© 2021 Nestor Aleksandrovich Manichkin
2021 – №2 (22)
Manichkin N. A. (2021). Cifrovizacija mediciny v realijah pandemii: k diskussii o problemah biovlasti [Digitalization of Medicine in the Conditions of a Pandemic: to the Discussion on Biopower Problems]. Medicinskaja antropologija i biojetika [Medical Anthropology and Bioethics], 2 (20).
Nestor Aleksandrovich Manichkin, Cand. Hist. Sc., is a Senior Research Fellow of the Center for Medical Anthropology, Institute of Ethnology and Anthropology (Russian Academy of Sciences, Moscow).
Keywords: COVID-19, Big Data, VR, governmentality, 4P medicine, pandemic, biopower, biopolitics, technical equipment, telemedicine, digitalization, virtualization, medicalization
Abstract. The article discusses the processes of medicine digitalization from a social-anthropological perspective. Eliciting an essential connection of the technical and the humane, the author denies the digitalization enthusiasts’ thesis about technologies’ social neutrality, problematizing their development in light of biopower and biopolitical production. According to the author, it is necessary to introduce into the discussion the consequences of medicine digitalization the agenda of governmentality, public medicalization, and the emergence of new techno-bio-political links that threaten individual and public life with major, yet unclear transformations.
Virtualization and technization, the processes that increasingly seize public and private lives, have long become important objects for various academics in the humanities. In the late XX century, voices have become louder that attest to disillusionment in the technical optimism typical for early modernity. Such opinions are also expressed in regard of cybernetics. An important direction of this critique is discovery in the XX century of deep links between the technical and capitalism, technology and thinking, technical machinery and machines of social production, which allowed the French thinker Michel Foucault to convincingly and thoroughly analyze the link between political institutions of the modern history, statistics, biological control, market and governmentality. A more profound look into technologies’ social aspects involves phenomenology and epistemology of the technical sphere. Such analysis allows understanding that the technical is not merely a product of human creativity but a phenomenon of activity and knowledge production directly linked to the human’s existential positioning in the world, the subject’s image, and way of domination over nature.
One of the harshest critics of the new round of digitalization that accompanies the COVID-19 pandemic, the Italian philosopher and sociologist Giorgio Agamben in has based his recent judgments on the analysis of the link between the technical and the biopolitical that he did in his works of late XX-early XXI century. COVID-19 pandemic made visible and legitimized the electronic tracing and data registration means, by plugging them to biopower’s disciplinary apparatus, which in a way made it Agamben’s self-fulfilling prophecy. In the concrete situation, Agamben’s topics may be found in the situation of discontinuity between the doctor and the patient, who under the conditions of telemedicine, be it an emergency practice conditioned by the demands of the pandemic or an ordinary practice included in the digital medicine package, leads to the shift from doctor-centric medicine to a device-centric one.
The coronavirus pandemic contributes to a rapid rise of power and influence of large technologic corporations. It will not be an exaggeration to say that never in human history have such vast and well-structured biological archives been created. The process of monitoring the body’s biological parameters now involves not only doctors and patients (as well as healthy people) but technical agents too; interestingly, doctors are often not necessary in this process. The development of telemedicine implies a trend that unmakes health as a private and intimate area and increasingly integrates it into the machinery of control and market. A personalized approach is compatible with market technologies, which is manifested in the heights of personalization gained by targeted advertisement. It is quite possible that the offer of medicines and medical services will be using achievements of these technologies and increasingly involve the consumer in a medicalized reality.
Another facet of techno-bio-social indiscernibility was formed by the addition of the police apparatus to the union of technological and medical realities. The use of drones and mobile applications that track the person’s location and biological parameters has become commonplace.
Medicalization of the political discourse and social life serves as an excellent biopower tool. Digitalization that accompanies medicalization (now also uniting with it) secures biopower’s superb penetration – a certain show-through of the social body.
The pandemic time, that has activated medicalization of the public life, digitalization of medicine, and emergence of new techno-social links, has also brought to the forefront the main means to criticize the ongoing processes – biopolitics. From a biopolitics point of view, medicine is an important part of biopower that organizes control over the social body. This raises the question about the limits of such power. The situation of the pandemic clearly demonstrates that the risk of biopolitical control’s transition to totalitarian forms is quite high. This makes it necessary to take the epoch’s dominating discourses in a critical way. One of them is about the safety of the technical as such. Digitalization enthusiasts often say that technologies per se cannot be considered harmful or dangerous; it is their misuse that can spoil the originally useful idea. This is naivety. Anthropology, sociology, and philosophy have elicited the double-edged link of the technical and the socio-cultural, embeddedness of the technical into the social and the mental. According to Gilles Deleuze, machines are social before they are technical. Technical equipment, being a human means to bring nature into present existence, is consonant to what is sometimes called managerial logic and what is more broadly understood as governmentality.
It is likely that we are at the start of the formation of a new governmentality type (the one after liberalism, authoritarianism, and neoliberalism) – a digital type. It will actively utilize Big Data technologies that allow to control the person’s awakenings, to calculate and forecast the person’s actions, to encourage him towards expressing certain affects. Digital medicine is one of the important aspects of the new biopolitical control. We know that medicine is not pure science but a part of historical (and, consequently, political) systems, while technology is not a passive thing in the actor’s hands, thought to possess free will, but a means of the human subject’s existence in the conquered existence. Based on this assumption, we should try to clarify the truth of unfolding techno-bio-political processes.
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