CHAPTER 1

LOCATING BIOLOGICAL CITIZENSHIP

Stem cell advocacy is not a political movement. It is a consumermovement! If you ask people on the street if they support this, theydo, not because it is a public health issue, but because it's a personalhealth issue.

—Bernard Siegel, stem cell advocate

Our parks are closing. Our education budget is being slashed. Ourinfrastructure goes unrepaired. Cops are being laid off. Our universitystudents' tuition is shooting through the roof. Kids are being thrown offMedicaid.... But the CIRM keeps borrowing from the impecunious topay for its fat salaries and luxurious buildings.

—Wesley J. Smith, consumer advocate

"LOCATION, LOCATION, LOCATION!" is the enduring indicator of value withrespect to prime real estate; but in a nongeographical sense, it servesto signal social worth as well. Where, on an individual level, one is"located" within crosscutting social hierarchies—for example, whetherone is a Hollywood executive with a bevy of top medical specialists onspeed dial versus a drugstore clerk who turns to the ER for medical care,and then only with the most unbearable maladies—can be a matter oflife or death.

Our position in the social world gives us a particular vantage pointwith respect to everything from the new organic supermarket movinginto our neighborhood to the latest scientific innovation that promisesto regenerate our relative's stroke-induced paralysis. For the executive,the new supermarket is perhaps one more welcomed option; for theclerk, such neighborhood revitalization likely means her rent will increase,forcing her to move out. There is little wonder then that residentsin a growing number of transitional neighborhoods throughoutthe country have attempted to protest the construction of Whole FoodsMarket stores as a visible symbol of their impending displacement,rightly inferring the inverse relationship between more healthful foodoptions on their doorstep and their ability to keep up with rising propertyrates. In our enthusiasm for expanding healthful food options aspart of serving the collective good, we neglect the larger social contextin which goods are brought to market. Even analysts who might otherwisecritically attend to these dynamics can be swept up in the promiseof regeneration. Sociologist Loïc Wacquant points out this

troublesome trend in recent studies of gentrification, whereby thetakeover of working-class districts by middle- and upper-class residentsand activities is increasingly presented wholesale as a collectivegood.... By focusing narrowly on the practices and aspirationsof the gentrifiers through rose-tinted conceptual glasses, to thenear-complete neglect of the fate of the occupants pushed aside andout by urban redevelopment, this scholarship parrots the reigningbusiness and government rhetoric that equates the revamping ofthe neoliberal metropolis as the coming of a social eden of diversity,energy and opportunity.

The broader social context is one in which the individualistic logicof free choice is rather costly for those who cannot afford all the upgradestaking place in the public domain. Returning to the issue ofregeneration in the biomedical context, one young Filipino Americanman who lost part of his lung to tuberculosis observed that

the promise of therapeutic treatments derived from stem cell researchgives individuals like me a hope for normalcy. Yet, as an immigrantfrom a low-income family, I can't stop from cringing atthe thought that the low-income and marginalized communities ofthe state still have no explicit guarantee of access to the promised"cures" of Prop. 71—much less to adequate health care in general.

Another man born with cerebral palsy asked whether "as a Black, disabledactivist living on SSI [Social Security Insurance], would this propositionreach my people and other people of color who are wheelchairusers because of police brutality? ... With $3 billion going toward thisresearch, how much will go toward social programs, health care, and therun-down hospitals in our cities?"

By contrast, in the epigraph to this chapter, stem cell advocate BernardSiegel asserts that proponents of this research are part of a "consumermovement" for more and better choices in treating currentlyincurable illnesses—a "personal health" as opposed to public health issue.In isolation, who would object to the amelioration of sickness via moreeffective therapies? But despite numerous physical and symbolic attemptsto erect walls, build gates, pave private ways, and create social closures soas to separate "us" from "them," our life chances and well-being are notsimply "personal" but interconnected. We cannot afford to examine anycampaign for public underwriting of stem cell research as a movement toproduce biomedical goods without locating it within broader systems ofpower, inequality, and the collective good. The relationship between oursocial positions and the positions we take on the question of stem cellinvestment is reinforced by how much power we do or do not have to pullthe levers of influence in response to our concerns and interests. Thatis, the higher our position in the social landscape, the more the objectiveworld (institutions, policies, laws, and so on) reflects what we hold mostdear. So, despite occasional delays, the Whole Foods Market eventuallymoves into the neighborhood, and residents unable to afford the highercost of living must eventually move out.

In one of the most organized community campaigns to first resist,then engage, the supermarket company, residents of Jamaica Plain,Massachusetts, joined together in a "Whose Foods? Campaign," askingthe company to sign on to a Good Neighbor Agreement and donate1 percent of its annual revenue from the local store to fund "local anti-displacementorganizing ... and the creation and/or preservation oflocal affordable housing" for the duration of the store's twenty-year lease.In demanding "a small slice of the pie," the Whose Foods? Campaign isakin to the efforts of those seeking to establish a mutual...