This is an edited and abridged excerpt from Chapter Six of Foucault: The Birth of Power, Polity Press, forthcoming 2017.

On 7 February 1973, in his course The Punitive Society, one of the examples Foucault gives of the moralisation of questions is a contemporary one. He suggests that there is “a kind of historical symmetry” between the eighteenth-century questions he has been examining in relation to dissidence and “the present-day movement of ‘moral dissidence’ in Europe and the United States”. His examples in the lecture are movements that “struggle for the right to abortion, to the formation of non-familial sexual groups, to idleness”, which are joined in the course manuscript by “the right to homosexuality” and the “right to drugs”. ¹ In the eighteenth century “morality, capitalist production, and the State apparatus” had been linked together; “the function of present-day groups is to undo this”. Their work is broader than just breaking the rules; it is to challenge then, “to attack this connection, this coercion”. ² His main example in the present moment concerns French politics.

Think of the manifesto by abortion doctors and of the response of the Minister, Foyer, who made this quite extraordinary statement: it is altogether regrettable that the doctors’ manifesto appeared during the election, because the problem of abortion is a problem of legislation and so must be dealt with in calm and reflection; since it is a problem of legislation, it cannot be raised during the election campaign. ³

As a note by editor Bernard Harcourt explains, Foucault is referring to Jean Foyer, Minister of Health, who had declared on 6 February 1973 that “it is deplorable that a political operation be launched on such a serious problem during an election”. ⁴ President Georges Pompidou had previously made a similar point. Foyer was reacting to a letter signed by over 300 doctors, published in Le nouvel observateur on 5 February 1973, declaring that they had performed abortions illegally. ⁵

Foucault’s involvement was not that of a detached observer, using a contemporary story to situate his historical analysis. When he suggests that Foyer’s view is that such legislation must be decided upon by legislators alone, and that Foyer “does not want the problem to be addressed by those who elect the legislators”, he is thinking of the current campaign with which he was involved. He suggests that Foyer’s point is indicative:

This is precisely because a moral distance is introduced regarding abortion: what power [le pouvoir, i.e. the government] means when it says that only elected deputies are able to take care of this issue, but not those who elect them, is that the ethical-juridical problem of abortion is not a matter for the explicit choice of individuals, not a matter for the national will itself… To say that the deputies can change the law without their electors having any control over this, is to say that the change can be a matter only for power and those elected, not as representatives of a real national will, but as agents of a power that precisely exceeds their mandate, since it cannot be fixed by electoral mandate. So it is only at the level of the exercise of power that something like abortion legislation can be modified. ⁶

The intertwined nature of “the system of morality and the actual exercise of power” has, for Foucault, existed in present form since the nineteenth century. It continues to have an effect in the present. Morality “is inscribed in power relations and only the modification of these power relations can bring about the modification of morality”. ⁷

Foucault is referring to a wider context, of course, but also the specific work of the Groupe Information Santé (GIS). This was a group formed on the model of the better-known Groupe d’Information sur les Prisons (see their manifesto). The GIS was officially created on 14 May 1972, though some work was conducted beforehand. The GIS membership comprised many doctors alongside sociologists and philosophers. It described its focus as “industrial medicine, health of immigrants, abortion, medical power”. ⁸ It was based in Paris but regional groups were set up in cities across France. Its aim was partly to decentre the medical profession from its position of power, and give people back the control over their bodies and lives. They were concerned with workplace medicine, industrial injuries or sicknesses, including campaigns around lead poisoning in the manufacture of car batteries in the Penarroya factory in Lyon and silicosis in miners. They provided health input into autogestion projects, such as the workers takeover of the Lip watch factory. They were also involved in supporting immigrant hunger strikes and the use of non-trademarked drugs, and in challenging the profits of big pharmaceutical firms and the way doctors used specialized knowledge in oppressive ways. ⁹ The journal Tankonalasanté published some of their collected information sheets; ¹⁰ a report on their first general meeting in Bordeaux; and their three key campaigns on abortion, factory health, and immigrant workers. ¹¹

In a text that can be read as their founding manifesto from late 1972, to which Foucault was the only named contributor, the group discusses the political nature of the inquiry, the need for marginalized groups to assert their power and claims that medical issues are at the forefront of class struggle. They stressed that class relations did not just happen “in the factory or workshop”, and that “medical texts do not occupy a neutral position in relation to class struggle”. ¹² While they did mention the financial arrangements around the French medical system, the system of social security and challenge the “medicine of profit”, ¹³ their point is broader than this, and has to do with the division between intellectual and manual labour. The group was especially interested in the mobilisation of specialised knowledge for progressive political ends: what Foucault would call the ‘specific intellectual’. ¹⁴

Part of the group’s aim was to “break the secrecy” around professional and expert knowledge in medicine. They aimed to “challenge the division between scientific knowledge and everyday practice, between manual and intellectual work”. ¹⁵ The doctors recognised that they “may already be too conditioned by the system” to be sure that “their health projects were a real innovation, and not mere management reforms. Knowledge has been a bulwark which has put us outside all social reality”. ¹⁶ It suggested that doctors conduct such inquiries or investigations within a closed system of knowledge, “the carceral space within which what we call ‘science’ traps them”. ¹⁷ In sum, they wanted “to break down the ‘inquirer-inquiry’ distance that exists at the heart of the conventional doctor-ill person relation”. ¹⁸

We want more than a medicine of profit, we want more than a medicine which objectifies man, we want more than a knowledge which is nothing more than a clever mask for oppression. We know that medicine, precisely because it affects a fundamental human good, health, is among others a site of class struggle.

We have chosen to participate in this struggle. ¹⁹

Some of the work of the GIS was based on the example of the ‘popular tribunal’ held in Lens to inquire into the death of sixteen men in a mining accident there. At the tribunal Jean-Paul Sartre had played the role of prosecutor, suggesting that the explosion had been caused by the company putting profit ahead of safety. Doctors had been called as expert witnesses, and as well as the accident had testified about conditions such as ‘black lung’.

In their 1974 report La médecine désordonnée, which summarises and documents their work to date, the GIS outline their purpose in general terms.

The GIS has set itself the task of developing an intolerance for the health system in France, both unblocking and correcting information regarding health problems, and struggling against false propaganda that confuses an increase in medicine consumption with an improvement in health conditions.

Improving health conditions to the GIS means improving living conditions in all respects – in the workplace, on public transport, in leisure time, and in private life: A life without freedom, initiative, and flourishing; a life that is truncated and fragmented. What we call a struggle for ‘improving living conditions’ is in fact a struggle for life. It is also a struggle for health. ²⁰

The GIS’s most important campaign concerned abortion. At the time, abortion was illegal in France, but a public campaign has begun with an open letter signed by 343 women, published in Le nouvel observateur on 5 April 1971. ²¹ The letter declared that while an estimated million women a year had abortions, they were forced to do so “in dangerous conditions because they are forced to do it in secret, while this operation, performed under medical supervision, is simple”. In order to break the silence, the women declared: “I am one of them. I declare that I have aborted. Just as we demand free access to contraceptives, we demand free abortion”. Signatories included Colette Audry, Simone de Beauvoir, Catherine Deneuve, Marguerite Duras, Gisèle Halimi and Liane Mozère.

One class aspect was that abortion was more easily available for women with money to travel to countries with more liberal laws: a choice not available to all. The October 1972 Bobigny trial, when a girl who had been raped and her mother were prosecuted for abortion, had highlighted the law’s problems. ²² Halimi defended the mother and daughter, and a media campaign led to the acquittal of the daughter but a second trial for the mother. In early 1973 the GIS coordinated a second open letter, this time by 331 doctors who declared that they had conducted abortions. This letter, published on 5 February 1973, called for contraceptives to be available to all, including minors, with widely available information and to be reimbursed by social security; and that abortion be freely available on the same terms. This was a decision, it declared, which should be entirely up to the women concerned. ²³ This was the letter to which Minister Foyer was reacting, in the remarks Foucault quotes in his lecture of 7 February 1973.

The GIS partnered this media campaign with an anonymous pamphlet, Oui, nous avortons! [Yes, we abort!], also in 1973. It comprised a mix of statements, testimonies, information, images, a photo-story and cartoons. No authors were named, and it was simply billed as ‘a special bulletin’ of the GIS. It began with noting the prohibitions against “abortion, incitement to abortion, or propaganda in favour of this act” to be found in the penal code and the public health code. It detailed the implications for women or medical personnel, but noted that while traveling abroad to have an abortion was an offence, it was 90% likely that no charges would be brought, thus underlining the right being effectively available for some, but by no means all women. ²⁴ This pamphlet then, was an intervention against a situation where women could die or suffer physical or mental problems as a result of the lack of available, safe treatment. Written in the voice of a group of women, one of the opening parts states that “It is for us to decide to bring a child into the world or not. We are the first ones responsible for our bodies and our lives at all times”. ²⁵ It stressed three key aspects: the availability of advice, the safety of possible treatments, and the ability to pay for them. It explained how pregnancy could be tested and terminated in the very early stages; detailed the ‘aspiration’ technique both with text and diagrams, some hand-drawn and some with photographs of equipment such as the speculum. It explained likely side effects and the recovery period. It then went on to look at methods for more advanced pregnancies, to discuss contraceptive methods and their benefits and side effects. It provided names and addresses of overseas doctors and clinics, along with costs. Much of the second half is given over to women telling their stories. An annexe reprints the doctors’ letter, and the statement read to a press conference just a few days later. ²⁶ It closes by saying that signatures and foreign addresses are not enough to resolve the problem, and that “they will wait no more… the law must be abolished”. ²⁷

Despite the doctors who had signed the open letter, and the name and address for contributions and donations being given in the pamphlet, the publication led to Foucault, Alain Landau and Jean-Yves Petit being given a court-summons as the presumed authors. The three men note in a defiant statement in Le nouvel observateur on 29 October 1973 that police spies monitored attendance at group meetings, and they had been seen there. This was “serious circumstantial evidence” against them. The three affirmed they did belong to the GIS, wrote and distributed the pamphlet and supported the cause. ²⁸ How much they were genuinely responsible for its writing, and how much they were shielding others remains unclear. Much of the tone of the text is written as a collective of women, and Foucault’s involvement in the actual writing, which is largely specialist and outside his expertise, is likely to be minimal. But the response is much more characteristic of his involvement, and it appears he wrote the co-signed text. It states that the pamphlet was

aimed at creating a situation in which [abortion] can be talked about, and in which, once they have come out of the shameful secrecy where some people seek to keep them, women can finally have free access to information on abortion and contraception: a situation in which they are no longer at the mercy of greedy and hypocritical doctors or left to themselves, forced to resort to manoeuvres that are dangerous for their lives. ²⁹

The three men suggest that the kind of information in the pamphlet is precisely that which the government wants to keep from women.

For, if women learn that it is possible to have an abortion in a simple and risk-free way (using the aspiration method under the best sterile conditions) and without charge; if they learn that it isn’t necessary to do seven years of study in order to practice this method, they risk deserting the commercial circuits of abortion and denouncing the collusion of doctors, police, and the courts, which makes them pay dearly, in every sense of the term, for the liberty they take in refusing a pregnancy. ³⁰

The reforms currently being discussed in France are not, they suggest adequate. They propose a certain number of “strictly limited cases” where it might be allowed – “rape, incest, a definite abnormality in the embryo, and when the birth would risk provoking ‘psychic disturbances’ in the mother” – but then only on the say of two doctors. This would mean “a strengthening of a medical power that is already great, too great, but that becomes intolerable when it is coupled with a ‘psychological’ power that has earned a reputation for incompetence and abuse in its application to internments, medico-legal evaluations, ‘children at risk’, and ‘pre-delinquent’ young people”. ³¹ The hospital or private clinic settings will replicate, rather than improve, the current situation: “two abortion circuits: one, a restrictive hospital experience for the poor; the other, private, liberal—and expensive”. The government was thus constructing a polarisation between ‘good doctors’ to whom it would “give complete power and every benefit”, and those, like the GIS, “who would establish abortion, contraception, and the free use of one’s body, as rights”. ³²

Abortion and contraceptive rights were part of a wider concern with sexual education. For example, Foucault spoke in defence of a medical doctor, Jean Carpentier, had been suspended for circulating a text on this topic at a school in 1972. Making a political point, the text, Apprenons à faire l’amour [Learn to make love], was then published in an expanded version by Maspero in 1973. ³³ Foucault suggested that medicine often exceeded any narrow boundaries and had become a “guardian of morality”, “not only defining what is normal or not normal, but ultimately what ultimately what is legitimate or illegitimate, criminal or not criminal, what is debauchery or malpractice”. ³⁴ Here the relevance is that in abortion doctors would have a crucial role in decisions that would be made under the proposed reforms.

Another censorship case concerned the twelfth issue of the journal Recherches, entitled ‘Grande Encyclopédie des homosexualités: Trois milliards des pervers’, published in March 1973. ³⁵ Recherches was the house journal of a research group led by Félix Guattari. Guattari was prosecuted and issues of the journal were seized and destroyed. Foucault wrote a short piece for Combat highlighting the problems in the political and legal process, and raising the question of “the relation between politics and sexuality”, a theme which was beginning to play a crucial role in his own work. ³⁶ Foucault explicitly links the political question of “male and female homosexuality” to the wider struggle women’s liberation, mentioning the Mouvement de libération des femmes (MLF) and abortion rights. He underlines that it is because of a wider struggle for the uses of the body, as more than just labour force, that sexuality emerges as a political problem. ³⁷ Foucault would also work with CERFI on collaborative research into hospitals, public health and town planning.

The abortion campaign met with success. In 1975 the ‘Veil law’, named after the Minister of Health, Simone Veil, allowed the voluntary interruption of pregnancy, initially for a trial period, but this provision became permanent law in 1979. Until 1982 abortion was not supported by social security, and only in 1992 did it cease to be an offense under the law, rather than an exception. In this struggle the GIS’s involvement was part of a wider network of movements, such as Mouvement pour la Liberté de l’Avortement et de la Contraception (MLAC) founded in 1973; Choisir [choose], founded by Halimi in 1971; along with the earlier MLF. ³⁸

In terms of reproduction health this is an examination of what might be called the biopolitics of birth. The doctors that Foucault and his partner Daniel Defert met at this time were later involved in another project with Defert after Foucault’s death, the establishment of the AIDES group on HIV/AIDS. ³⁹ Like the work of the GIP, the Groupe Information Asiles and other groups such as Group d’Information des Travailleurs Sociaux – a social work advocacy group – the GIS saw the labour as political, and the role of intellectuals alongside practitioners as crucial. All had the goal of freeing up information. Defert had entitled one of his pieces “when information is a struggle”. ⁴⁰ For Gisèle Halimi, these groups were important at the time because they were picking up issues neglected by mainstream politics: “The value of these movements is that they rouse the torpid consciences of the well-fed, and that they are like a shout in the silence”. ⁴¹