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    • Shameless Self-Promotion: “The Subject and Power of Bioethics”

      By Gordon Hull

      I have a new paper up on SSRN, "The Subject and Power of Bioethics," which was invited to a forthcoming issue of the Journal of Ethics, Medicine and Public Health.  The abstract is:

      The present paper argues that late work of Michel Foucault is helpful in understanding contemporary bioethics.  Specifically, Foucault’s writings on biopower and subjectivity are increasingly relevant as we consider the intersection of public policy and clinical ethics in a socio-political context increasingly structured by the demands of neoliberalism.  Although Foucault’s earlier work on the clinical gaze has been important to bioethics, that is no longer as important as his later, incomplete research into power and subjectivity. 

      The paper develops this argument in four steps.  In the first, I look at a classic phenomenological approach to clinical bioethics by Richard Zaner, starting from which I develop a Foucauldian perspective.  In that section I also offer a basic outline of what I take Foucault’s primary theoretical contributions to be by way of an initial explication of the biopower-subjectification nexus.  The following two sections of the paper present exemplary applications of Foucauldian theory to two areas at the intersection of public policy and clinical bioethics.  The first is the procedure for testing women for the BRCA1/2 mutations, mutations that impose on carriers a significant risk of developing breast and ovarian cancer.  A comparison between American and Dutch practices underscores not only the new ways that genetic testing interpret the body, but also the importance of local political and cultural contexts for understanding how the test is presented, administered and managed.  The second is a consideration of the intersection of employee wellness programs and wearable technologies.  In it, I develop Foucault’s thought that subjects in the Christian West have long been encouraged to understand themselves confessionally, offering to authority figures the “truth” about themselves.  I then interpret the compulsory use of wearables as a verification strategy for compliance with wellness programs as exemplary of such confessional strategies.  The final section ties the discussion back to the clinical encounter as Zaner formulates it as an inherently moral encounter structured by vulnerabilities that matter for understanding the selfhood of patients.  Based on the preceding examples, I make the case that American understandings of selfhood are increasingly separated from any sense of publicness, and that this structuring of selfhood is of increasing importance in framing and adequately understanding bioethics today.

    • Travel Ban 2.5, the Camp, and the Airport

      by Gordon Hull

      On Wednesday night, the Trump administration implemented as much of its long promised Muslim Ban as it thought the Supreme Court would allow.  Travelers from a list of six countries who did not have a “bona fide” connection or “close familial relationship” to someone in the U.S. would be banned.  The administration interpreted the Supreme Court’s ruling as restrictively as possible – the Court said that a mother-in-law would be an example of a close familial relationship, but didn’t mention grandparents – so having a grandparent here (or being a grandparent there) isn’t a close familial relationship.  The ruling smacks of arbitrariness and was rolled out as secretly as possible, and it’s not even clear that it actually does much at all. Then again, the original ban also was a poorly-worded, arbitrary mockery of the rule of law.  For example, the “policy” began with zero warning, leaving travelers stranded in airports with no legal options.  So too, the six countries were allegedly named because of their propensity to breed terrorists, but no one from any of them has committed a terrorist act in the U.S. since 2001.  Countries from which terrorists have come – Saudi Arabia – are not on the list.  Some of the countries have no functioning governments, but Iran does.  And so it goes.  That’s what happens when you promise to get rid of Muslims and then realize that you can’t get away with just making that so by campaign promise.

      In Homo Sacer, Agamben declares that the camp (the paradigmatic case of which is the Nazi concentration camp) is the archetype of modern power, suggesting that “the camp as dislocating localization is the hidden matrix of the politics in which we are still living” (175).  He proposes that the model of the camp can be seen in all sorts of institutions: the stadium at Bari where the Italians herded Albanian immigrants, the track where the Vichy herded the Jews before deporting them, and the halls at airports where foreigners asking for refugee status are detained, “all equally [are] camps” (174).  As someone who has read a lot of Adorno, I found this assimilation of airport waiting halls and the Holocaust somewhere between uncomfortable and offensive.  I am still uncomfortable with the comparison, but I do think some of the logic that Agamben is identifying is at work here.  That logic is one in which “the normal order is de facto suspended and in which whether or not atrocities are committed depends not on law but on the civility and ethical sense of the police who temporarily act as sovereign” (174).

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    • Another week, another unanimous SCOTUS IP Decision – this time, disparaging Trademarks

      The Supreme Court ruled unanimously today (well, an opinion and a concurrence) that a provision in the Lanham Act banning “disparaging” trademarks violated the First Amendment. In the case in question, an Asian-American musician named Simon Tam had attempted to register his band’s name, “The Slants,” in a clear effort to reclaim the slur.  The PTO had refused the registration, on the grounds that it was a disparaging term. The Federal Circuit ruled in favor of Tam (my thoughts on that decision are here).  Writing for the Supreme Court, Justice Alito declined to resolve whether the case required strict or intermediate scrutiny, on the grounds that the disparagement clause failed the weaker, intermediate scrutiny standard.  Alito found two asserted government interests: one was protecting against speech that offends, and he dismissed that argument on the grounds that the “the proudest boast of our free speech jurisprudence is that we protect the freedom to express ‘the thought that we hate’” (citing a 1929 dissent by Justice Holmes).  The second interest was in the protection of the orderly flow of commerce.  Here, he pointed out that the statute was in no way narrowly-drawn, as intermediate scrutiny would require.  In the first of a series of reductios, he argued that:

      “The clause reaches any trademark that disparages any person, group, or institution [emphasis original; he is quoting statutory text]. It applies to trademarks like the following: “Down with racists,” “Down with sexists,” “Down with homophobes.” It is not an anti-discrimination clause; it is a happy-talk clause. In this way, it goes much further than is necessary to serve the interest asserted.”

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    • Exhausting Patents

      In another chapter of its ongoing battle with the Federal Circuit (and the second in a week), the Supreme Court (SCOTUS, I will refer to the Federal Circuit as the CAFC) ruled last Tuesday in Impression Products v. Lexmark International that the sale of a patented product “exhausts” the patent-holder’s claim to derive patent revenue from that particular article.  First, a brief background.  Printer toner is like razor blades: companies charge extravagant prices for the toner without which their printers will not operate, while selling the printer itself fairly cheaply.  Such a strategy creates secondary markets in toner, either in third party cartridges that are designed to be compatible with the printer, or in strategies for refilling used cartridges.  Naturally, printer companies hate this, and so engage in all sorts of strategies to stop it.  They warn consumers that using non-proprietary cartridges will cause poor print quality and void their warranty.  They design their devices to try to detect off-brand toner, and refuse to operate if one is installed. These strategies tend to fail in court.  In 2004, the 6th Circuit ruled that efforts to circumvent the cartridge-detection system did not violate the DMCA (= copyright law).

      In last Tuesday’s case, Lexmark had sued a manufacturer of aftermarket ink cartridges, which had been taking used cartridges from either overseas markets or from consumers who had emptied them, refilling them, and then selling them.  Lexmark argued that its exclusive rights should extend to the resold cartridges.  The SCOTUS threw cold water on that argument, citing settled common law on property: when you sell something, you don’t get to derive revenue from subsequent sales.  If Lexmark wanted to try to extend its patent rights, the company could contractually forbid users to give their spent cartridges to companies like Impression, for example, but that would be a matter of contract law, not property.  But patents are a species of property, and patent rights are “exhausted” – i.e., end – when the patented product is sold.

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    • Biopower, Juridical Power, and Patent Trolls

      Patent law seems like an easy place to talk about biopower.  After all, it has been possible to patent life forms for some time now, and large numbers of patents are issued for products that directly affect life, as in the case of pharmaceuticals and other medical innovations.  Biopolitical implications of patent law are thus easy enough to adumbrate, even if one wants to construe “life” in narrow, biological terms.   There is, however, another angle that needs to be considered, which is the institutional structure of patent law.  If one effect of the emergence of biopolitics is the rise of the regulatory state and the decline of judicial power, we see in the case of patent law an ongoing struggle between institutions representative of those forms of power.  Two Supreme Court decisions in the past week illustrate this conflict; this post will deal with the first (TC Heartland) and I will have something to say about the second in a follow-up post.

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    • Kant on Big Data?

      A recent paper by Ermanno Bencivenga in Philosophical Forum argues that it’s “time for philosophy to step into the conversation” (135) about big data, in particular to refute the thesis, which the article identifies in a 2008 piece in Wired, that big data will mean that we no longer need theory: “with enough data, the numbers speak for themselves” (qt. on 135).  The paper draws on concerns about spurious correlations: to demonstrate that a correlation is legitimate, it “must be shown to manifest a lawlike regularity; there must be a theoretical account of it,” that laws have to cohere with one another, and so on (139).  In other words, “knowledge is constitutionally dependent on theory” (ibid.).   Bencivenga concludes:

      “Big Data enthusiasts are (unwittingly advocating a new definition of what it is to know.  Their agenda is (unwittingly) semantical.  Except that it is not worked out, and any attempt at developing it in the semantical terms that have been current (and antagonistic) for the past two millennia is hopeless.  I will not rule out that a new set of terms might be forthcoming, but the burden is / on those enthusiasts to provide it; simply piling up data and being awed by them will not do.  What would be needed, ironically, is a new theory of knowledge, which so far I have not seen.  This is the reason why I have made an effort to get clearer about the claims being made, so that we can have a more orderly discussion of them and what it would take to make progress in it” (141-2).

      Fair enough, though I do want to note that the paper does not engage with any literature about big data other than the dated piece from Wired; and to hear enthusiastic techno-babble from Wired is not surprising.  That’s what they do.

      It’s also worth pointing out that these sorts of concerns have been expressed before.  Here are danah boyd and Kate Crawford from a widely-cited paper in 2012.  After noting that “Big data reframes key questions about the constitution of knowledge, the processes of research, how we should engage with information, and the nature and categorization of reality” (665), they caution that:

      “Interpretation is at the center of data analysis. Regardless of the size of a data, it is subject to limitation and bias. Without those biases and limitations being understood and outlined, misinterpretation is the result. Data analysis is most effective when researchers take account of the complex methodological processes that underlie the analysis of that data” (668)

      These are cherry-picked quotes – arguably, the entire paper is a response to the sort of enthusiasm in the Wired piece, and the focus on our hidden rules for interpretation is clearly directed at the view that somehow data self-interprets.  And there are certainly more papers that bring up this and analogous topics; Luciano Floridi raises similar ones here (Floridi’s worries resonate well with Amoore’s, discussed below).  That said, I think there’s something to be said for speaking of big data in Kantian terms, though not perhaps for the reasons Bencivenga advances.

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    • Republican Thanatopolitics

      Foucault reminds us that biopolitics is describes a kind of power structure according to which some will be compelled to live (or have their lives as members of a favored population optimized), while others will be allowed to die.  As he puts it, “the ancient right to take life or let live was replaced by a power to foster life or disallow it to the point of death” (HS1, 138).  Although much work has focused on techniques by which biopower works to optimize a population, it is worth attending to the disallowance of life, the thanatopolitics that is the other half of biopower, because the Republican party is engaged in producing a very effective case study.

      As Foucault says a few pages later, “a power whose task is to take charge of life needs continuous regulatory and corrective mechanisms.  It is no longer a matter of bringing death into play in the field of sovereignty, but of distributing the living in the domain of value and utility” (HS1, 144).  Those who are deemed to be without sufficient value or utility are allowed to die.  Much attention here has focused on Foucault’s brief remarks on “race” war in Society must be Defended, where he proposes that biopower creates a “race” of those who must die, so that “we” can live.  He is thinking of Nazi Germany and the logic of cold war deterrence, but  current Republican policies show that thanatopolitics can operate at a much more granular and subtle level.

      I am of course talking about the AHCA, the mean-spirited tax cut for the wealthy, sponsored by gutting the (limited) ability of the Affordable Care Act (ACA) to provide for the needy.  Various theorists after Foucault – François Ewald in particular – have emphasized the role of insurance in biopolitics as it comes to regulate and define acceptable behaviors according to actuarial risk.  Here we see its role in thanatopolitics.  There’s a good analysis of the AHCA’s evolution and structure here; suffice it to say that the law, if enacted, would end up in at least 24 million people losing access to insurance (largely by gutting Medicaid and ending the mandate that people have insurance. Republicans are flatly lying about this).  It also allows states to scale back guarantees for coverage of those with pre-existing conditions, and allow states to scale back what services have to be included in health insurance; the primary target appears to be maternity and contraceptive coverage.  Apparently the old, white men who are behind this forgot that they had mothers who required medical care.  There’s a fig leaf $8 billion to fund high-risk pools, which no one qualified thinks comes near to the cost of funding those pools.  It’s not a full regress to pre-ACA levels, but it’s about as far as things can go without requiring enough votes in the Senate to overcome a filibuster.

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    • Trump Administration Hypocrisy of the Day: What Should Local Cops be Doing?

      I know there’s a lot of material to pick from here, but the following two positions are hard to reconcile with a straight face.  Since Trump’s and his surrogates’ big mouths have been used against him before in Court, perhaps some court will see this one.  On the one hand, the mass deportation program is demanding that local law enforcement help federal immigration officials out.  Although (surprise!) the term has no clear meaning, Trump has targeted “sanctuary cities” for federal punishment.  The cities, like San Francisco, are fighting back, arguing (apparently with good precedent, though I stress that I don’t know much about this area of the law. For a decent discussion, start here) that it’s unconstitutional to force local law enforcement to do the work of the feds.  The entire state of California is joining in.  The substantive argument is that local law enforcement needs immigrant communities to be willing to help deal with crime, and that people will be justifiably terrified to come forth if they fear deportation.  So local complicity in mass deportation will make local crime-fighting much more difficult.  California Lt. Governor Gavin Newsom wrote on his Facebook page that “on average, 35.5 fewer crimes are committed per 10,000 people in sanctuary counties, the median household annual income is $4,353 higher, the poverty rate is 2.3% lower, and unemployment is 1.1% lower. Before you take away our funds, I suggest you take a look at the facts, Mr. Attorney General.”  The status of all of this is up in the air; San Francisco is reporting that the administration is backing down considerably from its earlier bluster.  But the bluster is quite clear: local law enforcement is to be part of the deportation effort.

      On the other hand, the Jeff Sessions Justice Department has decided to throw away everything that’s ever been done by the DOJ to deal with police violence in inner cities, trying especially to nullify existing consent decrees in places like Baltimore.  Local police, says the Sessions DOJ, should be allowed, even encouraged, to resume racist stop-and-frisk policies and the like.  Why? In a memo to DOJ employees, there were several bullet points, including that “the safety and the protection of the public is the paramount duty and concern of law enforcement officers;” and that “local control and local accountability are necessary for effective local policing.  It is not the responsibility of the federal government to manage non-federal law enforcement agencies.”  There is a further bullet point that says cooperation with the federal government is important, and that local authorities need to comply with DOJ grant conditions and federal law.  But the direction of the memo is clearly to say that the feds should butt out of local law enforcement.

      Maybe he should copy ICE on that one.

    • Today in Creepy Privacy Invasions: Burger King

      Apparently Burger King ran an ad that attempted to trigger Google Home by having a Burger King employee say “OK, Google: What is the Whopper burger?”  First the ad was up, then it was down, now BK says that it might come back.  The ad was supposed to trigger Google Home to read the first line of the Wikipedia definition of the Whopper. Annoyed Google customers promptly changed the line to say the burger contained cyanide.  A handle that looked suspiciously like a BK executive then changed it back into effusive praise.  As of this moment, the Wikipedia front page reads much more neutrally.  So apparently it’s been reverted, or the BK sock puppet isn’t at work yet.

      We don’t have a good regulatory strategy for this one.  The only one that comes immediately to mind is some sort of creative deployment of the Computer Fraud and Abuse Act (CFAA), which essentially criminalizes accessing a computer beyond authorization.  But there are reasons to be very concerned with this strategy.  The CFAA was used in an ill-conceived federal cyberbullying case, where the problem was not that the bullying, which resulted in a teenager committing suicide, was not bad (cyberbullying is epidemic, usually misogynistic and generally awful), but that the CFAA interpretation advocated in the case would have legitimated the idea that using a fake name or email address online was a federal crime.  That said, the CFAA might put a stop to this sort of saturation of all of life with advertising.  You probably did not authorize Burger King to access your home system, although I wouldn’t be surprised if terms of service didn’t start taking that sort of complaint off the table very soon.  In any case, don’t expect the current government to help: while the Republicans were involved in their circular firing squad trying to destroy the ACA, they did pass legislation blocking impending regulations protecting the privacy of ISP-collected data.

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    • North Carolina Repeals and Replaces HB 2

      As you probably have heard, in a flurry of activity yesterday, the North Carolina legislature repealed and replaced its omnibus LGBT-hate law, HB 2.  The state was clearly moved to act by an NCAA deadline (repeal by Thursday, or no championships until 22) and an AP report earlier in the week that said the law would cost the state $3.7 billion over ten years.  Almost no one is happy with the new measure, particularly LGBTQ advocates.  The replacement law indeed eliminates the restriction on trans bathroom access, though it allows harassment of trans people under “indecency” laws.  It does not, however, as many of its advocates (who are being parroted by national media like NPR as I type this) claim “reset” the state to its pre-HB 2 status.  The replacement bill also locks into place an explicit refusal to offer employment and other civil rights protections to LGBTQ individuals in state law, and it forbids other governmental entities in the state (cities, schools, universities) from going further either on bathroom access or other employment laws.  Two clauses of the very short bill accomplish this.  Section 2 says:

      "State agencies, boards, offices, departments, institutions, branches of government, including The University of North Carolina and the North Carolina Community College System, and political subdivisions of the State, including local boards of education, are preempted from regulation of access to multiple occupancy restrooms, showers, or changing facilities, except in accordance with an act of the General Assembly.”

      Section 3, which is staggeringly broad if you read it literally (the literal read was apparently not intended by those who  wrote it) says that “No local government in this State may enact or amend an ordinance regulating private employment practices or regulating public accommodations.”  At the very least, cities like Charlotte are prohibited from enacting LGBTQ protective ordinances like the one HB 2 struck down.  Hence we have not returned to the status quo.  The law does sunset in 2020, but of course the legislature would be free to push that into the indefinite future.

      I don’t have a lot to say here on the bill itself, because it clearly does not put the state where it ought to be.  Refusing to protect gender non-conforming individuals from discrimination is a disgrace.  It’s also bad policy to ban municipalities from raising the minimum wage (an aspect of all this that was explicitly in HB 2 and which remains under section 3, despite it getting almost no media attention), though I won’t make that case here.  It might or might not even bring the NCAA back.  I also am still not sure that it would survive a Romer-based challenge, since the clear intent is to freeze-out employment discrimination protection for LGBTQ people. 

      I do want to note one thing that’s not getting a lot of press.  In signing the bill, Democratic Governor Cooper said that “In a perfect world, with a good General Assembly, we would have repealed HB2 fully today, and added full statewide protections for L.G.B.T. North Carolinians.”  In this he is absolutely right.  The NC legislature has been on a far right crusade for years and is desperate to hang on to political power as a way to continue that process.  They do that through gerrymandering, voter suppression, and efforts to control local election boards.  As I noted in the linked post above, more people voted Democrat than Republican in North Carolina in both 2012 and 2014.  And yet somehow the Republicans have veto-proof majorities in both houses of the legislature.  That outcome ought to be unacceptable because it says quite clearly that the legislature lacks democratic legitimacy.  A lot of December’s attempt to make election boards Republican has been struck down.  There is litigation pending, including a 4th Circuit decision that said the most recent legislative maps target minority voters with “surgical precision,” and a pending order to have statewide elections in 2017 under new maps (the state has appealed this to the Supreme Court).  If the Courts get around to striking down all of this, things might get better.  But in many respects, the HB 2 debacle is also a symptom of a deeper failure of governance and democratic legitimacy.