Care ethics takes as central the discerning of needs in those being cared for and attempts to meet those needs. Perceptive caring agents are more likely to be able to identify needs in those for whom they are caring. The identification of needs is no small matter, not least in teaching encounters. This paper modestly proposes that at least some of the needs a caring agent should attempt to meet are a function of the identity of the patient of caring (...) action. Taking Nel Noddings’ account of care ethics as representative, I present it in outline. This leads to the needs-identification problematic. Following this I turn to Soran Reader’s account of needs. I interpret this to offer what I designate as identity as ‘what-ness’. Such an understanding of identity-based needs is a starting point for the caring agent but a more nuanced account, of identity as ‘who-ness’, is argued to be preferable. Identity as ‘who-ness’, as expressed in Paul Ricoeur’s work, advances the discussion, culminating in his concept of the ‘capable human being’. Having brought this aspect of Ricoeur’s thought into conversation with care ethics, I offer an account of identity-based needs conducive to the broader aims of the care ethical project. Finally, I consider what this bolstered account of care ethics might say about a brief and illustrative teaching encounter. (shrink)

Abstract“Patient-centred care” is the recent response to the malaise produced in the field of health care from the point of view both of a technical mentality and the paternalistic model. The interest in the story-telling approach shown by both the humanities and the social sciences has favoured a “narrative turn” in medicine too, where the new ethics of therapeutic relationship consider the hermeneutic method a means by which to integrate evidence and subjectivity, scientific data and patient experience. The aim of (...) this paper is to show how Ricoeur’s theory of “threefold mimesis” makes a conceptual contribution to the use of narrative interviews in nursing and also be successfully transferred into and applied in the field of healthcare in general. First, the paper examines how this narrative approach might open up new possibilities for the acquisition of in-depth knowledge of patients’ life experiences, a condition indispensable for the improvement of the quality of care. Secondly, it highlights how this Ricoeurian method seems capable of provide an opportunity for healthcare professionals to review their own understanding of the caregiver-patient therapeutic relationship, beginning with their confrontation with the patient’s world as revealed by the narrative they provide. (shrink)

Background:Metaphors are often used within the context of ethics and healthcare but have hardly been explored in relation to moral reasoning.Objective:To describe a central set of metaphors in one case and to explore their contribution to moral reasoning.Method:Semi-structured interviews were conducted with 16 parents of a child suffering from the neurodegenerative disease CLN3. The interviews were recorded, transcribed, and metaphors were analyzed. The researchers wrote memos and discussed about their analyses until they reached consensus.Ethical considerations:Participants gave oral and written consent (...) and their confidentiality and anonymity were respected.Findings:A central set of metaphors referred to the semantic field of the hands and arms and consisted of two central metaphors that existed in a dialectical relationship: grasping versus letting go. Participants used these metaphors to describe their child’s experiences, who had to “let go” of abilities, while “clinging” to structures and the relationship with their parent. They also used it to describe their own experiences: participants tried to “grab” the good moments with their child and had to “let go” of their child when he approached death. Participants, in addition, “held” onto caring for their child while being confronted with the necessity to “let go” of this care, leaving it to professional caregivers.Discussion:The ethical analysis of the findings shows that thinking in terms of the dialectical relationship between “grasping” and “letting go” helps professional caregivers to critically think about images of good care for children with CLN3. It also helps them to bear witness to the vulnerable, dependent, and embodied nature of the moral self of children with CLN3 and their parents.Conclusion:Metaphorical reasoning may support the inclusion of marginalized perspectives in moral reasoning. Future studies should further explore the contribution of metaphorical reasoning to moral reasoning in other cases. (shrink)

Residents’ councils in Quebec’s residential and long-term care centres have the mandate to promote the improvement of living conditions for residents, to assess their level of satisfaction, and to defend their rights. Based on two studies on the autonomy of councils, we examined how committees can express themselves on topics other than those the management is already aware of, to reveal various previously unknown aspects of the services, and to voice unexpressed concerns. We are especially interested in what makes management (...) receptive, or not, to what the committee members say. The councils’ ability to express them selves is, in fact, inseparable from its capacity to listen to the management teams, and we seek to determine the conditions required to perform this dual capacity. (shrink)

Our paper focuses on the philosophical perspective of constructing active caring masculinities agencies in the contemporary feminist discourse. Since contemporary feminisms are not simply anti-essentialist, but more importantly, polyphonic, we believe that it is far more appropriate to talk about ‘masculinities’ as opposed to ‘masculinity’. We are proposing a revised understanding of the self in which the self is not defined primarily in the dichotomous, categorical one-other relationship. We use Paul Ricoeur’s anthropology to describe the self as relational, as well (...) as Joan Tronto’s recent perspective on care which fits well with a Ricoeurian reconstruction of the self. We also engage with Raewyn Connell’s discourse on masculinity and more specifically, hegemonic masculinity. By using ‘caring masculine agencies’ as an alternative to ‘masculinity as reactive anti-femininity’, we are proposing a paradigm shift that hopefully is flexible enough to respect the dynamism inherent to any act of gender-identification. (shrink)