Giorgio Agamben — Medicine as Religion

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That science has become the religion of our time, that in which people believe they believe, has been obvious for some time now. In the modern West there have coexisted and, to a certain extent, still coexist three great systems of belief: Christianity, capitalism, and science. In the history of modernity, these three “religions” have often intersected, entering from time to time into conflict and later reconciling in a different way, until they progressively reached a sort of peaceful, articulated coexistence, if not a true and proper collaboration in the name of a common interest.

What is new is that between science and the other two religions there has ignited, without our noticing it, a subterranean and implacable conflict, the successful results of which for science are daily before our eyes and determine in an unheard-of way all aspects of our existence. This conflict does not concern, as happened in the past, theory or general principles, but, so to speak, cultic practice. Indeed, science too, like every religion, knows diverse forms and levels through which it organizes and orders its structure: to the elaboration of a subtle and rigorous dogmatic there corresponds in practice an extremely broad and widespread cultic sphere which coincides with what we call technology.

It is not surprising that the protagonist of this new war of religions should be that part of science where the dogmatic is less rigorous and the pragmatic aspect stronger: medicine, whose immediate object is the living body of human beings. Let us attempt to fix the essential character of this victorious faith with which we must increasingly settle accounts.

  1. The first characteristic is that medicine, like capitalism, has no need of a special dogmatic, but limits itself to borrowing its fundamental concepts from biology. In contrast with biology, however, it articulates these concepts in a Gnostic-Manichean sense, that is, according to an exaggerated dualistic opposition. There is a malign god or principle, namely disease, whose specific agents are bacteria and viruses, and a beneficent god or principle, which is not health, but recovery, whose cultic agents are medicines and therapy. As in every Gnostic faith, the two principles are clearly separated, but in practice they can contaminate each other and the beneficent principle and the doctor who represents it can make a mistake and unknowingly collaborate with their enemy, without this invalidating in any way the reality of the dualism and the necessity of the cult through which the beneficent principle fights its battle. And it is significant that the theologians who set its strategy are the representatives of a science, virology, that does not have its own place, but is situated at the border between biology and medicine.
  2. If this cultic practice up to now was, like every liturgy, episodic and limited in time, the unexpected phenomenon that we are witnessing is that it has become permanent and all-pervasive. It is no longer a question of taking medicines or submitting when necessary to a doctor visit or surgical intervention: the whole life of human beings must become in every instant the place of an uninterrupted cultic celebration. The enemy, the virus, is always present and must be fought unceasingly and without any possible truce. The Christian religion also knew similar totalitarian tendencies, but they concerned only some individuals—in particular, monks—who chose to put their entire existence under the emblem “pray unceasingly.” Medicine as religion takes up this Pauline precept and, at the same time, reverses it: where monks gathered together in convents to pray constantly, now the cult must be practiced even more assiduously, but while remaining separated and at a distance.
  3. Cultic practice is no longer free and voluntary, exposed only to sanctions of a spiritual order, but must be rendered normatively obligatory. The collusion between religion and profane power is certainly not a new thing; what is completely new, however, is that it no longer concerns, as happened for heresies, the profession of dogmas, but exclusively the celebration of the cult. Profane power must keep watch so that the liturgy of the medical religion, which coincides by now with all of life, should be observed point by point in deeds. That we are dealing here with a cultic practice and not a rational scientific demand is immediately obvious. The most frequent cause of death in our country by far are cardiovascular diseases and it is well known that these could be reduced if we practiced a healthier form of life and if we followed a particular diet. But it has never crossed the mind of any doctor that this form of life and diet, which they recommended to the patient, should become the object of a juridical norm, which would decree ex lege what must be eaten and how we should life, transforming our whole life into a health requirement. Precisely this has been done and, at least for now, people have accepted, as if it were obvious, renouncing their own freedom of movement, work, friendships, loves, social relations, their own religious and political convictions. Here we see the extent to which the two other religions of the West, the religion of Christ and the religion of money, have ceded primacy, apparently without a fight, to medicine and science. The Church has renounced its principles purely and simply, forgetting that the saint whose name the current pope has taken embraced lepers, that one of the works of mercy was visiting the sick, that the sacraments can be administered only in person. Capitalism for its part, albeit with some protest, has accepted losses of productivity that it has never dared to consider, probably hoping to find later on an arrangement with the new religion, which at this point seems disposed to reach a settlement.
  4. The medical religion has unreservedly taken up from Christianity the eschatological urgency that the latter had let fall by the wayside. Already capitalism, in secularizing the theological paradigm of salvation, had eliminated the idea of an end of days, substituting for it a permanent state of crisis, without redemption or end. Krisis is originally a medical concept, which in the Hippocratic corpus designated the moment when the doctor decided whether the patient would survive the disease. Theologians took up the term to indicate the Last Judgment which takes place on the last day. If we observe the state of exception in which we are living, we would say that the medical religion conjoins together the perpetual crisis of capitalism with the Christian idea of an end time, of an eschaton in which the final decision is always underway and the end is both precipitated and dilated, in the unceasing attempt to be able to govern it, yet without ever resolving it once and for all. It is the religion of a world that feels as though it is a the end and yet is not in a position, like the Hippocratic doctor, to decide whether it will survive or it will die.
  5. Like capitalism and unlike Christianity, the medical religion does not offer the prospect of salvation and redemption. On the contrary, the recovery which it seeks can only be provisional, since the evil God, the virus, cannot be eliminated once and for all, but mutates continually and assumes ever new, presumably more dangerous, forms. Epidemic, as the etymology of the term suggests (demos is in Greek the people as a political body and polemos epidemios is in Homer the name for civil war) is above all a political concept, which is preparing to become the new terrain of world politics—or non-politics. It is possible, however, that the epidemic that we are living will be the actualization of the global civil war that, according to the most attentive political theorists, has taken the place of traditional world wars. All nations and all peoples are now in an enduring war with themselves, because the invisible and elusive enemy with which they are struggling is within us.

As has happened many times in the course of history, philosophers must again enter into conflict with religion, which is no longer Christianity, but science or that part of it that has assumed the form of a religion. I do not know if bonfires will return and books will be put on the Index, but clearly the thought of those who continue to seek the truth and reject the dominant lie will be, as is already happening before our eyes, excluded and accused of spreading fake news (news, not ideas, because news is more important than reality!). As in all moments of emergency, real or simulated, we see once again the ignorant slander philosophers and scoundrels seeking to profit from the disasters that they themselves have provoked. All this has already happened and will continue to happen, but those who testify to the truth will not stop doing so, because no one can bear witness for the witness.