BackgroundKnowing the opinions of patients with Progressive Neurological Diseases (PNDs) and their family members on end-of-life care can help initiate communication and the drawing up of a care plan. The aim of this paper is to describe the creation and psychometric properties of the newly developed APND-EoLC questionnaire (theAttitudes of Patients with Progressive Neurological Disease to End of Life Carequestionnaire).MethodsFollowing focus group discussion, four main areas of interest were identified: patients’ and family members’ attitudes towards end-of-life care, factors influencing decisions (...) about treatment to prolong patients’ life, concerns and fears regarding dying, and opinions on the system of care. The created questions were divided into domains based on factor analysis and psychometric properties were evaluated by sample of 209 patients with PND and 118 their family members.ResultsThe final version of the scale contains a total of 28 questions divided into six domains (end-of-life control, keeping patients alive, trust in doctors/treatment, trust in social support, sense of suffering, and dependence/loss of control) and five individual questions determining views of the care system with specified response options. Construct validity was verified by confirmatory factor analysis for each evaluated area individually. Appropriate psychometric properties were identified in the questionnaire.ConclusionsThe APND-EoLC questionnaire can be recommended for use in both research and clinical practice. (shrink)

Volume 20, Issue 4, May 2020, Page 35-37.

Nurses and other medical practitioners often experience moral distress: they feel an anguished sense of responsibility for what they take to be their own moral failures, even when those failures were unavoidable. However, in such cases other people do not tend to think it is right to hold them responsible. This is an interesting mismatch of reactions. It might seem that the mismatch should be remedied by assuring the practitioner that they are not responsible, but I argue that this denies (...) something important that the phenomenon of moral distress tells us. In fact, both the practitioners’ tendencies to hold themselves responsible and other people’s reluctance to hold the practitioners responsible get something right. The practitioners may be right that they are responsible in the sense of having failed to meet a binding moral requirement, even when the requirement was impossible to meet. This makes moral distress a fitting response because it correctly represents their own action as a wrongdoing. However, others may meanwhile be right that the practitioners are not responsible in the sense of being culpable and blameworthy. To blame others, or oneself, for certain failures, including those that are unavoidable, would be unfair. My claim depends on distinguishing between the fittingness and the fairness of holding someone (including oneself) responsible for moral failure. Having drawn the distinction, I suggest that moral distress should be addressed in a way that both recognizes it as a fitting response and avoids the unfairness of blame. (shrink)

In production and consumption of food, several ethical values are at stake for different affected parties and value conflicts in relation to food choices are frequent. The aim of this article was to present an ethical framework for well-grounded decisions on production and consumption of food, guided by the following questions: Which are the affected parties in relation to production and consumption of food? What ethical values are at stake for these parties? How can conflicts between the identified values be (...) handled from different ethical perspectives? Four affected parties, relevant for both production and consumption of food, were identified, namely animals, nature, producers and consumers. Working form a bottom-up perspective, several values for these parties were identified and discussed. For animals: welfare, not being exposed to pain and natural behavior; for nature: low negative impact on the environment and sustainable climate; for producers: fair salaries and safe working conditions; and for consumers: access to food, autonomy, health and food as part of a good life. As several of these values can come into conflict when choices of what to eat should be made, the article argues for the need of weighing values from four different perspectives in food ethics dilemmas, namely duties, consequences, virtues and care. The suggested ethical framework can provide moral guidance to both producers of food and to consumers in a supermarket. Thereby, it can contribute to more well-grounded decisions concerning what to eat and make people feel a little bit more secure when reflecting over the question: What shall we eat? (shrink)

Care is more than dispensing pills or cleaning beds. It is about responding to the entire patient. What is called “bedside manner” in medical personnel is a quality of treating the patient not as a mechanism but as a being—much like the caregiver—with desires, ideas, dreams, aspirations, and the gamut of mental and emotional character. As automata, answering an increasing functional need in care, are designed to enact care, the pressure is on their becoming more humanlike to carry out the (...) function more effectively. The question becomes not merely whether the care automaton can effect good bedside manner but whether the patient’s response is not feeling deceived by the humanlikeness. It seems the device must be designed either to effect explicit mere human-“likeness,” thus likely undermining its bedside-manner potential, or to fool the patient completely. Neither option is attractive. This article examines the social problems of designing maximally humanlike care automata and how problems may start to erode the human rights of users/patients. The article then investigates the alternatives for dealing with this problem, whether by industrial and professional self-regulation or public-policy initiatives. It then frames the problem in the broader historical perspective in terms of previous bans, moratoria, and other means of control of hazardous and potentially rights-violating techniques and materials. (shrink)

The main aim of this paper is to shed light on two somewhat underappreciated theories, which, by drawing attention to the embodied and relational nature of the self, both went beyond the disembodied and individualist paradigm long before most current leading approaches in the field. The paper first considers the routes out of the crisis of this paradigm proposed by care ethics. The first part focuses mainly on Carol Gilligan’s relational account of subjectivity, which served as an inspiration for the (...) development of care ethics as a moral theory, and discusses the strengths and weaknesses of her account. In the next step, the paper sets out to compare the view of the self deployed by care ethics with Donald Winnicott’s account of the transitional area of play. The paper argues that both care ethics and Winnicott’s theory make it possible to understand human subjectivity as at the same time dependent and mature, ambivalent and integrated, vulnerable and responsible, relational and non-arbitrary. Winnicott and care ethicists jointly demonstrate that it is neither an absolute symbiosis with others, nor a total separation from them, that is decisive for the well-being of an individual and a social field. Rather, it is beneficial and morally desirable to cultivate concrete interpersonal relationships in the area of complex relationality. The paper concludes that the crisis of the disembodied and individualistic paradigm of the self cannot be overcome by an uncritical emphasis on the positive function of relational, embodied and supra-individual aspects of human existence. Though essential, these aspects are at the same time complex and developmentally conditioned. (shrink)

Journal of Social Philosophy, EarlyView.

The purpose of this paper is not to provide an overall picture of care ethics, but, rather, to reflect upon the concept of care, which has gained significance in particular scientific contexts. Undoubtedly, the importance of the subject of care represents a challenge on the level of fundamental philosophical positions and a diversified look into the occurring forms of the psychological and social suffering, dependency, and vulnerability. I will shed light on tenets that are considered central to the care ethics (...) and that have led to the setting up of the relationship between care and democracy. By introducing the basic aspects of Carol Gilligan’s and Joan Tronto’s theories, I will emphasize their vocation to be politically relevant. A discussion on the relationship between care and justice on the one hand, and needs and rights on the other, will follow. Can hearing voices of care make democracy more just? How can care ethics provide a concrete support for democracy? On the political level, care ethics builds on the assumptions of the necessary relatedness and equality between individuals who are decisive in the light of the welfare state perspective. Upon closer examination, one may see that the setting up of these relationships is not new to the liberal perspective. Liberalism is historically rooted in the fundamental interconnection between freedom and equality. Virtues such as care and meekness can be formulated in the language of politics, but they still remain unpolitical. On the one hand, engaging in a critical reflection upon such virtues might be an indispensable measuring instrument for distinguishing a good democracy from a bad one. On the other hand, care ethics does not prove to be a real alternative to the ethics of justice. In this regard, care ethics seems to show its feet of clay. (shrink)

This chapter first introduces naturalistic approaches to ethics more generally and distinguishes methodological ethical naturalism (the focus of this chapter), from metaphysical ethical naturalism. The second part then discusses evolutionary ethics as a specific variant of methodological ethical naturalism. After introducing the concepts of evolutionary theory that are relevant for evolutionary ethics, I will sketch the history of evolutionary ethics, which offers an interesting lesson about why it became a controversial topic, and then focus on four central questions about ethics (...) that can be approached from within the framework of evolutionary ethics: 1. What should we do? 2. Why are we moral? 3. Are there moral facts? 4. Can we have justified moral beliefs and moral knowledge? (shrink)

Studies of creative industries typically contend that creative work is profoundly precarious, taking place on a freelance basis in highly competitive, individualized and contingent labour markets. Such studies depict creative workers as correspondingly self-enterprising, self-reliant, self-interested and calculative agents who valorise care-free independence. In contrast, we adopt the ‘ethics of care’ approach to explore, recognize and appreciate the communitarian, relational and moral considerations as well as interpersonal connectedness and interdependencies that underpin creative work. Drawing on in-depth interviews with creative workers (...) in a range of marginal socio-cultural contexts, we argue that creative workers cultivate and sustain a diverse array of practices of care arising from an affective concern with the well-being of others. Far from being merely individualistic and crudely competitive actors, creative workers enact practical ethical responsibilities and affectivities towards a range of human and non-human others, including families, local communities and neighbourhoods, colleagues, artistic scenes and their adjacent genres, and surrounding national and linguistic cultures. In emphasizing the fundamental and structuring role of care in contingent labour markets our approach accords with recent trends in the social sciences that ‘affirmatively’—as opposed to ‘negatively’ and ‘suspiciously’—recognize that mutuality, solidarity and affectivity are powerful drivers of action on a par with or even exceeding market-driven self-centredness. (shrink)

Debates about empathy's role in morality are notoriously complex. On the one hand, proponents of empathy argue that it plays a crucial role in the process of making moral judgments, moral motivation, moral development, and the cultivation of meaningful personal relationships. On the other hand, critics of empathy warn that it is especially susceptible to a number of morally troubling biases and motivational shortcomings. Yet there is little consensus about what empathy is or what it might be good for from (...) a moral point of view. As a result, critics and proponents of empathy alike often wind up talking past each other and debates about empathy's role in morality reach an impasse. This paper proposes a typology of empathy's affective, cognitive, and motivational dimensions and the different forms that empathy can take depending on the nature and degree of prominence of these. It argues that different forms of empathy are well equipped to handle some moral tasks as well as ill‐equipped to handle others. Its aim in doing so is to clarify an otherwise conceptually thorny set of debates and to amplify future research on empathy and its role in the moral life. (shrink)

Elizabeth Anscombe and Mary Midgley discussed Aristotle's ethics as an alternative to modern moral philosophy. This idea is best known from Anscombe's 1958 paper ‘Modern Moral Philosophy’. The main...

The theories of Locke, Hume and Kant dominate contemporary philosophical discourse on property rights. This is particularly true of applied ethics, where they are used to settle issues from biotech patents to managerial obligations. Within these theories, however, the usual criticisms of private property aren’t even as much as intelligible. Locke, Hume and Kant, I argue, develop claims about property on a model economy that I call “Frontier Town.” They and contemporary authors then apply these claims to capitalist economies. There (...) are two problems with this application: First, we’ll be considering the wrong kind of property: The only property in Frontier Town are means of life. Critics, however, object to property in concentrated capital because they associate only this kind of property with economic coercion and political power. Second, the two economies differ in central features, so that very different claims about empirical consequences and hence about fairness and merit will be plausible for each. This second problem, I argue, is a consequence of the first. I conclude that Frontier Town theories are more likely to distort than to illuminate property issues in capitalist economies. (shrink)

There have been many attempts to define care in terms of the virtues, but meta‐analyses of these attempts are conspicuously absent from the literature. No taxonomies have been offered to situate them within the broader care ethical and virtue theoretical discourses, nor have any substantial discussions of each option's merits and shortcomings. I attempt to fill this lacuna by presenting an analysis of the claim that care is a virtue (what I call the “virtue thesis” about care). I begin by (...) distinguishing weaker and stronger versions of the virtue thesis, arguing that the weaker version is an orthodox view among care ethicists. I then go on to develop a taxonomy of approaches available to care ethicists seeking to flesh out the virtue thesis. The three I identify are analogical approaches, according to which care is analogous to some existing virtue; supplementalist approaches, according to which care is a novel virtue; and cardinalist approaches, according to which care is a cardinal virtue. Following this, I defend the virtue thesis from some foreseeable objections and argue that its most promising version is analogical. (shrink)

In contrast to medical care, which is focused on the individual patient, public health is focused on collective health. This article argues that, in order to better protect the individual, discussions of public health would benefit from incorporating the insights of virtue ethics. There are three reasons to for this. First, the collective focus may cause neglect of the effects of public health policy on the interests and rights of individuals and minorities. Second, whereas the one-on-one encounters in medical care (...) facilitate a compassionate and caring attitude, public health involves a distance between professionals and the public. Therefore, public health professionals must use imagination and care to evaluate the effects of policies on individuals. Third, the relationship between public health professionals and the people who are affected by the policies they design is characterized by power asymmetry, demanding a high level of responsibility from those who wield them. Against this background, it is argued that public health professionals should develop the virtues of responsibility, compassion and humility. The examples provided, i.e. breastfeeding information and vaccination policy, illustrate the importance of these virtues, which needed for normative as well as instrumental reasons, i.e. as a way to restore trust. (shrink)

A dominant area of inquiry within intergenerational ethics concerns how goods ought to be justly distributed between noncontemporaries. Contractualist theories of justice that have broached these discussions have often centered on the concepts of mutual advantage and reciprocal cooperation between rational, self‐interested beings. However, another prominent reason that many in the present feel that they have obligations toward future generations is not due to self‐interested reciprocity, but simply because they care about what happens to them. Care ethics promises to be (...) conceptually well‐suited for articulating this latter reason: given that future generations are in a perpetual condition of dependency on present‐day people's actions, this is precisely the kind of relational structure that care theorists should be interested in morally evaluating. Unfortunately, the care literature has been largely silent on intergenerational ethics. This article aims to advance this literature, offering the blueprints of what a care ethic concerning future generations—a “future care ethic”—should look like. The resultant ethic defends a sufficientarian theory of obligation: people in the present ought to ensure the conditions needed to encourage and sustain a world that enables good caring relations to flourish. (shrink)

The practice of relational leadership is essential for dealing with the increasingly urgent and complex social, economic and environmental issues that characterize sustainability. Despite growing attention to both relational leadership and leadership for sustainability, an ethical understanding of both is limited. This is problematic as both sustainability and relational leadership are rife with moral implications. This paper conceptually explores how the moral theory of ‘ethics of care’ can help to illuminate the ethical dimensions of relational leadership for sustainability. In doing (...) so, the implications of ethics of care more broadly for the practice of relational leadership development are elaborated. From a caring perspective, a ‘relational stance’ or logic of effectiveness can be fostered through engaging in a reflective process of moral education through conversation. In starting this dialogue, we can begin to build capacity for relational leadership for sustainability and, thus, support the development of individual well-being and organizational and societal flourishing. (shrink)

For Aristotle, in making the deliberate choice to incorporate the extensive requirements of the young into the aims of one’s life, people realise their own good. In this paper I will argue that this is a promising way to think about the ethics of care and parenting. Modern theories, which focus on duty and obligation, direct our attention to conflicts of interests in our caring activities. Aristotle’s explanation, in contrast, explains how nurturing others not only develops a core part of (...) the self but also lead to an appreciation of the value of interpersonal relationships. (shrink)

Although it has been recognized that employees regularly engage in non-green behaviors, little research has been conducted to explain how these behaviors may be avoided. Using data from a three-wave study, this study tested a moderated-mediation model in which trust in the immediate manager was expected to increase the indirect effect of supervisory support for the environment on non-green behaviors through employee environmental commitment. While the findings showed, as predicted, that exchange relationships with the immediate manager reduce the tendency of (...) employees to engage in non-green behaviors, the indirect effect of supervisory support on non-green behaviors through employee environmental commitment was moderated at a low level of trust in the manager, contrary to predictions. Though unexpected, this result seems less surprising when discussed in the light of negotiated exchange, suggesting that employee efforts to avoid non-green behaviors need to be seen as the result of a deal between managers and subordinates. The findings of this study contribute to the emerging literature on social exchange in an environmental context and have implications for organizations seeking to achieve environmental sustainability. (shrink)

Some people feel that they should boycott Israel or their local anti-LGBTQ bakery, despite it being difficult to establish these obligations based on standard consequentialist or deontic considerations. I develop a framework on which such self-reports are accurate: I propose that we see some boycotting as akin to a public mourning practice, such as the Jewish tradition of sitting shiva. Mourning practices are complex and socially recognized ways of honoring the dead, as well as expressing and directing the range of (...) emotions we have in the face of loss. Likewise, I suggest that some boycotts are a way of standing in solidarity with victims, as well as expressing and giving direction to our reactive attitudes in the face of injustice. And just as your obligations to mourn are grounded in community membership and your relationships with others, I say the same about your obligations to participate in those boycotts. (shrink)

Increasingly it is recognised that the background characteristics of employees in the hotel industry affect their ethical behaviour in the service delivery process. In particular, the gender of employees in the hotel industry has been shown to affect the ethical conduct of employees. Despite this recognition, few empirical studies in Ghana have examined the relationship between the gender of employees in the hotel industry and their ethical behaviour. Based on a cross-sectional survey of 320 randomly sampled hotel employees in the (...) Kumasi Metropolis, Ghana, this paper will investigate the relationship between the gender of hotel employees and ethical behaviour in the performance of their daily service delivery roles. Data will be analysed using descriptive statistics and correlation analysis. Findings suggest that there are more male employees than females in the hotel industry in Kumasi. More males than females also occupy managerial positions. However, females were more likely to exhibit ethical conduct in the service delivery process than their male counterparts. The implications of these findings will be discussed. Conclusions will be drawn and recommendation for further research will also be indicated. (shrink)

ABSTRACTGiven the existing inequities in climate change, any proposed climate engineering strategy to solve the climate problem must meet a high threshold for justice. In contrast to an overly thin paradigm for justice that demands only a science-based assessment of potential temperature-related benefits and harms, we argue for the importance of attention to recognitional justice. Recognitional justice, we go on to claim, calls for a different type of assessment tool. Such an assessment would pay attention to neglected considerations such as (...) relationships, context, power, vulnerability, narrative, and affect. Here we develop a care-ethics related tool for assessing the justice of climate engineering with stratospheric aerosols, and suggest that qualitative social science methods may be required for its effective application. We illustrate the use of this tool with a case study involving interviews about stratospheric aerosol injection conducted in Kenya, the Solomon Islands... (shrink)

In this paper, we argue that ‘good care’ in residential nursing homes is enacted through different care practices that are either inspired by a ‘professional logic of care’ that aims for justice and non-maleficence in the professional treatment of residents, or by a ‘relational logic of care’, which attends to the relational quality and the meaning of interpersonal connectedness in people’s lives. Rather than favoring one care logic over the other, this paper indicates how important aspects of care are constantly (...) negotiated between different care practices. Based on the intricate everyday negotiations observed during an ethnographic field study at an elderly nursing home in Germany, the paper puts forth the argument that care is always a matter of tinkering with different, sometimes competing ‘goods’. This tinkering process, which unfolds through ‘intuitive deliberation’, ‘situated assessment’ and ‘affective juggling’ is then theorized along the conceptualization of a ‘practical ethics of care’: an ethics which makes no a priori judgments of what may be considered as good or bad care, but instead calls for momentary judgments that are pliable across changing situations. (shrink)

A growing epidemic of chronic illness in working populations contributes to a negative spiral of work and organizational outcomes including increased absenteeism, prolonged disability or illness claims, early work termination, and non-voluntary unemployment. Chronic illness, characterized by fluctuating trends in clinical and embodied experience along a prolonged time course, is intersubjectively experienced within a social context, and variably responded to and managed within and between organizations and countries. Drawing from global health, we discuss chronic illness experience and organizations as context (...) for chronic illness experience. We then propose a model of ‘organizational caregiving,’ highlighting how invested relational understanding, attitude, intent, and acts of care can enrich the work and organizational experiences of employees with chronic illness. (shrink)

ABSTRACTThe search for universal ethics among journalists has yet to receive general acceptance because previous attempts have sought a code of ethics to which all journalists around the globe could agree. Yet, starting with the universal principle of caring for others leads to seeing the feminist approach to ethics, namely the ethics of care and feminist discursive ethics, as a partial approach toward a universal ethic for journalists. Building on the work of Gilligan, Steiner, Buzzanell and others, we argue that (...) such an approach would have universal appeal. The implications of this for the training of journalists include getting journalists to recognizie the universality of caring for others and apply the 6 steps toward ethical public discourse. The migration crisis in Europe in 2015 provides an example of how this could lead to more compassion in the coverage of those who are most vulnerable in modern societies. (shrink)

Care ethics emphasizes responsibility as a key element for caring practices. Responsibilities to care are taken by certain groups of people, making caring practices into moral and political practices in which responsibilities are assigned, assumed, or implicitly expected, as well as deflected. Despite this attention for social practices of distribution and its unequal result, making certain groups of people the recipient of more caring responsibilities than others, the passive aspect of a caring responsibility has been underexposed by care ethics. By (...) drawing upon the work of the French phenomenologist Jean-Luc Marion, a care ethical conceptualization of responsibility can by enriched, by scrutinizing how responsibility is literally a response to something else. This paper starts with a vignette of an everyday situation of professional care. After that the current body of care ethical literature on responsibility is presented, followed by Marion’s phenomenology of givenness, using his analysis of Caravaggio’s painting The Calling of St. Matthew and resulting in his redefinition of responsibility. In the next section we present a table in which we juxtapose four distinct paradigms of responsibility, which we will describe briefly. The final section consists of an exploration of the paradigms by an analysis of the vignette and results in a conclusion concerning what Marion’s view has to offer to care ethics with regard to responsibility. (shrink)

Aging brings about the ordeal of coping. Younger people also cope, but for those in old age, the ordeal is so often elegiac, forced upon the self by changing functions within the body and by the outside social world, with its many impediments to the continuity of former roles, pursuits, and self‐identities. Coping with change can be affirming, but when what is being forgone seems more valuable than what lies ahead, it is travail. For most, the coping is managed more (...) moderately by a sense of resignation. This is especially true for those who survive into profound old age, when one is viewed as if being old is one’s essential identity and nature. We must recognize and affirm difference and change without stigmatizing or losing sight of the specific capabilities and circumstances of the individual. This is what I think the often‐used, but less often clearly defined, notion of a “person‐centered” orientation should signify.Individuals age, but so do societies, not simply because they have a large population over age sixty‐five, but in the sense that societies as a whole are also buffeted by significant disruption in orders of meaning. Aging has a public as well as a private manifestation, a social as well as a personal embodiment, and how it is paid attention to in culture, politics, and policy makes a great difference to how aging is concretely experienced in human lives. In this essay, I explore how the moral imagination nurtured by the practices of solidarity and care—and nurturing them in turn—can come of age—and how these practices can take their rightful place in an ethically mature political culture. (shrink)

Interactions between an intelligent software agent and a human user are ubiquitous in everyday situations such as access to information, entertainment, and purchases. In such interactions, the ISA mediates the user’s access to the content, or controls some other aspect of the user experience, and is not designed to be neutral about outcomes of user choices. Like human users, ISAs are driven by goals, make autonomous decisions, and can learn from experience. Using ideas from bounded rationality, we frame these interactions (...) as instances of an ISA whose reward depends on actions performed by the user. Such agents benefit by steering the user’s behaviour towards outcomes that maximise the ISA’s utility, which may or may not be aligned with that of the user. Video games, news recommendation aggregation engines, and fitness trackers can all be instances of this general case. Our analysis facilitates distinguishing various subcases of interaction, as well as second-order effects that might include the possibility for adaptive interfaces to induce behavioural addiction, and/or change in user belief. We present these types of interaction within a conceptual framework, and review current examples of persuasive technologies and the issues that arise from their use. We argue that the nature of the feedback commonly used by learning agents to update their models and subsequent decisions could steer the behaviour of human users away from what benefits them, and in a direction that can undermine autonomy and cause further disparity between actions and goals as exemplified by addictive and compulsive behaviour. We discuss some of the ethical, social and legal implications of this technology and argue that it can sometimes exploit and reinforce weaknesses in human beings. (shrink)

How should feminists view acts of self-sacrifice performed by women? According to a long-standing critique of care ethics such acts ought to be viewed with scepticism. Care ethics, it is claimed, celebrates acts of self-sacrifice on the part of carers and in doing so encourages women to choose caring for others over their own self-development. In doing so, care ethics frustrates attempts to liberate women from the oppression of patriarchy. Care ethicists have responded to this critique by noting limits on (...) the level, form, or scope of self-sacrifice that work to restrict its role in their theories. While we do not here take issue with the initial feminist critiques of self-sacrifice, we suspect that the strategies offered by Care ethicists in response are importantly flawed. Specifically, these responses undervalue the positive roles that self-sacrifice can play in fighting patriarchal oppression. As a result, in attempting to restrict an oppressive norm, these responses risk foreclosing on valuable means of resistance. Our aim is to explore these positive roles for self-sacrifice and thereby rehabilitate its standing with feminists. (shrink)

Moral distress has been the subject of extensive research and debate in the nursing ethics literature since the mid-1980s, but the concept has received comparatively little attention from those working outside of applied ethics. In this article, I defend a care ethical account of moral distress, according to which the phenomenon is the product of an agent’s inability to live up to one of her caring commitments. This account has a number of attractions. First, it places a greater emphasis on (...) the importance of the relationship between the caregiver and her cared-for than that found in previous accounts. Second, it does not make problematic assumptions about the correctness of a caregiver’s moral judgments, as has been claimed in relation to previous accounts of moral distress. Finally, my account allows for a clear conceptual distinction to be drawn between moral distress and other forms of negative moral emotion such as guilt and regret. Earlier accounts draw this distinction by appealing to the causal aetiology of moral distress, but as I show here, such appeals are ultimately unsuccessful unless they are made from an explicitly care ethical starting point. One of the implications of my account is that moral distress has the potential to occur in the context of any caregiving relationship. This claim is explored in the final section of the paper, in relation to student-teacher and parent-child caregiving. (shrink)

In this article, I will explore the ethical concerns arising out of the use of preimplantation tissue typing to create saviour siblings. There are two main ethical concerns about the welfare of the child to be born as a result of PTT. The first is whether the child to be born is treated as a commodity, as simply a means to save the life of his or her sibling. The second is whether the child to be born will be harmed (...) as a result of PTT, either physically, psychologically or socially. These two ethical concerns reflect an individualistic approach to the welfare of the child, whose interests are treated as largely separate to the interests of other family members. I will argue that the welfare of the child born as a result of PTT should be conceived more broadly to include not only the child’s individual interests, but also the collective interests the child shares with his or her family. I base this broader conception of welfare on the notion of human flourishing, which recognises that the welfare of a child is inextricably connected to the welfare of the intimate collective that is his or her family. The collective interests of intimate family members are particularly relevant in the context of PTT, as the members are engaged in a shared journey to save the life of an ill child. (shrink)

In India, the private healthcare sector is rapidly growing. The focus on profit and curative treatment in this sector carries the danger of overtreatment and lack of attention to types of care where the margin of profit is limited, such as palliative care. Since further expansion of the private healthcare sector is unavoidable and even necessary due to limited government spending on healthcare in India, ways to promote palliative care awareness in such an environment need to be found. An important (...) step towards this goal is the development of healthcare ethics education with a focus on those ethical theories which are most appropriate from a socio-cultural perspective. Principlism, the dominant model in Western healthcare ethics which applies the principles autonomy, beneficence, nonmaleficence and justice to ethical cases, may not be most suited to the Indian context. Principlism very strongly focuses on individualistic autonomy. Although autonomy can obviously not be neglected in Indian healthcare, ethical theories which pay more attention to relational aspects may be more appropriate. In this context, Care Ethics appears as a valuable ethical theory. Moreover, the focus on caring relationships in Care Ethics clearly points to the need of palliative care. Development of socio-culturally appropriate healthcare ethics education can inculcate ethical sensitivity which will benefit palliative care in India. (shrink)

In recent times, daily, ordinary medical practices have incontrovertibly been developing under the condition of complexity. Complexity jeopardizes the moral core of practicing medicine: helping people, with their illnesses and suffering, in a medically competent way. Practical wisdom (a modification of the Aristotelian phronèsis) has been proposed as part of the solution to navigate complexity, aiming at the provision of morally good care. Practical wisdom should help practitioners to maneuver in complexity, where the presupposed linear ways of operating prove to (...) be insufficient. However, this solution is unsatisfactory, because the proposed versions of practical wisdom are too individualistic of nature, while physicians are continuously operating in varying teams, and dealing with complicated technologies and pressing structures. A second point of critique is, that these versions are theory based, and thus insufficiently attuned to the actual context of everyday medical practices. Now, our proposal is to use an approach of practical wisdom that enables medical practices to counter the complexity issue and to re-invent the moral core of medical practicing as well. This implies a practice oriented approach, as thematized by practice theory, qualitative empirical research from the inside, and abduction from actual performed practical wisdom towards an apt understanding of phronèsis. (shrink)

Many criminal offenders come from disadvantaged backgrounds, which punishment entrenches. Criminal culpability explains some disadvantageous treatment in state-offender interactions; yet offenders remain people, and ‘some mother’s child’, in Eva Kittay’s terms. Offending behaviour neither erases needs, nor fully excuses our responsibility for offenders’ needs. Caring is demanded in principle, recognising the offender’s personhood. Supporting offenders may amplify welfare resources: equipping offenders to provide self-care; to meet caring responsibilities; and enabling offenders’ contribution to shared social life, by providing support and furthering (...) the choices of others seeking to engage with them. The desistance paradigm (viewing desistance from offending as a process, following from an offender’s active choice in the context of stabilising social structures and personal circumstances), implies that a supportive environment may facilitate reduced recidivism. While decisions about criminal culpability need justice, we may use state resources most effectively by also including care ethics in our thinking about punishment. (shrink)

The paper offers a wide-angle view of ethics and welfare through the lens of ‘moral economy’. It examines economic activities in relation to a view of welfare as well-being, and to ethics in terms of economic justice. Rather than draw upon abstract ideal theories such as Rawlsian or Capabilities approaches, it calls for an evaluation of actually existing sources of harm and benefit in neoliberal capitalism. It argues that we need to look behind economic outcomes in terms of how much (...) money different people have, examine their economic relations to others, and evaluate the justifications of these relations and their associated rights and practices. It distinguishes three sources of income – earned income, transfers, and unearned income, and argues that the last of these has no functional or ethical justification but has major implications for welfare. It then comments on the policy implications of the argument, including brief comments on asset-based welfare and universal basic income policies, and concludes. (shrink)

Background: For many years the body of literature known as ‘care ethics’ or ‘ethics of care’ has been discussed as regards its status and nature. There is much confusion and little structured discussion. The paper of Klaver et al. (2014) was written as a discussion article to which we respond. Objectives: We aim to contribute to the ongoing discussion about the status and nature of care ethics. Research design: Responding to ‘Demarcation of the ethics of care as a discipline’ by (...) Klaver et al. (2014) and ‘Three versions of an ethics of care’ by Edwards (2009), we identified shared concerns and formulated criticisms of both texts in order to develop an alternative view. Participants and research context: This paper has been written from the academic context of a master in care ethics an policy. Ethical considerations: We have tried to be fair and respectful to the authors discussed. Findings: Both Klaver et al. (2014) and Edwards (2009) raise important concerns about the question if care ethics can be considered an academic discipline, and to what extend it can be seen as a moral theory. Despite shared concerns, their arguments fail to convince us in all respects. Discussion and conclusion: We propose to conceive care ethics as an interdisciplinary field of inquiry, incorporating a dialectical relation between empirical research and theoretical reflection. Departing from the notion of caring as a practice of contributing to a life-sustaining web, we argue that care ethics can only profit from a loosely organized academic profile that allows for flexibility and critical attitude that brings us close to the good emerging in specific practices. This asks for ways of searching for a common focus and interest that is inherently democratic and dialogical and thus beyond demarcation. (shrink)

In this paper, I take up the challenge that political activism runs the risk of generating abstract freedoms for oppressed subjects and neglecting the effects of oppression on the development of subjectivity. I argue that a political activism in concert with a companion ethics of advocacy and listening is best positioned to improve the political and economic conditions of individuals as well as ensure that they are able to realize their freedom in meaningful action. In this paper I distinguish political (...) emancipation from human emancipation using the political and ethical writings of Simone de Beauvoir. I then argue that a feminist ethics of advocacy and listening can serve the project of human emancipation as emancipatory advocacy. I then return to Beauvoir to illuminate the dynamics of privilege, risk, and ambiguity in emancipatory advocacy through her own activism and advocacy in the case of Djamila Boupacha and Algerian independence. (shrink)

This paper advances stakeholder salience theory from the viewpoint of small businesses. It is argued that the stakeholder salience process for small businesses is influenced by their local embeddedness, captured by the idea of social proximity, and characterised by multiple relationships that the owner-manager and stakeholders share beyond the business context. It is further stated that the ethics of care is a valuable ethical lens through which to understand social proximity in small businesses. The contribution of the study conceptualises how (...) the perceived social proximity between local stakeholders and small business owner-managers influences managerial considerations of the legitimacy, power and urgency of stakeholders and their claims. Specifically, the paradoxical nature of close relationships in the salience process is acknowledged and discussed. (shrink)

This paper uncovers a distinctively social type of injustice that lies in the kinds of wrongs we can do to each other specifically as social beings. In this paper, social injustice is not principally about unfair distributions of socio-economic goods among citizens. Instead, it is about the ways we can violate each other’s fundamental rights to lead socially integrated lives in close proximity and relationship with other people. This paper homes in on a particular type of social injustice, which we (...) can call social contribution injustice. The paper identifies two distinct forms of social contribution injustice. The first form involves compromising a person’s social resources so as to deny her adequate scope to contribute socially. The second form involves unjustly misvaluing a person as a social contributor, usually by not taking her seriously as a social contributor. (shrink)

Over the past years, various accounts of ethical consumption have been produced which identify certain concepts as central to mediating the ethical relationship between the consumer and the consumed. Scholars across disciplinary fields have explored how individuals construe their ethical consumption responsibilities and commitments through the notions of identity, taking care and doing good, proximity and distance, suggesting the centrality of these themes to consumer engagement in ethical practices. This paper contributes to the body of research concerned with unravelling consumers’ (...) conceptually mediated relationship to moral and ethical issues in the sphere of consumption by revealing a new set of ideas through which people interpret and relate to consumption ethics. Drawing upon findings from an empirical study on self-perceived ethical food consumers, I demonstrate that people’s perceptions and views of ethical problems around consumption are bound up with notions of vulnerability, suffering, and harm, and that these notions permeate and impact all aspects of ethical consumer behaviour. The paper concludes by arguing that we need to further explore the conceptual underpinnings of ethical consumer commitments and practices, and expand the conceptual toolkit of research on ethical consumption to account for a wider range of ideas and notions that shape individual as well as collective motivations, intentions, and actions throughout the process of becoming and being an ethical consumer. Finally, the paper suggests a specific analytical framework to facilitate such research. (shrink)

In this paper, I argue that care ethics should be understood as a form of value pluralism. Writers on the ethics of care tend not explicitly to address issues in the theory of value, although much of what has been written about care ethics may be taken to suggest that it endorses some form of value monism. I argue against this conception of care ethics by showing that the practical reality of caregiving is more accurately represented by a pluralist account (...) of value. Practices of care are plausibly guided by a number of distinct and potentially conflicting values. These include quality of life, autonomy, dignity, personal development, and the value of nurturant relationships. Whilst caring takes each of these values to be important in its own right, they are not always jointly realisable, and carers are sometimes forced to promote one such value at the expense of another. The possibility of conflict between values is, of course, precisely what a pluralist conception of value tells us to expect. In this respect, then, value pluralism more faithfully reflects the reality of caregiving than does value monism, and care ethicists ought for this reason to endorse it. (shrink)