The March of Medicalisation: Curing the Finitude of Life

Like baldness, old penises and a little girth, grey hair has entered a process of medicalisation. Today’s Sydney Morning Herald announces that scientists have found a cure for going grey. Or at least they have diagnosed the phenomenon as “massive oxidative stress” that results from the “accumulation of hydrogen peroxide in the hair follicle, which causes hair to bleach itself from the inside out.” This all sounds very plausible and scientific. I do not doubt that these scientists are providing an accurate description of the chemical and physiological processes leading to hair going grey.

While this will be welcome news for people with genetic or nutritional conditions associated with greying, the real commercial and media interest in this discovery is not for its impact on the lives of those with vitiligo. In addition to curing a specific biological conditions this technology will prominently be used to “cure” socio-psychological problems in living that inhibit a recognition of the finitude of life. The increasing number of cashed-up-baby-boomers are an enormously profitable market for this discovery and other biomedical technologies that purport to “cure” conditions associated with ageing.

Of course, some say that the lines between therapy and enhancement are arbitrary and we should embrace all that biomedicine has to offer. Perhaps. However, promises of improving, enhancing and extending life may also re-define, transform and undermine the very features of life that we initially wanted to “enhance”.

Biomedical and pharmacological technologies increasingly mask the fragility and vulnerability of the body and human existence. Further, the expansion of biomedicine into areas of life not previously considered medical leads to biomedicine becoming the frame of reference that determines the appropriate course of action to take when a problem arises, medical or otherwise.

Thus biomedicine not only assists us with knowing what to do about our greying, ageing and flaccid bodies, but when we can no longer make the infirm firm, biomedicine continues to shelter us from the realities of finite life. That is, when we have exhausted the biomedical possibilities of shaping and governing life, when our bodies move beyond the biomedical frame, we can use it to deliver us from “the strange, weird, and spooky” condition known as death.

The cure for greyness, like certain aspects of euthanasia, is not so much of a problem for what it is or purports to do, but for the way that it subtly transforms the terms of reference of who we are and how we live.

Lifestyle Intervention and the Aesthetics of Obesity and Smoking

The sustained concern over obesity as a threat to population and economic security has led to a proliferation of medical and non-medical experts intervening in the daily lives and practices of individuals. These interventions commonly fall under the rubric of lifestyle. Seen as both the cause and solution, the modern lifestyle is the target of modification strategies and techniques.

Of course, interventions into lifestyle are not entirely new or exclusive to obesity. Smoking, homosexuality, extreme sports or drug-use have all been described as lifestyles with associated health risks that justify outside intervention. Yet, I contend that obesity is unique in its characterization as a political, economic, aesthetic and public health problem that emanates from individual choices and practices.

The uniqueness of obesity is partly evidenced in comparison to smoking. While smokers have attracted a significant share of vitriol and harassment, much of the blame for smoking and the associated health impacts is reserved for “Big Tobacco”. If repentant, smokers can be characterized as the victims of industry deception and chemical addiction. Although there is anger directed toward “Big Food”, obesity is primarily framed as the result of individual choice and lack of control.

Furthermore, there is an aesthetic difference that distinguishes obesity from smoking. While there are active efforts to counter the “coolness”of smoking, the iconic images of Humphrey Bogart or Audrey Hepburn with cigarettes in hand continue to influence Western aesthetics. And the more recent fictional characters, Don Draper and Joan Halloway stubbornly resist the cliché that “kissing a smoker is like kissing an ashtray”. In contrast, the aesthetics and celebrity of obesity are comical, grotesque or both. Cartoon characters like Homer Simpson or Peter Griffin who eat anything within reach, from a week old sandwich to the legs of a paralytic friend, serve to confirm the message that obesity is grotesque in form and the result of lack of control.

This aesthetic also carries with it a judgement on the ability of an individual to self-govern and also to govern others. Kim Beazley, the former leader of the opposition in Australia was once told by Prime Minister Bob Hawke that the Australian people wouldn’t elect a fat prime minister. A contemporary example in the US is Chris Christie. Since at least the 2012 Republican primaries Christie’s weight has been a continual talking-point. These discussions are set to increase as speculation grows over his intentions to run for President in 2016.

Contemporary concerns about obesity and its relation to aesthetics, self-governance and the governance of others resembles regulations over sexual conduct in Ancient Greece. In examining the problematization of sexual practice in Ancient Greece, Michel Foucault outlines the link between a husband’s sexual conduct, household management and governance of the city. According to Foucault, the Greek husband’s authority and control over his home (of which his wife was a part) reflected his ability to have authority and control over himself and the life of the city.  While the husband was free to engage in sexual practice outside of the conjugal relation, “having sexual relations only with his wife was the most elegant way of exercising his control” (HSII, 151). Further, when Aristotle condemns extra-marital sexual relations as dishonourable it is not that the activity deviates from a moral law or order, rather such action demonstrates the husband’s inability to conduct himself in relation to the ethical substance of pleasure with the appropriate degree of self-control and mastery.

The example of Nicoles the ruler of Cyprus illustrates this point. According to Isocrates, Nicocles explains his conjugal fidelity in saying, “I am the king, and because as somebody who commands others, who rules others, I have to show that I am able to rule myself.” Therefore if Nicocles wishes to rule others and the city with glory and authority then he must rule himself first. Foucault argues that for the Greeks the mode of subjection was politico-aesthetic in which “political power, glory, immortality and beauty are all linked together at a certain moment.” Thus the Greek free man is at liberty to engage in sexual activity with someone other than his wife, however if he has accepted the politico-aesthetic mode of subjection, if he wishes his existence to be characterized by self-mastery and beauty, then he will recognize the particular rules of conduct that are constitutive of that subjectivity.

In a somewhat similar fashion, the American (or Australian, or any citizen of a Western liberal democracy) is free to indulge in whatever culinary and dietary activity he or she wishes, however, in return the society will discount beauty and the capacity for self-governance and the governance of others and thereby justify interventions into their daily choices, activities and practices.

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Neoliberalism is like fundamentalism or postmodernism. No one identifies as such, but we know it when we see it and when we see it we don’t like it. And go to a conference in the humanities and you’ll hear about it; again and again.

In discussing Foucault’s lectures on neoliberalism, back when it used to be neo-liberalism, Colin Gordon summarizes Foucault’s perspective as follows.

In a nutshell, he suggests that recent neo-liberalism, understood (as he proposes) as a novel set of notions about the art of government, is a considerably more original and challenging phenomenon that the left’s critical culture has had the courage to acknowledge, and that its political challenge is one which the left is singularly ill equipped to respond to’ (Gordon, ‘Governmental rationality: an introduction’ in The Foucault Effect, 1991).

Gordon wrote this twenty years ago. Foucault gave the lectures thirty years ago. Yet the left has not grown teeth and like the lion in The Wizard of Oz, courage has not been found and Toto hasn’t peeled back the curtain. This is partly due to the left seeking to critique neoliberal governmentality while holding on to a redundant theory of the State. Neoliberal practices of government do not flow from the State, but the neoliberal state, if we can call it such, is the effect of the practices. This leaves the left playing a game two moves too late.