Charles L. Bosk, What Would you Do? Juggling Bioethics and Ethnography

Brenda L. Beagan
2009 Canadian journal of sociology  
a sociologist also appointed to University of Pennsylvania's Center for Bioethics, brings to bear on a host of ethical concerns over 30 years' experience in medical ethnography, in a text both thoughtprovoking and engaging. He examines both the social organization of bioethics as a growing occupational domain in health care, and the everyday ethical dilemmas of sociologists who conduct ethnography in health care settings, including studying medical ethics. Bosk argues that bioethics as a field
more » ... olidifies notions that what can go wrong in medicine concerns moral values, rather than structural arrangements, power, privilege, and authority. In a sense, the rise of bioethics, a field operating largely within medicine, displaced more fundamentally confrontational challenges. He also notes that there is no way to assess the work of bioethicists, inasmuch as it is not clear what effectiveness would mean: fewer legal complaints? quicker resolution of conflicts? greatly expanded discussion of ethical issues, by health professionals and patients? Without measures of success, not to mention agreed upon goals, means, procedures, qualifications, and realms of authority, it is not clear what makes bioethics a distinct field. In the late 1970s, Bosk studied surgical training, focusing on how surgeons and residents came to define what counted as blameworthy and blameless errors (i.e., those that warrant censure or dismissal versus those that are good for learning). The essay "Margin of Error" constitutes one of the strengths of this book, as he applies the same kind of analysis to bioethics, arguing that bioethicists cannot make blameworthy errors when there is no consensus in the field about what constitutes a mistake. In my view, the most interesting sections of the book occur when the human side of medical ethnography is explored. Bosk describes grappling to impose order on years of fieldnotes, trying to juggle analysis with the need for confidentiality and anonymity. He details the responses of some study participants, highlighting the particular issues that arise when doing ethnography in settings where locals will access and read your work: have you sufficiently masked identities to prevent readers
doi:10.29173/cjs6280 fatcat:lvgfr6uzoba6jmdol2ottpqtue