In an Israeli documentary titled Precious Life, a little boy in Gaza with a deadly autoimmune disease is offered a chance at treatment in a Tel Aviv hospital by an Israeli pediatrician, an Israeli journalist who raises funds for the operation, and an anonymous donor who agrees to provide the money. All that remains is to find an organ match for the transplant. While everyone is anxiously waiting, the journalist engages the child’s mother in conversation. He tells her that he is troubled by the idea of Palestinian martyrdom, because all “life is precious.” The mother replies that she accepts the idea of martyrdom, because death is normal for her people. “No,” she tells him, “life isn’t precious.” The journalist asks about the boy they are trying to save: Would she let him become a martyr? The mother says she would. The journalist is baffled and disturbed, but leaves the conversation there. Then Israel invades Gaza. The invasion delays the operation, which nearly costs the child his life, although he is eventually saved. Many other Palestinians are not as lucky. While in Gaza, the documentary’s director finds himself in conversation with a surgeon, who asks him why he is making a film about the saving of one life while Israel is taking the lives of hundreds. We learn that three of the surgeon’s daughters have just been killed in the bombing of their home.

Anthropologist Didier Fassin uses these scenes in his new book, Life: A Critical User’s Manual, to argue against the confident tendency among many in the Global North to treat an individual life as sacred while refusing to address the social structures that cause many lives to be treated as anything but. His targets are readers in places like Israel and the United States whose lives, despite the fearmongering on the right in both countries, are not particularly endangered; his hope is to get them to understand the political imperatives that determine the lives—as well as the deaths—of so many others both in the Global North and elsewhere, places where life’s flagrant riskiness and the inequality of its value must unfortunately be taken for granted. By making this argument, Fassin redirects his readers away from humanitarianism’s self-congratulatory ethic of rescue and toward a structural politics that aims at the transformation of collective life.

Trained as a medical doctor as well as an anthropologist, Fassin is especially sensitive to cases in which the saving of an individual life is presented as the definitive humanitarian gesture. In Palestine, to adopt a medical model of rescue and think in such terms is, in Fassin’s view, to be distracted from the larger and more pressing issue of justice for Palestine, however that justice might be defined. Distracting people from these longer-term questions of social change, he speculates, may even be what the medical model of rescue is intended to do.

Fassin develops this argument further in his book’s discussion of refugees and asylum seekers, or sans-papiers, in France. In 1998, the country adopted a new and seemingly humanitarian policy, opening its doors to “undocumented migrants whose life was endangered by a serious health issue for which treatment was not accessible in their home countries,” at the same time that it was closing its doors to refugees in the strict sense. Seven years after the law changed, “the chance of being regularized was…seven times higher when one’s life was threatened by [physical] disease rather than by a risk of persecution.” Disease, as Fassin observes,

seems both objective and value-free: it resides in the cells and the organs. On the contrary, persecution implies taking the side of victims and delivering value judgments: it is about causes and ideologies. The institutions of the host countries feel more comfortable with the supposed neutrality of the former than with the suspected partiality of the latter.

The moral Fassin draws from these cases is that, given the deep structures that underlie the sorry state of the world, humanitarianism is no substitute for political struggles against systemic oppression. This conclusion will hardly shock most progressive readers, but it seems especially apt these days because, as he takes pains to show, some of the most intellectually influential thinkers since the 1970s have focused on life in a way that discourages these kinds of struggles. His key example is Michel Foucault, whom Fassin seems to suspect and admire in almost equal measure, but he also takes aim at general modes of ethical thought.

Life: A Critical User’s Guide is divided into three sections: “Forms of Life,” “Ethics of Life,” and “Politics of Life.” In the first, Fassin explores those sets of shared assumptions—the “forms of life,” as he calls them, borrowing an enigmatic phrase from Ludwig Wittgenstein—about what life is and how to value it. These forms are what make agreement possible and life meaningful, but as Wittgenstein noted, they do so without necessarily making any claims to being universally true. As a result, the question of what foundations (if any) these “forms of life” possess remains unanswered. Are they “shared by the whole human species,” Fassin asks, or is any particular form “inscribed in a given space and time?”

Fassin’s answer to this question is that they can be both at once. While the forms of life are expressed through different cultures and languages, what is ultimately and decisively held in common by earth’s diverse peoples is the experience of what he calls “planetary inequality.” Nowhere are lives equally valued. Most anthropologists would say that these differences in valuation are themselves valuable. But Fassin’s concern is less to protect difference than to extend equality.

Building on this argument, Fassin reports on interviews that he conducted in the Calais “Jungle,” a refugee encampment that existed on the outskirts of the city from 2015 to 2016, and in the “dark buildings” of Johannesburg—luxury offices and apartments that have been abandoned by their owners and are now inhabited by asylum seekers. In both places, one can hear a common set of experiences being described, even if they’re conveyed through various tongues. The precarity of these people’s lives goes far beyond the vexed issue of their legal status or any quantitative measure of their poverty; it is a global problem as well as one specific to France or South Africa. “All lives are precarious,” Fassin tells us, “but certain lives much more so than others—and above all, quite differently.”

In many ways, this sounds like an anthropologist’s plea for the recognition of difference, but Fassin also frames this statement in universalistic terms and around the desire for ethics to begin (again) to think more universally. While human beings experience risk and inequality differently, these conditions remain linked to a set of planetary problems that require planetary solutions. Humanitarianism, which has largely claimed this scale as its own, must be supplanted, or at least inflected, by politics.

The section on the “Ethics of Life,” which tells the story of the Israeli journalist and the Palestinian mother, takes off from this point about the priority of politics—but along the way, Fassin poses questions that he doesn’t pretend he can answer. He queries the persistence in ethical discourse of religious concepts like the value of self-sacrifice, and he seems even more perplexed that our society cannot tolerate the martyrdom of hunger strikers (who, unlike suicide bombers, leave no victims) and will even take extreme precautions to prevent death-row inmates from ending their own lives.

Fassin asks whether the government of South Africa was right to make antiretroviral drugs publicly available, thereby benefiting many, while taking scarce resources away from such basic needs as nutrition and housing. In making this choice, the South African government honored the medical profession’s principle that each life is sacred rather than the political principle that all people should be treated equally and have access to life’s basic necessities. Moreover, as Fassin points out, the steep increase in inequality that followed this reallocation of resources did not receive the same critical attention that the AIDS crisis in South Africa did.

Here, as in all of his examples from around the world, Fassin wants his readers to better understand the ethical logic and political consequences of such choices. At the same time, and more ambitiously, he wants to show a certain universality that carries over from one set of choices to another. While he doesn’t permit himself to declare authoritatively what is right or wrong in any of them, he wants to make a case that ethics and politics can—and, in fact, must—apply across very different situations.

Fassin credits Foucault with inspiring anthropology’s recent interest in ethics, a disciplinary turn that helps explain the existence of his own book. But he also holds Foucault partly responsible for the reluctance of anthropologists to assert any ethical or political claims of their own. Perhaps he is a bit unfair here; after all, this reluctance is also a reaction to the trauma of anthropology’s early complicity with colonialism and its subsequent desire to withhold judgment, especially regarding non-Western cultures. But he does make an important point: While Foucault and many anthropologists rightly insist that to properly study the practices that form ethical subjects, one needs to find a way to withhold one’s normative commitments in order to understand others’, this also limits our capacity to make moral judgments. Foucault instructed us that norms are assumed to be in the service of the oppressors, so why assert our own? That’s why Foucault left us, Fassin complains, with only an ethics of self-care: the idea of focusing on oneself, not on others. It’s as if he were saying, “I oppress, but I oppress no one but myself.”

In addition to Foucault’s anti-normative bias, Fassin argues that the problem with his understanding of ethics is that it is self-contained, a form of individual self-mastery that is indifferent to the society around it and thus indifferent to politics. Foucault “disconnects the reflexive exercise of creating a moral self from its social conditions of possibility”—or, to put this another way, he is not interested in the social forces that limit the kinds of selves that can be formed. Fassin suggests that new anthropological approaches to ethics oriented around Foucault’s “care of the self” have become too particularistic, and hence blind to the inescapable issue of planetary inequality that Fassin insists should be at the center of any politics or ethics of life. “The word ‘inequality,'” he observes, “does not belong to [Foucault’s] vocabulary.”

Turning from ethics to the local and global structures that create and sustain life, the book’s final section, “Politics of Life,” discusses in a rapid but fascinating survey “the way in which the monetary appreciation of lives developed over the last 2,000 years.” Here, Fassin puts on his anthropologist’s hat to talk about dowry and bride price, considered as payment for a life given in marriage, as well as the widespread premodern traditions of compensation to the victim’s family in cases of murder. But in both sets of examples, he also comes to political conclusions, stressing again how some lives are assumed to have more value than others. The rise of modern law, which supposedly created a formal equality among individuals, marked an improvement on this situation. Yet, as Fassin argues, this formal equality masks other forms of inequality—and not just the chasm between the rich and the poor. Fassin doesn’t talk much about capitalism in this discussion, but that’s in part because capitalism alone, in his view, doesn’t fully account for inequalities based on race, gender, sexuality, and (a special interest of his) citizenship status.

Bringing this argument into the present, Fassin then takes up the value of lives lost as it was calculated by the September 11 Victim Compensation Fund. The fund’s payments to families, he notes, depended on estimates of what their loved ones would have earned in the future, among other factors, so that poorer families received dramatically less money than rich ones. As a result, great gulfs of inequality emerge even in the wake of someone’s death. The families of women killed in the attack were compensated, on average, at 63 percent of what the families of men received.

Fassin also examines the 9/11 fund in the context of the much lower compensation for victims of the Oklahoma City bombing in 1995 and Hurricane Katrina in 2005:

with the Oklahoma City bombing, the fact that the enemy was a young white middle-class war veteran who had served in Iraq rendered the building of a common affliction more difficult. Likewise, in Louisiana, the victims were mostly poor black people, which limited the possibility of a shared grief in a country where the contrasting reactions to the disaster revealed the scars of its long history of racism and discrimination.

In the Iraq War, in which US forces killed many Iraqi civilians, intentionally or by mistake, compensation has rarely been awarded to the families—and when it has been, it has averaged about $4,000. By contrast, the total benefits paid to the families of US troops killed in the war “can exceed $800,000,” Fassin notes. “The ratio in terms of what life is worth is 1 to 200.”

These are facts that, to put it mildly, Foucault has not taught his followers to pick up on, but they are needed to capture the particular character of our era’s planetary inequality. In his book’s concluding section, Fassin argues that Foucault’s much-quoted term “biopolitics” is also partly to blame. The term is unhelpful, Fassin insists, because it is doubly misnamed. Biopolitics, as Foucault understands, is not really about the value or significance of life so much as it is about how life is regimented and governed, nor is it really about politics, which involves struggle against the scandalous inequality of human life and thus can never be reduced to mere governance.

Foucault, Fassin continues, “is interested in the way in which what today seems self-evident emerged—birth control, measurement of mortality, management of public hygiene, control of migration flows—rather than in the social forces at play in this process.” These are all important issues. But for Fassin, politics is about biography as well as biology, about meanings and values as well as those technologies that organize (and often oppress us in) everyday life. One might argue, as I have, that there is more of an overlap between Foucault and Marx than Fassin recognizes here. But there is no doubt that Foucault is reluctant “to incorporate social criticism in his genealogical critique.” Yet this is precisely what Fassin wants anthropology to do.

At the same time, Fassin is by no means a knee-jerk anti-Foucaultian. Like Foucault, he wants to jostle his readers loose from verities that, to them, seem self-evident. For Fassin as well, much of what is dangerously “self-evident” involves the uncritical invocation of the human and the humane. Wary of the invocation of the human on a global scale, as this strain of humanitarianism has so often provided an excuse for military intervention, Fassin is equally suspicious of the so-called post-human movement—inspired by a certain version of environmentalism, as well as by Foucault and his followers—that values life itself over and above (and sometimes against) specifically human life, and thus is liable to wander away from human-centered ethical issues like society’s responsibility to the refugee, or away from ethics as such.

Rather than giving up on humanitarianism, Fassin asks us to keep at it while remembering that such humanitarianism will not help unless it seeks to have an impact on the deep structures that determine whose lives have the most value and who will suffer as a result. Moral economy, in short, must go hand in hand with political economy.

In Fassin’s 2011 book, Humanitarian Reason: A Moral History of the Present, he accused his fellow French anthropologist and sociologist Pierre Bourdieu of failing to see “that suffering is also a characteristic language of the contemporary world and that compassion has become a political force.” Meanwhile, Fassin criticized Luc Boltanski, another sociologist and strong advocate of humanitarianism, of abandoning “any perspective on the contemporary world.” What Fassin advocates here under the heading of politics—a concept that is crucial enough to his argument to call for some additional elaboration on his part—is forbidden from making either mistake.

A reworking of the distinguished Adorno lectures at the Institute of Social Research at Goethe University, Frankfurt, Life: A Critical User’s Manual offers a handy synthesis of the research that Fassin has been conducting for decades on three continents, much of it with migrants and people with AIDS. But the book also gestures toward a synthesis of French and German philosophical thought, the latter having long been much more comfortable in the domain of the universal.

Fassin’s title alludes to Georges Perec’s 1978 novel Life: A User’s Manual, which proposes, in 99 chapters grouped around the inhabitants of one Paris apartment building, that each individual life might turn out to be a piece in a huge, invisible jigsaw puzzle. By invoking this humane but extraordinarily complicated novel, Fassin brings Perec’s argument into the world of politics and worries that we are perhaps fed up enough with our puzzling differences to embrace what ties us together. As an anthropologist, he is trained to look for and respect differences, both between cultures and individuals. As a medical doctor, he knows what all human bodies have in common and the mortality that we ultimately face. And as a philosopher, he seems ready to ask whether our infinitely diverse particulars might be gathered up—if not into something universal, then at least in a pattern, into something that might resemble the plot of a novel.

The word “critical,” which Fassin adds to Perec’s title, seems intended to suggest that Fassin has the beginning of an answer to the question Perec leaves more ambiguously unanswered about what holds us together. If so, it’s because the inequality of human lives is the overriding and unbearable condition that, today at least, all of us share.