Bourdieu meets Foucault the medicalization and (in) visibility of the disabled body


Lucia Wolff Ruiz*

The world health organization estimates that 15 percent of the global population, or over one billion people, live with some form of disability. Yet, many disabled people remain invisible, living in poorly adapted places, or not having full control over medical decisions they want to make over their very own bodies.

Historically, biopower emerged with the transformation of power structures in Western societies in the 17th century but had its most drastic development in the 18th century. The sovereign whose sword could take or pardon life got replaced by a complex society which developed the power to life; this is, the mechanisms to care for, limit, and even terminate life. Whereas the power of the sovereign is a power that “lets live”, bio power is a power that “makes live”. It targets life as to improve, optimize and ensure it.

Along with bio politics, a new type of medicine developed, whose main function was to ensure public hygiene. Institutions centralized the power of this new medicine, integrated its knowledge and coordinated the care given to the patients. Bio politics also was concerned with estimates and forecasts, so that regulatory mechanisms were put into place to prescribe norms, seek out averages, and compensate for variations in “the general population”. For Foucault, the body (not mattering whether disabled or not) isn’t there a priori but rather constructed through discourse. Human sciences such as medicine produce a discourse, a knowledge that shapes how the disabled body is perceived and treated. The contemporary disabled subject has then emerged in tandem with the vast apparatus put in place to secure the well-being of the general population.

This machinery has been comprised of asylums, income support programmes, special education programmes, rehabilitation regimes, prostheses, and prenatal diagnostic procedures, among many others. These practices have been methods to classify, codify and manage social anomalies, and through which people have been divided from others and labelled as (for example) “physically impaired” “insane” “handicapped” or “deaf”.

Similarly, as Foucault described in the birth of the clinic the process of medicalization shifted the location of care from the home to hospitals, especially after World War II, because it was assumed that this would increase efficiency. This has now become an accepted truth, and we usually assume that better care can only be gotten outside the home. If a person is indeed, discharged and transferred into their home, the personal care services received might be highly musicalized, a service that could look very different under the “independent living” model developed by people with disabilities. Another negative impact of medicalization for the disabled population is that if they’ve been defined as vulnerable or unable to speak or judge for themselves, then someone “who knows better” is given the power to make the important decisions. Here, the Foucauldian notion of the construction of discourse shines through. So, there is no real appeal to medical decisions, at best one can none comply or refuse treatment.

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