Progressive family policy regimes typically aim to promote and protect women’s opportunities to participate in the workforce. These policies offer significant benefits to affluent, two-parent households. A disproportionate number of low-income and impoverished families, however, are headed by single mothers. How responsive are such policies to the objectives of these mothers and the needs of their children? This chapter argues that one-size-fits-all family policy regimes often fail the most vulnerable household and contribute to intergenerational poverty in two ways: by denying (...) at-risk children adequate parenting, and by undermining their mothers’ legitimate interest in nurturing and caring for their own children. The capabilities of these mothers and the well-being of their children are better served by policies which recognise maternal caregiving as a productive and valuable occupation meriting equal respect and social support. (shrink)

This paper examines older people’s access to care experiences in rural China by integrating anthropological investigation with ethical inquiry. Six months of fieldwork in a post-reform primary hospital show how rural residents struggle to access gerontological and nursing care under socially disadvantageous conditions. This anthropological investigation highlights the unmet needs in medical and nursing care for older people, as well as some social, institutional and structural elements that impede access to care. Centring on protecting the vulnerable as informed by feminist (...) ethics scholarship, this paper argues that the failure to meet older people’s dependency needs is unjust, on the premise that it suggests a denial of the inherent value, rights and dignity of older people. This paper appeals for the provision of greater care and support by the state through putting in place social arrangements that better advance older people’s access to care. Some policy recommendations concerning health and social care reform for older people in rural China are also proposed. (shrink)

There is a consensus that the effects of medical brain drain, especially in the Sub-Saharan African countries, ought to be perceived as more than a simple misfortune. Temporary restrictions on the emigration of health workers from the region is one of the already existing policy measures to tackle the issue—while such a restrictive measure brings about the need for quite a justificatory work. A recent normative contribution to the debate by Gillian Brock provides a fruitful starting point. In the first (...) step of her defence of emigration restrictions, Brock provides three reasons why skilled workers themselves would hold responsibilities to assist with respect to vital needs of their compatriots. These are fair reciprocity, duty to support vital institutions, and attending to the unintended harmful consequences of one’s actions. While the first two are explained and also largely discussed in the literature, the third requires an explication on how and on which basis skilled workers would have a responsibility as such. In this article, I offer a vulnerability approach with its dependency aspect that may account for why the health workers in underserved contexts would have a responsibility to attend to the unintended side effects of their actions that may lead to a vital risk of harm for the population. I discuss HIV/AIDS care in Zimbabwe as a case in point in order to show that local health workers may have responsibilities to assist the population who are vulnerable to their mobility. (shrink)

In diesem Aufsatz vertrete ich die These, dass die Betreuungsverbote und einschränkungen für Kleinkinder, die im Zuge der Corona-Pandemie in Deutschland galten und immer noch gelten, in bestimmten Fällen zu signifikanten Verlusten des Wohlergehens von Kleinkindern führen. Dabei beziehe ich mich auf Kleinkinder, die in Strukturen leben, in denen die außerhäusliche Betreuung einen gewichtigen Beitrag zur Kinderbetreuung leistet. Ich werde dafür argumentieren, dass für diese Kinder der Wegfall der Kinderbetreuung bedeuten kann, dass gewichtige aktuelle immaterielle Wohlergehensinteressen nur noch teilweise oder (...) gar nicht mehr befriedigt werden. Um diese Interessen und das Ausmaß ihrer Nichtbefriedigung zu beschreiben, greife ich auf das Konzept der Kindheitsgüter zurück und werde mich dabei auf drei gewichtige immaterielle Wohlergehensinteressen konzentrieren: das Interesse des Kindes an pädagogisch wertvollen Betreuungsstrukturen, das Bedürfnis des Kindes nach Austausch und Spiel mit Gleichaltrigen und das Interesse des Kindes, frei von Sorgen und Ängsten zu sein. Die anschließende kinderethische Auswertung dreier aktueller Studien zur Situation der Kinder und Familien unter den Bedingungen der Corona-Pandemie zeigt, dass besonders die Umstände während des Lockdowns im Frühjahr 2020, aber auch die fortbestehenden Einschränkungen bei der Kinderbetreuung sowie die veränderte Arbeitssituation der Eltern erheblich dazu beitragen, dass das Wohlergehen von Kleinkindern in dieser Hinsicht beeinträchtigt wird. Am Ende des Aufsatzes werde ich mich der Frage widmen, was bei der Ausgestaltung zukünftiger Maßnahmen zur Bekämpfung der Corona-Pandemie aus kinderethischer Perspektive berücksichtigt werden sollte, um das Wohlergehen der Kleinkinder so gut wie möglich zu schützen. (shrink)

The ethics of care addresses aspects of the human condition that other moral theories overlook—our vulnerability to injury, inevitable dependencies, and ubiquitous needs. In the grip of these experiences, we require care from others to survive and flourish. The precarious nature of human existence represents a related experience, one less thoroughly explored within care ethics. Through examination of these occasions for care, this article offers two contributions: First, a map of the conceptual relations between care ethics’ four key concepts: need, (...) vulnerability, dependency, and precariousness. As a subset of these efforts, I investigate the relevance of precariousness and precarity for care ethics by asking what they require of caring relations that vulnerability does not. Second, a more precise articulation of care ethics’ normative foundations and accompanying elucidation of the alternative vision of moral responsibility care ethics advances. Examining need, vulnerability, dependency, and precariousness through the lenses of finitude and embodiment exposes two common forms of conflation: between precarity and vulnerability and between dependency and vulnerability. Analysis of the moral significance of the body as a site for care reveals a novel portrayal of the normative foundations of care ethics and the reasons why we care for one another ethically. (shrink)

Not all forms of human fragility or vulnerability are unavoidable. Sometimes we knowingly and intentionally impose conditions of vulnerability on others; and sometimes we knowingly and intentionally enter into and assume conditions of vulnerability for ourselves. In this article, I propose a presently overlooked basis on which one might evaluate whether the imposition or assumption of vulnerability is acceptable, and on which one might ground a significant class of vulnerability-related obligations. Distinct from existing accounts of the importance of promoting autonomy (...) in conditions of vulnerability, this article offers a preliminary exploration of the nature, role, and importance of resilience promotion, its relationship to autonomy promotion, and its prospects for improving human wellbeing in autonomy inhibiting conditions. (shrink)

“Bodily autonomy” has received significant attention in bioethics, medical ethics, and medical law in terms of the general inviolability of a patient’s bodily sovereignty and the rights of patients to make choices (e.g., reproductive choices) that concern their own body. However, the role of the body in terms of how it can or does contribute to a patient’s capacity for, or exercises of their autonomy in clinical decision-making situations has not been explicitly addressed. The approach to autonomy in this paper (...) is aligned with traditional theories that conceive autonomy in terms of an individual’s capacities for, and exercises of rational reflection. However, at the same time, this paper extends these accounts by arguing that autonomy is, in part, embodied. Specifically, by drawing on phenomenological conceptions of the experience of autonomy, we argue that, in principle, the body is a necessary component of the capacity for autonomy. Secondly, through the presentation of two different cases, we highlight ways in which a patient’s body can contribute to the autonomy of treatment choices. Ultimately, we hope to encourage others to explore additional conditions under which a concept of embodied autonomy should be employed in medical decision making, how its underlying principles might be operationalised in clinical situations, and its consequences for approaches to patient autonomy in healthcare practice, policy, and law. (shrink)

Phenomenology gives rise to certain ontological considerations that have far-reaching implications for standard conceptions of patient autonomy in medical ethics, and, as a result, the obligations of and to patients in clinical decision-making contexts. One such consideration is the phenomenological reduction in classical phenomenology, a core feature of which is the characterisation of our primary experiences as immediately and inherently meaningful. This paper builds on and extends the analyses of the phenomenological reduction in the works of Husserl, Heidegger, and Merleau-Ponty (...) in order to identify and explain its implications for our current understanding of the principle of respect for patient autonomy and the norms of clinical decision making. (shrink)

One barrier to optimal pain management in the neonatal intensive care unit is how the healthcare community perceives, and therefore manages, neonatal pain. In this paper, we emphasise that healthcare professionals not only have a professional obligation to care for neonates in the NICU, but that these patients are intrinsically worthy of care. We discuss the conditions that make neonates worthy recipients of pain management by highlighting how neonates are vulnerable to pain and harm, and completely dependent on others for (...) pain management. We argue for a relational account of ethical decision-making in the NICU by demonstrating how an increase in vulnerability and dependence may be experienced by the healthcare community and the neonate’s family. Finally, an ethical framework for decisions around neonatal pain management is proposed, focussing on surrogate decision-making and the importance of compassionate action through both a reflective and an affective empathy. As empathy can be highly motivating against pain, we propose that, in addition to educational programs that raise awareness and knowledge of neonatal pain and pain management, healthcare professionals must cultivate empathy in a collective manner, where all members of the NICU team, including parents, are compassionate decision-makers. (shrink)

In this article I seek a more complete understanding of evil action. To this end, in the first half of the article I assess the conceptual strengths and weaknesses of the most compelling theories of evil action found in the contemporary philosophical literature. I conclude that the theories that fall under the category I call ‘‘Nuanced Harm Accounts’’ successfully identify the necessary and sufficient conditions of the concept. However, necessary and sufficient conditions are not coextensive with significant features, and Nuanced (...) Harm Accounts are incomplete even if they are correct. In order to supplement them, in the second half of the article I examine the normative relation that obtains between perpetrators and victims of evil and find them to be parties to a relation of asymmetrical power in which the vulnerability of the weaker party is exploited by the stronger party for its advantage, pleasure, or otherwise to achieve its aims. Moreover, the parties in the relation reciprocally enable each other’s role relative to one another. The strength of the more powerful party emerges out of the states of vulnerability of the victims, and the victims are vulnerable relative to the power(s) of the perpetrator. (shrink)

Transhumanism is a challenging movement that invites us to rethink what defines humanity, including what we value and regret the most about our existence. Vulnerability is a key concept that require thorough philosophical scrutiny concerning transhumanist proposals. Vulnerability can refer to a universal condition of human life or, rather, to the specific exposure to certain harms due to particular situations. Even if we are all vulnerable in the first sense, there are also different sources and levels of vulnerability depending on (...) concrete social circumstances. Recently, Michael Hauskeller argued about a fundamental incompatibility between transhumanism and vulnerability. He understands vulnerability as an existential category, linked to woundability and mortality. This idea is akin to ontological vulnerability, but it does not notice some important features of social vulnerability. On the other side, transhumanism is a complex and non-homogeneous movement. Here we distinguish between a strong and a weak version of transhumanism. We will propose that the salience of vulnerability is only diminished in the radical one, while a moderate version can reconcile vulnerability with human enhancement. Thus, vulnerability, a concept that has recently gained much importance as an anthropological category in contemporary ethics, is not necessarily at odds with any transhumanist project. (shrink)

This paper raises several concerns about vulnerability as an alternative language to conceptualize injustice and politicize its attendant injuries. First, the project of resignifying “vulnerability” by emphasizing its universality and amplifying its generative capacity, I suggest, might dilute perceptions of inequality and muddle important distinctions among specific vulnerabilities, as well as differences between those who are injurable and those who are already injured. Vulnerability scholars, moreover, have yet to elaborate the path from acknowledging constitutive vulnerability to addressing concrete injustices. Second, (...) vulnerability studies respond to, and have been shaped by, debates in the 1980s and 1990s over oppression, identity and agency. This genealogy needs to be acknowledged and evaluated. As I demonstrate, prominent theorists define vulnerability in contradistinction to victimization, adopting neo-liberal formulations of victims and victimhood. Finally, I turn to address the politics of vulnerability. At issue are not simply matters of utility or programmes for implementation, but the fraught relationship among ontology, ethics and politics, which I address through an engagement with Rancière's conception of the political and the case of the Black Lives Matter movement. (shrink)

This paper will highlight how the existing approaches to the Strawman Fallacy and the Principle of Charity are unable to fully accommodate the problems of interpreting children’s arguments. A lack of charity is as problematic as an excess of charity when arguing with children, and can contribute to misinterpretation of arguments. An application of moderate charity avoids the pitfalls of misrepresenting children. However, interpreting children’s arguments with the appropriate amount of charity is a challenging task. The argumentative context is relevant (...) in determining the interpretive approach and the extent of charity that can be justified. The context of arguing with children necessitates an Ethics of Care-based approach to interpretation. Michael Gilbert’s concept of coalescent argumentation exemplifies how Ethics of Care can be realized during argumentative exchanges involving children. (shrink)

The High Court continues to exercise its inherent jurisdiction to make declarations about interventions into the lives of situationally vulnerable adults with mental capacity. In light of protective responses of health care providers and the courts to decision-making situations involving capacitous vulnerable adults, this paper has two aims. The first is diagnostic. The second is normative. The first aim is to identify the harms to a capacitous vulnerable adult’s autonomy that arise on the basis of the characterisation of situational vulnerability (...) and autonomy as fundamentally opposed concepts or the failure to adequately acknowledge the conceptual relationship between them at common law. The second part of this aim is to draw upon developments in analytic feminist philosophy to illustrate how standard approaches to autonomy are ill-equipped to capture the autonomy issues of capacitous vulnerable adults when their decisions regarding care and treatment are at stake. The second (normative) aim is to develop an account of self-authorised, intersubjective autonomy on the basis of analytic feminist insights into the relational practices of recognition. This account not only attempts to capture the autonomy of capacitous vulnerable adults and account for the necessary harms to their autonomy that arise from standard common law responses to their situational vulnerability, it is also predicated on the distinctions between mental capacity, the satisfaction of conditions for informed consent and the exercise of autonomy, meaning that it is better placed to fulfil the primary aim of the inherent jurisdiction – to facilitate the autonomy of vulnerable adults with capacity. (shrink)