Ethics, Embodiment Re/Production and the Lifecourse

Written following a symposium I was involved in organising, held on June 6th 2014 at the University of Edinburgh.

“[B]ioethics is out of touch. It is out of touch with bodies themselves” (Shildrick 2005; p. 2)

Feminist theorists such as Margrit Shildrick have been prominent in critiquing bioethical discussions which take for granted bodies and embodiment. In Ethics of the Body: Postconventional Challenges, an edited collection by Shildrick and Mykitiuk, this is explored via papers addressing a range of topics which both invoke bioethical engagement, but also unsettle and question notions of embodiment and what bodies are. For me, the book has been a useful and enduring resource, since different chapters within it address areas of empirical research or teaching I’ve been involved in: addictions (Helen Keane), mental health (Nancy Potter), disability (Jackie Leach Scully), and sex/gender (Katrina Roen).

On 5th June 2014, a symposium, Ethics, Embodiment, Re/Production and the Lifecourse, at the University of Edinburgh, interrogated questions about the relationship, and potential for mutual collaboration between, theories of embodiment and bioethics. The symposium was part of a Wellcome Trust strategic award, The Human Body, its Scope, Limits and Future, on which Sarah Cunningham-Burley, my co-organiser, is co-investigator.

What can theoretical work on embodiment contribute to discussions about the ethical implications of biomedical innovations? What can bioethics contribute to theoretical work on embodiment?

The focus of the symposium on re/production and the lifecourse reflected an attempt to look at embodiment and ethics in terms of reproduction, and especially the challenges raised by new reproductive technologies, but also to consider how biomedicine increasingly works across the lifecourse to produce different types of bodies. Such biomedical innovations and interventions raise significant ethical questions. They also raise important questions about the nature of bodies and embodiment.

My own interest in embodiment and bioethics, and what the two might contribute to one another, led from work I undertook during a postdoctoral fellowship at IASH (Institute for Advanced Studies in the Humanities). While there I was working broadly on ethics and self-harm, but I focused especially on exploring the ways that academic discourse about the ethics of treating self-harm addressed embodiment. Perhaps unsurprisingly, most of what I found, which was itself limited, tended not to engage much with self-harm as an embodied practice. Indeed, this is reflective of the vast majority of academic work on self-harm – it tends to gloss over the messy, lived, corporeal aspects of being or caring for someone who self-harms.

The relative lack of engagement in (some) bioethical work with embodiment, and especially fleshy, lived bodies, was raised by many of the speakers who contributed to the symposium. I’ll be writing a more detailed blog and report of the day; but here is a brief overview of the speakers and their talks:

Session 1: Reproduction, ethics and embodiment

  • Elizabeth Ettorre, opened the day sketching out the need for an embodied ethics, which is open to and engages with bodily, embodied diversity; is empathic; and attends to embodied emotions as a part of ethical reflection.
  • Danielle Griffiths followed, taking an embodied perspective to ethical debates about new reproductive technologies; particularly those that have been proposed but not yet realised: male pregnancy and ectogenesis.

Session 2: Ethics, medicine and disabled bodies

  • The second session addressed disability and medical treatments or ‘fixes’. Fadhila Mazanderani discussed the role of patient’s embodied experiences in guiding their decision making regarding controversial treatments for MS; contrasting this type of evidence with, for example, Randomised Control Trials that are often prized in clinical decision making.
  • Jackie Leach Scully raised a series of provocative arguments regarding the development, use and representation of prosthetics. She suggested that the use of prosthetics contributes to the normalisation of certain types of disabled body; and the marginalisation of others.

Session 3: Biomedical innovations and enhancements

  • Next, Gill Haddow addressed a different type of assistive device (ICDs), though this one designed to prolong/extend/save life; discussing the embodied and relational consequences of being a ‘cyborg’.
  • Finally, Sarah Chan addressed bioethical debates about enhancement, using this discussion to problematize dominant bioethical discourse about normality, especially as applied to gender and disability.

The third session was also to have included a paper from Anne Kerr, discussing body work and emotional labour in biomedical innovation. Anne couldn’t present on the day unfortunately, but her paper would have been a great addition.

There were a number of common themes and threads running throughout the day, which I need more time to think about in order to do them justice. What was very clear was that there is a great deal of scope for further work which engages with bioethics and embodiment, especially when this explicitly includes attention to emotions.

References

Shildrick, M. (2005), ‘Beyond the Body of Bioethics: Challenging the Conventions’, in Shildrick, M. and Mykitiuk, R. (eds.), Ethics of the Body: Postconventional Challenges, London, MIT Press.

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Self-injury and embodied emotions

This is a slightly edited version of the first blog I ever did, reproduced from CRFR’s blog, which you can see here. This post was originally posted in 2012, when the first article from my PhD research on self-harm was published in the BSA journal: Sociology.

Self-injury is an under-theorised and little understood behaviour, despite reports that rates of self-injury are on the increase. Measuring the prevalence of self-injury is notoriously difficult: the number of people who present at a hospital reporting self-harm and self-injury are only a small proportion of all cases. Studies that have sought to measure prevalence have tended to focus on adolescent groups, and to date, there is no data on the incidence of self-injury and self-harm among the general adult population in the UK.

This blog on self-injury and emotions, is based on an article published in 2012, in Sociology.

Self-injury is usually studied from a clinical perspective: however, sociological approaches have the potential to greatly improve understandings of the practice. Recognising the emotional aspects of doing self-injury or understanding more about the societal and life factors that might lead someone to injure themselves can be an important way of exploring self-harm. Such approaches challenge some clinical psychological and psychiatric perspectives which tend to frame self-injury as ‘a problem’ located within the individual.

I undertook research to explore the ‘lived experience’ of self-injury, gathering the life stories of 12 people who had self-injured. People involved in the study were identified from non-clinical community sites, to increase the chances of including people who had not engaged with formal support services. Participants were aged between 21 and 37 years old from mixed backgrounds, although the majority were studying for, or had gained, higher educational qualifications.

Self-injury was defined as the cutting, burning or hitting the outside of the body, resulting, in most cases, in visible, lasting and sometimes permanent marks on the skin. As part of the study people frequently explored the reasons they had self-injured and, in most cases, they referred to how it enabled them to ‘work on’ their emotions through their body:

Control and Release: Release, relief and control were used by many participants when describing their self-injury. For some it allowed them to regain ‘control’ over their emotions, and their lives, while for others it was about controlling otherwise uncontrollable feelings.

“when the situation seems to spiral and I’m whooo losing it. Em and it was like right, regain control, this is what I’m gonna do, I’m going to cut myself…and it’s like, releasing something…and then when that whatever it is is released then your sortie regaining control…” (Anna)

Participants in the research suggested that when they felt they had little or no control over their body or life, control enacted through self-injury could be experienced positively. These explanations for self-injury reflect tensions between being ‘in control’ whilst at the same time needing to have a ‘release’. Similar language is used when people describe other embodied practices such as drinking, smoking and exercising.

Eliciting or Creating Emotions: Others suggested that they had used self-injury to bring out emotions that were ‘missing’. Self-injury in these cases generated a feeling of ‘something’ in response to ‘emotional numbness’:

“I wasn’t pretending that I wasn’t upset but I would just, I wasn’t letting people to know I was upset, if you see what I mean…I wanted to be able to feel I wanted to, you know, live or experience stuff, or… and so, self-harming was, you know a way of, feeling, pain, you know feeling pain ‘cos it was something.” (Francis)

In contrast, some participants talked about self-injury generating positive feelings:

“I think the first time it was associated with kind of a rush and, and a buzz.” (Justin)

These accounts, by indicating that ‘work’ is done on the emotions, through the body, demonstrate the interconnected nature of mind and body, challenging idea that they are, or could ever be, separate.

Reference to the article below, and clicking will take you to the article itself. A pre-pubulication version is available via my academia.edu profile. The research was supported by an ESRC funded PhD studentship, at the University of Edinburgh (2005-2010).

Chandler, A., (2012) Self-injury as Embodied Emotion Work: Managing Rationality, Emotions and Bodies, Sociology, 46 (3).