Biomedicine and the Human Condition: Challenges, Risks, and Rewards (review)

At a time when risk, disease, health, biotechnology, and the regulation of biomedical research are themes that chime relentlessly in both political discourse and everyday life, in so-called developed countries at least, there is little doubt that biomedicine is a pervasive force molding both individual and collective aspirations. One of the stated aims of Biomedicine and the Human Condition is to provide a general readership with the opportunity to "consider personally relevant issues of human biology" (p. xiii). Michael Sargent engagingly and accessibly surveys developments in biology and biomedicine—predominantly in the twentieth and twenty-first centuries—and embeds them in discussions of reproduction, birth, infection, ageing, epidemics, pharmacology, genetics, and genomics. In doing so he provides a useful platform from which to consider the relationship between the "science" and our lives as embodied biological beings. For this, he is to be commended.

A second goal of the book is to place biomedical innovation in its "historical and cultural context" (p. xiii). In this regard it is far from successful. To be sure, some context is provided through historical anecdote and vignette. However, Sargent fails to explicitly link biomedical innovation with wider social, cultural, political, and historical processes. Given that he is a research scientist and not a social historian, it might be argued that this is understandable—except that there is a default explanatory principle organized around three questions that for the author constitute the human condition: "How to breed successfully, how to avoid disease and how to live to a decent age are questions that have perplexed our ancestors throughout recorded time" (p. xi). By asserting the salience of these questions at least as far back as the book of Genesis, the author describes biomedical innovation, broadly conceived, as a modern and rational attempt to answer them. Unsurprisingly, the narrative is one of progress, of heroic efforts, of revolutionary discovery, of war against infection and disease, and frequently of recalcitrant and reactionary unenlightened publics. It is disappointing that well over three decades of scholarship in the fields of sociology and anthropology of medicine, science studies, and social history have not infected the author's work.

To render the human condition as a response to the exigencies of bare life, ignoring both sociocultural mediation and the political struggle for the meaning of a good life, is to barely address the human condition. One is reminded of the cautionary note in Hannah Arendt's Human Condition (1958) in which she argues that a society that focuses exclusively on individuals as biological beings and on human biological finitude will fail to achieve the only type of immortality compatible with the human condition: the creation of enduring and democratic political institutions. Matters of political philosophy aside, what prevents this book from becoming a useful resource for thinking through the dynamics of contemporary molecular biology is the scant attention—as well as the derisory and sometimes cavalier tone—accorded to the social, cultural, political, economic, and ethical dimensions of contemporary biomedicine. To cite one of many possible examples: for Sargent, the "quaint" concern with respect to the "commodification of human life" is no concern at all because it already exists in the United States in the form of surrogate motherhood, and more broadly in the international trade in "Third World babies," which is no more reprehensible than "the business relationships with the 'oldest profession'" (pp. 317–18)!

Sargent has a talent for the lively presentation of biological processes and biomedical procedures. However, his inability (or perhaps unwillingness) to seriously explore the meaning of the human condition beyond the exigencies of bare life produces a book that fails to deliver what its title promises.