The March special issue of the Journal of Sociology has a special issue edited by Emma Kowal and the ever-excellent Alan Petersen, from Deakin and Monash Universities in Australia exploring the sociology of ‘bio-knowledge,’ and so may be of real interest to physiotherapists.
Kowal and Petersen’s editorial offers a potted history of sociology’s interest in the field and provides some very useful references. The editorial is reproduced below, and an index of the full edition of the journal can be found here (link).
Sociology of bio-knowledge at the limits of life
In what has been called ‘the century of biology’ (Venter and Cohen, 2004), the reach of the ‘bio’ seems limitless. This prefix has been attached to diverse entities, activities, perspectives and fields of practice: bioscience, biomedicine, biotechnology, bioeconomies, biobanks, biorepositories, biosecurity and bioethics, to name a few. Beginning in the mid 1980s, the process of biomedicalisation, as characterised by Adele Clarke and colleagues, has substantially transformed the relations between knowledge, practices and identities. Biomedicalisation is characterised by efforts to optimise health, especially through risk reduction strategies implemented across all aspects of daily living (Clarke et al., 2010). New fields of ‘bio-knowledge’ (Petersen, 2013), in particular molecular biology, stem cell science, neuroscience and genomics, are reshaping subjectivities and the concept of life itself (Rheinberger, 2000), particularly at its limits: conception (see MacGregor’s contribution), disability (see Kenny), addiction (see Duff) and death (see Kowal and Radin). Bio-knowledge is mobilised to promote new economies (see Petersen and Krisjansen) and new forms of public engagement (see Marks and Russell).
This special issue considers sociological understandings of the manifestations and implications of bio-knowledge. Sociologists have arrived at the study of bio-knowledge and its impacts relatively late when compared to, say, historians and philosophers of science, whose field of study has its origins in the early modern period and, arguably, the pre-modern period. The field of bioethics is more recent, but traces a long history of interest in bio-knowledge – four or more decades, depending on whether one highlights seminal figures, key organisations or events, or technological breakthroughs (Fox and Swazey, 2008: 24–8). While the sociology of ‘everyday life’ has long captured the sociological imagination, from Simmel to Bourdieu, biological ‘life itself’ has been a much more recent interest (Franklin, 2000; Rose, 2006). Sociologists’ systematic engagement with bio-knowledge only commenced in the 1990s, and with earnestness in the 2000s as the mapping of the human genome gained pace and various ethical, social and legal research funding initiatives followed in its wake.
In general, the sociological study of bio-knowledge has followed some steps behind purported science and technology breakthroughs, attendant media coverage, and policy and bioethics interest. Even then, this engagement has largely focused on the contexts and implications of specific technologies (e.g. genetics, stem cell therapies) rather than questions of epistemology and the politics of knowledge. If there is a single element common to professional sociological identities, it may be an opposition to biological explanations, even if this has been often implicit. In the late 19th and early 20th centuries, there was some consensus among sociologists that the discipline’s unique field was the study of ‘the social’ or of ‘society’, as opposed to say, the study of ‘law’, ‘politics’ or ‘culture’ which defined other disciplines; however, it has been argued that such consensus no longer exists (Wickham, 2012). According to Wickham, the consensus about sociology’s object gave the discipline a public influence that it now lacks (2012: 341). If one accepts Wickham’s argument about sociology’s lack of a unifying object – which is supported by Scott (2005), who points to the fragmentation of contemporary professional sociology – then it should come as no surprise that sociologists have failed to articulate an explicit moral or political standpoint in regard to what sociology has been at least implicitly opposed.
Sociologists have often drawn attention to the uses and abuses of biological essentialism; however, they have often been neglectful of the systems, networks and actors that produce bio-knowledge. Recently, some sociologists have argued that sociology needs to adopt a more sophisticated and productive dialogue with biology; indeed, to ‘bring back’ the biological into sociology (Williams et al., 2003). This call is unsurprising given the breakdown of the nature/culture divide which has been hastened by the synthetic possibilities of contemporary biotechnology (Franklin, 1995; Latour, 1993). In a world where natural and cultural objects blur into each other (if they have ever been divided), sociology’s characteristic quarantining of the social from the biological is untenable.
The papers in this special issue demonstrate the role of sociology in making sense of and influencing debates and policy relating to emergent fields of bio-knowledge. The need for such engagement has become urgent. Developments in the life sciences have been of growing interest to the media, policy makers and scholars from diverse fields. A new wave of research that gathered pace in the 1990s focused unprecedented attention on the prospects for the biosciences to ‘transform’ life, with many commentators predicting they would deliver both human value, especially improved health, and economic value. The announcement of the cloning of Dolly the sheep in 1996 and the completion of the mapping of the human genome in 2000, combined with growing optimism surrounding genomics, stem cell science, and reproductive medicine and neuroscience, has led to much hype that the life sciences will imminently ‘revolutionise society’. However, debates on the implications of these developments have generally been led by those outside the discipline of sociology; principally, by scientists, philosophers, bioethicists and legal scholars. Questions concerning the normative implications of developments have often been framed as ‘bioethical’ questions. Sociologists have been noticeably absent from discussion on the ‘big picture’ implications of developments, leaving others, such as bioethicists, to explain them.
With some important exceptions (Brosnan, et al., 2013; Corrigan, 2003; Cribb et al., 2008), sociology has in the main continued to occupy a ‘handmaiden’ role to bioethics in debates about the significance of bio-related developments. The dominance of bioethics reasoning – characterised by deference to abstract principles when analysing complex sociopolitical issues (Petersen, 2011: 6–7) – has limited theoretical horizons. Sociology has its own distinctive perspectives and questions to pose in relation to bio-knowledge and its impacts, and through theoretically informed empirical investigations can add dimensions missing from more abstract bioethical reflections.
Sociological work on the enmeshment of bio-knowledge with the workings of power and politics has been influenced, in particular, by the writings of the French philosopher-historian Michel Foucault. Foucault’s concepts of bio-power and bio-politics, introduced in The History of Sexuality, vol. 1 and in his lectures (Foucault, 1990, 2003, 2010), have been highly influential in sociology and are drawn on by most contributors in this special issue. The concept of bio-power describes how technologies and practices of government emerging in the 19th century and persisting today control individuals and populations, and promote self-governance especially through bodily practices. The process of biomedicalisation goes hand in hand with new forms of molecular bio-politics (Clarke et al., 2010; Rose, 2006).
The emerging convergence between genetic technologies, nanotechnologies, neuro-imaging and information technologies creates new means for addressing health problems and building economies, accompanied by new forms of subjectivity and novel moral and political landscapes (Sunder Rajan, 2006; Waldby and Mitchell, 2006; Cooper, 2008). For example, the rise in the 1990s of a new measure to calculate the global burden of disease, the Disability-Adjusted Life Year (DALY), has produced a new mode of the economisation of life that measures life in units of time and reconfigures it as a revenue stream (see Kenny’s contribution). The DALY is one fascinating iteration of the emerging ‘bioeconomy’. The bioeconomy has come to signify the promises surrounding the power of bio-knowledge, with great optimism that new technologies, such as stem cell treatments, will help address the degenerative conditions of ageing populations while creating a new basis for generating economic value (see Petersen and Krisjansen’s contribution).
The history of bioscience highlights that new biotechnologies tend to be surrounded with great optimism and utopian predictions as well as fear and dystopian imagery. There is now a large body of sociological and other social science work exploring the science, policy and public representations of biotechnologies, and how these have been shaped by such imagery. This has included explorations of the new genetics (e.g. Kitzinger, 2008; Kitzinger and Williams, 2005), cloning (Petersen, 2002), and stem cell science (Wainwright, et al., 2007). The dynamic role played by promissory discourse, for example in relation to stem cell science, has been investigated by some scholars working in the field of science and technology studies (e.g. Brown, 2005; Brown and Michael, 2010). As this work highlights, ‘technology’ is already social, in that both ‘framings’ of its significance and the path of its development reflect particular interests, values and priorities. The legal treatment of the products of human conception within reproductive medicine is a case in point. MacGregor’s contribution examines how the performativity of law frames some products of conception as ‘human’ from as little as 15 days post-conception, while in other contexts a foetus at 20 weeks gestation that is miscarried is not considered a person requiring burial. Debate is likely to continue within legal circles and the general public as the point where an embryo or foetus becomes a ‘natural human’ is socially negotiated and renegotiated, and is further complicated by transgenic technologies that produce hybrid life forms consisting of human and non-human elements.
It is clear that science and technology impacts unequally on groups: different actors have different stakes in imagined or emerging biofutures. Thus, many parents and patient groups may, for example, welcome growing access to genetic technologies on the grounds of increasing choice in reproductive decision-making and health care, while disability groups may perceive such technologies as potential tools of discrimination and eugenic selection (Shakespeare, 1998). The value-laden, culture-specific character of technologies is especially evident when one crosses cultural boundaries and moves through time. As Kowal and Radin note in their contribution, the collection of Australian Indigenous blood samples in the 1960s was undertaken with a different set of concerns and priorities than pertain today. As their study reveals, holding samples in suspension, as ‘latent life’, gives rise to normative issues that were not foreseen when the collection was established. One unforeseen issue scientists must now face is the extent to which Indigenous people may care for samples held in the freezer and even seek to have them returned.
Questions of care are important in other papers, drawing on Foucault’s work on the ‘ethics of care’ (Foucault, 1997). In his later work, Foucault was interested in exploring the prospects for a form of ethics that breaks with the normalising discourses of modern society and can be wholly explained neither by moral philosophy nor by authorising disciplinary discourses. Rather, an ethics of care is informed by relational practices by which individuals nurture themselves and their communities. As Duff argues in his contribution, the field of drug abuse should recognise the role of an ‘ethics of care’ in shaping the practices of drug users. Such recognition could transform current approaches to treating addiction that consider drug taking to be exclusively pathological and ignore the role of drugs in practices of care. Marks and Russell, in their contribution, similarly draw on an ethics of care approach to analyse the latest iteration of public engagement in science policy in Australia. The authors frame care as an antidote to ‘corrosive critique’ and as providing the basis for a normative sociology of bio-knowledge that assembles matters of concern and takes responsibility for them (Latour, 2004).
While sociologists can document trends and scan horizons, they are not in the business of offering predictions. However, in analysing trends, they can draw lessons from earlier developments, to indicate how things may develop – presenting likely scenarios based on, say, what is known of the dynamics of technological cycles, the significance of unfulfilled expectations, or the operations of actor networks – along with some analysis of the potential social consequences. The papers in this special issue analyse dimensions of bio-knowledge at the limits of life, demonstrating how sociology can provide insights into developments as they unfold.