Bioethics and Biomedicine: A Review of Rose's Politics of Life

Introduction: The Bioethical Landscape

Human evolution has produced an increasingly perceptive understanding of the inner workings of the human body. A more detailed comprehension of both physiology and genetic makeup have offered remarkable new insights into ways to relieve human suffering, preemptively address conditions previously regarded as chronic, and lengthen and improve human life. In just the space of a decade, science has made monumental strides in identifying the building blocks of human life. From the mapping of the human genome, a project completed in 2003, to the day's top headlines on stem cell research in the political and philosophical arenas, our improved grasp of human genetics has opened exciting new doors for medicine and science.

However, just as many opportunities have been realized, so too have an extraordinary array of questions been raised. This is the primary subject at issue for Nikolas S. Rose, whose 2006 text The Politics of Life Itself examines the controversies, quandaries, and obstacles that both stand in the way of progress and provide a moral conscience to restrain the unbridled enthusiasm for progress demonstrated by science, medicine, and the commercial interests thereby affected. Rose's text is a useful contribution to the bioethical perspective: it espouses opportunities that can relieve human suffering while also insisting that core strategic and moral questions must first be addressed if we are to proceed wisely and advantageously.

Rose's Framework and the Concept of Optimization

The greatest strength of Rose's text is the optimism and evenhandedness with which it approaches the prospects before us. Engaging in a straightforward examination of the various nuances of bioethicality in both a philosophical and practical context, he inserts a comprehensive investigation of what lies ahead into a very current morass of issues. As a point of introduction, he indicates that this lack of clarity is the most confounding force in contemporary debates. Rose notes the dramatic response to the revelations of the Human Genome Project, writing that "some believed that the sequencing of the human genome would inaugurate an age of genetic manipulation with marvelous, perhaps terrifying consequences. Linking genomics with developments in reproductive technology, such as pre-implantation genetic diagnosis and cloning, they imagined a world of engineered people, with qualities and capacities fabricated on demand" (Rose 1).

Rose couches his examination in a useful framework constructed around a set of conditions he argues can define the various points of debate shaping bioethics discourse today. By distilling the characteristics of each of these conditions and illustrating the divides they have provoked, Rose proceeds to offer a perspective of compromise. This is demonstrated in the text's treatment of optimization. With respect to medical attention, treatment, and ingenuity offered to individuals, Rose considers that there has always been associated with medical treatment a primary interest in achieving the greatest possible results through the advancement of knowledge and the improvement of technologies. With regard to biomedicine, however, Rose suggests that the discussion on optimization is changing considerably.

Rose indicates that "contemporary technologies of life are no longer constrained, if they ever were, by the poles of health and illness. These poles remain, but in addition, many interventions seek to act in the present in order to secure the best possible future for those who are their subjects" (Rose 6). Among the restraints and motives implicated in this subject, Rose notes that a wide variance in ethical positions, the imposition of spiritual ideals, the relevance of political processes, and the ever-present conflicts created by the financial aspects of modern medicine have all played their part in making optimization a highly debated concept. It is no longer clear today — particularly in light of the unprecedented frontier opened by our better understanding of the human genome — how optimization should be defined. To Rose, the increasing divergence on this matter of biotechnological optimization is a fundamental impasse to realizing medical potential.

Somatic Expertise and the Rise of Bioethics

Another of the conditions that complements this matter is that of somatic expertise, which draws the question of bioethicality directly into the debate. As Rose indicates, the advancements that have occurred in the field have produced an expansive industry of participants and interested parties. With the emergence of new technologies and procedures has come the emergence of new experts. According to Rose, "around these experts of the soma cluster a whole variety of new pastoral experts — genetic counselors are perhaps the best exemplars — whose role is to advise and guide, to care and support, individuals and families as they negotiate their way through the personal, medical, and ethical dilemmas that they face. And, perhaps most remarkable, has been the rise of a novel expertise of 'bioethics'" (Rose 6).

This is the subject that commands perhaps the greatest importance in Rose's text, striking relevance into every other aspect of the debate by suggesting that this essentially subjective lens has come to dominate a field traditionally ruled by empiricism. To this point, optimization has been distinctly shaped by this — at times false or self-proclaimed — sense of somatic expertise. The concept of bioethics as a formal discipline, Rose implies, has introduced new voices into scientific debate that do not always operate on empirical grounds, complicating efforts to reach policy consensus.

Works Cited

Rose, N. S. The Politics of Life Itself. Princeton University Press, 2006.