The ethics of care, adopted in much of the nursing literature, is usually framed in opposition to the Kantian ethics of principle. Irrespective of whether the ethics of care is grounded in gender, as with Gilligan and Noddings, or inscribed on Heidegger's ontology, as with Benner, Kant remains the philosophical adversary, honouring reason rather than emotion, universality rather than context, and individual autonomy rather than interdependence. During the past decade, however, a great deal of Kantian scholarship – including feminist scholarship (...) – has rendered this series of oppositions questionable, challenging the view that an ethics of care and Kant's moral law are irreconcilable. This paper therefore re‐examines Kant's writings, drawing on recent scholarship, and argues both that they provide the care ethicists with everything they require, and that they offer something beyond an ethics of care, something that repairs the deficits in philosophies of caring. It concludes by suggesting that a Kantian ethics of care has significant implications for the construction of nursing knowledge. (shrink)

In this essay I distinguish four different modes of feminist critique of reason. Discussing the work of authors such as Keller, Irigaray, and Butler, I point out that the issue of masculine connotations has been addressed with regard to different concepts-or at least different aspects-of reason. In view of a tendency to overdraw the objections, I suggest to reformulate the feminist critique of reason. I also argue that a rediscovery of those philosophical concepts of reason that do not restrict this (...) term to instrumental rationality might be useful for this purpose. (shrink)

Patient-centered care is now recognized as a clinical method and ideal model for patient – health professional relationships, and many definitions have influenced its evolution. Overall the patient-centered care literature has provided relatively little to define patient-centered care at the level of the patient-professional relationship. Additionally, patient-centered care lacks grounding in ethical theory. This thesis asserts that theoretical concepts from the ethics of care can provide a stronger conceptual basis for patient-centered care.This thesis begins with a critical interpretive review of (...) the patient-centered care literature, yielding 12 articles that previously introduced new theoretical and definitional work on patient-centered care and patient-centered communication. Six common themes and ideas were discovered, and include Engaging the Patient as a Whole Person, Recognizing and Responding to Emotions, Fostering a Therapeutic Alliance, Promoting an Exchange of Information, Sharing Decision Making, and Enabling Self-Management and Patient Navigation. These elements were then compared to key elements of the ethics of care. This thesis argues that feminists have good reason to consider care as a type of moral duty, and it describes how this duty functions. This thesis also argues that a duty to care is triggered when caregivers are presented with particular substantive forms of vulnerability. Specifically, this thesis argues that vulnerable subjects whose constitutive needs are at risk require particular moral obligations. The links between the ethics of care and patient-centered care are discussed, including how an ethics of care response ought to function in the health care context. Finally, the cases of J.J. and Makayla Sault, two aboriginal girls who refused chemotherapy in favour of traditional aboriginal healing practices, are analyzed. This thesis offers a short scoping review of the bioethics discourse surrounding these cases. A review of this discourse revealed several common themes, which included the peripheral importance of culture and history, the equating of best interests with survival, the supremacy of science-based medicine, and the impartial application of ethical principles. This thesis recommends that health care professionals apply an ethics of care approach to similar ethical dilemmas in the future, which involves shifting one's ethical focus to the central relationships of the case, understanding the unique perspective of the patient's narrative, and promoting a care-based rather than a justice-based approach to problem-solving. (shrink)

Two humanist, critical approaches—those of Dorothy Dinnerstein and Immanuel Kant—are summarized, compared, and employed to critique gender bias in science education. The value of Dinnerstein’s approach lies in her way of seeing conventional “masculinity” and conventional “femininity” as developing in relation to each other from early childhood. Because of women’s dominance of early childcare and adults’ enduring, sexist resentment of that dominance, women become inhumanely associated with the non-adult qualities of immaturity, dependence, and childish vulnerability and punish-ability; and male human (...) beings—to whom woman-resenting convention assigns the impossible task of absolutely triumphing over “the feminine,” childhood experience, and all human vulnerability—become inhumanely held to unachievable standards of super-hero invulnerability and god-like mental and practical infallibility. The value of Kant’s approach lies in his insistence that our sense of what is right and necessary for social progress must arise in a practically engaged and experientially full manner, rather than (1) from concepts (such as rigid ideological prescriptions) conceived as being detached from sense experience and as arising from an otherworldly, divine or quasi-divine realm of moral infallibility (such concepts being conventionally associated with “masculine” authority and leadership), or (2) from a sense of being trapped in what—in a given historical, cultural, or experiential moment—may appear as an absolute and unchangeable reality of embodied human experience (an anti-critical, anti-intellectual, and anti-progressive sense of things often associated with disempowered “feminine” experience). I demonstrate that critique integrating these approaches is useful in a science education setting. (shrink)