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Nikolas Rose

The value of life: somatic ethics


& the spirit of biocapital

What is the value of life?1 This may Erbitux £11,739. On average, these treat-
seem a pretentious or a philosophical ments extend the lives of those with
question. But it is the subject of much terminal bowel cancer by ½ve months.
contemporary discussion. In August nice made its judgment using a model
2006, England’s National Institute for that estimates the costs per ‘quality ad-
Clinical Excellence (nice), which ad- justed life year’ (qaly) gained, and set
vises on medicines available on the Na- a ‘willingness to pay’ cap of £30,000 per
tional Heath Service (nhs) in England, qaly. Each of the treatments exceeded
ruled against two treatments for late- that limit. Many cancers sufferers and
stage bowel cancer–Genentech’s Avas- their supporters contested this decision.
tin and ImClone Systems’ Erbitux. Al- It was, they said, a question of the value
though these treatments were widely placed on their lives, the value of ½ve
available in a number of countries, nice months of life.
declared that their use was not “compat- What, then, is the value of life? A
ible with the best use of nhs resources.” Google search for ‘the value of life’
nice estimated that treatment with turns up 417,000 pages in 0.22 seconds.
Avastin would cost £17,665.65 a patient, Among them, Brainy Quote of the Day
gives us Michael de Montaigne’s wise
words: “The value of life lies not in the
Nikolas Rose is James Martin White Professor
length of days, but in the use we make
of Sociology and director of the bios Centre for
of them.” But more generally, what one
the Study of Bioscience, Biomedicine, Biotechnol-
sees in these pages is an instructive in-
ogy and Society at the London School of Econom-
tertwining of the ethical and the eco-
ics. His numerous publications include “Govern-
nomic. Of course, many of the Google
ing the Soul: The Shaping of the Private Self”
hits lead to the deliberations of bioethi-
(1989), “Inventing Our Selves: Psychology, Pow-
cists; in fact, The Value of Life is the title
er and Personhood” (1996), “Powers of Free-
of a book by the prominent British bio-
dom: Reframing Political Thought” (1999), and
ethicist John Harris. But for those of us
“The Politics of Life Itself: Biomedicine, Power,
who are not bioethicists, current debates
and Subjectivity in the Twenty-First Century”
(2006).
1 This paper draws on Nikolas Rose, The Poli-
© 2008 by the American Academy of Arts tics of Life Itself (Princeton, N.J.: Princeton Uni-
& Sciences versity Press, 2006).

36 Dædalus Winter 2008


over the value of life provide one way question itself is posed. Today, it is in- The value of
life: somatic
to explore the nature of contemporary creasingly framed in terms of dignity. ethics & the
biopolitics. The U.K.’s Voluntary Euthanasia So- spirit of bio-
ciety, for example, recently changed its capital
First in the Google listing is the Pope, name to Dignity in Dying. The value of
life here seems to exist in a kind of trans-
or rather, the late Pope John Paul’s en-
cyclical letter of 1995, “Evangelium Vitae: actional space between the claim that
On the Value and Inviolability of Human existence itself has some intrinsic value,
Life.” In it, the Pontiff declares the in- and the claim that value should attach,
comparable worth of the human per- not to life as vitality, but to life as a sub-
son, and expresses concern about the jective state–to the ‘dignity’ of those
increase in threats to the life of individu- who live it.
als and peoples, especially where life is
weak and defenseless. He is particularly S econd in Google’s hierarchy are the
troubled by the new threats opened up economists, for whom life can certain-
by biomedical progress; he believes that ly be given a precise value. Value of life,
certain sectors of the medical profes- here, is usually calculated with the clas-
sion, authorized by the state, are endan- sical economic measure of ‘willingness
gering the lives of the weakest, often to pay.’
with the free assistance of health-care Since there are few ways to test how
systems. much individuals are, in reality, willing
The late Pope represents only one to pay for their life, health-care spend-
pole of the bioethical debate that now ing stands as the most popular proxy,
rages over the question of whether life in measuring the value accorded to in-
can be subject to judgments of value– creased longevity. One example of this
or, whether different forms of life can calculation is evident in a paper by Rob-
or should be valued differently. Could ert Hall and Charles Jones, with the title
one ever legitimately say, ‘My life has “The Value of Life and the Rise of Health
no value’? Could a life be of such little Care Spending.” They point out the rise
value that it might be a life not worth in the United States in the proportion of
living, a life that should be ended? resources devoted to health care: “The
That little phrase, ‘life not worthy of share was 5.2 percent in 1950, 9.4 percent
life,’ admittedly carries chilling over- in 1975, and 15.4 percent in 2000. Over
tones. It evokes the German debates the same period, health has improved.
on euthanasia that preceded the mur- The life expectancy of an American born
derous eugenic regime in Germany from in 1950 was 68.2 years, of one born in
1900 to 1945, so movingly analyzed in 1975, 72.6 years, and of one born in 2000,
Michael Burleigh’s book Death and De- 76.9 years.” Set the additional invest-
liverance. And yet, today, it seems we ment against the additional years of life,
cannot avoid this issue, especially at the and one has a measure of the implicit
start or end of life–in cases of severely value Americans attribute to life.
disabled neonates maintained on life Others try to calculate the potential
support, or those suffering from a pain- societal bene½ts, in ½nancial terms, for
ful and terminal disease who wish for reductions in mortality and morbidity.
physician-assisted suicide. Kevin Murphy and Robert Topel esti-
What is important for my analysis is mate that, for the United States, “re-
not the answers given, but the way the duced mortality from heart disease alone

Dædalus Winter 2008 37


Nikolas has increased the value of life by about that reduce the statistically expected num-
Rose
on $1.5 trillion per year since 1970 . . . . Even ber of accidental fatalities by one [em-
life a modest 1 percent reduction in cancer phasis added].4
mortality would be worth nearly $500
In a related but different economic
billion.”2
frame, one ½nds the debates over the
Something similar is happening when
compensation given by the government
health economists use measures like the
to victims of disaster. When the U.S.
qaly to evaluate the costs of disease or Air Force killed and injured a number
the bene½ts of treatments: it is an imper-
of people in bombing the Chinese Em-
fect yet seemingly necessary technology
bassy in Belgrade in May 1999, the U.S.
to enable tragic choices, translating im-
government agreed to pay $4.5 million
possible moral judgments about suffer-
in damages, which amounted to about
ing into a technical and calculable form.
$150,000 per victim. On the other hand,
Other experts estimate the value of life
when a U.S. Marine jet hit aerial tram-
in terms of the money people are pre-
way cables in Italy in 1998, the United
pared to invest to reduce small risks of
States gave close to $2 million to each
death.3 The U.S. Department of Trans-
Italian victim. Even this disparity in
portation, in a paper prepared just after
the value of life pales when one learns
September 11, calls this amount the ‘val-
that when a U.S. gunship attacked and
ue of a statistical life’:
strafed four villages in Afghanistan in
A de½ned value of life has been pursued 2003, killing sixty people, the Karzai re-
by governmental agencies here and abroad gime offered the Afghan wedding vic-
for over thirty years. It is regarded as an tims about $200 on behalf of each indi-
essential element of cost-bene½t analysis vidual killed.5
to guide public policy in the areas of regu- In the United States itself, the next
lation and investment in health and safety. of kin of each person who died in the
Some measure is necessary to ensure pru- September 11 attacks received some $2
dent management of public and private million, sparking an angry debate in the
resources. Although saving an identi½able United States about the respective com-
life is often regarded as a moral impera- pensation to the victims of Hurricanes
tive on which no monetary value can be Rita and Katrina, and to the families of
placed, prevention of every possible accidental troops who have died in Iraq. Life, it
death would be intolerably costly in terms of seems, can be given a monetary value in
both money and the quality of life. The term compensation for its loss, yet that valu-
“value of a statistical life” (vsl) is widely ation depends upon the citizenship of
used to emphasize that value is placed, not those who have lost it, and the ½nancial
on a particular life, but on safety measures and political resources of those who con-
test that loss.

2 Kevin M. Murphy and Robert H. Topel, “The


Value of Health and Longevity,” nber Working
Paper 11405, June 2005, http://www.nber.org/
papers/W11405 (accessed March 20, 2006). 4 http://ostpxweb.dot.gov/policy/EconStrat/
treatmentoflife.htm#1 (accessed March 12,
3 For example, W. Kip Viscusi, “The Value 2006).
of Life,” New Palgrave Dictionary of Economics
and the Law, 2nd ed., 2005, http://ssrn.com/ 5 http://www.cursor.org/stories/afghandead.
abstract=827205. htm (accessed March 12, 2006).

38 Dædalus Winter 2008


The lawyers come third in Google’s essary to provide care. But they reveal The value of
life: somatic
listings. A host of papers dealing with something about our contested politics ethics & the
the value of life considers the ways in of life. spirit of bio-
which the courts measure compensation On the one hand, then, all human life capital
in wrongful death suits, where relatives has a value beyond price, and every life
sue doctors or others to recover damages is of equal value. And yet we know that
from someone they hold responsible for in practice, some forms of life are judged
a death. This is a fertile market for law- more valuable than others. Every ses-
yers in the United States, judging from sion of genetic counseling, every act of
the numerous pages posted by law ½rms amniocentesis, and perhaps even every
encouraging individuals to make such piece of cosmetic surgery embodies just
claims. such a premise: some forms of life, some
However, in the United States at least, ways of living, are worth more than oth-
such claims making has taken a different ers, and sometimes people are willing
turn–in the form of claims for wrong- to pay for them. Every actuarial calcu-
ful birth or wrongful life. Willy and Cyn- lation for an insurance premium, every
thia Fields won damages of $1.7 million decision about health-care provision, is
for the wrongful birth of their severely also based on such a presupposition.
handicapped daughter Jade, on the ba-
sis that their doctor failed to pick up
the signs of abnormality (in an ultra-
My Google search did not really cap-
ture a fourth dimension–that of capital.
sound scan of the fetus) that would have By this, I mean the practice of express-
prompted them to have an abortion.6 ing the value of a life–of an individual,
This was a wrongful birth case, in which family, lineage, nation, population, race,
parents take action against a medical species or diversity of species–in terms
practitioner for failing to uncover infor- of genetic or human capital.
mation in genetic screening or counsel- The phrase ‘genetic capital’ was, per-
ing that would have enabled the mother haps, ½rst used by modern-day propo-
to have her pregnancy terminated. Per- nents of eugenics, such as the authors
haps wrongful life cases are even more of The Bell Curve, who drew on the more
telling, for here the damaged, disabled, respectable use of the notion in evolu-
or terminally ill child, through his or her tionary biology.7 Some transhumanists
legal representatives, sues for having have now taken up the phrase to argue
been allowed to be born–for example, for a new kind of eugenics for improving
a child with Tay-Sachs, condemned to the genetic capital of the nation.
a short life ½lled with suffering before Sarah Franklin has suggested that it
an inevitable death. In effect, the child was ½rst in the area of stockbreeding
is claiming to have been damaged by that the idea of genetic capital took
having been allowed to live at all–for shape–the capital that was not so much
being condemned to a life not worth in each member of the flock but in the
living. Of course, these cases are about heritable characteristics of the lineage.8
raising money, for lawyers, for parents,
for children; sometimes they are mere- 7 Richard J. Herrnstein and Charles Murray,
ly routes to obtaining the resources nec- The Bell Curve: Intelligence and Class Structure in
American Life (New York: Free Press, 1994).
6 http://www.cbsnews.com/stories/2003/ 8 Harriet Ritvo, “Possessing Mother Nature:
06/19/60minutes/main559472.shtml. Genetic Capital in the Eighteenth Century,”

Dædalus Winter 2008 39


Nikolas The idea of a kind of value inherent in or potential, to become a kind of entre-
Rose
on the hereditary quality of one’s stock preneur of oneself and one’s family.
life originated before modern genetics. But
in its modern form one can see it in an
invitation issued by the Kansas-based
W hat is one to make of this intertwin-
ing of economic and ethical concerns,
Decatur Beef Alliance in 2000: “The these complicated relations among dif-
Alliance gives progressive cattlemen a ferent registers of value? What can it
way to cash in on their genetic capital tell us, if anything, about contemporary
and their management expertise . . . . biopolitics?
Any cattleman with superior genetic Certainly the practice of medicine
cattle meeting the [de½ned] live animal has become infused with these ways of
speci½cations . . . can get involved.”9 thinking about the value of life.11 Belief
The idea of genetic, or biological, cap- in the value of a healthy life, and of one’s
ital has now become central to the lan- right to control and shape that life, has
guage of those seeking to protect the become central to the ethical self-man-
planet and its biodiversity. Thus, in agement of many individuals and fami-
January 2006, The Hindu Times reported lies, and underlay many challenges to
S. Kannaiyan, chairman of the National the paternalistic power that doctors ex-
Biodiversity Authority of India, as say- ercised over their patients. Attempts to
ing, “Biodiversity represents the very ‘empower’ the recipients of medical
foundation of human existence; yet, by care, to emphasize ‘active citizenship,’
our heedless actions, we are eroding this and to transform patients into ‘consum-
biological capital at an alarming rate.”10 ers’ were underpinned, in part, by the
The idea of genetic capital resonates hope that each individual would act to
with that of human capital, which has protect and enhance the value of their
emerged in the writings of Chicago own life and that of their family, because
School economists such as Gary Becker, they were committed to a secular value
for whom all choices that individuals of health.
make about matters like education or From another direction, the practice
medical care are seen as investments in of medicine has become saturated with
their own human capital. This notion issues of ½nancial value. This phenome-
of human capital links to the ways in non is evident, not just in the growth of
which, in advanced liberal ethics, each private health insurance and the com-
individual is urged to live his life as a moditization of health it entails, but al-
kind of enterprise to maximize lifestyle so in the regulation of prescriptions or
reimbursements for medical activity
in John Brewer and Susan Staves, Early Modern by health management organizations
Conceptions of Property (New York: Routledge, (hmos) and National Health Services.
1996). As we have seen, these organizations
9 “An Invitation to Join the Decatur Beef Al-
base many of their judgments on the cri-
liance” (speech, Commercial Agriculture Pro-
ducer’s College, Oberlin, Ky., November 14,
2000), http://agebb.missouri.edu/commag/ 11 Richard Horton, editor of the influential
inst/decbeef.htm. medical journal The Lancet, provides an over-
view of some of the key issues; R. Horton,
10 http://www.thehindu.com/2006/01/16/ Health Wars: On the Global Front Lines of Mod-
stories/2006011600810200.htm (accessed ern Medicine (New York: New York Review
March 20, 2006). of Books, 2004).

40 Dædalus Winter 2008


teria of value for money, and the costs nomic corporations to the sequencing of The value of
life: somatic
and bene½ts of different forms of med- the human genome.13 In contemporary ethics & the
ical intervention captured in measures biomedicine, the laboratory, the facto- spirit of bio-
such as qaly. ry, and the stock market are interlinked. capital
Further, medical knowledge, indeed Where funds are required to generate
medical truth itself, has become subject candidates for truth in biomedicine,
to intense capitalization. Basic and ap- and where the allocation of such funds
plied biological research–whether con- depends upon a calculation of ½nancial
ducted in biotech companies or in uni- return, commercial investment shapes
versities–has become bound up with the very direction, organization, prob-
the generation of intellectual property, lem space, and solution effects of bio-
and illness and health have become ma- medicine as well as the basic biology
jor ½elds for corporate activity. This is that supports it. In an era in which bio-
largely because contemporary molecu- tech enterprises such as Genentech pro-
lar biomedicine requires the investment claim that they are “in business for life,”
of resources over long periods–for biopolitics has become bioeconomics.14
equipment, laboratories, clinical trials,
and regulatory compliance–before it
can achieve a return. Increasingly, such 13 I have argued elsewhere that images of the
investment comes from venture capital development of scienti½c disciplines that por-
provided to private corporations, who tray a path from the laboratory to society, de-
also seek to raise funds on the stock mar- scribed in the language of ‘application,’ are
ket. Hence, biomedicine has become misleading, especially in those domains that
have what Michel Foucault termed a “low epis-
subject to all the exigencies of capitaliza- temological threshold.” The psychological sci-
tion, such as the obligations of pro½t and ences, for example, were ‘disciplined’ around
the demands of shareholder value.12 their ½elds of application–in industry, the
A path-dependent perspective on bio- schoolroom, the military, the courtroom–and
medical truth is necessary here. Biotech only later established in the university. Nikolas
Rose, The Psychological Complex: Psychology, Pol-
companies do not merely apply or mar-
itics and Society in England, 1869–1939 (Boston:
ket scienti½c discoveries: the pharma- Routledge & Kegan Paul, 1985). The impact of
ceutical industry has been central to re- military priorities and funding should not be
search on neurochemistry, the biotech underestimated, in even the most apparently
industry to research on cloning, and ge- theoretical of disciplines such as mathematics.

14 The collection edited by Sarah Franklin and


Margaret Lock made signi½cant advances in
12 Once more I must stress that there is noth- our understanding of biocapital, pointing to
ing novel in itself in close relations between in- the new hybrids of knowledge, technology, and
dustrial corporations and the development of life involved in patenting, sequencing, map-
scienti½c research, outside and inside universi- ping, purifying, branding, marketing, and pub-
ties. The image of scienti½c knowledge as devel- licizing new life forms: these studies contrib-
oping within the sequestered space of the uni- uted to my own less ethnographic approach
versity laboratory, funded by public moneys, to these issues; S. Franklin and M. Lock, eds.,
detached from commercial imperatives, mobi- Remaking Life and Death: Toward an Anthropolo-
lized only by Mertonian norms of disinterested- gy of the Biosciences (Santa Fe, N.M.: School
ness applies, if at all, only to a few disciplines of American Research Press, 2003). I am grate-
during an exceptional period in the mid-twenti- ful to Franklin for letting me read her own de-
eth century. Novelty, today, lies in the particu- velopment of these ideas in advance of publi-
lar con½guration taking shape around the life cation; S. Franklin, Dolly Mixtures (Durham,
sciences. N.C.: Duke University Press, 2006).

Dædalus Winter 2008 41


Nikolas
Rose
C atherine Waldby initially proposed Yet something has changed. The very
on the term ‘biovalue’ to characterize the emergence of the language of bioeco-
life ways that bodies and tissues derived nomics brings into existence a new
from the dead are redeployed to enhance space for thought and action. The bio-
the health and vitality of the living.15 economy has appeared as a space to be
The Organization for Economic Coop- mapped, managed, and understood;
eration and Development developed a it needs to be conceptualized as a set
similar idea in its ‘foresight’ exercise to of processes and relations that can be
explore the potential of economic activ- known and theorized, that can become
ity that “captures the latent value in bio- the target of programs that seek to in-
logical processes.” More generally, we crease the power of nations or corpo-
can use the term to refer to the many rations by acting within and upon that
ways in which qualities or capacities in- economy.
herent in vitality have become a poten- The normalization of the term ‘bio-
tial source for the production of value. capital’ is one indicator of this new
We should not overstate the novelty turn. March 2005 saw the third annu-
of these developments. Humans long al conference of BioCapital Europe in
ago put the vital properties of the natural Amsterdam–an event for pharmaceu-
world into service, with the domestica- tical and biotech companies across Eu-
tion of animals and plants. They turned rope.17 In Australia, around the same
these properties into technologies when time, the state of Queensland estab-
they, for example, harnessed the milk- lished a au$100 million biocapital fund
producing capacities of cows and the to establish globally enduring biobusi-
silk-producing capacities of silkworms nesses. In May 2005, BioSpace, a lead-
for the generation of biovalue.16 Con- ing online information source for the
temporary projects to embody human biotech and pharmaceutical industry,
desires and aspirations within living en- published the ½fth edition of BioCapital,
tities–organisms, organs, cells, mole- which showcases a variety of biophar-
cules–in order to extract a surplus–be maceutical companies located within
it food, health, or capital–can be traced the Mid-Atlantic region; it includes an
to these early events. interactive BioCapital Hotbed map that
also highlights research institutes, non-
pro½t organizations, and universities
15 C. Waldby, The Visible Human Project: Infor- within the area.18 Moreover, ‘biocapi-
matic Bodies and Posthuman Medicine (New York:
Routledge, 2000).
17 The conferences of BioCapital Europe en-
16 In volume 3 of Capital, Marx points to the able biotech companies to present themselves
signi½cance of the capitalization of cattle and to venture capitalists, institutions, and other
sheep breeding in enabling capital to become biotech and pharmaceutical companies look-
an independent and dominant force in agricul- ing for investment opportunities within the
ture. Franklin argues that the cloning of Dolly biotechnology market. See www.biocapitaleu-
the sheep–made possible by the investment rope.com (accessed November 25, 2005).
of venture capital in the hope of creating trans-
genic ‘bioreactor’ sheep to produce marketable 18 See http://www.biospace.com/news_story.
enzymes for treating human diseases–binds aspx?Storyid=20035520&full=1 (accessed No-
the oldest de½nitions of capital as ‘stock’ to vember 25, 2005). There are now many such
the newest forms that it takes in contemporary Hotbed Maps, which can be found at http://
biocapital. Human aspirations become literally www.biospace.com/biotechhotbeds.aspx (ac-
‘embodied’ in living capitalizable entities; ibid. cessed November 26, 2005). The original 1985

42 Dædalus Winter 2008


tal’ is used in the title of numerous in- not ful½lled, at least in the short term.20 The value of
life: somatic
vestment and consultancy organizations UmanGenomics in Sweden sought to use ethics & the
worldwide. Marxists and post-Marxists bioethical shields to insulate itself from spirit of bio-
may disagree about whether biocapital- some of the criticisms; but it too found capital
ism is a novel mode of production, but that its business model was not viable.21
they cannot dispute the existence and The ‘ex-socialist state’ bioeconomies,
signi½cance of biocapital as a way of such as Lithuania and Estonia, emerged
thinking and acting. from Soviet domination with compre-
Projects to govern the bioeconomy hensive medical and genealogical rec-
sometimes involve surprising alliances ords, together with relatively stable pop-
between political authorities and prom- ulations and some unusually prevalent
issory capitalism.19 A number of ‘strong medical conditions: these seemed to
state’ bioeconomies–most famously il- provide a favorable point of entry to a
lustrated in Iceland and Sweden–decid- future in which biotechnology would
ed to license private companies to un- generate employment, boost industry,
dertake the genetic sequencing of their and promote both public and sharehold-
populations and to combine this with er value.22
publicly held genealogical and medical Meanwhile, ‘developing state’ bio-
records, in the hope that they would be economies have turned claims about
able to identify the genomic bases of
common complex disorders. In the case
of decode in Iceland these hopes were 20 G. Palsson and P. Rabinow, “Iceland: The
Case of a National Human Genome Project,”
Anthropology Today 15 (5) (1999): 14; H. Rose,
The Commodi½cation of Bioinformation: The
Icelandic Health Sector Database (London: Well-
Biotech Bay™ Map for the San Francisco come Trust, 2003). See also http://sunsite.
Bay Area hangs on permanent display in the berkeley.edu/biotech/iceland/new.html. In
Smithsonian Institution’s National Museum a press release of August 2, 2005, decode Ge-
of American History. BioCapital was ½rst netics put a brave face on their progress but
launched in 1996. nonetheless reported losses in their second
quarter. See http://www.decode.com (ac-
19 Franklin and Lock, in 2003, attributed cessed August 11, 2005).
the term ‘promissory capitalism’ to Charis
Thompson’s then-unpublished work on what 21 A. Abbott, “Sweden Sets Ethical Standards
she termed “the biotech mode of (re)produc- for the Use of Genetic ‘Biobanks,’” Nature 400
tion”; S. Franklin and M. Lock, “Animation (July 1999): 3; K. Høyer, “Conflicting Notions
and Cessation: The Remaking of Life and of Personhood in Genetic Research,” Anthropol-
Death,” in Franklin and Lock, eds., Remaking ogy Today 18 (5) (2002): 9–13; K. Høyer, “‘Sci-
Life and Death: Toward an Anthropology of the ence is Really Needed That’s All I Know.’ In-
Biosciences. See C. Thompson, Making Parents: formed Consent and the Non-Verbal Practices
The Ontological Choreography of Reproductive of Collecting Blood for Genetic Research in
Technologies (Cambridge, Mass.: mit Press, Northern Sweden,” New Genetics and Society 22
2005), especially chap. 6. The idea that specu- (3) (2003): 229–244; A. Nilsson and J. Rose,
lative, risk, and venture capital depend upon “Sweden Takes Steps to Protect Tissue Banks,”
issuing promissory notes against the hope of Science 286 (1999): 894; S. Rosell, “Sweden’s
future returns has long had a central place in Answer to Genomics Ethics (letter),” Nature
studies of the rise of capitalist economies. I 401 (September 16, 1991).
draw on arguments made in my Clifford Bar-
clay Memorial Lecture at the London School 22 For the Estonian Genome Project, see
of Economics and Political Science in Febru- http://www.geenivaramu.ee/index.php?show
ary 2005. =main&lang=eng.

Dædalus Winter 2008 43


Nikolas the diversity of their populations into 1 million by 2010, an enormous increase
Rose
on exploitable resources. Thus, in China over the estimated 70,000 today. Gov-
life (which has emphasised gene testing, ernment of½cials plan to double their in-
biobanking, and stem cells) and India vestment in biotechnology in the next
(which points to the diversity of its gene ½ve years.”25
pool, developed pharmaceutical indus- This is not simply another case of
try, cros, and ‘good subjects’ for trials), predatory Western capitalism plunder-
local and national state authorities have ing the resources of the poor. A report
focused on the development of biotech of a U.K. government mission to India
as a driver of economic development, in 2003 was headed with a quote from
inward investment, and international then–Indian Prime Minister Atal Behari
competitiveness. Vajpayee: “Biotechnology is a frontier
Many Western and other First World science with a high promise for the wel-
economies have also stressed their po- fare of humanity.” At that time India had
tential competitive advantage in what 160 biotechnology companies with com-
enthusiasts like to term ‘the knowledge- bined revenues of $150 million, driven
based bioeconomy.’ In 2003, the U.K. by developments in the health-care sec-
House of Commons Trade and Industry tor; the industry was expected to grow
Committee Report on Biotechnology iden- to $4.5 billion by 2010 and to generate a
ti½ed biotechnology, especially biomed- million or more jobs.
icine, as a key economic driver. It esti- In China, the government spent about
mated that, in 2002, the U.K. biotech- $180 million building a biotech industry
nology industry had a market capitali- from 1996 to 2002. By December 2006,
zation of £6.3 billion, accounting for 42 total R&D spending in China exceeded
percent of the total market capitaliza- that of Japan for the ½rst time, and Chi-
tion of European biotechnology, with na became the world’s second-highest
pharmaceutical biotechnology as the R&D investor after the United States:
dominant branch.23 spending by central government in 2006
In the United States, Ernst & Young reached 71.6 billion rmb, or almost $10
reported that the biotech sector, in 2003, billion, a considerable portion of which
was a $33.6 billion industry, with a total was directed to biotechnology and bio-
of 1,466 companies, 318 of which were medicine. Government funds were di-
public.24 It also revealed that “in Aus- rected to basic science, leaving the spin-
tralia . . . total revenues among publicly out to the clinic and the manufacturing
traded companies increased 38 percent to the growing private biotech industry.
from $666 million in 2001 to $920 mil- And before the Hwang debacle, the Stem
lion in 2002. The number of . . . people Cell Research Centre in South Korea had
employed in the industry jumped 24 guaranteed government funding of $7.5
percent from 5,201 to 6,464.” And in Ja- million for ten years.
pan, the “government anticipates the
nation’s biotech workforce will surge to I n each region, political investment
to support the development of the bio-
technology sector is driven, in part, by
23 See U.K. House of Commons Trade and In- fears of losing out in an intensively com-
dustry Committee, Report on Biotechnology, 2003.

24 Ernst & Young, Resilience: America’s Biotech- 25 Ernst & Young, Beyond Borders: Global Bio-
nology Report, 2003. technology Report, 2003.

44 Dædalus Winter 2008


petitive global bioeconomy. Ernst & companies, and governments and non- The value of
life: somatic
Young’s Global Biotechnology Report 2005: biotech industrial conglomerates have ethics & the
Beyond Borders argues that “from Malay- to provide the capital that, in the West, spirit of bio-
sia to Michigan, governments are devel- would be raised in other ways.28 capital
oping strategic plans with ambitious Nevertheless, the allure of biocapital
goals for biotech” and points out that remains strong. Politicians in countries
“the global industry raised a whopping across the globe continue to foster the
$21.2 billion in 2004” from private capi- growth of a biotech sector and to seek a
tal for early-stage development. niche in this global bioeconomy by em-
Yet even this was not enough to meet phasizing the features that make them
the challenge of ½nding early-stage particularly attractive, whether these be
capital.26 The global biotechnology in- genetically stable populations, a skilled
dustry’s revenues grew by 17 percent and cheap labor force, or a range of sig-
in 2004, to $54.6 billion, but it was still ni½cant diseases. They attempt to map
making net losses of $5.3 billion, and the potential of this biotechnological
many companies seeking to raise funds revolution through exercises in fore-
from ipos did not obtain the valuations sight, and formulate strategies to devel-
they sought and suffered falls in share op it: targeted research funding, tech-
prices. Times were ‘challenging,’ espe- nology transfer, support for start-up and
cially in Europe and the United States, spin-out ½rms, tax breaks for research
partly because of developments in regu- and development, low regulatory hur-
lation and legislation: the U.S. debates dles, and much more. These local inten-
over the ethics of stem cell research, si½cations of biocapital are linked into
and the tendency of key policymakers transnational circuits of capital, knowl-
to “scrutinize research agreements be- edge, researchers, techniques, and also
tween academic medical centers, clini- material artifacts–tissues, cell lines,
cians and biotech/pharmaceutical com- reagents, dna sequences, organs, and
panies,” and to question “potential con- the like. Such circuits of vitality are not
flicts of interest.”27 themselves new–consider the long-
The Asian biotech sector meanwhile standing practices of ethnobotanical
continues to grow aggressively (“bio- collections of seeds and plants, or of
tech companies in the region increased the exchange of biological material and
their top-line revenues by 36 percent model organisms such as fruit flies,
in 2004”), although they too face ‘chal- which were central to modern genet-
lenges’: worries over ip protection have ics.29 But today, a kind of disembedding
hampered investment from Western has occurred. Molecularization strips
tissues, proteins, and molecules of their
26 And, especially in the United States, one speci½c af½nities–to a disease, to an or-
should not neglect the “opportunities and chal- gan, to an individual, to a species–and
lenges in biodefense” following the terrorist
attacks of September 11, 2001: Department of
Health and Human Services spending on bio- 28 Ibid., 67.
defense increased almost fourteenfold from
2001 to 2005, and the Bioshield Act of 2004 ear- 29 M. J. Balick and P. A. Cox, Plants, People and
marked £5.6 billion for U.S. countermeasures Culture: Science of Ethnobotany (New York: Sci-
against pathogens. enti½c American Library, 1996); R. E. Kohler,
Lords of the Fly: Drosophila Genetics and the Ex-
27 Ernst & Young, Beyond Borders: Global Bio- perimental Life (Chicago: University of Chicago
technology Report, 2005, 35. Press), 1994.

Dædalus Winter 2008 45


Nikolas enables us to regard them as manipula- human beings conduct their lives is a
Rose
on ble and transferable units, which we can ‘soteriology’: a way of making sense of
life move from place to place, from organ- one’s suffering, of ½nding the reasons
ism to organism, from disease to disease, for it, and of thinking of the means by
from person to person. which one might be delivered from it.
Vitality has been decomposed into a I suggest our own soteriology increas-
series of distinct and discrete objects ingly takes a somatic form. Human be-
that can be rendered visible, isolated, ings identify and interpret much of their
decomposed, stabilized, frozen, banked, unease in terms of the health, vitality,
stored, commoditized, accumulated, and morbidity of their bodies; they
exchanged, and traded across time and judge and act upon their soma in their
space, organs and species, and diverse attempts to make themselves not just
contexts and enterprises, in the service physically better, but also to make them-
of bioeconomic objectives. Whether it selves better persons. This is what I call
is the transfer of genes, and their prop- a ‘somatic ethic.’
erties (e.g., lumiscence, salt tolerance), Is there a relationship between the
from one species to another; the transfer birth of the bioeconomy and the emer-
of treatments from one disease to anoth- gence of the living biological body as a
er; or the transfer of tissues, blood plas- key site for the government of individu-
ma, kidneys, and stem cells, molecular- als–as the contemporary locus for so
ization is conferring a new mobility on much of our unease and discontents, as
the elements of life, enabling them to the site of hope and potential overcom-
enter new circuits–organic, interper- ing? What are the links between the
sonal, geographical, and ½nancial. modern salience of biocapital and the
And along with this ‘flattening’ goes ethical work that human beings are do-
another–the attempt to flatten the ing upon themselves in the name of
transnational circuits themselves, to health, longevity, and vital existence?
construct one of those level playing To address this, we need to distinguish
½elds, in which standardized intellec- this sense of ethics from that entailed in
tual-property regimes, forms of ethi- the idea of bioethics. Bioethics can oper-
cal governance, standards and regula- ate as a legitimation device within the
tions, and information allow distinct regulatory technologies of government,
and widely separated economic actors as they deal with highly controversial
to trade with one another, and yet up- issues of life and its management.30 It
on which each local actor seeks to gain can serve to insulate researchers from
competitive advantage. criticism, and from the detailed exami-
nation of the nature and consequences
M ax Weber famously argued that of their activities, by bureaucratizing the
processes whereby they obtain ‘ethical
there was an ‘elective af½nity’ between
a certain religious ethic of worldly ascet- clearance’ for what they do. Crucially,
icism that he saw in Calvinism and the
early emergence of capitalism in Europe 30 B. Salter and M. Jones, “Human Genetic
and North America. His thesis has been Technologies, European Governance and the
the subject of extensive debate, interpre- Politics of Bioethics,” Nature Reviews Genetics 3
(10) (2002): 808–814; B. Salter and M. Jones,
tation, and empirical refutation. But it “Biobanks and Bioethics: The Politics of Legiti-
was grounded in his more profound in- mation,” Journal of European Public Policy 12 (4)
sight that central to the ways in which (2005): 710–732.

46 Dædalus Winter 2008


bioethics also provides the essential might more accurately be termed ‘bio- The value of
life: somatic
ethical guarantees that enable elements morality,’ whose aim is to develop prin- ethics & the
–tissues, cells, eggs, sperm, embryos, ciples, and promulgate codes and rules, spirit of bio-
body parts–to move legitimately around as to how research or clinical work in capital
the circuits of biocapital so that they biomedicine might be conducted. At a
can be combined and recombined in set- time when the somatic, the bodily, the
tings from laboratory to clinic. Franklin ‘bio,’ have become so central to our
coined the term ‘ethical biocapital’ to forms of life, we should not be surprised
draw attention to the way in which bio- that one response is to try to discipline
tech corporations themselves now seek these dif½culties: to ½nd some algo-
to internalize these ethical considera- rithms to adjudicate them, to standard-
tions in their business models and their ize procedures for the potentially con-
artifacts. Bioethics thus often seems to flictual decisions concerning them. In
arise from an alliance between those this way, problematic issues can be
who want or need an ethical warrant for transformed into technical questions:
their commercial or scienti½c activities Have the proper procedures been fol-
–whether they be pharmaceutical com- lowed? Have the proper permissions
panies or those whose careers depend been obtained? Is con½dentiality as-
upon research with human subjects– sured? Has informed consent been ob-
and those who see here a potential locus tained? Bioethics, here, like accountan-
for grants, recognition, a professional cy, legal regulation, and so forth, has
vocation, and a public role–philoso- indeed become an essential part of the
phers, theologians, ethicists, and others. machinery for governing the bioecono-
And as some critics claim, there are cer- my; for facilitating the circuits of bio-
tainly moments when bioethicists, and logical material required for the genera-
the clean bill of health they can offer, tion of biocapital; and for supervising
seem to be for sale: when bioethicists, all those practices in which life itself is
in taking subsidies for their education- the object, target, and stake.
al activities, accepting grants, and act- But I am more interested here in an-
ing as consultants to biotechnology and other sense in which we can think of the
pharmaceutical companies, may have ethics of the bio. This concerns the ethi-
betrayed the trust vested in them, legiti- cal considerations deemed relevant by
mating the unacceptable at the cost of participants–not just patients and their
human lives.31 families, but also researchers, clinicians,
But alongside the urge to critique, regulators, and even those working in
we need to attend to what this demand the world of commerce–in their actual
for bioethics manifests. Perhaps, at the conduct in relation to the dilemmas they
simplest level, we need to distinguish face and the judgments they must make.
between two general senses in which Many detailed ethnographies of bioso-
the biological and the ethical are inter- cial communities demonstrate the ways
twined. On the one hand stand those in which today’s biological citizens are
practices and ways of thinking that reformulating their own answers to
Kant’s three famous questions: What
can I know? What must I do? What may
31 C. Elliot, “When Pharma Goes to the Laun- I hope? We also see this in studies of the
dry: Public Relations and the Business of Med-
ical Education,” Hastings Center Report 34 (5) ethos of the authorities and profession-
(2004): 18–23. als enmeshed in contemporary vital pol-

Dædalus Winter 2008 47


Nikolas itics, in those working in and for com- our hopes for salvation, for the future–
Rose
on mercial biotechnology and pharmaceu- are themselves shaped by considerations
life tical companies, and perhaps even in about the maintenance of health and the
those investors whose concerns seem prolongation of earthly existence.
purely ½nancial. While they may have The management of health and vitali-
their own share of cynicism, pragma- ty, once derided as narcissistic self-ab-
tism, ambition, greed, and rivalry, they sorption, has now achieved unparalleled
are also searching for, assembling, and ethical salience. The tensions between
inventing ways in which they might the intensifying demand for the prod-
evaluate, adjudicate, and justify the de- ucts of the bioeconomy–organs, em-
cisions they must make when human bryos, pharmaceutical products, and the
vitality is at stake. like in the West–and the inequities and
It is this sense that is closest to my no- injustices of the local and global eco-
tion of a somatic ethic. I use ‘ethic’ here nomic, technological, and biomedical
to refer to ways of understanding, fash- infrastructure required to support such
ioning, and managing ourselves in the a somatic ethic seem to me to be a con-
everyday conduct of our lives.32 If our stitutive feature of contemporary bio-
ethic has become, in key respects, so- politics–and one in which the differen-
matic, this is because it is our soma– tial value of life is very much at stake.
our genome, our neurotransmitters, our What I have tried to do, in a schemat-
‘biology’–that is given salience. It is al- ic and provisional manner, is to sketch
so because the authorities that articu- the somatic ethical economy, which per-
late the rules for living now include not haps has an elective af½nity with a cer-
merely doctors and health promoters, tain form of capital–biocapital–and
but so many other somatic experts: ge- with the capitalization of life itself. To
netic counselors, support groups, proj- paraphrase Max Weber, we do not have
ects for the public understanding of ge- to decide between a materialistic and a
netics, and bioethicists. And it is because spiritualistic interpretation of these de-
the forms of knowledge that are shap- velopments.33 Somatic ethics and bio-
ing our understandings of ourselves are capital have been locked together since
themselves increasingly ‘biological’– birth. For only where life itself has
medical, of course, but also coming achieved such ethical importance, only
more directly from genomics and neuro- where the technologies for maintaining
science, in their popular presentations, and improving it can represent them-
their scienti½c elaborations, and in the selves as more than merely the corrupt
hybrid forms they take within lay dis- pursuit of pro½t and personal gain, only
courses of everyday life. Finally, it is be- when they can place themselves in the
cause our expectations for our lives– service of health and life, is it possible
for biocapital to achieve such a hold on
our economies of hope, imagination,
32 I have discussed the way of thinking about
ethics and self-technologies developed by Mi- and pro½t. In this sense, I suggest, so-
chel Foucault and Giles Deleuze elsewhere: G. matic ethics is intrinsically linked to the
Deleuze, Foucault (Minneapolis: University of spirit of biocapital.
Minnesota Press, 1988); M. Foucault, The His-
tory of Sexuality, vol. 2, The Use of Pleasure (Lon-
don: Penguin, 1985); N. Rose, Inventing Our 33 M. Weber, The Protestant Ethic and the Spirit
Selves: Psychology, Power, and Personhood (New of Capitalism (London: George Allen & Unwin
York: Cambridge University Press, 1996). Ltd., 1930), 183.

48 Dædalus Winter 2008