Nietzsche, Foucault und die Medizin. Philosophische Impulse für die Medizinethik ed. by Orsolya Friedrich et al. (review)

The idea underlying Nietzsche, Foucault und die Medizin is laudable in at least two respects. First, it brings together Nietzsche and Foucault—a connection so multifaceted and fruitful that, despite the many recent volumes and essays devoted to it, it is still far from exhausted. Second, it focuses on the ethics of medicine, which, given the extraordinary development of medicine in the past two centuries and its related ethical challenges, is a field that increasingly demands philosophical reflection, finding in Nietzsche and Foucault extremely rich and fertile ground. As the editors point out in their introduction, the depth and breadth of Nietzsche's and Foucault's insights into the philosophy of medicine—including its epistemological, sociological, ethical, and political dimensions—are only now beginning to be acknowledged (10).

The volume consists of twelve articles, which are organized into three main sections. The first, "Medizin und die Produktion von Gesundheit/ Krankheit," deals with methodological aspects of Nietzsche's and Foucault's approaches that help to clarify the processes of production and conceptualization of health and sickness. Diana Aurenque's article, "Nietzsche und die 'unzählige[n] Gesundheiten des Leibes,'" analyzes the meaning and implications of the current pluralization of the concept of health in medicine, taking Nietzsche's claim that "there are countless healths of the body" (GS 120) as a starting point and contrasting it with the influential contemporary approaches of Christopher Boorse and Lennart Nordenfelt. Aurenque's stated aim is to understand what "health(s)" mean today and to gain new perspectives on the risks and limits, advantages and disadvantages, of a pluralistic conception of health (25).

Werner Stegmaier's "Über Gesundheit und Krankheit in außermoralischen Sinn" offers an illuminating account of Nietzsche's and Foucault's "techniques of distinction [Unterscheidungstechnik]" as applied to the concepts of health and sickness, using as a background his own "philosophy of orientation." According to Stegmaier, Nietzsche and Foucault respond to the need in modern societies for greater and stronger conceptual complexification, which in the field of philosophy of medicine can be seen in their "de-asymmetrization [De-asymmetrisierung] of the distinction between health and sickness" (42; translations are my own throughout). That is, by abandoning the traditional dichotomy between health and sickness and by placing each in a new evaluative light, Nietzsche and Foucault invite us to expand and deepen our understanding of these concepts. In particular, Stegmaier places Nietzsche's revaluation of health and sickness in the context of his attempt to overcome current morality and society (47–54) and Foucault's approaches to health and sickness in the light of his concept of "biopolitics" (54–59).

The two remaining essays of this first section focus exclusively on Foucault and on two of his major works of the 1960s, The Birth of the Clinic (1963) and The Order of Things (1966). Galia Assadi's essay, "In Verteidigung des Anormalen," explores the resources provided by The Order of Things for deciphering and deconstructing the structure of modern psychiatric discourses, demonstrating how Foucault's insights into the (discursive, political, economic, and epistemic) conditions of the possibility of our present might enable us to challenge and eventually overcome the individualism of our current ethics of medicine (65). Assadi's aim is not only to encourage further philosophical discussion of Foucault's works in the field, but also to reveal the potential of Foucault's reflections when it comes to broadening and reorienting current medical-ethical debates, especially in the controversial field of the ethics of psychiatry (73–80).

In "Wie der Blick in Serie ging," Tanja Prokić presents a perspicuous analysis of Foucault's archaeology of "medical perception" in The Birth of the Clinic, contrasting her interpretation with Philipp Sarasin's influential approach in his introduction to Foucault (Michel Foucault zur Einführung [Hamburg: Junius, 2005]). Through the reconstruction of the "two movements" that...