ABSTRACT
Is there a right to be healthy? A right to a healthy life, to the provision of health care, to a healthy child? Is there a duty to be well? An obligation to conduct oneself in such a manner as to minimise one’s sickness, one’s frailty, the burden that one places upon one’s family, one’s neighbours, one’s community, one’s society? And how do such rights and duties vary from place to place – how do they differ, say, between the European experience over the twentieth century and into the twenty-first, and that in China? By these questions I do not mean to introduce a bioethical or philosophical discussion, let alone a legal one. I do not mean ‘right’ here in the sense of something justifiable, but rather in the sense of an expectation that is, or can become, legitimate, thinkable, practicable, a basis for action, or the grounds for concern. Something that can become all those things – a legitimate ground for expectation, etc. – for particular individuals or groups, in certain times and places, and in the eyes of various authorities. Something that can be used to ground or frame demands on professionals, political activists or the State, or to mobilise popular campaigns. By a ‘duty’ here, likewise, I do not mean something enshrined in law, although it may be, or enforced by the police powers or legal agencies of the State. Rather, I mean a duty in the sense that the strategies, practices, judgments, policies and actions of diverse authorities embody the belief that individuals should act in such a way as to maximise their health and should conduct themselves and those they care for in a manner that would minimise threats to health, say by adopting certain authorised practices of self-care, hygiene, disease awareness, self-medication, regulation of procreation or medical treatment that are considered appropriate at certain times and places. These two linked questions – the right to health, the duty to be well – are aspects of what I term ‘biological citizenship’ (Rose 2001; Rose and Novas 2005; Rose 2007). This term is not really an analytical concept. I regard it as a sensitising notion with a perspectival intent.2 ‘Citizenship’ here does not refer to a formal legal status, but rather to the ways in which various authorities – political, religious, professional – think about inhabitants of a territory as actual, potential or non-citizens, and to the formation of programmes, strategies and projects to create, manage or regulate those inhabitants as citizens (cf. Marshall 1950;
Veyne 1997). I also use it to refer to certain styles of self-formation, that is to say, the ways in which individuals come to understand themselves as citizens of certain sorts, members of populations, races, nations, and to the related practices of affiliation, differentiation and stratification in relation to other individuals and groups (Foucault 1982; Rose 1996). I suggest that, in both these senses, citizenship, in many countries, since at least the nineteenth century, has been linked to biological conceptions of human beings, infused with, and shaped by, ideas about the biological nature of human beings. These ways of thinking about those who are subject to authority in terms of their biology has entailed both inclusion and exclusion, dividing actual citizens, from those who are potential citizens, from those impossible citizens whose biological make up precludes them ever being considered as citizens. Analyses of biological citizenship thus focus on how the vital capacities of people, and peoples, have, at different times and places, entered the domain of government. By government here, I mean to refer to more or less rationalised endeavours to conduct, shape and steer the ways in which human individuals and groups act (Foucault 1979; Rose 1989, 1999b). Many authorities are involved in such endeavours – not merely politicians or those in the apparatus of the state – civil servants, social workers and the like – but those in religious organisations, philanthropic movements, doctors, lawyers, psychiatrists, community organisations, industrial relations experts, vocational guidance officers, factory managers, newspaper columnists, television programme makers, designers and architects, and many more. Such conduct of conduct can use multiple technologies – threats, laws, sanctions, persuasion, bribery, indoctrination, guidelines, education, professional obligations, moral or political exhortation, collective or group expectations, incitement, inducement, conversion, ethical inculcation, the calculated management of space and time and much more. Each of these technologies for the government of conduct operate in a kind of transactional space between the ways in which our conduct is acted upon by others, and the ways in which it is acted upon by ourselves. Acted upon in the light of knowledge – be it ‘scientific’ or lay. Acted upon by means of certain techniques, whether specially invented or borrowed from elsewhere, and acted upon in ways oriented to avert certain outcomes considered undesirable and towards particular ends thought desirable. To the extent that it is what we now term our ‘biology’ that is acted upon – an anachronistic term, I know, and one that only comes into being in the West at the start of the nineteenth century – we are governed in the name of some more or less explicit idea of life, of what is of value in the living of it, of how it is best to be managed, of what can enhance or damage it (Rose 2007). And if biological citizenship is predicated upon knowledge of human life, it is thus shaped by the different conceptions of life itself that hold sway at different times and places, in different practices, and for different authorities and lay persons. This is the subject of my discussion here. After a rapid overview of biological citizenship in Europe, I ask what form biological citizenship might be taking in China. I do not write as a China expert – far from it – but rather, largely on the basis of the empirical work of others, I explore some of the ways in which the vital capacities of its people
(collectively and individually) have entered realms of calculation, expertise and conduct of conduct.
