ABSTRACT
This book’s point of departure was that there is a need to recognise how science and technology have contributed to defining and articulating ageing as a societal issue. While the official version of the ‘ageing society’ is that it results solely from the interaction between demographic changes and modern social and economic institutions, for which new technological and scientific solutions are needed, in this book I have argued that science and technology have significantly shaped the way in which we understand and manage the relationship between ‘population problems’, the economy, society and individuals. My proposal was to set up a research programme that delves deep into the knowledge making practices, the tools, the technologies, the devices, the knowledge making sociotechnical institutions that underpin the ageing society. My second proposal was that if we aim to focus on the epistemic infrastructure of the ‘ageing society’, what we find is uncertainty and multiplicity – most notably evident in the controversy between ‘pessimistic’ and ‘optimistic’ analyses of the societal consequences of demographic ageing. To explore these uncertainties and multiplicities, the book investigated a diverse – multiple, coexisting – array of ‘agencements’ that are key to understanding the relationship between science, technology and the ‘ageing society’. But this approach had another objective: to avoid an uncritical search for ways to restore and secure agency for older people within technological democracies. This is particularly important, I argued, in a context where there are increasing calls for ageing individuals to actively engage with science, technology and medicine in order to enhance health, activity and their overall involvement in social, economic and cultural spheres. Rather than juxtaposing present, unsatisfactory circumstances with idealised forms of getting older, I suggested that it is possible not only to show how ‘it could have been otherwise’ but also – through the deployment of patchwork stories – to bring to bear the ways in which it has always been otherwise, that is to say, to fully exhibit the ‘heterogeneity of what was once imagined consistent with itself ’. I provided the first piece of the patchwork in Chapter 3 where I detailed the epistemic character of the ‘ageing society’ by linking its assembling – its gathering into a thing – to an emerging collective inquiry into the actuarial techniques
and practices upon which the liberal welfare state had been based. First outlining a genealogy of the relationship between the ‘population problem’ and the economy, the chapter suggested that the ‘social security crises’ of the early 1980s brought to bear concerns about the accuracy and reliability of demographic calculations and economic forecasting to accurately predict increased life expectancies and correlated imbalances of social security programmes. The ‘ageing society’ can only, from this perspective, be described as an established uncertainty concerning how to deploy procedures of scientific research and technological innovation in addressing and managing these uncertainties. I suggested further that the public recognition of the epistemic – but unstable – underpinnings of the ‘ageing society’ served as the context to rearticulate a set of technoscientific promises from the 1980s to the present day. This relied on a reconfiguration of ageing as a matter of concern (Latour, 2005) – i.e. on a rearticulation of how to intertwine knowledge production and political process in relation to ageing. In as much as the ‘insurance society’ had relied on and reinforced models of ageing that enacted ‘old age’ as a fixed biological, psychological and socioeconomic stage in life (Katz, 1996), for which specific clinical and social security programmes were required, this rearticulation required both and simultaneously opening up established knowledge on age-related functional decline – on the relationship between disability and death – and exploring what kinds of institutions would be most suitable to new arrangements of ‘vitality’. The uncertainties attached to this double exploration were, I suggested, partially settled through the pronouncement of a set of technoscientific promises offering to modify health and work through an assortment of converging tools and forms of knowledge – a series of agencements – ranging from the molecular to the sociological. In Chapter 4, I explored the role of what I labelled the eugenic agencement in the stabilisation of the link between the ‘mechanisms of life’ and the economy. I argued that this epistemic and moral concern with ‘the quality of populations’ and migratory flows played a significant part in shaping the social security systems of liberal welfare states, including old age pensions. Tracing how population science experienced a shift away from lowering birth rates towards a focus on life and health expectancy, I suggested that this transformation was achieved through a reinforcement of the problematic role of migration in the cultural economy of population management. In this, the possible quantitative redress of population ageing by migration became increasingly trumped by the aim to bolster the use of existing ‘human capital’, through the extension of health and active working life. From this perspective, the technoscientific promise of raising the efficiency and productivity of existing human capital was the result of a series of epistemic and policy lock-in – and lock-out – processes. Partially in line with what Rose (2009) proposed, this resulted in a shift in the logics of biopower, whereby the classification of the eugenic value of persons is replaced by a valuation of the genetic and molecular components of ways of living. However, my view is that this relied on opening up death to biopower, rather than its replacement by a
sole focus on morbidity. Drawing on models of epidemiological transition, I showed how management of the factors associated with the onset of mortality in the life course defined the ‘central issue of vitality’ in populations in the ‘ageing society’. This also means that the relationship between illness and death remains an open, unstable matter within the ‘ageing society’. Chapter 5 explored how age measurement was identified as the infrastructural key to the double exploration of the links between ageing, illness and death, on the one hand, and the institutions that would be most suitable to new arrangements of ‘vitality’, on the other. I have proposed that, in this process, a variety of epistemic and normative uncertainties about the role of chronological age to ascertain age-specific norms, values and expectations were publicly raised. In order to resolve these problems, a multiplicity of ‘personalised’ age standards were proposed between the 1940s and the 1980s. These were grouped in four types. First, there were those aimed at using functional assessments to enhance efficiency. The second type included measurements that linked the monitoring of somatic qualities to health and efficiency. Third were measures that linked functionality to the unique contribution of older individuals to society. Lastly, there were measurements focused on exceptional longevity. Because none of these alternative standards has been able to replace chronological age, I have argued that these two processes have combined to produce torquing effects between chronological age and individual trajectories, and between and within alternative age measurements such as ‘biological age’. Such torque effects were explored in more detail in relation to biological age, which can be seen as the dominant alternative to chronological age in contemporary societies. In relation to this, I described how uncertainties in biological age validation and implementation have drawn on and reinforced two modes of organising knowledge production to meet the challenges of the ‘ageing society’: one, that relies on chronological age as a variable to create clusters of health risk – and on biomedical experts as pastoral guides of individual conduct (Rabinow and Rose, 2006) – and another which aims to embody in the alternative standard itself the machinery of individualisation of health, work and technology. Chapter 6 further investigated the issue of individualisation in the ageing society. Taking as a point of departure the established consensus that ageing is a process where genetic, environmental, lifestyle and experiential factors combine in unique individual trajectories, it found – like the previous chapter – fundamental uncertainties about the meaning and use of the individual as an epistemic entity to understand and manage ageing. I proposed that the best window into these uncertainties was an in-depth exploration of a methodological agencement – the longitudinal study of ageing – which I conducted through a case study of the genesis and development of the BLSA from the 1950s until the present. This exploration showed how the BLSA’s evolution was underpinned by an interaction between different sets of epistemic practices, devices and norms, particularly as understanding the relationship between ageing, health and life expectancy became more pressing in wider society.
