The Politics of Care: From Biomedical Transformation to Narrative Vulnerability

The fact that illness creates vulnerability is taken for granted. In this chapter, however, I consider whether a biomedical intervention that ‘rescues’ a person from illness or disability necessarily reduces vulnerability. Biomedical intervention transforms a life story and so renders an ongoing identity narrative (temporarily) unusable; in doing so it generates forms of narrative vulnerability. This can be particularly damaging in situations when a new identity narrative is not readily available – if the intervention is very novel, for example. When biomedical interventions transform the lives of chronically ill or disabled people they alter identities as well as health status, and against the more tangible vulnerabilities of illness and impairment, narrative vulnerability is easily overlooked. Working from a personal example of dramatic and persisting narrative vulnerability following catastrophic organ failure and transplantation, I explore some of the consequences for patients and providers of care.

Bodies that Still Matter

This chapter starts with an obvious presupposition: no body can sustain itself on its own. The body is not a self-subsisting kind of being; it is, rather, given over to others in order to persist. What does it mean to be “given over” to others, and to have this as a constitutive feature of embodied life? It may be that we require care, or that we are vulnerable in a way that cannot be overcome. How do these two terms work in relation to embodied lives that encounter unlivable situations as a result of unaddressed exposure or infrastructural failures of care? The bodies that assemble to object to unlivable conditions make certain kinds of demands. How do we understand the form and aim of such demands on the part of bodies that require support, address, and conditions for persistence? This chapter seeks to show that the kind of claim bodies make on politics follows from the radical lack of self-sufficiency that characterizes bodies more generally. The lack of self-sufficiency is not a political problem, but politics emerges precisely when the social organization of what Marx called “basic requirements” consistently fail and “basic requirements” begin to make their claim on the broader social and political world.

Vulnerable Civilians: Coalition Checkpoints and the Perception of Hostile Intent

This chapter examines civilian casualties at coalition checkpoints in Afghanistan and Iraq, focusing on the decision to use lethal force against individuals considered to be hostile. Drawing on the testimony of American soldiers, this chapter argues that the decision to use lethal force can be seen as an affective judgement, with soldiers often resorting to ‘muscle memory’ as they sought to identify potential threats amidst the chaos and confusion of war. It will argue that these affective judgements do not occur within a cultural vacuum but are animated and informed by a set of background assumptions that mark certain populations as dangerous, threatening and hostile before they even arrive on the scene. To understand what made civilians so vulnerable to death and injury at coalition checkpoints, it will be necessary to inquire into the affective schemes of intelligibility that render certain lives disposable and certain bodies profoundly injurable in war.

Revealed in the Wound: Medical Care and the Ecologies of War in Post-Occupation Iraq

Decades of war and western interventions in Iraq have produced toxic legacies of wounding and affliction that have redefined geographies and everyday experiences of vulnerability and care. Building on what I call anthropology of wounding, I explore a number of methodological insights related to conducting ethnographic research on war injury across conflict landscapes in the Middle East. Taking the “wound” as a method, I explore what is “revealed” in such wounds as they map the incongruent trajectories, terrains and relations of vulnerability and care in everyday life. Anchoring my analysis in a deeper understanding of the changing ecologies of war, I show how an anthropology of wounding further unravels the biosocial relations of distress and care, and provides a deeper understanding of the lived experiences of war and the body, as well as the inscription of a history of war in the molecular and genetic makeup of the environment.

Vulnerability as Relational: Cash and Care for Elderly Ik in Uganda

Based on fieldwork among the elderly in the Ik community in Northern Uganda, this chapter argues that the two apparently opposite concepts of vulnerability and human security are closely related in the sense that both phenomena fundamentally hinge on other people. Elderly Ik are often very vulnerable and dependent on family care. Cash transfers for elderly people are a mixed blessing in this overall fragile context of poverty and insecurity because the balance in intimate generational interdependence changes and this often creates friction in families. Following the cases of two elderly Ik who receive cash transfers, and the effect these have in their families, the chapter argues for relationality as a starting point for understanding vulnerability and human security.

‘It Rips You to Bits!’: Woundedness and Compassion in Carers’ Narratives

To be vulnerable is not only to be open and exposed to the world, but in some sense to be wounded by it. As Arthur Frank (1995) observed, these wounds won through adversity call out for stories. For those who provide care to others, these stories are rarely singular or coherent, but throb and ache again as each day bringsa new flavour and flux. While vulnerable narratives expose the self to the world, they also provide a basis for responding to that world with attentive presence. I use the word ‘compassion’ to refer to this receptive engagement and caring responsiveness to suffering, arguing that cultural stories shape the ways vulnerable compassionate subjectivities are formed. In order to illustrate this cultural shaping of woundedness and compassion, I examine the narratives of carers of older family members in Japan and England. Ethnographic examples reveal the ways individuals develop vulnerable narratives and the ways these narratives are constrained by cultural and political circumstances.

Decolonial Feminism and Global Politics: Border Thinking and Vulnerability as a Knowing Otherwise

Decolonial thinking has introduced border thinking as an epistemological position that contributes to a shift in the forms of knowing in which the world is thought from the concrete incarnated experiences of colonial difference and the wounds left. In this chapter, Argentinean feminist philosopher Maria Lugones’ (1992) interpretation of Gloria Anzaldua’s Borderlands foregrounds its main argument: border thinking as an embodied consciousness in which dualities and vulnerability are central for a decolonisation of how we think about the geo and body politics of knowledge, coloniality, political economy and of course, gender in International Relations and Global Politics.

Vulnerability and the Politics of Care: Transdisciplinary Dialogues

This chapter introduces the linked concepts of vulnerability, politics and care, considering how all three have developed in distinctive ways within and across different disciplines in the humanities and social sciences, and their complex relation to one another. Concentrating on philosophy, anthropology and international relations, we review the major theoretical contributions to the study of vulnerability and care that have emerged out of work on precarity, feminism, and the ethics of care. We then propose a transdisciplinary approach to vulnerability that places various concepts and methodologies in closer dialogue with each other. These dialogues form the basis of the four sections of the book, each of which is briefly described with reference to the chapters.

On the Condition of Being Open

[T] here are others out there on whom my life depends, people I do not know and may never know. This fundamental dependency on anonymous others is not a condition that I can will away. No security measure will foreclose this dependency; no violent act of sovereignty will rid the world of this fact....

The Problems and Potentials of Vulnerability

The discourse on vulnerability has been beset by criticism. This chapter argues that the account of vulnerability best suited to address these problems is one that places the ambiguities of the concept at its center. Foregrounding vulnerability’s ambiguity makes it possible both to do justice to the complexity and diversity of experiences of vulnerability, and to provide a sufficiently theoretically complex and nuanced concept. The chapter focuses on three aspects of vulnerability in order to respond to this criticism: the attribution of commonness to vulnerability and the contrast between a universal, ontological notion of vulnerability and a situational one; vulnerability’s connection to affect; and vulnerability’s relationship to social identity, inequality, and oppression. In the final section, the claim that understanding vulnerability as ambiguous best captures its simultaneously political and ethical salience is applied through analysis of two recent assertions of vulnerability in US immigration politics.