This paper presents a profile of the welfare regime in Lebanon which is posited on the twin precepts of human ethics and welfare particularism. It highlights the key role that moral values play in the conceptualization and implementation of social policy, as well as in the measurement of welfare outcomes. This is marked by the dominance of duty, traditionalism and elitism in the ethics of religious welfare in Lebanon. The paper argues that the social (...) class='Hi'>welfare regime in Lebanon overlaps with the debates on the ethics of care and on virtue ethics in Western moral philosophy. This is also linked in with contemporary conceptualizations of religious ethics in Judaism, Christianity and Islam. The paper asserts that religious ethics is a valid endeavour in its own right and an ever more pertinent subject matter for the study of social welfare and social policy. This challenges the traditional dichotomy between reason and faith which has subdued the relevance of religion to public life. Indeed, religion, the nuclear family and clientelism networks are shown to play a critical role in Lebanese social welfare, such that, in spite of state incapacity, the welfare regime there cannot be considered rudimentary. The method adopted for this research was a large qualitative case study involving service providers and users at the Ministry of Social Affairs and five leading Christian and Muslim religious welfare organizations in Lebanon. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.1 (2003) 99-102 [Access article in PDF] Living with Contested Knowledge and Partial Jennifer Clegg and Richard Lansdall-Welfare THESE CAREFUL AND CONSTRUCTIVE comments bring grist to our mill. Before responding to them, we observe first that they offer no substantive challenge to our thesis: ambiguities associated with meaning in the disabled life make it more likely that professional service providers will make dogmatic responses (...) to bereavement, and perhaps other essentially contested topics, responses that are defended by isolationism.Some welcome ideas came from left field to refresh our thinking, such as Colman's observations on the gendered nature of care. She reminded us that although the audit from which these cases came was established to investigate bereavement in general among adults with intellectual disability, its rough and ready sampling failed to ensure the expected range of bereavement types. Somehow the bereavements constructed as relevant for audit all transpired to concern the death of mothers. Moreover, of the six relatives who agreed to be interviewed concerning these bereavements, two were stepfathers and four were sisters. Colman underlines the invisibility of care work usually done by female family members: how wise or less wise decisions create the conditions for bereavement reactions, and how changes to care arrangements following bereavement fall most heavily on them. Traustadottir (2002) discussed the way new care initiatives often put pressure on female family members and staff to do more unpaid work. For example, Circles of Support encourages them to include people with intellectual disability in their personal social networks, without considering the personal costs. Such observations have yet to emerge from the umbrella of feminist research. Separatism has served feminism well, but issues of women and care do need to find their place in mainstream reviews.Another useful reminder from Colman is that the person with intellectual disability is not the only concern to families, although only a few adult services manage to hold wider systemic factors in mind (Clegg and Burnham 2000). If the person may make naïve comments at a funeral that would devastate family members whose needs take priority, the person will be excluded.The potency of bereavement was discussed twice. Casenave suggests that because "disability is a loss experience" bereavement resonates with it, casting some doubt onto the suggestion that our thesis generalizes to other contested topics. Reinders criticizes clinicians for being purblind to the tragic. The anonymous reviewer who questioned [End Page 99] the relevance of our discussion of the quality of "presence," a quality Reinders considers highly relevant, illustrates the point better than we can. Recognizing the way clinicians have little "patience with the notion of the tragic" encourages reflection on what other human experiences fail to capture our attention.Although these are all potentially valuable directions, we focus here on comments that may enhance our ability to work without dogma. Since at least the 1980s, clinicians in intellectual disability have criticized the discipline for using linear and univariate rather than complex and multivariate theories, and for a naïve search for magic answers (reviewed in Clegg 1993). It is our contention that little has changed, and that uncertain meaning and normalization combine to create ideal conditions for dogma. Reinders' exposition of the various uses of meaning in our article and in different linguistic and historical traditions develops a vital but neglected topic in intellectual disability, which we consider in some detail. We conclude by arguing that developments require us to distance ourselves from the universality and commonality inherent to normalization, and create new ways to appreciate particularity and diversity.The gist of Reinders' complex argument appears to be that the problems we identify in managing bereavement in intellectual disability stem from a modernist understanding of meaning that is erroneous. Implicitly, those who eschew its pursuit demonstrate the greater wisdom, because neither dialogue nor activities such as reflection can generate meaning that is unattainable. If we understand his position correctly, he contrasts two principal understandings of meaning: comprehension and apprehension.Comprehension is the illusory modernist idea that humans are agents who make sense of themselves... (shrink)

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 article argues that intersectional analyses of care work also need to include a temporal aspect. Drawing on ethnographic research on Slovak au pairs working in the UK and on interviews with both providers and employers of paid childcare in Slovakia, I examine how the temporariness of care work is created within both migrant and non-migrant settings. In particular, I demonstrate that both employers and providers conceptualise paid childcare as a temporary period in their lives and show the (...) consequences of this conceptualisation in their valuing of care work. In both examined cases, I focus on the role of care/welfare and migration regimes in the production of temporariness in care work and argue that both providers and employers of paid care construct their involvement in domestic work as a specific life course experience. While for au pairs, working stays in the UK represent a specific transition period from adolescence to adulthood, employers in Slovakia decide to employ particular types of domestic workers in relation to the particular developmental phases of their families and households. (shrink)

The spread of liberal individualism to the family is often portrayed as deeply inimical to the welfare of children and young people. In this view, the family is the bastion of the private and the antithesis of the contractual, rights-oriented model that underpins public life. This chapter examines that proposition critically.

Many authors have described the ethical issues associated with international adoption for all members of the adoption triad, including adoptive parents, birth parents and the adopted child, and for both sending and receiving countries. This paper explores how political variants of care ethics, combined with a narrative approach to practice, can be used as a conceptual framework for ethically informed practice with families formed via international adoption. Political variants of care ethics foreground the particularized needs of the individual, (...) but also take into account the broader social, political, economic and cultural dynamics in which the experience of individuals occurs. This framework is particularly applicable to collaborative work with individuals or groups, such as families formed via international adoption, whose experience is both highly individualized and shaped by broader contexts and issues of social justice. This paper describes how changes in the social construction of international adoption have meaning for applied ethics and practice. Political variants of care ethics are then explored as a framework for ethical decision making. Finally, the relevance of a narrative, approach to practice is considered. This approach focuses on understanding the needs and experiences of families from their own points of view and within the social, economic, cultural and political contexts in which they have lived; linking a relationship-based, narrative approach to practice to important assumptions in many models of care ethics. (shrink)

Justice, Care, and the Welfare State explores contemporary welfare state reform from a moral and philosophical perspective. It offers detailed arguments about the nature of justice in the areas of family policy, education, health care, old age pensions and long-term care, disability, and employment and poverty support. Challenging the ideal nature of much contemporary political philosophy, Engster applies political philosophy to public policy issues in order to generate concrete policy recommendations for better supporting social (...) justice. (shrink)

This book is a critical analysis of Australian family policy issues. The argument of the book rests on three cardinal principles. The first is that the family is a miniature society, a social unit. The second is that in producing, caring for, and educating children the family contributes to the good of the wider society. The third is that in caring for dependants – young or old – the family is a welfare institution. The general (...) thrust of the book is in favour of the principle of financial support for families with children, but with equity between separated and divorced families and intact families. (shrink)

the arguments in their favour are weak. Arguments based on reciprocity fail to explain why only means-tested public benefits should be subject to work requirements, and why unpaid dependant care work should not count as satisfying citizens’ obligations to reciprocate. Argu- ments based on promoting the work ethic misattribute recipients’ nonwork to deviant values, when their core problem is finding steady employment consistent with supporting a family and meeting dependant care responsibilities. Rigid work requirements impose unreasonable costs (...) on some of the poor. A welfare system based on a rebuttable presumption that recipients will work for pay, conjoined with more generous work supports, would promote justice better than either unconditional welfare or strict requirements [1]. (shrink)

Adoption may be defined as ‘the legal process through which the state establishes a parental relationship, with all its attendant rights and duties, between a child and a (set of) parent(s) where there exists no previous procreative relationship’ . In adoptions from care, state intervention effectively converts an established, or nascent, adult– child relationship into ‘family’ in the legal sense. From the state’s perspective, adoption thus entails the transfer of parental responsibilities for a child in public care (...) to a private family unit, enabling the state to permanently delegate its duties towards a child to this new unit. This seemingly straightforward legal act raises deeper philosophical questions relating to such state ‘family creation’, particularly when the child’s perspective is taken. Such a child- centric approach normatively regards children as equal moral beings, who ought to be included in actions concerning them, regardless of their capacity to form and express an opinion. Accordingly, adoption from care can be described as a moral decision, aimed at doing what is in the child’s best interests. The purpose of this chapter is to explore a suspicion of a lack of child- centrism in adoption from care practice, and to illustrate how adopted children’s rights are inferior to those of their non- adopted peers. This will shed light on a practice currently lacking transparency and accountability and will increase our understanding of how we fail to treat children as equal moral individuals in decision- making that severely impacts children’s lives. (shrink)

In industrialized democracies, contractionist social welfare policies have transformed healthcare systems. This has led to reallocations of long‐term care work that have perpetuated gender inequities. The appropriated work of female family caregivers substitutes for paid nursing work, and the household is the primary site for long‐term care delivery. In this article, central premises of critical social theory are used to analyse current long‐term care policy and to explicate how research facilitated the development of mixed economies (...) of care. Problematic consequences of home caregiving are revealed through a depiction of contemporary Canadian families, a critique of the related empirical research literature, and a discussion of the assumptions that underlie long‐term care policies. The article concludes with suggestions which nurse researchers could use to contribute to the reformulation of policies to render them just and equitable. (shrink)

According to Bayertz the core meaning of solidarity is the perception of mutual obligations between the members of a community. This definition leaves open the various ways solidarity is perceived by individuals in different communities and how it manifests itself in a particular community. This paper explores solidarity as manifested in the context of families in respect of caregiving for a family member who has become dependent because of disease or illness. Though family caregiving is based on the (...) same perception of mutual obligation as the solidarity that supports welfare arrangements in society, the manifestation of solidarity in families is different. Solidarity that underpins welfare arrangements is based on a perception of mutual obligation towards an anonymous dependent other and is enforced by the government. Solidarity in families is directed towards a concrete other and is based on free choice, albeit often accompanied by a strong sense of personal duty. In this paper we try to distinguish between solidarity as a sociological concept and as a moral concept. An important moral element of solidarity, as expressed in families, is the need for recognition of family caregivers, not only of their concrete practical efforts, but also of their own identity as caregivers and as individuals. We illustrate this argument by referring to examples in the Nuffield Council on Bioethics report Dementia : ethical issues, about the experiences of family caregivers in dementia care and the importance for them of recognition of their role. (shrink)

This study explores the pivotal role of the body for political recognition and rights claims in child welfare “moral” interventions. I examine how the bodily figures in child welfare assessments, linking these manifestations to the concept of the moral economy of care. A sample of assessment reports from a Swedish municipality, all addressing violations of children’s bodies or integrity, are used as empirical material. I show how the psychosomatically suffering child is being best “heard” as vulnerable. I (...) also argue that such a moral economy of care silences children’s accounts of gendered and racial injustices. Furthermore, racialized moral divides are indicated when assessments of different child bodies are considered. A concluding remark points to a need for a child welfare moral economy of social justice that responds to structural intersecting injustices in childhoods, including to those of a racialized child welfare and its individualized and symptom-oriented services. (shrink)

What motivates grandparents to their altruism? We review answers from evolutionary theory, sociology, and economics. Sometimes in direct conflict with each other, these accounts of grandparental investment exist side-by-side, with little or no theoretical integration. They all account for some of the data, and none account for all of it. We call for a more comprehensive theoretical framework of grandparental investment that addresses its proximate and ultimate causes, and its variability due to lineage, values, norms, institutions (e.g., inheritance laws), and (...) social welfare regimes. This framework needs to take into account that the demographic shift to low fecundity and mortality in economically developed countries has profoundly altered basic parameters of grandparental investment. We then turn to the possible impact of grandparental acts of altruism, and examine whether benefits of grandparental care in industrialized societies may manifest in terms of less tangible dimensions, such as the grandchildren's cognitive and verbal ability, mental health, and well-being. Although grandparents in industrialized societies continue to invest substantial amounts of time and money in their grandchildren, we find a paucity of studies investigating the influence that this investment has on grandchildren in low-risk family contexts. Under circumstances of duress there is converging evidence that grandparents can provide support that helps to safeguard their children and grandchildren against adverse risks. We conclude by discussing the role that grandparents could play in what has been referred to as Europe's demographic suicide. (shrink)

What is family-centred care of a hospitalized child? A critical understanding of the concept of family-centred care is necessary if this widely preferred model is to be differentiated from other health care ideals and properly evaluated as appropriate to the care of hospitalized children. The article identifies distinguishable interpretations of family-centred care that can pull health professionals in different, sometimes conflicting directions. Some of these interpretations are not qualitatively different from robust interpretations (...) of the ideals of parental participation, care-by-parent and partnership in care that are said to be the precursors of family-centred care. A prominent interpretation that regards the child and his or her family collectively as the ‘unit of care’ arguably arises from ambiguity and is significantly problematic as a model for the care of hospitalized children. Clinical practice driven by this interpretation can include courses of action that do not aim to do what will best promote a hospitalized child’s welfare, and such cases will not be unusual. More broadly, this interpretation raises challenging questions about the responsibilities and authority of health professionals in relation to the interests of hospitalized children and their families. (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)

Beyond reasonable doubt, the influence of Western culture and civilizations has enervated traditional African family systems, and their functions as providers of social welfare. Hitherto, traditional African family and clan by extension served as the plausible medium by which Africans proffered solutions to those social, economic and other existential problems found within their communities. However, measuring and evaluating the successes of the various social welfare programs organized by the family and clan was a difficult task (...) to achieve. It seems the services rendered merely controlled the social problems but did not improve the standard of living of the victims. This paper seeks to critically analyse the traditional African family system and its role as a provider of social welfare and argues that it can complement the Western models towards holistic social integration. Thus this work adopts the theory of change as a tool for understanding how Western models of social welfare should be integrated with traditional African approaches to care for the ‘weak’ in the society. Advocating for a paradigm shift from the modern models of providing social welfare to the traditional African family and clan model is consequent upon the claim that the latter is more embracing in approach. (shrink)

The global community, from UNESCO to NGOs, is committed to promoting the status of women in science, engineering and technology, despite long-held prejudices and the lack of role models. Previously, when equality was not firmly established as a key issue on international or national agendas, women’s colleges played a great role in mentoring female scientists. However, now that a concerted effort has been made by governments, the academic community and the private sector to give women equal opportunities, the raison d’être (...) of women’s universities seems to have become lost. This paper argues otherwise, by demonstrating that women’s universities in Japan became beneficiaries of government initiatives since the early 2000s to reverse the low ratio of women in scientific research. The paper underscores the importance of the reputation of women’s universities embedded in their institutional foundations, by explaining how female scientific communities take shape in different national contexts. England, as a primary example of a neoliberal welfare regime, with its strong emphasis on equality and diversity, promoted its gender equality policy under the auspices of the Department of Trade and Industry. By contrast, with a strong emphasis on family values and the male-breadwinner model, the Japanese government carefully treated the goal of supporting female scientists from the perspective of the equal participation of both men and women rather than that of equality. Following this trend, rather contradictorily, women’s universities, with their tradition of fostering a ‘good wife, wise mother’ image, began to be highlighted as potential gender-free institutions that provided role models and mentoring female scientists. By drawing on the cases of England and Japan, this paper demonstrates how the idea of equality can be framed differently, according to wider institutional contexts, and how this idea impacts on gender policies. (shrink)

`I would encourage undergraduates students to read it, for it does summarise well a classical Marxist analysis of social policy and welfare' - Social Policy The anti-capitalist movement is increasingly challenging the global hegemony of neo-liberalism. The arguments against the neo-liberal agenda are clearly articulated in Rethinking Welfare. The authors highlight the growing inequalities and decimation of state welfare, and use Marxist approaches to contemporary social policy to provide a defence of the welfare state. Divided into (...) three main sections, the first part of this volume looks at the growth of inequality, and social and environmental degradation. Part Two centres on the authors' argument for the relevance of core Marxists concepts in aiding our understanding of social policy. This section includes Marxist approaches to a range of welfare issues, and their implications for studying welfare regimes and practices. Issues covered include: · Class and class struggle · Opression · Alienation and the family The last part of the book explores the question of globalization and the consequences of international neo-liberalism on indebted countries as well as the neo-liberal agenda of the Conservative and New Labour governments in Britain. The authors conclude with the prospect of an alternative welfare future which may form part of the challenge against global neo-liberalism. (shrink)

Appropriate and balanced decision-making is sentinel to goal setting and the provision of appropriate clinical care that are attuned to preserving the best interests of the patient. Current family-led decision-making in family-centric societies such as those in Singapore and other countries in East Asia are believed to compromise these objectives in favor of protecting familial interests. Redressing these skewed clinical practices employing autonomy-based patient-centric approaches however have been found wanting in their failure to contend with wider sociocultural (...) considerations that impact care determinations. Evaluation of a number of alternative decision-making frameworks set out to address the shortcomings of prevailing atomistic and family-centric decision-making models within the confines of end-of-life care prove these alternative frameworks to be little better at protecting the best interests of vulnerable patients. As a result, we propose the Welfare Model that we believe is attentive to the relevant socio-culturally significant considerations of a particular case and better meets the needs of end-of-life care goals of preserving the welfare of patients. Employing a multi-professional team evaluation guided by regnant psychosocial, legal, and clinical standards and the prevailing practical and clinical realities of the particular patient’s setting the Welfare Model provides a clinically relevant, culturally sensitive, transparent, and evidence-based approach to care determinations. (shrink)

William M. Epstein charges that most current social welfare programs are not held to credible standards in their design or their results. Rather than spending less on such research and programs, however, Epstein suggests we should spend much more, and do the job right. The American public and policymakers need to rely on social science research for objective, credible information when trying to solve problems of employment, affordable housing, effective health care, and family integrity. But, Epstein contends, (...) politicians treat welfare issues as ideological battlegrounds; they demand immediate results from questionable data and implement policies long before social researchers can complete their analyses. Social scientists often play into the political agenda, supporting poorly conceived programs and doing little to test and revise them. Analyzing Aid to Families with Dependent Children (AFDC) and the recent welfare reform act, Food Stamps, Medicaid, job training, social services, and other programs, Epstein systematically challenges the conservative’s vain hope that neglect is therapeutic for the poor, as well as the liberal’s conceit that a little bit of assistance is sufficient. (shrink)

From the state to the family: reconfiguring the responsibility for long‐term nursing care at homeThis paper discusses the implications of the shift in the location of the provision of healthcare services from healthcare institutions to the home, which has occurred or is projected to occur in coming years. It is argued that the responsibility for the provision of care and assistance needed by the elderly living at home and people with long‐term conditions living at home has shifted (...) from public services to the family. Studies of care‐givers have shown that in many situations they experience tremendous burdens, financial difficulties and health problems. Their social lives have been confined to the home, and contacts with friends and neighbors have been significantly reduced. This situation needs to be addressed by nurses, who in many cases serve as the bridge between the home and the official healthcare system. Using Foucault’s exploration of power, particularly his idea of governmentality, a genealogy of care‐giving in the home in Iceland’s health‐care has been constructed. The main findings were that, although this is occurring somewhat later than in many other countries, the state is withdrawing from its previously defined responsibility for the health and well‐being of the nation. At the same time the citizen’s responsibility for maintaining health is emphasized. Based on these findings, the argument is made that nurses in Iceland can have a profound influence on policy‐making in relation to the organization of services provided in those homes. Suggestions are made as to how this can be done, which may be of interest to nurses in other countries. (shrink)

This article comments briefly on three specific issues in Shazia Choudhry’s paper “‘Best Interests’ What can healthcare law learn from family law?” The three issues are: (1) the implications of ‘best interests’ and ‘welfare science’ for women within the family law and the health care law context, (2) the risk of capture by the ‘welfare science’ industry, and (3) the proposal that a committee of medical experts and medical ethicists should be set up to provide (...) reports to the Court of Protection on cases brought under the Mental Capacity Act 2005 (MCA). I argue that the risk of capture by ‘welfare science’ is equally large in health care law and that a committee of the kind envisaged by Choudhry is unlikely to contribute significantly to conflict resolution under the MCA. (shrink)

Work—family policy strategies reflect gendered assumptions about the roles of men and women within families and therefore may lead to significantly different outcomes, particularly for families headed by single mothers. The authors argue that welfare states have adopted strategies based on different assumptions about women's and men's roles in society, which then affect women's chances of living in poverty cross-nationally. The authors examine how various strategies are associated with poverty rates across groups of women and also examine more (...) directly the effects of specific work—family policies on poverty rates. They find that while family benefits and child care for young children unequivocally lower poverty rates, particularly for families headed by a single mother, long parental leaves have more ambivalent effects. The findings suggest that it is critical to examine the gendered assumptions underlying work—family policies rather than viewing all work—family policies as the same. (shrink)

“At-own-risk discharges” or “self-discharges” evidences an irretrievable breakdown in the patient–clinician relationship when patients leave care facilities before completion of medical treatment and against medical advice. Dissolution of the therapeutic relationship terminates the physician’s duty of care and professional liability with respect to care of the patient. Acquiescence of an at-own-risk discharge by the clinician is seen as respecting patient autonomy. The validity of such requests pivot on the assumptions that the patient is fully informed and competent (...) to invoke an at-own-risk discharge and that care up to the point of the at-own-risk discharge meets prevailing clinical standards. Palliative care’s use of a multidisciplinary team approach challenges both these assumptions. First by establishing multiple independent therapeutic relations between professionals in the multidisciplinary team and the patient who persists despite an at-own-risk discharge. These enduring therapeutic relationships negate the suggestion that no duty of care is owed the patient. Second, the continued employ of collusion, familial determinations, and the circumnavigation of direct patient involvement in family-centric societies compromises the patient’s decision-making capacity and raises questions as to the patient’s decision-making capacity and their ability to assume responsibility for the repercussions of invoking an at-own-risk discharge. With the validity of at-own-risk discharge request in question and the welfare and patient interest at stake, an alternative approach to assessing at-own-risk discharge requests are called for. The welfare model circumnavigates these concerns and preserves the patient’s welfare through the employ of a multidisciplinary team guided holistic appraisal of the patient’s specific situation that is informed by clinical and institutional standards and evidenced-based practice. The welfare model provides a robust decision-making framework for assessing the validity of at-own-risk discharge requests on a case-by-case basis. (shrink)

“At-own-risk discharges” or “self-discharges” evidences an irretrievable breakdown in the patient–clinician relationship when patients leave care facilities before completion of medical treatment and against medical advice. Dissolution of the therapeutic relationship terminates the physician’s duty of care and professional liability with respect to care of the patient. Acquiescence of an at-own-risk discharge by the clinician is seen as respecting patient autonomy. The validity of such requests pivot on the assumptions that the patient is fully informed and competent (...) to invoke an at-own-risk discharge and that care up to the point of the at-own-risk discharge meets prevailing clinical standards. Palliative care’s use of a multidisciplinary team approach challenges both these assumptions. First by establishing multiple independent therapeutic relations between professionals in the multidisciplinary team and the patient who persists despite an at-own-risk discharge. These enduring therapeutic relationships negate the suggestion that no duty of care is owed the patient. Second, the continued employ of collusion, familial determinations, and the circumnavigation of direct patient involvement in family-centric societies compromises the patient’s decision-making capacity and raises questions as to the patient’s decision-making capacity and their ability to assume responsibility for the repercussions of invoking an at-own-risk discharge. With the validity of at-own-risk discharge request in question and the welfare and patient interest at stake, an alternative approach to assessing at-own-risk discharge requests are called for. The welfare model circumnavigates these concerns and preserves the patient’s welfare through the employ of a multidisciplinary team guided holistic appraisal of the patient’s specific situation that is informed by clinical and institutional standards and evidenced-based practice. The welfare model provides a robust decision-making framework for assessing the validity of at-own-risk discharge requests on a case-by-case basis. (shrink)

How do we know which institutions provide good care? Some scholars argue that the best way to think about care institutions is to model them upon the family or the market. This paper argues, on the contrary, that when we make explicit some background conditions of good family care, we can apply what we know to better institutionalized caring. After considering elements of bad and good care, from an institutional perspective, the paper argues that (...) good care in an institutional context has three central foci: the purpose of care, a recognition of power relations, and the need for pluralistic, particular tailoring of care to meet individuals? needs. These elements further require political space within institutions to address such concerns. (shrink)

This paper outlines briefly care as a formal construct of a highly regulatory approach to being looked after in the setting of foster care. It then moves on to consider care and its expression within the interdependencies and everyday moral ?workings out? between people in caring relationships. These relationships are informed partly by exterior regulation, but also emerge predominantly from care as a social process and daily human activity in which the self exists through and with (...) others. Drawing from an in-depth qualitative study of 10 foster families supported by local authorities or independent agencies in Wales, the paper examines the meaning of care in what is often a nebulous mix of paid and unpaid fostering. The moral texture of the foster family is revealed in regard to three areas of everyday domestic life that are often taken for granted and rarely researched: the symbolism of food, issues of the body, and aspects of touch. The paper concludes with a brief reprise of foster care as relational, constitutive and contextual in contrast with care as a professional and regulatory discipline. (shrink)

The welfare reform law of 1996 completely overhauled the nation's system of assistance to low-income families. The reauthorization of that law, now several months overdue because of congressional delays, presents an opportunity for religious social ethicists to evaluate the adequacy of our nation's anti-poverty efforts. This paper surveys policy developments from 1996 to 2003 and analyzes five key issues in the reauthorization debate: the size and structure of welfare block grants; work requirements; welfare time limits, sanctions, and (...) exemptions; marriage promotion and the family cap; and ancillary programs providing work supports such as food stamps, Medicaid, and child care subsidies. A variety of ethical critiques of policy proposals is offered, some of them from the perspective of Catholic social teaching. The trail of missed opportunities in welfare reform will probably continue, as American social policy fails to act upon an accurate portrayal of the challenges facing poor families today. (shrink)

The welfare regime of Southern Europe, and Greece in particular, does not adequately cover the needs of its citizens. On the contrary, and within this context, family welfare has to be much more efficient. Moreover, the support received from the family imposes a sense of reciprocity, as receivers are expected to be givers in the future. This reciprocity is assisted mainly by the female members of the kin, defining to a degree their housing practices. Data (...) for this paper is derived from a wider research project investigating young people's housing practices and family strategies through in-depth interviews in Athens, Greece. Bringing gender to the fore, it explores how the housing provision from family is impacted by the receivers’ gender role in connection to family welfare obligations. (shrink)

This essay argues that concerns regarding the impact of work/family balance on gender inequality should be extended to broader analysis of all care work. Paid or unpaid care devoted to all dependents has distinctive characteristics that contribute to disempowerment and underpayment. Expenditures of money as well as time increase economic vulnerability. Public policies should provide greater support for caregiving outside the market, improve the supply and quality of purchased care services, and challenge conventional accounting systems that (...) mismeasure economic welfare. (shrink)

The welfare of the child is the prevailing principle and concern regarding access to assisted reproduction in Western countries today, and there is a wish to avoid harm to future children. New research fields have developed in order to provide scientific evidence on the welfare of children living with different “types” of parents. Assisted reproductive technologies (ART) seems to be heading in a responsible direction where the care and concern for future children is vital. However, the claim (...) of this article is that the principle of the welfare of the child confuses the ethical framing of ART. Several philosophers in the past have argued that potential people must be regarded as outside the moral domain, and therefore cannot be harmed or benefitted. This message has not reached the policymakers, probably because the welfare of the child principle seems to fit so elegantly with common sense. In this article a different ethical framing of ART is proposed. The author argues that “futile care” and not “the welfare of the child” should be the guiding principle for eventually rejecting access to ART. The desired goal of ART treatment should be understood to be the production of functional families. Assisted reproduction is primarily about us, actual people in an actual society, and how potential children may affect us. (shrink)

In this article we examine the association between national welfare regime and the propensity of middle–aged and older individuals with adult children of their own to provide social support to aged parents. Using data from mature adults (50+) in 26 European countries, we examine whether older and younger generations compete for the time resources of the middle “sandwiched” generation, and whether national policy context shapes this competition. Contrary to expectations, we found that sandwich generation members were less likely (...) to provide support to their parents in Conservative–Mediterranean and East European regimes, but more likely to do so in universalistic Social–Democratic regimes. This evidence supports the hypothesis that well–developed welfare states “crowd–in” family support to older individuals. Middle generation members who provided social support to their adult children tended to provide to their older parents as well. This was particularly true in the two regimes where resources and public benefits tend to be more generous and may be interpreted as state benefits that reduce intergenerational competition. Findings are discussed in terms of the capacity of state policies to shape the allocation of family resources to older adults where extended family lineages have become the norm. (shrink)

The current thesis discusses how tools for analysing power are developed predominately for adults, and thus remain underdeveloped in terms of understanding injustices related to age, ethnicity/race and gender in childhoods. The overall aim of this dissertation is to inscribe a discourse of intersecting social injustices as relevant for childhoods and child welfare, and by interlinking postcolonial, feminist, and critical childhood studies. The dissertation is set empirically within the policy and practice of Swedish child welfare, here exemplified by (...) the assessment framework Barns Behov i Centrum. It aims to explore how Swedish child welfare, as a field of knowledge, modes of knowing and knowing subjects, constitutes an arena for claims and responses to intersecting social justice issues. The material consists of BBIC primers and selected samples from, a total of 283 case reports from a Swedish social service agency. The case reports address assessments of children. This dissertation is based on four qualitative studies using discourse analysis, as well as analysis inspired by thematic and case-study methodology. Two studies focus on child welfare discourses in BBIC documents involving social problems and violence, and two studies are based on child welfare case reports. Studies I­­-II address child welfare policy and practice by analysing the conditions required for children to participate, in terms of children’s moral status and in terms of status of ‘evidencing’ needs for protection. Studies III­­-IV explore this further from the perspective of intersecting and embodied social injustices in childhoods. Together, the studies interconnect child welfare as a field of knowledge, modes of knowing and knowers with child welfare as a moral arena for claims to rights, recognition, and social justice. The synthesised findings point to child biowelfare, in which justice discourses are largely absent. Biowelfare is informed by a mode of knowing and ‘evidencing’ risks to children’s health and development, which are confined to scientific predicting-believing, seeing-believing by professionals and a moral economy of care, all of which constrain the idea that injustices are structural and intersecting. Biowelfare primarily responds to children as ‘speaking’ biological bodies, rather than as voices of justice. In this sense, injustices of an epistemological nature are interconnected with social injustices. When issues of justice are mobilised in case reports and policy, they come across as rather ‘unjust’, primarily confined to the sphere of the family home of racialised children and not connected to ‘general’ children. In addition to intersections of age, ethnicity/race and gender, class and health are fundamental to recognition and protection in biowelfare. Finally, the dissertation indicates the need for a moral economy which responds to intersecting social injustices such as racial, gender-based and ageist violence in childhoods, and violations of children’s bodily integrity. (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)

While caregiving in northern, rural and remote communities takes place in the context of conditions unique to smaller communities, caregivers live with social policies that are shaped by urban norms rather than rural realities. In times of economic decline and government cuts rural issues of limited services and infrastructure as well as dependency on a single industry can lead to unemployment, community and family instability, and a decline in health and well-being. During these times caregivers face increased pressure to (...) voluntarily fill the gaps left by service cuts. Research with women caregivers in four communities in northern British Columbia (BC), Canada explores the experiences of caring and the social, geographic, economic and political contexts within which the caregiving occurs. The discourse of economic efficiencies that speaks solely to the monetary value of care is contrasted with the human condition of connectedness and relationships. These two contradictory perspectives are uncovered during interviews with women caregivers and analyzed in the framework of Olena Hankivsky's discussion of an ethic of care. (shrink)

Islamic family law plays a significant role in minimizing the unpleasant effects of the family break up faced by the divorced women and their children by protecting their rights to financial support after divorce. This study undertakes to discuss the historical development of the financial rights after divorce applicable among the Muslims in the pre and post colonial periods, particularly with reference to the iddah maintenance, mut’ah, arrears of maintenance, and child maintenance. The study indicates that despite the (...) provisions were inconformity with the Islamic principles, the applications were restricted and influenced by the Shafi’i madhhab. However, the amount of iddah maintenance and mut’ah were substantial taking into account the standard of living of the Malay society in the 15th and 16th century. This means that the welfare of the divorced women was taken care of since the codification of the Islamic law and its implementation in the Malay society. (shrink)

Feminist writings often argue that the welfare state, like the society that underpins it, is patriarchical, and that a major overhaul of policy is necessary in the quest for gender equality. This is possibly a valid claim, if not for all welfare states, then at least for some. The very same objective would, nevertheless, appear additionally persuasive if women-friendly policy can be shown to improve not only the welfare of women, but of all. In this article I (...) shall attempt to demonstrate that the feminist case need not be based on the narrower cause of women's emancipation because improving women's welfare will, simultaneously, improve upon societal welfare. Or, to put it differently, gender equality is potentially a substantial Pareto improvement in so far as women are emerging as the axial principle of any positive welfare equilibrium for post-industrial society. The post-war welfare equilibrium was built around the male breadwinner's earnings and job security, coupled to the family's internalization of caring needs. The “standard production worker” cum male breadwinner became the normative guideline for institution-building. Be it the full employment commitment, collective bargaining, labour market regulation, or social protection, all were primarily designed to safeguard his job, earnings capacity, and social entitlements. His security was assumed to deliver universal security. The male breadwinner constituted the nexus between economy and family, between production and consumption. As research has shown, women's economic dependence on men was near absolute in the post-war decades. This dependency was doubly reinforced because few married women worked and if they did, their wages were typically low. (shrink)

This positional paper explores the role of personal networks (family and friends) in caring for people with mental health problems. Since the eighties, major changes have been made in the organization and focus of professional mental healthcare. Correspondingly, new expectations and changes in the division of care responsibilities between people with mental health problems, their personal networks and their professional care providers were created. In this paper, I investigate how the transition in mental healthcare changed the allocation (...) of care responsibilities between personal networks, people with mental health problems and professional caregivers. I will consider why care responsibilities of personal networks have been taken for granted in these processes, and discuss whether personal networks should have a more prominent voice in the assignment of care responsibilities, and how this can be done. A theoretical framework of feminist care ethics inspired by scholars such as Margaret Urban Walker, Joan Tronto and Hilde Lindemann is used to reflect on the need for social inclusion. (shrink)

The essays of this volume consider how acknowledgement of the fact of dependency changes our conceptions of law, political theory, and morality, as well as our very conceptions of self.

Choice over home care has become an important pillar in the provision of publicly financed long-term care for people of all ages. In many European welfare states, cash-for-care schemes give care recipients greater choice over home care arrangements by allowing them to pay for care provided by acquaintances, friends and even family members. Paying for such informal care, however, is increasingly contested due to growing care needs, rising costs and the (...) perceived need to tighten access to publicly funded care. Citizens in paid care-giving roles are thus pressured to continue their care unpaid or re-divide their care-giving responsibilities with lay ?citizen-carers?. On the basis of a Dutch case study, this article examines how paid family care-givers experience this call for greater self-sufficiency in providing care. An analysis of 25 interviews and 21 letters of complaint revealed that care-givers felt trapped between their desire to derive social status from paid work and their inability to reject or re-divide previously paid care responsibilities. In a society where all citizens are expected to work, care-givers feel that their previously paid care-giving is devalued from a public to a private matter, despite the government's attempts to reframe care as an act of good citizenship. (shrink)

Client-provider relationships have significant effects on how individuals comprehend their life situation during chronic disease and illness. Yet, little is known about how frontline health care providers (HCPs) influence client’s identity formation through meaning-making with clients such as HIV-positive women living in poverty. This requires ethical consideration of the meanings made between clients and providers about client’s health and well-being, both individually and in the larger society. Health care providers (N = 15) and married women living with HIV (...) (N = 33) in north-central India engaged in separate intensive interviews providing narrative data which were analysed using a conceptual framework crossing Lipsky’s street-level bureaucracy theory (Lipsky 2010) with meaning-making processes. HCPs and women construct meanings of women’s role as caregivers that impact women’s sense of identity, health, and well-being. Findings indicate that despite being well-intentioned, HCPs inadvertently reinforce rigid gender norms and convey that women’s worth is tied to their familial caregiving role. HCPs’ discretionary advocacy may also reinforce societal images of women as incapable and needy, thereby harming them more generally. Attention to the gender-sensitive training of HIV health care providers may assure that discretion is ethically interrogated to promote gender equity and enhance women’s access to social welfare services. (shrink)

This article explores how the Slovenian women's lifestyle magazine Naša žena (Our Woman) helped the Yugoslavian socialist project construct and shape the ideal socialist woman, and argues that she became the crucial ally in implementing socialist ideas in the everyday lives of Slovenians. The article shows how texts on food preparation and consumption, as well as those touching on household management and family care, published in Naša žena from 1960 to 1991 played an important part in the ‘civilising’ (...) process that shaped behaviour, directed cultural and social practices, influenced social relations and constructed women's identities during socialism. We show how food-related texts (articles, recipes, columns, advertisements and advertorials) were never far removed from the larger political and economic socialist realities. In fact, they bore witness to changes in living standards and told stories about gender regimes, socialist ideologies and fantasies. These texts belong to a corpus of social transcripts that guide collective understandings of what it means to select, prepare, cook and eat food; what constitutes good cooking and eating; and who is responsible for preparing meals. Despite official socialist feminist rhetoric about freeing women from backward patriarchal arrangements, this article shows that texts offering food-related advice in socialist Yugoslavia contained explicit instructions for the ‘correct’ performance of the social roles of women, legitimising women's roles as worker, mother, wife and housekeeper. Above all, a woman was to be an ‘engineer’ of the private domain whose goals were to feed her family and keep the nation healthy and hence productive, and to modernise her kitchen in support of the technological and economic development of Yugoslavia. (shrink)

Despite the well-documented social, economic, and adaptive advantages for young children, adolescents, and adults, the traditional family in the West is in decline. A growing percentage of men and women choose not to be bound by the traditional moral and social expectations of marriage and family life. Adults are much more likely than in the past to live as sexually active singles, with a concomitant increase in forms of social isolation as well as in the number of children (...) born outside of marriage. These social shifts are also connected to public policies that provide incentives for individuals to exit the family, leaving behind its social, capital, and economic resources. The individualistic character of the social-democratic egalitarian ideology that underlies the current dominant approaches to health care financing in Western Europe and much of North America, for example, is associated with a decline in family stability. Welfare entitlements, including state-based health care, have made it easier to exit the family, undermining the centrality of the family’s core human relationships. This essay argues for the importance of recognizing the cardinal role and reality of the family and for the importance of family-based health care savings accounts for preserving family integrity, while also providing for sustainable long-term health care reform. (shrink)

During the 16-year civil war in Mozambique thousands of children were separated from their families as a direct or indirect result of conflict and displacement. International organizations lent support to a national family tracing and reunification programme coordinated by the government Department for Social Action. Drawing on the findings of an empirical study of the sustainability of substitute family care, this article describes the tensions associated with the involvement of international organizations during the emergency conditions of the (...) war, in post-war rehabilitation and in longer term development. It explores the ethical dimensions of social welfare interventions across borders and continents and concludes by arguing a case for international humanitarian agencies to base their interventions to ?help? separated children on deeper knowledges of the social and political history, and the values, beliefs and normative practices of the populations with whom they work. (shrink)

Contemporary ideas about caring in welfare states can wreak havoc if applied to one's own life. In this essay, a mother offers a personal commentary on the debate regarding diakonia and caring. She identifies three concepts, popular in contemporary caring discourse, that threaten her ability to genuinely and effectively care for those around her, particularly her family. The first problematic concept is that the state ought to provide care on our behalf. The second is that people (...) have rights to claim, but no one in particular bears the responsibility. The third is that the Church is responsive rather than normative in the social setting. (shrink)