Background:The public domain of midwifery practice, represented by the educational and hospital institutions could be blamed for a subconscious ethical dilemma for midwifery practitioners. The result of such tension can be seen in complaints from maternity service users of dehumanised care. When expectations are not met, women report dehumanising experiences that carry long term consequences to both them and their child.Objectives:To revisit the ethical foundation of midwifery practice to reflect the feminist Ethic of Care and reframe what is (...) valuable to women and midwives during the childbirth experience.Research Design:A comprehensive literature review is presented from the midwifery and feminist ethics discourse.Ethical Considerations:Nil to report.Findings:Women are vulnerable during childbirth as they need care, yet they prioritise elements of relationship in their experience. The Ethic of Care approach equalises the relationship between the midwife and the woman, providing the space for relationship building and allowing midwives to meet the expectations of their accepted responsibility.Discussion:Some midwives manage to balance the demands of the institution with the needs of the woman. This is described as both an emotional and professionally challenging balancing act.Conclusion:Until there is a formal acknowledgement of the different ethical approach to midwifery practice from within the profession and the Institution, midwifery identity and practice will continue to be compromised. (shrink)

Since the mid-1980s, there has been a gradual ethical drift in the provision of maternal care in African health facilities in general, and in Cameroon in particular, despite government efforts. In fact, in Cameroon, an increasing number of caregivers are reportedly not providing compassionate care in maternity services. Consequently, many women, particularly the financially vulnerable, experience numerous difficulties in accessing these health services. In this article, we highlight the unequal access to care in public maternity services (...) in Cameroon in general and the Noun Division in particular. For this study, in addition to documentary review, two qualitative data collection techniques were used: direct observation and individual interviews. Following the field work, the observation data were categorized and analyzed to assess their relevance and significance in relation to the topics listed in the observation checklist. Interviews were recorded using a dictaphone; they were subsequently transcribed and the data categorized and coded. After this stage, an analysis grid was constructed for content analysis of the transcripts, to study the frequency of topics addressed during the interviews, as well as divergences and convergences among the respondents. The results of this data analysis showed that money has become the driving force in service provision. As such, it is the patient’s economic capital that counts. Considered “clients”, pregnant women without sufficient financial resources wait long hours in corridors; some die in pain under the indifferent gaze of the professionals who are supposed to take care of them. In sharp contrast, the findings revealed that financially privileged patients are able to bribe caregivers to attract their favour and obtain prompt, careful, and effective care. These ethical abuses observed in the Noun public health facilities drive women to use, from the beginning of their pregnancies to the delivery, only healthcare delivered by traditional health attendants. (shrink)

Starting from two paintings by Salvador Dalì (The Enigma of William Tell and Autumnal Cannibalism), the article explores Sigmund Freud and Carl Gustav Jung’s idea of erotic cannibalism. The fear of being eaten is an archetype of the collective unconscious, as fairy tales clearly reveal. Following Jacques Derrida’s reflections, the author suggests that the fear of being eaten is not limited to anthropophagic cultures, because there is a sort of symbolic cannibalism which has to do with the capacity for annihilation. (...) The petrifying gaze of Medusa, described by Jean Paul Sartre, is a good example of this symbolic cannibalism. On the opposite side of the spectrum, compared to the petrifying gaze, we find the recognizing look of a mother toward her child. For the child, the mother embodies the good subject, which is reassuring and nonthreatening (the fairy who stands in contrast to the devouring ogre in fairy tales). Sara Ruddick explicitly refers to this motherhood model in her book Maternal Thinking, where she lays out the methodology for the ethics of care. The maternal, or recognizing gaze, as the opposite of Medusa’s gaze portrayed by Sartre, is well described in a compelling text by the Italian novelist Luigi Pirandello. At the same time, it plays an important role in Georg Wilhelm Friedrich Hegel’s The Phenomenology of the Spirit. Finally, the article returns to Salvador Dalì, showing how in his life, the artist experienced the Other’s gaze in both forms: the objectifying one, represented by the artist’s father (portrayed in The Enigma of William Tell), and the recognizing one, embodied by his partner Gala (portrayed in Autumnal Cannibalism). (shrink)

RESUMEN En el contexto griego clásico, Demeter era venerada como diosa de la agricultura y protectora de la fertilidad. Asimismo, la relación entre esta deidad y su hija Koré-Perséfone representaba la fortaleza del vinculo maternal. Este artículo explora las dimensiones simbólicas de esta figura mitológica, poniendo de relieve sus conexiones con un modelo ético de maternidad asociado al cuidado y a la resistencia frente a las injusticias. Además, se aborda una lectura de este mito desde la perspectiva de la (...) teoria feminista contemporánea, mostrando su cercania con los planteamientos del ecofeminismo. ABSTRACT In the classical Greek context, Demeter was worshipped as a goddess of agriculture and a protector of fertility. Moreover, the relationship between this deity and her daughter Kore-Persephone represented the strength of the maternal bond. This article explores the symbolic dimensions of this mythological figure, highlighting its connections with an ethical model of motherhood related to care and resistance against injustices. In addition, this article approaches this myth from the perspective of contemporary feminist theory, showing its links with ecofeminism. (shrink)

Fetal and Maternal Bodies brings together the voices of abortion providers, abortion counselors, clinic owners, neonatologists, bioethicists, and historians to discuss how and why providing abortion care is moral work. The collection offers voices not usually heard as clinicians talk about their work and their thoughts about life and death. In four subsections--Providers, Clinics, Conscience, and The Fetus--the contributions in this anthology explore the historical context and present-day challenges to the delivery of abortion care. Contributing authors address (...) the motivations that lead abortion providers to offer abortion care, discuss the ways in which anti-abortion regulations have made it increasingly difficult to offer feminist-inspired services, and ponder the status of the fetus and the ethical frameworks supporting abortion care and fetal research. Together these essays provide a feminist moral foundation to reassert that abortion care is moral work. (shrink)

Modern mainstream ethical theories with its overemphasis on autonomy and non-interference have failed to adequately respond to contemporary social problems. A new ethical perspective is very much needed. Thanks to Carol Gilligan's 1982 groundbreaking work, 'In a Different Voice' , we now not only have virtue and communitarian ethicists, but also a group of feminist philosophers, charting a new direction for ethics that tempers modern ethics' obsession with autonomy, contractual rights, and abstract rules. Nel Noddings, in her 'Caring: (...) A Feminine Approach to Ethics and Moral Education', further contributed to this important discussion. In this work, Noddings proposes a new kind of moral ideal. She calls it "caring." Noddings defines "caring," as a direct, felt concern and action from the one-caring toward the well-being of the cared-for. In other words, care is a state of mental engrossment and motivational displacement that impels caring actions for the happiness of the cared-for and it transcends any rule-bound moral judgment. A caring attitude is best manifest in the spontaneous emotive bond of love between a mother and a child. This human relation of unscrutinized maternal love and care should be the model of ethics. Noddings's theory evokes a vigorous debate concerning whether or not the model can withstand rigorous philosophical scrutiny as a stand-alone ethical theory. This paper first discusses the strengths and weaknesses of a pure care ethics. Secondly, it demonstrates why both the Kantian and the Aristotelian attempts are unsatisfactory, and it offers a Confucian solution to the problems of care ethics. It argues that notwithstanding gender-oppressive practices that are at times associated with Confucianism, Confucian ethics of 'ren' (humaneness) is both more compatible with care ethics and is better equipped with conceptual resources than Kantian liberalism or Aristotelian virtue ethics to handle the moral predicament of the postmodern world. The paper demonstrates that care is an inherent element of Confucian 'ren' but that 'ren' is more than Noddings's care. It examines three essential principles that can be extracted from philosophical classical Confucianism: (1) an affectionate and particularistic approach to persons, (2) the mutual conditioning of the two prominent Confucian virtues -- humaneness (ren) and ritual propriety (li), and (3) the inseparability of the familial and the political self. The last section of the paper applies Confucian care ethics to concrete cases such as the geriatric care crisis and the problem of poverty. (shrink)

Introduction -- The ethics of care and global politics -- Rethinking human security -- 'Women's work' : the global care and sex economies -- Humanitarian intervention and global security governance -- Peacebuilding and paternalism : reading care through postcolonialism -- Health and human security : gender, care and HIV/AIDS -- Gender, care, and the ethics of environmental security -- Conclusion. Security through care.

Feminist reflections on the sexual division of labour have given rise to a body of knowledge on the ethics of care from different disciplines, including philosophy, in which outstanding contributions to the topic have been formulated. This approach is applicable to the analysis of any phenomenon and particularly that of disasters. As various investigations have highlighted, the consequences on the population throughout all of a disaster’s phases (prevention, emergency, and reconstruction) require an analysis of differentiated vulnerabilities based on (...) gender and other identity categories, such as social class, ethnicity, age, disability, sexual identity, etc. The interrelation between all these variables gives rise to differentiated impacts that cannot be ignored in catastrophic contexts, where survival and sustaining life are at stake, so care becomes a central issue. Research on the topic has also identified that, along with the analysis of social vulnerability, we must consider the capacity for agency, both individual and collective, where care is once again of vital importance. Considering the gender approach and its multiple intersections is thus a fundamental theoretical-practical proposal for the study of disasters from philosophy, as it implies an unavoidable epistemic, ontological, and ethical reflection in the face of risk reduction. (shrink)

In this paper, I investigate Freud’s study of infantile zoophobias. According to Freud, in nearly all cases of infantile animal phobias, the feared animal functions as a father figure. The feared animal takes on the prohibitive role as the father substitute. The substitutability of the animal and the father is crucial for Freud, as it anchors his theory regarding the familial, social, and religious structure of a patriarchal society. In light of this standard animal-father substitution, Freud’s biography of Leonardo da (...) Vinci stands out as a provocative exception. In this psychoanalytic biography, Freud examines da Vinci’s relationship with a vulture—only here the vulture is an androgynous creature that serves as a mother substitute. More significantly, unlike other accounts of infantile zoophobia, the vulture has an empowering rather than crippling effect on the infant da Vinci. With the story of the androgynous vulture, I argue that Freud’s interpretation of da Vinci opens up a new way to understand our relationships with animals—a way that not even Freud himself anticipated. In short, I analyze the significance of this deviant case of animal obsession in Freud’s corpus and its ramifications for reconceiving the human-animal relationship. (shrink)

This book is a comprehensive and unique text and reference in medical ethics. By far the most inclusive set of primary documents and articles in the field ever published, it contains over 100 selections. Virtually all pieces appear in their entirety, and a significant number would be difficult to obtain elsewhere. The volume draws upon the literature of history, medicine, philosophical and religious ethics, economics, and sociology. A wide range of topics and issues are covered, such as law (...) and medicine, truth-telling by the physician, research, population policy, genetics, abortion, dying, and individual rights in medical care. The selections span the centuries, beginning with material from the works of Hippocrates, continuing through Thomas Percival, John Stuart Mill, and Claude Bernard, down to modern commentators like Henry K. Beecher, Walsh McDermott, David L. Bazelon, Paul Freund, H. L. A. Hart, John Rawls, Paul Ramsey, Richard McCormick, Rashi Fein, and Bernard Barber. The text has eight major divisions, beginning with sections on the ethical dimensions of the physician-patient relationship in history; the moral bases of medical ethics; and regulation, compulsion, and protection of the consumer in clinical medicine and public health. Each of these sections includes key essays that appear for the first time. All of the book's major divisions contain primary documents: codes such as the Hippocratic Oath, Medieval Law for the Regulation of Medicine, and the first as well as the most recent code of the American Medical Association; court decisions, including those on Karen Quinlan and on abortion in the United States and West Germany; government documents such as the statement of the National Commission on the Protection of Human Subjects, the Tuskegee Syphilis Report, the British Parliamentary debate on euthanasia, and the Council of Europe on rights of the sick and dying; and various published guidelines such as the Harvard Medical School brain death criteria, the American Hospital Association on patient's rights, and Pope Pius XII on the prolongation of life. Cases that illustrate moral dilemmas are provided for discussion purposes. Each section is preceded by a succinct editor's introduction. The documents and essays are of practical value for practitioners and students in medicine, law, ethics, and counselling, and for individual patients and groups concerned with medical care. Through encompassing divergent viewpoints, the essays and primary documents were selected to encourage humane practices and deepen understanding of the multiple traditions that shaped and do shape the development of medicine. (shrink)

A motivation problem may arise when morally principled public policy calls for serious sacrifice, relative to ways of life and levels of well-being, on the part of the meInbers of a free society. Apart from legal or other forms of “external” coercion, what will, could, or should move people to make the sacrifices required by morality? I explore the motivation problem in the context of morally principled public policyconcerning our legacy for future generations. In this context the problem raises special (...) moral-psychological difficulties. My inquiry suggests pessimism regarding our ability to solve the motivation problem relative to what morality requires on behalf of future generations. (shrink)

When a mother kills her child, we call her a bad mother, but, as this book shows, even mothers who intend to do their children harm are not easily categorized as "mad" or "bad." Maternal love is a complex emotion rich with contradictory impulses and desires, and motherhood is a conflicted state in which women constantly renegotiate the needs mother and child, the self and the other. Applying care ethics philosophy and the work of Emmanuel Levinas, Maurice (...) Merleau-Ponty, and Simone de Beauvoir to real-world experiences of motherhood, Sarah LaChance Adams throws the inherent tensions of motherhood into sharp relief, drawing a more nuanced portrait of the mother and child relationship than previously conceived. The maternal example is particularly instructive for ethical theory, highlighting the dynamics of human interdependence while also affirming separate interests. LaChance Adams particularly focuses on maternal ambivalence and its morally productive role in reinforcing the divergence between oneself and others, helping to recognize the particularities of situation, and negotiating the difference between one's own needs and the desires of others. She ultimately argues maternal filicide is a social problem requiring a collective solution that ethical philosophy and philosophies of care can inform. (shrink)

Following decades of maltreatment of women in obstetric care, professional respect for maternal autonomy in obstetric decision making and care have become codified in global and national professional ethical guidelines. Yet, using the example of birth after cesarean, identifiable threats to maternal autonomy in obstetrics continue. This paper focuses on how current scientific knowledge and obstetric practice patterns factor into restricted maternal autonomy as evidenced in three representative maternal accounts obtained prior and subsequent to (...) birth after cesarean. Short- and long-term remedies to improve the current state of restricted maternal autonomy in clinical practice surrounding decision making on birth after cesarean are provided. (shrink)

In July 1993, the Scottish Highlands Centre for Human Caring sponsored a conference with the title Exploring the Spirituality in Caring. The papers given at the conference and included in this volume are offered as a contribution to the debate that must take place in nursing and in the wider context of health care provision. Ann Bradshaw's paper puts the debate in context arguing that nursing is fundamentally a loving response to the human being created in the image of (...) God. (shrink)

The bioethical principle of respect for a person’s bodily autonomy is central to biomedical and healthcare ethics. In this article, we argue that this concept of autonomy is often annulled in the maternity field, due to the maternal two-in-one body (and the obstetric focus on the foetus over the woman) and the history of medical paternalism in Western medicine and obstetrics. The principle of respect for autonomy has therefore become largely rhetorical, yet can hide all manner of unethical (...) practice. We propose that large institutions that prioritize a midwife–institution relationship over a midwife–woman relationship are in themselves unethical and inimical to the midwifery philosophy of care. We suggest that a focus on care ethics has the potential to remedy these problems, by making power relationships visible and by prioritizing the relationship above abstract ethical principles. (shrink)

In recent years there has been an explosion of interest in Artificial Intelligence (AI) both in health care and academic philosophy. This has been due mainly to the rise of effective machine learning and deep learning algorithms, together with increases in data collection and processing power, which have made rapid progress in many areas. However, use of this technology has brought with it philosophical issues and practical problems, in particular, epistemic and ethical. In this paper the authors, with backgrounds (...) in philosophy, maternity care practice and clinical research, draw upon and extend a recent framework for shared decision-making (SDM) that identified a duty of care to the client's knowledge as a necessary condition for SDM. This duty entails the responsibility to acknowledge and overcome epistemic defeaters. This framework is applied to the use of AI in maternity care, in particular, the use of machine learning and deep learning technology to attempt to enhance electronic fetal monitoring (EFM). In doing so, various sub-kinds of epistemic defeater, namely, transparent, opaque, underdetermined, and inherited defeaters are taxonomized and discussed. The authors argue that, although effective current or future AI-enhanced EFM may impose an epistemic obligation on the part of clinicians to rely on such systems' predictions or diagnoses as input to SDM, such obligations may be overridden by inherited defeaters, caused by a form of algorithmic bias. The existence of inherited defeaters implies that the duty of care to the client's knowledge extends to any situation in which a clinician (or anyone else) is involved in producing training data for a system that will be used in SDM. Any future AI must be capable of assessing women individually, taking into account a wide range of factors including women's preferences, to provide a holistic range of evidence for clinical decision-making. (shrink)

A motivation problem may arise when morally principled public policy calls for serious sacrifice, relative to ways of life and levels of well-being, on the part of the members of a free society. Apart from legal or other forms of “external” coercion, what will, could, or should move people to make the sacrifices required by morality? I explore the motivation problem in the context of morally principled public policy concerning our legacy for future generations. In this context the problem raises (...) special moral-psychological difficulties. My inquiry suggests pessimism regarding our ability to solve the motivation problem relative to what morality requires on behalf of future generations. (shrink)

This article is an exploration of the ways in which maternal subjectivity is negotiated and defined in the context of the act or process of giving birth. As such, it is offered as a contribution to and discussion of recent feminist evaluation of childbirth management systems. Written from the partial perspective of my own experiences of pregnant and maternal embodiment, the article considers whether the ethic of the birth plan is a satisfactory representation of consumer needs and participation (...) in contemporary maternity care. By way of a selective personal account of various models of consumer-orientated and woman-centred childbirth management services that exist in Australia and New Zealand, I draw on ideas from feminist theories of corporeality and the dialogical tradition of social thought in order to rethink the ethical encounter between the labouring woman or consumer and her care provider or practitioner. (shrink)

Virginia Held assesses the ethics of care as a promising alternative to the familiar moral theories that serve so inadequately to guide our lives. The ethics of care is only a few decades old, yet it is by now a distinct moral theory or normative approach to the problems we face. It is relevant to global and political matters as well as to the personal relations that can most clearly exemplify care. This book clarifies just (...) what the ethics of care is: what its characteristics are, what it holds, and what it enables us to do. It discusses the feminist roots of this moral approach and why the ethics of care can be a morality with universal appeal. Held examines what we mean by "care," and what a caring person is like. Where other moral theories demand impartiality above all, the ethics of care understands the moral import of our ties to our families and groups. It evaluates such ties, focusing on caring relations rather than simply on the virtues of individuals. The book proposes how such values as justice, equality, and individual rights can "fit together" with such values as care, trust, mutual consideration, and solidarity. In the second part of the book, Held examines the potential of the ethics of care for dealing with social issues. She shows how the ethics of care is more promising than Kantian moral theory and utilitarianism for advice on how expansive, or not, markets should be, and on when other values than market ones should prevail. She connects the ethics of care with the rising interest in civil society, and considers the limits appropriate for the language of rights. Finally, she shows the promise of the ethics of care for dealing with global problems and seeing anew the outlines of international civility. (shrink)

We must reconceive the ethical relationship between mothers and their newborn babies. The intertwinement of mother and baby does not disappear with birth but rather persists in the form of postpartum maternal tethering. Drawing upon three years of ethnographic fieldwork and training in the United States and China, I argue that dependencies associated with postpartum maternal tethering make it extremely difficult for postpartum mothers to act autonomously, even in the relational sense. Breaching this tether opens up new possibilities (...) for thinking about the bioethics of vulnerability, dependency, and care by denaturalizing and desanctifying the mother-baby relationship and diversifying newborn care. (shrink)

As members of the fetal surgery advisory board at a large tertiary care center, we read with great interest Hendriks’ et al. target article proposing a new ethical framework for fetal therap...

This book exploits the power of phenomenological methods to access and describe lived moral experiences of pain and suffering for patients, their families and the wider community. Creating new fields of communication for patients, their family members and health professionals in shared decision making processes, this book builds on knowledge about suffering to help and guide correct action in preventing and relieving chronic pain and improving systems of care. It offers a new phenomenology for understanding moral experience in serious (...) illness and suffering, and its implication for policy, practice and research. A series of applied chapters, looking at individual experiences of suffering and care experiences, present some areas of ethical inquiry, including: pain and suffering maternal care ethics evaluation and moral deliberation about treatment options decision-making and moral agency end-of-life experiences of care. Exploring how moral phenomenology could provide fruitful alternatives to traditional frameworks in bioethics, this is an important addition to the literature. It will be of interest to scholars and students of bioethics and phenomenological methods in the health and human services. (shrink)

Virginia Held assesses the ethics of care as a promising alternative to the familiar moral theories that serve so inadequately to guide our lives. The ethics of care is only a few decades old, yet it is by now a distinct moral theory or normative approach to the problems we face. It is relevant to global and political matters as well as to the personal relations that can most clearly exemplify care. This book clarifies just (...) what the ethics of care is: what its characteristics are, what it holds, and what it enables us to do. It discusses the feminist roots of this moral approach and why the ethics of care can be a morality with universal appeal. Held examines what we mean by "care," and what a caring person is like. Where other moral theories demand impartiality above all, the ethics of care understands the moral import of our ties to our families and groups. It evaluates such ties, focusing on caring relations rather than simply on the virtues of individuals. The book proposes how such values as justice, equality, and individual rights can "fit together" with such values as care, trust, mutual consideration, and solidarity. In the second part of the book, Held examines the potential of the ethics of care for dealing with social issues. She shows how the ethics of care is more promising than Kantian moral theory and utilitarianism for advice on how expansive, or not, markets should be, and on when other values than market ones should prevail. She connects the ethics of care with the rising interest in civil society, and considers the limits appropriate for the language of rights. Finally, she shows the promise of the ethics of care for dealing with global problems and seeing anew the outlines of international civility. (shrink)

Recent literature shows that ethics of care can be used as a theoretical basis to add a new, important dimension to social issues. Th.

Eminent moral philosopher Michael Slote argues that care ethics presents an important challenge to other ethical traditions and that a philosophically developed care ethics should, and can, offer its own comprehensive view of the whole of morality. Taking inspiration from British moral sentimentalism and drawing on recent psychological literature on empathy, he shows that the use of that notion allows care ethics to develop its own sentimentalist account of respect, autonomy, social justice, and deontology. (...) Furthermore, he argues that care ethics gives a more persuasive account of these topics than theories offered by contemporary Kantian liberalism. The most philosophically rich and challenging exploration of the theory and practice of care to date, _The Ethics of Care and Empathy_ also shows the manifold connections that can be drawn between philosophical issues and leading ideas in the fields of psychology, education, and women's studies. (shrink)

Background Caring is a core function of nurses and it confers upon them ethical obligations as ethical agents. Failure to carry out such ethical obligations raises ethical concerns. This study was not intended to explore ethical concerns, but the reported findings reveal problems which have ethical implications. This paper aims to elucidate the ethical issues inherent in the findings and propose strategies to mitigate them. Research design and methods An exploratory-descriptive qualitative design was used within a larger Action Research Study. (...) Data were collected through focus group discussions with nurse/midwives, and through exit interviews which were conducted with the women who participated in the study on their day of discharge. Six focus group discussions and thirty exit interviews were conducted, and data were analysed through thematic analysis. Participants and research context The study took place at selected maternal and child healthcare settings in Lilongwe, Malawi. The participants were nurse/midwives and women who were admitted in maternal and child healthcare settings and were purposively sampled. Ethical considerations Ethical approval was obtained from the relevant ethics committee and all ethical guidelines were followed in the conduct of the study. Findings The findings are presented under three themes which emerged from the data. The findings reveal effects of staff shortages on patient outcomes, problems experienced in low resource clinical settings and disrespectful nurse/patient communication. Conclusion The findings reveal that institutional factors constrain moral agency and patient safety is severely compromised in some of the clinical settings in Malawi which raises serious ethical concerns. (shrink)

Background Respectful maternity care (RMC) emphasizes the social and relational elements of maternity care and is a crucial part of initiatives to improve service accessibility and quality. Women's perceptions have influenced much of what we know about RMC and contempt in the labor ward. In order to understand midwives' perspectives of RMC, this meta-synthesis focused on them. Method For this inquiry, the databases PubMed/Medline, Embase, Web of Science, and Scopus were searched to find studies on midwives' perceptions of (...) RMC written between 2011 and April 20th 2023. The included articles were to English language restriction. The results of the included research were examined using thematic analysis. Using the inclusion criteria, 84 potentially relevant articles were carefully reviewed, and only 22 were ultimately selected for synthesis. The quality of the qualitative study was assessed using the CASP, a tool for quality evaluation and PRISMA guidelines were followed. Using the MAXQDA program, the cited quotes and the original authors' interpretations were combined. Result There were 22 studies total, thematic synthesis was determined to be appropriate for a total of 22 research studies. Following are the topics which we summarized our analysis: in six major themes: Midwives’ conceptualizations of RMC, Midwives commitment to woman’s rights, The value and impact of RMC to midwives, Midwife’s perception of disrespectful care, Challenges in providing respectful maternity care, and Midwives’ recommendations for optimal RMC practice. Conclusion In addition to specific focus on promoting cooperation, policies to enhance health systems and strategic consideration of the midwifery profession's future are required. (shrink)

There has been increased interest in the potential of maternal immunisation to protect maternal, fetal, and infant health. Maternal tetanus vaccination is part of routine antenatal care and immunisation campaigns in many countries, and it has played an important part in the reduction of maternal and neonatal tetanus. Additional vaccines that have been recommended for routine maternal immunisation include those for influenza and pertussis, and other vaccines are being developed. Maternal immunisation is controversial (...) since regulators, professionals, and the public are often reluctant to accept pharmaceutical interventions during pregnancy. So far, little attention has been given to the ethics of vaccination during pregnancy. In this Personal View we argue that maternal immunisation should be offered in response to concrete, severe risks of disease for mother and child, and we explain how this requirement of serious risk can be used to guide ethical decision-making about maternal immunisation. (shrink)

Beginning with a focus on the ethical foundations of caregiving in health and expanding towards problems of ethics and justice implicated in a range of issues, this book develops and expands the notion of care itself and its connection to practice. Organised around the themes of culture as a restraint on caregiving in different social contexts and situations, innovative methods in healthcare, and the way in which culture works to position care as part of a rhetorical approach (...) to dependency, responsibility, and justice, The Ethics of Carepresents case studies examining institutional responses to end-of-life issues, the notion of informed consent, biomedicine, indigenous rights and postcolonialism in care and theoretical approaches to the concept of care. Offering discussions from a variety of disciplinary approaches, including sociology, communication, and social theory, as well as hermeneutics, phenomenology, and deconstruction, this book will appeal to scholars across the social sciences with interests in healthcare, medicine, justice and the question of how we think about care as a notion and social form, and how this is related to practice. (shrink)

This article engages with the care ethics of Laudato Si’ through the lens of postcolonial ecofeminism. Laudato Si’ speaks of the family of creation where nature is both a nurturing mother and a vulnerable sister, reflecting patriarchal associations of women with nature, fragility, and the virtue of care. This indirectly undermines the need for men to engage in care/social reproduction work as well as the strengthening of women’s agency. While this kin-centric ecology acknowledges the interdependence of (...) creatures, it maintains the hierarchy of humans over nature and underlines this family’s headship by an all-powerful Father. Laudato Si’s family ecology and God language inadvertently reifies women–nature–care connection and reinforces the logic of male domination. This study recommends exploring gender inclusive images of the Trinity and the family of creation in mutual relations to foster care that promotes both the agency of women and nature. (shrink)

Indigenous ethics and feminist care ethics offer a range of related ideas and tools for environmental ethics. These ethics delve into deep connections and moral commitments between nonhumans and humans to guide ethical forms of environmental decision making and environmental science. Indigenous and feminist movements such as the Mother Earth Water Walk and the Green Belt Movement are ongoing examples of the effectiveness of on-the-ground environmental care ethics. Indigenous ethics highlight attentive caring (...) for the intertwined needs of humans and nonhumans within interdependent communities. Feminist environmental care ethics emphasize the importance of empowering communities to care for themselves and the social and ecological communities in which their lives and interests are interwoven. The gendered, feminist, historical, and anticolonial dimensions of care ethics, indigenous ethics, and other related approaches provide rich ground for rethinking and reclaiming the nature and depth of diverse relationships as the fabric of social and ecological being. (shrink)

This article considers the difficulties with using Gillon's model for health care ethics in the context of clinical practice. Everyday difficulties can arise when caring for people from different ethnic and cultural backgrounds, especially when they speak little or no English. A case is presented that establishes, owing to language and cultural barriers, that midwives may have difficulty in providing ethically appropriate care to women of Pakistani Muslim origin in the UK. The use of interpreters is discussed; (...) however, there are limitations and counter arguments to their use. Training is identified as needed to prepare service providers and midwives for meeting the needs of a culturally diverse maternity population. (shrink)

Recent work in clinical nursing ethics has been influenced by two main areas of insight associated with the challenge levelled by the women's movement to traditional thinking about morality and ethics. Broadly speaking these two realms have been distinguished as articulating ‘feminist’ socio‐political and ‘feminine’ ethic of care concerns. Often these two impulses are seen as pulling against each other, or worse, the ‘feminine’ emphasis on the ethics of care is seen as reinforcing the dynamics (...) that elicit the ‘feminist’ concern. In this paper I suggest how an expanded understanding of an ethic of care in clinical settings can provide resources for dealing with both concerns. A discussion of the way institutional relations can ride rough‐shod over the ‘feminist’ insights of ethical care, in the second part of the paper, provides evidence for my conclusion that ethical nursing care depends on recognizing that both areas of insight are imperative for its success. (shrink)

The object of this essay is to explore the central role played by the ‘ethic of care’ in debates within and beyond feminist legal theory. The author claims that the ethic of care has attracted feminist legal scholars in particular, as a means of resolving the theoretical, political and strategic difficulties to which the perceived ‘crisis of subjectivity’ in feminist theory has given rise. She argues that feminist legal scholars are peculiarly placed in relation to this crisis because (...) of their reliance on the social ‘woman’ whose interests are the predominant concern of feminist legal engagement. With the problematisation of subjectivity, the object of feminist legal attention disappears and it is in attempts to deflect the negative political consequences of this that the ethic of care has been invoked, the author argues, unsuccessfully. The essay concludes with suggestions as to how the feminist project in law might proceed in the wake of the crisis of subjectivity and the failure of the ethic of care to resolve it. (shrink)

This comparative study of the ethics of care and the Confucian concept of jen argue against two assumptions made by Chenyang Li in his own study of these two traditions. Against him, I argue that a "feminine" morality is not adequate to address human equality, and that care-orientated theories like jen and care seem incompatible with the feminist commitment to oppose the subjection of women.

We agree with van der Pijl et al that the question of how to ensure consent is obtained for procedures which occur during labour and childbirth is vitally important, and worthy of greater attention.1 However, we argue that the modified opt-out approach to consent outlined in their paper may not do enough to protect the choice and agency of birthing people. Moreover, while their approach reflects a pragmatic attempt to facilitate legal clarity and certainty in this context, this is not (...) necessarily responsive to the messy realities of decision-making during labour (and beyond). We outline some of our concerns with their proposals and demonstrate how these illuminate some broader, longstanding tensions around consent and medical law. The authors place significant focus on the particularities of labour, outlining six ways in which maternity care is ‘unlike the usual healthcare setting’ (van der Pijl M et al,1p4). We support the need for attentiveness to these particularities and the problematic nature of consent in this context. Recent scholarly attention on the possible ‘political, ethical and theoretical implications and meanings of birthing embodiment’ (Chadwick R,2p2) has invited more nuanced conversation about consent, agency and decision-making during labour. However, while recognising the embodied particularities of labour, we must also avoid essentialising the differences of labouring bodies and thereby reinforcing exclusionary norms of consent. This points to a long-standing tension in feminist theory between the universal and the particular; between recognising and responding to the powerlessness of individuals without …. (shrink)

In the last few decades, the ethics of care as a feminist ethic has given rise to extensive literature, and has affected moral inquiries in many areas. It offers a distinctive challenge to the dominant moral theories: Kantian moral theory, utilitarianism, and virtue ethics. This chapter outlines the distinctive features and promising possibilities of the ethics of care, and the criticisms that have been made against it. It then examines the ethics of care’s (...) recognition of human dependency and of the importance of responding to needs; its interpretation of the roles of emotion and reason in moral understanding; and its critique of liberal individualism and development of a conception of the person as relational. The ethics of care contrasts care with justice, tries to integrate them, and reconceptualizes public and private life and morality. (shrink)

Background: As a normative theory, care ethics has become widely theorized and accepted. However, there remains a lack of clarity in relation to its use in practice, and a care ethics framework for practice. Maternity care is fraught with ethical issues and care ethics may provide an avenue to enhance ethical sensitivity. Aim: The purpose of this scoping review is to determine how care ethics is used amongst health professions, and to (...) collate the information in data charts to create a care ethics framework and definition for midwifery practice. Method: The scoping review was conducted according to the Preferred Reporting Items for Scoping reviews (PRISMA-ScR) and Joanna Briggs Institute (JBI) recommendations. The search was applied to the databases CINAHL, MEDLINE, PschInfo and Pubmed which were searched in September 2019 and again in July 2021. The inclusion criteria were guided by the mnemonic for search terms: Participants, Concept, and Context (PCC) and included variations of health care professionals, care ethics and utilization. The search was limited to qualitative studies published in English between 2010 and 2021. A data extraction tool was used to extract and synthesize data into categories. The articles were screened for eligibility by title, abstract and full text review, by two independent reviewers. Ethical Considerations: The scoping review was guided by ethical conduct respecting authorship and referencing sources. Results: Twelve of the initially identified 129 studies were included in the scoping review. Data synthesis yielded four categories of care ethics use by health professionals: relationship, context, attention to power and caring practices. In combination, the evidence forms a framework for care ethics use in midwifery practice. Conclusion: Care ethics use by health professionals enhances ethical sensitivity. A framework and definition for care ethics for midwifery practice is proposed. This review will be of interest to midwives and other health practitioners seeking to enhance ethical sensitivity. (shrink)

Illustrating the tensions and possibilities that the notion of the ethic of care as a democratic and citizenship issue may have in discourses of citizenship education in western states is the focus of this article. I first consider some theoretical debates on the definition of an ethic of care, especially in relation to issues of justice and (im)partiality. Then, I discuss the reconceptualization of care on the basis of two related but distinct themes: the reconciliation of justice (...) and care, and the rethinking of citizenship. Following this, I lay out some implications for citizenship education and answer the question of what learning and teaching for/about a reconceptualized ethic of care can contribute to changing current perceptions of and actions towards immigrants, refugees and asylum seekers. (shrink)