Value and Reform

I'd like to respond to Bryan Palmer's concept of reform in relation
to a theorized dichotomy of theory and practice. According to Bryan, a
theortetical approach is tangential to his position as a policy maker,
because it is in the actual application of a political practice with which
he is concerned, as opposed to wider, "formal" philosophical speculation.
(I introduced the term "nihilism" into this debate not from a belief in any
"value relativism," but in response to Bryan's questions of "why not rape?"
and "why not murder?": it's always surprising to see a lack of morality
proposed precisely in terms of what the moral code forbids -- the
intensification of the moral domain that is theorized as absent).
Since Bryan would, by defintion, like to see a reform in the field
of his political practice, his determination of Foucault's work as books of
reform is commensurate with his beliefs and his practice. I would hold,
however, that this contention is false: a theoretical ideology underlying a
political practice. _D&P_ is not about penal reform: it is about the way
penal reform has led to the entrenchment and dissemination of penal
technologies throught our society; _BoC_ is hardly about medical reform, but
innovations in clinical theory.
Since my background is in the life sciences, and my avocation is the
history of the life sciences, I'll constrain myself to the medical field.
(It's disquieting that in a forum devoted to Foucault, we see so much
commentary on Foucault -- the unsaid said more profoundly then what is said
in the texts -- and a wide application of "Foucauldian" theories that were
developped in very narrow fields, rather than a practice of geneaology and a
reading of archives.) Reform is itself a historical category: in 1793,
Phillipe Pinel suggested, in _The Clinical Training of Doctors_, a less
famous reform of hospital practice, involving the treatment and care of
patients, based upon nosological principles. X. Bichat's response is famous:

"How weak appears the reasoning of many great physicians, when we examine
it, not in their works, but on the dead body....What is observation worth,
if we are ignorant of the seat of the disease? Your may take notes, for
twenty years, from morning to night at the bedside of the sick...which, not
being united in one point, will necessarily present only a train of
incoherent phenomena. Open a few bodies, this obscurity will soon
disappear, which observation alone would never have been able to have
dissipated." (Introduction, _General Anatomy_).

By contrast, it is enlightening to read Pinel's _Treatise on
Insanity_ in comparison with the DSM IIIr or IV: between the two, there is
not a change in knowledge, only an intensification -- here, at least, Pinel
is our contemporary. The DSM or psychiatric _Diagnostic and Statistical
Manual_ , for those who might not have read it, is a fascninating document:
the clinical specification of psychiatric illness without prescrptive
intention, though the necessary basis of all pharmacological prescription
because a clinical diagnosis, though only nosological, is necessarily
anterior to any action. A description of clinical depression must be made
before a tricyclic or MAO inhibitor can be given.
_The Birth of the Clinic_ describes mutations in knowledge leading,
from Bichat, to the positive definition and treatment of disease -- who
would deny the frayed glory of antibiotics? Conversely, _Madness and
Civilization_ , for example, discusses the role of humanism and reform in
the determination of the inhumane.

Michael Santos

A norm cannot be normative without being militant, that is, intolerant. In
intolerance, in aggressive normativity, there is of course hatred, but in
tolerance there is contempt. Values tolerate what they deem to be
valueless. -- Georges Canguilhem


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