In previous posts in this series I have discussed how devices such as X-ray, CT and EEG scans produce representations of the internal structures and processes of the body while reformulating and extending the “medical gaze” into new areas. These do not simply provide an objective picture of reality but construct it in particular ways through highlighting particular aspects and visualising them through partial representations. I have also shown how these representations form part of structures of governing people and bodies by generating “truth claims” and legitimising particular interventions.
In this post I will develop these points through a consideration of the impact of genetic technologies on how human bodies and health are understood and managed.
The ability to analyse our genetic material has had a big impact on how we understand what it is to be human and what it is possible to do to and know about our bodies. But as I have suggested throughout this series no system of understanding of bodies and health is ever simply objective.
Rather, genetics, like other frameworks for understanding, provides a particular representation. The “enframing” which genetics offers us one in which our health and physical capacities (and perhaps our behaviour and personalities) are determined by particular genes. At least this is often the way in which genetics is presented in public discourse; that genetic code determines particular outcomes.
However, this is not entirely accurate. There are very few things which are determined by genetics (eye colour is one) in most cases (and particularly for illnesses) people are considered to have a greater or lesser genetic predisposition towards traits or illnesses with the determining factor being in their “environment”.
Nikolas Rose has suggested that the emergence of genetic technologies of analysis and intervention has contributed to the development of a new form of biopolitics . The concept of biopolitics is used to discuss the political interest which governments and rulers have taken in the health and bodies of the population. The necessity of healthy bodies for industrial production and large-scale wars made rulers realise that they needed to take an interest in public health.
But with these older forms of biopolitics bodies considered valuable for their physical capacities so the focus of biopolitical interventions was on the avoidance of disease and physical training. The focus was on the “molar” level of the whole body of the individual. This is in contrast to the focus on the “molecular” (or sub-individual) level which genetics enables.
Today scientists, medics and governments are aware that there is potential to exercise power and extract value on this molecular level. Genetic knowledge can mean that the development of diseases can be predicted and therefore potentially avoided. This can enable a maximization and improvement of the health of the population not through training and health interventions but through the manipulation of genetics.
There is also value in the genetic material itself. For instance, this became clear in 1998 when the Icelandic government sold access to the genetic database of their entire population to an American company to conduct research.
We can also see the effects of genetic knowledge on how we understand ourselves and our relationships to one another through the constitution of new kinds of “genetic subjects”. Ian Hacking has discussed the formation of new “biosocial identities” based on genetic knowledge. Groups have formed around genetic disorders with people finding kinship through their condition and often advocating for research and awareness of it.
Companies such as 23andMe offer “direct to consumer” genetic testing. For around £100 people can now have their genetic code mapped (a process which twenty years ago would have cost billions). Their mail order tests can reveal the genetic risk of a range of conditions and information on genetic heritage thus showing where you have come from and how your life might develop. They are thus not only offering health insights but providing a particular narrative about peoples’ identities.
Many people struggle to know how to respond to knowledge about their genetics. Advising people on their genes has produced a whole medical sub-discipline of “genetic counselling”. This service is designed to help people to make decisions about their lives and particularly their family planning decisions based on the genetic risk that they or their (potential) offspring carry.
Genetic science here constructs potential futures for people that would not exist without this new knowledge forcing people to reflect on their bodies, lives and that of their unborn (and perhaps unconceived) children.
In the next post I will discuss the impact which the generation and analysis of digital data is having on how we understand and manage our health and bodies.