The Medicalization of Cyberspace (Extract)

Posthumanism: The Absent Present
Extract from
‘The Medicalization of Cyberspace’ by Andy Miah & Emma Rich
(2008, Routledge, pp.111-114).
111
[The online pro-ana movement] is one example of how the virtualization of

identity has led to a prostheticization of the body, which is revealed as a
removal process towards an artificial prosthetic – a prosthetic that is designed to
not fit, to be burdensome. This notion of a prosthetic burden returns us to the
main theoretical premises of the book, where the medicalization of cyberspace
encompasses the consideration of health outside of the traditional medical
environment and within the multi-faceted, non-regulated (rather than
unregulated) space of the Internet.
The medicalization of cyberspace embodies the way that medical practice is

developing in the contested conditions of postmodernity, where ethical
discourse takes place within a space of ambiguous realness. As Braidotti (2002:
2) observes, ‘we live in permanent processes of transition, hybridization and
nomadization, and these in-between states and stages defy the established
modes of theoretical representation’. In keeping with these observations, we
have not attempted to assert a single, comprehensive view of the body in
cyberspace. Instead, we have explored how questions of materiality and
humanness emerge via the context of medicalized cyberspaces. Through our
examples, various
112
modes of enacting what Sandberg (2001) describes as ‘morphological freedom’

have been articulated. The auctioning of a human kidney on eBay, the
proanorexia movement and the rhetoric of the first human clone each clarify the
broadening base of ethical concern and its challenge to social science. This
confrontation takes two forms, the first of which is most clearly espoused by
Fuller’s (2006) critique of ‘bioliberalism,’ as fundamentally antithetical to
sociology’s socialism. Fuller’s concern is that the legitimization of such
practices leads to a diminishing respect for human subjectivity, and his views
are not unlike Fukuyama’s (2002) attack on technoprogressive or transhumanist
claims. Fuller’s encounters with bioethics are part of a series of inquiries by
social scientists who have become critical of the politics of bioethics. Over the
past few years, a number of other sociologists have offered similar critiques of
how bioethics should engage more fully with sociological issues (Haimes 2002;
Hedgecoe 2004; de Vries et al. 2006; López 2004).
The second confrontation involves the operable mode of sociology, as the study
of societies. This is explained usefully through another example. In 2002,
designers from the Royal College of Art in London developed a prototype of a
telephone tooth implant that would sit permanently lodged in the tooth, rather
like a cavity filling. These designers had no intention of developing the product,
and so in one sense the episode was a hoax (Metz 2006). Yet the media treated
the concept as a genuine product that might arrive soon on the market. The
imaginary artefact took on a life of its own and came to constitute the conditions
within which such prospects came to matter to previously unengaged
communities Indeed, with the increasing miniaturization of technology to the
nano scale, the concept is difficult to dismiss outright, although such
applications are nowhere near realization. Again, this reminds us of the
examples discussed earlier in the context of David Cronenberg’s film The Fly
(1986). This provocation appeals to the kinds of blurred space that are now
characteristic of discussions about the future, where technological possibility is
treated as technological probability or inevitability. Perhaps the height of the
success for these designers was making the front cover of Time magazine,
which confirmed the extent of their provocation.
Such future-casting advances the sociological criticisms of futurology in quite

interesting ways, and these provocations are inextricable from an analysis of
medicalized cyberspace. Indeed, imagining the (ethical) future has become a
more legitimate practice for sociologists via the recent trend towards upstream
public engagement on science and technology issues, which has, in turn,
provoked discussions about the value of empirical ethics. While one might
discuss the politics and sociology of these possible futures – bioliberalism
versus bioconservativism – what seems uncontested is the rebiologization of
sociology that the debate presumes. Indeed, Delanty (2002) takes stock of the
challenge this provokes by considering how the science of genetics is inevitably
socially constructed by individual agency, and so we must look to the social
sciences to make sense of this. He goes on to locate these discussions in the
context of a public discourse that resembles the upstream engagement debates
about science.
113
Accompanying these conversations is the emerging conceptual lens of mobility,

which Urry (2000) offers to explain how sociologists must work in a period that
is characterized by the absence of societies. We will return to this concept in the
conclusion, though it is useful to mention that an integral aspect of this work
attends to the digital dimensions of mobile cultures. It offers further support for
considering online health discourses as mechanisms through which to make
sense of technological identity and its relationship to the officialdom of
medicine. However, it is also important to link these ideas with other
contemporary health care debates, such as the notion of medical tourism, where
clients travel the world in search of medical laws that accommodate their
particular need or desire. One can include our earlier discussions about body
and organ trafficking within such debates.
Within cultural studies, there have been some precedents for these discussions
about the ethics of bioliberalism, which we have already mentioned in various
ways. Thus, conversations about cyborgs – more Kevin Warwick’s enhanced
human than Donna Haraway’s interest in the differently able – have infused
imaginative practices of cultural forecasting by aligning it with the established
politics of cultural studies. For example, Gray appeals to the concept of the
cyborg to address the interests of marginal groups whose humanness is not
given full moral or legal recognition. His ‘cyborg bill of rights’ establishes that,
among other things, there must be freedom of ‘consciousness’ and of ‘family,
sexuality, and gender’ (2002: 28–29). His ideas and, more recently, Zylinska’s
(2005) relocation of ethics within cultural studies, culminating in her own
manifesto for feminist cyberbioethics, stop short of utopian claims in order to
argue on behalf of Otherness – of allowing people the freedom of biological
modification in so far as it addresses plausible identity claims.
However, one almost feels that these manifestos are characteristic of an

optimistic phase within the social sciences – the aspiration to study as yet
unknowable societies. In response to these discussions about the role of
bioethics in social sciences (and vice versa), Zylinska’s ‘feminist
cyberbioethics’ retreats from what might be described as cyber-libertarianism or
bioliberalism to a proposed study of the ‘ethics of hybrids’. These ideas have
clear connections with a range of literature, such as Butler’s (1993) notion of
‘bodies that matter’ and Mary Douglas’s (1965) thesis on ‘matter out of place’,
whose work has been discussed recently in the context of biological
modification (Coyle 2006). The Pro-Ana community also responds to this
problematic, as it is constituted by the presence of medical knowledge out of its
proper, regulated sphere and, arguably, beyond the reach of that sphere. Like
Zylinska (2005), we also revert from the cyborg paradigm in order to apply a
more precise, theoretical claim about the medicalization of cyberspace. This is
because our claim is only partially connected to the cyborg metaphor (as cyborg
ritual), which has become only one form of various ways of conceptualizing the
implications of machinic interfaces with biology. We also consider that
Haraway’s cyborg has often entered contemporary academic parlance without
taking into account how non-central were her aspirations to talk about the
imminence
114
of the cyborg as a posthuman entity. Rather, Haraway’s ideal sits comfortably

with the idea that there are fewer and fewer reasons to accept clarity over
ontological distinctions. Indeed, Haraway suggests as much when proclaiming
that ‘the cyborg is our ontology; it gives us our politics’ (1991: 150), thus
invoking our earlier claim about the presence of the anorexic body in Pro-Ana
movements. In each of the cases we discuss, the cybernetic organism cannot be
reduced to mere information; yet the body is both absent and present in
cyberspace.
The concept of presence is a crucial, though contested, notion in studies of

digital cultures. Stories of suicide chat rooms (Rajagopal 2004) suggest that
communication about sensitive or private issues online can often be
accompanied by a weak sense of responsibility in participants that works to
counter the quality of the experience. This has implications for what we call the
bioethics of cybermedicine. Discussions about physical presence are
accompanied by criticisms of bioethics as an industry of sorts, which lacks a
demonstrated ability to prioritize social needs – such as welfarist conceptions of
health care (Purdy 2001; Turner 2003; Zylinska 2005). To this, we might also
add the commercialization of ethical culture – shopping, eating, energy,
tourism, etc. – as further evidence of how the ethical has become hyphenated in
the sense offered by Zizek (2004), as a surrogate for genuine ethical concern. In
this manner, the absent presence within bioethics is characterized by its
overwhelming presence within the public sphere, but lacking any ability to
argue on behalf of basic health care needs. We are both overwhelmed and
unassisted by bioethics, to the point where key scholars in the midst of
discussions about medicine’s future are beginning to think ‘beyond bioethics’
(Fukuyama and Furger 2007). This situation also explains why our construction
of the absent present is ethical: it is the presence of an ethical commitment
within cultural studies, which is constituted by an absence of the capability to
scrutinize judgements. This is not a criticism of pluralism as such, nor wholly a
criticism of those who have pioneered bioethics. Indeed, it is more carefully an
appeal to consider what literature should inform bioethical deliberations and to
support Callahan (1993: S9) in his counsel that bioethics must continue to
‘expand its own horizons’.
References
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Callahan, D. (1993) Why America Accepted Bioethics. Hastings Center Report

23: S8–S9.
Coyle, F. (2006) Posthuman Geographies? Biotechnology, Nature and the

Demise of the Autonomous Human Subject. Social And Cultural Geography, 7:
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Cronenberg, D. (1986) The Fly, produced by Stuart Cornfeld (film).
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Modernizing the Regulation of Human Biotechnologies. Washington, DC: Paul
H. Nitze School of Advanced International Studies.
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Posthumanism: The Absent Present

[The online pro-ana movement] is one example of how the virtualization of

The medicalization of cyberspace embodies the way that medical practice is

modes of enacting what Sandberg (2001) describes as ‘morphological freedom’

Such future-casting advances the sociological criticisms of futurology in quite

Accompanying these conversations is the emerging conceptual lens of mobility,

However, one almost feels that these manifestos are characteristic of an

of the cyborg as a posthuman entity. Rather, Haraway’s ideal sits comfortably

The concept of presence is a crucial, though contested, notion in studies of

Butler, J. (1993). Bodies That Matter: On the Discursive Limits of ‘Sex’.

Callahan, D. (1993) Why America Accepted Bioethics. Hastings Center Report

Coyle, F. (2006) Posthuman Geographies? Biotechnology, Nature and the

Cronenberg, D. (1986) The Fly, produced by Stuart Cornfeld (film).

Delanty, G. (2002) Constructivism, Sociology and the New Genetics. New

Douglas, M. (1965) Purity and Danger. London: Routledge.

Fukuyama, F. (2002) Our Posthuman Future: Consequences of the

Fukuyama, F. and Furger, F. (2007) Beyond Bioethics: A Proposal for

Fuller, S. (2006) The New Sociological Imagination, London: Sage.

Haraway, D. (1985/1991) A Cyborg Manifesto: Science, Technology, and

Hedgecoe, A. M. (2004) Critical Bioethics: Beyond the Social Science Critique

López, J. (2004) How Sociology Can Save Bioethics. Maybe. Sociology of

Metz, R. (2006) Lying Through Their Teeth. Wired. Available at

Urry, J. (2000) Sociology beyond Societies: Mobilities for the Twenty-First

Zizek S. (2004) Organs without Bodies: On Deleuze and Consequences.

Zylinska, J. (2005) The Ethics of Cultural Studies. London: Continuum.

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