Content area
Full Text
Thank you for inviting me to give this lecture - and apologies for my rather pretentious title.1 I want to do something quite modest - to sketch out the approach that I have taken to the analysis of the biopolitics of the 21st century - which I term 'a politics of life itself'. I want to talk about five dimensions where I believe that we can see significant mutations occurring. I name these, rather awkwardly, molecularization, optimization, subjectification, expertise, bioeconomics. But first, let me say a few words about medicine.
MEDICINE - THEN AND NOW
You will not be surprised if I start with Michel Foucault. His great book on medicine, Birth of the Clinic teaches a methodological lesson (Foucault, 1973). The birth of the clinical gaze at the start of the 19th century came about through intersecting changes in many different areas: changes in practices of assistance, re-organization of medical professions and medical pedagogy, new ways of keeping records in hospitals that enabled new statistics of illness and death, developments in pathological anatomy and post-mortem dissection of those who died in hospital, and so forth. If we are living in the midst of a mutation, we should heed this lesson: not to look for a single cause but try to chart the way in which multiple shifts enable something new to emerge - something that does not stabilize, but continues to mutate.
'The body itself' still remains the focus of the clinical gaze. But Foucault's book, first published in 1963, was written at the end of the 'golden age' of clinical medicine. As he wrote, a new kind of medicine was taking shape. Many have described this new medical territory (e.g. Armstrong, 1983, 1995; Arney and Bergen, 1984; Clarke et al. , 2003; Horton, 2004; Starr, 1982). Medical jurisdiction extended beyond accidents, illness and disease, to the management of chronic illness and death, the administration of reproduction, the assessment and government of 'risk', and the promotion of health. The maintenance of the healthy body became central to the self management of many individuals and families. And while the scope of medical authority was extended in this way, it also came under unprecedented challenge. Critics diagnosed a medicalization of social problems, argued that...