Governing through Speech: The New State Administration of Bodies

CONDITIONAL decriminalization is the most obvious common feature of the change in practices affecting the relationship between the individual and his or her body that has taken place over the last few decades. This is particularly true of corporal practices involving the beginning and end of life, which has seen the conditional decriminalization in France of the use of contraception in 1967, abortion in 1975, sex change in 1976, homosexuality in 1982,1 and today, the insistent demand for the decriminalization of euthanasia. This withdrawal of authority has taken place by the removal of the penalty rather than by the proclamation of formal rights. In this area of civil law or public health law, as in criminal law analyzed by Michel Foucault, it is less a question today of “punishment” than of “surveillance.” What type of supervision are we dealing with here? Does the shift of state control from punishment to supervision in France necessarily lead to a new deployment of state control in the direction of “disciplinary” control? Does it lead to the process of lining up bodies, gestures, and postures in rows that Michel Foucault described at length in reference to prisons and schools? Clearly not. Although 80 percent of the dying in France are found in hospitals today, these patients are not separated from the others but scattered among the various wards, and women who come to ask SOCIAL RESEARCH, Vol. 70, No. 2 (Summer 2003) Governing through Speech: The New State Administration of Bodies* DOMINIQUE MEMMI *This paper is a summary of a part of the thesis presented in Memmi (2003) and was translated from the French by Susan Taponier. for contraceptives or an abortion, for example, are only briefly held captive by hospital departments. The control over their use of their own bodies obviously calls other procedures into play. Financial Incitement Although this control seems to be characterized by explicit withdrawal of legal authority, in reality it has been accompanied by what I would call “financial incitement” and control through “biographical compliance.” The authorization given to new corporal practices has taken concrete form in France, where we have seen: national health insurance coverage of (female) contraception in 1974, abortion in 1982, and soon thereafter artificial insemination, the RU 486 pill and in vitro fertilization. This financial coverage is tantamount to full social recognition. We have forgotten the bitter debates once sparked by these issues and how long it took for them to be granted coverage: seven years elapsed between legalization and coverage by national health insurance of both contraception (1967 to 1974) and abortion (1975 to 1982). Similarly, the condemnation of surrogate motherhood (“gestational carriers”), pronounced by the National Ethics Committee in its first opinion in 1984, took the form of proposing to refuse legal recognition of such a costly practice. Sterilization is another example of this system of “financial” supervision without punishment. Until 1994, no legal action was taken when it was practiced under the former criminal code nor was it covered by national health insurance.2 Conversely, total insurance coverage of palliative “care” (which might, however, be categorized as simply maintaining a comfort level) and the creation of “special work leave to care for the dying,” which allows the dying to be assisted by a close family member for up to three months (Law of 9 July, 1999), indicate clearly that palliative care is the sole method of alternative treatment for the dying that is officially tolerated in France today. 646 SOCIAL RESEARCH The state’s financial contribution in these areas reveals the increasing management of biological complications as a social and political concern. The increasing financial coverage of what has gradually developed into an unacceptable biological risk or misfortune is precisely what Michel Foucault defined as the advent of biopolitics (as opposed to disciplinary supervision). It desperately tries to preserve and “foster life” in the face of the threats and risks surrounding it. On the one hand, there is the “risk” of unwanted pregnancy (overcome by contraception, sterilization , prenatal diagnosis, abortion), and on the other, the “risk” arising from the obstacles of sterility, hypofertility, or declining fertility due to age (overcome by medically assisted procreation). Biological complications encountered in reproduction or in...