ABSTRACT
In this chapter, I consider how the neuropsychiatric biopolitics of dementia is bound up with a recent problematisation of ethnicity facilitated by an uncritical dementia studies. I begin by charting the 21st-century escalation of interest in ethnicity across the dementia economy. In the context of wider political sensitivities to race and ethnicity, a range of dementia-related ethnic inequalities have become a major concern for charities, governments and researchers. This turn toward ethnicity as a dementia-related issue encompasses a collection of developments that should be of concern for dementia scholars, from the operationalisation of social difference (i.e. how we collate and compare people) to the attribution of blame for bad outcomes. After outlining dementia’s ethnic turn generally, I unpack core representations of inequality, whereby a range of different dementia-related outcomes, such as diagnosis rates and medication use, are normatively evaluated as either good or bad. I argue that these normative appraisals of select outcomes are not based on evidence. Instead, they are grounded in intuition, convention and the wider influence of neuropsychiatric biopolitics, with which they are broadly aligned and hence serve to substantiate.
Once I have assessed the biopolitical nature of outcome measures in appeals to ethnic inequalities, I then consider the operationalisations of ethnicity used in such appeals. The extent to which ethnicity functions as a category fallacy in social scientific analyses has long been debated, and problems in this vein continue to undermine appeals to dementia-related ethnic inequalities. More than this, I argue that the use of ethnicity (however it is conceived) as a means of stratifying outcomes implicitly positions those inequalities as intrinsically ethnic in nature. Hence, it racialises them, irrespective of differences and similarities within and between the categories that are used. This leads to a problematisation of ethnicity, particularly minoritised ethnicity, 1 as a causal factor, itself contributing to the bad outcomes with which it is associated. From this position, arguments centring on notions of cultural inadequacy are commonly presented as explaining the observed ethnic inequalities. I contend that such arguments echo historic racialisations of psychiatric disorder to position minoritised ethnic people as victims of ethnically distinct characteristics that are intrinsic to them rather than extrinsic structural constraints.
Following my discussion of the mechanics of this problematisation of ethnicity, I argue that the ethnic turn, within which dementia studies itself plays an important role, actively supports a neuropsychiatric biopolitics of dementia. I suggest that it does so by linking the “badness” of minoritised ethnicity with a failure to comply with neuropsychiatric biopolitics through the self-governance of personal conduct. Minoritised ethnicity becomes a cautionary tale of how not to be, showcasing the importance of neuro-compliance. The imagined ethnic other does not think right, does not act right, and is therefore doomed to suffer. In response, I argue that a more critical dementia studies should reflect on how it engages with ethnicity, particularly by asking whose interests are best served by that engagement, and to especially consider the extent to which such engagements might be considered racist. Rather than developing educational interventions to somehow improve minoritised ethnic people, we could pursue more pluralistic approaches to dementia that recognise the value commitments at stake in various perspectives and resist the tendency to position some ideas as inherently superior.
