointed out that disability justice embraces a framework of abolitionism, that is, “disability justice,” Kelley writes, “demands nothing less than the overthrow of ableism and all the structures that undergird it” (Kelley 2022; emphasis in Kelley; also, Mingus 2011). My argument is that in order for philosophy to advance justice for disabled people, bioethics–as a mechanism and technology of the apparatus of disability–must be abolished.

 As I have pointed out, philosophers 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, bioethicists have played a vital 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 MAiD 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). Meanwhile, the Canadian philosophical community continues to virtually exclude disabled philosophers, especially disabled philosophers of disability. As I have indicated, the legitimation of the MAiD legislation in Canada and the exclusion of disabled philosophers from Canadian philosophy are interwoven by the medicalized understanding of (the apparatus of) disability that is mutually constitutive of them.

In addition to the ways in which bioethicists and philosophers influence and prop up the neoliberal eugenicist arguments of Canadian politicians, they repeatedly generate–in high-profile bioethics journals, on influential bioethics blogs, and for their impressionable bioethics classes–caricatures and sloppy renditions of the arguments against MAiD legislation that disabled Canadian philosophers and other disabled Canadian authors and their allies advance. An example of this careless exercise of ableist privilege is a “feature” article that Schüklenk and Canadian feminist law professor Jocelyn Downie recently published in an issue of Journal of Medical Ethics. In the article, Downie and Schüklenk (2021) purportedly substantiate–with a single citation to a 1999 article written by an American disabled author–their responses to objections from opponents of MAiD in Canada who argue that the Bill C-7 legislation and Canadian proponents of MAiD ignore the social and political circumstances out of which the legislation and arguments that support it have emerged.

Like Schüklenk, a growing number of bioethicists, both within 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. Indeed, 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 adherence to it throughout the profession can be identified in (for example) a variety of diversity and inclusiveness reports compiled by nondisabled philosophers who (1) express unwarranted satisfaction with and optimism about the current situation of disabled philosophers; or (2) display skepticism about arguments that I and other disabled philosophers of disability make according to which disabled philosophers are excluded from philosophy; or (3) ignore that situation of disabled philosophers altogether. Exceptions to this exclusion—exemplified by practitioners of 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, among its other pursuits, 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 sustained 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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