Liminal Biopolitics: Towards a Political Anthropology of the Umbilical Cord and the Placenta

Abstract

One of the most intriguing bio-objects in the emerging field of regenerative medicine is umbilical cord blood. Employed in existing haematological therapies, but also loaded with potentialities for future uses, cord blood has been lately the focus of a regulatory debate which confronts public and private forms of biobanking. This article explores the political and anthropological side of this debate, describing the ways in which different health practices related to the umbilical cord (and to its symbolic sibling, the placenta) have been involved in processes of societal production and reproduction. Through the use of ethnological and historical data, and their comparison with current practices, I contend that the technical manipulation of cords and placentas goes much longer into the past than what a first glance suggests, and that these two objects can be understood as biological spaces in which forms of social belonging and versions of the societal bond are at play. The current conflict between public and private cord blood banks is therefore interpreted as part of a longer history of bodily practices, and as reflecting recent mutations in the biopolitical constitution of advanced liberal societies.

Hybrid practices in cord blood banking. Rethinking the commodification of human tissues in the bioeconomy

“…The dominant bioethical and biomedical discourse associates the "redistributive tissue economy" (Santoro 2009) of public UCB banking with particular ethical and social values and sentiments of belonging to a national community (Santoro 2011;Beltrame Confidential Author Version -Pre-proof 8 2014). As Waldby noted, public UCB banking evolved using the established blood services as its logistic basis.…”

The hybrid bioeconomy of umbilical cord blood banking: Re-examining the narrative of opposition between public and private services

“…The logic of public UCB biobanking would produce "a subjecthood that is, simultaneously, biological and national" (Santoro, 2009, p. 18). This is explained by the fact that, historically, public UCB banks were built on the previously established bureaucratic networks of donation and storage of blood and thus joined to the discourse and the ideology of Titmuss's The Gift Relationship, where the act of donation is a socio-political symbol of social integration (Santoro, 2011). Accordingly, population-based biobanks partake in the construction of national and polity identities (Busby and Martin, 2006).…”

“…The public system of UCB banks could be seen as an epitomizing case of state-led biopolitics of the population (Santoro, 2011;Beltrame, 2014) that identifies "the supply of blood, organs and other bodily fragments and the body politic" (Santoro, 2009, p. 18). Brown noted that public UCB biobanking "is promoted with reference to a solidaristic moral economy of gift and altruistic participation in imagined community and nationhood" (2013, p. 98).…”

“…The simple opposition postulated in bioethics and biomedical literature is mainly prescriptive and normative. However, if we take into account public-private interactions and the overlaps and hybridization between redistributive and market economy, how can we explain the different biopolitical pacts (Santoro, 2011) related to biobanking models without sacrificing distinction between the 'regime of truth' ascribed to current haematological applications and the 'regime of hope' (Martin et al, 2008b) in future-oriented promises of regenerative medicine 3 ? In other words, how can we explain the different cultural, social and biopolitical implications of UCB bioeconomies, when the narrative of opposition is untenable?…”

“…Other studies have highlighted how new family duties and responsibilities are implied in private banking. It prefigures a particular kind of (neoliberal) subject: the calculative and selfmanaging agent (Rose, 1993), who cares for his/her own health and for his/her family and kin Santoro, 2011;Beltrame, 2014). The market does not reshape these relations according to commercial transactions, but mediates new family duties and kinship responsibilities .…”