Source: Dissertation Abstracts International, Volume: 79-11(E), Section: A.

Adviser: Naomi Rogers.

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This dissertation maps the relationships that took shape between biomedical research, medical care, and Alaska Native self-determination over the course of the Cold War. I argue that Cold War biomedicine in Alaska can best be understood as an industry, one that was constituted through various forms of biomedical labor. In taking this approach, this dissertation demonstrates how biomedicine in Cold War Alaska was figured both as a tool for colonial biopolitical governance and as a site from which Alaska Native peoples could exercise self-determination.

Beginning in the late 1940s, when the polar regions took on a new Cold War strategic importance, biomedical researchers flocked to Alaska to study its environments and peoples. This surge in research became part of Alaska's emerging colonial economy. Alaska Native peoples labored as research subjects, and American biomedical researchers and health officials claimed that their work could make Alaska Native bodies healthy and fit to serve as an industrial workforce. In doing so, they aimed to enroll Alaska Native peoples as participants in their own territorial dispossession, both by literally removing them from their lands through mass hospitalization campaigns and by refiguring their relationship to the land in terms of wage labor.

However, in the 1960s, a powerful Alaska Native activist movement rose up in response to territorial dispossession and economic exploitation, and began to argue that medical care for Alaska Native peoples should be controlled by Alaska Native communities. This activism culminated in the passage of the 1971 Alaska Native Claims Settlement Act (ANCSA), the largest land claim in American history, which led to the creation of thirteen for-profit Alaska Native Regional Corporations. Instead of gaining land rights or tribal membership, Alaska Native peoples were enrolled as shareholders in these corporations. Alaska Native Regional Corporations were tasked not only with generating profits, but also with providing healthcare and social services to the Alaska Native peoples who lived in their respective regions. As a consequence, increased access to healthcare became one of the primary dividends of ANCSA, and the most immediate way in which many Alaska Native peoples experience the benefits of self-determination.

Observing the rise of Alaska Native self-determination, biomedical researchers, social scientists, and anthropologists turned their attention to "acculturation," a form of psychic distress that was thought to be indicative of cultural erosion in colonial contexts. This body of research, I argue, was intended to show that Alaska Native peoples were incapable of engaging in capitalist enterprise without experiencing severe psychological consequences. Indigeneity has often been cast as incommensurable with capitalism. Scholars have demonstrated that certain economic activities, particularly those that are highly profitable, are seen as anathema to the maintenance of authentic Indigenous identities. My research demonstrates that this debate, usually framed in terms of law, land, and culture, has been fundamentally shaped by biomedicine. In Alaska, where the preservation of Alaska Native self-determination has depended upon continued economic success, debates surrounding the impact of capitalism on physical, mental, and spiritual health had particularly high stakes.

American colonial biomedicine aimed to construct the relationship between biomedical and economic indigeneity in specific ways, but Alaska Native peoples contested these constructions and found ways to engage with biomedical enterprise on their own terms. By the 1980s, Indigenous activists across the circumpolar regions had begun to contest the practices and priorities of biomedical research in the Far North. They pressured biomedical researchers to respond to the needs of Indigenous communities and to respect new sets of ethical expectations. Initially, researchers were eager to respond to these demands and to frame their work as ethically unproblematic. However, these initial changes did little to disrupt the power structures of biomedical research and were held up as insufficient by Alaska Native political leaders.

In an effort to consolidate complete control over biomedicine, Alaska Native health organizations gradually began to fund and control their own medical research divisions, and to conduct their own ethical review processes, with the intention of improving Alaska Native peoples' health. But the practices of these organizations, and the systems of biomedical labor that they produce, have sometimes borne a troubling resemblance to the very patterns of colonial research that Alaska Native activists had protested against. Cold War biomedicine, this project suggests, not only produced biomedical knowledge in colonial spaces, but sets of formations and relationships between institutions of research, care, and ethics that have profoundly impacted how contemporary biomedicine enrolls individuals as patients and subjects.