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The Social and Historical Subject in Sartre and Foucault and Its Implications for Healthcare Ethics

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The Social and Historical Subject in Sartre and Foucault and Its Implications for Healthcare Ethics Marquette University e-Publications@Marquette Dissertations, Theses, and Professional Dissertations (1934 -) Projects The Social and Historical Subject in Sartre and Foucault and Its Implications for Healthcare Ethics Kimberly Siobhan Engels Marquette University Follow this and additional works at: https://epublications.marquette.edu/dissertations_mu Part of the Bioethics and Medical Ethics Commons, and the Comparative Philosophy Commons Recommended Citation Engels, Kimberly Siobhan, "The Social and Historical Subject in Sartre and Foucault and Its Implications for Healthcare Ethics" (2017). Dissertations (1934 -). 723. https://epublications.marquette.edu/dissertations_mu/723 THE SOCIAL AND HISTORICAL SUJBJECT IN SARTRE AND FOUCAULT AND ITS IMPLICATIONS FOR HEALTHCARE ETHICS By: Kimberly S. Engels, BA, MA A Dissertation submitted to the Faculty of the Graduate School, Marquette University, in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Milwaukee, WI August 2017 ABSTRACT THE SOCIAL AND HISTORICAL SUBJECT IN SARTRE AND FOUCAULT AND ITS IMPLICATIONS FOR HEALTHCARE ETHICS Kimberly S. Engels, BA, MA Marquette University, 2017 This dissertation explores Jean Paul Sartre’s and Michel Foucault’s view that subjectivity is socially and historically constituted. Additionally, it explores their corresponding ethical thought and how these viewpoints can be applied to ethical issues in the delivery of healthcare. Sartre and Foucault both hold the view that human beings as subjects are not just participants or spectators in social practices, rather, they become subjects with ontological possibilities through their interaction with these practices. In Chapter One, I trace Sartre’s views on subjectivity in his two major works Being and Nothingness and The Critique of Dialectical Reason, Volume 1, showing how he argues that we are constituted as subjects through a dialectical interaction of consciously intended praxis with the reified results of human affairs, or practico-inert. In Chapter Two, I trace Foucault’s views on the subject through all three periods of his career, and show how he argues that we are constituted as subjects through systems of thought, strategies of power, and practices of the self. I specifically differentiate the views of each philosopher from those of the more traditional moral philosophers Immanuel Kant and John Stuart Mill, who view the subject as self-determining and ahistorical. In Chapter Three, I examine each thinker’s later lectures on ethics, and show that each philosopher presents an outline for an ethical mode of being, which I call “ethical subjectivity.” For both philosophers, ethical subjectivity requires critical historical reflection, ethics as an ongoing task, and innovation. In Chapters Four and Five, I use Sartre’s and Foucault’s views on subjectivity and ethics to analyze two contemporary issues in healthcare ethics: conscience-based refusals and mandatory HPV vaccination. Through discussion of these two issues, I show how focusing on the social, historical, material dimensions of how we become who we are introduces a different starting point for analysis and leads to a unique discussion in contrast to the ethical approaches rooted in the thought of Kant or Mill. i ACKNOWLEDGMENTS Kimberly S. Engels, BA, MA This dissertation would not have been possible without the generous financial support of the Smith Family Foundation for the 2015-2016 academic year and the Rev. John P. Raynor, S.J. Foundation for the 2016-2017 academic year. The financial support provided by the Smith Family Foundation made it possible for me to spend three weeks studying Sartre’s unpublished lecture on ethics at the Bibliothèque nationale de Paris in September of 2015. The financial support from the Rev. John P. Raynor, S.J. Foundation relieved me from teaching responsibilities so I could spend the 2016-2017 academic year completing my dissertation in a timely manner. I would like to thank the Marquette Graduate School for the teaching and research assistantships that provided me with funding for the first three years of my studies. I would like to thank the Marquette University Philosophy Department for providing me with a lectureship in my fourth year and nominating me for fellowships in my fifth and sixth year. This funding definitely helped me succeed and contributed to the efficient completion of my degree. I am indebted to my director, Dr. Pol Vandevelde, for his guidance throughout the completion of this dissertation, from helping me develop the initial ideas to reading the final edits. His constant support and prompt and helpful feedback were integral to the successful and efficient completion of this project. He has also provided me with exceptional guidance throughout my six years studying at Marquette University. He has never hesitated to help me at every stage of my graduate career in various roles: through ii teaching, academic advising, assisting in revising works for publication, and, of course, directing this dissertation. I am also deeply indebted to my second reader, Dr. Kevin Gibson, for his feedback on my dissertation in addition to his mentorship throughout my graduate career. He provided me with invaluable support and guidance during my first year of graduate school that helped me find my footing as a new student and solidified my foundation as a future scholar. He was the first to suggest that I could merge my historical interest in Sartre with contemporary healthcare ethics. He introduced me to the world of academic publishing and helped prepare me for the academic job market. He has never hesitated to provide assistance, encouragement, and guidance whenever asked, and often without being asked. I would like to thank my other readers, Dr. Stanley Harrison and Dr. Noel Adams, who agreed to serve on my committee without hesitation. They both have provided support, advice and much appreciated kindness throughout my years at Marquette. Their scholarly expertise helped improve this project. I would like to extend gratitude to Dr. Kristin Haglund in Marquette University’s College of Nursing for assisting me with the empirical analysis in Chapter Five. Her expertise in adolescent health was extremely beneficial for ensuring I was accurately portraying the adolescent health problem that I discuss. I am grateful for the members of the North American Sartre Society, especially Dr. Elizabeth Butterfield. I presented portions of three of these five Chapters at various meetings of the Sartre Society over the past six years, and I received insightful, encouraging feedback each time. Dr. Butterfield in particular has given me extremely iii positive, yet also critical and challenging feedback over the years that helped develop my expertise in Sartre. Her own scholarly work on Sartre’s ethics unquestionably aided me in forming my own views on the subject and influenced the ideas in this dissertation. I would like to thank Dr. Lissa Skitolsky for first introducing me to Continental philosophy, especially the works of Foucault, many years ago at Luther College. It was her teaching and mentoring that inspired me to pursue a graduate degree in philosophy and I will always be grateful to her for that. I would like to express gratitude to my father, Gerald J. Engels, for introducing me to philosophy all those years ago and entertaining my musings as a young philosopher. He encouraged my probing into foundational philosophical questions at a young age and encouraged studying philosophy in undergrad. Last, but not least, I would like to thank my husband, Umair Khan, for his support while I completed my degree. He tolerated being married to a graduate student for six years, which is not an easy task. I would not have finished my degree without his ongoing support. iv TABLE OF CONTENTS ACKNOWLEDGMENTS……………………………………………………………….i INTRODUCTION……………………………………………………………………….1 CHAPTER ONE: SARTRE AND OUR MATERIAL, HISTORICAL, AND SOCIAL POSSIBILITIES: THE SUBJECT AS SPIRAL AND THE PRACTICO-INERT……..17 Introduction……………………………………………………………………..17 1. Critique of Dialectical Reason: Current Literature………………….……...21 2. From In-itself/For-itself to Praxis/Practico-inert……………………………25 2.1 From Nihilation to Dialectic, Negation to Spiral……………………25 2.2 The In-itself to Practico-Inert: Current Literature…………………...35 3. Our Given Possibilities………………………………………………………44 3.1 The Material: Physical Objects, Human Artifacts, and Altered Nature ………………………………………………………………44 3.2 Language, Attitudes, and Ideas………………………………………47 3.3 The Social and the Other……………………………………………..49 3.4 Class Being…………………………………………………………..52 4. Sartre, Subjectivity, and Freedom……………………………………………55 4.1 Freedom in Being and Nothingness………………………………….55 4.2 Freedom in The Critique of Dialectical Reason, Volume 1………….56 5. The Kantian Subject and the Sartrean Liberal Subject………………………61 5.1 Kant and the Noumenal Self…………………………………………63 5.2 The Dialectical Spiral Versus the Noumenal Self…………………...67 Conclusion……………………………………………………………………….72 v CHAPTER TWO: FOUCAULT AND OUR MATERIAL, HISTORICAL AND SOCIAL POSSIBILITIES: SYSTEMS OF THOUGHT, STRATEGIES OF POWER, AND PRACTICES OF THE SELF……………………………………………………………75 Introduction: Foucault’s Turn to the Subject…………………………………….75 1. Foucault and Subjectivity: Current Literature……………………………….79 2. First Axis: Discursive Practices and Possible Knowledge in The Order of Things and The Archaeology of Knowledge…………………………………85 2.1 The Order of Things…………………………………………………85 2.2 The Archaeology of Knowledge……………………………………..91
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