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Before Bioethics: A History of American Medical Ethics from the Colonial Period to the Bioethics Revolution by Robert Baker (review)

emerged as an intractable obstacle to the global regulation of disease. By the early twentieth century, international regulatory agencies had devised effective regulations against the spread of rinderpest, foot and mouth, and pleuropneumonia by imported cattle. But in our own time, conflicts arising from the exportation of New Zealand apples and bananas from the Philippines, as well as from the much-publicized threats of mad cow disease and avian bird flu, have seriously challenged the reasonable cooperation and balance of interests that characterized nineteenth-century international regulation. Harrison provides detailed and gripping accounts of the fears of trade competition and loss of national sovereignty that inform the efforts of nations to deploy international (WTO) standards for the risk management of disease. He sees these invocations of risk assessment as grounded in “illusions” that threaten “eternal argument.” Harrison acknowledges these recent challenges to effective regulation, but they do not lead him to reconsider the optimism propelling his human history of the regulatory possibilities occasioned by the growth of global trade. In this regard, it is interesting to note that Foucault appears nowhere in Harrison’s analysis. This omission is, no doubt, a sign of the times. But perhaps Foucault’s understanding of the discursive limit of the modern nation, of how the threat of disease produces “society” as something palpable that must be “defended”—might help to make sense of the complex and over-determined strategies by which nations in a global, free-trade context have conceived of their sovereignty through the problem of the relationship between trade and epidemics.