#317      43 min 14 sec
Molecular gaze: How discoveries in the life sciences are changing our identities and politics

Sociologist Prof. Nikolas Rose explores how scientific developments have changed conceptions of human identity and governance, and what this means for our political, socio-economic and legal futures. Presented by Lynne Haultain.

“This constant obligation to live in a life of freedom by maximising your abilities is, I think, a kind of problematic ethical form.” - Prof Nikolas Rose




Prof Nikolas Rose
Prof Nikolas Rose

Nikolas Rose is Professor of Sociology and Head of the Department of Social Science, Health and Medicine at King’s College, London. He was previously (2006-2011) Martin White Professor of Sociology and Director of the BIOS Centre for the Study of Bioscience, Biomedicine, Biotechnology and Society at the London School of Economics and Political Science.

He is also co-PI for the EPSRC funded Centre for Synthetic Biology and Innovation (CSynBI) and part of the Ethics and Society Division of the Human Brain Project. His recent work has focused on the drivers, nature and implications of developments in the life sciences and biotechnology and more generally on the relations between the social sciences and the life sciences.

His most recent books are The Politics of Life Itself : Biomedicine, Power, and Subjectivity in the Twenty-First Century (Princeton, 2006); Governing The Present (with Peter Miller, Polity, 2008) and Neuro: the New Brain Sciences and the Management of the Mind (with Joelle Abi-Rached, Princeton, 2013).

Credits

Host: Lynne Haultain
Producers: Eric van Bemmel, Kelvin Param
Audio Engineer: Gavin Nebauer
Voiceover: Nerissa Hannink
Series Creators: Kelvin Param and Eric van Bemmel

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VOICEOVER

This is Up Close, the research talk show from the University of Melbourne, Australia.


LYNNE HAULTAIN

Hi, I'm Lynne Haultain and welcome to Up Close.  Nikolas Rose is Professor of Sociology and Head of the Department of Social Science Health and Medicine at Kings College London.  Professor Rose explores how scientific developments have changed conceptions of human identity and governance and what this means for our political, socioeconomic and legal futures.  Ever since the advent of human science, since the first anatomists and medics started exploring the nature of our human physicality that growing knowledge has had a fascinating and dynamic interrelation with how we think of ourselves, the quality of our humanity and the nature of our societies.  The more we know about bodily systems and molecules the more it colours our view of our place in the world and the more complex and fundamental that link becomes.

Nikolas Rose says that the most far reaching ethical innovations are now being made through medical and biomedical thought and not by moral philosophers and ethicists.  Professor Rose is visiting Melbourne as a guest of the Australian Sociological Association in partnership with the School of Social and Political Sciences at the University of Melbourne and Victoria University and he's very kindly agreed to join us for a conversation.

Professor Rose, welcome.


NIKOLAS ROSE

Thank you for having me on your program.


LYNNE HAULTAIN

Well I'd like to look at how we got to this position, how we got here but let's start at the end.  Why do you say that the cutting edge of moral and ethical philosophy now sits with medicine?


NIKOLAS ROSE

Well let me give you an example that I think makes that very clear.  Philosophers have worried for age about the relationship between the mind and the brain, are the mind and the brain the same thing, are they two different substances and so on and so forth.  It's been a pervasive question in philosophy and in moral philosophy for centuries if not millennia.

But what's happening now is that certain technical developments arising from the neurosciences seem to resolve that or at least they resolve it to the satisfaction of the technology.  I'm talking here of those technical developments which claim to be able to see thought, to see intention, to see belief in the brain itself, to see the brain when it's thinking, not just thinking in general but when it's thinking about specific things, when it's imaging certain words, when it's having certain kinds of intentions, to see these in the patterns of activation of the brain.  The belief is beginning to take shape in the neurosciences that there are observable material traces in the brain that at least mark every single thought that the human being has and are in principle legible.

So what does that mean for that age old question of the relationship between the mind and the brain?  It basically means as far as the neurosciences are concerned to be very simple about it, that mind is what brain does.  So an age old question in moral philosophy, still troubling of course, there's a huge explanatory gap between what we know about the nerve cells, about their membranes, about their biophysical and chemical properties, how does that give rise to thought?  If we try and deal with that philosophically, we still can't answer that question.


LYNNE HAULTAIN

Yes.


NIKOLAS ROSE

But if we try and deal with it technically we appear to already have answered it.  So that's why I say that these ethical and philosophical questions are now being reposed within the life sciences themselves.


LYNNE HAULTAIN

So you call this the politics of life itself, this is the convergence if you like of life and the way in which we reflect ourselves as humanity.  You also call that ethopolitics.  Is that right?


NIKOLAS ROSE

Well they're two slightly different things.  Why I say the politics of life itself is because in so many parts of our world today it is these vital aspects of human existence that pose not just ethical but political questions.  So take for instance, talking about the brain take the question of dementia and the growing problems of dementia and how those are going to be managed or at the individual level, how do we deal with those people who we believe might be developing dementia, do we develop a pre-symptomatic test to identify whether or not my memory lapse a second ago is actually a sign of mild cognitive impairment or is it just because I'm tired, what would happen if we were able to predict those people who are going to develop Alzheimer's disease at an early age, what would be the kinds of ways in which we would deal socially and politically with those questions?

So that's why I say the politics of life which is about these questions of our existence as vital organisms, our life, our pathologies, our unhappinesses and indeed our mortality as we think about things like physician assisted suicide, those kinds of questions.  These have become central to our politics.


LYNNE HAULTAIN

Let's talk about how we got here then because this is clearly the very cutting edge of science as you say and of our ethical considerations of what it is to be human, that connection between mind and brain. But the history of science as it's interacted with our sense of ourselves as human is long and has some fascinating twists and turns and some really evident trends over the last sort of 100, 150 years or so.  It seems to me that our gaze has been getting tighter and tighter over time.  We started out looking at public health if you like, the transmission of disease, large scale issues of transmission of disease and drama in Victorian times and it was all about the mass population and maintaining sort of a general public health.  Now we're down to molecules and genes within cells.  That vision has got so much tighter over time.  What has that meant for the way in which we see ourselves?


NIKOLAS ROSE

I think you're absolutely right in characterising this move to a kind of molecular gaze on the body.  We understand the body at the molecular level, we understand the way in which individual molecules work, we understand the ways in which they connected together, we understand the ways or we try to understand the ways in which they're organised into circuits and so on and we understand our pathologies increasingly at that molecular level.

What does that mean?  I think what it begins to mean, which is interesting and problematic, is that we think that when bodies go wrong, when bodies are sick, when people are ailing the way to understand and indeed to intervene on those ailments is to intervene at the molecular level.  So there's a kind of move which is not altogether unproblematic from those broad campaigns of social hygiene, of urban reform, et cetera, et cetera, to believe that we can understand and address all the ills that humans are heir to by understanding their biomolecular mechanisms and indeed the very idea of biomedicine that we have these days, a word that slips easily off the tongue, seems to indicate that medicine should be based on an understanding of basic human biology which is molecular biology.

Yet at another level we know that the gross inequities in human health, in human morbidity, in human mortality and life expectancy and so on, absolutely horrifying if you begin to think of them, that in some areas even in one country in some expectancy of a man at birth is 47 and in another area it's 82, it's difficult to accept that the way in which one should understand and intervene on those is by intervening at the molecular level on each individual.  So we need to try and continue understanding of these molecular processes but to realise that the body itself as a vital organism, yes of course it's a vital biological organism but it's always an organism in constant transaction with its environ, with its milieu, and we have to begin to understand those transactions which are supra molecular which may have their effect through the molecules of the body, through the genes, through the nerve cells, et cetera, but probably have their fundamental cause somewhere else.


LYNNE HAULTAIN

Have we become seduced then by the molecular gaze as you call it, by the capacity to see ever smaller and to understand that system at an even more detailed level?


NIKOLAS ROSE

I think, understandably, that's the way in which the sciences come to anatomise the body at this molecular level and once you begin to think that everything, every ailment must pass through those molecules it's almost inevitable to think that that's the place where you're going to tackle the disease and also of course it's highly funded, it's exciting, there are grants to be won, there are papers to be published, there are Nobel prizes to be won, all that is absolutely terrific but there is a sense in which yes it does divert our attention from some things which are perhaps less tractable, less manageable but there are these fundamental social and political processes that throw people into illness in the first place, working the body of course. But if we simply focus on their organic basis then I think we're going to have a lot of difficulty in addressing them.

I think actually in the sciences themselves, in the life sciences that I've been looking at there's a growing realisation of that.  If we go back a few years to the excitement about the Human Genome Project, the belief that you could understand almost every ailment that a human was going to develop over their life by sequencing their inherited genetic complement, their inherited genome, well now we realise that it's by no means as simple as that, that genes simply express themselves.  What's most important in most disorders is the way in which those genes are shaped, are expressed over the course of a lifetime, gene expression, gene methylation or what's fashionably called epigenesis.

So it's the way in which the environment, the milieu, experience gets under the skin and shapes the way in which genes express themselves over a lifetime.  That's what leads to the disorder not simply the sort of working out of an inherited genetic program. And the same is true in neuroscience.  We're beginning to realise that the brain, the human brain is perhaps the organ most open to experience, modulated from the moment of conception onwards by the encounter between the organism and its world, first of all its mother, secondly all those that surround it, the world of culture, the world of stress, the world of the city, the world of the countryside, how these things get under the skin.  This phrase 'how does the world get under the skin' has become very popular in the sciences themselves as an attempt to recognise that the body itself cannot be understood except if it's located in this wider set of relations.


LYNNE HAULTAIN

This transition to this way of thinking has had a really fascinating impact on the language that we use around science too.  I mean if we were to take the broad sweep that we were talking about earlier we've moved from talking about systems and frameworks and engineering and mechanical sorts of language to the language as you've already used of informatics, of expression, of splicing even in the way we talk about Super 8 film.  So it's become the language of communication which is about that expression, isn't it?


NIKOLAS ROSE

Yes, it's become partly the language of communication and of course the idea of genes as codes led to a whole lot of work on the informational basis of life and, of course, that coding nature has been really rather important in ways of thinking about living beings but somehow the code is not enough.  Flesh is not just code and so it is informatics but it's also the way in which informatics works its way out through the vital properties of the organism.  Personally, this maybe not a line we want to pursue but I'm a bit of a neo-vitalist in the sense that I think organisms that are alive and that mobilise their resources to struggle against death, that those organisms have a certain character that needs to be understood.  They are not simple mute matter so yes it's information but it's information as it works its way out through the flesh.

The challenge I think in many of the life sciences these days is a challenge not so much of informatics directly but of complexity.  We know an awful a lot about these molecular properties.  In neuroscience we know an awful lot about how neurons work, we know about their membrane properties, we know about their ion channels, we know about their biophysical properties, we can characterise the many different types of neurons in the human brain, we can even see how they connect. But what's much more complicated for us to understand is how hundreds, thousands, millions of these neurons organise themselves into circuits and how out of those circuits higher level functions emerge and out of those higher level functions more complex functions emerge.

When we say complexity, it can often be a sort of hand waving we really don't understand but if we're going to understand the human brain and I think the human body, we have to begin to be able to think in those complex relations.  Reductionism as it's called, trying to understand things at the level of the most basic processes has been a hugely successful experimental and explanatory paradigm but perhaps it's come to its end.  And this is why I, as a social scientist, I'm interested in these questions partly of course to think about the history and the politics of them but partly because organisms exist in a social field and that's a scientific fact and not just a sociological claim.


LYNNE HAULTAIN

Phenomenon, indeed.


NIKOLAS ROSE

Yes.


LYNNE HAULTAIN

I'm Lynn Haultain and this week on Up Close I'm speaking with Professor Nikolas Rose of Kings College London about the strands of human history and biology and philosophy which intertwine to change the way we think about our bodies and our societies.

Nikolas, I want to talk about economics because that is another huge element in this discussion about how science interacts with the way in which we see ourselves and where the pressures are. Because it seems to me that we've moved to economics as a motivation for science.  You alluded earlier to the compulsion towards research because it's well funded, because there is reward and incentive in it.  Cost benefit, how have we come to this and what sort of impact do you think that overlay is having on the way in which science is done and the way in which we see ourselves?


NIKOLAS ROSE

I think you're absolutely right that science today as it's practiced is inescapably tied up with economics. And this in a number of ways, especially in the life sciences.  I'm less familiar with the Australian situation than with the European situation or the Asian situation but in many of those regions the belief is that these new life sciences are going to provide the basis for a new economic revolution.  There was the digital revolution and now there's the life sciences revolution.

We're moving towards a knowledge based bioeconomy in which the exploitation of the surplus that there is in vital entities is going to be a crucial source of capital, what's often called bio capital, the emergence of bio capital.  So there's big investment in the life sciences, there's big government projects to develop the life sciences.  Singapore are very big biopolis, in China, a huge amount of national investment in the life sciences.  This investment in the life sciences I think is in search of value in two different ways.  Of course, because there is a value in life itself, there is a value in health and the negative of that, the costs of ill health are huge and growing on national economies.

The burden of disease, I don't like that phrase burden but the  burden of disease is large and growing, and so to some extent investment in the life sciences is investment in trying to maximise that value. But of course the other side of it, investment in the life sciences, is to realise an economic value.  So there's a kind of fusion in the search for the value of life and the economic value that can be extracted and we see this in the way in which every aspect of human health has become highly capitalised, the huge investment and profits generated by the pharmaceutical industry, by now the medical devices industry, by all those industries that are organised around the management of human life.

Health, the health sector, hospitals, medicine, drugs, equipment is inconceivable without investment.  That of course has some good sides.  We have fantastic treatments that we would never have before.  It has some downsides in that there's only investment in those things that's going to generate a value.  We see this in investments in drugs and investments in medical devices.  Those that have a potentially large market get their investment, those that have a small market or even a large market but with little resources like in Africa, the diseases in Africa, all sorts of new techniques have to be used to lever the value into those areas.

So charting out this bioeconomy and beginning to work out the costs and benefits as you put them, who gains, who loses and how we can begin to bring a bit of equity to that, that's certainly one of the prime motivations of the new department that I've started at Kings College London which works fundamentally on how one understands these global inequities in health and disease.  It's a little way away from my earlier work which is on the history of the emergence of these ways of thinking about ourselves but to some extent it grows out of this.  We know, we can understand their history, perhaps when we understand their history, how they've been put together, the determinants of the ways in which we think about ourselves now, the emergence of these complicated apparatuses for governing ourselves and governing our health, perhaps if we can begin to trace those configurations historically, we're also in a little bit of a better situation to know where to intervene in them to transform them.

That's been the logic of the changes that I've made in my own intellectual investments over the last 10 years or so.


LYNNE HAULTAIN

It seems to me also that a new strand in all of this is the focus on enhancement rather than addressing illness or defect.  It's about improving one's assets or one's physical being and that's where the commercial edge really comes into play.  Would you agree?


NIKOLAS ROSE

I think it's certainly a new commercial edge.  There's a lot of debate about enhancement, is anything new about enhancement?  We enhance our intellectual capacities when we drink a cup of coffee or something like that?  Education is a form of enhancement.  We can have a long discussion about the exact limits and novelty of enhancement but I think it's certainly the case that now we seek to enhance or optimise our capacities by building on and utilising these new biomolecular and neuromolecular knowledges. And one sees very, very rapid transition from the emergence of some ideas within the sciences themselves to their deployment and their take-up in the commercial field.

Take one little tiny example, I've been working on neuroscience for the last eight years or so and one of the arguments in neuroscience as I mentioned earlier is the idea that your brain is modulatable, you can change your brain through experience.  Your brain is plastic as it's said.  You can 'rewire' your brain.  Okay this phrase rewiring your brain has become a very popular one.  Look on the internet now, you can find dozens and dozens of books or training kits of things for parents to use with their children, you can rewire your brain for personal growth, you can rewire your brain for love.  So very, very rapidly, this way of thinking about the brain as modulated by experience becomes taken up in the hope that we can improve ourselves, some of it quite valid and scientifically based, some of it, quite frankly, fantasy and snake oil, you know.

The dream that we could make ourselves better, the dream that we can improve ourselves is a very powerful one.  One shouldn't be too sniffy and critical about the fact that now there's a kind of democratisation, everybody wants to improve themselves not just the elite who have always tried to improve themselves, live longer and so on.  The dream of living longer and improving yourself is open to more and more people but perhaps just the desire to live longer or enhance your intelligence or whatever maybe turns you away from the quality of that thing that you want to extend or enhance, you know.


LYNNE HAULTAIN

And I wonder I suppose if you were to take that line out the impact that has on the diversity of the community because the pressure seems to inhere on the individual to make the effort to improve themselves and are we beginning to see a phase where that pressure mounts and mounts, and the prospect of people living happily with diverse abilities becomes problematic.


NIKOLAS ROSE

Yes, you mentioned my work on the changing ways in which people understand themselves. Well those changing ways in which people understand themselves are very much linked to the language and the techniques of the sciences and biomedicine as I have argued also turn into techniques that people use to try and improve themselves and perhaps the obligation to improve yourself, to act on yourself, to make yourself better, to make yourself more entrepreneurial, to make yourself more successful at work, to make yourself more successful at love. So this constant obligation to live in a life of freedom by maximising your abilities is, I think, a kind of problematic ethical form.

You mentioned earlier the phrase I used by ethopolitics, that is kind of governing oneself through a kind of ethic in order to transform oneself.

The other side of your question was about diversity.  This is an interesting political area at the moment whether or not the implications of these new abilities that we have should be to try and normalise everybody, to bring everybody up to a certain kind of normal functioning or whether we should accept diversity. So in the area for instance of autism, there's a very strong movement for neuro diversity which says that no, those of us who are autists and they use that phrase autist, not people with autism, they use the...


LYNNE HAULTAIN

Or autistic.


NIKOLAS ROSE

Yes, they use the master category which so many of us fought against.  Now I'm not a schizophrenic, I am a person with schizophrenia.  No, autists.  We are autists, we are differently abled and we demand the ability to live in a different kind of way.  So I think we are seeing those contests emerging now.  We've seen them in the disability movement, we are seeing them in this neuro diversity movement and so on.

It's not clear to me whether or not our acceptance of diversity is becoming less, our envelope of normality is becoming tighter and tighter and tighter.  To some extent it is I think because of a whole series of processes.  We are less tolerant of diversity, we see difference as danger, we see difference as threat and we organise our experts and our regimes of government in order to contain those risky dangerous different kinds of individuals.


LYNNE HAULTAIN

And as individuals, we pathologise the difference.


NIKOLAS ROSE

Yes, we sometimes pathologise the difference in ourselves, yes but we are quick to pathologise or to use the cliché which needs of unpacking, we are quick to medicalise difference and to see that difference as having its roots in a biological or biomedical pathology and then to think that what we should do towards that is to cure, and cure in this sense means not cure a disorder but normalise the individual.  And I think we see this again and again and again in the medicalisation of a whole range of differences in our lives.  Of course not all medicalisation is bad, you know?  The application of medical expertise to problems has transformed our world and transformed it largely in a good direction so to just say it's been medicalised is rather to beg the question of whether or not that is a thing that one would approve of ethically and politically or not.


LYNNE HAULTAIN

You're listening to Up Close and I'm Lynne Haultain and with me today renowned sociologist Dr Nikolas Rose talking about his very keen observations of science and society and how they influence each other.

Just as we were talking, Nikolas, I was thinking is this a western preoccupation?


NIKOLAS ROSE

I think that's an empirical question as us sociologists like to say.  Now, my work has largely focused on the global north and looked at these developments in the global north. And in the global north I've charted the rise of different ways of thinking about ourselves linked to different ways of governing ourselves, the emergence of psychological notions of ourselves in the 19th and into the 20th century, then the emergence of this absolute understanding of ourselves as sort of fleshly embodied lively creatures and the sort of ethic of managing our bodies and then more recently, the emergence of this idea of ourselves as embrained and the brain is a crucial way of thinking about all sorts of problems of society and all sorts of problems of ourselves.

I think we can see those ways of thinking, although at different rates and in different domains probably across the global north.  Now are we seeing similar things in China?  Are we seeing similar things in India?  As I say, these are empirical questions.  I don't think there is the difference that we sometimes imagine.

A good colleague of mine is doing work on assisted reproductive technology clinics in India where there's a very big market for assisted reproductive technology clinics, it's a very big economic area, these clinics charge a great deal for IVF treatment and so on so that is in a sense a similar development to the development that one sees, say, in the United States.  On the other hand it has a particular Indian character.  It's to do with the way in which one values one's own genetic child, it's to do with feelings of family loyalty and that you're letting down your family if you don't have your child and so on.  These are run not by multinational corporations from America but by Indian entrepreneurs.


LYNNE HAULTAIN

So you're saying that the movements are the same but perhaps with different emphases and cultural contexts?


NIKOLAS ROSE

Yes. So I don't think one's seeing globalisation and that everything is the same but these technologies travel and they're taken up in different ways in different contexts.  In China for instance I did some work for a good few years, there is also a very big problem of infertility despite the one child policy.  The restriction of the one child policy means that everybody wants the most perfect child that they can have and those that are infertile go to fertility clinics and these again are highly profitable enterprises but linked to a Chinese context, Chinese history, Chinese politics or the one child policy, the Chinese belief in what a child means to the family and so on and so forth.

The same biotechology if you want to call it that, the same techniques mean different things and are deployed differently in different countries.  One sees the same with drugs and all these things.

As I say, I'm fortunate to be working in an area where there is a great deal of extremely sophisticated empirical largely ethnographic work which is beginning to chart out in detail these differences and we're learning something about similarity and something about difference between different cultures through that work.


LYNNE HAULTAIN

Which will be fascinating but I suppose as a lay person I look at your work and think this is an important connection between the social sciences and the physical sciences if you like and the biomedical science – critical. And as you've described, we really can't make sense of ourselves as biological unless we see ourselves in that broader context.  But I wonder how persuasive that is with the broader scientific community who tend to see their work as immutable, that it's about the revelation of reality rather than anything that's contextual or that might change depending on the context.


NIKOLAS ROSE

So I've spent a lot of my time over the last 10 or 15 years working with life scientists, working with biologists, working with geneticists, working with neuroscientists and most recently working with synthetic biologists and working in a big project called the Human Brain Project.


LYNNE HAULTAIN

Just before you proceed, what is a synthetic biologist?


NIKOLAS ROSE

Okay so synthetic biology is advanced technologies of genetic engineering that tries to use genetic engineering techniques but in a much more sophisticated way to try and modulate the function of organisms so that they can do something that you want them to do that they wouldn't do naturally.  So for instance to shape organisms so they're much more effective as being stock for biofuel or to engineer bacteria so that those bacteria can live in very harsh and unpleasant conditions, can identify pathogens like oil pollution or whatever in those conditions and can bioremediate or digest those oils in...


LYNNE HAULTAIN

Eat them up.


NIKOLAS ROSE

Eat them up, yes and excrete them in a less harmful way.  So to use these techniques to bring together capacities that may be in one creature and another creature and another creature as it were to make the organisms that evolution forgot.


LYNNE HAULTAIN

So make the platypus.


NIKOLAS ROSE

Make the platypus, yes or design the platypus.  It's to use engineering design principles to try and engineer biology, engineer vital processes so that they can do the things that you want to do.  Now both in synthetic biology and to some extent in neuroscience the very idea of this is both entrancing and troubling. Entrancing because it suggests that we can make biology do our will and we can use these biological techniques to address fundamental social challenges, the challenge of there being insufficient food, the challenge of pollution, the challenge of energy production, the challenge of creating better drugs and so on and so forth.  And if one can do this perhaps one should do this but of course these raise great anxieties amongst people.  Is it risky?  How is the risk going to be controlled?  These are vital organisms as well.  We know they evolve.  What's going to happen when they escape from the lab?


LYNNE HAULTAIN

Frankenstein comes to mind.


NIKOLAS ROSE

Frankenstein, et cetera, et cetera.

So here's the place where the life scientists, my colleagues in synthetic biology will work with the social scientists to begin to understand those questions, to begin to think about ways in which they can talk to the public about what they're doing, to be able to explain what they're doing, why they're doing it, what are the risks, what are the benefits, to begin to move away from the fact that the fears of the lay public are irrational, to do something which I think is democratically highly desirable which is to build scientific citizenship, to take the public seriously, to explain what you're doing to people. And the more we see how that happens and when that happens well, the more we realise that the so-called lay public, if the time is taken to explain to them carefully they are very good at thinking through these things, at balancing risks and benefits, recognising the strengths and limits of the science and recognising that science has risks but it can also produce the kinds of world that we live in.

So that's the kind of social responsibility of science.  The phrase it goes under in Europe is responsible research and innovation which is to make the scientists themselves think through and take seriously the social and political implications of their work and build that right back into their research design, into their experimental structures, into their developmental procedures and bring that through in negotiation with the public because they know with all the experiences with the genetic modification of food and things like that that if that doesn't happen that the very potentially extremely valuable developments will kind of crash and burn.

So I'm not sure that that gets to the sense of the very science, the very truth itself being changeable socially and historically although maybe scientists are perhaps more open to the idea that they know what they know because of the explanatory systems that they've got at the moment and in 20 years' time or 50 years' time it's going to change.  And we've got very good examples of that because the Human Genome Project which was started on the belief that there are 300,000 genes, the more complicated an animal was the more genes it had, human beings must have more genes than fruit flies or carrots, [it] actually turns out that humans only have 23,000 genes and everything we thought we know about genetics we realised that we don't know.  And the science itself has taught us that we should be wary of believing that our current truths are immutable.

In neuroscience too, science does have a kind of powerful way of demonstrating that fundamental beliefs actually don't work when you try and make them work.  It's quite difficult to make things true in science actually.


LYNNE HAULTAIN

Which takes me back to a story you tell in your writings about Copernicus and Freud [who] made a similar connection as well, ever since Copernicus humanity has suffered these blows against its mastery, the more we know the more we realise that we are in the thrall of things beyond dust.

NIKOLAS ROSE

So the more we know the more we know we don't know.  I think that's a lesson in humility for our scientists who for all sorts of reasons are often induced to make overstated claims about what they do know and often as we saw with genetics, proven not to be the case.  So I think humility amongst the scientists is important but there's another thing about the Copernican and Freudian Revolution which since we're coming to the end of our time might be just worth mentioning.

The Copernican Revolution, I suppose the cliché is that it shows that the earth is not the centre of the universe.  The Freudian Revolution shows that consciousness is not the centre of the human being.  The Neuroscientific Revolution and indeed the revolution of the life sciences more generally shows that we are vital living creatures, that we don't really understand and we don't have conscious control over the way in which we act, the way in which we think, that so much of what we do that we think is a product of our consciousness and our will happens at a preconscious level.  And that's an important lesson in humility to us it seems, to me, to believe that the ego isn't the master in its own house and we are in some ways organisms like any other organism with a limited grasp over what it is that we do.


LYNNE HAULTAIN

Nikolas, earlier you mentioned risk.  Let's talk about the politics of risk.


NIKOLAS ROSE

So I think risk plays a huge part in our world in all sorts of different ways.  Risk historically was not always a bad thing.  The person that took the biggest risk was going to reap the biggest rewards and if you go back to the 18th century you can certainly see that case.  Risk capital is capital that you invest in order to get a return and so on and so forth.  We should be aware that risk does not always carry the negative connotations that it does.  However, I think probably over the last 40 or 50 years it's that negative sense of risk that has become so dominant in the way in which we think and risk goes a long with a kind of obligation to do something about the risk.  So to use the phrase made most famous by Ian Hacking, what is risk thinking?  Risk thinking is bringing the future into the present and making it calculable.  So you think about the future in the present, you calculate about that future and then you act in the present to do something to change that future.  That's Hacking's idea of risk thinking.

So risk, when you calculate a risk you have an obligation to act. And we see this in organisations, as soon as you risk assess something you must risk manage it and if you don't risk manage it you are held culpable for not having done that risk management.  So risk becomes an obligation for all those professionals and risk also becomes an obligation for individuals themselves who begin to think about their activities in terms of their risks, who begin to think about their futures in terms of risks and the way in which they must insure themselves against those risks.  The prudent individual is the one who thinks about their future, thinks about their old age, thinks about unemployment, thinks about illness and takes steps now in order to guard against those things that are possibly going to happen in the future.

One of the characteristics of current social and political environment is that we've moved from a situation when our state and our welfare system and our social insurance system tried to manage those risks for us into a situation where increasingly we together with professional advisors have to manage those risks for ourselves, and if we don't manage the risks, if we're kind of imprudent then we carry the consequences of it, you know.  It's a personal responsibility so risk and responsibility go very much closely together.


LYNNE HAULTAIN

We also see this played out in legal and commercial contexts where the liability applies to big tobacco or to burger chains that might cause your Diabetes 2, that sort of stuff, so that becomes critical to public health.


NIKOLAS ROSE

Absolutely.  I think it's undoubtedly a good thing that organisations, especially those that produce tobacco and alcohol and so on should be required to think about the risks that are generated by their products and take steps either to insure against them or to secure or compensate those persons who have been injured by those risks.  And the same is true of pharmaceutical companies as well.  We know the debates and we know the way in which they have worked out.  There's a downside to that of course which is that, in particular in pharmaceutical companies, if they become very risk averse, if they recognise that one drug that goes wrong with a small group of people is enough really to wreck the profitability of that enterprise, since we live in a capitalist society a risk averse pharmaceutical industry is one that's not going to engage in a lot of innovation precisely for those kinds of reasons.

So there's that kind of risk and then there's the risk that individuals feel they have to try and understand in relation to their illness.  So genetic risk profiling for instance, are you at risk of heart disease, are you at risk of a stroke, are you at risk of not being able to have a healthy child?  So risk, bringing the future into the present and making it calculable often requires you to act in the present as if the worst was going to happen and take all sorts of steps in the present to avert that.  And we see, talk about pharmaceuticals, the most highly selling pharmaceuticals are not those that treat illness, they're those that treat risk because risk is illimitable.  The empire of risk is illimitable so we take statins and we take drugs to lower our blood pressure, we perhaps even take a little half aspirin or something like that.  In other words we take drugs not to treat illnesses but to treat risk.

So there's something I think intriguing about the rise of this empire of risk and the other side of that of course is that people find it quite hard to calculate risk, to calculate probabilities.  If you say your risk of getting a heart attack is 20 per cent above that of the general population, what does that mean?  You have to understand what the risk is in the general population.  The risk of getting a heart attack in the general population is one in a hundred then your risk is probably, if you've got a 20 per cent elevated risk, your risk is one in 80.

It's quite difficult to calculate those probabilities and I think that's a challenge for our educators but my interest is the way in which this proliferating obligation to think about risk and to take prudent steps to secure yourself against risk in the future and increasingly that move to say the person or the actor who has to secure against risk is not a collective securing itself against risks with social insurance, it's you and your family and your responsibility working with private organisations advised by all sorts of experts to manage your own risk.  And if you don't manage your own risk, if you don't take steps whether it's not eating too much fatty food, not smoking, not drinking too much alcohol, if you are an imprudent individual then in some way or other you deserve what fate has given to you.

So yes, risk thinking is highly pervasive, it shapes individuals, it shapes the gaze of experts.  I've looked a lot at psychiatry and psychiatry has become increasingly a discipline concerned with the management of risk in the population that it treats.  Everybody is risk assessed, everybody is risk managed and the way in which the individual is treated depends upon their level of risk.


LYNNE HAULTAIN

Nikolas, thank you so much for joining us on Up Close.  It's been a pleasure having you with us.


NIKOLAS ROSE

Thanks for having me on your program.


LYNNE HAULTAIN

I've been talking about how we understand the human condition through biology, history and sociology with Professor Nikolas Rose who's Head of the Department of Social Science Health and Medicine at Kings College London and the author of many books including The Politics of Life Itself, Biomedicine, Power and Subjectivity in the 21st Century and Governing the Present with Peter Miller.  You'll find more details of his publications on the Up Close website together with a full transcript of this and all our other programs.

Up Close is a production of the University of Melbourne Australia created by Eric van Bemmel and Kelvin Param.  This episode was recorded on 28 August 2014 and was produced by Kelvin Param and Eric van Bemmel with audio engineering by Gavin Nebauer.  I'm Lynne Haultain.  Thanks for listening and I hope you can join us again soon.


VOICEOVER

You've been listening to Up Close.  We're also on Twitter and Facebook.  For more information visit upclose.unimelb.edu.au.  Copyright 2014, the University of Melbourne.


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