Like many of the movements loosely grouped under the under the rubric of cultural or identity politics, disability studies has its origins in the political and social turmoil of the 1960s. For disability activists, the traditional imperative to "fix" or efface disabled people is the hallmark of a modern, normalizing society that has little tolerance or willingness to accommodate the differences of disabled people. Furthermore, for many disabled people a "cure" is neither possible and for some may not even be desirable.

Against the normalizing demand for disabled people to be adapted to their environments (usually through overcoming their disability or by becoming reconciled to their situation), the disability studies movement has focused on improving quality of life through the transformation of social and physical environments. Supporting and complementing this activism, early British disability theorists argued for a distinction between impairment as a medical condition and disability as the effect of a social process.

This British "social model" of disability, as it came to be called, countered the traditional assumption that disability is the direct result of an individual deficit or incapacity. For disability scholars, disablism describes not only a variety of discriminatory practices, but also the way in which disability, as an effect of social oppression, is naturalized through medical and popular discourse as the "symptom" of individual attributes, that is, as the effect of impairments. In the United States, foregrounding the socio-political dimensions of disability and focusing attention on patterns of discrimination allowed disability studies to link itself with other versions of identity politics, which were largely predicated on a "minority-group model" of activism. As Harlan Hahn writes, "From this perspective, the problems faced by disabled citizens are essentially similar to the difficulties encountered by other minorities. The basic issues are prejudice and discrimination evoked by visible or labeled human differences" (171). Thus, parallel and concurrent to the theorization of the "social model" of disability, there developed a strategy of activism that put forward claims to rights and to protections against discriminatory practices and environments. 1

By the late 1980s, the early disability studies movement had achieved a significant level of scholarly output and political effectiveness. Concurrently, the "social model" of disability came under critique for mirroring the Cartesian dualism of the medical model and ceding study of impairment to medical authority (Hughes 67). More crucially, in the age of biopolitics and poststructuralist critique, a whole series of parallel distinctions that ground the original "minority-group" and "social" models of disability have become increasingly problematic: identity/body, discursive/material, social/biological, and thus, disability/impairment. Intervention and transformation of discourses about disability, social attitudes, and institutional policies continues to be central to the mission of disability studies and disability activism. Yet, understanding the construction of the disabled body and continued theorization of disability require bridging the gap between materialist, discursive, personal, institutional, and political perspectives. On this theoretical front, recent scholarship has called for a "sociology of body" which would take its cue from the poststructuralist emphasis on the body as a politicized space. 2

Through the last decade, disability studies scholarship has significantly challenged previous theoretical models and explored new avenues of development for the field. The work of Michel Foucault has proved especially important to these efforts. Two early and influential uses of Foucault's work for disability studies include Margit Shildrick and Janet Price's, "Breaking the Boundaries of the Body" (1996) and Shelley Tremain's, "On the Government of Disability" (2001). More recently the edited-collection, Foucault and the Government of Disability (2005), illustrates the wide-ranging relevance of Foucault's work for contemporary disability studies scholarship. 3 More generally, citations and uses of Foucault's work in disability studies scholarship have become increasingly ubiquitous and diverse in application over the last two decades. For the present study, I would like to focus on two primary dimensions of Foucault's work and their points of contact with disability studies.

First and foremost, Foucault's work is relevant for contemporary disability studies because of his theorization of the body as a thoroughly and inexorably politicized space. In his genealogical studies, Foucault undertakes the task to "expose a body totally imprinted by history and by the process of history's destruction of the body" ("Nietzsche, Genealogy, History" 357). Foucault's work challenges the traditional "social model" of disability insofar as it reifies and naturalizes "impairments" as the transhistorical and neutral foundations of disability. Building on continuing critique of the "social model," Tremain employs Foucault's work to argue that impairments themselves are not "intrinsic defects that demand to be corrected or eliminated (as the 'medical model' assumes)" but rather are "created by social and economic arrangements and conditions that can be transformed" (Tremain, "Biopower …" 598). Foucault's work challenges us to recognize that the "difficult physical realities" of disability are themselves socially constructed and to undertake the task of diagnosing the forces that produce them. 4 There is no outside to the historical effects and socio-political operations of power on the body.

Second, and complementarily, Foucault theorizes the modern social field in terms of biopolitics. He argues any attempt to understand modern political struggles and the claims of rights discourse must begin by recognizing such claims as a political response to what he characterizes as the triumph of biopower. As Foucault describes it, biopower is the proper name for the emergence and integrated exercise of both a technology of discipline, which produces docile bodies, and the normative regulation of populations; it takes life itself as the object of its exercise: "One might say that the ancient right to take life or let live was replaced by a power to foster life or disallow it the point of death" (The History of Sexuality 138). While biopower takes life as its object of exercise, it does so by applying itself to the "everyday life categories of the individual." Biopower extends the mechanisms of disciplinary societies through an intensification of individuals' relationships to themselves and their own self-governance: "it is a form of power that makes individuals subjects. There are two meanings of the word "subject": subject to someone else by control and dependence, and tied to his own identity by a conscience or self-knowledge" (Foucault, "The Subject and Power" 130).

In light of Foucault's analysis, the disability studies movement should be understood as an effect of biopower; that is, it constitutes disabled people as subjects who claim a "right to life," a claim that relies on the essential promise of a form of power that produces "disability" as a socially and politically marginalized identity. As Wendy Brown argues in States of Injury: Power and Freedom in Late Modernity (1995), in liberal societies such claims are filtered through the discourse of universal human rights:

In this story, the always imminent but increasingly politically manifest failure of liberal universalism to be universal—the transparent fiction of state universality—combines with the increasing individuation of social subjects through capitalist disinternments and disciplinary productions. Together, they breed the emergence of politicized identity rooted in disciplinary productions but oriented by liberal discourse toward protest against exclusion from a discursive formation of universal justice. (58)

Considered from the genealogical perspective such claims and protest are of a piece with the landscape of biopower rather than an effective challenge to it. In the following study, my aim is to reevaluate disability studies in terms of the configuration of social relations that have produced disability as identity and motivated claims for social protection.

Technologies of normalization are not solely or primarily about the exclusionary, prohibitive functions of social neglect, stigmatization, and institutional paternalism. Rather, the primary danger we face today is the continued intensification of power relations through increasingly invasive and privatized mechanisms of rehabilitation. As Jeffrey Nealon writes in Foucault Beyond Foucault: Power and Its Intensifications since 1984 (2008), "societies of control extend and intensify the tactics of discipline and biopower (by linking training and surveillance to ever-more-minute realms of everyday life), they also give birth to a whole new form" (68). Ultimately, I argue that we have already moved past a point where rights discourse is the primary front in the battle against disablism. As reform efforts have begun to focus on quality of life issues and empowering "consumers" of health services, we have entered into a new era of grappling with problems unique to societies of control.

The Failure of Rights Discourse

It is commonplace in disability studies to assert that we are all only "temporarily-abled." On the one hand, the statement points to the likelihood that most of us will experience some form or period of disablement during our lifetimes. On the other, as Eva Kittay points out, even those of us who lead full and healthy lives will experience dependency at least twice, "when we are infants and when we are very old" (qtd. in Squier 24). At times, this invocation almost seems to suggest that if only the mythical "normal subject" would accept that it too will be disabled someday, then a primary obstacle to the social acceptance and accommodation of disability would disappear. 5

In this formulation, we might recognize a version of what Nealon characterizes as the theoretical success of identity politics. Namely, the linguistic turn of identity politics arrives at the recognition that "any state of sameness actually requires difference in order to structure itself" (4). Yet, the realization of a common intersubjective ground to social and linguistic identity formation does not entail a political success. As Nealon goes on to argue:

…because intersubjective theories argue that we need each other for recognition and happiness, such theories continue to harbor a regulatory ideal of complete subjective freedom, which is actually freedom from recognition, freedom from difference itself. It is not necessarily surprising, then, that needing the other often shows itself as resenting the other. (Alterity Politics 7)

Insofar as identity politics are thematized through reference to a lack, a failure of wholeness, and the instability of identity in the same, it tends to reinscribe as an object of desire the very privileges it seeks to deconstruct. Thus, identity politics have often been haunted by the unacknowledged goal of attaining the privileges from which certain categories of people are excluded and thereby maintains as ideal the configuration of power relations that produce these politicized identities as effects (Brown 7).

As an example, we might consider Lennard Davis's "dismodernist" approach to identity politics, an approach that is founded on the radical version of "lack" discovered in disability. Davis sees the disability movement as having a unique potential to destabilize the "normal subject" insofar as it presents a "real," physical (i.e., not merely discursive) lack that not only problematizes identity, but materially challenges the illusion of independence:

In a dismodernist mode, the ideal is not a hypostatization of the normal (that is, dominant) subject, but aims to create a new category based on the partial, incomplete subject whose realization is not autonomy and independence but dependency and interdependence. This is a very different notion from subjectivity organized around wounded identities; rather, all humans are seen as wounded. Wounds are not the result of oppression, but rather the other way around. Protections are not inherent, endowed by the creator, but created by society at large and administered to all. The idea of a protected class in law now becomes less necessary since the protections offered to that class are offered to all. (Bending Over Backwards 30)

Whereas, Davis wants to unsettle the privilege of the "normal subject," his invocation of the lack or "wound" creates a platform for extending this very privilege (elided as "protections" in the passage) to the disabled. Precisely because everyone is recognized as lacking, the goal remains to achieve wholeness through dependence on each other: "The dismodernist subject is in fact disabled, only completed by technology and interventions" (Davis 30). Davis's argument for a "right to be ill" ends up becoming an argument for a right to be protected from illness or even a "right to be normal" for all. Of course, it is not particularly the commitment or goal that is problematic, but the appeal to rights discourse itself.

The essential and unavoidable problem with rights discourse is that it appeals to a liberal notion of equality that " insofar as it neither constitutes political community nor achieves substantive equality, guarantees only that all individuals will be treated as if they were sovereign and isolated individuals" (Brown 110). As Brown argues, the formal equality of liberalism abandons the individual to the social forces that produce her or him as a politicized identity. Thus, the problem with rights discourse and the desire to seek melioration within its institutions is that "[it] continuously recolonizes political identity as political interest—a conversion that recasts politicized identity's substantive (and often deconstructive) cultural claims and critiques as generic claims of particularism endemic to universalist political culture" (Brown 59). Along these lines, we might consider Brown's example of the way in which an identity such as the "welfare subject" is produced and regulated through categories of "motherhood, disability, race, age, and so forth" (59). While such subjects seek the intervention of the state, that is, a political solution for social inequity, the response is further reform and administration by the institutions that produced these subjects as effects. In other words, the entire system becomes a closed circuit: "Thus, disciplinary power politically neutralizes entitlement claims generated by liberal individuation, while liberalism politically neutralizes rights claims generated by disciplinary identities" (Brown 59).

For another example, political efforts to address racism culminate in affirmative action legislation, which in turn becomes a mean of regulating ethnic identities through institutional and legal procedures. This effectively shifts debates and conflicts over racism from a political issue to one addressed in the educational system and through workplace litigation. At the same time, conservatives characterize such programs as reverse discrimination that unfairly provides "rewards" based on characteristics (i.e. race) which the government should disregard. Brown describes a two-stage process whereby political claims against social inequalities are depoliticized and privatized through disciplinary administration and the logic of formal justice.

This pattern holds equally true for the disability movement. Though intended to politically contest social inequalities pertaining both to the allocation of resources and the self determination of the disabled, measures such as the ADA ultimately depoliticize and privatize these claims by reinserting them into the purview of judicial institutions: "It converts social problems into matters of individualized, dehistoricized injury and entitlement, into matters in which there is no harm if there is no agent and not tangibly violated subject" (Brown 124). Furthermore, such measures not only neutralize political claims as private interest, but through bureaucratic codification reify the subject categories that are meant to protect and serve as a means of further disciplinary regulation.

In consideration of the latter claim, it is important to recognize the way in forms of disciplinary discourses imply and reinforce one another. Historically, this has been particularly true of the relationship between medical and judicial discourse. In his lecture series on this very topic, Foucault reiterates the fundamental thesis of much of his work, that power is productive, that it "multiplies itself on the basis of its own effects" and operates primarily through the "formation of knowledge" (Abnormal 48). Disability scholars have pointed out that a primary aspect of court decisions pertaining to disability has been the reliance on medical knowledge. As Hahn points out, "courts have viewed medical evidence of a functional impairment as an essential pre-condition for legal findings about disability" (185).

Even legislation designed specifically to aid and accommodate the disabled is often administered in ways that undermine its positive impact. For example, in her critique of the questionnaire that determines eligibility for the Disability Living Allowance (DLA), Shildrick characterizes the way in which state administered aid becomes an opportunity for oppressive surveillance: "No area of bodily functioning escapes the requirement of total visibility, and further the ever more detailed subdivision of bodily behavior into a set of discontinuous functions speaks to a fetishistic fragmentation of the embodied person" (qtd. in Hughes 69). In this way, disabled people are made subject to the invasive examinations, surveillance, and objectification that are the hallmark and most obviously oppressive aspect of technologies of normalization.

Fiona Campbell argues that, more insidiously, legal proceedings depend on an "inherently negative" conception of disability that frames all disabled people as abject victims of a "personal tragedy" (109). Following Wendy Brown, Campbell argues legal proceedings reify and codify the interrelation of disability, dependency, and victimhood. Most profoundly, they require "disabled people to trade in trade in, negotiate, and maintain" an identity of "social injury" (115). Rights discourse unavoidably appeals to legal processes and procedures that subjugate disabled people in the dual sense already cited from Foucault: they are made "subject to … control and dependence, and tied to … identity by a conscience or self-knowledge" ("The Subject and Power" 130).

A primary goal of disability activism is to contest the traditional view of disability as a private problem that should be fixed by adapting disabled bodies to a normalized society. It is thus ironic and tragic that the discourse of rights through which such claims have been advanced is, when viewed in light of Brown's analysis, a further mechanism of depoliticizing difference as private; appeals to rights and their codification may actually deepen the social injuries they to address. However, as I will argue further, it is important to recognize that these injuries are not simply injuries of exclusion. Though in one sense political claims for a "right to life" are rejected by disciplinary justice, in another sense these claims for a "right to life" are channeled, redirected, and quarantined within the productive apparatus of juridical and medical institutions. A collective, political protest is referred and deferred to the site of the individual's confrontation with technologies of normalization.

Technologies of Normalization

[T]he norm is not at all defined as a natural law but rather by the exacting and coercive role it can perform in the domains in which it is applied. The norm consequently lays claim to power … Canguilhem called it a polemical concept … The norm brings with a principle of both qualification and correction. The norm's function is not to exclude and reject. Rather, it is always linked to a positive technique of intervention and transformation, to a sort of normative project. (Foucault, Abnormal 50)

One of Foucault's teachers, Georges Canguilhem provides a helpful introduction into Foucault's analysis of the normalizing regime of truth. In The Normal and the Pathological (1966), Canguilhem traces the epistemological development of his titular concepts through the work of thinkers like François Broussais, Claude Bernard, and Auguste Comte. The foundation of a vitalist paradigm of health begins with Broussais whose contribution was to define "all diseases as consisting essentially 'in the excess or lack of excitation in the various tissues above or below the degree established as the norm'" (Canguilhem 47-8). The importance of this principle is that it denies the ontological difference of health and disease; health and sickness became different in degree rather than in kind.

However, Canguilhem goes on to argue that deviations from the norm should be recognized as pathological only insofar as they diminish the vitality of the organism; health is no longer defined as the absence of sickness or pathological symptoms. It does not consist in the "silence" of the body. Rather, normativity, that is, the "possibility of transcending the norm, which defines the momentary normal, the possibility of tolerating infractions of the habitual norm and instituting new norms in new situations," becomes the essence of health (197).

For scholars like Sharon Snyder and David Mitchell, Canguilhem's value lies in his critique of the norm as a tool of medical and social judgment. In the following passage, dysfunction is revealed as a term that imbeds an evaluative judgment of a given deviation from the norm as pathological:

Canguilhem argued that anomaly offered medicine a more appropriate gauge than dysfunction because it surrendered the violence of evaluation that infused any notion of deviance … Rather than interpret bodily and cognitive differences in terms of their degree of deviation from a standardized norm, anomaly recognized difference as the neutral expression of a biologically diverse species adapting to the pressures of environmental and internal forces. (Snyder and Mitchell 373)

The essential point here is that if health is the experience of normativity (the ability to establish new norms), then standardized norms (social or biological) have no necessary basis for preference or idealization from a scientific standpoint. Health cannot be measured by a fixed standard or set of norms.

Canguilhem's work provides an additional ground for recognizing the social construction of disability. Not only are judgments of health ethically suspect when based on prescribed standards, but also pathology is instead descriptive of a "reduction of the individual's possibilities for interactions with its environment, which is felt as the experience of suffering and limit" (Margee 304). Depending on the available accommodations or context, a given impairment or biological or social anomaly need not necessarily be experienced as pathological and may even prove adaptive. Of course, this would support the argument that disability results from a lack of adequate social support.

However, Canguilhem goes beyond the social construction of disability by arguing that "even apparently biological facts such as human height and life span are 'inseparably biological and social'" (Margee 305). There are myriad ways in which social forces shape the environments in which norms are established. The effects of technology and industry can contribute to physiological anomalies. For example, the prevalence of carcinogens contributes to cancer and pollution may cause respiratory illness. However, this would also include the environment of cultural practices. Fast food culture leads to an increase in rates of obesity and diabetes. In his essay on Nietzsche, Foucault puts the matter this way:

We believe, in any event, that the body obeys the exclusive laws of physiology, and that it escapes the influence of history, but this too is false. The body is molded by a great many distinct regimes; it is broken down by the rhythms of work, rest, and holidays; it is poisoned by food or values, through eating habits or moral laws; it constructs resistances … (Foucault, "Nietzsche, Genealogy, History" 360)

Thus, the experience of disability is not only constructed by social forces insofar as they contribute to whether or not a given impairment is experienced as limiting, but the various physiological or psychological anomalies described by the term impairment are themselves socially conditioned.

Canguilhem's work provides additional weight to critiques of the traditional "social model" of disability. If disability and impairment (referring to social stigmatization or lack of accommodation and physiological or psychological anomaly respectively) are both products of social forces, then social construction cannot be described as a solely discursive or purely interpellative phenomenon. In other words, any version of the "social model" of disability that seeks to distinguish between the social effects of disability and more or less material, pre-existing category of impairment is untenable. As Tremain argues:

the apparent universality of the entity called "impairment" is assumed to be evidence for its prediscursive existence, furthermore, conceals the fact that the constitutive knowledge-power relations that circumscribe impairment have already put in place broad outlines of the forms in which that discursive object will be materialized. Thus, insofar as proponents of the social model claim that disablement does not follow necessarily from impairment, they misunderstand the productive constraints of modem power. For the category of impairment emerged and in part persists in order to legitimize the style of reasoning (and its associated disciplinary practices) that generated it in the first place. ("Biopower …" 601)

Bodies, through their history, development, and functionality are penetrated thoroughly and effectively by force and are thereby enmeshed in relations of power. Through these relations of power, individuals and eventually forms of subjectivity are constituted as objects to be studied and sites of the application of techniques of power. If for Canguilhem norms are a polemical concept, then for Foucault they are a "technique of intervention" (Foucault, Abnormal 50).

In one of Foucault's most famous formulations, he argues that the institutions of biopower do not primarily employ the model of the exclusion of lepers, but rather the inclusive models of quarantine, surveillance, and regulation of the plague: "Rather than the massive, binary division between one set of people and another, it called for multiple separations, individualizing distributions, an organization in depth of surveillance and control, an intensification and a ramification of power" (Discipline and Punish 198). Under the quarantine model, the prohibitive function of the law is increasingly replaced with a process of normalization that seeks to maximize the life of both the individual and the species:

Such a power has to qualify, measure, appraise, hierarchize, rather than display itself in its murderous splendor; it does not have to draw the line that separates the enemies of the sovereign from his obedient subjects; it effects distributions around the norm … (Foucault, The History of Sexuality 144)

In the age of biopower, the oppressed, pathologized, and criminalized are no longer excluded as enemies; they become necessarily integrated as endemic threats to the health of the body politic. In administering the life of both the society and the individual, in terms of both social deviance and pathological dysfunction, the norm is the common tool: "The norm is something that can be applied to both a body one wishes to discipline and a population one wishes to regularize" (Foucault, Society Must Be Defended 252-3).

The Racism of Biopower

[D]eath now becomes the moment when the individual escapes all power, falls back on himself and retreat, so to speak, into his own privacy. Power no longer recognizes death. Power literally ignores death. (Foucault, Society Must Be Defended 248)

… the disabled body represents the incomplete, unbounded, compromised, and subjected body susceptible to external forces: property badly managed, a fortress inadequately defended, a self helplessly violated. (Thomson 45)

In his 1975-76 lecture series Society Must Be Defended (2003), Foucault explicates the stakes and implications of the protective role biopower establishes for itself. For a form of power that takes life as its object, incapacity and death pose the essential problem: "Death was now something permanent, something that slips into life, perpetually gnaws at is, diminishes it and weakens it" (243-4). Under the regime of biopower, it would seem that the closer one approaches to death—the extinction of life and the limit of power's grasp—the more one is excluded, ignored, left out. Like death, illness is private. For disabled people, insofar as they are deemed to lack capacity, they are less available to a power that operates primarily on capacities. In this sense, incapacity would seem to simultaneously shield the individual from power and yet leave them outside the care of society—hardly a bargain.

Certainly, such a description would fit with analyses that emphasize the way in which disabled bodies are elided and excluded in an ableist society. In this sense, the right of biopower to make live or let die is exercised through the tools of social normalization and the judgment of diagnosis: "What in fact is racism? It is primarily a way of introducing a break into the domain of life that is under power's control: the break between what must live and what must die" (Foucault, Society Must Be Defended 254-5). Undeniably this has been the experience for many individuals. As a threat to the health of the social body, the disabled people have often suffered from moral judgment, social exclusion, and even attempts at elimination.

However, while it is true we may recognize a "kind of 'metapower' structured essentially around a certain number of great prohibition functions," it can "only take hold and secure its footing where it is rooted in a whole series of multiple and indefinite power relations that supply the necessary basis for the great negative forms of power" (Foucault, "Truth and Power" 309-10). Any attempt to analyze or contest the state of oppressed groups or identities must begin by recognizing that they are produced by a "micro-physics of power" that is essentially productive and operates by constituting subjectivities as the simultaneous object and instrument of its exercise of knowledge/power (Foucault, Discipline and Punish 28).

In the case of disability, norms are the primary tool or technique of this microphysics. They play such a crucial role because they link interventions at two levels: the regulation of populations—birth rate, crime, disease—and direct interventions in the health of the individual. Norms also constitute new form of law that becomes a tool for correcting social deviance and a tool of functional regulation in health. In other words, the norm is both a rule of conduct and a tool for the administration of dysfunction and pathology (Foucault, Abnormal 162). In the age of biopower, the great push is for fuller extension of power across the whole of the social body—seeking to penetrate it as deeply and efficiently as possible. The positivist administration of health produces a normalizing spectrum that seeks not only to wield evaluative judgment and exert a regulative influence, but more importantly to map the whole of social terrain along this continuum.

Thus, though biopower utilizes a polemic deployment of the norm to introduce a differential value to life and lives, the primary goal is not exclusion and prohibition, but intervention and transformation through productive techniques:

[The Classical Age] invented a technique of power that does not act by excluding but rather through a close and analytical inclusion of elements, a power that does not act by separating into large diffused masses, but by distributing according to differential individualities, a power linked not to ignorance but rather to a series of mechanisms that secure the formation, investment, accumulation, and growth of knowledge. (Foucault, Abnormal 48)

Insofar, as biopower seeks to invest the whole social field, observation and intervention must become increasingly detailed so as to invest life as completely as possible to the ultimate limit of death. The great machineries of quarantine were fueled not by the necessity of better containing disabled people or criminals, but rather by the need to extend the exercise of biopower as completely as possible. Forms of surveillance, examination, and observation attempted to discover disease wherever it might lurk and to classify and diagnose pathological symptoms with as great of acuity as possible.

Rather than working on the body wholesale, medicine sought to know and regulate its functions in increasingly differentiated ways. 6 Even while aspects or capacities of a person's health and body are analytically deracinated from the whole, these regimes of knowledge and techniques of discipline are the means by which individuals and subjects are constituted:

The examination as the fixing, at once ritual and 'scientific,' of individual differences, as the pinning down of each individual in his own particularity … indicates the appearance of a new modality of power in which each individual receives as his status his own individuality, and in which he is linked by his status to the features, the measurements, the gaps, the 'marks' that characterize him and make him a 'case.' (Foucault, Discipline and Punish 192)

Thus, a failure of classification, intervention, and diagnosis is the degree to which a person remains obscure, unobserved, and untrained—the extent to which a person is "let die."

Ultimately, the analytical inclusion and observation of disability under biopower comes at a cost. One of Foucault's primary insights is that through processes of self-replication and the intensification of programs of knowledge production, the institutions of biopower tend to reify, deepen, and sustain the phenomena and individuals they study. The central question for disability studies is not why members of an ableist society fail to recognize their common interest in disability activism. Nor is the question why disabled people have been excluded and ignored. Rather, in light of our engagement with Foucault, the question becomes one of understanding the ways in which disability is sustained, constituted, and reified by technologies of the normalization and institutions of quarantine.

Undeniably, the fundamental goal of disability studies must be a pragmatic one—to actively transform our shared social environment in ways that will reduce the degree to which individuals may experience the "suffering and limit" that is the essence of the pathological. However, in this pursuit, we must remain cognizant of the increasingly ubiquitous mechanisms of control imbedded in the techniques of intervention and transformation of individual and social health: "What is at stake, then, is this: how can the growth of capabilities be disconnected from the intensification of power relations?" (Foucault, "What is Enlightenment?" 55).

Institutional Critique and Continued Dangers

Thus, a particular group of people like those labeled mentally retarded are removed from the general social and economic context; categories of learning deficiency or social friction are differentiated and refined; particular techniques are then devised for intervening at particular physical, behavioral, or cognitive points. (Trent 274)

Thus, as the more repressive, obviously controlling goals of self-discipline or even symptom reduction recede from view, the madman becomes more like an under-skilled laborer than an ill patient, more in need of rehabilitation than treatment, and more an object of technology than a specter of fear. The body becomes controllable through its own productivity, and this culturally congruent emphasis on production—be it of skills, data, or training programs—replaces the more ambivalent desire to exert physical and even psychological control. (Lilleleht 174)

There are good reasons why institutional critique plays such a central role in disability studies. After all, medical disciplines and institutions both configure material and social contexts for the actions of individuals, but also discursively shape the identity of disabled people through the authority of scientific knowledge. Over the course of the last several decades, critique of medical institutions has sought to limit the degree of control those with disabilities or illnesses must encounter when they seek medical care. Concretely, this has meant challenging the "dominance of the expert in decision making by emphasizing the right of the most objective and rational standpoint to take precedence in any decision situation" (Gatens-Robinson and Tarvydas 28).

While healthcare continues to be dominated by the expert status of the physician or medical provider, the movement and critique has had some success. For example, consumer-directed rehabilitation attempts to change this relationship by ceding to the agency of the consumer or patient. Developing over the course of the last decade, this movement begins with the assumption that "if people with disabilities are to experience personal satisfaction and quality of life, they must play the central role in directing the disability policy and rehabilitation service delivery that are central to their empowerment" (Kosciulek, et al). On the surface this shift appears wholly positive. It values the experience and desire of the individual and relinquishes as much autonomy as possible to the patient. Prior to this shift, the focus of rehabilitation had been on the cultural and institutional imperative of independence. Since the shift, the central issue has become quality of life as determined or defined by disabled people themselves. Certainly, this would seem on the surface to provide a way of improving individual capacities without intensifying relations of power. However, it is important to recognize that in consumer-directed rehabilitation the "consumer's" relationship to him or herself is still directly managed through the mediation of the caregiver.

Even while the goal of training may be supplied by the individual, the coercion of training lies in its method. The procedures, documents, and progress reports accompanying rehabilitation merely lighten the operation of observation and training. As Erica Lilleleht argues in her critique of contemporary psychiatric rehabilitation, in the kinder, gentler version of treatment "overtly controlling observation loses its physical basis and becomes increasingly detailed and dehumanized" (177).

Though an individual consumer may choose the goals of their rehabilitation or treatment, ultimately they are broken down into step-by-step procedures that exert a form of control that is more deeply imbedded than previous forms of treatment:

… even though this approach does not attempt to cure, or even treat, mental illness psychiatric rehabilitation does seek to redevelop the skills of the chronically mentally ill and to help them become integrated participants in a production-oriented society. In attempting this, however, it relies on technologies so minute in focus, detailed in application, and depersonalizing in experience (in other words, so disciplinary in form) that it risks making skill development a perpetual and strangely disconnecting process. Thus, just as the schizophrenic may never be completely cured of his mental illness, so too might he never be done with his rehabilitation. (Lilleleht179)

For Lilleleht, the reforms of rehabilitation merely offer a lightening and intensification of techniques of power. The goal is no longer to cure or fix any form of deviance, but to isolate and regulate it. Less and less do individuals find themselves simply excluded by power; and, concomitantly, there is less and less of an impetus to strictly mold individuals to fit a standard. While it is true that deviance from the norm provokes constraint and correction, normalization will be a process that takes as its aim the pursuit of an ever extending normativity—the ability to produce new norms of health. The judgments of power, its diagnostic spectrums, classifications, and interventions become increasingly regulatory in nature.

Consequently, the contemporary landscape that disability studies must confront is that of the society of control. Echoing the dilemma of Lilleleht's schizophrenic, Gilles Deleuze describes the society of control as one in which "one is never finished with anything":

The apparent acquittal of the disciplinary societies (between two incarcerations); and the limitless postponements of the societies of control (in continuous variation) are two very different modes of juridical life, and if our law is hesitant, itself in crisis, it's because we are leaving one in order to enter the other. ("Postscript" 5)

Though they may appear on the surface to empower individuals, contemporary procedures of knowledge production and mechanisms of control only solidify relations of power at a deeper level by involving individuals as "consumers." In societies of control, we are not only incited to discover the "truth" of our identity and to be subjugated thereby; we are also induced to pursue a program of rehabilitation that would secure a new foundation for our always, already displaced abject identities. In other words, the productive moment in the society of control is not solely the constitution of the individual as object for disciplinary examination, but the injunction for individuals to experiment and objectify themselves in the pursuit of ever evolving forms of normativity and health. In such circumstances, political theory and practice must increasingly concern itself with the space of the self or subject. As power is exercised through the individual's relationship to him or herself, then the attempt to create practices of freedom must necessarily begin there as well. Ultimately, in this context, Foucault provides an important basis for critique not only of institutions, but of reform efforts as well. As Lilleleht's analysis attests, even well-intentioned reforms like consumer directed rehabilitation require close scrutiny.

Becoming Otherwise

Of course, no one wants the social stigma associated with disability, but social recognition of disability determines the practical help a person receives from doctors, government agencies, insurance companies, charity organizations, and often from family and friends. (Wendell 264)

Though the primary goal of this study has been a historical-critical understanding of the ways in which biopower has sought to grasp or circumscribe the human differences associated with disability, it is also important to recognize that disabled people have generally benefited from these "advances." One of the most perplexing aspects of engaging in disability studies and activism is that it is difficult to imagine doing without these forms of intervention. Yet, this difficulty only foregrounds the fact that disabled people are uniquely vulnerable to the control of disciplinary mechanisms through their dependence on medical care and intervention. What makes contemporary forms of power so insidious is that they are productive. While political accommodations extended through legislation and medical care is clearly valuable and necessary, they are clearly problematic to the degree that they have been structured as paternalistic; that is, interventions to improve the health or quality of life of the individual are often administered in ways that imbed forms of control and governance.

In structuring the possible field of others, these disciplines not only configure material and social contexts for the actions of individuals, but discursively shape the identity of individuals with disabilities through the authority of scientific knowledge. Undoubtedly, this is the reason why a great deal of critique has focused on disciplines and institutions. In a very sober account of the current state of disability studies, Snyder and Mitchell support the value of disciplinary critique as it has been made through the work of Foucault for one. However, they also point to a need for speaking to the experience of disability:

The theoretical diagnosis had been limited to an archaeology of institutional power that sought artificially to stabilize meanings of the body. To narrate a phenomenology of the body requires an approach that can capture its defining elasticity—not as an established fact, but rather as a mutable, temporal, "first-person" organism. Such is the domain of literature and art. (381-2)

The point is not to recover some authentic self prior to relations of power, but rather to reconfigure our status as subjects through the manipulation of our relation to our selves. Certainly, art or literature that involves discovering new modes of "self-knowledge" is one way to begin challenging the modes of subjugation characteristic of disability as an identity.

Through Foucault, we should recognize that the call for a "right to life" emerges along with the disciplinary forms of governmentality that increasingly structure relationships of the self to the self. Ultimately, the struggle against the modes of subjugation concomitant with institutional attempts to ameliorate conditions of "suffering and limit" should be recognized as a crucial aspect of the experience of disability:

The conclusion would be that the political, ethical, social, philosophical problem of our days is not to try to liberate the individual from the state, and from the state's institutions, but to liberate us both from the state and from the type of individualization linked to the state. (Foucault, "The Subject and Power" 134)

Individual human beings have never been and will never be completely independent; they will never exist outside of relations of power. Similarly, dependence on disciplinary forms of care will continue to be a fact of life for many. Thus, disability studies should focus on critique of disciplines and institutions as a means of challenging the degree of control involved in relations of dependence, along with attempts to discover new modes of subjectivity or forms of self-knowledge—ultimately, to challenge the ways in which we are subjugated through and made subject to technologies of normalization.