Epigenetics and the Biocitizen

Epigenetics, it is claimed, has opened the door to considering the ways that human bodies undergo environmentally-induced change and more radical still, how those changes can be inherited. Researchers are especially interested in whether epigenetics can explain how physical and social environments influence health outcomes, including those understood to be racially based. The turn to epigenetics as a more compelling, actionable type of evidence of racism over and against what is produced by other health sciences rests on a number of assumptions about the body—including its temporality and embodied becoming—thereby necessitating an elaboration of what we mean by the “bio” of biocitizenship. This chapter argues that epigenetics’ method for constituting evidence and translating it into action enacts a biologistic and deterministic racialism, one animated by a materialism more likely to sabotage than enable biocitizenship and its claims for redress.

The Citizens of Incubators

Neolife are technologically created and fragmented life forms that have been manipulated by humans and cannot survive without artificial life support. This essay focuses our attention on one of the main vessels of neolife - the incubator. In recent years, especially as a result of the human genome project and through the field of synthetic biology, there is a shift to obscure the incubator as a surrogate vessel and render it neutral, thereby obscuring how, throughout history, what life is chosen or forced to be put in an incubator reflects on human wants and desires. Neolife can be seen as the entanglement of life with its surrogate apparatus, echoing interests of human-centric control, which affect and effect the larger milieu. By focusing on the incubator as such, we question the very idea of biocitizenship, focused as it is on human life, on intact, whole bodies, and on the distinction between environment and biology. Furthermore, the incubator has, throughout its history, served to reproduce and recuperate the very ideologies of race and gender upon which normative biocitizenship depends, despite the fact that developments in biotechnology and the design of neolife may offer the illusion of a “new citizenship” that breaks free from hegemonic human social constructions of species, gender, race, and class.

Governing Sexual Health

This chapter describes how sexual health has become a touchstone in discussions about political belonging in the United States. By linking the management of the individual body to the governance of the social body, proponents of sexual health projects define healthy societies, responsible conduct, and “good” and “bad” sexual citizens. While the uptake of sexual health by federal health agencies suggests movement toward the centralized administration of the concept, other uses of the term escape the control of any central biomedical or state authority. This essay considers how projects of sexual health, some organized by the state and some the efforts of a politically diverse range of activists, circulate within worlds of politics and governance. It concludes that as proponents of sexual health work to establish the proper relations between bodily conduct and social order, they offer a range of templates for modern biocitizenship.

The Supra-Cyborg

This essay offers a supra-individual perspective on biocitizenship. By developing the concept of the supra-cyborg, it envisions biocitizenship as the organization of humans within a supra-biological form of being, which is to say a form shaped by humans’ symbolizing capacities, but not wholly determined by them. Attending to our inhabitation within supra-cyborgs highlights the importance of the contest between corporations and governments and the rise of Global Governing Corporatocracies. The literalizing metaphor of the supra-cyborg also highlights as a key political question: whether it is possible for humans to live well outside of supra-cyborgs, and if not, what kind of supra-cyborg organization we should seek to synthetically engineer. This vision also re-calibrates a sense of which lines of action might be most promising for those who seek to implement either justice or care across human groups or greater space for nonhuman beings.

Patient Activists

This chapter includes reflective essays by patient activists regarding their own work that serve as responses to key concepts in the biocitizenship literature

The Rise of Health Activism

Biosociality has proven to be a generative concept for STS scholars, anthropologists and medical sociologists and has been subject to sustained engagement, development and critique. A number of researchers have taken the concept and tested it against a range of empirical sites of inquiry including patient, health and disease advocacy. In particular, when groups have formed in relation to genetic and disease conditions, classifications such as race and gender appear to be powerful mobilizing and shaping forces. But what about social class? Is class a regressive category of little salience today? Or does it help us to understand some of the dynamics of group formation and activism? Drawing on work in medical sociology on class, health and neoliberalism, this chapter explores the ways in which class is salient to discussions of biosociality and patient advocacy movements.

Feeding Hunger-Striking Prisoners

This essay explores the tension between state practices of biocitizenship that champion human vitality and health and the state’s exercise of bodily violence. This tension erupts sharply in grappling with the imperatives and crisis of forcible feeding of hunger strikers that are incarcerated or detained indefinitely. Forcible feeding transforms the bodies of hunger strikers into dependents and makes such techniques more acceptable to concerned audiences. Yet this is also an exercise of state sovereign power through the exercise of biopolitics on subjects produced not as liberal subjects of consent or economic subjects of rationality, but as a population of dependents who must be managed. This essay examines the imperatives and contradictions of biocitizenship and biosecurity through the debates over forcible feeding of hunger strikers in Guantanamo, Israel, U.S and Australian immigrant detention facilities.

The Necropolitical Functions of Biocitizenship

This chapter explores how biocitizenship works to maintain national borders and relegate certain populations—in this case, immigrants with HIV/AIDS—to death. Although immigrants are not citizens, they and their biological conditions are placed under perhaps more scrutiny than those with citizenship status, making the framework of biocitizenship an appropriate one for understanding how decisions regarding how immigrants with HIV/AIDS should be treated were made and also how people responded to aspects of those decisions. To provide this exploration, this chapter examines the controversy, protests and boycott surrounding the 6th International AIDS Conference (IAC) held in San Francisco in 1990 to demonstrate an often uncommented upon aspect of biocitizenship: its necropolitical functions.

Carceral Biocitizenship

On October 19, 2007, nineteen-year-old Ashley Smith died of self-inflicted strangulation while on suicide watch at the Grand Valley Institution for Women in Kitchener, Ontario, Canada. As she tied a ligature around her neck, correctional officers, who had been instructed not to enter into her cell if she was still breathing, watched—and in compliance with Canadian regulations—video-recorded her death. The three correctional officers who stood by and watched Smith’s suicide were charged, along with one of their supervisors, with criminal negligence causing death. This essay explores how various institutions constituted Smith as a carceral biocitizen—a subject caught between biopolitical practices and scenes of legal sovereignty. More specifically, the chapter posits that Smith’s death was produced by a diffuse agency that cannot be definitively located or prosecuted—a neoliberal administration of law that presumed that Smith was already “socially dead,” and was, thus, no citizen at all. This form of biocitzenship radically diverges from accounts that find in biocitizenship a form of agency through which one might lay claim to life in an affirmative biopolitics.

Biocitizenship on the Ground

This chapter examines medical student activism during the civil rights and War on Poverty era, the momentum it sustained for a short time, and the reasons for its sudden implosion and dissipation. This chapter examines specific internal currents within academic medical centers themselves: debates over the narrowness of the curriculum; a growing sense of obligation to surrounding environs (especially campuses located in urban ghettoes); the entry of women, Jews, and non-whites into student bodies; and incipient recognition of bodily integrity, particularly of research subjects and patients used in teaching. The confluence of these trends and debates, together with the political moment, produced the new socially conscious medical student and the organizations through which they agitated. Within, a number of unforeseen conflicts emerged, and what were once unifying principles became sources of fracture, sending these students off on distinct trajectories after they graduated.