Andrew Sayer has argued that a truly critical social science and practice is critical precisely because, “explanations of social practices must be critical in order to be explanatory, and that the necessity of critique gives social science a potentially emancipatory character” (Sayer, 1997, 473). In social work practice and research, like all critical social science, we don’t always agree on the nature of the problem (i.e., what the problem is), often we disagree about the cause or source of the problem, and sometimes we cannot agree on how best to remove the problem (i.e., the intervention). And very often, our most desired solutions are not feasible. And sometimes we have feasible solutions for some problems that cause problems for others or cause other unintended problems. This is the swampy ground on which we research and practice social work. And it is also in this swampy ground where we must confront our normative claims and propositions; here is where we make value claims and pass negative judgments about offending causes.
Social scientists (sociologists, anthropologists, and psychologists) have in recent years produced a very significant body of literature on ethics and moral philosophy (Keane, 2017; Laidlaw, 2013; Lambek, 2010; Mattingly and Throop, 2018; Vandenberghe, 2018; Zignon, 2010). Indeed, many have described an ethical turn in the social sciences, and you will not find much of this literature cited in social work research, where it has been confined mainly to ethics journals and then mostly in the United Kingdom. We propose, here, an ethical turn in social work research and practice, which builds on our 2014 article for Social Work Research.
Below, we offer what we will call a Critical Science for Social Work (CSSW) and we’ll take the Affordable Care Act as an illustrative example:
Affordable Care Act (ACA, 2010)
1. Identify the problem: access to affordable healthcare insurance
2. Identify the cause: private (market) distribution of healthcare insurance
3. Pass negative judgment: The private market monopoly has a negative outcome/influence for all
4. All things being equal, a government sponsored (ACA) healthcare program will remove the unwanted determination—unaffordable private insurance premiums.
It is recognized, of course, that enlightening people as to the source of illusions and unwanted determinations responsible for their social conditions (or facilitating their reflexivity) about why millions are without healthcare insurance is not a sufficient condition for emancipation, and may indeed increase conflict. We only need to point to the current US administration’s unrelenting efforts to undermine or altogether eliminate the ACA. Indeed, for emancipation the mechanisms actually generating the problems must also be removed or blocked. The ACA may have stumbled, leading to its criticism, on this last point. The ACA, all things being equal (step 4), assumed one causal source, the private insurance market, and this closed the circuit causing us not to recognize other possible mechanisms producing the high cost of healthcare. The rollout of ACA was fraught with problems and disappointments—most would agree it has been disappointing and this had led to the current desire, especially among neoliberal Democrats and others in the stabilizing class (see Jean Claude Milner on the stabilizing class, reference list below), to improve the ACA, not repeal it. The quest for emancipation, or social improvement in the case of ACA, therefore, involves addressing normative questions and the feasibility of alternatives. And the latter creates uncertainties about what is possible and the inescapability of normative claims What do we mean?
Let’s consider the problem of feasibility: If the problem was only in the private market, would a national healthcare program (Medicare for all) be feasible? What alternatives are feasible? In the gap between the source of the problem (private market) and the solution (ACA) normative questions proliferate:
Would healthcare be more affordable without any market role? And what would this look like?
Are there viable alternatives to our current system?
Is a single-payer system a viable alternative? Would a single-payer system reduce healthcare costs for everyone?
What other mechanisms causing high healthcare costs were unaccounted for (e.g.,individual health and lifestyle choices, structural issues like poverty, fast food and mass production of unhealthy food)? Would the latter potential causes also need addressing for the ACA to be successful?
And here is the rub: There are no absolute answers to these questions. A critical science of social work must engage moral philosophy. There is a necessary and inevitable normative claim in step 3—passing a negative judgment on the cause of the problem. In short, it’s impossible to skip step 3 and then imagine taking the next step, number 4: issuing policies and actions to remove the causes of unwanted determinations—unaffordable health insurance premiums. In our five vodcasts on covid-19 and social work, produced for the Rutgers School of Social work, we offer examples of how CSSW is applied to the problem of unequal exposure to the virus: nursing home residents, mass incarceration and frontline workers.
References
Badiou, A., & Milner, J. C. (2018). Controversies: Politics and Philosophy in Our Time. John Wiley & Sons.
Keane, W. (2017). Ethical life: Its natural and social histories. Princeton: Princeton University Press.
Laidlaw, J. (2013). The subject of virtue: An anthropology of ethics and freedom. Cambridge University Press.
Lambek, M. (Ed.). (2010). Ordinary ethics: Anthropology, language, and action. Nerw York: Fordham University Press.
Longhofer, J., & Floersch, J. (2014). Values in a science of social work: Values-informed research and research-informed values. Research on Social Work Practice, 24(5), 527-534.
Mattingly, C., & Throop, J. (2018). The anthropology of ethics and morality. Annual Review of Anthropology, 47, 475-492.
Vandenberghe, F. (2018). Sociology as practical philosophy and moral science. Theory, Culture & Society, 35(3), 77-97.
Zigon, J. (2010). Moral and ethical assemblages. Anthropological Theory, 10(1-2), 3-15.