In his highly original work, Birth of the Clinic, Foucault focuses his attention on the human experience and the rational for its continued homogenous reality. He discusses in great detail concepts about ideological space, the transformation of language and the politicization of medicine. He attempts to illustrate and illuminate the development of methods of medical practice especially those influenced and regulated by the relations of power. But Foucault’s ideas about power are hard to define and comprehend. One reason for this is the common interpretation of power (when we think of power, we think about that which serves some sort of control). But to understand Foucauldian power, we must think in terms of power made from a system of complex relations. In this article, we will attempt to disentangle the discourse that complicates and obscures the relationship between political ideology and medical technology. We will examine the politicization of medicine and the agenda for the establishment of bio politics in modern culture.
In this work, Foucault focuses on the processes of modern social and political homogenization within the framework of medicine. He incorporates, often in metaphorical terms, models of several influential forms that seem to be theoretical orientations of historical and psychological contexts. Not only are the theories and methodologies of scientific, positivist ideology deconstructed but those of empirical based historical contexts are scrutinized as well. When we turn our attention to the field of medicine in the United States in the early 20th century, we will find that relations of power were responsible for the transformative effect of the re-organization of medicine and the status of the patient.
At the beginning of the 20th century, most Americans depended on naturopathic and herbal remedies for sickness and disease. Yet, these cures were “unpatentable” and “unmarketable.” A group of American oligarchs decided to introduce pharmaceuticals as a new lucrative opportunity which would later become the economic foundation of a new medical economy. To do this, they first had to denounce naturopathic cures as quackery and then overhaul the American medical education system. Later, political legislation would be used to prohibit its further use as an approved form of medical practice. In other words, by denouncing natural and homeopathic cures, influencing medical education in academia, and the politicization of practices and cures, the American medical system was in effect overhauled.
It seems to have started with a report on the state of the American medical education system by Abraham Flexner (1910) that resulted in sweeping reforms to the system. In this report, only drug-based, allopathic medicine requiring expensive medical procedures and lengthy hospital stays was supported as authentic medical practice. Further, it recommended that surgery, radiation therapy, and synthetic drugs become the basis for treatment and practice. But this also required a new definition of the status of the patient in society, and the establishment of a certain relationship between the public and medical experience. Instead of remaining the familiar symbol of past times, a politicized consciousness called for medicine to change its emphasis. Here, we see the character of medicine regulated more by a transferable logic that was beneficial to certain interests.
The takeover of American medical education began with the takeover of American educational institutions. The oligarchs offered tremendous amounts of money to schools that agreed to cooperate with them. In turn, the donors suggested that the schools allow them to place certain individuals on the board of directors of these institutions. Many of the major universities received large grants and accepted representatives from these funding sources. As a result, schools were able to construct new buildings, add expensive equipment to their laboratories and hire top-notch teachers. But at the same time, the direction of medical education was turned in favor of the practice of pharmaceutical drugs. From that point on, doctors were taught the use of pharmaceutical drugs in the practice of medicine.
Almost overnight, entire medical industries developed from research centers funded by the oligarchs who held monopolies on the pharmaceutical markets. During WWI, for example, a new cancer therapy developed as a result of the use of muster gas. In fact, the entire staff of the U. S. Chemical War Service conducted research on muster gas to develop a form of chemo-therapy. Later, several major pharmaceutical companies would dominate the drug industry and become some of the largest pharmaceutical companies in the world.
The structure of the discourse on pharmaceuticals, its controlling interests and practices helped to shape conceptions of social and cultural practices about medicine. Further, the scientific aim of describing and practicing medicine and the importance of interests and objectives of subjective-based concepts of power continue to influence its development. The significance of work by scholars such as Foucault, and that of a few others, precipitated a reexamination of previous concepts in human sciences and thus made it possible to question fundamental ideas and perspectives in a new way that has culminated into important critiques on the development of modern medical practice.
Foucault, M. (1973). The Birth of the Clinic: An Archaeology of Medical Perception. New York: Pantheon Books; Flexner, A. (1910). Medical Education in the United States and Canada. New York: Carnegie Foundation for the Advancement of Teaching; Griffin, G. E. (1974). World without Cancer. West Lake, CA: American Media; Prado, C. G. (2000). Starting with Foucault. Boulder, CO: Westview Press; The Corbett Report. (2015) How Big Oil Conquered the World. https://www.corbettreport.com/episode-310-rise-of-the-oiligarchs/.