For many of us working in bioethics, the most exciting movement in our field is what Alan Cribb calls the “social turn” in healthcare ethics. A touchstone for Cribb’s framework-building project in Health and the Good Society is the question: how do clinical ethics and public health ethics come together?
“Framework” can mean more than one thing. It can mean a code to apply, like a checklist, to determine the ethical acceptability of a proposed course of action. One familiar proposal in this area is that public health’s emphasis on the common good can correct the bioethicist’s emphasis on individual choice (see for instance (Kass 2001)). This would have us re-prioritize items on the checklist. “Framework” can also mean something more like a map of the terrain or an exploration of the conceptual space within which the questions at hand arise and may be treated: a disciplinary (re)configuration. Cribb is after the latter kind of “framework,” specifically with methodological intent. Bioethics has always brought together philosophers, lawyers, and doctors to contribute their distinct expertises; what Cribb advocates is an integration of this evolving project with the social sciences: history of medicine, social studies of technology, medical sociology and anthropology, not to mention political science and policy studies. These come to the bioethical enterprise not as “add-ons:” they bring deep engagement with, and contextualization and scrutiny of, the very terms in which the traditional partners in bioethics operate.