Science, technology, medicine and the socialist movement by The Radical Science Journal Collective

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The Embodiment of Values
We want to move on to writing about how science and technology are constituted by historical forces. A phrase which may appear cryptic at first has helped us to grasp this: technology, science and medicine are the embodiments of values. 'Advanced' societies have searched for so long for certainties through the study of the embodiment itself — the Baconian 'light and fruit' — that they have lost sight of what knowledge is the embodiment of. The artefacts of technology, the medicines, procedures and regimes of medicine; the 'findings', theories and metaphysical foundations of science — all are derived from purposive endeavours which are historically specific. They are assigned by this R&D department, that industrially-induced lung disease, and the other framing of the manifold of nature as 'code' or 'information', as in the case of molecular biology. At a deeper level. individualism evokes individualist transport and leads to the internal combustion engine as the appropriate power source for automobiles. Another example: greater expenditure on fixed capital, e.g., in large cotton mills, requires constant running of machines to secure an adequate return on investment. This calls forth the need for reliable attendance, shift work and a fit workforce — which can be aided by better nutrition and public health. Science helps by searching out the role of micro-organisms in acute, debilitating infections. When much has been learned about the germs, the treatment of war wounds accelerates the development of a range of antibiotics. The model becomes: discrete disease, single causes, specific cures. Each of these connections is, of course, only part of a wide network of determinations, setting limits, exerting pressures within a manifold of social/natural alternatives, giving direction to developments which — in the last instance — are determined by the 'production and reproduction of real life' (Engels' phrase, Marx and Engels, Selected Correspondence, p.417). This is structured in ways based on the social relationships of the mode of production in a particular period of history.
In other periods the need for reliable navigation, the development of chemical dyes, the problems of illumination and portable sources of power and then of fuel for diesel and petrol engines, and of information transfer and storage have engendered — successively — developments in astronomy and horology, chemistry and electricity, petroleum geology and petrochemistry, electronics and solid state physics, culminating in the recent developments of microprocessors, genetic engineering and biotechnology.
Of course, an atom is an atom and an electron an electron, and the enduring findings and theories of science are true. 'Truth', however, does not obviate the 'fact' that researchers formulate their questions and set criteria for acceptable answers in terms which express the values and priorities of a given epoch and its ruling elite. Truth, then, is a practical construct from human labour. The search for particular units of matter and the effort to build apparatuses whose movements of electrons make this or that current or this or that molecule is an effort to embody particular values in the service of particular social relations. Nature is framed: we have no access to it in a primordial state of innocence.
Finally, at the deepest level, the metaphysical foundations of modern science are the embodiment of the deepest assumptions of the mode of production, selected from among various ontological and epistemological positions in a wide-ranging debate during the 16th and 17th centuries.[9] We have for too long had our gaze diverted from the struggle over values to the problem of the epistemological status of their embodiments. And while we are making sure that our readers don't find it easy to caricature our position, we should add that we do not mean to underestimate the recalcitrance of things, fixed capital and existing knowledge. Our intention, on the contrary, is to show how difficult it is to change 'the way things are', at the same time that we show that they aren't merely things.
Since the argument of this section may strike readers as abstruse, we offer two examples — one from technology, one from medicine. A simple example of how technology embodies values is the automobile. Its design incorporates a set of assumptions about the size of groups in which people travel, the variability of destinations (and the articulation of that tremendous flexibility with living patterns and road networks), the safety parameters of travel, the cost and availability of energy resources. A reconstitution of transportation might vary the size and safety levels, the risks we are prepared for people to take to obtain fuel (e.g., North Sea platform workers and divers) or brake linings (e.g., asbestos, see below). The amount of pollution is already being controlled in some countries, requiring significant changes in design and involving some very sophisticated technologies in exhaust systems.
An entirely different aspect concerns power in many senses of the word. A driver can now express his/her aggression and competitiveness through control over a powerful instrument by putting the accelerator on the floor, racing through the gears and leaving rubber on the road. A reconstituted technology might have built-in monitoring devices to control acceleration, gear selection and speed in order that safety and fuel economy should come before expression of ego. The technology could be constituted differently to embody different values. The properties selected from the manifold of nature would be different ones, serving different ends. Alternatively, the society — workers — might decide not to have automobiles at all and, instead, make a decent public transportation system and divert resources toward, say, track hovercrafts, road-rail vehicles, kidney machines and/or solar heating panels.
There is another aspect to this example of the car. Cars do embody the individualistic values of 'society', but 'society' in turn expresses the movements of capital in a way analogous to what we said above about the appearance of academic freedom and the reality of control. Just as science is organised, so too is the expression of individualism in transport. Machismo is marketed through the design, the advertising, even the name - Avenger, Jaguar, Fury, Firebird, Pinto, Mustang. National images differ: the VW called 'Golf' in Britain is called 'Rabbit' in America. Cars are also favoured as transport by hidden subsidies. While the railways come under close scrutiny because their subsidy is publicised and taken from tax revenue, the automobile industry enjoys the benefits of capital's private support (with injections of 'the taxpayers' money' in times of crisis, under the guise of pump-priming). Capital provides its meritocracy with tax-free perks to the extent that 70% of new car registrations are by private firms. The costs in pollution, accidents and disruption of communities by road schemes and traffic are paid not by private capital but by society at large. Society pays for all the costs of public transport, while capital appears to have provided a cheaper alternative. Overall, the individual choice to travel by car seems a rational choice in a free market, rather than a heavily subsidised, dangerous, costly embodiment of particular values.
In that example, we tried to move out from apparently technical matters such as the size of cars, the internal combustion engine, and the linkage between the throttle and the carburettor to much wider issues abut the expression and manipulation of personality in late capitalism and the relations between capitalism and transport policy. These issues include: who decides what products to make, how much to squander energy, pollute, despoil the environment and allow people to be killed in accidents (7000 a year in the UK).
Our next example also involves a number of contexts. Hilary and Steven Rose argued that our approach 'confuses the social determinants of a phenomenon for (sic) the phenomenon itself — it is not the social relations of the Hebden Bridge asbestos factory which penetrated the lungs of the workers, but the asbestos fibres. The asbestosis and the painful deaths of the workers are not merely social relations either (Roses, Socialist Register, p. 327). We would, of course, never want to be forced to choose analytically between the social determinants and the properties of asbestos fibres or to say anything as daft as that disease and death are ‘merely’ social relations. What we do want to argue is that thinking about asbestos and asbestosis in terms of values, social relations and practices — rather than strictly in terms of a substance with properties and a disease with symptoms — can help in understanding the hazards and in fighting them. Selection and framing from the manifold of nature led to particular criteria for which properties to seek and which substance to use for insulation and brake linings, for the conditions permissible in mining and processing it, for the 'safe level' of exposure to it, as well as for manufacturing and cleaning equipment, safety equipment and extractor fans, health and safety legislation and monitoring, the handling of data on lung dysfunction, etc. To isolate 'the phenomenon' of a fibre or its effect on lung tissue and to set these against all the rest is to create a dichotomy, whereas it is the organisation of the totality which is crucial. The same is true of dangerous pathogens, nuclear radiation, vinyl chloride monomer causing liver cancer in process workers (Clutterbuck); dioxin, the impurity in a herbicide causing chlorachne and birth defects in Seveso, Vietnam and elsewhere (Pomata); coal dust causing black lung ; noise, causing deafness (Fletcher); oil sprays (Dalton), lead in petrol (Peters) and the stresses of executive and domestic life, causing ulcers and depression (Schneider). We are not suggesting that a labour process perspective should simply displace either the traditional concentration on substances and diseases, the preoccupations of science's epistemology: 'objectivity' and 'scientificity'. Indeed, we will argue below that the British Left has been surprisingly silent about these issues and has failed to extend its critique of scientism into the privileged area of science itself. What we are proposing is a re-ordering of priorities around questions of knowledge production and a re-contextualisation of the epistemological issues. We think the labour process perspective is more likely to open up agitational possibilities where they were previously not apparent, no matter what the ultimate answer might be to the epistemological questions. In so far as the epistemological issues have a place, our view is that it should be in the context of 'science' as a set of practices, producing use values. We find such an approach more fruitful than bringing forward ever more elaborate analyses of the problems of perception and/or veridical knowledge. We situate problems of perception and knowledge within production. We also take this to be the point of Marx's 'Theses on Feuerbach', The Poverty of Philosophy, The Grundrisse, etc., as applied to the problem of knowledge (Schmidt).
If we take this new order of priorities seriously, i.e., if we think in terms of values and practices and social relations embodied in science and not in terms of reified knowledges, then we re-locate the epistemological aspect as a problem within concrete practices. In the case of asbestosis, this leads us to want to know how the disease appears within production. Production, in this case, means the practices by which asbestos is extracted and prepared for industrial use and by which it is fabricated into other products such as sheets of insulation and brake pads. But 'practices' must be taken in a broader sense as well. It includes taking it home and around the community on workers' clothes. It also includes the whole range of other practices by which its use becomes necessary and tolerable and by which danger is contained within a small group for the innocent 'benefit' of everyone else. (This sort of blinkering is characteristic of the relations between producers and consumers. Think of commonplace or precious commodities and then think of the lives and work and hazards of those who produce them: sugar, cocoa, tea, coffee, rush matting, silicon chips, slates, coal, oil, gold, diamonds.)
Here we have two sorts of practices — the material extraction/fabrication, and the fragmentation of labour processes — organised so that people do not perceive the real human cost of producing and using asbestos. Capital has constituted illness, especially occupational illness, in a particular form. This has been done through the mediation of medicine, insurance and factory legislation, especially the Workmen's Compensation Acts. All of these practices involve the production of knowledge. Karl Figlio has described the 'insurance mentality', by which he means the tendency to fragment illness into units of 'assessable risk'. Like machinery, human investments can be written off over a specified period, and the costs to capital of 'down-time' or premature write-off can be calculated and the risk can be insured against (Figlio, RSJ 10, pp. 49-51). This is true in everyday practice, in that companies can decide on the costs of risking their workforce and can transfer responsibility for health and illness onto those who fall ill by calling in an insurance assessor and fixing an acceptable premium to compensate them (Kaufman, p. 34). This practice, which involves knowledge producers in the insurance business (actuaries) as well as physicians, literally shifts the burden. But it also reconstitutes the issue: illness becomes quantifiable risk. All risk means hazards and possible 'irresponsible' behaviour such as failure to wear protective clothing or breathing apparatus. The victim-blaming ideology isn't simply a clever ruse (Berliner, pp. 118-20; Ryan; Duster). Rather, it is built into the historically developed relations of production which — at the same time — in the case of factory legislation, had a progressive moment in limiting the workers' disablement from factory work.
The fragmented way we tend to see these practices makes it difficult for us to think holistically about illness. We do not normally see the relevant labour processes and their articulations as part of a single story bristling with potential sites of socialist struggle. When illness does occur, it seems natural to follow the procedure already set up: to certify disablement, litigate for compensation, call in inspectors to examine sources of potential hazard and fight through trade unions for better conditions. These are sets of discrete practices, but they sustain the broader, less easily comprehended, sense of the nature of illness as separate diseases, contracted as a kind of accident. In fact the model for Workmen's Compensation for industrial illness was the accident, and the subsequent history of compensation has involved the separation of 'genuine' accidents from non-accidents. These are all material practices, but they work ideologically as well, so that any other way of thinking becomes absurd. That is, people tend to think along the same fines when new instances arise, accepting the model which separates the pathogenic substance from the disease and separates both from social relations.
However, previously inaccessible areas of agitation are opened up by analysing practices whose articulations ideologise illness as hazard — limiting the question to that of assigning responsibility or weighing risk against cost in defining threshold limit values (Doyal, p.79; Levidow in RSJ 9; Peters). Pursuing the study of labour processes and their articulations opposes all of capital's attempts to hive off ill health into agitationally less promising areas — those favoured by sociologists, such as class incidence, life-style or environmental factors. Of course, no matter what agitational possibilities the labour process perspective brings to the range of practices which form the network of articulated labour processes, and no matter what theoretical advantage it confers for seeing scientificity in terms of nature mediated by social relations, the fact remains that it cannot cure the exposed worker. Unfortunately, people tend to pose these concerns as stark alternatives. Indeed, our critics try to skewer us with a dichotomy between the phenomenon and its social relations. The point, however, is that illness as social relations of production. and illness as hazard, both emerge as inseparable aspects of the same labour process.
Knowledge production, specifying the lung damage and tissue change which characterize asbestosis, holds out the prospect of cure. Such details comprise a set of scientific problems which we have never sought to dismiss — problems of objectivity. These problems fall within the sphere of embodiments, sequestered from what they are embodiments of, and stem from a preoccupation with the epistemological problem of certainty. They arise inescapably in the practices of knowledge production and of trade union bargaining over pay, conditions and compensation. This means that the aspect of illness as hazard — which concerns unions, physicians, pathologists, health and safety workers and ill workers — is real and important. But to see illness only as they see it (and must see it) is to work within capital's constitution of illness. The other necessary component is, as we see it, inseparable: the social relations internal to the production of asbestos and asbestosis. Failure to see the inseparability will ensure that we cannot struggle towards healthy production. We need to open up the possibility of contesting the labour processes which make the diseases and their risks appear inevitable, the scientific knowledge of them 'true', and their study and cure the sole progressive approach.
It is difficult for us to understand how those who oppose our approach manage to conjure up extra words for our slogans and to disprove triumphantly an assertion which we never made: that science is just or merely social relations. The labour process perspective attempts to situate the traditional concerns of scientificity in a way which treats them historically, as part of a set of articulated practices.
Some Marxist Insights
We want to offer some passages which have helped us to work out our approach. We have been struck by the failure of orthodox marxists to take up some of the insights in these texts. More particularly, writers who have made powerful critiques of other aspects of knowledge and culture have not subjected science to the same scrutiny.
A fitting conclusion to the previous section might be this passage from Lukács’ History and Class Consciousness:

’Marxism, however, simultaneously raises and reduces all specialisations to the level of aspects in a dialectical process. This is not to deny that the process of abstraction and hence the isolation of the elements and concepts in the special disciplines and whole areas of study is of the very essence of science. But what is decisive is whether this process of isolation is a means towards understanding the whole and whether it is integrated within the context it presupposes and requires, or whether the abstract knowledge of an isolated fragment retains its ”autonomy“, and becomes an end in itself’ (p.28).

On the question of how class struggle leads to the embodiment of structured social relations in new technologies, Marx offers this guide to the history of machinery and the role of science:
’It would be possible to write a whole history of the inventions made since 1830 for the sole purpose of providing capital with weapons against working-class revolt. We would mention, above all, the self-acting mule, because it opened up a new epoch in the automatic system.
’Nasmyth, the inventor of the steam hammer, gave the following evidence before the commission on Trades Unions, with regard to the improvements on machinery which he himself introduced as a result of the widespread and long-lasting strikes of engineers in 1851. ”The characteristic feature of our modern mechanical improvements is the introduction of self-acting tool machinery. What every mechanical workman has now to do, and what every boy can do, is not to work himself but to superintend the beautiful labour of the machine. The whole class of workmen that depended exclusively on their skill, is now done away with. Formerly, I employed four boys to every mechanic. Thanks to these new mechanical combinations, I have reduced the number of grown-up men from 1500 to 750. The result was a considerable increase in my profits.”
’Ure says this of the colouring machines used in calico printing: ”At length capitalists sought deliverance from the intolerable bondage” (namely, the terms of their contracts with the workers, which they saw as burdensome) ”in the resources of science, and were speedily re-instated in their legitimate rule, that of the head over the inferior members.“ Then, speaking of an invention for dressing warps, whose immediate occasion was a strike, he says: ”The combined malcontents, who fancied themselves impregnably intrenched behind the old lines of divisions of labour, found their flanks turned and their defences rendered useless by the new mechanical tactics, and were obliged to surrender at discretion.” Of the invention of the self-acting mule, he says: ”A creation destined to restore order among the industrious classes... This invention confirms the great doctrine already propounded, that when capital enlists science into her service, the refractory band of labour will always be taught docility”’(Capital 1, pp. 563-4).
The social constitution of technology is stressed in The Grundrisse:
’It must he kept in mind that the new forces of production and relations of production do not develop out of nothing, nor drop from the sky, nor from the womb of the self-positing Idea; but from within and in antithesis to the existing development of production and the inherited, traditional relations of property’ (p. 278).
The point is driven home in a later passage:
’Nature builds no machines, no locomotives, railways, electric telegraphs, self-acting mules, etc. These are products of human industry; natural material transformed into organs of the human will over nature, or of human participation in nature. They are organs of the human brain, created by the human hand; the power of knowledge, objectified. The development of fixed capital indicates to what degree general social knowledge has become a direct force of production, and to what degree, hence, the conditions of the process of social life itself have come under the control of the general intellect and been transformed in accordance with it. To what degree the powers of social production have been produced, not only in the form of knowledge, but also as immediate organs of social practice, of the real life process' (p. 706).
We hope that in the light of this we can be understood more easily when we refer to ideology as a material force in work, science and everyday life. Marx makes the connection explicit:
’But to the degree that large industry develops, the creation of real wealth comes to depend less on labour time and on the amount of labour employed than on the power of the agencies set in motion during labour time, whose ”powerful effectiveness” is itself in turn out of all proportion to the direct labour time spent on their production, but depends rather on the general state of science and on the progress of technology, or the application of this science to production. (The development of this science, especially natural science, and all others with the latter, is itself in turn related to the development of material production.)... No longer does the worker insert a modified natural thing as a middle link between the object and himself; rather, he inserts the process of nature, transformed into an industrial process, as a means between himself and inorganic nature, mastering it. He steps to the side of the production process instead of being its chief actor’ (pp. 704-5).
Two generations later, in the wake of Taylorism and Fordism, Gramsci observed that the 'so-called exact or physical sciences' had 'come to acquire, within the philosophy of praxis [his term for marxism while writing in Mussolini's prisons], a position of near-fetishism, in which indeed they are regarded as the only true philosophy or knowledge of the world' (Prison Notebooks, p.442). But marxism, as Stuart Hall has reminded us, rests on a historical epistemology (WPCS 6 pp. 153, 155). Gramsci applied this to the historicity of science and its objects of study. In his critique of Bukharin, he says this of conceptions of matter and of science:
’Matter as such is therefore not our subject but how it is socially and historically organised for production, and natural science should be seen correspondingly as essentially an historical category, a human relation. Has the ensemble of the properties of all forms of matter always been the same? The history of the technical sciences shows that it has not. For how long was the mechanical power of steam neglected? Can it be claimed that this mechanical power existed before it was harnessed by man-made machines? Might it not be said in a sense, and up to a certain point, that what nature provides the opportunity for are not discoveries and inventions of pre-existing forces — of pre-existing qualities of matter -—but ”creations”, which are closely linked to the interests of society and to the development and further necessities of development of the forces of production?’ (Prison Notebooks, pp. 465-6).
Lest it be thought that this does not apply to science itself, he concludes his reflections on 'matter' as follows:
’According to the theory of praxis it is evident that it is not atomic theory that explains human history but the other way about; in other words that atomic theory and all scientific hypotheses and opinions are superstructures’ (p. 468).
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