Analysing Biopower And Agency Linked To Euthanasia Philosophy Essay

Human life can be perceived as a way of being that ensures autonomy upon the physical body. However, state authority, surveillance and law are moderating this individual freedom and moral decision-making.

Nowadays, euthanasia remains a highly controversial and sensitive medical and ethical issue. My research and final thesis for the master will focus on the narratives of people, residing in houses for the elderly in Antwerp, Belgium. Emphasis is placed on whether upcoming media interest in euthanasia influences elderly thoughts and decision making regarding assisted suicide. Wishes about end-of-life decisions, opinions of relatives and law interpretations of medical practitioners are being investigated in this study. And finally the way government’s authority influences people’s agency in end-of-life decision making.

With this paper, I intend to widen my knowledge of two main anthropological topics linked to the subject of euthanasia, namely biopower and agency. Biopolitics concern the political implications of social and biological facts and phenomena, with political choice and action directly afflicting all aspects of human life. Agency, on the other hand, can be seen as an alternative attempt to maintain autonomy in one’s own life and death, under the influence of the state’s disciplining interference. Both forms of power are studied in this paper, and their interrelationship is critically viewed.

Keywords: Biopolitics, Agency, Power, Health, Ethics

2. The history of biopower

In Foucault’s The Birth of Biopolitics (Lectures at the College de France, 1978-1979), an analysis of liberalism and neoliberalism as forms of biopolitics is presented. According to Foucault, biopower can be perceived as a technology of power, intending to manage individuals as a group. This political technology differentiates because of its ability to control populations as a whole, and is thus essential to the development of modern capitalism (Foucault, 2008). This shift from the managing and micro-controlling of individuals to disciplining a population emerged in the eighteenth-century. Even though this seems as an opportunity to gain more natural rights and liberty for individuals, this liberal government no longer limits state power because of the incompatible tension between freedom and security (Foucault, 2008, McSweeney, 2010). As Foucault argued, liberalism concerns the biopolitical. For liberalism promotes an imagined self-governing of life through a certain capture and disciplining of natural forces of aggression and desire within the framework of a cultural game, governed by civil conventions and instituted laws (Foucault, 2004). In this conception, ‘life is as much of a cultural construct as is law, although the naturalness of life, thought of as innately self-regulating, is always insinuated. Both in economics and in politics, liberalism rejoice in an order that is supposed to emerge naturally from the clash of passions themselves (Milbank, 2008: 2).’

Rabinow and Rose seek to enlighten the developments in Foucault’s concept of biopower, which ‘serves to bring into view a field comprised of more or less rationalized attempts to intervene upon the vital characteristics of human existence (Rabinow, 2006: 196-197).’ Foucault distinguishes two poles of biopower: the first one focuses on an anatomo-politics of the human body, seeking to maximize its forces and integrate it into efficient systems. The second pole entails biopolitics of the population, focusing on the species body, the body imbued with the mechanisms of life: birth, morbidity, mortality and longevity (Rose, 2007: 53). Thus, according to Rabinow and Rose, ‘we can use the term ‘biopolitics’ to embrace all the specific strategies and contestations over problematizations of collective human vitality, morbidity and mortality; over the forms of knowledge, regimes of authority and practices of intervention that are desirable, legitimate and efficacious (Rabinow, 2006: 197).’

In order to clarify the concept of biopower, three elements must be included. The first one comprises one or more truth discourses about the ‘vital’ character of living human beings, and an array of authorities considered competent to speak that truth. Secondly, the strategies for intervention upon collective existence in the name of life and health, and lastly, modes of subjectification, through which individuals are brought to work on themselves, under certain forms of authority. Biopolitical analyses also explore how poverty, body commodification, and notions of risk and control are lived and shaped by the intersections of state imperatives, local traditions, and the global reach of medicine (Kaufman, 2005: 320). It is been inextricably bound up with the rise of the life sciences, the human sciences and clinical medicine. It has given birth to techniques, technologies, experts, and apparatuses for the care and administration of the life of each and of all, from town planning to health services (Rose, 2007: 54). Nevertheless, we need to be untrammeled by obligations to authoritative states and international bureaucracies, as most crimes against humanity are committed by powerful states (Farmer, 2004: 242).

2.1 Criticism

Rabinow and Rose are critical of Agamben (1995, 1996, 1998, 2000, 2005) and Negri (2000), who ‘suggest that contemporary biopower takes the form of a politics that is fundamentally dependent on the domination, exploitation, expropriation and, in some cases, elimination of the vital existence of some or all subjects over whom it is exercised (Rabinow, 2006: 198).’ The following fallacies in Agamben and Negri’s work are mentioned. Firstly, their use of biopower as a totalizing term in which ‘biopower serves to secure the dominion of a global form of domination that they term ‘Empire’ (ibid.: 198).’ Rabinow and Rose agree that it is necessary to extend the scope of traditional analyses of economic exploitation and geopolitics in order to grasp the way in which the living character of human being is being harnessed by ‘biocapital’. However, this expanded concept of biopower leaves little room for analytical work. Therefore, Rabinow and Rose agree that this version of the concept of ‘biopower’ is antithetical to that proposed by Foucault because it can describe everything but analyse nothing.

Secondly, Agamben’s view of the Holocaust as the ultimate exemplar of biopower and use of the obscure metaphor of homo sacer. According to Rabinow and Rose: ‘the power to command under threat of death is exercised by States and their surrogates in multiple instances, in micro forms and in geopolitical relations. But this does not demonstrate that this form of power – commands backed up by the ultimate threat of death – is the guarantee or underpinning principle of all forms of biopower in contemporary liberal societies. Nor is it useful to use this single diagram to analyse every contemporary instance of thanatopolitics (ibid.: 201).’

And lastly, Agamben’s interpretation of contemporary biopolitics as the politics of a State modelled on the figure of the Sovereign, and of all forms of biopolitical authority as agents of that Sovereign. Rabinow and Rose believe that this interpretation fails to notice ‘the dependence of sovereign rule on a fine web of customary conventions, reciprocal obligations and the like – in a word, a moral economy […] sovereign power is at one and the same time an element in this moral economy and an attempt to master it (ibid.: 200).’ States can only rule because of the ways in which they manage to connect themselves to the ever-growing apparatuses of knowledge collection and problematization that formed alongside the state apparatus since the 19th century.

Furthermore, in the analysis of biopower, Rabinow and Rose focus on three topics that they believe condense some of the biopolitical lines of force active today. The first one embraces race. At one point, the link between biological understandings of distinctions among population groups and their socio-political implications seemed broken and race was crucial as a socio-economic category, a mark of discrimination and a mode of identification that remained extremely salient socially and politically, from the allocation of federal funds to the manifestations of identity politics. However, ‘at the turn of the new century, race is once again re-entering the domain of biological truth, viewed now through a molecular gaze (ibid.: 206).’ A new molecular deployment of race has emerged seemingly almost inevitably out of genomic thinking. Funding for research in DNA sequence variations ‘has been justified precisely in biopolitical terms, as leading towards and ensuring the equal health of the population in all – or some – of its diversity (ibid.: 207).’ Rabinow and Rose believe that ‘new challenges for critical thinking are raised by the contemporary interplay between political and genomic classifications of race, identity politics, racism, health inequities, and their potential entry into biomedical truth, commercial logics and the routine practices of health care (ibid.: 207).’

The second topic entails reproduction. Since the 1970s, sexuality and reproduction have become disentangled, and the question of reproduction gets problematized, both nationally and supra-nationally, because of its economic, ecological and political consequences. Reproduction has been made into a biopolitical space ‘in which an array of connections appear between the individual and the collective, the technological and the political, the legal and the ethical (ibid.: 208).’ According to Rabinow and Rose ‘the economy of contemporary biopolitics operates according to logics of vitality, not mortality: while it has its circuits of exclusion, letting die is not making die (ibid.: 211).’ They argue that changes are about capitalism and liberalism and not eugenics.

And lastly; genomic medicine. Rabinow and Rose narrate how the first biopolitical strategies concerned the management of illness and health and how these provided a model for many other problematizations operating in terms of the division of the normal and the pathological. This model was popular in liberal societies ‘because they establish links between the molecular and the molar, linking the aspiration of the individual to be cured to the management of the health status of the population as a whole (ibid.: 212).’ Whether or not genomic medicine will lead to the creation of a new regime of biopower depends on both the uncertain outcome of genomic research itself, and on contingencies external to genomics and biomedicine. If the new model of genomic medicine were to succeed, and to be deployed widely, not only in the developed but also in the less developed world, the logics of medicine, and the shape of the biopolitical field, would be altered. New contestations would emerge over access to such technologies and the resources necessary to follow through their implications. Additionally, as the forms of knowledge generated here are those of probability, new ways of calculating risk, understanding the self and organizing health care would undoubtedly emerge (Rabinow, 2006: 214). It is important to see that in this, the political and social implications are shaped more by the political side of biopolitics than the medical side, which is also mentioned by Vaughn (2010). Milbank (2008) is discussing this topic from an alternative point of view. ‘Laws typically proceed from sovereign power granted legitimacy through a general popular consent as mediated by representation. In so far as such a procedure is taken to be normative, it can be seen as embodying a ‘natural law’ for the origin of legitimate power from the conflicts in human life (Milbank, 2008: 5).’

To conclude; within the field of biopower, the term biopolitics is used to embrace all the specific strategies and contestations over problematizations of collective human vitality, morbidity and mortality, and can therefore be linked to the implementation of the euthanasia law. It includes a form of power expressed as a control that extends throughout the depths of the consciousnesses and bodies of the population (Rose, 2007: 54). At the end of life, ethnographers have focused their attention in the distinction between the social and biological death of the person and the practical and ethical quandaries created by the late modern ability and desire to authorize and design one’s own death, and the ways in which death is spoken, silenced, embraced, staved off, and otherwise patterned (Kaufman, 2005: 319). The policy of euthanasia can thereby be seen as an array of authorities considered competent to judge a human’s quality of life. ‘In one sense, to say that the sovereign has a right of life and death means that he can, basically, either have people put to death of let them live, of in any case that life and death are not natural or immediate phenomena which are primal or radical, and which fall outside the field of power. […] In any case, the lives and death of subjects become rights only as a result of the will of the sovereign (Foucault, 1997: 24).

3. Agency

In the previous chapter it has become clear that biopolitics can be perceived as an empowered discipline which reduces humans to mere life and biological statistics and processes. But has a human being no other destiny then to be at the mercy of the ‘puppet master’ called the state?

According to Mahmood (2005), it is quite clear that the idea of freedom and liberty as the political ideal is relatively new in modern history. Nor, for that matter, does the narrative of individual and collective liberty exhaust the desires with which people live in liberal societies? How do we then analyze operations of power that construct different kinds of bodies, knowledges, and subjectivities whose trajectories do not follow the entelechy of libratory politics? It encourages us to conceptualize agency not simple as a synonym for resistance to relations of domination, but as a capacity for action that specific relations of subordination create and enable (Mahmood, 2005, 22).

Ortner believes agency and social power are very closely linked. In her article Power and Projects: Reflections on Agency (2006), she agrees with Ahearn that oppositional agency is only one of many forms of agency and that ‘domination and resistance are not irrelevant, but that human emotions, and hence questions of agency, within relations of power and inequality are always complex and contradictory (Ortner, 2006: 137).’ She also mentions Giddens’ viewpoint that the concept of action is logically tied to that of power because of its transformative capacity, but that the transformative capacity of agents is only one dimension of how power operates in social systems.

Ortner sees agency as part of her theory on ‘serious games’. The concept of serious games is grounded in practice theory, because ‘as in practice theory social life in a serious games perspective is seen as something that is actively played, oriented toward culturally constituted goals and projects, and involving both routine practices and intentionalized action (129).’ However, it moves beyond this in looking at more complex relations, namely power, and more complex dimensions of subjectivity, those involving intentionality and agency.

Although agency is considered universal, the agency exercised by different persons is far from uniform and differs enormously in both kind and extent. At the ethnographic level, however, what is at stake is a contrast between the workings of agency within massive power relations. In the most common usage agency can be virtually synonymous with the forms of power people have at their disposal, thereby implying that people in positions of power have ‘a lot of agency’. On the other hand, Ortner notes that the dominated too also have certain capacities, and sometimes very significant capacities, to exercise some sort of influence over the ways in which events unfold. ‘Resistance is then also a form of ‘power-agency’ (ibid.: 144).

Thus, Ortner believes that the less powerful seek to nourish and protect by creating or protecting sites ‘on the margins of power’. These cultural projects can be ‘simple goals for individuals, related to intention and desire, but many projects are full-blown ‘serious games’, involving the intense play of multiply positioned subjects pursuing cultural goals within a matrix of local inequalities and power differentials (ibid.: 144).’ Agency becomes the pursuit of (cultural) projects, but it is also ordinary life socially organized in terms of culturally constituted projects that infuse life with meaning and purpose. Hence, the agency of projects is not necessarily about domination and resistance; it is more about people having desires that grow out of their own structures of life. Ortner views this as people playing their own serious games in the face of more powerful parties seeking to destruct these. So this is not free agency, as ‘the cultural desires or intentions […] emerge from structurally defined differences of social categories and differentials of power” (ibid.: 145).’

To Ortner, ‘the point of making the distinction between agency-in-the-sense-of-power and an agency-in-the-sense-of-(the pursuit of) projects is that the first is organized around the axis of domination and resistance, and thus defined to a great extent by the terms of the dominant party, while the second is defined by local logics of the good and the desirable and how to pursue them (ibid.: 145).’ She considers that the agency which is involved in significant cultural end, is inevitably involving internal power-relations. Consequently, the agency of project intrinsically hinges on the agency of power.

3.1 The free individual?

The ultimate purpose of the serious games theory is always to understand the larger forces, formations, and transformations of social life. The way Ortner sees social agents is that they ‘are always involved in, and can never act outside of, the multiplicity of social relations in which they are enmeshed” (ibid.: 130).’ Thus while all social actors have agency, because of their engagement with others in the play of serious games they can never be ‘free agents’. This social embeddedness of agents takes two forms; the first one being relations of solidarity among friends and family. The second form involves relations of power, inequality and competition. Ortner emphasizes that ‘agency is never a thing in itself but is always a part of a process of what Giddens calls structuration, the making and remaking of larger social and cultural formations (ibid.: 134).’

Ortner admits the dangers of overemphasizing agency as this gives precedence to individuals over context and that too much focus on the agency of individuals and/or groups results in a gross oversimplification of the processes involved in history, thereby ignoring both the needs and desires of human beings and the pulse of collective forces and losing sight of the complex, and highly unpredictable, relationship between intentions and outcomes. However, Ortner believes the solution is ‘the framework of practice theory within which neither ‘individuals’ nor ‘social forces’ have precedence, but in which nonetheless there is a dynamic, powerful, and sometimes transformative relationship between the practices of real people and the structures of society, culture, and history (ibid.:133).’

Furthermore, Ortner believes that ‘agency can be said to have two fields of meaning, one being about intentionality and the pursuit of (culturally defined) projects), the other about power, about acting within relations of social inequality, asymmetry, and force (ibid.: 139).’ However, agency is never merely one or the other. Intentionality refers to ‘a wide range of states, both cognitive and emotional, and at various levels of consciousness, that are directed forward toward some end (ibid.: 134).’ There exists a continuum between both ‘soft’ and ‘hard’ definitions of agency. In soft definitions, intentionality is not taken into account or not seen as being consciously held in the mind. However, what is then the distinction between agency and routine practices? On the other end of the spectrum, and Ortner shares this viewpoint, are those definitions of agency that emphasize the strong role of active intentionality in agency that differentiates agency from routine practices.

Pre-modern thought did not conceive of agency solely in terms of individual freedom or else in terms of explicit representative sovereign action – leaving a consequent problem of the apparent spontaneous patterning of the unplanned. This was because it did not think of an act as primarily an expression of freedom or as something ‘owned’ by the individual or the sovereign’s will or motivation. Instead, it paid more attention to the fact that every act is always pre-positioned within a relational public realm and in turn cannot avoid in some way modifying that realm, beyond anything that could in principle be consented to by the other, since the full content of any act is unpredictable (Milbank, 2008: 23).

In conclusion, Ortner advocates that a distinction should be made between agency as a form of power (agency of power) and agency as a form of intention and desire, as the pursuit of goals and the enactment of projects (agency of projects). While they form two distinct fields of meaning, they are also interrelated as both domination and resistance are always in the service of projects. Thus, agency is a complex term whose senses emerge within semantic and institutional networks that define and make possible particular ways of relation to people, things, and oneself. Yet, ‘intention’ , which is variously glossed as ‘plan’, ‘awareness’, ‘willfulness’, ‘directedness’, or ‘desire’ is often made to be central to the attribution of agency. Although the various usages of agency have very different implications that do not all hang together, cultural theory tends to reduce them to the metaphysical idea of a conscious agent-subject having both the capacity and the desire to move in a singular historical direction: that of increasing self-empowerment and decreasing pain (Asad, 2003: 78-79).

4. Conclusion

After thoroughly having examined both the subjects of biopower and agency, and following the course Theory and Practice, awareness has grown once again in realizing how much one’s been ‘lived.’ Disciplining of the state interferes in such a wide array of human life; consisting of for example the school system, employment, medicines and ultimately death. It becomes clear that agency, performed in ways we have discussed in class, simply does not exist, because of the dominant and prevailing power of the state. It is not owned by social actors, but interactively negotiated and best seen as a disposition toward the enactment of projects. Despite of this negotiating, individuals never become ‘free agents’. This and other research shows that the law and the policy of euthanasia influencing people’s right to determine their own life. Today, most requests for euthanasia to end a life with dignity are denied, because people do not fit into the criteria and the so-called ‘carefully requirements’ the law states. But to what extend do such institutions of power have the moral right to determine and monitor personal decisions of individuals?

As Foucault (2003) states: the very essence of the right of life and death is actually the right to kill: it is at the moment when the sovereign can kill that he exercises his right over life. In my opinion people should maintain autonomy over their own life and death, and that the government should not intervene from above into such personal, subjective and fundamental choice. However, apart from the awareness of the fundamental mediation of the state, we remain political animals. In the end, everyone wants to pursuit personal goals in life, and in order to accomplish those, we cannot do much more than just put up with the fate of being obliged well-behaved citizen.