Epigenetics in the Neoliberal “Regime of Truth”

Abstract

Recent findings in epigenetics have been attracting much attention from social scientists and bioethicists because they reveal the molecular mechanisms by which exposure to socioenvironmental factors, such as pollutants and social adversity, can influence the expression of genes throughout life. Most surprisingly, some epigenetic modifications may also be heritable via germ cells across generations. Epigenetics may be the missing molecular evidence of the importance of using preventive strategies at the policy level to reduce the incidence and prevalence of common diseases. But while this "policy translation" of epigenetics introduces new arguments in favor of public health strategies and policy-making, a more "clinical translation" of epigenetics is also emerging. It focuses on the biochemical mechanisms and epigenetic variants at the origin of disease, leading to novel biomedical means of assessing epigenetic susceptibility and reversing detrimental epigenetic variants. In this paper, we argue that the impetus to create new biomedical interventions to manipulate and reverse epigenetic variants is likely to garner more attention than effective social and public health interventions and therefore also to garner a greater share of limited public resources. This is likely to happen because of the current biopolitical context in which scientific findings are translated. This contemporary neoliberal "regime of truth," to use a term from Michel Foucault, greatly influences the ways in which knowledge is being interpreted and implemented. Building on sociologist Thomas Lemke's Foucauldian "analytics of biopolitics" and on literature from the field of science and technology studies, we present two sociological trends that may impede the policy translation of epigenetics: molecularization and biomedicalization. These trends, we argue, are likely to favor the clinical translation of epigenetics-in other words, the development of new clinical tools fostering what has been called "personalized" or "precision" medicine. In addition, we argue that an overemphasized clinical translation of epigenetics may further reinforce this biopolitical landscape through four processes closely related to neoliberal pathways of thinking: the internalization and isolation (aspects of liberal individualism) of socioenvironmental determinants of health and increased opportunities for commodification and technologicalization (aspects of economic liberalism) of health care interventions.

Epigenetics, ethics, law and society: A multidisciplinary review of descriptive, instrumental, dialectical and reflexive analyses

“…Among other types of possible influences, financial pressures by private actors to commodify research findings and to commercialize clinical applications of epigenetics could impede other types of translations of epigenetics. For instance, they could impede collective preventive strategies aimed at improving public health more directly by tackling environmental injustices and social inequalities (Dupras and Ravitsky, 2016b; Niewöhner, 2011).…”

“…Another explanation, which we tend to lean toward, is that the genetic era, and its exaggerated emphasis on the biological sources of identity, behavior and health, had created some sort of vacuum for any molecular-scale evidence that would reinvigorate the epistemic status of social sciences and humanities. Paradoxically, social and political theories were in need of biological support (see Dupras, 2017), in order to be able to counterstrike ongoing geneticization and biomedicalization processes on the same epistemic battlefield (see Dupras et al, 2016b); this is what epigenetics was finally offering.…”

Transgenerational epigenetics and environmental justice

“…In a society transfixed by technology and frequently indifferent to the plight of the less fortunate, there is a risk that the societal response to transgenerational epigenetic harms will emphasize clinical rather than environmental interventions to treat those afflicted rather than address the underlying social and economic causes of hazardous exposures. "Thus epigenetics, possibly more than any other biological science, transforms external determinants of health into internal ones" [ 114 ]. In evaluating the societal implications of epigenetics, as with other areas of emerging science, biological processes should not obscure the role of human actions in the etiology of environmentally-related health effects.…”

Epigenetic Discrimination: Emerging Applications of Epigenetics Pointing to the Limitations of Policies Against Genetic Discrimination

“…Interestingly, non-deterministic readings of epigenetics could also promote stigmatization and discrimination, this time based on the presumed capacity of individuals to avoid harmful exposures during their lifetime ( Meloni, 2017 ). It is, however, important to remain cautious about the interpretation that epigenetic modifications, in contrast with genetic mutations, are the result of free and voluntary decisions on the part of at-risk individuals ( Chiapperino and Testa, 2016 ; Dupras and Ravitsky, 2016b ; Vears and D’Abramo, 2017 ).…”