Regarding Bioethics: A Sociology of Morality
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Regarding Bioethics
A Sociology of Morality

C. Wright Mills said that when done well, sociology illuminates the intersection of biography and history. This essay examines how the author's vocational choices and career path were shaped by historical circumstance, leading him to a degree in sociology and to participation in the odd and interesting interdiscipline of bioethics. Drawing on a distinction between sociology in bioethics and sociology of bioethics, the essay considers the value of sociology to the bioethical project.

You might say that my interest in medicine and ethics was determined long before I was born. I am a typical third-generation immigrant. Around the turn of the 20th century, all four of my grandparents left the Netherlands, joining a wave of European émigrés crossing the Atlantic in hopes of a better life in the United States. My American-born parents, like many second-generation immigrants, entered the workforce immediately after secondary school, their wages needed for the economic stability of their families. Denied the opportunity to attend university, they vowed that their children would have access to the benefits afforded by higher education. While I do not recall specific parental encouragement [End Page 74] to seek a professional career, all four of my older siblings pursued vocations in medicine, a path characteristic of third-generation immigrant children. None became medical doctors, but all found work in the health-care sector: a counselor, a neuroscientist, a veterinarian, and a health-care administrator.

In my first semester of college I dutifully followed the example set by my siblings, enrolling in the courses recommended for premed students. Did I have a choice? But history intervened. I began my post-secondary education in 1969, an era marked by public unrest and the struggle for civil rights. An idealistic 18-year-old, and a bit bored by my science classes, my head was turned by the changes going on around me. It seemed to me that there were far more pressing problems to diagnose and treat than ordinary illnesses. Captivated by engaging professors in the social sciences and philosophy, I abandoned the premed curriculum and became a sociology major.

Sociology allowed me to see the otherwise invisible ways the world around us is shaped, offering new and fascinating explanations for the behavior of people, organizations, and institutions. Reading the work of Thorstein Veblen (1899), for example, I learned why Americans buy Cadillacs when Chevys will do. Veblen, whose parents came to the United States from Norway, saw this curious American way of wasting money as the predictable result of the confusion of wealth and status. In societies where riches confer honor—if you are rich you must be reputable and worthy of high regard—people will "conspicuously consume," finding ways to publicly display their affluence. I learned from Emile Durkheim (1897) that suicide—seemingly the most individual of decisions—had social causes. Looking carefully at records of death, Durkheim discovered that rates of suicide increased, not only in periods of economic depression, but also during economic booms, not only when people feel isolated, but also when people are so thoroughly integrated in a group that they are willing to sacrifice their lives for the greater good. Durkheim demonstrated that suicide rates are not just measures of individual despair, but are associated with too much or too little integration in society, too many or too few rules.

This new way of seeing the world fascinated me, but the choice for sociology did not extinguish my interest in medicine. Rather, sociology showed me a different, novel, and more interesting side of medicine. It was Talcott Parsons (1951) who noted that hospitals and prisons, while seemingly different, serve the same function in society: removing the deviants (persons who had violated the norms of law or health) and "treating" them, with the goal of returning them to normal life in the community. The ethnographer Erving Goffman (1961) took this idea further, describing both prisons and hospitals as "total institutions," organizations that control every aspect of "inmate" life from one's dress, to one's identity, to the timing of all bodily activities. As a result of my sociology courses, I discovered...