Bioethics is better able to include various kinds of people, but this tension between the disability movement and modern bioethics shows that we still have a long way to go in our considerations of the moral status of patients.
A Foucauldian Perspective on Marginalized Bodies in Medicine
While it has been over 200 years since the initial publication of Mary Shelley’s Frankenstein, its contemporary relevance is markedly evident in the wide range of perspectives and analyses of the text that continue to be produced across a variety of disciplines. At its heart a story of dehumanization and the horrific consequences of unregulated scientific endeavors, Frankenstein is perfect for interrogating how we are conditioned to view and treat subjects in modern medicine, and recent scholarship has begun to explore the applicability of the novel to the recently established discipline of medical ethics. A literature review of articles that used Frankenstein to discuss issues of “ethics, bioethics, science, technology, or medicine,” conducted by Cambra-Badii et al., however, found there to be a lack of analysis of the broader ethical consequences of Victor Frankenstein’s research as opposed to the nature of his creation and the circumstances surrounding it.1 Some scholars have attempted to close this gap, including physicians and bioethical researchers, Drs. Julian Koplin and John Massie, who in “Lessons of Frankenstein” articulate the connections between “recent developments in stem cell and neurobiological research” and the text’s lessons on our moral obligations to these novel products of science.2 However, this article and similar research in the field of medicine as it pertains to Frankenstein fails to interact directly with the content of the novel or do a close reading or analysis of the text itself, opting instead to relate the general themes to broad ethical issues in medicine. Furthermore, research in the field of medicine is more engaged with the fictional “Creature” as a way to think about potential posthuman creatures of the future, overlooking the more relevant contemporary analysis of the Creature as a homolog for “Othered” lives in modern medicine.
While there is certainly value in using the novel to inform an ethics that reevaluates how we should treat a hypothetical, posthuman “Other,” a much more valuable use of the narrative is a close reading of the text informed by real contemporary issues of “othering” in medicine and healthcare. Disabled lives, transgender and queer lives, Black and Indigenous lives—human lives—have been systemically mistreated on the basis of their “non-normality,” resulting in “preventable differences in the burden of disease, injury, violence, or the opportunities to achieve optimal health.”3 This disparity is explained through the lens of the “medical gaze” in Michel Foucault’s The Birth of the Clinic, in which he describes how the patient or subject in medicine is often perceived within a purely biomedical framework—as a body or object affected by illness—disregarding the crucial aspects of narrativity and personal identity as relevant to the process of healing. The harms of the medical gaze are even more apparent when it comes to lives, identities, and stories that are systemically marginalized and unheard, and Foucault’s very pertinent link between narrative identity and the medical gaze, especially in an analysis of Frankenstein, is relatively unexplored. Using a Foucauldian lens to read the Creature as an ‘Othered’ figure in Frankenstein underscores the importance of narrative competence—the ability to understand, interpret, and respond to the stories of others—in deconstructing the medical gaze and recognizing the subjective experiences of people and patients, highlighting the need for greater empathy and understanding towards marginalized individuals and non-normative lives in society and medicine.
The fictional Creature in Frankenstein is aligned with the abnormal body and the “Other” by the unnatural nature of his creation, which further leads to his social exile and struggle to be perceived past his external appearances. Non-normative lives, as they are referred to in this essay, broadly encompass individuals who are similarly exiled, considered as existing outside or on the fringes of what is considered the “normative” body, including those whose bodies are transformed by illness, disability, and other aspects of identity. Though he does not directly resemble a human patient, the posthuman novum of the Creature can be read as an estranged version of these present day individuals. Prominent science fiction literary scholar, Darko Suvin, describes the novum as the strange, new, and scientifically plausible innovations that are a necessary feature of science fiction—in the case of Frankenstein, the scientific creation of the posthuman, “abnormal” Creature—which he describes as introducing a “Unknown or Other” that “estranges the empirical norm.”4 This representation of the Creature is not intended to similarly estrange the posthuman entities that medical scholars using Frankenstein are interested in, but instead take this partly recognizable yet unfamiliar subject of a “non-normative” life to induce reflection on our empirical reality—specifically disabled and Othered people that are subjected to the medical gaze and similarly exiled from medicine and society.
It is clear that this was in part the basis of Shelley’s criticism: that we should question Victor’s outcasting of his “monstrous creature,” simply because he does not fit into the category of normal. Her own life, upbringing, and the cultural contexts of the world she grew up in bleed into this message. In “Assembling Frankenstein,” Chris Baldick argues that the “rationalist innovation and reform” that Shelley’s mother embraced was “identified with the monstrous,” and Shelley’s “strong identification with her mother’s memory taught her to question the category of the ‘monstrous’ and to sympathize with moral outcasts.”5 The Creature’s criticisms of mankind’s vices, including the “division of property, of immense wealth and squalid poverty,” reflect Shelley’s own beliefs about social inequality and marginalization.6 Whether or not the Creature was written as a representation of a particular kind of Othered figure, this non-normality of his identity and body are integral to the outcomes of the novel and its characters, and can be extrapolated to figures of the Other in society and medicine.
This analogy of the Creature and the medical Other expands to show the narrative’s larger reflection on the practice of the medical gaze in modern medicine, which originated in the historical contexts that also produced Frankenstein. Through the blending of imagination and reality, the genre of science-fiction is able to critically engage with the values and “social-historical forces that have led to the current global hegemony of technoscience,” including those that produce the stories unique novum.7 It is no coincidence that the responses of Victor Frankenstein and larger society to the Creature resembles the framework and evolution of the doctor-patient dynamic described in The Birth of the Clinic; Foucault describes how “up to the end of the eighteenth century medicine related much more to health than to normality,” whereas “nineteenth century medicine was regulated more in accordance with normality than with health,” engaged with the goal of preserving life through “the medical bipolarity of the normal and the pathological.”8 Though Victor’s responses to the Creature and the consequences he faces as a result are often read as merely the unfortunate actions of an individual, it is clear that the novel and the responses of the society within it are also larger reflections of the medical gaze of Shelley’s time, in which disease and difference were placed in opposition to a desired normalcy. The premise of the novel and the social rejection that the Creature faces originates from this bipolarity between the normal and non-normal, where the latter was seen as not just divergent, but evil.
In this framework, illness is seen as an evil that takes away life, and is seen as something that plagues the body of the being afflicted by it, rather than an integral part of the creature affected by it. This is reflected in the language that Victor uses as he anguishes over the death of his mother, describing her illness as “the most irreparable evil” that extinguished “the brightness of a beloved eye.”9 In the eyes of Victor and many of this time period, the people who lived with afflictions of chronic illness or disability, were seen as being “contaminated” with this supposed “evil,” reflecting upon the moral status of the individual. In her Foucauldian analysis of fictional representations of disease and disability, Nicole Markotic argues that “the contaminated body became a marker for moral decay, exteriorizing the process of death,” meaning that “illness and disability both indicated a disreputable body…where the original body free of sin moved away from its pristine state towards ultimate death and decay.”10 Illness, disability, and the non-normative body are, under this lens, “contaminated” by death, and the ultimate goal of the clinic of Shelley’s time was to eradicate this contamination, which is reflected in the disgust that Victor and others express in their encounters with the Creature. The Creature, who is a reanimated, zombified being, exists on the fringes of life and death, which is incomprehensible and even disgusting to Victor. Upon looking at his creature alive for the first time, he is horrified by the “wretch” he once hoped would be beautiful.11
This response to the non-normalcy of the Creature’s body is purely rooted in visual perception, with no respect or dignity for the living being, sidelining any attempt for communication or understanding. This desire for the body to fit a certain aesthetic framework is often disparate when it comes to non-normative and disabled lives in contrast to those that fit into the category of “normal.” In “Introducing Disability Aesthetics,” Tobin Siebers argues that “not all bodies are not created equal when it comes to aesthetic response,” as “the senses revolt against some bodies, while other bodies please them.”12 This unfortunate phenomenon clearly resonates with how the Creature was continuously perceived throughout the novel, with children shrieking and women fainting before he “hardly placed [his] foot within the door.”13 Furthermore, the Creature is rarely given the chance to speak, with judgments made in response to his aesthetic appearance always preceding even an attempt by the Creature to articulate himself. The Creature is objectified and left voiceless, not only by his own initial inability to speak, but the incapacity for others to listen.
This proximity between the Creature’s suppressed speech and identity and the social rejection and lack of care that he encounters highlights the importance of using narrativity and narrative identity to understand subjects in medicine, especially those whose voices are already ignored. The Creature notably describes his inability to speak during the beginning of his story to Victor, explaining how he “wished to express [his] sensations in [his] own mode,” but his unfamiliarity with language and social isolation “frightened [him] into silence again.”14 While this can be interpreted as a metaphorical allegory for the voicelessness of the Other, it is also worth noting that the reason for the Creature’s inability to express himself is a consequence of his social rejection. Whether as a creator or a physician, part of Victor’s obligation to his creation is listening, language, and communication. This failure of the clinician to consider the narrativity and subjectivity of the patient is what Foucault describes in the paradigm of the medical gaze, and simply affording the patient a sense of understanding and empathy is the first step in deconstructing this harmful perception.
Even when the Creature is able to use language to communicate, his voice remains unheard, the aesthetic and pathological appearance of his body once again prioritized above his expression. When Victor first catches sight of the Creature on Mont Blanc, he expresses that he “felt a faintness” seize him, as he trembled with “rage and horror” at the mere sight of the Creature, once again highlighting the prioritization of the aesthetics of the body over the Creature’s identity and expression.15 Even as the Creature uses his newfound skills of language to explain to Victor that he wishes for both of them to simply do their duties to one another, Victor springs upon him in rage.16 To this, the Creature simply wishes for Victor to be calm and hear him.17 However, Victor and many of the other characters in the novel do not truly listen to the Creature, blinded by their disgust and discomfort with his non-normal body, responding in ignorance to his plights.
The only form of understanding and true kinship that the Creature experiences takes place when his voice is detached from his bodily appearance. In his interactions with De Lacy, the blind old man who lives near the Creature’s initial dwelling, the Creature’s narrative identity precedes his aesthetic appearance. Given the old man’s lack of sight, the Creature is finally able to engage in his first real conversation with another being. After the Creature recounts his experiences of prejudice and loneliness to De Lacy, the old man explains that though he is blind and “cannot judge of [his] countenance,” there is something in the Creature’s words that persuades him of his sincerity.18 For the first, and unfortunately last time, the Creature is understood, and almost cared for, before that hope was once again ripped away as his sighted family comes upon the creature in their home, exhibiting the same physical responses of violence and disgust to the Creature’s body that he had been experiencing since his birth.19
De Lacy’s own experiences of disability and being Othered notably contribute to the affinity that the two characters have for one another, but more importantly, De Lacy did something that every other character in the novel should have done—he listened. That is the failure of Victor, and of a society that rejects the Creature’s body because it is “plagued” by difference. In fact, the dignity and empathy of the Creature is highlighted by his recognition of the stories behind each of these characters. This interaction and alignment between the Creature and the disabled De Lacy is not born out of the Creature’s selfishness, but his own genuine feelings of empathy and kinship with the narrative identities of De Lacy and his family. Though he begins by living through them by proxy as he engages in listening to and understanding all of their stories and identities, he begins to feel a newfound sense of kinship with these figures. His ability to engage with the narrative identities of De Lacy and his family naturally spurs a sense of empathy and kinship in the Creature, who explains that “when they were unhappy, I felt depressed; when they rejoiced, I sympathized in their joys.”20 Without even interacting with them, through the simple act of listening, he was able to recognize their narrative identity and the people behind the physical body—he “learned the history of [his] friends,” recounting particular details about this family’s lives, including where De Lacy’s family was from, how Safie’s father caused their ruin, and they all underwent similar experiences of being othered that the Creature could empathize with.21
Through this theme of exile, the Creature is directly compared to the humans he encounters in the woods, including Safie, De Lacy, and even Victor Frankenstein himself, with whom he shares the experience of being an outcast. Safie recounts how her father was condemned and cast into prison, not due to the crime he was accused of, but rather “his religion and wealth.”22 Even De Lacy, “blind and aged” and vulnerable, is “thrown into prison” and condemned to a “perpetual exile from their native country.”23 The Creature’s ability to express these stranger’s stories with a sense of empathy and consideration for their moral worth is something that not even Victor was able to achieve, and as a result, the stories of both Victor and the Creature—physician and patient—end in tragedy.
Arguably, if Victor had treated the Creature with the same dignity and respect that the Creature treated these human outcasts, and if the Creature had experienced acceptance and care that acknowledged the state of his body and identity together, the tragedies of the novel may have presumably been avoided. When the Creature requests Victor to create another being like him, in order to have someone who may be able to give him this acceptance of all aspects of his existence, he is once again brutally denied, witnessing Victor “destroy the creature on whose future existence he depended for happiness.”24 Though the subsequent violence of the Creature may take the reader out of the allegory for the medical gaze and othered lives—his monstrous reaction is simply a manifestation of the intensity of the consequences for the social rejection that he faces, a reclamation of power in the face of subjugation. The tragic endings and consequences of the societal rejection and lack of empathy for the Creature can be read as a kind of warning against Victor’s shortcomings in his treatment of his creation.
Victor, by employing the medical gaze, ignores the intimate relationship between the body, illness, and identity, all of which contribute to and exacerbate the rejection of the Creature and other lives. The framework of viewing the body as non-normal and contaminated by death, and the separation of identity from illness, and illness from the body, is particularly devastating when it comes to disabled and non-normative lives, as their subjectivities are intimately connected to the physical body. The rhetoric of trying to rid a life of “difference” or “non-normalcy” is what has been used to justify the eradication of non-normative and disabled lives, and it is abundantly clear that this rhetoric also has deeply scarring effects on the individual, as seen in the story of the Creature.
The harms of ignoring identity behind illness are even more apparent when it comes to lives, identities, and stories that are systemically marginalized and unheard. This is why disability scholars implore us to adopt “alternative disability moral psychologies,” or ways to transform the current “curriculum” of bioethics with nuanced narratives that can make disability a true consideration in bioethical frameworks.25 As public perception and ethical norms have adjusted to progress, bioethics is better able to include various kinds of people, but this tension between the disability movement and modern bioethics shows that we still have a long way to go in our considerations of the moral status of patients.
In order to combat the medical gaze’s ignorance towards the subjectivities of patients, we can look to language, communication, and perception, and their importance within the novel. For example, De Lacy and the Creature, were able to truly see each other without ignoring the other’s affliction, acknowledging their plights and identities behind their appearances, illustrating the potential that narrative competence has in deconstructing the medical gaze. In contrast, the failings of characters like Victor to engage with this communication and understanding leads to the issues of otherization in the novel, further highlighting the importance of narrativity.
As we reflect on the importance of communication and narrativity within the frames of the novel, we can also expand our frame to reality: thinking about the language of the novel invokes a certain response of empathy for the Creature and the Other. In considering the applicability of these lessons to actually deconstructing the medical gaze in modern medicine, we can look to the novel field of narrative medicine, established by physician and professor, Rita Charon, who emphasizes the importance of skills acquired through narrative thinking in improving doctor-patient interactions and reflective thinking in the field.26 This is the specific value of using literature and the text to engage with pure language and narrativity, and the skills gained from even analyzing these texts that are explicitly or implicitly engaged with bioethics and medicine can be used to combat rampant ignorance towards patient identity. This is why other scholars’ arguments fall short in that they recognize Frankenstein’s value in addressing and deconstructing issues in medicine such as a lack of empathy and our ethical obligations to medical subjects, yet they ignore the narrativity of the novel and the creature as central to these issues.
Though it is arguably more important to acknowledge the shortcomings in how we treat othered lives in medicine today, these same ideas can also be used in looking towards the future, as other scholars have attempted to do. The deconstruction of the medical gaze is something that perhaps expands beyond the clinical setting, but also within the society that produces and upholds it, worsening outcomes for non-normative lives. While society and medicine have come a long way since Shelley’s time, these harmful views that prioritize an eradication of non-normative lives by pathologizing illness and biology and ignoring identity are still prevalent. Whether the narrative of Frankenstein is used to imagine our responses to the “science-fictional” prospect of how we may treat posthuman creatures of the future, or used to the reflect on modern medicine’s treatment of non-normative lives, Shelley’s work implores us to interrogate the human and the moral value of recognizing the subjectivities of each and every being in medicine and beyond.
- Irene Cambra-Badii, Elena Guardiola, and Josep-E. Banos, “Frankenstein; or, the Modern Prometheus: a Classic Novel to Stimulate the Analysis of Complex Contemporary Issues in Biomedical Sciences,” BMC Medical Ethics, vol. 22, no. 17 (2021): 5.
- Julian Koplin and John Massie, “Lessons from Frankenstein 200 Years On: Brain Organoids, Chimaeras and Other ‘Monsters,’” Journal of Medical Ethics, vol. 47, no. 8 (2021): 567.
- Haeok Lee, “The concepts of health inequality, disparities and equity in the era of population health,” Applied Nursing Research, vol. 56 (2020): 3.
- Darko Suvin, Metamorphoses of Science Fiction: On the Poetics and History of a Literary Genre (Yale University Press, 1979), 64.
- Chris Baldick, “Assembling Frankenstein,” Frankenstein: the 1818 text, contexts, criticisms, edited by J. Paul Hunter, 2nd edition (W.W. Norton and Company, Inc., 2012), 178.
- Mary Wollstonecraft Shelley, Frankenstein: the 1818 text, contexts, criticisms, edited by J. Paul Hunter, 2nd edition (W.W. Norton and Company, Inc., 2012), 83.
- Istvan Csicery-Ronay, “Introduction,” The Seven Beauties of Science Fiction (Wesleyan University Press, 2012), 10.
- Michel Foucault, The Birth of the Clinic. 3rd ed., (Routledge, 2003), 51.
- Shelley, Frankenstein, 26/
- Nicole Markotic, “Re/Presenting Disability and Illness: Foucault and two 20th Century Fictions,” Disability Studies Quarterly, vol 23., no. 2 (2003): 180.
- Shelley, Frankenstein, 35.
- Tobin Siebers, “Introducing Disability Aesthetics.” Disability Aesthetics, by Tobin Siebers, (University of Michigan Press, 2010), 1.
- Shelley, Frankenstein, 73.
- Shelley, Frankenstein, 71.
- Shelley, Frankenstein, 67.
- Shelley, Frankenstein, 68.
- Shelley, Frankenstein, 68.
- Shelley, Frankenstein, 94.
- Shelley, Frankenstein, 94.
- Shelley, Frankenstein, 77.
- Shelley, Frankenstein, 84-85.
- Shelley, Frankenstein, 85.
- Shelley, Frankenstein, 87.
- Shelley, Frankenstein, 119.
- Joseph A. Stramondo,“Why Bioethics Needs a Disability Moral Psychology,” The Hastings Center Report, vol. 46, no. 3, The Hastings Center, Wiley (2016): 22-27.
- Rita Charon, “Narrative Medicine: A Model for Empathy, Reflection, Profession, and Trust,” The Journal of the American Medical Association, vol 286, no. 15, (2001): 1300.