This article critiques Zimbabwe's refugee policy and practice context, with a focus on the ideological underpinnings of aided income generation activities in Zimbabwe's Tongogara refugee camp. We apply the lenses of Joan Tronto's political, or democratic ethics of care, and Fiona Robinson's critical ethics of care, to conduct an ideology critique of the aid agencies' expressed goal of refugees' economic ‘self-reliance’. We demonstrate that their underlying assumptions about ‘dependency’ and ‘autonomy’, in conjunction with Zimbabwe's policy of refugee encampment, are at (...) the heart of the income generation activities’ lack of sustainability. We argue further that all caring relationships are characterised by unequal power relations, and that this needs to be acknowledged in order to enable a shared commitment to equal participation, in a partnership towards agreed-upon development goals. Moreover, the ideologies of autonomy and self-reliance must be replaced with a policy commitment to fostering interdependence as the ontological condition under which income generating activities can evolve into sustainable livelihoods. We recommend that the critical ethics of care and the radical-democratic practices for which it calls, provide an apt framework within which to reconsider the policies governing refugee support and practices, so as to foster a caring context for human wellbeing. (shrink)

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)

In this paper I will examine how the Mental Capacity Act 2005 regulates the assessment of decision-making capacity in England and Wales. I will argue that there are difficulties in reconciling the Act with how people make decisions in practice. I will explore how ideas from the ethics of care and from phenomenology can be used to take better account of how capacity flows from a person's relationships as well as their individual abilities. I will conclude by discussing some of (...) the ethical issues that have arisen in my assessments of decision-making capacity and how I have tried to respond. (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)

Notions of care for humans and more-than-humans appear at the margins of the sustainability transformations debate. This paper explores the merits of an ethics of care approach to sustainability tr...

This paper explores ethical concerns arising in healthcare integration. We argue that integration is necessary imperative for meeting contemporary and future healthcare challenges, a far stronger evidence base for the conditions of its effectiveness is required. In particular, given the increasing emphasis at the policy level for the entire healthcare infrastructure to become better integrated, our analysis of the ethical challenges that follow from the logic of integration itself is timely and important and has hitherto received insufficient attention. We evaluated (...) an educational intervention which aims to improve child health outcomes by making transitions between primary to secondary care more efficient, ensuring children and parents are better supported throughout. The programme provided skills for trainee paediatricians and general practitioners in co-designing integrated clinical services. The key ethical challenges of integrated care that arose from a clinical perspective are: professional identity and autonomy in an integrated working environment; the concomitant extent of professional responsibility in such an environment; and the urgent need for more evidence to be produced on which strategies for integrating at scale can be based. From our analysis we suggest a tentative way forward, viewed from a normative position broadly situated at the intersection of deontology and care ethics. We adopt this position because the primary clinical ethical issues in the context of integrated care concern: how to ensure that all duties of care to individual patients are met in a newly orientated working environment where clinical responsibility may be ambiguous; and the need to orientate care around the patient by foregrounding their autonomous preferences and ensuring good patient clinician relationships in clinical decision-making. (shrink)

This article conceptualises theories of ethics relevant to the recognised problem of decision variability in child protection. Within this field, social workers are faced with multiple ethical imperatives when making decisions about children’s care. They must respond to justice principles concerned with duties and consequences, as well as ethical obligations created by the relational and contextual elements of each case. Recent scholarship on decision variability highlights the justice issues that arise when decisions in response to apparently similar cases differ. An (...) ethical imperative is that similar cases should be treated ‘like for like’ so that children’s and family’s rights are upheld consistently. This article contends that ethical concepts relating to both universalist duties such as respect for persons, extended by the concept of interactive universalism, and contextual responses based on an ethic of care, help theorise the complexities of ethical decisions in child protection. These concepts develop a nuanced understanding of the ways social workers resist risk discourses, may make decisions reflecting the participation of service users, and contextual evaluations of risk based on understanding service user’s life histories. Understanding this combination helps explain the reasons behind variability, and evaluate the moral acceptability or otherwise of apparently variable decisions. (shrink)