The purpose of this article is to re-examine an ethic of care as the main ethical approach to nursing practice in light of past and present developments in nursing ethics, and to briefly speculate whether or not it will survive within nursing in the future. Overall, it is maintained throughout that the terms ?caring?, ?nursing? and an ?ethic of care? are inextricably linked. This is because, it is argued, professionally focused nursing practices are based predominantly on a well-recognised moral commitment (...) to deliver expert care, and that a care-based ethic is the major factor in the construction and maintenance of these practices. Subsequently, the influences and developments of a caring ethic in nursing are firstly re-examined, and the discussion is supported by evidence from more recent nursing research and theoretical developments. Consideration is given to the philosophical underpinnings of both care theory and caring ethics, and the fundamental importance of caring in nursing, as an interpersonal relationship and as an appropriate ethical response, is made transparent. Finally, an outline of the future possibilities that may affect an ethic of care in nursing is offered. (shrink)

The body in need of care is the subaltern of the neoliberal epistemic order: it is that which cannot be heard, and that which is muted, partially so even in care ethics. In order to read the writing by which the needy body writes the world, a new ethics must be articulated. Building on Jacques Derrida’s philosophy of deconstruction, Gayatri Chakravorty Spivak’s notions of subalternity and epistemic violence, critical disability scholarship, and corporeal care theories, in this article I develop an (...) ethics of needs. This is an ethical position that seeks to read the world that care needs write with the relations they enact. The ethics of needs deconstructs the world with a focus on those care needs that are presently responded to with neglect, indifference, or even violence: the absence of care. Specifically, the ethics of needs opens a space—a spacing, an aporia—for a more ethical politics of life than neoliberal biopolitics can ever provide, namely, the politics of life of needs. (shrink)

Concern for human vulnerability seems to be at the heart of bioethical inquiry, but the concept of vulnerability is under-theorized in the bioethical literature. The aim of this article is to show why bioethics needs an adequately theorized and nuanced conception of vulnerability. We first review approaches to vulnerability in research ethics and public health ethics, and show that the bioethical literature associates vulnerability with risk of harm and exploitation, and limited capacity for autonomy. We identify some of the challenges (...) emerging from this literature: in particular, how to reconcile universal human vulnerability with a context-sensitive analysis of specific kinds and sources of vulnerability; and how to reconcile obligations to protect vulnerable persons with obligations to respect autonomy. We then briefly survey some of the theoretical resources available within the philosophical literature to address these challenges, and to assist in understanding the conceptual connections between vulnerability and related concepts such as harm, exploitation, needs, and autonomy. We also sketch out a taxonomy of sources and kinds of vulnerability. Finally, we consider the implications for policy evaluation of making vulnerability an explicit and central focus of bioethics. Our investigation is in the form of a broad survey motivating a research agenda rather than a detailed analysis. (shrink)

This paper argues that human rights-based approaches to human security overlook the importance of caring values, relations of care, and care work in the achievement and long-term maintenance of human security. It outlines an alternative approach to the ethics of human security which combines a feminist ontological and normative position on the centrality of caring values and practices in sustaining life with a feminist account of the gendered political economy of contemporary globalisation. Moreover, it argues that a critical, feminist ethics (...) of care can provide a comprehensive ontological and normative framework for integrating economic exclusion with violence, and thus for understanding and conceptualising human security in a way that is sensitive to the role played by gender identities and other types of power relations. This, I argue, can be achieved through an interrogation of the relationship between neoliberal globalisation and hegemonic forms masculinity in the context of contemporary global governance. (shrink)

This article closely reads “Chelsea Girls,” an autobiographical short story by Eileen Myles that depicts her experience caring for the diabetic, bipolar poet James Schuyler when she was a young writer getting started in East Village in the late 1970s. Their dependency relationship is a form of queer kinship, an early version of the caring relations between lesbians and gay men that HIV/aids would demand over the next two decades as chosen families emerged to nurture gay men and lesbians rejected (...) by their families of origin. The representation of queer kinship offers an alternative to more traditional portrayals of care in literature that focus on the heteronormative family, a site of care that feminist dependency theory also paradoxically privileges. This article synthesizes insights from queer theory and critical disability studies in order to expand our understanding of the roles participants in care can play, the ways they can feel, and the outcomes they can achieve. Myles and Schuyler’s dependency relationship was sustaining for both of them and also critical for her development as a pioneering lesbian poet in an art world still dominated by men. (shrink)

A case study of Chinese grandparents’ transnational caregiving experiences in Canada highlights two issues that have received limited attention in the broader feminist care literature: elderly persons are usually positioned as receivers rather than providers of care; and transnational care studies focus on women migrating as part of “global care chains,” rather than on elderly family members migrating to meet the caring needs of adult kin who work in market economies that do not recognize caring responsibilities. The paper concludes by (...) arguing that the distribution of care responsibilities needs to be one of the pillars in the pursuit of transnational social justice. (shrink)

Background:Scholarly work is needed to develop the conceptual and theoretical understanding of trust to nursing practice. The transition from hospital care to complex pediatric homecare involves nurses in myriad roles, including management and care provision. Complex pediatric homecare transforms children, families, professionals, and communities, but its exact implications are unclear.Research objectives:To conduct an ethical inquiry into the role and responsibilities of nurses in the qualitative experience of adults involved in the hospital-to-home transition of young, ventilator-dependent children.Research design:We followed methods described (...) by Franco Carnevale. We used a sociologically grounded theoretical orientation—trust—to re-interpret qualitative data for an ethical inquiry into a specific facet of that data.Participants and study context:The participants included 26 adults, including 14 nurses, involved in the hospital-to-home transition in a Canadian province. Participants represented family, hospital, home, and government.Ethical considerations:The Conjoint Health Research Ethics Board at the University of Calgary approved this study.Findings:First, the concept and practice of trust was salient to the experience of transition. For example, responsibilities’ allocation between hospital-based professionals to mothers, home-based nurses, and non-professionals necessitated reliance and vulnerability. Second, the consequences of distrust connected to recognized challenges. For example, tensions along rural–urban, medical-family, and professional–personal divide each revealed suspicion and uncertainty that led to isolation and anxiety for all involved. Third, recommendations to improve the experience and mitigate the challenges of transition can be grounded in trust promotion. For example, transition-specific education programs and codes of ethics would promote openness, recognize mutual vulnerability, and advance trust in transition.Conclusions:The challenges to transition evidenced distrust, while trust represents a powerful tool to counter these challenges and their implications. A climate of trust could bridge divides between mothers and professionals; rural and urban professionals; and professionals with differing relationships with the family. (shrink)

Sigmund Freud famously described three existential insults to humanity stemming from heliocentrism, evolution, and psychoanalysis. In recent years we are, perhaps, beginning to see the emergence of a fourth: interdependency. Over the last several centuries, Anglo-American culture has modelled itself on a vision of the independent individual – strong, autonomous, and self-sufficient. Yet from feminist theory, communitarianism, disability theory, institutionalist economics, and elsewhere, the evidence mounts that independence is, in most contexts, a myth. We are, in fact, fundamentally social beings: (...) fragile, vulnerable, variously disabled, and intrinsically dependent. In their time, each of the existential insults had profound effects; they forced a re-examination of the self, which rippled throughout the culture and uprooted old practices. This article argues that taking interdependency seriously would similarly lead to profound changes in our culture, our central political concepts, and even our major institutions. (shrink)

The ethic of care provides not only a basis for understanding relationships of care at the micro level but also a potent form of political ethics, relevant to the development of welfare services. Williams (2001), for example, argues that the concept of care has the capacity to be a central referent in social policy?a point at which social and cultural transformations meet with the changing relations of welfare (Williams 2001, p. 470). English social care services are currently in another period (...) of change precipitated by the ?personalisation agenda?. This agenda is seen as having the potential to revolutionise social care, to create the conditions needed to tailor services to individual needs, and to give service users greater choice and control, including, where possible, control over their own service budgets or direct possession and management of care funds. These developments are inextricably linked to broader economic and social trends, key amongst which are the ageing of the population and changing economic conditions affecting both the labour market and the market for care services. This article applies the feminist ethic of care to an analysis of the personalisation agenda in the context of care for dependent older people. It highlights fundamental political questions posed concerning the nature and extent of older people's need for care, responsibility for meeting these needs and the associated costs. It questions whether the personalisation agenda could potentially offer a more responsive form of care, by placing more power and control in older people's hands. Key points considered are the individualisation of care and the ways in which control is conceptualised. The article concludes with an assessment of the feminist ethic of care as a basis for policy evaluation. (shrink)

Political philosophy presents a static conception of childhood as a state of lack, a condition where intellectual, physical, and moral capacities are undeveloped. This view, referred to by David Kennedy as the deficit view of childhood, is problematic because it systematically disparages certain universal features of humanity—dependency and growth—and incorrectly characterizes them as features of childhood only. Thus there is a strict separation between childhood and adulthood because adults are characterized as fully autonomous agents who have reached the end of (...) their moral and cognitive development. I argue that this view is mistaken, and limits both the developmental abilities of adults and ongoing moral development within an organized state. I propose that we view dependency as a human condition. By doing so, children and adults form the kind of relationship with one another that encourages the growth and development of our moral sense in both childhood and adulthood. (shrink)

This paper examines the support for diversity from a moral perspective. Combining business ethics theory with a lens of critical discourse analysis, it reconstructs the debates on the ethicality of three disability inclusion practices—positive discrimination, job adaptations, and voluntary disclosure—drawn from multi-stakeholder interviews in disability-friendly organizations. Discursive resistance to disability inclusion practices, otherwise known to work, arises out of moral beliefs characteristic of an ethic of justice, whereas support is more often informed by an ethic of care. This study contributes (...) to the literature by laying bare how ethics fuel ‘resistance to’ rather than ‘support for’ diversity and inclusion. Like prior studies, it links such resistance to the myth of individual merit, noting that some re-appropriation of an ethic of justice becomes possible when legal awareness around issues of disability is raised in the context of work. In addition, it identifies an ethic of care as holding the greatest potential for fostering workplace inclusion yet cautions for two adverse side effects that may arise when promoting corporate care: the potential of paternalism and the inclination to individualise inherent to wellbeing initiatives. (shrink)

This article explores the current parenting culture, particularly the promotion of competitive and excessive parenting, as an important background issue against which the debates around pre-natal testing take place. It offers an alternative vision of parenting, relying on care ethics, which sees parenting as a relationship, rather than a job. A relationship that should change a parent’s understanding of what is valuable in life. Parenting should not be about moulding the ‘perfect child’ but being open to being profoundly changed. The (...) parent–child with a disability relationship offers particular opportunities to find new meanings and values in life. This analysis is offered as another dimension to the debates over pre-natal testing. It is not intended as an argument against such testing, but rather raises concerns about some of the broader attitudes around it. (shrink)

This article explores the current parenting culture, particularly the promotion of competitive and excessive parenting, as an important background issue against which the debates around pre-natal testing take place. It offers an alternative vision of parenting, relying on care ethics, which sees parenting as a relationship, rather than a job. A relationship that should change a parent’s understanding of what is valuable in life. Parenting should not be about moulding the ‘perfect child’ but being open to being profoundly changed. The (...) parent–child with a disability relationship offers particular opportunities to find new meanings and values in life. This analysis is offered as another dimension to the debates over pre-natal testing. It is not intended as an argument against such testing, but rather raises concerns about some of the broader attitudes around it. (shrink)

The central role of care in human history is beyond questioning [...].

The impacts of the activities of technological societies extends further into the future than their capacity to predict and control these impacts. Some have argued that the repercussions of this deficiency of knowledge cause fatal difficulties for both consequentialist and deontological accounts of future oriented obligations. Increasingly, international politics encompasses issues where this problem looms large: the connection between energy production and consumption and climate change provides an excellent example. As the reach of technologically-mediated social action increases, it is necessary (...) to ask whether a political imaginary that extends itself to match this reach requires new concepts, and how far they should displace traditional political concepts of obligation, based on reciprocity and harm avoidance. This paper draws on recent scholarship on the role of concepts of care in political philosophy, bringing together phenomenological and feminist concepts of care in contributing to a positive concept of non-reciprocal intergenerational obligation that defends a constitutive connection between care and justice. (shrink)

The phenomenon of technological hazards, whose existence is only revealed many years after they were initially produced, shows that the question of our responsibilities toward future generations is of urgent importance. However, the nature of technological societies means that they are caught in a condition of structural irresponsibility: the tools they use to know the future cannot encompass the temporal reach of their actions. This article explores how dominant legal and moral concepts are equally deficient for helping us understand what (...) future-oriented responsibility requires. An alternative understanding of responsibility is needed, one which can be developed from phenomenological and feminist concepts of care. Care, by opening up for us an understanding of the diversity of values that are constitutive of a worthwhile life, also connects us to the future as the future of care. As such, it provides us with ethical resources that can guide us in the face of uncertainty. (shrink)

As the number of people affected by dementia increases rapidly, dementia has been transformed into an epidemic which endangers global health and wealth, and many populations are now living in what Jain terms a time of prognosis, in fear of the disease. Through its strong association with ageing and memory loss, dementia is conceived of as a linear decline into loss of self and death, and those with dementia as other. More significantly, imagined as a threat that signifies both a (...) loss of able-bodied workforce and a large population dependent on care and support, dementia inevitably feeds into the ‘crisis-of-care’ narrative that is prominent in many ageing societies. With one of the fastest ageing populations in the world, and an extremely low birth rate, the dementia prognosis is particularly acute in Japan and dementia is strongly linked to the idea of a ‘care crisis’. This situation has produced an increasing number of cultural representations of dementia and care and this paper considers three of these cultural texts, all rooted in the historical and cultural contexts in which they were produced: the novel The Twilight Years; the film Memories of Tomorrow; and the comic book Pecoross’ Mother and Her Days. The analysis concentrates upon their representations of care, seeing this as a space where the ethical relationship between self and other can be negotiated and where time with dementia can be imagined and re-imagined. The analysis of these texts from a feminist ethics perspective demonstrates the potential of popular and creative representations to interrogate and potentially expand the meanings of dementia, ageing and living in prognosis. (shrink)

In the UK, current policies and services for people with mental disorders, including those with intellectual disabilities (ID), presume that these men and women can, do, and should, make decisions for themselves. The new Mental Capacity Act (England and Wales) 2005 (MCA) sets this presumption into statute, and codifies how decisions relating to health and welfare should be made for those adults judged unable to make one or more such decisions autonomously. The MCA uses a procedural checklist to guide this (...) process of substitute decision-making. The personal experiences of providing direct support to seven men and women with ID living in residential care, however, showed that substitute decision-making took two forms, depending on the type of decision to be made. The first process, ‘strategic substitute decision-making’, paralleled the MCA’s legal and ethical framework, whilst the second process, ‘relational substitute decision-making’, was markedly different from these statutory procedures. In this setting, ‘relational substitute decision-making’ underpinned everyday personal and social interventions connected with residents’ daily living, and was situated within a framework of interpersonal and interdependent care relationships. The implications of these findings for residential services and the implementation of the MCA are discussed. (shrink)

Au regard du vieux débat sur la « fuite des cerveaux », le devoir de promouvoir le développement des pays pauvres semblait incompatible avec le droit humain à l’émigration. A l’encontre de cette idée, Jagdish Bhagwati a proposé dans les années 70 une mesure qui permettait au personnel qualifié de quitter les pays pauvres, tout en taxant leur revenu au bénéfice de leurs pays d’origine. Cet article discute (et rejette) trois justifications possibles de la taxe Bhagwati. Il conclut qu’une telle (...) mesure ne peut être défendue ni comme une compensation pour ce que le pays aurait gagné si les diplômés n’avaient pas émigré, ni comme une obligation de réciprocité basée sur l’investissement dans l’éducation, ni comme une mesure de diminution de l’inégalité entre les opportunités des migrants et de ceux qui restent au pays. Si la mobilité géographique va de pair avec la mobilité sociale, taxer les migrants revient à taxer la mobilité sociale, plutôt que les hauts revenus eux-mêmes. (shrink)

The intersection between virtue and care ethics is underexplored in contemporary moral philosophy. This thesis approaches care ethics from a neo-Aristotelian virtue ethical perspective, comparing the two frameworks and drawing on recent work on care to develop a theory thereof. It is split into seven substantive chapters serving three major argumentative purposes, namely the establishment of significant intertheoretical agreement, the compilation and analysis of extant and new distinctions between the two theories, and the synthesis of care ethical insights with neo-Aristotelianism (...) to generate a virtue ethical theory of care. In the first two chapters, I outline virtue ethics and care ethics, and argue for considerable agreement over central premises. Chapter 2 summarises the foundational commitments of care ethics, focusing particularly on their relational ontology and its links to the other ethical claims care ethicists universally ascribe to, namely particularism, partialism, the moral salience of emotions, and the rejection of hard public/private distinctions. Chapter 3 lays out the central concepts in neo-Aristotelian virtue ethics, including eudaimonism, virtue, and character traits, and drawing a number of comparisons between virtue and care ethics specifically with regard to relational ontology and the meta-ethical commitments it underpins. In addition to doing the necessary expository work for the remainder of the thesis, Chapters 2 and 3 also argue that care ethics and virtue ethics have much more in common than is typically acknowledged – the first major contribution of this thesis to the literature. Chapters 2 and 3 to provide at least a prima facie justification for pursuit of the questions I confront in the remainder of the thesis. In Chapter 4, I ask what differentiates these two ethical theories. I survey some of the differences which philosophers in either camp have identified and offer some of my own. I suggest that several of those differences either rest on misunderstandings of one ethic or the other, or that in erecting a divide between virtue and care ethics they also disunify ethics of care. I do, however, identify two differences which seem defensible. Specifically, they are that virtue ethics seems to lack an account of care, which I define minimally as a response or responsiveness to need, and that virtue and care ethics organise their meta-ethical and normative concepts differently. This chapter thus presents a second contribution to the literature: a study of the differences between virtue ethics and care ethics. It also serves to set the trajectory for the remaining chapters, where I respond to the claim that virtue ethics lack an account of care. I spend the remainder of the thesis constructing what I take to be a satisfying foundation for a virtue ethical theory of care. In Chapter 5, I offer three initially viable means of incorporating care into virtue ethics, all of which treat care as a virtue. These are the analogical approach, according to which care is analogous to an existing virtue; the additive approach, according to which care is a novel virtue; and the bundling approach, according to which care is a bundle of virtues. I also offer and evaluate reasons to reject the claim that care is a virtue, concluding that the claim is indeed a viable one so long as the concept of care is sufficiently thick, and I contend that analogical approaches, and particularly analogies with charity, outperform the others. Chapter 5 therefore serves two ends. First, it proffers a novel meta-analysis of concepts of care as a virtue, and thus makes a third contribution to the literature. In doing so, it makes an inroad into the second: the development of a neo-Aristotelian theory of care. Chapter 6 continues this project. I attempt to show how care can be construed as an act-type and a practice. I argue in this chapter that practices are a subcategory of actions, and that care qualifies as an Anscombean act-type which aims at the meeting of needs relating to the care-recipient’s flourishing. I go on to consider the implications of this account for ethics which deploy care as a moral concept, maintaining that it not only offers a better account of consequences than theories of care which include success criteria, but also that it affords us interesting insights into the distinction between ‘caring about’ and ‘caring for’ which allow us to make sense of certain tenets of neo-Aristotelianism. This represents a contribution to both discourses, since neither care nor virtue ethicists working at the intersection of their respective normative theories have delved very deeply into the philosophy of action. Chapter 7 discusses caring relations, suggesting that a virtue ethical theory of caring relations can lean on the work care ethicists have done, and adding some necessary refinements, such as a distinction between ideal and non-ideal caring relations, and a theory of caring relations as reasons for action. This final chapter also draws these three concepts of care together by arguing that virtuous caregivers who are invested in the flourishing of those for whom they care are also sensitive to the relations those care-recipients bear to their institutional environment. I argue that because they are caring participants in caring relations, virtuous agents are characteristically motivated by states of need and dependency to engage in certain sorts of conventionally political practices. In other words, the virtue or virtues of caring characteristically manifest in certain sorts of political or social practices, relating specifically to those areas of moral life. This allows us to build upon recent work in feminist virtue ethics of the sort offered by Tessman and Friedman. I also offer a novel analysis of migration, suggesting that the account of care presenting here is analytically useful both when it comes to historical cases of migration such as the underground railroads and escapes from Nazi-occupied Europe, but also for contemporary issues such as the migrations occurring in the Southern United States and in much of Europe. I thus conclude not only that virtue ethicists ought to incorporate care into their normative framework, and that the theory of care presented here is a coherent one, but that this leads us naturally into applied topics such as virtue politics. I conclude the thesis by considering some its implications and by identifying some further avenues for research. (shrink)

This short article provides an overview of "care ethics" for students who are new to moral theory.

El presente trabajo explora las conceptualizaciones actuales de la capacidad de resistencia que se aplican a personas con habilidades-diversas. El concepto de ‘ableísmo’ es presentado y se demuestra su utilidad como un lente analítico. Los resultados indican que un enfoque ecológico a la capacidad de resistencia representa un problema para el avance de los derechos de las personas con habilidades diversas. En concreto, la presencia de asunciones y lenguaje ‘ableístas’ demuestran una continua necesidad de examen crítico de las políticas relacionadas (...) con la capacidad de resistencia y su capacidad para incorporar a la población con habilidades diversas. Sugerimos que una ética feminista del cuidado de personas con habilidades diversas contribuye a la comprensión de la capacidad de resiliencia, promoviendo una agenda positiva de los derechos de las personas con habilidades diversas y dando una dirección positiva para políticas en esta área. Los resultados seguramente ayudaran a hacer frente a las lagunas existentes en la literatura de este tema, y serán de gran importancia para los responsables de políticas, investigadores, y la población con habilidades diversas. (shrink)