The Challenge of Biological Citizenship and the Role of Civil Society Organizations: A Framework for the Analysis

Contemporary Western  healthcare systems are in a transitional phase,  because they are experimenting a structural change of their nature.  The first level of implication is concerned with the transformation of health concern into what has been defined as “healthism”: it entails considering health as solely an individual matter, and a fundamental moral value. By elevating health to a primary value, a metaphor for all that is good in life, healthism reinforces the privatization of the struggle for wellbeing and the broader historical trends progressively shaping the “healthist society” in the neoliberal globalization era.

This normalization and responsibility process goes well beyond the boundaries of medicine and of the regulation of bodies (and minds, in the case of psychiatry): the biopolitics of the populations becomes a discourse and a practice about how subjects are conceived as good and “normal” citizens. This changing function of the healthcare system as institutions of social control through norms of health and practices of health education increasingly involving corporality as source of social identity, rights and obligations can be described as “biological citizenship”. It is a field made up by new technologies which intervene upon the body at various levels, from the more superficial one of cosmetic surgery to the deeper of embryo selection and gene therapy.

However, we should consider biological citizenship as an ambivalent process: in fact, we can talk of an “active biological citizenship” as opposed to the merely passive one imposed from above: in fact, there is growing evidence of the importance of patients’ associations, disease advocacy organizations, and self-help groups giving rise to new forms of subjectivation and collective action. These new kind of civil society organizations focus on the extension of rights, on the emergence of new possibilities of participation, and the choice-enhancing options of the new healthcare technologies.