Tuesday, December 22, 2020

Sara Rushing's "The Virtues of Vulnerability"

Sara Rushing is an Associate Professor of Political Science at Montana State University, Bozeman, and Co-President of the Association for Political Theory from 2020-2022.

She applied the “Page 99 Test” to her new book, The Virtues of Vulnerability: Humility, Autonomy, and Citizen-Subjectivity, and reported the following:
From page 99:
While hospice, like homebirth, can be figured as a site of “systems-challenging praxis”—a space of resistance to the managerial hyper-interventionism of mainstream medicine, and the biopolitical imperative to maximize life at all costs—it is still not a domain of total choice and control. If within the mainstream medical approach to death and dying conversations about “the good death” are largely absent, within hospice they are thoroughly present and often carry a clear message about what a good death entails. These normative commitments include personal growth toward death, making peace with life and its end, resolving lingering familial tensions, and, importantly, allowing death to follow its own natural course. Overwhelmingly (since only about seventeen jurisdictions globally allow for PAD [physician assisted dying], including, in the United States, eight states and the District of Columbia), the timely death as conceptualized within the hospice framework is the one the body “chooses.” Talk of accelerated or assisted dying can be regarded as a sign of depression that must be treated in order for one to achieve a good death, not an expression of rational clarity or agency by the dying.
If someone picked up my book and randomly flipped to page 99, they would be thrust deep into a vocabulary I’d been building over the past 98 pages (the body; systems-challenging praxis; medical hyper-interventionism; choice and control…). They would encounter this vocabulary in the context of the second “bodily” site the book explores: death and dying, particularly as it shapes up within hospice care, versus in the ICU or other very medicalized hospital locales. The page also references the first site I explore: childbirth, particularly as it shapes up under midwifery care, versus in the labor and delivery department of a hospital, where 33% of women end up birthing surgically.

As a proxy for the book as a whole, this page does alright! What I think it does not capture – which a reader of the whole might be delighted by, or might feel was more than they bargained for based on page 99 – is the broader political theory framework that drives my overall analysis of these sites of bodily vulnerability. There are lots of books one might read on birth, death, and illness (the last of which, in my book, is explored in the context of veterans seeking treatment for combat-related PTSD within the Veterans Affairs Mental Health medical complex). But my distinct approach is to see these moments of contact with the medical-legal-policy-insurance nexus (i.e. “the clinic,” or what the sociologist Wendy Simonds has called “Hospital Land, USA”) as sites of political awakening where a new subjectivity may be formed, which I characterize specifically in terms of “citizenship.” By citizenship I do not mean legal status or voting, but rather a sense of oneself as desiring and deserving participatory inclusion (power, knowledge, voice, agency) in the decisions that affect one’s life. Big picture, I take our very human quest for autonomy seriously, but argue that it has to be paired with a certain kind of humility. I use these contexts of vulnerability in bodily encounters with medicine/medicalization to explore the limits of our self-determination as “Rational, Autonomous Individuals (a story that breaks down all the time in our lived experience), but also the way that autonomy can be cultivated in these contexts, when they are relational, supportive, and entail mutual humility between patient and doctor.
Learn more about The Virtues of Vulnerability at the Oxford University Press website.

--Marshal Zeringue