The focus of the study is the conflict between care and concern for particular patients, versus considerations that take impartial considerations of justice to be central to moral deliberations. To examine these questions we have conducted qualitative interviews with health professionals in Norwegian hospitals. We found a value norm that implicitly seemed to overrule all others, the norm of ‘making a difference for the patients’. We will examine what such a statement implies, aiming to shed some light over moral dilemmas (...) interwoven in bedside rationing. (shrink)

In The Ethics of Care, Virginia Held explores what values of care might fulfil normative criteria for evaluating the moral worth of relations. Held identifies seven potential values: attentiveness, empathy, mutual concern, sensitivity, responsiveness, taking responsibility, and trustworthiness. Though Held’s work is helpful as a starting point for conceptualizing some normative criteria, two problems need addressing. First, Held does not provide sufficient justification for why these potential values ought to be considered genuine values in the care ethical framework. Second, Held (...) overlooks two other potential values cited in the care literature: competence and respect. This paper builds upon Held’s work to offer a more coherent understanding of the values of care. It does so by scrutinizing and conceptually organizing the above nine potential values. Of these nine, only four are considered genuine values: attentiveness, mutual concern, responsiveness, and trustworthiness. It is concluded that good caring relations are those that exemplify the four values of care in their deliverance of caring practices. (shrink)

Individual research protections provided by bioethical principles can be extended to group protections, particularly for place-based communities and cultural groups who may share a common harm or burden. In this article, an argument is made for the need to consider the group conditions of individual research subjects in the ethics of individual report-backs of human biomonitoring results. Human biomonitoring, the measuring of concentration of chemicals or their metabolites in blood, urine, breast milk, hair, and other biological samples, can provide an (...) assessment of an individual's exposure to a chemical and can integrate exposures from multiple pathways and sources. Biomonitoring studies have been increasing in the past decade for such purposes as measuring the levels of chemicals that are ingested by members of the general population and at what concentrations, to determine if exposure levels are higher in some groups vs. others, to track temporal trends to establish reference ranges for chemical exposures, and to investigate an association with health. (shrink)

In this article I argue that the ethics of care provides us with a novel reading of human relations, and therefore makes possible a fresh approach to several empirical challenges. In order to explore this connection, I discuss some specific normative features of the ethics of care—primarily the comprehension of the moral agent and the concept of care—as these two key elements contribute substantially to a new ethical outlook. Subsequently, I argue that the relational and reciprocal mode of thinking with (...) regard to the moral agent must be extended to our understanding of care. I term this comprehension “mature care”. Citing conflicts of interests as examples, I demonstrate how this conceptualization of care may further advance the ethics of care’s ability to take on empirical challenges. Finally, I discuss political implications that may emanate from the ethics of care and the concept of mature care. (shrink)

In “Conceptions of Care,” Tove Pettersen discusses and articulates select ways in which care can be comprehended. Several difficulties related to an altruistic understanding of care are examined before the author presents the case for a more favorable concept: mature care. Mature care is intended to take into account the interests of both parties to the caring relationship. This understanding of care facilitates the expression of the relational and reciprocal aspects of caring while emphasizing the equal worth of all involved. (...) Also attended to is the embeddedness of care in wider cultural and political contexts. (shrink)

This paper aims at addressing some questions considering the conflicting normative claims of partiality, i.e. to provide for the caring needs of the particular patient, and impartial claims of treating all patients with a relevant need equally. This ethical conflict between different conceptions of moral responsibilities within professional ethics relates to debates between an ethics of care and an ethics of justice. An ethics of care is a particularistic position that endorses some form of partiality, i.e. favouring persons to whom (...) one stands in particular relationships. This paper argues that also a professional ethics must endorse some kind of partiality at the clinical level of health care. In fact, consideration of care for particular patients is a prerequisite for giving proper and attentive care towards the individual patient. This paper will discuss how partial concerns might be balanced against claims of distributive justice within the frame of the formal principle of justice. It is concluded that there is an urgent need for the recognition of the consequences of macro-level decisions for the possibility of the discharge of moral responsibility on a clinical level of health care. This would mean that health care institutions should adapt for the possibility of a basic standard of proper care and attention for the individual patient. (shrink)

In this paper I introduce a theoretical framework on care developed by the Norwegian nurse and philosopher Kari Martinsen, and I argue that this approach has relevance not only within nursing, but also within clinical medicine. I try to substantiate this claim by analysing some of the key concepts in this approach, and I illustrate the potential clinical relevance of this approach by applying it in relation to two care scenarios. Finally, I discuss some of the concerns that have been (...) raised in relation to the aim of highlighting care in medicine. (shrink)

In this paper, I discuss the role of care and competence, as well as their relationship to one another, in contemporary medical practice. I distinguish between two types of care. The first type, care1, represents a natural concern that motivates physicians to help or to act on the behalf of patients, i.e. to care about them. However, this care cannot guarantee the correct technical or right ethical action of physicians to meet the bodily and existential needs of patients, i.e. to (...) take care of them—care2. To that end, physicians must be competent in the practice of medicine both as evidence—based science (technical competence) and as patient—centered art (ethical competence). Only then, I argue, can physicians take care of (care2) patients’ bodily and existential needs in a compassionate and comprehensive manner. Importantly, although care1 precedes competence, competence—both technical and ethical—is required for genuine care2, which in turn reinforces an authentic care1. I utilize the play Wit, especially the character Jason Posner, and Francis Peabody’s exposition on caring for patients, to illustrate the role of care and competence in contemporary medical practice. (shrink)

In this article, the relevance of justice in care is discussed, with special regard to long-term care. After a short introduction laying out the conceptual framework of justice and care, followed by an exploration of some special challenges within long-term care, this article consists of two main parts. The first part deals with justice as a general (secular) philosophical phenomenon and draws especially upon principles of justice as developed by John Rawls. Both the principle of fair equality of opportunity and (...) the difference principle, according to which an unequal treatment may be justified, provided that those “worst off” benefit mostly and are relevant within the field of care. The feminist debate about an ethics of care is also considered since its more recent contributions offer interesting attempts to mediate between justice and care. The second part of the article introduces a Christian perspective on justice, with relevance for (long-term) care. From a Christian point of view, one will even more strongly than Rawls argue for a conception of justice, which gives priority to those worst off. It is also argued that justice and care converge in the practice of diakonia. Diakonia, in many traditions synonymous with the caring dimension of the church, always had a special focus on long-term care. In this kind of church-based practice, justice and care are reconciled. (shrink)

The idea behind this article is to discuss the importance and to develop the concept of reciprocity in asymmetric professional relationships. As an empirical starting point for an examination of the possible forms of reciprocity between patients and nurses in psychiatry, we chose two qualitative in-depth interviews with two different patients. The manners in which these two patients relate to medical personnel—one is dependent, the other is independent—show that this presents challenges to nurses. The theoretical context is provided by the (...) notion of mature care as it has been developed by feminist-oriented ethics of care, in contrast to the notion of altruistic care. In relation to the concept of mature care, we discuss how nursing can be perceived in demanding relationships with patients in psychiatry. Reciprocity implies that, in principle, the interests of the nurses also matter in a nurse-patient relationship. We show that reciprocity—in practice—is complicated and challenging in a number of different ways. Mature care—with its systematic inclusion of relationships and reciprocity—provides an alternative understanding of what takes place between patients and nurses compared with an altruistic notion of care. As such, mature care can be regarded as an useful paradigm for nurse-patient relationships in psychiatry. (shrink)

This article approaches issues arising out of being in the middle of the first wave of the COVID-19 pandemic in Finland in March 2020, both from the point of view of the lived experience of caring for people in our conference setting, and through analysing the statements and actions of the Finnish government from the point of view of an ethics of care. It argues that an ethics of care approach is better equipped at dealing with thinking about and understanding (...) complex life situations such as the spread of the pandemic than what the standardised taxonomy approaches offer. It further states that an ethics of care not only provides concepts and frameworks that help people grapple with challenging situations in an ethical manner, it also enables us to imagine how hospitality and solidarity can be envisioned anew. (shrink)

Summary/abstractAn ethical assessment is a complex, dynamic and comprehensive process that requires both ethical expertise and practical knowledge. An ethical assessment of a genetically modified organism (GMO, including genome edited organisms) must follow accepted and transparent methods and be based in relevant considerations. In addition, the Ethical guidelines must include a broad and adequate range of values, so that no groups, stakeholders, agents or areas are left out.

In The Case for Animal Rights, Tom Regan argues that although all subjects-of-a-life have equal inherent value, there are often differences in the value of lives. According to Regan, lives that have the highest value are lives which have more possible sources of satisfaction. Regan claims that the highest source of satisfaction, which is available to only rational beings, is the satisfaction associated with thinking impartially about moral choices. Since rational beings can bring impartial reasons to bear on decision making, (...) Regan maintains that they have an additional possible source of satisfaction that nonrational beings do not have and, consequently, the lives of rational beings turn out to have greater value.. (shrink)

Through the vehicle of Nicolas Sarkozy’s so-called “Dakar Address” we will analyse the West’s persisting lack of insight into the need for a Western decolonization. We will try to identify the dangers that come from this refusal, such as the abidance in colonial patterns, the enduring self-understanding as superior com-pared to Africa, and the persisting unwillingness to accept the colonial guilt. Decolonization has to be understood as a two-fold business. Decolonization is over-coming endured and perpetrated violence. It is not only (...) important that the colonial oppressed regain strength, it is equally important that the perpetrator of colonial violence understand their excess of violence and work on effecting its return impossible. We explain how Western thinking remains dangerous and untrustwor-thy if it refuses its own decolonization. Finally, we will draw attention to a fundamental pattern of Western thought that clashes with the fundamental values of the West: contempt. In a final step we suggest how this contempt can be overcome through desuperiorisation and the establishment of elative ethics. (shrink)

Straipsnyje, analizuojant skirtingus Carol Gilligan darbus, pristatoma šiuo metu vis didesnį matomumą šiuolaikinėje moralės filosofijoje įgaunanti, bet Lietuvoje dar mažai žinoma rūpesčio etika. Gilligan yra amerikiečių psichologė, kurios pagrindiniai darbai skirti moterų psichologijos ir mergaičių vystymosi problematikai. Nors ir pripažįstamas jos, kaip rū-pesčio etikos pradininkės, statusas, tačiau neretai akcentuojamas jos darbų psichologinis, o ne etinis aspektas, tai yra, plėtojami empiriniai tyrimai, paneigiantys ar patvirtinantys moterų ir vyrų moralinio žodyno skirtumus, moralinių samprotavimų ir lyties koreliaciją. Šiame straipsnyje analizuosime, kaip Gilligan darbuose (...) susipina etinė bei psichologinė plotmės, ir teigsime, kad ją galima laikyti naujos etinės paradigmos pradininke, kadangi normatyvinę rūpesčio sampratą ji grindžia nauja moralės filosofijai reliacinio subjekto prielaida, tokio subjekto, kurį formuoja ir konstituoja santykiai su konkrečiais žmonėmis. (shrink)

Most punishment theories acknowledge neither the full extent of the harms which punishment risks, nor the caring practices which punishment entails. Consequently, I shall argue, punishment in most of its current conceptualizations is inconsistent with treating offenders as equals qua persons. The nature of criminal punishment, and of our interactions with offenders in punishment decision-making and delivery, risks causing harm to offenders. Harm is normalized when central to definitions of punishment, desensitizing us to unintended harms and obscuring caring practices. Offenders (...) may be partially silenced and excluded by mainstream criminal justice practices which limit interaction between offenders and practitioners. When we ignore significant harms, or silence and exclude, we treat others as passive non-subjects. This partially objectifies offenders, and is inconsistent with treatment as equals. Penal theories employing harm-centred and harm-normalizing definitions of punishment can provide few resources to help practitioners either avoid, or recognize and respond to, harms. Care ethics, by contrast, motivates the avoidance of harm, ongoing inclusive engagement, and respectful interaction with others. I argue that defining punishment without presupposing harm facilitates the identification of morally problematic harms, and recognition of caring practices. I offer a principled argument, and political and pragmatic supplementary arguments, for responding to offenders without intentional harm and with care. Principles drawn from care ethics can help to strengthen mainstream criminal practices by structuring decision-making and action. Bottom-up alternative criminal justice practices share some values with these proposed guiding principles, allowing a partial test of the principles. I consider examples of restorative justice practices, therapeutic jurisprudence, community justice and other problem-solving court practices, in addition to considering how well mainstream punishment practices measure up to these principles. My analysis illuminates the strengths and weaknesses of the principles, and how they might contribute to securing treatment as equals for offenders in mainstream practices. (shrink)