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Genetic Hygiene: Discourses of Causation in North American Medicine

  • Author / Creator
    Blacker, Sarah E.
  • Abstract Written in an era that is witnessing an epistemic shift through which human health is increasingly being geneticized by North American science and medical institutions, this dissertation interrogates the discourses that make such a shift—and all of its material repercussions—possible. I contend that the naturalization of reductive and mono-contextual discourses of causation have acted as conceptual precursors to the epistemic dominance now secured by genomic and “personalized” medicine in 2015. Reading these discourses of causation as part of a larger hegemonic set of processes that find expression as a liberal form of self-management in the context of Canada as a state that invests in the productive capacities of its citizenry, this thesis narrates the development of reductive causation through three case studies that examine how state institutions have parsed forms of social inequality from forms of biological inequality, while epistemologically cementing the latter as the scientific mechanism of causation. Ultimately, this thesis aims to disrupt the hegemony of these discourses to create space for other knowledges concerning health and illness, including that of Indigenous Traditional Knowledge. I contend that the state’s parsing of social and biological forms of inequality is informed by a notion of biovalue—a concept developed by Catherine Waldby and Robert Mitchell to theorize a biologically novel form of value produced by innovations in molecular biology. But, for the purposes of my analysis, I situate biovalue on a macro scale that I argue is particular to a neoliberal state that retains social-democratic features such as social security and universal health care, and the ways in which economic considerations of such a state have led to institutions and policies that distribute resources based on calculations of gradients of biovalue. Biovalue measures capacity for productivity, and yet longstanding biological and political notions of variation and inequality, such as eugenic ideas concerning varying capacities for productivity along race and class divides, continue to inform state policy. The first chapter presents an early articulation of personal hygiene being framed as a form of self-management into which individuals—especially those living in poverty—are hailed as hygienic subjects, which is, in the interwar period, synonymous with responsible, self-determinate subjectivity. This chapter traces how the eugenic ideas and policies of the Canadian physician and policymaker Helen MacMurchy betray a calculation of biovalue that explicitly takes into account the perceived “drain” on state resources presented by unproductive citizens in the period preceding the implementation of universal health care following the passing of the Medical Care Act in 1966. The second chapter turns to a particular application of genomic science in the form of the development of pharmacogenetic drugs that divide therapeutic populations on the basis of race. This chapter draws attention to the multiple sites of power and knowledge production that have an interest in figuring race as a biological entity that “naturally” determines differential forms of biovalue, and the way in which science has been positioned as the preferred channel through which this knowledge is disseminated. In addition to revealing the extent to which science and the state are intertwined in their production of race as a form of valuation, this chapter notes how articulations of urgency accompany the shift into therapeutic applications, functioning as a political justification for intervention while eliding their centrality to modern racial projects. The third chapter considers how state calculations of biovalue in Indigenous communities in Canada have informed the development of two-tier public health in Canada in the form of race-targeted public health campaigns. Through an analysis of government policy, this chapter finds that these public health campaigns betray a persistent colonial attitude towards, and devaluation of, Indigenous lives—indirectly, through policy—and that in this sense, these public health campaigns can be understood as a logical extension of the colonial project that was at work in the Canadian government’s Indian Residential Schools. The overarching aim of this project is to bring to the forefront the multiple ways in which dominant discourses of causation prevent the development of new imaginaries, and keep us from asking critical questions beyond the reductive thinking produced by our current epistemological, technological, and funding infrastructures.

  • Subjects / Keywords
  • Graduation date
    Fall 2015
  • Type of Item
    Thesis
  • Degree
    Doctor of Philosophy
  • DOI
    https://doi.org/10.7939/R3ZS2KT5F
  • License
    This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.
  • Language
    English
  • Institution
    University of Alberta
  • Degree level
    Doctoral
  • Department
  • Specialization
    • English
  • Supervisor / co-supervisor and their department(s)
  • Examining committee members and their departments
    • Fee, Margery (University of British Columbia, Department of English)
    • Zwicker, Heather (English and Film Studies)
    • Kaler, Amy (Sociology)
    • Simpson, Mark (English and Film Studies)