Presentation - David Winickoff

Presentation - David Winickoff


Doing Biopolitics, Inventing Democracy


There is an irony that a meeting devoted to challenging the existing paradigm of bioethics would begin with principles.  It is, afterall, the book called The Principles of Biomedical Ethics, that still holds a dominant position in the field.  Its influence can hardly be exaggerated.  Since initial publication in 1979, it has gone through 6 editions.  With it, authors Beauchamp and Childress have helped shape two or three generations of bioethicists in the United States and in the world over.  The success of the book is due in no small measure to its four famous principles, what the authors take to be the moral core of modern biomedical ethics: autonomy, non-maleficence, beneficence, and justice.  So, in talking values and principles here, are we taking a page out of the very paradigm of bioethics that we purport to criticize?

The Beauchamp-Childress approach has attracted some strong criticisms, some, no doubt, from members of the audience here:  First, why these four principles?  Were they found at the bottom of Mt. Sinai, chiseled onto a tablet lost by Moses?  Second, principles come into conflict, so the deductive methods they lay out are often indeterminate.  Finally, as norms become authoritative, they can also become too rigid. 

All these criticism of “principlism” ring true, but they shouldn’t deter us from taking on the project of examining a core set of values for these meetings.   But we must start by claiming less than the principlists do, so that we, ironically, might be on firmer ground.   A list of values won’t determine right answers.  We should argue about them.  And we should think of them strategically.

What might the project of articulating values promise for the Tarrytown community?  I would suggest first that it is about getting the forest for the trees, in order to develop an understanding of the higher level concerns that cut across the ARTs, biobanks, BiDils, and Chakrabarties that we all work on.  Hopefully, we can use more general values and principles to connect across topics and cases, making new wholes.  Second, values and principles are mobile.  They can be communicated, understood, and deployed to develop coalitions.  Third, values like social justice, equality, human rights, ecological integrity and the common good – the Tarrytown values from last year – are in a constant state of evolution.  With or without us, their meanings develop along with technological change.  So, we jump in, or we’re left on the curb.

The five values just mentioned are good candidates for our discussion.  But in my remaining time, I’d like to briefly introduce a sixth: democratic governance of the life sciences.  This one is particularly difficult.  Achieving better democratic governance of the life sciences will actually require reinventing democracy. 

But let me start with what democratic governance should NOT always require.  It doesn’t require that every biology experiment and every question be approved by Congress, or town hall meeting.  This is the caricature of the democratic governance invoked by many scientific and bioethics experts to shield science from political accountability.

So what does the democratic governance of biotechnology mean? There are many forms of activity and institutions that make up the fabric of a vibrant democracy, so we shouldn’t be limited to one vision.  I hope that this will be a central topic here in Tarrytown.  For now, let me focus on the following two aspects: 

  • First, making science and technology a core concern of deliberative democracy;
  • Second, deepening representation in science and technology decision-making.

We can probably all agree that political space available to engage science and technology is narrow at best.  The reasons are readily apparent:  technical content, an entrenched science elite, the hype of innovation as the solution to all ills, neoliberal promotion of markets, and the extreme polarization of political life.

But we also probably agree that enhancing societal capacity to think and act well regarding science and technology is critically important.  For one thing, science and technology help constitute modern life – and like a constitution, they have the power to organize rights, authority, identity and culture.  With a kind of hard-to-discern permanence, science becomes nature; technology becomes built-in.

Even as this is happening, our political forms seem to grow more limited. Citizenship in the biopolitical realm is often reduced to the swipe of a credit card.   Should I purchase a spit-kit, or not.  There seem to be few opportunities for thought, or collective action.

This is why we may have to rethink democracy in order to create a richer biopolitics.

You are probably here because you think a richer biopolitics is possible.  That it is possible to develop democratic governance, develop richer forms of societal deliberation and representation in decision-making about the life science.  We are doing it. . . .   We do it, and must continue to do it, I would argue, with at least three tools, three democratic technologies.  I’ll call these critique, contestation, and construction.  We are each involved in one or more of these activities.  They are mutually reinforcing.  Let me close by reviewing these three tools that help us make democratic governance actionable. 

Critique is the systematic analysis of prevailing discourse and arenas of action.  It is a common concern across academic and civic actors alike, and it can also be a powerful form of networking.  It’s deployment is itself a normative act.  With critique, we open up closed spaces for political assessment and action, and denaturalize the world constructed by science and technology. 

Contestation.  Disputing, litigating or other direct challenges to the mainstream within diverse democratic fora, including courts, hearings, debates, and op-ed pages.  Think about the recent BRCA case, and the range of plaintiffs and amicus briefs it brought together.  But this isn’t just about winning particular battles;  it’s about achieving new kinds of standing in powerful institutions, and therefore about expanding representation in these fora.

Construction.  We are also engaged in reforming democratic institutions, and bringing new ones into being.  Here we move beyond a reactive mode, to envisioning the one we wish to inhabit, and finally constructing it, whether it is through legislation, organization, or education.

            *                      *                      *                      *

Our values should guide us, and challenge us.  What does democratic governance as an ideal challenge us to do?  I think that further developing mechanisms of deliberation and representation, as advanced through critique, contestation, and construction, moves us in a good direction.  If we do this, we have a great opportunity to invent the democratic governance of science, . . . even democracy itself.