With an estimated 12.1% of children aged 2–5 years already obese, prevention efforts must target our youngest children. One of the best places to reach young children for such efforts is the early care and education setting. More than 11 million U.S. children spend an average of 30 hours per week in ECE facilities. Increased attention at the national, state, and community level on the ECE setting for early obesity prevention efforts has sparked a range of innovative efforts. To assist (...) these efforts, CDC developed a technical assistance and training framework – the Spectrum of Opportunities for Obesity Prevention in the ECE setting – which also served as the organizing framework for the Weight of the Nation ECE track. Participants highlighted their efforts at national, state, and local levels pursuing opportunities on the Spectrum, the standards and best practices that had been the emphasis of their efforts, and common steps for developing, implementing, and evaluating initiatives. Strong leadership and collaboration among a broad group of stakeholders; systematic assessment of needs, opportunities and resources; funding sources; and training and professional development were reported to be integral for successful implementation of standards and best practices, and sustainability. (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)
This book explores two public sector scandals in the UK, drawing on Max Weber's thought on 'the iron cage' to understand how these cases of patient-neglect in NHS hospitals and failures by police and social workers to address the organised sexual exploitation of young girls occurred. Through examination of the management failures and institutional vulnerabilities, and with attention to the trends of bureaucratisation and rationalisation that characterised both scandals, it reveals the explanatory power of Weber's thought, developing a theoretical model (...) that updates and extends Weber's work in light of the cases discussed. Showing that ordinary people as well as ordinary people, including professionals, are still trapped in the 'iron cage', it will appeal to scholars of sociology and social theory, as well as those providing training and working within the caring and service professions of policing, social work and nursing. (shrink)
How care can resist the stifling force of the neoliberal paradigm In a world brimming with tremendous wealth and resources, too many are suffering the oppression of precarious existences--and with no adequate relief from free market-driven institutions. Care Ethics in the Age of Precarity assembles an international group of interdisciplinary scholars to explore the question of care theory as a response to market-driven capitalism, addressing the relationship of three of the most compelling social and political subjects today: care, precarity, and (...) neoliberalism. While care theory often centers on questions of individual actions and choices, this collection instead connects theory to the contemporary political moment and public sphere. The contributors address the link between neoliberal values--such as individualism, productive exchange, and the free market--and the pervasive state of precarity and vulnerability in which so many find themselves. From disability studies and medical ethics to natural-disaster responses and the posthuman, examples from Māori, Dutch, and Japanese politics to the COVID-19 pandemic and the Black Lives Matter movement, this collection presents illuminating new ways of considering precarity in our world. Care Ethics in the Age of Precarity offers a hopeful tone in the growing valorization of care, demonstrating the need for an innovative approach to precarity within entrenched systems of oppression and a change in priorities around the basic needs of humanity. Contributors: Andries Baart, U Medical Center Utrecht, Tilburg U, and Catholic Theological U Utrecht, the Netherlands; Vrinda Dalmiya, U of Hawaii, Mānoa; Emilie Dionne, U Laval; Maggie FitzGerald, U of Saskatchewan; Sacha Ghandeharian, Carleton U; Eva Feder Kittay, Stony Brook U/SUNY; Carlo Leget, U of Humanistic Studies in Utrecht, the Netherlands; Sarah Clark Miller, Penn State U; Luigina Mortari, U of Verona; Yayo Okano, Doshisha U, Kyoto, Japan; Elena Pulcini, U of Florence. (shrink)
Our current culture is dominated by the ideology of creativity. One is supposed to create the new and not to care about the things as they are. This ideology legitimises the domination of the "creative class" over the rest of the population that is predominantly occupied by forms of care - medical care, child care, agriculture, industrial maintenance and so on. We have a responsibility to care for our own bodies, but here again our culture tends to thematize the bodies (...) of desire and to ignore the bodies of care - ill bodies in need of self-care and social care. But the discussion of care has a long philosophical tradition. The book retraces some episodes of this tradition - beginning with Plato and ending with Alexander Bogdanov through Hegel, Heidegger, Bataille and many others. The central question discussed is: who should be the subject of care? Should I care for myself or trust the others, the system, the institutions? Here, the concept of the self-care becomes a revolutionary principle that confronts the individual with the dominating mechanisms of control. (shrink)
Care ethics can provide a valuable conceptual and normative resource for many issues in law, but given the conservative nature of law in general, much work needs to be done before care ethics can explicitly play such a role. In this paper I survey the landscape of law, discuss two attempts to incorporate care ethics into the normative framework of law, and suggest other avenues for incorporating care ethics in law and legal reasoning.
This book advocates for the philosophical import of care in re-evaluating problems of humanitarianism in the context of the ongoing international refugee and forced migration situation. In doing so, it rethinks the human capacity to care about the suffering of distant others. At a time when emotional resources are running low, there is a need to recast what it means to care, with the aim of generating a productive movement against the rise of value fundamentalism globally—embraced in mantras of ‘good (...) and evil’ and ‘us and them’—and to confront xenophobia and oppressive politics. The author draws upon a wide array of rich traditions, including historical and contemporary writings on self-care and care of the other, to re-examine the intersection of care ethics and justice. She also rethinks the relationship between care and contestation, here analyzed in the aesthetic, ethical, political, and religious domains of human experience. From within the context of this contingent historical repetition of political oppression, the book constructs a reminder not only of what it feels like to care, but how and why we should act upon our care. Care Ethics and the Refugee Crisis is an important contribution to the growing literatures on care ethics and immigration/forced migration in philosophy. It will also appeal to scholars and advanced students working in other disciplines such as political science, refugee and migration studies, and social anthropology. (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)
The aim of this paper is to offer theoretical insights into the care of the self, which often initiates therapist-patient relationships in clinical practice. The reason is that when patients care about their health status, they are inclined to establish a therapeutic relationship with physical therapists. Hence, the care for self may bridge the world of the patient's private experiences and the world of the healthcare system together with its interventions, which is represented by the physical therapist In this framework, (...) care means not only the patient's choice to undergo therapy but also his/her commitment to sustaining its effects in private life. This involves educational interventions by the physiotherapist who inscribes him/herself in his/her patients’ care of the self in order to alter their habits of physical exercise, diet, personal hygiene, body posture, etc. The argument in this paper is informed by the concepts of ethics developed by Michel Foucault and Richard Shusterman. (shrink)
In _Caring_, Peta Bowden extends and challenges recent debates on feminist ethics. She takes issue with accounts of the ethics of care that focus on alleged principles of caring rather than analysing caring in practice. Caring, Bowden argues, must be understood by 'working through examples'. Following this approach, Bowden explores four main caring practices: mothering, friendship, nursing and citizenship. Her analysis of the differences and similarities in these practices - their varying degrees of intimacy and reciprocity, (...) formality and informality, vulnerability and choice - reveals the practical complexity of the ethics of care. _Caring_ recognizes that ethical practices constantly outrun the theories that attempt to explain them, and Bowden's unique approach provides major new insights into the nature of care without resorting to indiscriminate unitary models. It will be essential reading for all those interested in ethics, gender studies, nursing and the caring professions. (shrink)
Quality care is more than a technical issue. It has a place among the core values of a company, and is thus an ethical issue as well as being a means and a benchmark for good management. The author is chairman of the Flemish Network for Business Ethics, Europastraat 31, 2850 Boom, Belgium. Tel: 00 31 3 844 00 89.
Contributors to this volume demonstrate how the ethics of care factors into a variety of social policies and institutions, and can indeed be useful in thinking about a number of different social problems. Divided into two sections, the first looks at care as a model for an evaluative framework that rethinks social institutions, liberal society, and citizenship at a basic conceptual level. The second explores care values in the context of specific social practices or settings, as a framework that should (...) guide thinking. (shrink)
This volume is an exploration of the ethical issues raised by health insurance, which is particularly timely in the light of recent advances in medical research and political economy. Focusing on a wide range of areas, such as AIDS, genetic engineering, screening and underwriting, new disability legislation and the ethics of private and public health insurance, this comprehensive and sometimes controversial book provides an essential survey of the key issues in health insurance. Divided into two parts, the first considers the (...) ethics of underwriting, risk assessment and the acceptance and refusal of insurance risk by insurers. Discussing the unjust treatment of high-risk applicants, the authors identify sources of unfairness to both parties of the insurance contract, indicating how reasonable trade-offs can be made. The second part considers the argument for a mix of public and private insurance for acute and long-term care, offering recommendations for changes in the balance of social insurance, and discussing the shift toward long-term contracts in private health care and pension insurance. (shrink)
In Comprehending Care, Tove Pettersen subjects the ethics of care, as advanced by Carol Gilligan, to a moral-philosophical examination. More precisely, she extracts the philosophical foundation in this ethics, probes its possible implications for moral theory of a more traditional stamp, and explores its normative plausibility. Pettersen exposes several misconceptions of Gilligan's work.
Contrary to the popular assumption that linguistically mediated social practices constitute the normativity of action (Kiverstein and Rietveld, 2015; Rietveld, 2008a,b; Rietveld and Kiverstein, 2014), I argue that it is affective care for oneself and others that primarily constitutes this kind of normativity. I argue for my claim in two steps. First, using the method of cases I demonstrate that care accounts for the normativity of action, whereas social practices do not. Second, I show that a social practice account of (...) the normativity of action has unwillingly authoritarian consequences in the sense that humans act only normatively if they follow social rules. I suggest that these authoritarian consequences are the result of an uncritical phenomenology of action and the fuzzy use of “normative”. Accounting for the normativity of action with care entails a realistic picture of the struggle between what one cares for and often repressive social rules. (shrink)
The purpose of this book is to assist health care professionals in understanding some of the complex contemporary issues that they confront and to provide guidance in making decisions. These issues are described and analyzed in the context of philosophical principles and methods in language that is understandable to the professional who is unfamiliar with the study of philosophy and ethics. -from Preface.
Palliative care is a recent branch of health care. The doctors, nurses, and other professionals involved in it took their inspiration from the medieval idea of the hospice, but have now extended their expertise to every area of health care: surgeries, nursing homes, acute wards, and the community. This has happened during a period when patients wish to take more control over their own lives and deaths, resources have become scarce, and technology has created controversial life-prolonging treatments. Palliative care is (...) therefore faced with more ethical problems that other areas of health care. This book, by a clinician, teacher, and writer on health care ethics, has been written to provide all those who care for the terminally ill--doctors, nurses, social workers, clergymen, physiotherapists--with the concepts and principles which will assist them with difficult decisions. It challenges many received doctrines of palliative care, but its well-illustrated central theme is that technical expertise must be controlled by humane, non-technical judgments. (shrink)
The drive for cost-effective use of medical interventions has advantages, but can also be challenging in the context of end-of-life palliative treatments. A quality-adjusted life-year (QALY) provides a common currency to assess the extent of the benefits gained from a variety of interventions in terms of health-related quality of life and survival for the patient. However, since it is in the nature of end-of-life palliative care that the benefits it brings to its patients are of short duration, it fares poorly (...) under a policy of QALY-maximization. Nevertheless, we argue that the goals of palliative care and QALY are not incompatible, and optimal integration of palliative care into the calculation of QALY may reveal a mechanism to modify considerations of how optimal quality of life can be achieved, even in the face of terminal illness. The use of QALYs in resource allocation means that palliative care will always compete with alternative uses of the same money. More research should be conducted to evaluate choices between palliative care and more aggressive therapies for the terminally ill. However, current limited data show that investing in palliative care makes more sense not only ethically, but also financially. (shrink)
We vindicate the widespread intuition that there is something morally problematic with for-profit corporations providing care to young children and elders. But instead of putting forward an empirical argument showing that for-profit corporations score worse than not-for-profits when it comes to meeting the basic needs of these vulnerable groups, we develop a philosophical argument about the nature of the relationship between a care organisation, its role-occupants, and care recipients. We argue that the correlation between profit and lower-quality care is a (...) result of intrinsic features of a for-profit model, combined with conceptual features of meaningful caring relationships, such that non-profits are the most reliable institutional providers of adequate care. Our claim is that care requires a kind of commitment that for-profit institutions are constituted to avoid, and that non-profit institutions are constituted to embrace. (shrink)
Newcomers and more experienced feminist theorists will welcome this even-handed survey of the care/justice debate within feminist ethics. Grace Clement clarifies the key terms, examines the arguments and assumptions of all sides to the debate, and explores the broader implications for both practical and applied ethics. Readers will appreciate her generous treatment of the feminine, feminist, and justice-based perspectives that have dominated the debate.Clement also goes well beyond description and criticism, advancing the discussion through the incorporation of a broad range (...) of insights into a new integration of the values of care and justice. Care, Autonomy, and Justice marks a major step forward in our understanding of feminist ethics. It is both direct and helpful enough to work as an introduction for students and insightful and original enough to make it necessary reading for scholars. (shrink)
Health Care Ethics Health care ethics is the field of applied ethics that is concerned with the vast array of moral decision-making situations that arise in the practice of medicine in addition to the procedures and the policies that are designed to guide such practice. Of all of the aspects of the human body, and … Continue reading Health Care Ethics →.
We intuitively think and talk about health care as a human right. Moreover, we tend to talk about health in the language of basic rights or human rights without a clear sense of what such rights mean, let alone whose duty it is to fulfill them. Additionally, in the care ethics literature, we tend to think of a dividing line between care and justice. In this dissertation I aim to draw care and justice together in what I call care justice. (...) To attend to care justice requires the reconceptualization of the value and practice of health care, and of the moral communities in which we enact care and justice. First, I argue for a strong right to health care, though not to health. Second, I argue that health care includes much more than mere medical care. On this account health care is special for the practices of care it values and communicates. Third, I establish a theoretical framework for why, and importantly how, health care entails other forms of care: social, economic and political. My approach engages a complicity framework to rethink moral community formation and participation, and the rights and responsibilities of individuals as participants in a collective moral community. I argue that it is within communities of membership, which I define as ethical homes, that we have duties to and expectations from others. The moral community as complicit ethical home provides a way to reimagine individual shared responsibility within moral communities, and particularly regarding responsibility for practices of care. (shrink)
Technological developments involving robotics and artificial intelligence devices are being employed evermore in elderly care and the healthcare sector more generally, raising ethical issues and practical questions warranting closer considerations of what we mean by “care” and, subsequently, how to design such software coherently with the chosen definition. This paper starts by critically examining the existing approaches to the ethical design of care robots provided by Aimee van Wynsberghe, who relies on the work on the ethics of care by Joan (...) Tronto. In doing so, it suggests an alternative to their non-principled approach, an alternative suited to tackling some of the issues raised by Tronto and van Wynsberghe, while allowing for the inclusion of two orientative principles. Our proposal centres on the principles of autonomy and vulnerability, whose joint adoption we deem able to constitute an original revision of a bottom-up approach in care ethics. Conclusively, the ethical framework introduced here integrates more traditional approaches in care ethics in view of enhancing the debate regarding the ethical design of care robots under a new lens. (shrink)
Being aware of social injustices can cause existential and mental pain; comes with a burden; and may impede a flourishing life. However, I shall argue that this is not a reason to despair or to choose to be willfully ignorant. Rather, it’s a reason to conclude that being conscious is not enough. Rather, during times of oppression, resisters must also prioritize well-being. One way to do this is by extending what I refer to as solidarity care. I begin by providing (...) an account of solidarity care. I then offer pragmatic ways in which one can extend solidarity care to others. I conclude by responding to two possible worries. (shrink)
Health Care Ethics examines the way ethical dilemmas are played out in everyday clinical practice and argues for an approach to ethical decision-making which focuses more on patient needs than competing professional interests. While advances in medical science and technology have improved the ability to save and prolong lives, they have also given rise to fundamental questions about what constitutes life and personhood, especially in the context of what are termed 'persistent vegetative state' and 'brain death'. Drawing on the example (...) of intensive care where such questions feature strongly in everyday practice, Kath M Melia examines how decisions are taken within the context of multiprofessional teamworking, including · whether to admit a patient and commence treatment · what the aim of treatment should be (i.e. palliation, care or cure) · when to limit, withhold or withdraw treatment · when to donate organs. As an area in which different professional groups work closely together, the author argues that there are lessons to be learnt from intensive care which can be applied to ethical decision making in all areas of health care for the greater good of patients. The book makes a significant contribution to the literature on ethics in health care and to the development of ethical decision making which prioritises the needs of patients. It is essential reading for ethicists, sociologists and health care professionals. (shrink)
Environmental ethics has to deal with the challenge of reconciling contrasting ecocentric and animal-centric perspectives. Two classic attempts at this reconciliation, which both adopted the metaphor of concentric circles, are discussed. It is concluded that the relationship between the animal and its environment, whether the latter is human or natural, should be a pivotal element of such reconciliation. An alternative approach is presented, inspired by care ethics, which proposes that caring for wild animals implies caring for their relationship (...) to the natural environment and thus taking action to maintain wildlife habitat. This type of care is labelled non-specific care because it is not directed towards the individual wild animal and its specific individual needs. In contrast, caring for domestic animals is called specific care because it is much more directed towards the individual animal's needs. (shrink)
Nurse practitioners can ease increased pressure on primary care shortage while providing a cost-effective and high-quality alternative to certain physician services. However, scope-of-practice laws are restrictive and their modification remains a source of controversy. Clearly, there is a need for new thinking around the scope of practice debate. This article conducted a review of literature and laws concerning the nursing scope of practice, as well as the outcomes of nurse-led care coordination models. It also examined different manifestations of the controversy (...) that arises in scope of practice debates. We argue that improved care coordination is necessary to improve outcomes and “bend the cost curve downward.” Allowing nurse practitioners and other providers to practice to the full extent of their licenses will result in improved care coordination. This can be accomplished by expanding nursing and other providers' scopes of practice. But any health care reform strategy, particularly with respect to chronic care management, must also serve to activate the patient herself as the keystone in the coordinated care process. Focusing first on the patient's need for coordinated care may be what is necessary to move beyond the existing impasse between physicians and nurses on scope of practice expansion. (shrink)
The use of traditional ethical methodologies is inadequate in addressing a constructed maternal–fetal rights conflict in a multicultural obstetrical setting. The use of caring ethics and a relational approach is better suited to address multicultural conceptualizations of autonomy and moral distress. The way power differentials, authoritative knowledge, and informed consent are intertwined in this dilemma will be illuminated by contrasting traditional bioethics and a caring ethics approach. Cultural safety is suggested as a way to develop a relational ontology. (...) Using caring ethics and a relational approach can alleviate moral distress in health-care providers, while promoting collaboration and trust between providers and their patients and ultimately decreasing reproductive disparities. This article examines how a relational approach can be applied to a cross-cultural reproductive dilemma. (shrink)
The gendered division of labour in combination with the feminisation of international migration contribute to shortages of care, a phenomenon often called ‘care drain’. I argue that this phenomenon is an issue of global gender justice. I look at two methodological challenges and favourably analyse the suggestions that care drain studies should include the effects of fathers’ and other male caregivers’ migration and, in some cases, the effects of migration within national borders. I also explain why care drain is a (...) problem of distributive justice, by looking at the background conditions that result in much of the care-givers’ migration. (shrink)
A drug overdose epidemic in North America has sped the expansion of harm reduction services. Drawing on fieldwork in Ottawa, Ontario, we examine forms of care among people offering and accessing these resources. Notably, our interlocutors do not always characterize harm reduction as caring for oneself. Thus, we differentiate between the ethics of care through which one enters desired subject positions, and anethical careful practices. Harm reduction is sometimes anethical, enacted through minor gestures that do not constitute ethical work (...) but allow for its future realization. Une épidémie d’overdose de drogue en Amérique du Nord a accéléré l’expansion des services de réduction des risques. En s’appuyant sur un travail de terrain à Ottawa, Ontario, nous examinons les formes de souci et soin parmi les personnes qui fournissent ces ressources et qui y ont accès. Tout particulièrement, nos interlocuteurs ne caractérisent pas toujours la réduction des risques comme le souci de soi. Ainsi, nous faisons la différence entre l’éthique du souci de soi et des soins par laquelle on entre dans les positions de sujets souhaitées, et les pratiques soignantes anéthiques. La réduction des risques est parfois anéthique, mise en œuvre par des gestes mineurs qui ne constituent pas un travail éthique mais permettent sa réalisation future. (shrink)
Since Carol Gilligan's In a Different Voice (1982) the ethics of care has developed as a movement of allied thinkers, in different continents, who have a shared concern and who reflect on similar topics. This shared concern is that care can only be revalued and take its societal place if existing asymmetrical power relations are unveiled, and if the dignity of care givers and care receivers is better guaranteed, socially, politically and personally. In this first volume of a new series (...) leading care ethicists from Europe and the United States focus on the moral significance of two concepts in the debate that ask for further reflection. In discussion with the work of Axel Honneth on recognition and the work of Emmanuel Housset on compassion a contribution is made to a reconsideration of recognition and compassion from an ethics of care perspective. This volume contains contributions by Andries Baart, Estelle Ferrarese, Chris Gastmans, Mieke Grypdonck, Emmanuel Housset, Carlo Leget, Hilde Lindemann, Axel Liegeois, Christa Schnabl, Joan C. Tronto, Annelies van Heijst, Linus Vanlaere, Frans Vosman and Margaret Urban Walker. (shrink)
In their strife for designing a moral system where everyone is given equal consideration, cosmopolitan theorists have merely tolerated partiality as a necessary evil (insofar it means that we give priority to our kin opposite the distant needy). As a result, the cosmopolitan ideal has long departed from our moral psychologies and our social realities. Here I put forward partial cosmopolitanism as an alternative to save that obstacle. Instead of demanding impartial universal action, it requires from us that we are (...) equally responsive in all the relationships we stand in. That goes from the local to the cosmopolitan sphere, since I defend that we are related with strangers as co-members of the global community. Thus, partiality not only is accommodated by cosmopolitanism, but actually supports it: only by having meaningful personal relationships we become able to care for distant strangers. (shrink)
ACKNOWLEDGMENTS. Among Those Who helped greatly in the initial stages of this project by making constructive suggestions on my first "caring" papers are Nick Burbules, William Doll, Bruce Fuller, Brian Hill, William Pinar, Mary Anne ...
In this book the relevance of language, perception and context are highlighted by discussing issues of end-of-life care, prenatal diagnosis, allocation problems as well as ethical conflicts in clinical practice.
Care Theory is a growing schoolof ethics that starts with the assumption ofthe relational nature of human beings. Incontrast, the dominant assumption of theautonomous view of human nature has made itdifficult to integrate ``relational'' aspects ofreality into the realm of political actionrelated to agriculture. Variables such ascommunity attachment, community vitality andrichness, and environmental ``fit'' cannot beincorporated into policy because such variablesare perceived to be tainted by ``attachment,''and compromise rational judgement. Feministagricultural theorists parallel Care Theory andhave the potential of extending Care (...) Theory tohuman-nature relations. Both taken togetherenrich each other and through that process,contribute to our understanding of the moralchoices embedded in agricultural systems,particularly hog production systems, the focusof this paper. (shrink)
This paper responds to arguments that polyamorous groups or care networks do not qualify for equal treatment with marriages. It refutes the points that polyamory is inherently hierarchical or unstable, that there are too few people in such arrangements to mount an argument for recognition, that polyamory harms children, and that there are insurmountable legal and practical hurdles to network marriage. Finally, it respond to the charge that extending recognition to polyamorists will devalue the recognition of same-sex marriage.