The literature on migrant care workers has tended to place little emphasis on the multiple relationships that migrant carers form with care recipients, employers/managers and work colleagues. This article makes a contribution to this emerging field, drawing on data from qualitative interviews carried out with 40 migrant care workers employed in the institutional and domiciliary care sectors in Dublin, Ireland. While the analysis revealed generally positive carer—care recipient relationships, significant racial (...) and cultural tensions were evident within the vertical and especially the horizontal relationships in the care workplace. The article argues that these findings highlight the need for additional research on the relationships formed in the long-term care sector and further theorizing on the meaning and importance of the affective components of care work within increasingly commodified care markets. (shrink)

This paper examines moral dilemmas faced by family caregivers of older adults who employ live-in migrant care workers. Being both a family caregiver as well as an employer of a live-in migrant care worker often puts family members at a crossroad, where moral decisions must be made. Lacking a formal role, family members do not have a professional code of ethics or other clear rules that can guide their actions, and their choices are rooted in (...) cultural, community, familial, and personal values. This paper discusses moral dilemmas that result from family caregivers’ dual commitment, to the wellbeing of their older sick relative who is the recipient of care, and to the wellbeing of the live-in care worker whom they employ. The paper uses relational ethics as a theoretical framework to discuss three cases that involve complex moral decision making in real life. (shrink)

In the current global care regime, care shortages in wealthy nations such as the United States, Canada, Italy, and Hong Kong are being addressed through the global supply of cheap migrant care labor from less wealthy nations. This paper argues that Feminist Care Ethics has a great deal to offer in the analysis of this global care regime. Joan Tronto's own critiques of the migration of care workers have focused on analogies between (...) workers and imported slaves: both are intrinsically exploited, vulnerable, excluded, and stigmatized. She argues that this situation undermines human virtue and the possibility of adequate care, and she advocates instead a model wherein caregiving is seen as a basis for .. (shrink)

Hiring international migrant eldercare workers to work hard for little pay simply because this traveling workforce needs wages higher than those they would receive back home seems somehow “wrong.” The standard justification for hiring migrants seems more like an excuse than a justification. My purpose in this article, however, is not to condemn people who hire international migrant eldercare workers, but to suggest that these employers as well as their employees are caught in the same moral (...) bind. Depending on how uncaring a state is about meeting its people’s fundamental needs including adequate long-term care, it will create a hostile environment for the development of caring people. But a society without a sufficient number of caring people risks unraveling. People who avoid care work and who shun the practice of care are, in my estimation, “marginal” to society in that they are not contributing to the foundation that makes society possible. (shrink)

My humanity is fractured if I neglect to care for vulnerable others. Indeed, if we grasp Virginia Held’s care ethics, we acknowledge that all humans are interdependent and that the vulnerable among us deserve particularly conscientious consideration—some level of care. Accordingly, I agree with Rosemarie Tong when she proposes that those who dodge caring roles marginalize themselves from society. This marginalization can occur if I squirm out of attending to my ailing family members’ needs, or if I (...) avoid (employment or volunteer) opportunities to care for those other than my family. It can also occur if I draw an arbitrary dichotomy between “work” and care, and devalue those in caring roles. Indeed, the United .. (shrink)

A care deficit is clearly evident in global cities such as London and is attributable to an ageing population, the increased employment of native-born women, prevalent gender ideologies that continue to exempt men from much reproductive work, as well as the failure of the state to provide viable alternatives. However, while it is now acknowledged that migrant women, and to a lesser extent, migrant men, step in to provide care in cities such as London, there is (...) less research on how this shapes the nature, politics and ethics of care. Drawing upon empirical research with low-paid migrant workers employed as domiciliary care providers in London, this paper explores the emergence of a distinct migrant ethic of care that is critically shaped by the caring work that migrant women and men perform. (shrink)

Women from post-socialist countries started migrating to Turkey in the second half of the 1990s to work in the domestic work sector. Migrant domestics have formed their niche as live-in caregivers, due to the disinclination of the existing local labour power to work in the care sector. Yet, the employer mothers, besides asking their live-in workers to tend their children, often demand that they also do the daily chores in the home, purposely leaving the heavy cleaning to (...) their Turkish domestics. This way, live-in migrant domestics are promoted from the status of foreign employees to fictitious family members, to eventually embody `the ideal housewife'. (shrink)

The feminization of care migration in transnational contexts has received a great deal of attention. Scholars, however, have been slow to investigate a similar trend in intranational contexts. This article expands existing research on global care chains by examining the gendered emotional labor of migrant domestic workers pertaining to China’s intranational care chains. While the former often foregrounds “racial or ethnic discounting,” the latter is characterized by “citizenly discounting” whereby migrant domestic workers are (...) subject to an overarching system of alienation, subordination, and exploitation owning to their second-class rural hùkŏu status. Drawing on a participant-observation study of nannies, this article highlights how the intersection of gender and rural-urban citizenship is the key to grasping China’s migrant domestic workers’ experiences of extensive alienation at the nexus of work, family, and wider society. By delving into a particular set of political, economic, and cultural forces in the Chinese context, the article makes a distinctive contribution to a more nuanced and context-sensitive understanding of the interface of gender, emotional labor, and care migration. (shrink)

Problem An estimated 100,000–500,000 migrant care workers provide live-in care in German households, many of them caring for older people with dementia. Social research has identified a wide range of structural social problems associated with live-in care. However, a systematic ethical analysis and discussion is still missing. Arguments This article explores the moral conflicts that arise in the microsetting of live-in arrangements for people with dementia. For this purpose, we conduct an ethical analysis of the (...) expectations of relatives towards live-in care for people with dementia based on a qualitative content analysis of 182 contributions from three German-language online forums. These expectations address live-ins as service providers, professional nurses, moral agents, and family members. Conclusion The diverse and often disappointed expectations of relatives are an expression of problematic and partly contradictory claims regarding live-in care for people with dementia. An ethical analysis of their legitimacy and coherence can help to improve the individual arrangement, the institutional organisation, and the moral framing and legal regulation of live-in care. (shrink)

Research on migrant care and domestic workers has focused on their multiple dislocations and exclusions in the diaspora, analysing a highly gendered global economy of care and domestic work. This article investigates the role of ritual performance and spirituality in female care workers’ projects of migration and in the emergence of their feminized and racialized subjectivities. On the basis of anthropological research in Israel and the Philippines, it analyses Filipina care workers’ narratives (...) of migration to Israel as a form of spiritual transformation, investigating their spiritual practices and emphasis on Christian morals like ‘compassion’ and ‘patience’ for their work. Israel, a country that has recruited Filipinos as carers for the elderly since the 1990s, is a destination country highly valued among Filipino Christians as the ‘Holy Land’. Focusing on evangelical Christians, the article portrays four women for whom migration to Israel signifies an ethical career: turning into ‘Holy Land’ pilgrims, Christ-like activists and missionaries, they are engaged in a deeply self-transforming journey. Rooting themselves in Christian spiritualities and morals, these women negotiate and ‘inhabit’ rather than openly challenge existing gender norms. Engaged in corporeal disciplining of their selves during affectively demanding care work, and in migration more generally, their moves are analysed as a form of ethical formation. (shrink)

Background Migrant live-in care workers are a main pillar of long-term care in many countries, including Germany. Several studies examining their working and living conditions reveal serious problems. However, a key element of live-in arrangements, namely the relationship between the individuals involved, has not yet been systematically investigated from an ethical perspective. Aim Building on previous socioempirical work that explored and set out the meaning of “care networks”, we start from the premise that live-ins are (...) embedded in a network of relationships which are essential for their employment and living situation. Methods The theoretical analysis draws on a network approach that takes care–ethical considerations into account. Using Joan Tronto’s four care–ethical phases, existing dependencies are described and reflected upon using the corresponding four care–ethical dimensions. The central questions are how dependencies in the live-in arrangement can be characterised based on the existing body of empirical studies and with a focus on the elements of power, dependency and trust in the ethical reflection on care. Results Based on this analysis, it becomes apparent that the ambivalence resulting from the simultaneity of different forms of asymmetry and mutual dependence is omnipresent in live-in arrangements and gives rise to seemingly contradictory forms of relationships and emotions. Responsibilities are vague and are constantly renegotiated on the basis of implicit assumptions and problematic role expectations and are also assigned without negotiation. Conclusions In the future, it will not only be necessary to better understand and clarify responsibilities at the micro level of the individual care arrangement from the various positions and roles and with a view to the changing processes of caring for another, but also to address the pressing ethical questions and problems in live-in arrangements at the meso and macro levels—enriched by care–ethical perspectives. (shrink)

BackgroundUndocumented migrants experience multiple institutional and legal barriers when trying to access healthcare services. Due to such limitations, healthcare workers often experience ethical dilemmas when caring for undocumented migrants. This article aims to understand how individual healthcare workers who regularly take care of undocumented migrants deal with these dilemmas in practice. So far, the role of healthcare workers in this context has mainly been theorized through the lens of biopolitics, conceiving of healthcare workers as merely (...) obedient instruments of humanitarian government or gatekeeping.MethodsBased on semi-structured, in-depth interviews and ethnographic observations with healthcare workers in Belgium, we explore how they ascribe meaning, reflect upon and give shape to care practices in relation to undocumented migrants. We use Foucault’s later work on care of the self to interpret the accounts given by the healthcare workers.ResultsHealthcare workers in clinical roles exercise a certain degree of freedom in relation to the existing limitations to healthcare access of undocumented migrants. They developed techniques such as purposefully being inattentive to the undocumented status of the migrants. They also try to master their affective responses and transform their bodily attitude towards undocumented patients. They perform practical mental exercises to remind themselves of their role or position in the wider healthcare system and about their commitment to treat all patients equally. These techniques and exercises are inspired by colleagues who function as role models, inspiring them to relate in an ethical way to limitations in healthcare access. The developed care practices sometimes reproduce, sometimes transform the legal and institutional limitations to care for undocumented migrants.ConclusionsThe findings nuance the biopolitical analysis regarding the role of healthcare workers in healthcare delivery to undocumented migrants that has been dominant so far. Theoretically this article provides a reconceptualization of healthcare ethics as care of the self, an ethical practice that is somewhat independent of the traditional professional ethics.Trial Registration Medical ethics committee UZ Jette, Brussels, Belgium – Registration date: 18/05/2016 – Registration number: B.U.N. 143201628279. (shrink)

The glaring lack of formal and informal caregivers in Germany has not only become apparent in hospitals and nursing homes but also in home care arrangements. One tension is particularly pertinent in such arrangements: a ‘family-oriented’ logic of the long-term care insurance and the individual wishes of those in need of care meet the actual possibilities of family carers. This care gap has been compensated for by 24-hour care workers, so-called ‘live-ins’, from Eastern Europe (...) for some years. This contribution maps the ‘live-ins’ situation comprehensively from an ethical perspective. Based on different constellations regarding the ‘live-ins’ status as a professional nurse or non-professional caregiver, which ethical principles and moral norms are affected by whom and potentially conflict with each other in such home care arrangements at a micro and meso level of care are outlined. Special attention is paid to the tension between self-care and care for others, and to questions of the shared responsibility in and social responsibility of those external services that are involved in home care in addition to the ‘live-in’. In order to uncover, understand and influence the current ethical problems, an ethical framework that considers both the divergent interests of all individuals involved in the home care arrangement and their mutual dependency and vulnerability is needed. (shrink)

Migrant farmworkers dominate the horticultural workforce in many parts of the Minority (developed) World. The ‘manual’ work that they do—picking and packing fruits and vegetables, and pruning vines and trees—is widely designated unskilled. In policy, media, academic, activist and everyday discourses, hired farm work is framed as something anybody can do. We interrogate this notion with empirical evidence from the Sunraysia horticultural region of Australia. The region’s grape and almond farms depend heavily on migrant workers. By-and-large, the (...) farmers and farmworkers we spoke to pushed back against the unskilled tag. They asserted that farmworkers acquire knowledge and skills over time and that experienced farmworkers are valuable—their value being brought into sharp relief against accounts of inexperienced farmworkers’ errors. Our interviewees provided rich insights into farmworkers’ engagements with crops and the intricacies of picking and pruning well. Far from being bereft of knowledge and skills, they recognised that experienced farmworkers bring benefits. They improve productivity, product quality and ultimately profits. This is especially so when open communication channels exist across the farm hierarchy, when experienced farmworkers’ insights are taken seriously by their employers. Our research is informed by organisational studies literature and scholarship on craft/making. Like factory floor workers and artisans, experienced farmworkers bring accumulated knowledge and skills to their work, gained through repeat performance. They reflect on and adjust their activities in dialogue with their materials and the environment. Experienced farmworkers demonstrate care, dexterity and judgement. They are not unskilled, and they are more than labouring bodies. (shrink)

The deteriorating situation of migrant workers’ health rights protection was once again highlighted in the case of Tseng Hei-tao. This case explicitly and implicitly showed that four conundrums—the Employment Restriction Conundrum, the Occupational Safety and Health (OSH) Legal Conundrum, the Morality Conundrum and the Identity Conundrum—are barriers to migrant workers’ right protection. The health rights of migrant workers could be safeguarded by abolishing the outdated household registration system designed in the planned economy era, improving (...) the rule of law, and strengthening administrative supervisions. This would fundamentally remove these barriers and thus contribute to migrant workers’ health rights protection. (shrink)

Migrant women are often stereotyped. Some scholars associate the feminization of migration with domestic work and criticize the “care drain” as a new form of imperialism that the First World imposes on the Third World. However, migrant women employed as domestic workers in Northern America and Europe represent only 2% of migrant women worldwide and cannot be seen as characterizing the “feminization of migration”. Why are migrant domestic workers overestimated? This paper explores two (...) possible sources of bias. The first is sampling: conclusions about “care drain” are often generalized from small samples of domestic workers. The second stems from the affect heuristic: imagining children left behind by migrant mothers provokes strong feelings of injustice which trump other considerations. The paper argues that neither source of bias is unavoidable and finds evidence of gender stereotypes in the “care drain” construal. (shrink)

This essay argues that Catholic (magisterial) social teaching's division of ethics into public and private creates a structural lacuna which makes it almost impossible to envision a truly just situation for migrant domestic careworkers (MDCs) within the current horizon of Catholic social thought. Drawing on a variety of sociological studies, I conclude that it is easy for MDCs to “disappear” between two countries, two families, and, finally, two sets of ethical norms. If the magisterium genuinely wishes Catholic ethicists to (...) address the plight of these migrant women, normative Catholic social teaching must pay more attention to household sociological realities and more fully absorb the feminist critique of the sharp line between the public and the private, between care and paid work. (shrink)

This paper examines nurses’ international migration within the broader context of female migration, particularly against more studied groups of women who have migrated for employment in care‐giving roles. We analyze the similarities and differences between skilled professional female migrants (nurses) and domestic workers (nannies and in‐home caretakers) and how societal expectations, meanings, and values of care and ‘women's work’, together with myriad social, cultural, economic and political processes, construct the female migrant care‐giver experience. We argue (...) that, as the recruitment of foreign workers gains visibility, strategies are introduced to better prepare female migrant care‐givers for the marketplace. Language, specifically command of English and accent modification, is highlighted as one means to assimilate migrant care‐givers to host communities. (shrink)

Growing demand for direct care workers to assist care-dependent elderly people has created an opening for migrant workers from low- income nations to sell their services to middle and high-income nations. Using Singapore as a case example, we draw on capability theory to make the case that receiving nations that import direct care workers should be held to global justice standards that protect workers’ floor level human capabilities. Specifically, we (1) show that (...) Singapore and other receiving nations fail to protect human capabilities at a threshold level required by dignity; (2) identify specific human capabilities placed at risk; and (3) recommend standards for receiving nations that support central capabilities. As populations in both developed and developing nations are rapidly aging, these concerns could not be timelier. (shrink)

The aim of this paper is to propose a research agenda for future studies of local forms of caregiving. It does this by exploring practices of care giving and receipt through the prism of childcare. Focusing on Nairobi, it investigates one critical form of care work in the city: the labour of women who work as ‘nannies’ in private homes, a form of labour that has received little systematic study or scholarly attention. Every day, women in Nairobi construct (...) complex and far-ranging care chains that ensure that the socially necessary labour of childcare takes place. The phenomenon of ‘diverted mothering’ that has been associated with the globalisation of care can also be understood as a local phenomenon. Whereas global care chains involving migrant domestic workers have been the focus of detailed investigation, hitherto the workings of more widespread and highly fragile local care chains in the cities of the third world have been neglected. We argue that it is critical to understand practices of intimate and emotional labour in the context not just of global migration but in situations of severe intersecting inequalities within the global south. (shrink)

Latinx migrant farmworkers face numerous barriers in accessing health care which are linked in part to self-medication practices using health products manufactured and sold abroad. This study explores the use of mail-ordered medication among the understudied population of Latinx migrant dairy workers in Vermont, a northeastern international border state. Thirty-four Latinx migrant dairy workers or their domestic partners were interviewed. Data analysis found that myriad health access barriers compounded by increased fear of law enforcement (...) as a result of international border proximity results in unequal knowledge about and local access to desired health care products and services. This unequal access experienced by those living closest to the border in addition to a familiarity and trust in Latin American pharmaceutical drugs, and varied experiences accessing health care services, are significant factors influencing the decision to request health products by mail. (shrink)

The metaphor of “care drain” has been created as a womanly parallel to the “brain drain” idea. Just as “brain drain” suggests that the skilled migrants are an economic loss for the sending country, “care drain” describes the migrant women hired as care workers as a loss of care for their children left behind. This paper criticizes the construction of migrant women as “care drain” for three reasons: 1) it is built on (...) sexist stereotypes, 2) it misrepresents and devalues care work, and 3) it misses the opportunity for a theoretical change about how skills in migration contexts can be understood. (shrink)

Despite the fact that there is unmet demand for nurses in health services around the world, some nurses migrate to destination countries to work as domestic workers. According to the literature, these nurses experience contradictions in class mobility and are at increased risk of exploitation and abuse. This article presents a critical discussion of the migration of nurses as domestic workers using the concept of ‘global care chain’. Although several scholars have used the concept of global (...) class='Hi'>care chains to illustrate south to north migration of domestic workers and nurses, there is a paucity of literature on the migration of nurses to destination countries as domestic workers. The migration of nurses to destination countries as domestic workers involves the extraction of reproductive and skilled care labor without adequate compensatory mechanisms to such skilled nurses. Using the case of the Canadian Live‐in Caregiver Program, the study illustrates how the global movement of internationally educated nurses as migrant domestic workers reinforces inequities that are structured along the power gradient of gender, class, race, nationality, and ethnicity, especially within an era of global nursing shortage. (shrink)

This article examines the relationship between globalization, care and migration, with specific reference to the ‘global care chain’ concept. The utility of this concept is explored in the light of its current and potential contributions to research on the international division of reproductive labour and transnational care economies. The article asserts the validity of global care chain analysis but argues that its present application to migrant domestic care workers must be broadened in order (...) that its potential may be fully realized. Accordingly, five ways in which the concept could be more broadly applied are outlined and applications of this expanded framework are illustrated through a case study of nurse migration in the Irish context. Finally, the discussion considers future directions for empirical and theoretical research into global care chains and suggests various lines of enquiry. (shrink)

This case study of Central American migration to Washington, DC closely examines how gender is related to the decision to migrate, as well as the choice of destination. The study investigates the social and economic conditions in sending Central American countries as well as those in a receiving city in the United States to determine why women predominate in certain labor migrations. A macrostructural analysis accounts for the conditions that delimit the flow of international migrants, but a concept termed gendered (...) labor recruitment provides the link between macro- and microlevels of analysis. Results of the research indicate that approximately seventy percent of the initial Central American migrants to the nation's capital in the 1960s and 1970s were women and that their migration may be attributed partly to informal labor recruitment. Over the years, Washington's government, diplomatic and professional workforce “recruited,” made arrangements for, or returned to the nation's capital with foreign workers who could provide basic services, primarily as domestics and child-care providers. (shrink)

Healthcare facilities in receiving countries regularly encounter guest workers whose need for acute or subacute care triggers the prospect of termination of employment and repatriation. In these scenarios, country‐specific migration and employment policies and norms of medical professionalism and ethics offer some guidance, but also create tensions. It is not clear under what conditions such medical repatriation is ethically permissible.This paper analyses the application of a previously articulated criteria for the ethical medical repatriation of undocumented immigrants, to the (...) situation of documented guest workers, with focus on the context of Singapore. We examine how these standards could be adapted and applied to the provision of care for guest workers, and argue that healthcare institutions and medical professionals have a duty to intervene in employers’ decisions to repatriate guest workers for medico‐economic reasons when repatriation essentially amounts to ‘patient dumping’. Barriers and challenges in implementing the criteria, and their possible solutions will be discussed. (shrink)

International migration has a female face in the beginning of the twenty-first century; since at least 1990, a total of 49 percent of international migrants have been women (UN 2008).1 Many women relocate in pursuit of goals that they can’t realize in their countries of origin, and many women move on their own to developed countries as caregivers to the very old or the very young, as nurses to attend to the sick in hospitals, and as domestic workers.2 How (...) should we regard their decisions to do so? One way of thinking about such moves is to deplore the fact that women have to move in order to attain certain goals in their lives; it would be more desirable to live in a world that would not make such moves necessary... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Driven from Home: Protecting the Rights of Forced Migrants Edited by David Hollenbach, SJ, and: Kinship across Borders: A Christian Ethic of Immigration by Kristen HeyerRené M. Micallef SJDriven from Home: Protecting the Rights of Forced Migrants EDITED BY DAVID HOLLENBACH, SJ Washington DC: Georgetown University Press, 2010. 296 pp. $20.46Kinship across Borders: A Christian Ethic of Immigration KRISTEN HEYER Washington DC: Georgetown University Press, 2012. 210 pp. (...) $29.23Although based on a conference held at Boston College in November 2008, Driven from Home is no less timely today, given the context of current debates on immigration in the United States, the European Union, Australia, and the Middle East. David Hollenbach’s introduction explains how the book brings together Christian (mostly Catholic) theologians, human rights activists, humanitarian practitioners, and legal scholars to help us focus on a class of persons referred to as “forced migrants” or “persons needing protection.” These individuals are neither classical “convention refugees” (according to international law definitions) nor are they simply “migrant workers” (in the classical sense) since their basic human rights to security and subsistence cannot [End Page 230] be adequately guaranteed in their home country or region. They do not emigrate merely in search of a higher standard of living; rather, forced migrants enter and settle in foreign lands seeking some sort of “protection” similar to that afforded to “conventional” refugees. More concretely, the book focuses on persons on the move—individuals fleeing violence and the extreme poverty rampant in regions devastated by ecological degradation and natural disasters.Extending the logic of the 1952 Refugee Convention and adapting it to the realities of today, one can argue convincingly that the international community has a duty to protect such persons when their states of origin are structurally unable or unwilling to afford protection (as argued in Susan Martin’s essay). However, paternalistic approaches that diminish rather than augment the agency of local governments and migrants are to be avoided (as maintained in M. Brinton Lykes’ essay). The book helps us reflect on what can be done to guarantee the basic rights of forced migrants not only at the level of international law and institutions but also through domestic and regional policymaking spurred and inspired by both Christian and secular global-humanitarian values. Such values are eminently compatible when applied to this particular issue (see Silvano Tomasi’s contribution). Agbonkhianmeghe Orobator’s essay—which offers insightful reflections (albeit rather general ones) from Christian ethics, ecclesiology, and biblical theology—likewise points to the need for a truly interdisciplinary approach to the issue. The other authors help the book achieve precisely this. Theological ethics finds its own distinctive place and voice in dialogue with a range of perspectives: legal and political sciences and case studies (Frank Brennan, Daniel Kanstroom); philosophical approaches (Arash Abizadeh); and sociological research on particular migrant populations (M. Brinton Lykes, Maryanne Loughry). The book includes essays that integrate case studies, technical reflections, useful summaries of theological principles and doctrines (J. Bryan Hehir, Mary M. DeLorey, and Tomasi), and philosophical stances (Abizadeh, Thomas G. Weiss), and present practical and legal proposals (see Martin’s essay). A stimulating read for scholars and for the general public, the volume provides good training material for faith-based activists and practitioners.The argumentation strategy in many of the essays in Driven from Home is to appeal to the reader’s sense of solidarity with the needy or suffering neighbor. It promotes the virtues of hospitable citizenship and hospitable disciple-ship while carefully trying to convince national and international policymakers to reinforce and expand the international protection regime. Emboldened by the 2005 “Responsibility to Protect” breakthrough at the United Nations, the authors seek to remain acceptable to a wide audience in an atmosphere of resurgent nationalism, nativism, and protectionism. The authors generally avoid harsh critiques of Westphalian models of sovereignty and do not dwell [End Page 231] on the Catholic doctrines of the universal destination of created goods and the (circumscribed) right to immigrate (and not only to emigrate). Rather, they seek to introduce a new protection niche without fundamentally challenging the prevailing ideology of sovereignty, gently proposing new legal instruments as though they... (shrink)

Do societies have an ethical responsibility to care for and about the health of undocumented migrants? Some people claim that societies have no responsibility to care for undocumented migrants because these migrants have no legal right to be in the country. But this view tends to ignore ethical responsibilities that are independent of legal status. Other people claim that all human beings, in virtue of their dignity and status as human beings, have a right to the highest standard (...) of health. But this view tends to ignore ethical responsibilities that arise out of relationships between a society and the undocumented migrants who are living and working in that society. In this article, I take a different approach. In the case of undocumented workers, I try to show how these workers are used in the economy and why a widely accepted pattern of responsibility should be extended to them. In the case of undocumented young people, I try to show how these people are socialized in a society and why a widely accepted pattern of responsibility should be extended to them. Toward the end of this article, I reflect on the nature and limits of these arguments. (shrink)

Food provisioning refers to the mental, physical and emotional labor involved in providing food for oneself and one’s family. The labor of food provisioning has been found to be made more difficult by a number of factors, including gender, socioeconomic status, age, and geography. However, little research has been done examining the labor of food provisioning among farm workers, a significantly marginalized population in the United States. In order to examine the food provisioning strategies and struggles of farm (...) class='Hi'>workers, we have been conducting pilot research with Latinx agricultural workers in southwestern Idaho. Employing a range of qualitative and quantitative methods, we examine the various strategies that farm workers use to provide food for themselves and their families, including accessing food banks, utilizing food stamps, purchasing groceries and accepting food from friends, family and employers. We consider this from a wider lens of “caring labor”. In addition, we explore food provisioning strategies in the context of economic and demographic changes in Idaho. We observe the ways in which changing crop patterns, in particular the growth the hops industry, relates to a transition in the labor force, especially an increase in women farm workers. We have also observed a shift away from employing migrant farm labor and towards the employment of “settled” Latinx residents from surrounding communities. These changes all influence the labor of food provisioning for rural Idaho Latinx families. (shrink)

In this article, the authors take up the historical figure of Dr Betty Paërl, who has surprisingly turned up in very different kinds of specialised archives. The white mathematics professor was located in IHLIA LGBT+ Heritage, the largest queer heritage collection in Europe, as a notable SM sexpert and spokesperson on transgender politics, and also found during archival research into the anti-(neo)colonial struggles of Suriname against the Dutch. Upon closer inspection of the materials, the authors find the recurrent image/item of (...) the whip that presses them to carefully think through how the archive of Dr Paërl casts light on a history that Katherine McKittrick calls being ‘in the shadow of the whip’. The article aims to combine an analysis of these versions of the whip in different visual and discursive registers to detect the liberatory politics underlying her activisms. To do so, the authors develop the intersectional model of the kaleidoscope employed by Dutch Black, migrant and refugee (BMR) feminist theorists to grasp the shifting patterns of power that Paërl battled and embodied as an activist of the anticolonial struggle, for sex workers’ rights, for kinky sex and for transgender people. This is all the more important in the historical study of transgender visual materials that most often arrive in archives via medical and police photography or pornographic materials. The historical researcher, the article argues, should be wary of (re)producing a static vision that would reduce transgender figures to sex and gender politics, or eclipse a vision of trans politics that dilates beyond sexuality. (shrink)

Because of the gradual aging of the population, hospital facilities for socio-sanitary care of the elderly are quite scarce relative to the very high number of elderly people present in the country. This has pushed a high number of families to privately hire home-care workers. The scientific literature gives a picture of the psycho-physical risks that this type of profession is exposed to; however, there is still a need for a more systemic reflection with regard to representations (...) about their role and competences. The aim of the present study is to outline the representations of the role and the skills it requires from home-care workers’ point of view. We reconstructed how home-care workers perceive and define the profession, and understand the necessary skills required from their point of view. Our results show that the professional profile of home-care workers still remains poorly defined and that professionals themselves struggle to find value and recognition, and to articulate what the skill set they develop is formed of. (shrink)

The Covid-19 pandemic broke on a world whose grip on epistemic trust was already in disarray. The first months of the pandemic saw many governments publicly performing reliance on epidemiological and modelling expertise in order to signal that data would be the basis for justifying whatever population-level measures of control were judged necessary. But comprehensive data has not become available, and instead scientists, policymakers and the public find themselves in a situation where policy inputs determine the data available and vice (...) versa. This essay asks how we can live with what Amoore has termed ‘post-Cartesian doubt’ in situations of existential risk, and what kind of approach to science and data can answer the moral and human demands of a situation such as the Covid-19 pandemic. I suggest that science and policy could be able to control the pandemic better by addressing the sources of uncertainty and missing data not as gaps in the information landscape, but as individuals who are likely to be members of less-visible and less powerful groups including low-wage workers, the elderly, migrants, prisoners and others. This would shift both data use and policy toward an ethics of care, an embodied approach which asks what people need and how they behave in relation to each other, rather than how to manage population-level behaviour. This approach, I argue, is more appropriate for pandemic response than a utilitarian calculation of how many people each country should expect to lose as a result of the disease. (shrink)

This paper investigates a moral conflict that care workers, defined as workers who care for dependent others, confront when they go on strike. Care workers who confront decisions about whether to go on strike are, in my analysis, caught between impossible options: Should they prioritize the needs of those who are currently dependent upon them, and forego striking, or prioritize their long-term ability to provide the best possible care, and partake in strikes? I (...) argue that care workers who confront these decisions are often caught in a tragic moral conflict where “moral failure” is inevitable. However, I argue that we should place blame for said moral failures not upon striking care workers themselves but upon employers and others responsible for creating the decision contexts in which care workers must morally fail. I also argue that those responsible for creating the decision contexts in which care workers must morally fail are guilty of various moral and material harms to care workers. (shrink)

Department of Philosophy and Center for Health Policy, Research and Ethics, George Mason University, 4400 University Avenue, MS 2D7, Fairfax, VA 22030, USA. Tel.: +1 703 993 1724; Fax: +1 5703 993 1555; Email: leckenwi{at}gmu.edu ' + u + '@' + d + ' '//--> . Abstract Here I consider the migration of health workers and propose a conception of transnational justice that can best address the concerns it raises, including the perpetuation of global health inequities. My focus will (...) be on nurses and direct care workers (DCWs), also called paraprofessionals—the vast majority of whom are women—coming from the global South to the United States. In the first part of the paper I will identify the factors behind this flow of what I will hereafter call ‘care workers’. From there, I will describe a conception of transnational justice that seems especially promising and explore selected policy options. Finally, I will conclude by offering specific prescriptions for action on the part of a wide range of agents, including institutions as well as individuals. CiteULike Connotea Del.icio.us What's this? (shrink)

Clinical Ethics, Ahead of Print. The migration of health-care professionals has often produced morally charged discussions among ethicists, politicians, and policy makers in the migrant-sending and migrant-receiving countries because of its devastating effects on the health of those left behind in the countries of origin.This movement of skilled professionals – their decision to leaving their countries of origin in search of better work environments – has created a phenomenon that has been described as brain drain. Although the (...) migration of health workers continue to bring prosperity to millions of people around the world, they have also evoked hopelessness in many more people. Thus, questions of global justice manifest themselves when it comes to the matters of brain drain and the just distribution of health and healthcare professionals. (shrink)

This article argues that intersectional analyses of care work also need to include a temporal aspect. Drawing on ethnographic research on Slovak au pairs working in the UK and on interviews with both providers and employers of paid childcare in Slovakia, I examine how the temporariness of care work is created within both migrant and non-migrant settings. In particular, I demonstrate that both employers and providers conceptualise paid childcare as a temporary period in their lives and (...) show the consequences of this conceptualisation in their valuing of care work. In both examined cases, I focus on the role of care/welfare and migration regimes in the production of temporariness in care work and argue that both providers and employers of paid care construct their involvement in domestic work as a specific life course experience. While for au pairs, working stays in the UK represent a specific transition period from adolescence to adulthood, employers in Slovakia decide to employ particular types of domestic workers in relation to the particular developmental phases of their families and households. (shrink)

Accidental human immunodeficiency virus (HIV) infection of patients in health care settings raises the question about whether patients have a right to expect disclosure of HIV/AIDS diagnoses by their health workers. Although such a right – and the correlative duty to disclose – might appear justified by reason of standards of informed consent, I argue that such standards should only apply to questions of risks of and barriers to HIV infection involved in a particular medical treatment, not to (...) disclosure of personal diagnoses. Because the degree of risk of HIV infection is low and disclosure would also have damaging consequences for health workers, and because patient protection is available in other ways, it is argued that no such generalized right should be recognized. Keywords: duty to disclose, HIV infection, HIV/AIDS diagnosis, informed consent, right to know CiteULike Connotea Del.icio.us What's this? (shrink)

Care workers frequently withdraw from elderly people in their care; this has resulted in a number of scandals in the media. Here I analyze an empirical scene observed at an old people’s home in Denmark, which contains behavioral patterns among the care workers which could be seen as withdrawal. At the same time it illustrates the care workers' commitment to the elderly. A paradoxical "empathy at a distance" is characteristic of the scene. When (...) analyzing my written observations in an interpretation group, my use of language was a point of discussion. What did it mean when I described the interactions between care workers and elderly residents in words commonly used to describe mother-child interactions? My use of language became a "hermeneutical key" which enabled a psychoanalytically inspired interpretation. This focuses on the care relationship as activating our earliest memories of our own care relations, independently of whether we are in the role of care providers or care receivers. Through collusion theory, the interpretation accepts both the anxiety which the helpless elderly people arouse in the care workers and their motivation for care work as two sides of a subjectively important theme. The article illustrates how working consciously with the researcher's subjectivity makes it possible to understand apparently irrational patterns. The insights thus gained may be used to prevent withdrawals in care work as an argument for care workers’ need for emotional supervision. (shrink)

Background Professional values create a basis for successful collaboration and person-centred care in integrated care and services. Little is known about how different health and social care workers assess their professional values. Research aim To describe and compare professional value orientation among different health and social care workers in Finland. Research design A quantitative cross-sectional study. Participants and research context We carried out an online survey of health and social care workers from (...) 8 March to 31 May 2022, using the Finnish version of the Nurses’ Professional Values Scale-3. The data were analysed using descriptive and advanced statistics. Ethical considerations Permission was received from all participating organizations and those who completed the survey provided informed consent. Results A total of 1823 health and social care workers, representing seven professional groups and students, took part. The overall level of professional values among the participants was relatively high. Commitment to providing patients and clients with equal care was more important than engaging with society and professional responsibilities in the work environment. Professional values were strongest among professionals with higher educational degrees and training in professional ethics. The same was true for workers who received organizational support for ethical practice, were satisfied with their work and had shorter work experience. Discussion Our results showed shared professional values among different health and social care workers and students. These results are meaningful for integrated care and services. At the same time, a clear need for strengthening engagement with society and professional responsibilities for developing work environments were identified. Conclusions Health and social care workers and students need training in professional ethics and organizational support for ethical practice and work satisfaction to maintain their professional values at different stages of their career. (shrink)

This article considers whether there is a specific demand for migrant domestic workers in the UK, or for workers with particular characteristics that in theory could be met by citizens. It discusses how immigration status can make it easier not only to recruit domestic workers, but also to retain them. `Foreignness' may also make the management of the employment relation easier with employers anxious to discover a coincidence of interest with the worker. Employers are not only (...) looking for generic `foreignness' however, but typically also seek particular nationalities or ethnicities of worker, which can raise difficulties for agencies who are not allowed to discriminate on the basis of `race'. (shrink)

This article addresses a stated need within the food justice movement scholarship to increase the attention paid to the political socialization of hired farm hands in industrial agriculture. In Canada, tackling the problem of farm worker equity has particular social and political contours related to the Canadian horticultural industry’s reliance on a state-managed migrant agricultural labour program designed to fill the sector’s labour market demands. As Canada’s Seasonal Agricultural Worker Program produces relations of ‘unfree labour’, engaging migrant farm (...) workers in social movement initiatives can be particularly challenging. Critical educational interventions designed to encourage migrant farm workers’ contribution to contemporary social movements in Canada must therefore confront the socio-cultural obstacles that constrict migrant farm workers’ opportunities to participate as full members of their communities. In this article, I argue that social justice oriented approaches to community-based arts can provide a means for increasing the social movement contributions of farm workers employed through managed labour migration schema such as Canada’s SAWP. (shrink)

Drawing on insights from scholarship on contentious action frames, this article examines the framing of demands for social justice for migrant farmworkers in Spain, Italy and Canada during the COVID-19 pandemic. We focus particularly on how activists in each country aligned their action frames with prevalent public discourses on the essential contribution migrants make to agricultural production, the need to guarantee “health for all,” and “increased vulnerability” of migrants’ lives during the global health crisis. Using these diagnostic frames, activists (...) in the three countries called for secure legal status for all migrants. Drawing on the literature on contentious action frames, we then analyze if action frames advanced by activists during the COVID-19 pandemic “resonated” with the understanding of these issues by policymakers. We challenge an approach to understanding resonance in binary terms as either present or absent. Instead, we introduce the notion of “ambivalent resonance” to draw attention to the fact that some frames are accepted only partially or only by some policymakers but not the others, as was the case in the three countries under study. We then situate this ambivalent resonance in the context of immigration priorities and recent trends in immigration policy development in these three countries and suggest that activists can build on ambivalences to advance migrant rights to status. (shrink)

Recent research points to the fact that new medical technological innovations are just as relevant in the context of long‐term care or chronic care as they are in the context of acute care. In the spirit of the Nuffield Foundation recommendations, this paper explores the possibilities of using robotic aides in long‐term care and identifies the tensions that must be considered and addressed if robotics is to be introduced successfully in nursing homes. Our examination is two‐pronged. (...) First, we delve into a fundamental issue surrounding AI, namely that of consciousness. We argue that automation will always have only a limited use in caregiving since caregiving as an activity requires the use of human‐type, that is, organic, consciousness. We support the thesis that the emergence and formation of human‐type consciousness require feelings such as empathy and the sense of touch, which, in turn, create the sense of kinship with fellow human beings. And second, we examine the benefits as well as risks of using robotic aides such as ZORA and PARO in long‐term care facilities. More specifically, we look at ZORA's use in a group setting, and PARO's use in an individual setting. We emphasize that long‐term care is one‐on‐one care, including but not limited to intimate care. Crucially, we argue that touch is at the heart of this type of care. We argue that some of the tensions with the use of robotic aides are generated precisely because of the lack of human touch. (shrink)

This thoughtful reflection on a valuable questionnaire survey of patients' attitudes regarding being told that their dentist had been infected with hepatitis B is of very direct relevance to HIV, as the authors show.1 The measured tone and analytical approach are a welcome change from the stridency that has characterised some of the debate elsewhere. I am very conscious that more time and effort has gone into drafting and redrafting, amending, revising and refining policy in this area than in any (...) other area of HIV control, with the probable exception of blood transfusion. Yet this is the setting that has the lowest risk among all established routes. Why has it been so hard to establish a satisfactory policy and practice to deal with this situation?Many factors, of course, apply. However, much seems to stem from a prevailing view, fostered by recent political administrations, that health care can be delivered in a risk-free way. This has also been linked with a “blame culture”, where adverse outcomes are seen as someone's fault, and where the professions are regarded with distrust. It has been fuelled by levels of concern about risk for HIV that have stemmed more from media “stories” about risk than careful risk assessment.Hence Blatchford et al comment that public anxiety about HIV relative to hepatitis B was a factor in assessing how the incident was handled, implying that HIV was of greater concern - even though the risk of transmission is some two orders of magnitude less. Interestingly, they also comment that, because the risk of death with HIV is higher than for hepatitis B, this balances the overall risk. I am not sure of the validity of this argument, …. (shrink)

The New Charter for Health Care Workers is a revision and updating of the earlier 1994 edition, also produced by the Pontifical Council for Health Care Workers. The work is divided into three major sections: "Procreating," "Living," and "Dying," each of which lays out authoritative teachings in medical ethics grounded in the traditional resources of the Church.