This chapter contains sections titled: Care and Gender in Contemporary Capitalist Societies Supporting Care and Moving Toward Gender Justice The Consequences of Property‐Owning Democracy for Gender and Care Conclusion References.

This paper discusses the question whether care work for dependent persons (children, the elderly, and disabled persons) may be entrusted to the market; that is, whether and to what extent there is a normative justification for the “commodification of care.” It first proposes a capability theory for care that raises two relevant demands: a basic capability for receiving care and a capability for giving care. Next it discusses and rejects two objections that aim (...) to show that market-based care undermines the caring motives essential to care, one of them because of its reliance on contracts and the other because of the corrupting influence of payment on motivation. If market care is in principle legitimate, the commodification question transforms into one about the appropriate combinations of market and non-market care. This question can be answered only by adding an additional complication: care is to be balanced against other activities, most notably work for the labor market. This brings in the problem of gender inequality, since paid work has been traditionally distributed to men and caring activities to women. I show how the capability theory of caring presented in this paper can help resolve the dispute between competing models for balancing work and caring. (shrink)

Since the mid-1980s, there has been a gradual ethical drift in the provision of maternal care in African health facilities in general, and in Cameroon in particular, despite government efforts. In fact, in Cameroon, an increasing number of caregivers are reportedly not providing compassionate care in maternity services. Consequently, many women, particularly the financially vulnerable, experience numerous difficulties in accessing these health services. In this article, we highlight the unequal access to care in public maternity services in (...) Cameroon in general and the Noun Division in particular. For this study, in addition to documentary review, two qualitative data collection techniques were used: direct observation and individual interviews. Following the field work, the observation data were categorized and analyzed to assess their relevance and significance in relation to the topics listed in the observation checklist. Interviews were recorded using a dictaphone; they were subsequently transcribed and the data categorized and coded. After this stage, an analysis grid was constructed for content analysis of the transcripts, to study the frequency of topics addressed during the interviews, as well as divergences and convergences among the respondents. The results of this data analysis showed that money has become the driving force in service provision. As such, it is the patient’s economic capital that counts. Considered “clients”, pregnant women without sufficient financial resources wait long hours in corridors; some die in pain under the indifferent gaze of the professionals who are supposed to take care of them. In sharp contrast, the findings revealed that financially privileged patients are able to bribe caregivers to attract their favour and obtain prompt, careful, and effective care. These ethical abuses observed in the Noun public health facilities drive women to use, from the beginning of their pregnancies to the delivery, only healthcare delivered by traditional health attendants. (shrink)

Commodification of health care is a central tenet of managed care as it functions in the United States. As a result, price, cost, quality, availability, and distribution of health care are increasingly left to the workings of the competitive marketplace. This essay examines the conceptual, ethical, and practical implications of commodification, particularly as it affects the healing relationship between health professionals and their patients. It concludes that health care is not a commodity, that treating (...) it as such is deleterious to the ethics of patient care, and that health is a human good that a good society has an obligation to protect from the market ethos. (shrink)

This paper explores new working time arrangements around a critique of the ‘commodification of time’ to illuminate the contradictions of such new flexibilities. Two features of these new arrangements are seen as relevant for evaluating the Marx/Engels analysis. Firstly, it roots the examination of time in commodification, although, as criticised in this paper, some authors have seen this as the generality of time rather than that within the exchange of labour power. Significantly — and central in all working (...) time arrangements — it is labour power that is sold, be it for a particular period of time, rather than the time itself. Hence, working time arrangements set boundaries against ‘free’ time or time in which labour power is not sold as a commodity, that ‘free’ time which was recognised in the traditional arrangements — fought over in early industrialism — which set premium payments against anti-social hours within ‘overtime’. New working time arrangements tend to blur the boundaries between ‘free’ and ‘working’ time, assuming an availability of labour power to capital. While much of the promotion of flexibility stresses the possibility of making adjustment to suit social and domestic requirements it is more usually the means for altering working time to meet the demands of capital. The much-vaunted case of Volkswagen has led to ‘working time accounts’ becoming the established temporal arrangement within the German car industry and increasingly becoming the norm for other European auto producers. The name given to these new working arrangements within the motor industry suggests that time has indeed become further commodified. For workers within these new time regimes, the hours owed to their employer is displayed along with their earnings — and deductions — on their wage slip. (shrink)

In light of recent developments that have occurred in the domestic sector in Europe and the debate on the externalisation of domestic and care activities, this article explores the impact of the gender regime on paid domestic work. The gender regime is defined here as the combination of two dimensions: gender equality outcomes and the ‘gender contract’. The aim is to investigate whether the gender regime can contribute to explaining cross-national similarities and differences, in terms of the size (...) of the domestic sector, its workforce composition—with a focus on the proportion of women and migrants—and its working conditions. The article shows the results of quantitative analyses conducted at the European level, which include the construction of a typology of gender regimes, based on selected indicators, and a descriptive comparative analysis of the domestic sector at national level, based on data from the 2015 European Union Labour Force Survey (EU-LFS). The findings suggest that the use of this typology of gender regimes can be a useful tool to explain cross-European differences in the domestic sector, but only regarding the size of the sector and the feminisation of the workforce. Concerning the proportion of migrants and working conditions in the domestic sector, no clear pattern emerges that can explain cross-national differences based on this typology. (shrink)

This article analyses the negative ethical impact of privatisation, alongside the ongoing marketisation of social care and social work provision for children and young people in England. It critically appraises the implications of a market-based formal social care system, which includes the risk-averse and often detached role of social workers within ever more fragmented sectors of care. Analysis begins with a discussion of background policy and context. The tendency towards ‘service user’ objectification and commodification are (...) then detailed, followed by a discussion of the limiting of choice for service users. Service and social fragmentation, and the often severely restricted ‘life chances’ of many children and young people in care, are then deliberated. The concluding discussion reiterates the ethical implications of marketisation in relation to ethical frameworks, including those associated with autonomy, informed choice, social exclusion and social justice. The tendency towards children increasingly being utilised as a means to an end within business-orientated sectors of care is highlighted, alongside moral questions asked about the State’s purpose in providing a community of support. (shrink)

A notable feature of post-Fordist economies is the increase in service jobs, which includes care occupations such as child care and elder care (Folbre 2001, 182). The commodification of caring activities raises issues surrounding the reception and dispensation of these services, and this is particularly salient to the focus of this paper, elder care. Because the demand for this type of care has greatly increased in recent decades (Glendinning, Schunk, and McLaughlin 1997; Kaye et (...) al. 2006) and also in recognition of the impact of caring activities on families, many countries have sought to initiate policies to provide state-funded services or to compensate family caregivers for their care work.1If help with the .. (shrink)

Developments in the provision of care and support services for disabled and older people across developed welfare states have led to the expansion of personalisation (sometimes called cash-for-care, direct payments, care payments, etc.) schemes, whereby cash is paid in substitute for care services and support. Although these schemes vary considerably in their scope and operation (sometimes paying carers directly, sometimes enabling disabled and older people to act as direct employers, sometimes mixing paid and unpaid care), (...) they share the characteristics of commodifying care and support services and will have a potentially profound impact on the relationship between individuals, families, communities and the welfare state. Although the schemes have been evaluated within their own national contexts, little work has been done so far to explore the theoretical implications of their development and extension, particularly from an ethics of care perspective. This paper intends to fill that theoretical gap by drawing on comparative evidence from several schemes across different national contexts to develop an analysis which draws on feminist theory and an ethics of care approach to examine (a) the gendered policy outcomes and impact of such schemes; (b) a feminist analysis of the governance implications of personalisation; (c) the implications for the gendered division of work, particularly between paid and unpaid care work and between different groups of paid and unpaid carers; (d) an ethics of care analysis of the impact of personalisation over the lifecourse of disabled and older people, and carers; and (e) a discussion of the relationship between commodification, empowerment, citizenship and choice drawing on the work of care ethicists. It will draw conclusions about the outcomes of a range of types of personalisation schemes and thus have implications for theory, policy and practice. (shrink)

Drawing on feminist labour law and political economy literature, I argue that it is crucial to interrogate the personal and territorial scope of labour. After discussing the “commodification” of care, global care chains, and body work, I claim that the territorial scope of labour law must be expanded beyond that nation state to include transnational processes. I use the idea of social reproduction both to illustrate and to examine some of the recurring regulatory dilemmas that plague (...) labour markets. I argue that unpaid care and domestic work performed in the household, typically by women, troubles the personal scope of labour law. I use the example of this specific type of personal service relation to illustrate my claim that the jurisdiction of labour law is historical and contingent, rather than conceptual and universal. I conclude by identifying some of the implications of redrawing the territorial and personal scope of labour law in light of feminist understandings of social reproduction. (shrink)

This study is the first to explicitly assess the connections between welfare state spending and the gendered and classed dimensions of unpaid care work across 29 European nations. Our research uses multi-level model analysis of European Quality of Life Survey data, examining childcare and housework burdens for people living with at least one child under the age of 18. Two key findings emerge: First, by disaggregating different types of unpaid care work, we find that childcare provision (...) is more gendered than classed—reflecting trends toward “intensive mothering”. Housework and cooking, on the contrary, demonstrate both gender and class effects, likely because they are more readily outsourced by wealthier individuals to the paid care sector. Second, while overall social expenditure has no effect on hours spent on childcare and housework, results suggest that family policy may shape the relationship between gender, income, and housework. Specifically, family policy expenditure is associated with a considerably smaller gender gap vis-à-vis the time dedicated to housework: This effect is present across the income spectrum, but is particularly substantial in the case of lower income women. (shrink)

Background Policy instruments based on the working of markets have been introduced to empower consumers of healthcare. However, it is still not easy to become a critical consumer of healthcare. Objectives The aim of this study is to analyse the possibilities of the state to strengthen the position of patients with the aid of a new financial regime, such as personal health budgets. Methods Data were collected through in-depth interviews with executives, managers, professionals and client representatives of six long-term (...) class='Hi'>care institutions. Results With the introduction of individual budgets the responsibility for budgetary control has shifted from the organisational level to the individual level in the caregiver-client relationship. Having more luxurious care on offer necessitates a stronger demarcation of regular care because organisations cannot simultaneously offer extra care as part of the standard care package. New financial instruments have an impact on the culture of receiving and giving care. Distributive justice takes on new meaning with the introduction of financial market mechanisms in healthcare; the distributing principle of ‘need’ is transformed into the principle of ‘economic demand’. Conclusion Financial instruments not only act as a countervailing power against providers insufficiently client-oriented, but are also used by providers to reinforce their own positions vis-à-vis demanding clients. Tailor-made finance is not the same as tailor-made care. (shrink)

In the intellectual confusion prevailing since the demise of Marxism and “marxism”, the attempt is made to define democracy as a matter of pure procedure, explicitly avoiding and condemning any reference to substantive objectives. It can easily be shown, however, that the idea of a purely procedural “democracy” is incoherent and self-contradictory. No legal system whatsoever and no government can exist in the absence of substantive conditions which cannot be left to chance or to the workings of the “market” but (...) must be posited as objectives of political activity. The confusion results from a deficient understanding of what makes a society and an empty idea of “freedom”. The objective of politics is not happiness, an affair to be left to the individuals, but it certainly is liberty understood as participation in the governance of the polity; it is also the pursuit of the common good, defined as the sum of the prerequisites and facilitations of individual autonomy depending on collective action, and as the realization of commonly agreed collective goals. (shrink)

This paper treats the political and ethical issues associated with the new caretaking technologies. Given the number of feminists who have raised serious concerns about the future of care work in the United States, and who have been critical of the degree to which society “free rides” on women's caretaking labor, I consider whether technology may provide a solution to this problem. Certainly, if we can create machines and robots to take on particular tasks, we may lighten the (...) care burden that women currently face, much of which is heavy and repetitious, and which results in injury and care “burnout” for many female caretakers. Yet, in some contexts, I argue that high-tech robotic care may undermine social relationships, cutting individuals off from the possibility of social connectedness with others. (shrink)

The body of information on the Internet is becoming increasingly geographical. This is both due to the expansion of established categories of geographic information and to the simultaneous enrichment of other types of information through geographic identifiers. As this repository of geographic information expands, it is also a key site for multiple processes of commodification transforming informational resources into market goods. Understanding the dynamics driving the integration of geographic information into the digital economy requires a comprehensive political economic analysis. (...) A key component of this analysis is to explain the logics of creation and allocation of economic value from geographic information on the Internet. Addressing this need, in the present article I deploy the property regimes schema developed by Schlager and Ostrom and expand it to elucidate the differentiated commodification processes of geographic information on the Internet. Property regimes are arrangements that define rules, distribute rights, and delineate roles with respect to particular goods. These arrangements are enabled by elements such as legal frameworks, jurisdictions, type of information, and technologies of access. In this article, I explore how the legal frameworks regulating traditional categories of geographic information have been destabilized in the process of technological innovation, leading to the creation of new informational goods along with their respective property regimes, and rearticulating legal, economic, and sociotechnical relations. To illustrate this, I analyze the case of Google Street View images through their property regimes in various jurisdictions. (shrink)

Malm and colleagues (2008) consider (and reject) five arguments putatively justifying the idea that healthcare workers (HCWs) have a duty to treat (DTT) during a pandemic. We do not have sufficient...

Recent findings in epigenetics have been attracting much attention from social scientists and bioethicists because they reveal the molecular mechanisms by which exposure to socioenvironmental factors, such as pollutants and social adversity, can influence the expression of genes throughout life. Most surprisingly, some epigenetic modifications may also be heritable via germ cells across generations. Epigenetics may be the missing molecular evidence of the importance of using preventive strategies at the policy level to reduce the incidence and prevalence of common diseases. (...) But while this “policy translation” of epigenetics introduces new arguments in favor of public health strategies and policy-making, a more “clinical translation” of epigenetics is also emerging. It focuses on the biochemical mechanisms and epigenetic variants at the origin of disease, leading to novel biomedical means of assessing epigenetic susceptibility and reversing detrimental epigenetic variants. In this paper, we argue that the impetus to create new biomedical interventions to manipulate and reverse epigenetic variants is likely to garner more attention than effective social and public health interventions and therefore also to garner a greater share of limited public resources. This is likely to happen because of the current biopolitical context in which scientific findings are translated. This contemporary neoliberal “regime of truth,” to use a term from Michel Foucault, greatly influences the ways in which knowledge is being interpreted and implemented. Building on sociologist Thomas Lemke's Foucauldian “analytics of biopolitics” and on literature from the field of science and technology studies, we present two sociological trends that may impede the policy translation of epigenetics: molecularization and biomedicalization. These trends, we argue, are likely to favor the clinical translation of epigenetics—in other words, the development of new clinical tools fostering what has been called “personalized” or “precision” medicine. In addition, we argue that an overemphasized clinical translation of epigenetics may further reinforce this biopolitical landscape through four processes closely related to neoliberal pathways of thinking: the internalization and isolation of socioenvironmental determinants of health and increased opportunities for commodification and technologicalization of health care interventions. (shrink)

Studies of creative industries typically contend that creative work is profoundly precarious, taking place on a freelance basis in highly competitive, individualized and contingent labour markets. Such studies depict creative workers as correspondingly self-enterprising, self-reliant, self-interested and calculative agents who valorise care-free independence. In contrast, we adopt the ‘ethics of care’ approach to explore, recognize and appreciate the communitarian, relational and moral considerations as well as interpersonal connectedness and interdependencies that underpin creative work. Drawing on in-depth (...) interviews with creative workers in a range of marginal socio-cultural contexts, we argue that creative workers cultivate and sustain a diverse array of practices of care arising from an affective concern with the well-being of others. Far from being merely individualistic and crudely competitive actors, creative workers enact practical ethical responsibilities and affectivities towards a range of human and non-human others, including families, local communities and neighbourhoods, colleagues, artistic scenes and their adjacent genres, and surrounding national and linguistic cultures. In emphasizing the fundamental and structuring role of care in contingent labour markets our approach accords with recent trends in the social sciences that ‘affirmatively’—as opposed to ‘negatively’ and ‘suspiciously’—recognize that mutuality, solidarity and affectivity are powerful drivers of action on a par with or even exceeding market-driven self-centredness. (shrink)

In this analysis I apply a Foucauldian approach to ethics to examine the politically prescribed moral and ethical character required of carers of aged persons at home in Australia and the role of nurses in shaping these behaviours. The work that spousal carers provide, although often founded on love and/or obligation, has been formalized through a variety of policy initiatives and technologies that serve to construct the moral approach they must adopt. This shaping of conduct at the most personal (...) level takes place through the application of codes of behaviour policed largely by nurses. These codes redefine the mode of coexistence between an aged husband and wife and propose a new form of relationship that is derived from and supports policies of the deinstitutionalization of care services for elderly persons. In this way modern carer policy has drawn on knowledge and governance of the self to produce a morality of caring that is both authoritative and scientific. (shrink)

Australia, along with other countries, has introduced New Public Management (NPM) into public sector hospitals in an effort to contain healthcare costs. NPM is associated with outsourcing of service provision, the meeting of government performance indicators, workforce flexibility and rationing of resources. This study explores the impact of rationing of staffing and other resources upon delivery of care outside of business hours. Data was collected through semistructured interviews conducted with 21 nurses working in 2 large Australian metropolitan hospitals. Participants (...) identified four strategies associated with NPM which add to workload after‐hours and impacted on the capacity to deliver nursing care. These were functional flexibility, vertical substitution of staff, meeting externally established performance indicators and outsourcing. We conclude that cost containment alongside of the meeting of performance indicators has extended work traditionally performed during business hours beyond those hours when less staffing and material resources are available. This adds to nursing workload and potentially contributes to incomplete nursing care. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Convention for Protection of Human Rights and Dignity of the Human Being with Regard to the Application of Biology and Biomedicine: Convention on Human Rights and BiomedicineCouncil of EuropePreambleThe Member States of the Council of Europe, the other States and the European Community signatories hereto,Bearing in mind the Universal Declaration of Human Rights proclaimed by the General Assembly of the United Nations on 10 December 1948;Bearing in mind the (...) Convention for the Protection of Human Rights and Fundamental Freedoms of 4 November 1950;Bearing in mind the European Social Charter of 18 October 1961;Bearing in mind the International Covenant on Civil and Political Rights and the International Covenant on Economic, Social and Cultural Rights of 16 December 1966;Bearing in mind the Convention for the Protection of Individuals with Regard to Automatic Processing of Personal Data of 28 January 1981;Bearing also in mind the Convention on the Rights of the Child of 20 November 1989;Considering that the aim of the Council of Europe is the achievement of a greater unity between its members and that one of the methods by which that aim is to be pursued is the maintenance and further realisation of human rights and fundamental freedoms;Conscious of the accelerating developments in biology and medicine;Convinced of the need to respect the human being both as an individual and as a member of the human species and recognising the importance of ensuring the dignity of the human being; [End Page 277]Conscious that the misuse of biology and medicine may lead to acts endangering human dignity;Affirming that progress in biology and medicine should be used for the benefit of present and future generations;Stressing the need for international co-operation so that all humanity may enjoy the benefits of biology and medicine;Recognising the importance of promoting a public debate on the questions posed by the application of biology and medicine and the responses to be given thereto;Wishing to remind all members of society of their rights and responsibilities;Taking account of the work of the Parliamentary Assembly in this field, including Recommendation 1160 (1991) on the preparation of a Convention on bioethics;Resolving to take such measures as are necessary to safeguard human dignity and the fundamental rights and freedoms of the individual with regard to the application of biology and medicine;Have agreed as follows:Chapter IGeneral provisionsArticle 1. (Purpose and object)Parties to this Convention shall protect the dignity and identity of all human beings and guarantee everyone, without discrimination, respect for their integrity and other rights and fundamental freedoms with regard to the application of biology and medicine.Each Party shall take in its internal law the necessary measures to give effect to the provisions of this Convention.Article 2. (Primacy of the human being)The interests and welfare of the human being shall prevail over the sole interest of society or science.Article 3. (Equitable access to health care)Parties, taking into account health needs and available resources, shall take appropriate measures with a view to providing, within their jurisdiction, equitable access to health care of appropriate quality. [End Page 278]Article 4. (Professional standards)Any intervention in the health field, including research, must be carried out in accordance with relevant professional obligations and standards.Chapter IIConsentArticle 5. (General rule)An intervention in the health field may only be carried out after the person concerned has given free and informed consent to it.This person shall beforehand be given appropriate information as to the purpose and nature of the intervention as well as on its consequences and risks.The person concerned may freely withdraw consent at any time.Article 6. (Protection of persons not able to consent)1. Subject to Articles 17 and 20 below, an intervention may only be carried out on a person who does not have the capacity to consent, for his or her direct benefit.2. Where, according to law, a minor does not have the capacity to consent to an intervention, the intervention may only be carried out with the authorisation of his or her representative or an authority or a person or... (shrink)

How do “international” epistemic communities shape regulatory contests between transnational firms and civil society organizations in the Global South? With the establishment of the World Trade Organization, member states committed to basing trade-restrictive national regulations on science-based “international” standards set by “international” standard-setting bodies. Yet we know little about how the WTO regime has shaped the operation of epistemic communities within standard-setting bodies and, in turn, how standard-setting bodies articulate with national policy-making processes in the Global South. Building on (...) class='Hi'>work in the new political sociology of science, I argue that neoliberal globalization and the establishment of the WTO have created incentives for Western epistemic communities to at once cast themselves as “international” under the WTO regime and orient their scientific agendas toward the priorities of transnational firms. Moreover, this transformation of epistemic communities has created opportunities for transnational firms facing contentious policy environments in the Global South to effectively outsource regulatory decision-making to “international” epistemic communities that can claim legal status under the WTO regime. Empirically, I focus on the case of one Western epistemic community—the Association of Analytical Communities International—and its claim to epistemic jurisdiction over pesticide residue standards for soft drinks in India. (shrink)

Bruno Latour is one of the founding figures in social network theory and a broadly influential systems thinker. Although his work has always been relational, little scholarship has engaged the relational morality, ontology, and epistemology of feminist care ethics with Latour’s actor–network theory. This article is intended as a translation and a prompt to spur further interactions. Latour’s recent publications, in particular, have focused on the new climate regime of the Anthropocene. Care theorists are just beginning to (...) address posthuman approaches to care. The argument here is that Latourian analysis is helpful for such explorations, given that caring for the earth and its inhabitants is the dire moral challenge of our time. The aim here is not to characterize Latour as a care theorist but rather as a provocative scholar who has much to say that is significant to care thinking. We begin with a brief introduction to Latour’s scholarship and lexicon, followed by a discussion of care theorist Puig de la Bellacasa’s work on Latour. We then explore recent work on care and the environment consistent with a Latourian approach. The conclusion reinforces the notion that valuing relationality across humans and non-human matter is essential to confronting the Anthropocene. (shrink)

How can work be a genuine good in life? I argue that this requires overcoming a problem akin to that studied by Marx scholars as the problem of work, freedom and necessity: how can work be something we genuinely want to do, given that its content is not up to us, but is determined by necessity? I argue that the answer involves valuing contributing to the good of others, typically as valuing active pro-sociality – that is, valuing (...) actively doing something good for others. This makes work better in one way, and may even make work something we are genuinely glad to have in our lives. Contemporary philosophical thinking about good work tends to focus on how work can be good for the person doing it, by providing, for example, self-realization or social relationships, while underappreciating the special importance of valuing social contribution. People will typically only really want work if they want a part of their lives to be about the good of others. This also means that work may be a part of the best life, something we should take into account when discussing work-related policies and the desirability of a ‘post-work’ future. (shrink)

Tronto explores the “care crisis” that now pervades advanced industrial societies, in which women are doing more paid work and, consequently, less of the care work of civil society. Tronto urges advanced industrial societies to rethink who is responsible for care and recognize the role that government should play in ensuring that care is provided for those who need it. Unfortunately, citizenship has traditionally been defined in ways that make no provision for responsibilities to (...) care for others. Tronto observes that “privatizing” care by relegating it to the marketplace does not provide a solution to the care crisis, since paid care work is subject to exploitation, partly because it is often done by illegal immigrants from Third World countries. Despite expecting privatization to be the likely solution to the problem, Tronto nevertheless recommends that care work be regarded as a governmental responsibility in order to make it more valued publicly. (shrink)

Ongoing changes in many Western countries have resulted in more healthcare services being transferred to municipalities and taking place in patients’ homes. This greatly impacts nurses’ work in home care, making their work increasingly diverse and demanding. In this study, we explore home‐care nursing through a critical discourse analysis of focus group interviews with home‐care nurses. Drawing on insights from positioning theory, we discuss the content and delineation of their work and the interweaving of (...) contextual changes. Nurses hold a crucial position in home healthcare, particularly in ensuring care for sicker patients with complex needs. Assessing health needs, performing advanced care, and at the same time, providing customized solutions in various homes were identified as distinctive for home‐care nurses’ work. Changes have made nurses’ work become driven by comprehensive tasks and acute medical needs that require much of their competence and time. Urgent care seems to take precedence in nurses’ work, leaving less time and attention for other tasks such as conversations and support for coping with everyday life. This underlines the need to investigate and discuss the content and scope of nurses’ work to help shape the further development of home‐care nursing. (shrink)

Since the era of deinstitutionalisation, many clinical approaches have emerged to enable the care and treatment of people suffering from mental illness. In recent years, the use of coercive approaches in the community (e.g., outpatient commitment or community treatment orders) has also increased internationally. Although nurses' role regarding these coercive approaches is central and significant, few empirical and theoretical writings have tackled this controversial nursing practice. The purpose of this paper is to analyse coercive nursing care through the (...) lens of French philosopher Gilles Deleuze's concept of ‘societies of control’. Taking up Michel Foucault's work on disciplinary power, Deleuze explores how the move from the striated spaces of closed institutions to the smooth spaces of societies of control took place since the middle of the 20th century. According to Deleuze, the overall objective of ‘societies of control’ is no longer simply to govern deviant behaviour in closed environments (e.g., psychiatric hospitals and prisons) but to ensure a regime of unrelentless surveillance in the open spaces of our communities. (shrink)

Fetal and Maternal Bodies brings together the voices of abortion providers, abortion counselors, clinic owners, neonatologists, bioethicists, and historians to discuss how and why providing abortion care is moral work. The collection offers voices not usually heard as clinicians talk about their work and their thoughts about life and death. In four subsections--Providers, Clinics, Conscience, and The Fetus--the contributions in this anthology explore the historical context and present-day challenges to the delivery of abortion care. Contributing authors (...) address the motivations that lead abortion providers to offer abortion care, discuss the ways in which anti-abortion regulations have made it increasingly difficult to offer feminist-inspired services, and ponder the status of the fetus and the ethical frameworks supporting abortion care and fetal research. Together these essays provide a feminist moral foundation to reassert that abortion care is moral work. (shrink)

This research investigates sociological ambivalence in negotiating care work in Japanese families. Women and their aging parents experience ambivalence based on conflicting norms of filial obligation, gender ideology, and cultural beliefs about the parent—child bond. Analysis of in-depth interview data showed ambivalence was based on conflict between norms and cultural beliefs and intergenerational differences in norms of caregiving. Not only are norms of care work in Japan gendered, but they also create conflicting demands for women who (...) are torn among providing care for their parents, providing care for their in-laws, and changing expectations for women in contemporary Japan. In the families studied, norms of filial obligation were challenged, but gendered definitions of care work were left largely intact. These findings challenge theories of elder care that identify a hierarchy of preferred caregivers based on filial obligation and gender. (shrink)

In this article, I propose to look at the organisation of reproductive labour in the ‘global North’ through a lens of epistemic ignorance. Focusing on the process of outsourcing, I argue that it creates forms of irresponsibility, and with it, epistemic ignorance. The devaluation of domestic work and the degradation of domestic workers is shaped by gendered and colonial ideologies, and Western epistemologies. These epistemologies underpin a strong subject/object split and buffer the denial of existing interdependencies. I problematise those (...) epistemologies by drawing on feminist care ethics, accounts of relational selves and relational responsibility, and alternative epistemologies. Grounding that discussion on vignettes from an in-depth study of heterosexual couples in Austrian households who outsource domestic work, I argue that the systematic failure to see what and who we are connected to in the domestic realm is shaped by gendered and racialised privilege, and driven by an epistemology of separation. My argument will unfold in two steps. First, I use the concept of the skin as an example of how the beliefs in an independent, autonomous self and a strong subject/object split disguise connectedness and relationality. This leads me to the second step, in which I explicate my notion of semipermeable membranes – a thinking together of ontological permeability and ethical responsiveness. I argue that active forms of ‘unknowing’ at work in ‘mundane,’ everyday, domestic performances have far-reaching consequences. (shrink)

First published in 1980, Caring and Curing is for all those involved in the 'caring professions' - medicine, social work, and the other health and welfare occupations. It is both an introduction to philosophy for the caring professions and a philosophy of those professions. The authors believe that the best way to introduce philosophy is to engage in it, to philosophize, and that the most exciting way to philosophize is to offer a reasoned but controversial point of view on (...) matters to which people are professionally committed. They argue, first, that there is an essential unity of the caring professions in that the concepts of health and welfare are different aspects of a single value judgement as to what sort of life a person should be enabled to live in his society. Secondly, they show the limits of scientific expertise in relation to human behaviour and argue that the education of medical and social workers should include broader humane disciplines to assist them in coping with the problems of ethics and values of all kinds in present-day society. Thus, the discussion introduces the main branches of philosophy and deals with many of the current moral dilemmas in medicine and social work. (shrink)

The purpose of this article is to analyse Adam Smith’s view of death in The Theory of Moral Sentiments for commercial society to determine whether the current commodification of goods (e.g. pharmaceuticals) and services (e.g. cryogenics) to assist people to deal with the fear of death was what Smith envisioned for meaningful existence and to find out what he proposed as a means to manage the fear of death in existence. The investigation revealed that Smith’s book contains many references (...) to death as a source of anxiety that negatively influences the lives of people, their happiness and meaning in life, and ignites fear and anxiety. The cultural measure of Smith’s time to manage the fear of death are magnanimity (e.g. war and suffering), the comfort of wealth, posthumous happiness (e.g. duty and sacrifice) and philosophy (e.g. Stoicism). The problem for Smith is that wealth and commodities, as is the case with the other means to deal with the fear of death, do not result in being-for-itself without the assistance of the impartial spectator which is a cognitive mechanism for self-awareness and socially located meaning-creation in the world with others. (shrink)

Previous research has examined growing globalized divisions in domestic labor through the perspective of poor migrant women who perform care work in advanced industrialized societies. This article explores this global trend in reverse, focusing on first-world women who migrate into developing countries and engage with local dynamics of care through volunteer work. Based on 15 months of ethnographic fieldwork with Helping Hands, an organization of expatriate wives that assisted a local state-run orphanage in Beijing, China, I (...) argue that gendered processes of privileged migration caused women to develop a “logic of care” that equated good care solely with maternal nurturance and emotional connection. This logic permeated their volunteer efforts, causing conflicts with Chinese state caregivers who prioritized the performance of reproductive tasks. This case demonstrates the socially constructed nature of logics that underlie care practices and their relationship to increasingly transnational configurations of privilege and inequality. When applied to first-world women’s charitable activities in developing countries, unquestioned gendered logics can reinforce larger global disparities of power through the stratified provision of care. (shrink)

In this paper, I discuss the idea of democratic love from the perspective of gender equality. More precisely, I argue that a particular form of gender inequality, namely a gender-specific division of care labour, jeopardizes democratic love. In the first two sections of the article, I introduce Anthony Giddens’ original idea of a ‘democratization of the personal’ and show how Axel Honneth has developed it by relying on the Hegelian notion of social freedom. In the third section, I discuss (...) how the problem of care work affects democratic love relationships and depict the solution to this problem advocated by recognition theory, namely economic recognition. After having reconstructed some possible affinities between socialist-feminist arguments and Honneth’s suggestions, as well as criticisms against them, I outline another recognition-theoretic strategy for recognizing care work. I argue that the recognition paradigm conveys a view of the love relationship as inherently implying a caring recognition of human beings’ dependencies and vulnerabilities. I conclude by hinting at the idea that caring recognition may be extended beyond the social sphere of love, as constituent of social relations in general. (shrink)

Classic feminist social theory highlights the exploitation of women’s labor in capitalist societies traditionally through an examination of how housework and childcare is perceived and organized, excluding an explicit analysis of older adult care work. In light of the surge in the demand for older adult caregiving over the last several decades, this paper uses older adult care work as a new lens to understand how gender, and its intersections with other critical identities such as race, (...) ethnicity, and nativity, are a basis for continued exploitation and marginalization in modern capitalist systems. Building on Marxist feminism and Sylvia Wynter’s work on social value and domination, I argue that women’s care labor, both paid and unpaid, is an instrument of capital accumulation that differentially exploits women based on key intersectional identities. An examination of the system of older adult care work in the United States allows us to see the multilayered and complex system of exploitation that creates and institutionalizes existing social hierarchies as capitalism seeks to expand. The paper ends with a discussion of two potential family care paths America could conceivably pursue in the coming years; one toward increased commodification of care work in line with neoliberal capitalism, and the other toward more comprehensive social welfare policies that alleviate women’s reproductive labor burden and begin to break down gendered and racialized hierarchies. (shrink)

Through in-depth interviews with 41 middle-class Puerto Rican transmigrants, this research examines how gender constrains global care work. Migration compromises embeddedness in care networks, concurrently heightening its meaning. Women felt these effects more acutely than men given their primary responsibility for reproductive work. Migrants engaged in emotion work to cope with constraints, strategically rearticulating care work; yet unsuccessful strategies resulted in further emotional dislocation, particularly for women. Migration led to a dichotomy in which (...) professional success was pitted against emotional fulfillment through care work. Gender, cultural, and geopolitical factors mediated this split, contributing to a permanently unsettled flow of migrants. (shrink)

“The current crisis in home care suggests we must meet immediately to discuss how Ontario can best meet its commitment to all those who require home care services and to the workers who provide the...

“The current crisis in home care suggests we must meet immediately to discuss how Ontario can best meet its commitment to all those who require home care services and to the workers who provide the...

An increasing recognition over the past five decades of the importance of patients’ autonomy and the right to be able to choose to limit medical treatment at the end of life has led to the development of a number of documents related to advance care planning, including the advance directive, medical power of attorney, and portable orders for life-sustaining treatment (POLST). While these documents are important aspects of advance care planning, without having goals-ofcare conversations, a specific plan, and (...) necessary supports to achieve these goals, the documents alone offer a false promise. Healthcare professionals must be trained on how to have indepth goals-of-care conversations with patients and their families, and effectively document the decisions. Advance care planning needs to be viewed as a process that must continue as the patient’s health status, social support system, and living environment change. Designating a healthcare representative who participates in goals-of-care conversations and can work with the healthcare team to make “just in time” decisions about care reduces the burden and stress on friends and family. In this article we discuss the strengths and limitations of advance directives, medical power of attorney forms, and POLST forms; propose concrete changes to optimize the effectiveness of each; and present a comprehensive approach to advance care planning that we hope will improve care for those nearing the end of life, and ensure that their wishes and goals to have or to limit treatment are more consistently honored. (shrink)