Beyond nature and culture: a note on medicine in the age of molecular biology

This paper is divided into two parts. In the first, I examine the relations among molecular biology, gene technology, and medicine, as well as some aspects of the consequences of these relations with respect to the human genome project. I argue that the prevailing momentum of early molecular biology resided in creating the technical means for an extracellular representation of intracellular configurations. As such, its medical impact was rather limited. With the advent of recombinant DNA technologies, a radical change of perspective ensued. The momentum of gene technology is based on the prospects of an intracellular representation of extracellular projects--the "rewriting" of life. Its medical impact is potentially unlimited. In the second part, I question the very opposition between nature and culture that implicitly underlies the notion of medicine as a "cultural system." I argue that both on a macroscopic level (global ecological changes) and on a microscopic level (genetic engineering), the "natural" and the "social" are no longer to be seen as ontologically different. In its uncanny oscillation between retrospection and foresight, between description and proclamation, and between assertion and hesitatiion, this essay translates an uneasiness that I have not been able to overcome while writing it. The essay conveys the tangled views of a hybrid author who himself cannot but oscillate between the perspectives of an actor in the field of molecular biology, a participant in the field of science studies, and a citizen.