‘Code Is Law’: Health, Knowledge Transference and the Theory of Machines

Drawing on an examination of the use of medical coding systems in the National Health Service in the UK, developments in artificial intelligence and theorisations of the machine, this paper explores shifting strategies for knowledge transfer in the contemporary economy. The paper aims to characterise some of the processes by which an immanent form of measurement of value is produced, demonstrating in the process the co-extensiveness of this form of measure with new structures of command. Evincing a concern that all too frequently critical social theory dealing with information technology in the contemporary economy treats the technologies themselves as a kind of black box, this paper essays a critical approach to the politics of software in the context of a broader discussion of cognitive capitalism. The paper is in three parts: a brief first section provides an outline of medical coding and its basic use within healthcare, exploring the development of one system in particular - Snomed – for its relations with the insurance industry and the management of risk. The second section then situates these systems and their allied practices within a broader discussion of the development of artificial intelligence, focusing on so-called expert systems. The aim here is to explore these developments in the framework of a theory of machines derived as much from Deleuze and Guattari as from Marx, to cast light on the libidinal underpinnings of the human-machine relationship. At this point the paper proposes the term 'knowledge transference' to draw attention to the conflictual, unconscious aspects of the human-machine relationship and the way this drama is played out at the micropolitical level of technical decision making. This section also places particular emphasis on the way in which language is put to work in coding systems, exploring the ways in which we can understand the way that formal language systems help to construct the mathematical-industrial space of contemporary capitalism. The final section explores the ways in which the new informational infrastructures of health and the commodification and hence quantification of medical knowledges are co-extensive with an imperfect set of strategies for the exercise of power which works as much on the shape of the future as the control of the present. The paper concludes with some pointers to the faultlines in the new ‘code is law’ paradigm of the 21^st century economy.

Andrew Goffey

Middlesex University

September 2008-09-10

Name: Andrew Goffey

Paper title: ‘Code Is Law’: Health, Knowledge Transference and the Theory of Machines

Affiliation : Department of Media, Middlesex University, London

Email address : a.goffey@mdx.ac.uk