Surgical citizenship and ethical subjects : reconstructing the body politic in Mexico

Abstract

This thesis presents the concepts of surgical citizenship and ethical subjects to characterise two mutually constituting modes of political life based largely on epistemic regimes and practices. "Surgical Citizenship" refers to the performance of citizenship in the production and negotiation of particular bioscientific scenarios by "ethical subjects." The concept of "ethical subjects" speaks to the self-monitoring surgical citizen who acts in accordance with national interests of health and progress especially in, but not limited to, situations where the reach of the State is otherwise limited.

Rather than attempt to provide a holistic or representational account of reconstructive surgery in Mexico, I take reconstructive surgery as a topic and Mexico as a geographic locale from which to launch an anthropology of ethics that highlights the relation between science and citizenship. To do this, I bring together work from the anthropology of science and medicine with recent, politically focused scholarship from Science and Technology Studies (STS).

The imaginations of my interlocutors - physicians, patients, politicians - were coproduced by real and perceived inadequacies of the Mexican State, the epistemic and empirical contexts in which they work, and the professional ethic of reconstructive surgery with its related imperatives. Futuristic fantasies of a modern democratic nation have long held a place in the Mexican national imaginary. The national present is often deemed chaotic, uncertain, and undisciplined. In reconstructing the bodies of patients surgeons simultaneously reconstruct fractures within Mexican political life. The clinic becomes a microcosm of the nation. Patients are coded as national subjects and their bodies become symptomatic markers of a society diagnosed by local surgeons as having a lack of control and a deficiency in discipline. They too are involved in the reproduction of the body politic. Patients and their families are encouraged to manage themselves in a certain way, one that involves negotiating various truth claims, bureaucratic regimes, and both emotional and physical pain.

This thesis contributes to previous scholarship by demonstrating how issues of ethics exist in both the mundane and the extraordinary, are reconfigured in international collaborations that blur and buttress borders, and shape the lived experience of patients and plastic surgeons. Show more