In Bioethics in Historical Perspective, Sarah Ferber presents an extensively documented set of case studies to trace historically specific events and suggest what bioethics is or can be. Ferber proposes that twenty-first-century bioethics forms a powerful medium for evaluating human relationships, personal values and philosophical conditions. She argues for the importance of a historical understanding of bioethics: one that affirms the contingencies that shaped the discipline in a distinctly Western social and cultural ethos, and simultaneously acknowledges bioethics in its constant state of becoming. Moreover, she convincingly shows how historical analysis enables us to perceive more clearly the social practice of bioethics. The book, however, is not intended to make substantial contributions to scholarly debates on the emergence of bioethics. It reasonably establishes a core introductory reading for graduate students in the field rather than a historical narrative on the emergence of the discipline. Ferber identifies particular sites, including religion, medical practice and biomedical research, that provide valuable areas for analysis.

Since the Second World War the ascendance of bioethics as an institution has championed the introduction into the public sphere of confined discussions from clinical medicine in science. This led to a social transformation of government and activism within the medical profession. Ferber enters the discussion of bioethics from a definition provided by philosopher Daniel Callahan, who cofounded the Hastings Center of New York in 1969. His model for bioethics included four related spheres: a theoretical foundation of the field; clinical ethics (day-to-day moral decision-making by those caring for patients); regulatory and policy bioethics, aimed to fashion legal procedures applicable to cases of certain types; and finally a cultural bioethics that attempts to relate the field to the historical, ideological and social context in which it is expressed. While the last approach is the essence of this book, bioethics is not an American invention and, though it is said to have emerged in the 1960s, there are a number of historical threads upon which it drew.

In Ferber's formulation, Western culture and its meaning stand as fundamental elements of contemporary bioethics. For example, she presents core Christian ideology in the early modern period that placed clergy and physicians central to the intersection of health, life and death. In the case of medicine – a science that creates knowledge about the reaction of the body to disease and its treatment – Ferber reminds us of these deeper religious undercurrents in the history of clinical practice. ‘Much modern bioethics debate can be seen as part of a standoff between two competing notions of the sacred: the sacred calling to heal and a theologically informed perception of the sacredness of human life’ (p. 16). As Ferber makes the case for Christianity as a specific cultural context in which recent bioethics evolved, she reflects on the discipline as a tool to evaluate the ways in which past attitudes affect perspectives of the present and frame activities of novelty, continuity and change. Identifying the roots of bioethical debates through cultural contexts also reveals the ethical and moral foundations of the discipline. Historically situating these practices and their connection to the sacred illuminates an important thread that Ferber traces to the important present-day bioethical concerns of abortion, embryo research and euthanasia.

Since the 1960s bioethics has acquired academic standing, institutional authority and public visibility. Historians tend to approach the historical development of the profession from the perspective of an outsider, observing the social, political and scientific forces that constituted this seemingly new and increasingly authoritative field. Ferber's account examines each case and provides a tailored historical précis with the goal of defining modern bioethics as a set of experiences, risks and benefits. Grounding discussions of bioethics she writes, ‘Modern bioethics is, among other things, a story of the ways in which members of different forms and forums for truth – or judgment seekers – have interacted with each other to stake out discursive territory in medical and health policy’ (p. 36). Yet, in order to understand this development in closer proximity, perhaps a social analysis with particular attention to power interests, authority and legitimacy claims would strengthen her argument. Whether strategic or not, bioethics has served specific interests in stabilizing certain areas of medical practice as a highly functional discipline for coopting criticism and medical authority. Regrettably, by not addressing ways in which bioethics functioned as a discipline within institutions, we are kept from larger questions that may include climate change and environmental impacts on human health.

Bioethics occupies a significant place in the evolution of clinical practice and medical science. The discipline continues to demand serious historical scholarship to contextualize the modern debates within health care policy, global health, clinical trials and pharmaceutical innovation, among many other contested areas of practice and inquiry. Ferber's book is best employed as a conceptual teaching tool derived from historical method to generate critical thought about topics within bioethics. She provides a series of exercises in each chapter, and concludes with summaries and short bibliographies of ‘further reading’ for deeper intellectual engagement with the themes of each chapter. The book can serve as a useful companion for larger survey courses in the history and sociology of medicine or for those who seek a general understanding of the emergence of bioethical discourse since the mid-twentieth century. Additionally, a readership of professionals in fields such as medicine, law and public policy may find this an excellent reference.