Abstract
This article defends ‘relational theorizing’ in bioethics and public health ethics and describes its importance. It then offers an interpretation of solidarity and care understood as normatively patterned and psychologically and socially structured modes of relationality; in a word, solidarity and care understood as ‘practices.’ Solidarity is characterized as affirming the moral standing of others and their membership in a community of equal dignity and respect. Care is characterized as paying attention to the moral (and mortal) being of others and their needs, suffering, and vulnerability. The wager of relational theorizing in health care and public health is that substantive ethical visions of solidarity and care will provide support for more just and egalitarian health care and public health policies.
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Notes
Certainly, if the import of this distinction on bioethics and public health ethics is relatively new, the distinction itself and discussion of these theoretical forms are not new in moral philosophy and moral psychology. They were central to the debate 40 years ago between Lawrence Kohlberg and Carol Gilligan, which Jürgen Habermas tried to mediate with his communicative ethics. See Wren [25].
Some versions of utilitarianism may be an exception to this, in so far as they take pain and pleasure as such to be the sources of good or evil in the world, quite independently of how these philosophical substances are embodied in, or experienced by, individual beings, and regardless of how such embodiment or experience is distributed in a society.
Relational bioethics is conceptually dynamic and pluralistic, frequently drawing on paradigm-shifting work in moral and political philosophy and on conceptual innovations ongoing in the humanities and the social sciences, including feminist theories, critical theories of various kinds, and orientations informed by philosophical pragmatism and hermeneutics, among others. The literature of relational bioethics and similar work in moral philosophy is large and growing. My sketch of it here is selective, glossing over important differences among particular thinkers, but I hope not misleading. My account draws upon [4, 6, 15] in particular.
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Acknowledgements
An earlier version of this article was presented as The Third Annual Jonathan Montgomery Lecture at the Centre for Health, Ethics, and Law, University of Southampton, on 15 January 2018. A more extended discussion of solidarity and care is presented in Jennings [11].
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Jennings, B. Relational Ethics for Public Health: Interpreting Solidarity and Care. Health Care Anal 27, 4–12 (2019). https://doi.org/10.1007/s10728-018-0363-0
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DOI: https://doi.org/10.1007/s10728-018-0363-0