1

Delegated biopolitics : a response to the contemporary revolt against the body destiny? *** Dominique Memmi Biopolitics, in the broad sense, could be defined as the administration of the living and of people. Biopolitics in the narrow, scientific sense of the term, is what Michel Foucault saw emerging at the end of the 18 th century: a pivotal turn in the direction of contemporary biopolitics (in the broad sense of the term). It was the moment when the old way of administering populations, in which sovereign power consisted in making someone die (or allowing someone to live) gave way to political action aimed, on the contrary, primarily at making someone live (or allowing someone to die) and providing the means to do so. To what extent can we draw upon Foucaults work in thinking about the very We shall do so here by contemporary developments (i.e. dating from the end of the 1960s) in the french and, to some extent, european administration of populations ? introducing the notion of delegated biopolitics. This refers to a policy that adopts the curious position of relying on the specific habitus of the targets of the policy. And by target this is obvious, since we are talking about habitus we are referring to individuals, and not, for example, to the peripheral powers, local authorities, grassroots assemblies, or even professions discussed in recent political science works on governance or deliberative democracy. Our approach strives also to keep in mind the crucible in which contemporary political developments are secreted, in other words, to take a close look at the social production of the political. As a result of a long non-participant observation in hospital services dedicated to reproduction (contraception, voluntary and medical abortion, artificial procreation) and observation of palliative care services, we have discovered that medical institutions rely today on a rather curious definition of the patient (Memmi 2003, FassinMemmi 2004 ). Through the many interviews required of patients who come to request these services, patients turned out to be considered reasonable, operating more on a conscious than unconscious level, controlling their impulses, and/or equipped with a high capacity for reflection : they are systematically required, for example, to think about for a certain period before expressing their final decision We might have ended here the analysis : this new way of administering populations (by speech and official consent) was intriguing enough to deserve a detailed presentation. definition of We tried to go further, adopting the hypothesis that the reason why institutions so persistently produced this patients, may be rooted in the fact that it has some relation with social recently into the social world as a to their own reality : this kind of patient may have come

interlocutor. Modern administration of procreative and dying body may be merely generated by a deep and general transformation of patients confronted

2
bodies. Hence, the ambition of this paper : find some cultural roots to the new way of administering populations. Trying to trace the genesis of modern biopolitics, we found a horrified representation of the body as destiny and a deep reluctance toward the unequal distribution of the quantity of life (Part 1). The concern, the obsession for health thus appears to be merely a late crystallisation of this phenomenon, and changes in the institutional system turn out to be based on changes in social habitus on that matter Part 2). How not to express than some dissatisfaction with Michel Foucaults analysis ? Attentive to the shift of the State and taking place two centuries ago from making someone die to making someone live, he was much less aware of the shift in the last forty years towards the gradual delegation to citizens of the right to make someone live or not (artificial procreation), to allow someone to live or not (abortion), and to allow oneself to die (prolonging life by therapeutic means), or even to make oneself die (euthanasia): a delegation that is oddly encouraged, guaranteed and supported by the State itself (Part 3). I. A new social intolerance of the unfair distribution of the quantity of life? Our work(Memmi , 2003) has partly consisted in bringing to the fore the appearance of an official, public catalogue of misfortune, linked to the corporal as a simple datum. For centuries, before the 18th century that Michel Foucault identified as a milestone in this history, the corporal biological datum was an indisputable, unquestionable fact of nature. Today, to put it succinctly, pathos the suffering that represented the most traditional justification for medical interventionism against the pathological no longer needs to be commandeered as an argument referring to physical suffering. absence of control, for everyone, over bodily destiny. This catalogue of social misfortunes will be grasped, above all, in the recognition given to it by public institutions: first hospital medical services, then the law and the State, in response to social movements that have increasingly helped publicise and politicise this account of legitimately reparable misfortunes. 1.1. Beginning and end of life: grievances The first institutional crystallisation of complaints now considered legitimate: the argument, solidified into law, of the new services provided by modern medicine. To obtain the services requested for the procreating body and the dying body, a highly unusual lack can now be expressed.Illness, particularly serious, to be sure (to obtain a therapeutic interruption of pregnancy), but also an unsatisfied desire for a child or parental desire, and distress that could justify euthanasia as it already legitimates voluntary abortion : patients have merely to be able to convince doctors , in one way or another (tears, life stories etc) , that they have good reasons to ask for medical beings to be pitied and contemporary Another form of suffering henceforth appears as the source of complaints and claims: it arises from the

3
intervention. The urgency for action is to be expressed to doctors in a convincing way by those who feel it. Recognition has thus been given to the possible extension of a new kind of complaint into the medical sphere, linked to variations in fertility or vitality according to the stages of life and individuals, and to the suffering of not being able to control those variations. The problem of controlling autonomy of the living produces risks of a new kind: the risk of facing the obstacles of sterility, infertility, age (medically assisted procreation), the opposite risk of engendering undesired offspring (contraception, sterilisation, abortion for personal or medical reasons), and the risk facing a slow or painful death. What is important is not the advent of risk as the fundamental constituent of contemporary biopolitics (cf. U. Beck, N. Rose, D. Armstrong), but the constitution of the distribution of quantity of life as a risk. To take up an old opposition, extensively discussed by Giorgio Agamben, the amount of bare life (zoe: the mere fact of living, common to all living beings) becomes a threat to life in the sense of existence (bios: the form or way of living proper to an individual or a group) (Agamben, 1995, 9). Or again: the quantity of life becomes capable of affecting what is designated as the quality of life. A random distributive event such as pregnancy can be seen as officially comparable to traditional health risks (such as sexually transmitted diseases) (MossuzLavau, 2000). Too much life becomes as problematic as bad health. The administration of these misfortunes, through the repeated production of mandatory autobiographies, was left to specialists of the body rather than of the soul, to doctors rather than to psychologists (or priests). The fact that biopolitics has been The problem is not transferred to these specialists is intriguing. Not only problems have become medicalised but also the corporal datum has been made into a social problem necessarily medical, but the solution is, because, more generally, the body has been constituted here as a social or psychological problem. Doctor, my corporal data may cause me serious psychological or social suffering, and that is your area of expertise. Precisely because there are medical solutions to the problem, doctors are expected to deal with it and are held entirely responsible. A pertinent example : the Perruche decision (Cour de cassation : 17 dcembre 2000), which introduced in France the idea that a child could be monetarily compensated for being forced to be born with a handicap, as the mother was not notified in time to be able to abort. The erratic distribution of bodily properties became intolerable partly because it could be corrected. 1. 2. The body destiny and the shame of the improper. = I FORGOT TO CHANGE THAT IN MY LAST VERSION ! What does this mean? The public sphere of complaint was structured in such a way as to open up areas in which people who had no say in the mater forty years earlier could legitimately voice complaints and grievances. In particular, the normal and the pathological were redefined, albeit under medical control. The pathological was no longer linked solely to the twofold traditional criteria identified by Canguilhem as suffering (pathos) and dysfunction. Taking charge of the catalogue of misfortunes

4
concerning fertility and the end of life showed that the pathological in the category of the medically reparable tended to be increasingly connected to variations in physical qualities over time and between different individuals. defined. The calculation of risks and corrective intervention no longer pertained only to health as it had been traditionally What was in question was the distribution of fertility, of sexual power, or A sort of suffering was held to arise from the autonomy of the physical resistance to illness in short, organic vitality depending on the stage of life and the individual. biological, as given with its variations, as well as from the fact that these variations were at least partially correctible by medical means. In short, biological as destiny became the subject of complaint. This resulted opening up areas in which these new legitimate forms of suffering could be expressed, namely, medical services that intervened on the quantity of life. It also resulted in systematic, consistent financial coverage of these risks by the national healthcare system (Memmi , 2003, chapter 3). Finally, it resulted in an affect that appeared in the course of our lengthy field analysis: shame. Arent you ashamed? a nurse kindly asked a woman who came in for her third abortion, and she pointed to a cheerful coloured poster showing the variety of available contraceptives. Im ashamed, a young woman said spontaneously in her distress at having to resort to abortion to correct a supposedly avoidable pregnancy. A peculiar, secular shame: it does not address the impulses in this case, sexual ones but the fact of not having controlled the possible biological consequences of those sexual impulses (Memmi , 2003). We encountered this shame at the other end of life, in the discourse of proeuthanasia activists, both at the grassroots level and among leaders of the movement. Their demand for euthanasia stems partly from fear of pain and the desire to avoid being a burden on the family for too long a period of time, but also, and just as much, because the idea of life continuing beyond the control of the individual, life as an animal or a vegetable, contrary to the representation of a subject defined by consciousness rather than the unconscious, by control over oneself rather than by impulses, has become unbearable. And, above all, because it is unbearable to give that representation to others. Whether it is a question of birth or death, it has become a sort of duty to refuse to abandon the corporeal biological to its own evolution and its expected cellular proliferation. This duty does not concern certain bodily functions or certain impulses The latter Sexual (sexuality, aggressiveness), but the evolution of the organic datum itself.

generates what I have called a shame not of the unclean (the dirty) but of the improper (an organicness that cannot be appropriated by the subject). intercourse with poorly controlled effects causes as much uneasiness as an uncontrolled end of life: the corporal datum must no longer be left to develop biologically even when it is not pathogenic.

5
II. From life to health: a widespread revolt? Bio individuation This catalogue of misfortunes, which found new sources of suffering in the corporal datum, obviously did not apply exclusively to random events linked to reproduction and death. It is the corporal datum in general that ultimately seemed to be the subject of the discourse of complaint and claim. Its relationship to health thus appears to be only a particular variant of it. 2 .1. Health. This evolution was initially conveyed by a profound transformation of the figure of the patient. To be sure, it is a transformation that occurred over several centuries, as historical works adopting the long view have shown (Weiner, 1993). But the phenomenon would seem to have been accentuated during the second half of the twentieth century. The attitude of patients became more active, crystallising in the appearance of a figure called variously the self-treater (C. Herzlich), homomedicus (P. Pinell), or homosanitas (P. Aiach, D. Delanoe), participating alongside the doctor (due especially, but not only, to long illnesses, diabetes or cancer) in the long-term administration of their own health. With changing forms of consumption, these patients demonstrated an increased feeling of medical competence (Peneff, 2000, this trend has only accelerated in the last three decades. 43-60), and The Today, the most diligent,

attentive, concerned surveillance of health is exercised by the potential patient.

French, as Georges Vigarello has shown, declared 75% more illnesses between 1970 and 1980, a change unrelated to the actual number of real ones. They became potential buyers of instruments heretofore reserved for healthcare professionals popularised, simplified tests for self-surveillance (of blood pressure, pregnancy, kidney stone risks, etc.), and targets for journalistic columns promoting various types of health selfassessment How to decipher your blood test, Good blood pressure readings, Tests for men (Vigarello, 1993, 306, 302). In short, surveillance medicine, analysed by David Armstrong as characteristic of the current stage in the history of the profession (Armstrong, 1995), rests in large part on the development of new trends towards selfsurveillance on the part of the patients themselves. Like the plays of Molire, but this time with utter seriousness, laymen have disguised themselves as their own doctors. What we find even more interesting here is the gradual process of publicising in the public realm what has been increasingly constituted as an extraordinarily sensitive problem. Thus, patients have served as a successful target for the development of autonomous medical journalism, with the appearance of specialised columns in the national media starting in the second half of the 1970 (Champagne, 1999, 52 sq.). In France, they began reading more than 15 health magazines (whereas only one or two existed in the 1970s) (Vigarello, 1993). They thus became possible prey for the top hospitals that received ever-increasing media attention (Ponet, 2001). They became Hence, the activists in associations defending the rights of healthcare users, which grew from the middle of the 1970s to a total of 600 in 1995 (Alternative-Sant, 1995).

6
defensive reactions of the medical world: widespread introduction of written consent,

discharge forms allowing people to leave the hospital, conciliation commissions at hospitals. Patents became the essential agents of this contemporary reflection on heath indicated by the publicising of health issues (Gati, 1999, 159 sq) and confusedly filled with a concern for perfect health (Sfez, 1995). This health-related vigilance has recently been conveyed in a more spectacular way, due to widespread media attention, in the extraordinary social awareness (quickly rephrased in political terms by the causes and the targets that exacerbated it) of a number of physical risks: AIDS, mad cow disease, asbestos and GMOs. While these issues have given rise to highly interesting works of genuine sociology in the last few years, and more recently in political science, taking risk as an object of study, the common thread linking these concerns has not been sufficiently noted. They do not involve risks to The damage to material goods, e.g. economic risks, but rather risks to bodily goods.

goods represented by epizootic hemorrhagic disease has received far less media attention than its effects on human health. Even environmental damage (soil, water and air pollution) is presented as something that can, through a threatening biological chain, affect human beings. A few indications of this growing awareness: the rapid change in sexual practices since the public revelation of the AIDS epidemic (when it was still rare to encounter HIV infection among family and friends) (Gerstl, 1999, 69), the deliberate consumer rejection of GMO products which have been the subject of publicly controversy in France, and the sudden, massive shift in the food market as soon as a new health risk is announced. This health surveillance ultimately gave rise to spectacular new political actors, justifying especially Didier Fassins analyses in terms of biolegitimacy and the promotion of the defence of the threatened body as a local and national political issue (Act Up, Aides, the medical humanitarianism of Mdecins sans frontires and Mdecins du monde, as well as, for example, Les Restaurants du Cur, or Stop-la-Violence, etc.), alerting the curiosity of a few political scientists significantly the youngest ones, with almost no mention of what lay behind part of the media attention: the new focus of this activism on the fate reserved to the body. 2.2. Bio-reflexivity. But beyond health (i.e. the concern for biological normalcy in the sense of a return to the silence of the organs), we have been witnessing for even a longer time turmoil about another facet of biological normalcy: the objectivation of the self and of the subject as a body, as an incarnate being. That is why we have spoken of bio-objectivation of the self or bioreflexivity. It takes the form of a realisation (not always unhappy) of incarnation itself. This time, it was borne out by older social movements going back to the end of the 1960s. The bio-objectivation of the self appears to predate the increased concern about health, which would seem to be no more than a variant of it. Feminism, the gay movement, the youth movement, struggles in favour of the disabled and the elderly, and

7
more generally the sphere of influence of May 1968: in every instance, the identity of the social movements of the time was based on a biological trait (sex, age, disability) rather than a social trait in the broad sense of the term (belonging to a social class). And what was often in question in the demands themselves was the fight against physical constraints. We should never forget, in this regard, that the resurgence of contemporary feminism was centred on the fight to legalise abortion, and what ignited the revolution of May 1968 at Nature was, after all, the prohibition against girls visiting the boys dormitories. While the social aggravation of discrimination was denounced by feminist discourse, the substrate or pretext of the phenomenon of discrimination was nevertheless physical data or constraints, or essential sexual practices (homosexuality). This was symbolically illustrated by women forming a vagina with their hands or brandishing bras to convey their very identity, whereas French feminism at the turn of the century had remained very discreet and even forgetful of the issue of birth control. A number of spokespersons thus took charge of translating into the public sphere, in successive waves and in political terms, something akin to a new vigilance over the self, which took the form of vigilance over the body, both in relation to multiplication and random biological events as well as ones bodily future, which had to be managed like a sort of lay salvation, over which public bodies should play the role of guardian. This discourse is peculiar indeed. It denounces the unfortunate effects of alienation, and even domination, linked to biological data or constructed as such. shared misfortune through a bodily trait. As the fight against alienation grew, it tended to ignore social groups: people joined together in A shift has thus taken place from the singular to the universal by the fact of having or being a body made in a given way, naturally equipped with a given sexual tendency (the homosexual demand), subject to a given physical danger or afflicted with a given disability. Let us now reconstruct this catalogue of misfortunes in its entirety: 1. Due to random events to which living beings are subject, the nature of being a body, of being human, is likely to engender considerable suffering or even real injustices between citizens. 2. This fact must therefore be the object of special attention on the part of public bodies. 3. These bodies must first ensure that the individual acquires greater control as well as awareness of these biological facts. The State then legalises interventions on the self, while exercising careful surveillance of the discourse and the degree of awareness of those who come to abort or to die 4. Once social misfortune was assimilated to loss of bodily control by the individual, it came to a peak when loss of control arose from a hold over the body by another (e.g.: imposed abortion, rape). (Iacub, 2002). These violations alone could justify halting the general advance towards more liberal policies in these matters, or even increased penalisation.

8
5. In both cases, what constituted the misfortune was not so much the physical violation as the mental and even social suffering it entailed (cf. the notions of distress, dignity, integrity) 2.3. Pastoral power and power over life. One unresolved phenomenon remains, to which attention should be drawn. Through our observation of the interviews required of patients requesting abortions or medically assisted procreation, in which they were invited to manifest at least their distress, we described at length what Nikolas Rose, following Michel Foucault, has termed pastoral power and what we have designated as lay governing by speech which now surrounds the beginning and the end of life. The new and ardent obligation to gather the words of the dying has already been identified by others abroad (Armstrong, 1995; Wouters, 1990), just as it has become pervasive France. in We took the risk of applying the same analysis to the governing of human

reproduction, and above all, establishing the similarity on this point between the beginning and end of life. Why this type of power turned out to be so important when life itself is concerned ? Pastoral power and power over life were shown by Nikolas Rose to be two important characteristics of contemporary biopolitics and our analysis confirms this : but is there any necessary connection today between the development as possible? of pastoral power and of power over life? Why is this power exercised on life itself, and as close to the individual This would be due to what I termed bioreflexivity: the contemporary reflection of the individual (or rather certain individuals, no doubt socially situated) on the self thought of in bodily terms. Merely saying this is not enough; it still has to be explained. How could it be done, however, given that we, experts are caught up in these representations ? A few examples: it is the body that Anthony Giddiness readily identifies as one of the focal points of contemporary reflection, which he sees as the characteristic feature of modernity. No longer a mere datum (due especially to the control acquired over reproduction), the body has thus become fully available to undergo the influences of modernity, and becomes strongly linked to the self, to which it is intimately coordinated in the reflexive projection of identity(Giddens, 1991). Much of the work on reflexivity and the in-depth examination of the meaning of identity and of contemporary individualisation has come from authors that spent time working on practices explicitly vested in the body: Nicholas Rose starting with health-related behaviours (Governing the Soul : the Shaping of the Private Self, 1984), Anthony Giddens starting with the study of sexuality (Modernity and Self Identity. Self and Society in the Late Modern Age, 1991), J.C. Kaufmann starting with the dynamics of laundry within the family and exposure of naked breasts (Ego. Pour une sociologie de lindividu, 2001) and, of course, starting with Michel Foucault, whose lifelong inspiration was centred on the body, and who, incidentally, gradually directed his gaze towards the importance of subjectivation in governing behaviour (LHermneutique du sujet, 2001), after a lengthy reflection on

9
sexuality from the standpoint of the discourse extorted or produced about it. The works we have mentioned may well be the scholarly translation of this specific reflection on the part of the educated middle classes regarding the body. Let us note, for example, that the end of the 1960s was also, as Michel de Certeau showed, an enormous speaking out. But it was filled with a profound concern with the theme of the body and sexuality, based on a rereading of certain cult authors (W. Reich). A name (bodyism) was even given in France to the dissemination of wide-ranging attention and reflection devoted to the body from the end of the 1960s (Maisonneuve, 1976), which, by the way, refracted to differing degrees on the production of the social sciences starting in the middle of the 1970s (Berthelot, 1985 ; Shilling,1993). All in all, what is striking here is the promotion of thinking that was no doubt socially situated capable of constituting the corporal datum both as an important locus of individual construction today, and as a problem, as an object of reflection. That phenomenon in itself would be worthy of investigation and explanation. . III. Where the concern for the self returns to the State One advantage of such a monographic analysis : by looking exclusively at the beginning and the end of life, it was possible to uncover the genesis of this sub-set of contemporary biopolitics, and the changing affects and representations of which it is partially composed. From reading an author like Michel Foucault, diachronic research, guided by the evolutionist approach of Norbert Elias, could be added to it. The dread of the improper mentioned earlier was shown, at least in the case of reproduction and death, to have a history: a long history, with important milestones first at the end of the 18th century, and again recently, starting in the second half on the 20th century, specifically around the end of the 1960s. To sum it up quickly, the milestone at the end of the 18 th century was constituted by a significant event, especially in France, which has been described as no less than a demographic revolution. It was a period marked by a notable drop in mortality as well as in the maximum number of children per couple. What this means is that, beyond a certain number of children, in the silence of the bedroom, couples began systematically practicing popular birth control techniques, in defiance of the Church (which has always remained hostile to birth control) and of the State (which consistently maintained a probirth policy until the Second World War) Birth and death were taken over by objective control as much as by the growing sentiment of a duty to exert individual control: the constitution of a duty to conduct oneself like an individual, capable of autonomy in the face of institutions. In short, the process of individuation this is precisely the name Elias gives it began to assert itself over the beginning and end of life. In this long-term history we have recounted and to sum it up even more succinctly

10
what characterised the end of the 1960s, aside from its acceleration, was the fact that this process which initially took place over against every form of authority, particularly the State, or on the sidelines in relation to it, turned explicitly towards it. Autonomous, clandestine practices became a demand. The silent, secular resistance of against Everyone had institutions came to admit its hostility, and thereby found its voice.

abortions. But people thought: Theyve had abortions; they should keep quiet about it. What was very shocking was that we said it, we demanded the right to abortion observed Gisle Halimi in retrospect, in reference to the petition in favour of the right to abortion of which she was one of the main sponsors ( Je dclare avoir avort , Le Monde, 8-9 avril 2001, p. 14). Here, the history of resistance did not begin with words, but with silent, clandestine actions. Only afterwards did the act become an outcry, and a reproach resolutely addressed to the State. Turning the fate of bodies and of people into a concern of the State was obviously not something new. It represented an underlying, longstanding trend that crystallised at the turn of the 18th and 19th centuries, and was clearly analysed in the early work of Michel Foucault in what he understood by the term biopolitics, taken here in its scientific acceptation. What appears to be new here is that the concern for the self, in its specific forms, returned to the State but in terms that unquestionably required a significant margin of autonomy and reflection on the part of citizens regarding these issues. In the 1960s, the earliest signs of this were once again the massive demand for State intervention resulting from the womens movement and the gay movement demanding reparation of the misfortunes resulting from bodily destiny, as well as the need to take difference, identity and sexual freedom into account. The more recent signs are the targets chosen in the course of the affairs mentioned earlier. Whether it was a question of contaminated blood, the radioactive cloud, asbestos, mad cow disease or epizootic hemorrhagic disease in sheep, in every instance it was understood that it was up to the State to respond, and in the absence of danger, preventively (the principle of precaution) to the extreme collective sensitivity to violations against individual bodies. Meanwhile, though less visibly, there was obviously an intensification of the complaints against the professional actors (doctors) and political actors (mayors, ministers) now held to be genuinely responsible for damage caused to the body. All in all, increased awareness of body-related issues was accompanied by a strong demand for State intervention. In short, from a traditional State concern, the concern for the body became one of the prominent forms of self-concern, analysed in the later work of Michel Foucault, before it returned to the State. The strength and forms of this selfconcern were therefore not totally removed from the contemporary manner that discursive self-discipline of bodies in which it is translated into a State concern. For what is at work here is not so much the advent of an ideal of control in practices as its institutional and state recognition. Procreative control over the self, introduced through do-it-yourself methods in the secret of the bedroom and in family councils, has ensured

11
the slow triumph of Malthusianism since the end of the 18th century. In the period

between the wars, neither the pill nor the intrauterine device was available, yet the rate of fertility in Europe was so low that, if it had been maintained, demographic growth would have been negative (e.g. 0.9 for France and 0.8 for Great Britain). Hence the concerns of Beveridge, for example, whose 1925 study showed that spontaneous contraceptive methods were the ones that had improved the most since the end of the 19th century (Beaulieu,1999). What followed however was the public recognition of the legitimacy of these practices (and the development of new contraceptive methods) in the name of a right to control ones procreation. Dont let the unforeseen decide for you, proclaimed the national campaign in favour of contraception in January 2002. One telling figure: it has been estimated that in 1952, family planning was practiced in 1% of countries, compared to 55% in 1974 and 96% in 1991; and an analysis of the major international conferences devoted to the question (Bucarest, 1982, Mexico, 1984, Genve, 1993, Le Caire, 1994) seems to attest to that fact: what used to be done voluntarily in the name of regulating national demographics increasingly tends to be justified in the name of individual control over reproduction. This is perhaps, as we have said, the most important point on which we diverge from the work of Michel Foucault. For, from this point of view, the historical evolution in question here cannot be simply incorporated, as Michael Foucault does, into the history of the transformation of biopower into the set of regulating mechanisms, ensured by the State, which appeared in the second half of the 18th century. The administration of the living, as we recalled in the introduction, was characterised by the fact that sovereign power, which once consisted in making someone die (or allowing someone to live), gave way to political action aimed, on the contrary, primarily at making someone live (or allowing someone to die). Michel Foucault was therefore more interested in describing the concern to multiply life, to eliminate, fight or offset whatever impeded it, and he had little to say about the methods of controlling the uses of the body that accompany this effort or who does what in these circumstances. In short, he did not have much to say about the issue of concern here, namely the gradual delegation to the citizen of the right to live or not, to make someone live or not (artificial procreation), to allow someone to live or not (abortion), and to allow oneself to die (prolonging life by therapeutic means), or even to make oneself die (euthanasia). In spite the very fact that this delegation has been encouraged, guaranteed, and supported by the State itself. What I am trying to analyse, says Foucault, (is) [] the way in which individuals, in their struggles, their confrontations and their projects, freely constitute themselves as subjects of their practices or, on the contrary, refuse the practices proposed to them. (Foucault, 1984, 1512) What we have tried to bring out here is rather how (and consequently why) institutions constitute them as subjects. Thus, the new bioreflexivity corresponded to a highly unusual form of governing conduct, a governance that willingly focused its concern on the bio, the soma, the

12
organic datum (justifying renewed interested in contemporary biopolitics), but also a governance that formally relied upon individuation, i.e. that willingly entrusted the rational management of the object whose uses it intended to regulate (in this case, the body) to individuals, who would assess on their own the probable evolution of their corporal data and calculate by themselves the risks and financial cost of correcting it. We have given a name to the contemporary form of governing conduct that echoes bioindividuation: individuated or delegated biopolitics. Because this publicly consented delegation of the surveillance of bodies has not been taken into account, anachronistic representations continue to litter and obscure some of the contemporary debates about the administration of life continue to be. This is the case, first of all, with a number of authors in recent years that have begun to show interest in biopolitics, above all Giorgio Agamben and Zygmunt Bauman (or, in a less heretical mode, Peter Sloterdjik), and the emphasis they have put on the State as the central, frightening figure of contemporary biopolitics (Agamben, 1995 ; Bauman,1989 ; Rabinow, 1996, 2000). When, for example, Giorgio Agamben makes the institution of the concentration camp the archetype of contemporary political administration of bodies, he is merely reflecting, with a few exceptions, an outdated model of the state. He is projecting onto the second half of the 20th century a tyranny of the State that tended to predominate in the first half. On the contrary, it is the metamorphoses of this centrality that we have sought to bring to the fore. A similar problem since we are dealing here with the administration of life and death choices has plagued the debate on good and bad eugenics (Roussel,1996). If the debate is so confused, it is because it constantly opposes forms of eugenics on the basis of their values and their aims, a practice to which the history of ideas is partial (e.g.: a positive eugenics consisting in wanting improved children with the attendant authoritarian, even Nazifying, deviations and a negative eugenics that would consist solely in avoiding abnormal births), rather than, in keeping with a more sociological approach, on the basis of the actors who take the initiative in this area (on the one hand, the eugenics of the founding fathers, researchers and thinkers manufacturing a State ideology and imposed upon future parents, and on the other, a spontaneous eugenics of parents who find more or less accommodating allies in medical practitioners). Yet, what occurred in the second half of the 20th century was, first and foremost, the substitution of the legitimate actors in these matters: the State was replaced by individuals, considered to be the most directly concerned (candidates for abortion, parents of future children afflicted with disabilities). Another snapshot that perfectly illustrates the culminating point of this evolution: French law, which set about proscribing any wide-scale practice of eugenic selection, nevertheless found room for selection on a case-by-case basis for the benefit of parents (Bachelard-Jobard, 2001). Also exemplary in this regard was the shift of the legitimate right to put to death away from the State (abolition of the death penalty in the early 1980s) to subjects (structuring of a sphere of influence favourable to

13
medically assisted suicide around 1984). Naturally, all this did not take place without tensions: the abrupt changes in national policy regarding the death penalty testify to this (since 1976, the death penalty has been reinstated in thirty-eight of the american states). And after clearly withdrawing from choices in matters of abortion in 1975, the following year, in legislating the donation of organs, the same French State invented the notion of presumed consent to permit organ removal, thereby making its authoritarian administration of life prevail over individual autonomy. The fact remains that the legitimacy of State-imposed eugenics, an idea that was perfectly acceptable before the war when it gave rise, in 1935, to the success of one of the greatest bestsellers in the history of French publishing, LHomme cet inconnu by Alexis Carrel, was passed on to a eugenics delegated to subjects but adjusted by the State. This delegation of biosurveillance and bioreflexivity by the State would have been publicly unthinkable and indefensible before the war, in the same way that state-centred eugenics is today. On the other hand, public support given to individual eugenics has been relatively tolerated, no doubt because it responds to the evolution of representations and, given its mode of intervention, is less explicitly authoritarian and can more easily go unnoticed. We have thus endeavoured to show how a highly unusual governing of conduct was introduced: a governance that is very concerned about bodies, exercised as closely as possible to the individual, in short, a delegated policy that willingly relies, in bodily matters, on the habitus of the subjects, who tend to trust in their ability to control their own bodies, even if it means leaving to institutions the task of an expression coming from Cas Wouters - monitoring their self-monitoring. Tracing the genesis of modern biopolitics, we found a horrified representation of the body as destiny, a reluctance toward the unequal distribution of quantity and quality of life, a growing intolerance for the misfortune constituted by the mere biological datum. This phenomenon deserves further analysis : not only because it has been relatively neglected by Michel Foucault, but also because his work may indirectly be testimony of it. Michel Foucault , indeed, has been obsessed too by the body as the locus of selfconcern, self-control and modern subjectivity. He has been obsessed by the body as the fulcrum of power. On the other side, he became increasingly attentive to the modes of governance exercised as closely as possible upon individuals : the procedure of confession, the process of subjectivation, the extreme, and sometimes rather nave promotion of ideal government of the self by the self. Perhaps Foucaults work could thus be viewed, in the scientific order, as an exemplary variant of the promotion of delegated biopolitics supported by bioreflexivity since the end of the 1960s ? References ***The present paper represents a modified version of chapters 11 and 9 of

14
my book (Memmi, 2003). It also represents a sort of dialogue with the work of Nikolas Rose, who has proposed a brilliant synthesis of his views on contemporary biopolitics in The Politics of Life Itself (Rose, 2001). Agreing with the idea that two essential changes have taken place in contemporary power (it tends to be exercised on life itself and as closely as possible on the individual), we merely try here, as a result of our own monographic analysis, to draw suggest attention to a few unresolved questions (why these two characteristics : on life itself and as closely as possible on the individual ?), to set the whole phenomenon we both observe within a long-term history (Memmi, 2003), and indicate with precision some recent milestones. My warm thanks to Suzan Taponier for the translation, and to Kathrin Braun and Herbert Gottweis for their advices.

- Agamben, G. (1995) Homo Sacer. Le pouvoir souverain et la vie nue, Paris : Seuil, 1995 - Alternative-Sant, LImpatient, Sant. Guide des associations, Paris/Genve : ditions Jouvence, 1995. - Armstrong, D (1995) Silence and Truth in Death and Dying , Soc. Sci. Med., vol. 24, n 8, pp. 651-657 . - Armstrong, D. (1995), The Rise of Surveillance Medicine, Sociology of Health and Illness, 17. - Bachelard-Jobard, C. (2001)LEugnisme, la science et le droit, Paris : PUF. - Bauman, Z. (1989)Modernity and the Holocaust, Cambridge : Polity. - Beaulieu E. et al., (1999)Contraception : contrainte au libert ?, Paris : O. Jacob. - Berthelot, J.-M. (1985), Les sociologies et le corps, Current Sociology, La Sociologie contemporaine, vol. 33, n 2. - Champagne, P. (1999)Les transformations du journalisme scientifique et mdical, in Mathien, M. (1999)Mdias, sant, politique, Paris : LHarmattan. - Foucault, M. (1984), Interview de Michel Foucault (by C. Baker, avril 1984), in Foucault, M. Dits et crits II, 1976-1988, Paris : Gallimard, p. 1512. - Gati, B. (1999) La publicisation des questions de la sant, in Mathien, M. (1999)Mdias, sant, politique, Paris : LHarmattan. - Gerstl, J. (1999) La sant dans lagenda. Le mdiatique, le public et le politique , in Mathien, M. (1999)Mdias, sant, politique, Paris : LHarmattan.

15
- Giddens, A(1991) Life Politics, Body and Self , in Giddens, A, Modernity and Selg Identity. Self and Society in the Late Modern Age, Polity Press, Cambridge, pp. 217 sq. - Iacub, M. (2002) Le Crime tait presque sexuel et autres essais de casuistique juridique, Paris : Epel. - Maisonneuve, J.( 1976) Le corps et le corporisme aujourdhui Revue franaise de sociologie, XVII, pp. 551-57. - Mossuz-Lavau, J (2000.), Une politique de rduction des risques sexuels pour les

femmes en difficult de prvention, Rapport lintention de la Direction gnrale de la sant/Division sida, Paris : mai 2000. - Peneff, J. (2000), Les Malades aux urgences, Paris : Mtaili - Ponet, P., (2001)Le champ mdical lpreuve du journalisme. Le cas des palmars des hpitaux parus dans la presse entre 1992 et 2000, DEA de sciences politiques, sous la direction de P. Champagne, Paris : Univ. de Paris I. - Rabinow, P. (1996)Artificiality and Enlightment : From Sociobiology to Biosociality , in Essays on the Anthropology of Reason, Princeton University Press, Princeton, p. 91-111. - Rabinow, P. (2000)Le Dchiffrage du gnme. Laventure franaise, Paris : O. Jacob. - Rose, N (2001) The Politics of Life Itself, Theory, Culture and Society, 18 (6), pp.1-30. - Roussel, F (1996) Leugnisme : analyse termine, analyse interminable, Esprit, n 6, june, p. 26-54. - Schilling C.( 1993)The Body and Social Theory, London : Sage Publications. - Sfez, L. (1995) La Sant parfaite. Critique dune nouvelle utopie, Paris : Seuil. - Vigarello, G. (1993), Le Sain et le malsain. Sant et mieux-tre depuis le Moyen ge, Paris : Le Seuil. - Weiner, D. The Citizen-Patient in Revolutionary and Imperial Paris, The John Hopkins University Press, Baltimore-Londres, 1993. - Wouters, C. (1990) Changing Regime of Power and Emotions at the End of Life : the Netherland 1930-1990 , The NetherlandJournal of Social Science, vol. 26, n 2, octobre, pp. 151-161.

16