This book presents the first systematic account of dependency care in a liberal theory of justice. Despite the fact that receiving dependency care is necessary for human survival, the practices with which we meet society’s care needs are seldom recognized for their functional role. Instead, norms about gender and race obscure and shape expectations about whose needs for care are legitimate as well as about whose caregiving labor more advantaged members of society will receive. These opaque arrangements must be made (...) visible if we are to remedy skewed intuitions and judgements about care. Freedom to Care develops a modified form of social contract theory with which to evaluate society’s caregiving arrangements. Building on work by feminist liberals and care ethicists, it reframes debates about care to move beyond gender with an inequality-tracking framework that can be employed in any culture. Because care provision has been enmeshed in the subordination of women and people of color, eliminating the invisibility of these forms of labor yields a critical liberal theory of justice with feminist and anti-racist aims. (shrink)

Caring for Liberalism brings together chapters that explore how liberal political theory, in its many guises, might be modified or transformed to take the fact of dependency on board. In addressing the place of care in liberalism, this collection advances the idea that care ethics can help respond to legitimate criticisms from feminists who argue that liberalism ignores issues of race, class, and ethnicity. The chapters do not simply add care to existing liberal political frameworks; rather, they explore how integrating (...) dependency might leave core components of the traditional liberal philosophical apparatus intact, while transforming other aspects of it. Additionally, the contributors address the design of social and political institutions through which care is given and received, with special attention paid to non-Western care practices. This book will appeal to scholars working on liberalism in philosophy, political science, law, and public policy, and it is a must-read for feminist political philosophers. (shrink)

This author’s reply addresses critiques by Daniel Engster, Kelly Gawel, and Andrea Westlund about my 2020 book, Freedom to Care: Liberalism, Dependency Care, and Culture. I begin with a statement of my commitment to liberalism. In section two, I defend the value of a distinction between conceptions of persons in the real world and in contract theory to track inequalities in care when indexed to legitimate needs. I argue, as well, that my variety of contract theory supplies the normative content (...) needed to reject the subordination of women of color. Acknowledging the enduring danger of expressive subordination, I emphasize my theory’s compatibility with the full social inclusion of people with disabilities. Section three then defends liberal dependency care’s compatibility with radical critique and transformative change by emphasizing the abstract nature of its core theoretical module. Finally, in section four, I reaffirm conceptual distinctions between autonomy skills, care skills, and a sense of justice by explicating their theoretical roles. In that section, I also embrace Westlund’s insight that theorists of justice need to have skills enabling responsiveness to other perspectives. To this new requirement for actual theorists of justice, I further add that we must attain capacities to engage critically with our society’s norms. Thus, the final section of this article supplements the justificatory module of liberal dependency care, building from the necessary conditions specified as two-level contract theory toward an account of necessary and sufficient conditions for this liberalism’s justificatory module. (shrink)

Dependency care is an asymmetric good; everyone needs to receive it, but it is not the case that we all have to provide it. Despite ethicists’ of care’s theorizing about the importance of dependency care, it has yet to be theorized within a form of liberalism. This paper theorizes two components of a liberal theory of dependency care. First, it advances a liberal justification to include the receipt of dependency care among the benefits of social cooperation. Then, it advances an (...) autonomy-based principle to guide how care should be provided (“strong proceduralism”). Strong proceduralism is based on an account of autonomy that incorporates the significance of a person’s skills when he parses options. Strong proceduralism consequently requires educational efforts to teach care-giving skills to groups who have not previously possessed them. I hypothesize that strong proceduralism will secure adequate care provision as the outcome of autonomous choice, but if an inadequate number of people choose to provide care, then a secondary stage of deliberations will be necessary. If the outcome of those secondary deliberations is that people want to have their care needs met, then a fair process for distributing infringements on autonomy must be devised. (shrink)

This essay assess the compatibility of Eva Kittay's dependency critique with Rawlsian political liberalism. I argue for the inclusion of a modified version of Kittay's revisions within Rawlsian theory in order to yield a theory that suppports a substantial subset of dependency work. Beyond these selected changes, however, I argue that Kittay's other proposed changes should not be included because they are incompatible with Rawls, and furthermore, their incorporation does not yield a theory that includes utter dependents.

This paper advances a Millian concept of care by re-evaluating his defense of the “common arrangement,” or a gendered division of labor in marriage, in connection with his views about traditionally feminine capacities, time use, and societal expectations. Informed by contemporary care ethics and liberal feminism, I explicate the best argument Mill could have provided in defense of the common arrangement, and I show that it is grounded in a valuable concept of care for care-givers. This dual-sided concept of care (...) theorizes care-giving both as a domain of human excellence and as labor with accompanying burdens. Liberal feminists should adopt this Millian concept of care, which can then inform principled thinking about distributive arrangements. (shrink)

The value of autonomy is a hallmark of liberal doctrine. It would seem to follow that liberals must reject the practice of “arranged marriage” on the grounds that the “arranging” component of the practice eschews autonomy and individuality. However, in policy debates in Great Britain, the difference between “arranged marriage” and “forced marriage” has been defined as the presence of autonomy or free choice for an arranged marriage and their absence in cases of forced marriage. A paradox seems to result: (...) arranged marriage is defined as a marriage practice that both rejects autonomy and requires autonomy. In this article, I will show that the resultant paradox arises from the inadequacy of the autonomy analysis rather than from any intrinsically puzzling feature of arranged marriage. I then offer an alternative normative framework to assess arranged marriage’s potential contribution to a just society. My tri-metric analysis for arranged marriage includes the autonomy of the participants (Metric 1), as well as two societal metrics: the fairness of the distribution of care-giving labor (Metric 2) and the degree to which the society meets its members’ legitimate needs for care (Metric 3). (shrink)

This essay responds to Jan Narveson’s libertarian commentary on my earlier work “Liberal Dependency Care.” There, I argued that the underlying logic of the circumstances of justice warrants adding care to a liberal theory of justice. In this essay, I rebut Narveson’s skeptical claims about the liberal credentials of my justificatory argument by identifying the extent to which my view shares the same reasonable constraints on liberty as those defended by John Stuart Mill. I also suggest that a libertarian refusal (...) to add care to the core functions of the state is plausible only if women’s labor remains invisible. Finally, I refute Narveson’s contention that my strong procedural principle of care provision is incipiently totalitarian. The case for public support to teach basic levels of attentiveness and responsiveness is analogous to the case for teaching the foundational skills of arithmetic, which are legitimately taught in primary and secondary schools. (shrink)

Accountable Care Organizations are a key mechanism of the Patient Protection and Affordable Care Act. ACOs will influence incentives for providers, who must understand these changes to make well-considered treatment decisions. Our paper defines an ethical framework for physician decisions and action within ACOs. Emerging ethical pressures providers will face as members of an ACO were classified under major headings representing three of the four principles of bioethics: autonomy, beneficence, and justice. Conflicts include a bias against transient populations, a motive (...) to undertreat conditions lacking performance measures, and the mandate to improve population health incentivizing life intrusions. After introducing and explaining each conflict, recommendations are offered for how providers ought to precede in the face of novel ethical choices. Our description of novel ethical choices will help providers know what to expect and our recommendations can guide providers in choosing well. (shrink)

This summary of Freedom to Care begins with the core claims and conceptualizations upon which the theory of liberal dependency care rests. It then summarizes the book’s chapters. The first five chapters (Part I) delineate its theoretical foundations, which include the two-level contract theory approach to distributive justice for caregiving arrangements. In Part II of the book, chapters six through nine, I formulate liberal proposals for justice-enhancing social change before identifying cross-cultural metrics of justice for the internal evaluation of caregiving (...) arrangements. (shrink)

The negative health effects of stress are well documented in medical and psychological research, but these effects are underexplored in political philosophy. This essay evaluates these effects in relation to the explanatory and normative value of the concept that I call “being at home.” The phenomenological description of the state of being at home is the sense of feeling safe and at ease in your context, and therefore able to relax. Although it characterizes a particular state of being for an (...) individual person, its conditions are relational. I show how the normative value of being at home can guide nonideal action-guiding recommendations to respond to racism in light of the claim that one of the negative effects of racism is a steady stream of disruptions to a person’s sense of ease in the world. Racism and microaggressions create stress, which then causes further negative health effects to the minority body. Consequently, the physical harms perpetrated by racist and sexist societies on the members of oppressed identities can be as great as the effects of actions standardly understood as violence. Demonstrating that a nonideal theoretical approach to bioethics is well suited to evaluating the philosophical ramifications of the bodily damage incurred by microaggressions, I recommend selective and episodic separatism from the perpetrators of microaggressions as a health-protective response to the realities of living in an unjust world. (shrink)

This summary of Freedom to Care begins with the core claims and conceptualizations upon which the theory of liberal dependency care rests. It then summarizes the book’s chapters. The first five chapters (Part I) delineate its theoretical foundations, which include the two-level contract theory approach to distributive justice for caregiving arrangements. In Part II of the book, chapters six through nine, I formulate liberal proposals for justice-enhancing social change before identifying cross-cultural metrics of justice for the internal evaluation of caregiving (...) arrangements. (shrink)

This author’s reply addresses critiques by Daniel Engster, Kelly Gawel, and Andrea Westlund about my 2020 book, Freedom to Care: Liberalism, Dependency Care, and Culture. I begin with a statement of my commitment to liberalism. In section two, I defend the value of a distinction between conceptions of persons in the real world and in contract theory to track inequalities in care when indexed to legitimate needs. I argue, as well, that my variety of contract theory supplies the normative content (...) needed to reject the subordination of women of color. Acknowledging the enduring danger of expressive subordination, I emphasize my theory’s compatibility with the full social inclusion of people with disabilities. Section three then defends liberal dependency care’s compatibility with radical critique and transformative change by emphasizing the abstract nature of its core theoretical module. Finally, in section four, I reaffirm conceptual distinctions between autonomy skills, care skills, and a sense of justice by explicating their theoretical roles. In that section, I also embrace Westlund’s insight that theorists of justice need to have skills enabling responsiveness to other perspectives. To this new requirement for actual theorists of justice, I further add that we must attain capacities to engage critically with our society’s norms. Thus, the final section of this article supplements the justificatory module of liberal dependency care, building from the necessary conditions specified as two-level contract theory toward an account of necessary and sufficient conditions for this liberalism’s justificatory module. (shrink)

Though accountable care organizations are increasingly important to American healthcare, ethical inquiry into ACOs remains in its nascent stages. Several articles have raised the concern that ACOs have an incentive to avoid enrolling high-cost patients and, thereby, have an incentive to deny care to those who need it the most. This concern is borne out by the reports of consultants working with newly formed ACOs. This paper argues that, contra initial appearances, there is no financial incentive for ACOs to avoid (...) enrolling high-cost patients. (shrink)

Book review of Serene Khader's "Adaptive Preferences and Women's Empowerment".