The operations of the familial body: genes, family and hereditary cancer

Abstract

This thesis examines the experiences of 47 Australian and American women who have been tested for BRCA1- and BRCA2-associated hereditary breast and ovarian cancer syndrome. Existing anthropological approaches to hereditary breast and ovarian cancer syndrome assert a stern analytic division between biomedical and genetic, and familial relatedness. By asserting the primacy of the individual, these approaches attempt to rescue the socially connected at-risk woman who chooses her relations with others affectively, from the genetic sequence that dictates her relations with others medically. This figure of the ‘individual’ is anthropologically considered to organise socially significant others according to either selfish or selfless motives: she may selfishly have children despite the risk of cancer she confers, or selflessly hold back her reproductive desires. These difficult emotional decisions, it is anthropologically asserted, are obscured by a medical world that dictates genetic relatedness. But, as I show in this thesis, analyses that sharply contrast genetic and social forms of relatedness prevent us from seeing their shared basis in, simultaneously, partiality and collectivity.

Rather than taking up the familiar combative anthropological stance in which the biomedical and the social are sharply contrasted, I take my cue from a basic principle of genetic inheritance. Genes challenge the discrete boundedness of the body: each person makes partial genetic contributions which, in concert with the partial contributions of others, yield the genetic collective that is ‘me.’ Just as persons are the collective product of partial contributions of others, so too is the social institution of the family. The family is a sociality made and maintained in fleshy relations between parts of bodies that together create a familial collective. Taking the notions of partiality and collectivity that are found in both genetic and social worlds of cancer as key motifs, I offer up a new analysis of precancerous lives. Instead of seeing at-risk women who act as bounded individuals – either selfishly or selflessly – I focus on the precancerous parts of women’s bodies that threaten to disrupt familial collectivities. Such an analysis tells us much about the importance of particular body parts to the intercorporeal sociality of the family, how critical it is that those parts remain reliably there, however unreflexively considered they might usually be, and how wrenching it is to have to remove parts critical to the making and maintenance of the family to remain in it as a living presence. Show more