Narratives of Neoliberalism: Clinical Labour in Context

William Viney writes – This is the fourth of five posts introducing individual papers from a special issue of Medical Humanities, edited by myself, Felicity Callard, and Angela Woods. A more general overview of the special issue can be found here.

Recent research in the medical humanities has stressed the embodied nature of experience, and this is often used as a way to counteract the numerical abstractions of the Western scientific imagination. This collection is cautious about these dichotomous engagements with scientific methods of inquiry and, more broadly, is keen to stretch conceptions of embodiment to accommodate the various ways that the human body can now be fragmented into discrete, commoditised units, and globally trafficked for profit. Tissues, organs, cells, DNA – all can be extracted, adapted, graded, disembodied and re-embodied. Bronwyn Parry’s discussion of donors and surrogates in fertility treatments reflects on a particular aspect of this corporeal segregation and commercialisation. Her article serves as an important reminder that a strong critique of neoliberal economics, which some argue coordinates new kinds of commercial exploitation, can risk ignoring the local cultural practices, material realities, motivations, and experiences of clinical labourers. To show how clinical labour is not a homogenous category, Parry compares the living conditions of sperm donors in California and oocyte and sperm donors from Mumbai. There are important differences in terms of security, wealth and motivation between these two locations, and yet these distinctions are lost in those analyses that are focused solely at on systemic level or eager to stress the common victimhood of its protagonists. Moreover, where a critique of neoliberalism might expect to find impersonal forms of deregulation, contractualisation, and internationalization in the clinics of Mumbai, Parry found a complex web of intermediaries, kin relations, gifting practices, and institutions eager to embrace regulation.

Parry’s article carries important lessons for critical medical humanities scholarship: becoming critical of and developing a set of activist positions against a newly emerging clinical practice, especially if this practice is unevenly distributed on a global scale, does not necessitate a zero-sum game between argumentative force and explanatory detail. What Parry’s ethnographically informed article highlights is the importance of local experience and styles of organisation, and how modern economies foster emerging, medical practices in concert with older, longer-standing histories of social practice, uneven development and social inequality. The task of scholarship in this area is not to anticipate and reproduce a grand narrative of undifferentiated exploitation. As Luna Dolezal explores in her response to Parry’s article, ‘pregnancy, as a gendered, existential and phenomenological experience’ is especially important to delineate given the ‘tendency to efface, or render irrelevant, women’s subjectivity in reproduction.’ The task, therefore, is to understand how clinical experience and capitalist enterprise, such as that of being a clinical donor or surrogate, develop within specific localities, through different and specific types of bodies.

Parry’s paper is available for free download and you can read the full introductory paper, too; both are available Open Access.

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