September 3, 2012
From Normative Theory to Diagnostic Practice
Hans Sluga
“Constant revolutionizing of production, uninterrupted disturbance of all social relations, everlasting uncertainty and agitation, distinguish the bourgeois epoch from all earlier ones,” Karl Marx writes in 1848 in The Communist Manifesto. Consequently, “all fixed, fast-frozen relations with their ancient and venerable prejudices and opinions, are swept away, all new formed ones become antiquated before they can ossify. All that is solid melts into air, all that is holy is profaned, and men at last are forced to face … the real conditions of their lives and their relations with their fellow men.”[1] With these powerful, persuasive words Marx proves himself the foremost diagnostician of his age. But the passage also raises questions about the limitations of his diagnostic insights. What are we to say about his genealogy of this modern condition? Is its fluidity entirely due to bourgeois economics? Why then did the same turbulences in the end also blow into Communist Russia and Communist China? And what are we to say about Marx’s prognostic powers? Does the maelstrom of modern life, in fact, force human beings to face “the real conditions of their lives”? Or does it not also produce ever new forms of social illusion?
None of this detracts from Marx’s astuteness as an observer of the peculiarly fluid nature of modern life. In a remarkable book of the 1980s – appropriately entitled All that is Solid Melts into Air – Marshall Berman has taken the trouble of elaborating on Marx’s theme from the perspective of the late twentieth century. Starting with Goethe’s Faust as the paradigmatic figure of the modern thinker and entrepreneur who must die when he can say of the moment: “Remain, because you are so beautiful,” Berman describes Baudelaire’s discovery of the transformations of modern life in Haussmann’s Paris, the emergence of St. Petersburg as the capital of revolutionary modernity, mirrored in literary works from Pushkin, through Gogol and Dostoevsky, to Andre Biely and Osip Mandelstam, and finally the partial destruction of the place of his own childhood, Brooklyn, New York, at the hands of the city planner Robert Moses. Berman speaks eloquently of a world of “great discoveries in the physical sciences, changing our images of the universe and our place in it; the industrialization of production, which transforms scientific knowledge into technology, creates new human environments and destroys old ones, speeds up the whole tempo of life, generates new forms of corporate power and class struggle; immense demographic upheavals, severing millions of people from their ancestral habitats, hurtling them half way across the world into new lives; rapid and often cataclysmic urban growth; systems of mass communication, dynamic in their development, enveloping and binding together the most diverse people and societies; increasingly powerful national states, bureaucratically structured and operated, constantly striving to expand their powers; mass movements of people, and peoples, challenging their political and economic rulers, striving to gain some control over their lives; finally bearing and driving all these people and institutions along, an ever-expanding, drastically fluctuating capitalist world market.”[2] In such formulations Berman proves himself, like Marx, to be a perceptive diagnostician of the present age. Today, in the year 2012, when we are still feeling the backwind of a global economic crisis, his words may have even more resonance than they did at the time of their publication thirty years ago. A new edition of Berman’s book would only require an additional chapter on the cities of Asia, perhaps on Hong Kong, Shanghai, or Beijing, and on what their explosive development means for the condition of human life in the twenty-first century, its hopes and despairs.
In one significant respect Berman advances beyond Marx’s formulations. Where Marx emphasizes the transforming power of modern life, Berman indicates that the standing, the solid, and even the holy persist surprisingly in the midst of the turbulence of modern life; that traditions, habits, forms of belief hang on; that old structures and institutions remain – rebuilt, re-functioned, sometimes only as a façade, but still visibly there. And also how new forms and formations crystallize out in this wild torrent – bigger, harder, more brutal, mightier or at least appearing to be so than anything that has come before. Berman is right: the Heraclitean flux and dialectical forward movement of the modern age disgorges over sharp cliffs and hard ground.
Marx and Berman together remind us of something we all know, of course, but often fail to see clearly enough and particularly so when we think philosophically: i.e., the distinctive fluidity, uncertainty, and fragility of the situation in which we are living today. My purpose in quoting their words was to bring this idea home to you once again in order to impress on you the further thought that it is not only our external circumstances that have changed and are changing but our entire human, moral and political existence. Contrast this to the prevailing tone in most of our moral and political philosophizing up to the present moment – its preoccupation from the ancient Greeks to today with timeless norms, universal principles, and necessary truths. It seems that philosophy is still seeking to erect stone tablets in the midst of our kaleidoscopically changing reality. The fluid nature of that reality should alert us, however, to the need for another kind of philosophical thinking – one that attends to the conditions in which we find ourselves and to the practical tasks we face, that this calls for an intimate knowledge of the present and that our tasks can certainly not be solved by appealing simply to abstract principles and norms. In place of the usual normative theorizing we need to foster, in other words, a diagnostic practice in our moral and political thinking.
2.
Michel Foucault was probably the most skillful practitioner of this diagnostic method in the late twentieth century. Much can certainly be learned from the way he engaged in that practice. I know, however, of only one occasion when he actually used the term “diagnostic” to characterize his work. That was in an interview with the Italian philosopher Giulio Preti in 1972. According to Preti, Foucault had said that philosophy was “above all a diagnostic enterprise” and the interviewer wanted to know what he meant by that. Foucault responded somewhat unhelpfully that by “diagnostic knowledge I mean, in general, a form of knowledge that defines and determines differences”[3] and let the matter rest at that. But the diagnostic form of philosophizing is, nonetheless, of the greatest importance for Foucault but he talks about it most often under the title of a “history of the present.” That was, for instance, what he had in mind when he said another interview in 1977: “It seems to me that since the 19th century, philosophy has not ceased asking itself the same question. ‘What is happening right now, and what are we, we who are perhaps nothing more than what is happening at this moment?’ Philosophy’s question is the question of this present age which is ourselves. This is why philosophy is today entirely political and entirely historical. It is the politics immanent in history and the history indispensable for politics.”[4] Foucault expanded on this theme by 1983 with his discovery of Immanuel Kant’s prize essay “What is Enlightenment?” of 1784. He first commented on that essay in his lectures on The Government of Self and Others in 1982-83. The following year he said more on the matter in a further interview he gave in Louvain (published under the title “What Our Present Is”) and in his well-known essay “What is Enlightenment?”
In the lecture course Foucault suggested that we should look at Kant as the source of two lines of philosophical reasoning. “”[I]n his major critical oeuvre – that of the three Critiques and above all the first Critique – Kant set out and founded that tradition of critical philosophy which posed the question of the conditions of the possibility of a true knowledge … That is the form of philosophy that you now find in the form of, say, Anglo-Saxon analytical philosophy.” We may want to add here that in the second Critique (and in his Groundwork of the Metaphysics of Morals) Kant also sought to lay down universal norms of moral action. But, Foucault argued that Kant’s essay “Was ist Aufklärung?”[5] and a number of his other incidental pieces pursue an entirely different kind of critical thinking by asking: “What is present reality? What is the present field of our experiences? What is the present field of possible experiences? Here it is not the question of the analytic of truth, but of what could be called an ontology of the present, of present reality, an ontology of modernity, and ontology of ourselves.” The great choice in philosophy today is then, according to Foucault, between these two Kant-inspired forms of philosophical thinking and it is with the second of them that aligns aligns the thought of Hegel, Marx, Nietzsche, and the Frankfurt School as well as his own.[6]
Foucault did not repeat the claim that the task for himself and the tradition with which he identified was to construct an “ontology” of the present, as if the goal of this kind of inquiry was to gain theoretical insight into the structure of our present reality. In his interview in Louvain he said instead that his intention was “to choose a field containing a number of points that are particularly fragile or sensitive at the present time.” He was not seeking, in other words, “to follow what is happening and keep up with what is called fashion… The game is to try to detect those things which have not yet been talked about, those things that, at the present time, introduce, show, give some more or less vague indications of the fragility of our system of thought, in our way of reflecting, in our practices.” [7] It should be evident from these words that Foucault did not see himself engaged in the purely intellectual enterprise of constructing an account of the present or even of constructing an account of the history the present. The characterization of his project at as a concern with “what our present is” or with a “history of the present” is therefore somewhat misleading. Foucault might have done better with the Nietzschean term “genealogy,” which, of course, he used at other time. But even that term may mislead us unless we understand that Nietzsche’s genealogy was also meant to be a diagnosis of the present and not a comprehensive history of morals; in addition we must also understand that Nietzsche’s genealogy was conceived to have practical consequences not just theoretical value. In the following I will speak of both Nietzsche’s and Foucault’s undertaking as diagnostic in character.
Foucault’s lectures at the Collège de France make evident that he saw the Kant of “Was ist Aufklärung?” as, in fact, the originator of such a practice. Foucault points out there that Kant was, of course, not the first philosopher speaking about his own time. Augustine and Descartes had certainly done so before him. But for Kant the question had been, first of all, “what is it in the present that currently has meaning for philosophical reflection?” Kant had, second, considered how this bears on the process of thought, knowledge, and philosophy, and who the bearer of that process is. And he had furthermore shown “how the person who speaks as a thinker, a savant, a philosopher, is himself a part of this process, and finally how such a person has a role in this process.[8] Foucault had gone on to expand on this point in his essay “What is Enlightenment?” by suggesting a link between Kant’s thinking about his own present and his three major Critiques. Enlightenment was for Kant the moment when reason could finally stand on its own feet, but it was precisely at this moment that a critique of reason became necessary. “Was ist Aufklärung?” is, according to Foucault, “a reflection by Kant on the contemporary status of his own enterprise.” The essay represents the first time that a philosopher has connected in this way, closely and from inside, the significance of his work with respect to knowledge, a reflection on history and a particular analysis of the specific moment at which he is writing and because of which he is writing. It is in the reflection on ‘today’ as difference in history and as motive of a particular philosophical task that the novelty of this text appears to me to lie.”[9]
Foucault expands on his conception of a history of the present by turning next to Baudelaire. Baudelaire, so he writes, is the most acute nineteenth century analyst of modernity for Baudelaire defines modernity as “the ephemeral, the fleeting, the contingent.” But being modern does not for Baudelaire consist in recognizing and accepting this perpetual movement, it
means rather “to grasp the ‘heroic’ aspect of the present moment.” This is not to treat the passing moment as sacred in order to try to maintain or perpetuate it. “For the attitude of modernity, the high value of the present is inseparable from a desperate eagerness to imagine it, to imagine it otherwise than it is, and to transform it not by destroying it but by grasping it in what it is.” Baudelaire’s modernity is a “practice of liberty that simultaneously respects this reality and violates it.” Modern man is “the man who invents himself. This modernity does not ‘liberate man in his own being’; it compels him to face the task of producing himself.[10]
2.
Consider by contrast how normative-theoretical philosophy looks at moral and political issues. It conceives of its problems typically as dilemmas, that is, as determinate situations in which one is faced with a choice between two or more definite alternatives. The choice may be simply between doing or not doing A, e.g. between helping or not helping someone, or between doing A and doing its opposite, as in telling the truth or lying, or between a number of possible actions such as favoring one of a number of persons. The assumption is usually that the situation itself is transparent and needs therefore little attention and that the range of alternatives is definite and foreseeable. The genuine and moral problem consists then in the question how we are to make the necessary choice before us. Our problem is, in other words, a decision problem and the decision problem is thought to be resolved by appeal to an abstract norm.
We can illustrate the envisaged situation with Kant’s dramatic example of the madman who storms into the house, a butcher’s knife in his hand, demanding to know whether X is at home. The situation is self-evident. The moral dilemma is simply whether to tell the truth or not. According to Kant this decision problem can be resolved by appealing to the categorical imperative. It is in precisely these terms that John Rawls, the most influential moral and political philosopher of our time, discusses the matter in his 1951 essay “Outline of a Decision Procedure for Ethics.” He asks in it whether “there exist a reasonable decision procedure which is sufficiently strong, at least in some cases, to determine the manner in which competing interests should be adjudicated.” And he concludes that “the problem of the justice of actions, as a theoretical question, is essentially the problem of formulating reasonable principles…”[11] While Rawls did not repeat these exact formulations in his later and better known writings, his view remained in effect that moral problems are decision problems that are to be resolved by an appeal to “reasonable” universal principles.
Decision problems can, as a matter of fact, be resolved in more than one way. We sometimes resolve them by making random choices, sometimes do so in an ad hoc fashion, and only sometimes we appeal to a general norm. Making a random decision – for instance, by tossing a coin or drawing a straw [12] – is common practice when some choice needs to be made but its outcome is of no great concern or when we want to assure, for reasons of fairness, that each of the choices has an equal chance of being made. We decide randomly, for instance, when we seek to determine who is to occupy which place in a contest or some other structured activity. The democrats of ancient Athens, for instance, assigned political offices by lot. Then there are the ad hoc decisions which may be based to various degrees on rational reflection and calculation but ultimately come down to choices made by particular persons on particular occasions. We know of such forms of decision making from political systems in which rulers govern without the use of laws. Finally, there are the rule- or norm-governed decisions with which we are thoroughly familiar, for instance, from modern bureaucratic life.
But, whatever the options, when it comes to moral dilemmas, it seems inappropriate to us – that is, to us as modern people – to decide them in a random fashion. We resist the idea, for instance, that we should let an omen or the stars determine the outcome of our decision. There have, however, been times when it was considered natural and even most appropriate to decide significant moral and political issues in precisely this manner. A few moral philosophers allow that ad-hoc decision making may be appropriate and inevitable even in moral situations (and they may be, all in all, on the right track). But the predominant view is surely that moral dilemmas must be resolved through an appeal to general rules, principles, commandments, or imperatives – not just any rules, however, but non-arbitrary, compelling, or “reasonable” rules or principles such as the ten commandments, the golden rule, the categorical imperative, or John Rawls’ principles of justice – rules with a claim to validity.
But where are we to find those rules and how will we validate them? Surely not by attending too closely to the specific situation to which we want to apply them. In order to discover a universal principle or rule we must, in fact, abstract from the particularity of the cases to which they are meant to apply. The moralist must, rather, look for a transcendent, transcendental, or rational grounding for his rules. Thus, the prophet Moses will leave his people behind in the Sinai desert in order to climb Mount Horeb where Yahweh himself, from behind a veil of fire and clouds, will dictate to him a set of commandments. In the allegory of the cave, Plato tells us that the philosopher must leave the human world and attend to the extra-worldly reality of the Forms if he wants to clear his mind of the common illusions. Only then, when he has seen the Form of the Good, can he return to the human cave to tell his people what the happy city will look like. John Rawls, adapting the metaphorical language of both the Old Testament and of Plato’s allegory, writes that those who want to determine principles of justice must withdraw behind a veil of ignorance. “Among the essential features of this condition is that no one knows his place in society, his class position or social status, nor does anyone know his fortune in the distribution of assets and abilities, his intelligence, strength, and the like. I shall even assume that the parties do not know their conception of the good or their special psychological propensities. The principles of justice are chosen behind a veil of ignorance. This ensures that no one is advantaged or disadvantaged in the choice of principles by the outcome of natural chance or the contingency of social circumstances. Since all are similarly situated and no one is able to design principles to favor his particular condition, the principles of justice are the result of a fair agreement or bargain.” [13]
There exist, in summary, a dominant form of philosophical understanding of the nature of moral and political problems. It involves three theses:
- Moral-political problems take the form of dilemmas: they are decision problems.
- These decision problems are resolved with the help of universally binding rules.
- When applied to a specific dilemma, those rules generate conclusions of the form: In situation X, chose Y where X is generally assumed to be transparent and Y definite.
I will speak of such rules (principles, imperatives, etc.) in the following as “norms” – reserving the term for this precise use.[14] And I will speak of theories that are committed to those three propositions as “normative theories.”
3.
Not all moral-political problems are, in fact, dilemmas, in contrast to what normative theory tends to assume. Whether a situation is transparent or not will depend on a number of factors: its complexity, its prevalence, and also its degree of permanence. Simple situations, recurring situations, and stable situations that allow for prolonged perusal are usually transparent. Furthermore, only if a situation is transparent is it likely to present us with definite choices. However, not all situations are clear-cut in the way of Kant’s madman example which describes a kind of situation that is certainly simple and recurrent, though not, perhaps, stable. Think, for instance, of the abortion or euthanasia debates and how they involve complex matters of fact (of biology, medicine, psychology, and sociology) as well as appeals to the intersecting and conflicting rights and obligations of individuals, potential individuals, families, care givers, and society at large. Think of political dilemmas, such as the one presented by the attack on the World Trade Towers in 2001, which constituted both a complex and a unique situation. And think of yet other situations such as the decision to throw nuclear bombs on Japan in 1945 which was not only complex and unique but highly unstable. It is, of course, with this type of situation that Marx and Berman see us concerned in our distinctive historical moment. Our moral philosophers are not unaware of the existence of such situations but they are little equipped to speak about them: their peculiarly abstract mode of thinking prevents them from getting into the bewildering labyrinths of our lives, the endless confusions of the human heart, the turbulence of our political and social reality. We are often forced to turn, instead, to newspaper stories, novels, movies, to biographical and historical narratives to learn about such matters. In them we discover how little the abstract norms of the moralists can help us. Or rather, that they sometimes help us, sometimes confuse us, sometimes prove irrelevant, and sometimes even contribute to our disasters.
We can look at the old debate about forms of government in this light. Since the beginning of political philosophy in the West there has been a debate about the best form of government. Hesiod (in his Histories) makes the Persian princes discuss this issue with the conclusion that monarchy is best. Plato argues subsequently that the rule of the philosopher-kings is best and Aristotle that the republican system mapped out in his Politics is the best. More recently we have come to agree that democracy is the best system of government – a view less widely held in history. All these claims rely, however, on three assumptions that are all dubious: the first is that we can once and for all tabulate the possible forms of government, the second that we can rank them in a linear order, and the third that it is up to us to choose which form of government to realize.
Aristotle who himself provided such a ranking at the same time modified and, I want to suggest, in effect undermined it in the fourth book of his Politics. He writes there that political theory must deal not only with what is ideal but also with what is practical. He explains there that “it is the task of the same branch of knowledge to consider first which is the best constitution, and what qualities a constitution must have to come closest to the ideal when there are no external factors to hinder it doing so, and secondly which sort of constitution suits which sort of civic body.” We may read these words as a compelling criticism of Plato’ political theory. In the Republic Plato had drawn the picture of an ideal city governed by philosopher-kings, but he had never made clear how such a system could be realized. Aristotle thought, in fact, (as he explained in book 2 of his Politics) that such a city was an absolutely impossibility. He continues the passage from which I have been quoting: “The attainment of the best constitution is likely to be impossible in many cities; and the good lawgiver and the true statesman must therefore have their eyes open not only to what is absolutely the best, but also to what is best in relation to actual conditions.” [15] To appreciate the full significance of this remark one must note that Aristotle is here, in fact, making two distinctions which he does, perhaps, not fully separate in his own thinking. The first merely qualifies the initial concern with the ranking of forms of government, whereas the second undermines it. The first of the distinctions in question is one between what is absolutely best and what is relatively best and the second between what is best and what is possible. Aristotle relies in effect on this second distinction when he adds: “Perhaps the reason why kingship was formerly common was because it was rare to find a number of men of outstanding goodness – all the more as the cities they inhabited were small… Later when it came about that there were a number of people of equal goodness, they no longer held back but sought to have something they could share in common, and so established a republic. … Since cities have become still larger, we may perhaps say that it is now difficult for any form of constitution apart from democracy to exist.” [16]
Aristotle’s words suggest a twofold approach to political theory: the first being a search for the best form of government and the second a determination of which of these systems can at any one time be realized. The implications of his words are, however, more radical than he himself realizes for they imply that the form of government we are likely to have is not or not fully up to us and thus not or not fully our own responsibility. One can admittedly in any circumstances plead and agitate for any (recognized) form of government, but whether that can be realized and whether it will prove to be effective and stable, depends on other factors than insight and moral willing. It will be determined, instead, by factors such as the complexity of the political system. For Aristotle, that complexity is a direct function of the number of people living under a system of government. That is probably too simple; there are other complicating factors such as economic, military, and environmental ones. Among those factors will, of course, also be the prevailing understanding of politics. For that reason it is not totally wrong to say that political attitudes and values determine our form of government – but only as one among many other factors.
4.
What we need when a problematic moral or political situation is not simple and transparent, but complex and irregular, is above all attention to the situation itself. We need to engage in exactly the opposite maneuver to that of the moralist’s ascent to mount Horeb, the philosopher’s departure from the human cave, or his withdrawal behind a veil of ignorance. We must stay on the ground, look at things from close up and in the full light of day, knowing very well who we are and where we are. We must get to understand the complexity of the situation in we are in because only in this way can we discover how best to act in the given situation. We need to engage, in other words, in what I am calling a diagnostic practice.
I will try to clarify further what I mean by that term by comparing and contrasting the project of a diagnostic practice in philosophy with diagnostic practice in medicine. Other kinds of comparison are, of course, possible like that with procedures in psychoanalysis that the later Wittgenstein had in mind as a model for his diagnostic and therapeutic form of philosophy. We might even compare philosophical diagnosis with the technical variety. I draw for two reasons on the medical model of diagnosis: first because it is the diagnostic thinkers themselves often make such a comparison and, second, because it helps to bring out what I consider problematic in the idea of philosophical diagnosis as it has been practiced so far.
I begin with distinguishing four aspects of medical diagnosis in order to compare them with philosophical diagnosis:
- Observation and identification of symptoms (phenomenology)
- Determination of the course of the disease (genealogy)
- Assessment of future prospects (prognosis)
- Choice of action to be taken (prescription and intervention)
The starting point of both medical diagnosis and philosophical diagnosis will always be a phenomenology of symptoms. I emphasize the word “symptoms” to bring out the difference between this kind of phenomenology and the Husserl’s phenomenology which concerns itself with noumena or essences. Symptoms are, to begin with, nothing but immediately accessible properties of things, bodies, situations, but they are also meant to be indicative of some other, underlying condition and that condition must (such as a bodily disease, a cultural decline, or a political crisis). The diagnostician is never interested in a complete survey of the object of diagnosis but only in symptoms of an underlying affliction. (He may even, like Wittgenstein, deny the possibility of any comprehensive view.) He is concerned, rather, with specific “pathologies” of one kind or other.[17] Now, not everything that is initially assumed to be pathological will turn out to be one and not everything that is initially assumed to be a symptom of a particular pathology will turn out to be a symptom of that pathological condition. The phenomenology of symptoms as the starting point of the diagnostic practice must therefore always be ready for revisions at subsequent stages in the diagnostic process. Medical diagnosticians are well aware of this; philosophical diagnosticians, on the other hand, tend to be more dogmatic and their diagnostic practice is therefore in greater danger of going wrong.
Medical diagnosis is typically concerned not just with current symptoms of a possible pathological condition but also with determining the genesis of those symptoms and thereby of the underlying affliction. The doctor will ask the patient how long he or she has felt sick and how their experienced lack of well-being started and how it developed. Genealogy is likewise appropriate and necessary in philosophical diagnosis. A dynamic picture of the condition under investigation is a precondition for a prognostic account of its further development and has to be the basis for any practical indication.
Prognosis is, however, always hazardous, even in medicine. The medical doctor needs to consider whether an infection is acute, vicious, in danger of spreading fast or whether it is mild and can be left to take its own course. Some diseases need only careful watching. Intervention may become necessary only at a later date. In some cases no intervention may be necessary at all. A disease may also be able to follow different paths and these may depend on the internal state of the organism or on outside conditions. In these cases various treatment options may need to be entertained.
Thus, when the medical diagnosis reaches its conclusion and considers possible prescriptions, a number of alternatives become apparent. It may turn out that the condition is best left on its own; that there is really no disease present. Another possibility is that prescription is impossible, because medical science has no means for it. Some prescriptions may be purely palliative, designed to alleviate the condition without improving it. There are prescriptions that can retard the course of the disease. There are also, in some cases, genuine cures and these can possibly be brought about in a number of different ways. Even such cures may, however, have side effects or long term detrimental implications. In every case, moreover, the medical prescription is specific, undertaken with an eye to the particular patient.
What I have said about medical diagnosis can be transferred immediately to the philosophical type. Here, too, phenomenology, genealogy, and prognostics go hand in hand. Here, too, there are degrees, alternatives, and limitations in the practical solution of diagnosed pathologies; here, too, there are more or less effective, promising, more or less drastic and precarious methods of treatment. There exist moral and political pathologies for which there is no treatment (we call them “tragic”). Sometimes we can only alleviate our moral and political afflictions or delay the progress of a moral or political decline. Although there are regularly recurring situations, our treatment of a diagnosed pathology will, in the end, always depend on the singular case.
We can see in this way most clearly how a diagnostic practice differs from normative theorizing in moral and political philosophy. Normative theory always assumes that every situation and every course of action can be evaluated, that each situation and course of action can be given a positive or negative value. Courses of action are good or evil, right or wrong, just or unjust, mandatory or forbidden. And in each case the proper course of action is the one which is good, right, just, or mandatory. From a diagnostic point of view in political and moral philosophy prescriptions must be assessed along many more axes. The differentiated treatment methods that emerge at the outcome of philosophical diagnoses differ thus radically from the up or down judgments produced by normative theories.
5.
I will try to make these considerations more precise with the help of Nietzsche. It is not at all easy to draw a connecting line through Nietzsche’s many-layered work. One is struck, nonetheless, by his pervasively diagnostic attitude: his concern with symptoms of moral-political pathologies, his extensive genealogical investigations, and the resulting plethora of prognoses and prescriptions. Already in his first book, The Birth of Tragedy out of the Spirit of Music, the ultimate concern is, despite all the attention devoted to antiquity, a diagnosis of Nietzsche’s own time. He diagnoses his own age as the moment of crisis and decline of a rationalistic optimism that is said to have had its beginnings in Socratic school. At the end, Schopenhauer’s philosophy and Richard Wagner’s music are advanced as means to a new tragic existence. This diagnosis is expanded shortly afterwards in the very timely Untimely Meditations with a critical examination of culture in Wilhelminian Germany. In opposition to the prevailing historicism of the period, he writes: “We want to serve history only to the extent that history serves life.”[18] In the Gay Science Nietzsche prognosticates a few years later the coming disintegration of all highest values. In his diary he notes: “Nihilism is knocking at the door.” And he asks himself: “Whence comes this uncanniest of guests?”[19] In the same notes he identifies multiple symptoms of this nihilism: anarchism and alcoholism, socialism and feminism, egalitarianism and nationalism. But these symptoms can be understood only through an exact study of the genesis of the underlying pathological condition. Nietzsche thus finds himself forced to support his phenomenology of the present age with “a genealogy of morals” that traces the evolution of moral sentiments from the pre-human state to contemporary society but with special attention to two decisive moments: the one in which the ancient world gives way to Judeo-Christian morality and the more recent one in which that new system of morality destructs itself from within. Like Marx before him, Nietzsche is motivated to engage in these diagnostic investigations because of the evident growing fluidity of the historical conditions. He writes: “Disintegration characterizes this time, and thus uncertainty: nothing stands firmly on its feet or on a hard faith in itself; one lives for tomorrow, as the day after tomorrow is dubious. Everything n our way is slippery and dangerous, and the ice that still supports us has become thin: all of us feel the warm, uncanny breath of the thawing wind; where we still walk, soon no one will be able to walk.”[20]
Nietzsche presents us with the clearest example of a diagnostic thinker who conceives of his undertaking in medical terms. To illustrate that point can quote a few characteristic sentences. “Modern virtue, modern spirituality, our science as a form of sickness,” we read in The Will to Power.[21] “What is inherited is not the sickness but the sickliness: the lack of strength to resist the danger of infections, etc., the broken resistance; morally speaking, resignation and meekness in face of the enemy.”[22] “The supposed remedies of degeneration are also mere palliatives against some of its effects; the ‘cured’ are merely one type of degenerates.”[23] And in the Genealogy of Morals we are told that the ascetic priest “combats only suffering itself, the listlessness of the one suffering, not its cause, not the actual state of sickness – this must form our fundamental objection to priestly medication.”[24] The influence of medical concepts and conceptions on diagnostic thought in philosophy becomes even more evident when we look at the crucial role assigned to the notion of crisis. That term has its origin in the medical theories of Galen and carries with it no moral or political associations.[25] In Galen’s theory, the word “crisis” designates, rather, a specific moment in the course of a disease – the maximum point, for instance, in a fever curve – which is identified also as the decisive point at which the disease either begins to retreat or the patient deteriorates and eventually dies. On Galen’s picture it is only at this moment that the course of the disease is unstable and medical prescription effective. The diagnostician must therefore do his utmost to identify that singular moment. From the eighteenth century onwards the term “crisis” comes to be applied also to political events and is appropriated in this new sense in particular by Nietzsche and other philosophical diagnosticians. In this process the term loses some of its specifically medical connotations but retains others. Thus moral and political crises are also understood as highpoints of some course of development, as moments of heightened instability. Crises are, moreover, still understood as calling for prescription – an prescription which, however, presupposes, a proper diagnosis of the condition. From Nietzsche’s “critique of Christian morality” which, he says, reveals a “critical tension” in our culture, “a crisis without equals on earth” to Schmitt’s “crisis of democracy” and of the state to Arendt’s “crisis of authority” the concept of crisis is constantly invoked in the course of the philosophical diagnosis.[26]
Hannah Arendt provides us with another particularly illuminating version of the diagnostic practice in political theory. Her writings are all focused on what she calls “the crisis of the present.” Her goal is to look at politics not from a timeless perspective but, as she puts it, “from the vantage point of our most recent experiences.” In various writings from the 1950’s she identifies the symptoms of the political crisis in a number of different ways. In her book on The Origins of Totalitarianism the political crisis is characterized by the appearance of what she considers to be an entirely new form of politics, that of the totalitarian systems of the East and the West. In her subsequent notes designed for an Introduction into Politics it is the self-destructive aspect of twentieth century politics she highlights. In The Human Condition a few years later she speaks of the first extraterrestrial satellite, the potential for manipulating the human gene pool, the automation of human labor, and the transformation of scientific knowledge as decisive symptoms of a political crisis. Like Nietzsche she seeks to trace the development of this crisis genealogically from the Greek city state to modern society and its deformations.
And again, Foucault insists that at the outset of any account of political power, “we have to know the historical conditions that motivate our conceptualization. We need a historical awareness of our present circumstance.”[27] “ Building on Nietzschean assumptions while modifying them at the same time, he gives us a detailed genealogy of modern bureaucratic society in Discipline and Punish and a genealogy of what he calls biopolitics, i.e. a population politics that extends from manipulation of the biological substance of human life to the welfare state and shows hew they have developed out of the distinctive forms of governmentality of the early modern state. He seeks to show in this way the oppressive character of an existing system of domination, exploitation, and subjection, against which we must learn to respond to in politically new ways. “To the vast new techniques of power correlated with multinational economies and bureaucratic states, one must oppose a politicization which will take new forms.” This politicization demands not only resistance but also a search for new forms of friendship and political association.
5.
Diagnostic practice as I have described it is a methodology that can be applied to various fields in philosophy but may be of particular interest when we think about moral and political problems. It can be (and has been already) used in various ways generating various and, indeed, conflicting conclusions. The application of this technique does not by itself guarantee truth. Progress along this front will require critique of the outcomes of diagnostic thinking so far. Hegel’s, Marx, Nietzsche, Heidegger’s Schmitt’s, Arendt’s, Foucault’s diverging diagnoses of the present need to be investigated.
So when Nietzsche writes that we are living in an age for which God is dead and that this signals the coming collapse of all of our highest values and, thus, the inevitable appearance of a total nihilism, and that to overcome this nihilistic threat we must create an altogether new set of values we need to look critically at this entire series of diagnostic claims: at Nietzsche’s phenomenology, his genealogy, his prognostic, and at his proposed prescription. Nietzsche’s diagnosis cannot, in fact, stand on its own feet; we must consider the symptoms of the present he has correctly identified, rather, in the light of the Marx’s insight into the instability of of modern life. Belief in God has not so far disappeared from the world, our highest values have not all disintegrated, but we can observe that our value systems have become more fluid and variable, and that our values are becoming more dispersed and transitory. This may or may not lead us into the nihilism that Nietzsche has predicted. It certainly contributes further to the instability and unpredictability of our social and political reality. It sharpens the crisis in which we find ourselves today and impresses on us the need to diagnose our time more thoroughly in order to determine what prescriptions are necessary – or possible.
Normative theorizing and diagnostic practice represent two different methodological approaches. As such they can be clearly distinguished as ideal types. But individual thinkers may well shift back and forth between these two types of thinking. We can, for instance, read some of Plato’s Apology and parts (if not all) of the Republic as attempts to diagnose the flaws of the democratic politics of the Athens of his time. The Republic provides us, in fact, also with a genealogy of the democratic state as the product of a process of decay that begins with the rule of the philosopher kings. Machiavelli’s work surely has a diagnostic tone, and so does Hobbes’s. The Leviathan is very much a book on the British civil war and how to remedy the religious conflicts that have torn the country apart. John Rawls, a paradigmatically normative thinker, recasts his theory of justice in later essays on the basis of a diagnosis of the present which remains, however, disappointingly thin and finally uncompelling in that it seeks to describe the present in essentially eighteenth century terms.
Reversely, diagnostic thinkers can also at times adopt attitudes more appropriate for normative theorizing. Schmitt’s abstract characterization of politics in terms of the friend-enemy schema and Arendt’s similarly abstract characterization of politics in terms of free communicative interaction are highly speculative and motivated, so I suspect, by ultimately normative concerns. Their essentialism is certainly no longer based on a diagnostic phenomenology and genealogy.
6.
The practice of medical diagnosis reminds us that observation of symptoms and identification of their genesis is insufficient for determining the nature of a affliction. The phenomenology and genealogy of symptoms requires an appropriate vocabulary for describing and classifying. The progress of medical diagnostics has, indeed, been accompanied by the development of conceptual tools for identifying and analyzing diseases. In a memorable book, Ludwig Fleck has described how medical diagnosis advanced with the identification of syphilis as a distinctive venereal disease.[28] The situation is similar in philosophy. Here, too, the diagnostic practice must pay attention to the terms and concepts available and work at their refinement. This is a hard lesson to learn in political philosophy where we want our thoughts to have practical import and perhaps even the power to affect and transform political life. To be told that the political philosopher needs to attend to his words and concepts, that political philosophy needs to undertake an investigation and revision of its linguistic and conceptual tools, may sound as if we were putting an obstacle on the road to an engaged and activated political thinking. But we should remind ourselves that some of the most revolutionary thought of the last 150 years had its origins conceptual innovations made in the reading room of the British Museum in London.
Marx’s diagnosis of his age was made possible only by his invention of a new vocabulary that allowed him to describe and categorize the phenomena he observed. The notions of class and class struggle, or bourgeoisie and proletariat, of capital and labor power, of capitalist economics and the socialist and communist revolutions were the terms he adopted for framing his insights. Nietzsche’s diagnoses are cast in the language of power and the will to power, of weakness and strength, health and decay, of master and slave, the slave revolt in morality, the death of God, and the revaluation of all values. Much of Arendt’s writing is, indeed, devoted to an investigation into the terms of philosophical diagnosis. The very first text she writes in political philosophy, a short note in her diary from 1950, raises the question “What is Politics?” It concludes that political philosophy has generally failed to reach the depth of other parts of philosophy because of its lack of attention to this question and a resulting confusion about the concept of the political. The concepts of (political) freedom, of authority, of action, of the public realm, of society and labor are also of critical concern for her. Foucault employs the notions of pastoral and disciplinary power, of sovereign power and biopolitics, and numerous other terms to formulate the outcome of his diagnostic observations. As diagnostic practice proceeds, it will, no doubt, have to create still new terminologies and classifications for sorting the phenomena, and for describing the genetic processes.
Medical diagnosis also alerts us to epistemic limits of the diagnostic procedure. The symptoms that the diagnostic process reveals may be insufficient for drawing firm conclusions about the nature of a affliction and about how to treat it. The diagnostic evidence may turn out to be uncertain, point in different directions, or be open to misinterpretation. Establishing the genesis of a disease is always difficult. For its reconstruction we are dependent on reports by patients and observers. The data gathered in this way may be incomplete, unreliable, and distorted. Even with today’s advanced medical technology much of the inner working of the human body is still not readily available to the diagnostician. Similar obstacles arise in the diagnosis of moral and political conditions. Here there is also a problem with the lack of data and their inferior quality. In addition, the philosophical diagnostician is characteristically located inside the situation he seeks to diagnose, whereas medical diagnosis is carried out from outside the patient’s body. The philosophical diagnostician will thus have to be content with data that are limited, colored, and possibly tainted by the location, the place and the time, in which they are gathered. Philosophical diagnosis operates for that reason under conditions that make for a high degree of unsurveyability. The outcome of diagnostic analysis in these fields has to be accordingly tentative and uncertain.
Here we have, perhaps, the weak point of philosophical diagnosis so far. While the diagnosticians generally recognize the recognize the epistemic limits of the diagnostic process, they generally fail to apply that insight to their own work. Philosophical diagnosis exhibits thus a tendency to adopting the dogmatic tone of abstract normative theorizing. Marxist socialism, for instance, with its emphasis on the “scientific” character of its diagnoses has always believed in the firmness of its prognostic conclusions. Capitalism will inevitably collapse, the Communist revolution is certain. On the basis of other diagnostic observations, Nietzsche has come up with an equally self-assured prognosis: “What I relate is the history of the next two centuries. I describe what is coming, what can no longer come differently: the advent of nihilism.” [29] This prediction is just as uncertain as that of the Communist Manifesto. Like Nietzsche, Arendt is also conscious of the epistemological limitations of the diagnostic practice. In the early Introduction into Politics she analyses how our understanding of our political reality is never entirely based on reasoned judgment. An essential role is played also by what she calls “Vorurteile,” i. e., prejudices or, perhaps better, prejudgments. But she once again reveals the limits of this insight in that she fails to accommodate her insight in her own work. She never asks, that is, to what extent her own political thought is the product of prejudice rather than judgment. We can identify the same weakness in Foucault’s diagnostic writings. While he is fully aware of the interrelation of truth and power: how power makes truth possible and truth, in turn, affects, modifies, and extends power, we find in his writings little recognition of the bearing of these insights on his own work. Foucault appears to be untroubled by epistemic doubt. Even our most coherently diagnostic writers, thus, fail to see the need to be skeptical about their own diagnostic powers and the outcomes of their diagnostic practice. Whereas medical diagnostics and epistemological skepticism are intimately linked in the history of Greek medicine and are often also associated in modern medical practice, our diagnostic political thinkers are still attached to a form of dogmatism that has its place more naturally in the normative tradition in political thought.
7.
I have tried to motivate a diagnostic practice in philosophy initially by talking about the need to distinguish between moral dilemmas and moral problems but I then turned to politics as the most obvious place for such a practice. I am convinced, however, that diagnostic procedures are also appropriate when we face moral problems. .
My earlier point was that moral dilemmas present us with straightforward decision problems which we take to be resolvable by appeal to some norm or other. But whether we treat our moral problems as dilemmas depends on how we view them. When moral philosophers seek to convince us of the importance of moral norms they often illustrate their arguments with simplified cases of the sort that Kant describes in his madman story. But moral situations are not always reducible to such simple narratives –though they sometimes may be so. That they are often not reducible to simple moral tales becomes evident when we start thinking about the situations in which we find ourselves from a fuller and broader perspective – from the perspective, for instance, of our entire life or our society and history – in the way literary, historical, and biographical narratives do. I admit that there is something to be said for the counter-consideration that though all human relationship are unique, human life nevertheless exhibits certain deep regularities. We are all born, live, and die; we all have certain needs; we all are capable of feeling pleasure and pain, we all love and hate. That is certainly true, but such general characterizations are usually insufficient to describe the complete texture of our lives and of the moral problems they generate. This bears on normative theory since we can say in general: no rule without regularity. Rules presuppose regularity; they are built on the implicit assumption of regularity; they lose their function when regularity goes out of the window. The rule: “Never tell a lie!” becomes pointless, if only one man at one moment in time ever faced the moral dilemma of whether to tell the truth. And if such dilemmas were to arise only very rarely, then the rule would have only a very limited interest. And a normative principle will also be pointless, if there is never an occasion to offend against it. There is no point in saying: “Don’t worship false gods,” if there is no such thing. Rules operate, in other words in domains that are regular but not fixed. Realizing this, the question becomes whether a given situation is such that it falls into precisely in this domain and this may be far from certain and far from often.
Our genuine moral problems are on the whole of a different sort: more complex, less transparent, less regular that the simplified cases our philosophers describe and they are often in fact unique. This does not prevent us from sometimes being able to give a simplified account of a problematic moral situation that, we think, still captures what is at stake in it. Kant’s situation of being faced with the murderous madman is different from my being faced with an angry colleague who wants to know why haven’t written the report I promised. But the moral issue at hand may still be the same: the question whether I should or should not tell a lie. And at this point, the moral problem may, indeed, turn for us into a moral dilemma and we may, indeed, come to believe that the issue is nothing but a decision problem which can be solved by drawing on an appropriate norm. Diagnostic practice does not, in fact, exclude the possibility of such situations, but it teaches us to look more sharply at when, why, and how it is appropriate to appeal to norms. It does not take the appeal to such norms for granted but treats it as an occasion for diagnosis.
Normative theory tends to look at human situations in an abstract and simplifying manner. It seeks to discern in them general patterns that can be regulated by universal norms. The diagnostic practice, on the other hand, considers those situations in their concrete density. It does not isolate moral dilemmas but understands specific individual circumstances as parts of a larger social, historical, and political pattern. And here I come to a last distinguishing mark between normative theorizing and diagnostic practice. The former tends to separate moral from political problems or alternatively sees concrete political problems as instantiations of abstract moral dilemmas. Diagnostic practice also occasionally separates the moral from the political (Schmitt and Arendt do so, for instance); it more characteristically wants to understand moral problems in political terms. This is evident in Nietzsche genealogy of morals which spells out a political history of morality. The same attitude is evident in Foucault’s late concern with both political power and the care of the self. In taking this stand diagnostic practice returns to a view first voiced by Aristotle according to which politics is the master science of the good.
Notes
[1] Cited from Marshall Berman, All that is Solid Melts into Air. The Experience of Modernity, Penguin Books, Harmondsworth 1982, p. 21.
[2] Ibid., p. 16.
[3] “A Historian of Culture,” in Foucault Live, 1989, p. 95.
[4] “End of the Monarchy of Sex,” Foucault Live, p. 222.
[5] For the sake of clarity I will refer to Kant’s essay by its German title and to Foucault’s essay on this piece as “What is Enlightenment?”
[6] The Government of Self and Others. Lectures at the Collège de France 1982-83, translated by Graham Burchell, Palgrave Macmillan, New York 2010, pp. 20-21.
[7] “What Our Present Is,” Foucault Live, p. 411.
[8] Loc. cit., p. 12.
[9] “What is Enlightenment,” The Foucault Reader, p. 38.
[10] Loc. cit., pp. 39-42.
[11] John Rawls, “Outline of a Decision Procedure in Ethics” in Collected Papers, edited by Samuel Freeman, Harvard University Press, Cambridge, Mass., 199, pp. 1 and 13.
[12] Sometimes we make random decisions but want to hide that fact (from ourselves and/or from others). We decide on the basis of an omen, or a sign from God, by consulting the stars, or by relying on a dream, or an inspiration, or an intuition.
[13] John Rawls, A Theory of Justice, 1st edition, p. 12.
[14] It has become popular in current philosophical parlance to speak more broadly of every practical stance as normative. This is unfortunate and confusing and, probably, a consequence of the pervasiveness of normative theorizing.
[15] Aristotle, Politics, 1288b
[16] Politics, 1286b.
[17] I have borrowed that term from Axel Honneth but I am aware of the possibly misleading associations it may evoke.
[18] Nietzsche, “On the Uses and Disadvantages of History for Life” in Untimely Meditations, edited by Daniel Breazeale. Translated by R. J. Hollingdale, Cambridge University Press, Cambridge 1997, p. 59.
[19] The Will to Power, 1.
[20] The Will to Power, 57
[21] Nietzsche, The Will to Power, 50
[22] The Will to Power, 47.
[23] The Will to Power, 42.
[24] Nietzsche, On the Genealogy of Morals, 3:17.
[25] On this theme see Reinhart Kosellek, Critique and Crisis
[26] On the role of the notion of crisis in German philosophy in the first half of the twentieth century see Hans Sluga, Heidegger’s Crisis, Harvard University Press, Cambridge, Mass. 1993.
[27] Michel Foucault, “The Subject and Power,”The Essential Works of Michel Foucault, vol. 3, p. 327
[28] Ludwik Fleck, The Genesis and Development of a Scientific Fact, Chicago: University of Chicago Press, 1979.
[29] Friedrich Nietzsche, The Will to Power, translated by Walter Kaufman, preface, 2.
