Though we cherish freedom and equality, there are human relations we commonly take to be morally permissible despite the fact that they essentially involve an inequality specifically of freedom, i.e., parental and fiduciary relations. In this article, I argue that the morality of these relations is best understood through a very old and dangerous concept, the concept of status. Despite their historic and continuing abuses, status relations are alive and well today, I argue, because some of them are necessary. We (...) must therefore carefully specify the conditions in which such status relations may morally obtain, as well as the duties of virtue and duties of right to which all parties are subject when it does (including a duty of care) to clearly articulate the ways in which these putatively moral status relations that essentially involve an asymmetry of autonomy (status relations) can go well or badly even within the context of the Kantian tradition from which our current legal and social practices arose. To this end, I offer Kant's own concept of status as a promising one because in Kant's theory, status is a nexus of virtue and right that is reducible to neither property nor contract but akin to each in familiar ways. Once status is admitted as an alternative to property and contract, status may be extended beyond Kant's domestic paradigm, most perspicuously to institutional ethics. In this article, I sketch a status-based theory of stakeholding that locates environmental impact, institutional oppression, and other significant features of our moral landscape within a Kantian framework of duties rich enough to more accurately characterize the complexities of stakeholding than current tradition has allowed. (shrink)

Acquired Immune Deficiency Syndrome (AIDS) is an emotive subject, particularly in southern Africa. Among those who have been directly affected by the disease, or who perceive themselves to be personally at risk, talking about AIDS inevitably arouses strong emotions - amongst them fear, distress, loss and anger. Conventionally, human geography research has avoided engagement with such emotions. Although the ideal of the detached observer has been roundly critiqued, the emphasis in methodological literature on 'doing no harm' has led even qualitative (...) researchers to avoid difficult emotional encounters. Nonetheless, research is inevitably shaped by emotions, not least those of the researchers themselves. In this paper, we examine the role of emotions in the research process through our experiences of researching the lives of young AIDS migrants in Malawi and Lesotho. We explore how the context of the research gave rise to the production of particular emotions, and how, in response, we shaped the research, presenting a research agenda focused more on migration than AIDS. This example reveals a tension between universalised ethics expressed through ethical research guidelines that demand informed consent, and ethics of care, sensitive to emotional context. It also demonstrates how dualistic distinctions between reason and emotion, justice and care, global and local are unhelpful in interpreting the ethics of research practice. (shrink)

In recent decades, care has played an increasingly crucial role in the self-understanding of the human being in the West. Nevertheless, there is a great deal of confusion and uncertainty surrounding the notion of care. One of the focal points of critics is the normativity of care. To what extent does care have an obligatory character? Only when the objective normative basis of care is sufficiently clarified, care practices can be evaluated and optimised from an ethical perspective. In this contribution (...) we explain how the anthropology of personalism could bring us closer to the normative core of care. The paper starts with a general overview of the contribution of care ethics in healthcare and the problems in relation to the normativity of care. Thereafter, we set the viewpoints of the Louvain tradition of personalism apart en show that this view on the human person is in keeping with a few basic principles of care ethics. Next, we describe how a personalist approach to care ethics can indeed indicate in which direction action must be taken so that human action may be considered ethically sound. (shrink)

In this article, we explore the potential contribution of care ethics to the field of media ethics. In the first part of this article, we discuss the theoretical and philosophical background of the ethics of care. In the second part, we suggest some specific avenues for theoretical, critical, and practical applications of care ethics to the field of journalism and media ethics.

Notwithstanding the fact that care ethics has received increased attention, it has also faced much criticism. One of the focal points of critics is the normativity of care. Only when the objective normative basis of care is sufficiently clarified can care practices be evaluated and optimized from an ethical point of view. We emphasize that two levels of normativity can be identified: the context level and the foundational anthropology level. The personalist approach to care ethics is normatively stronger, at least (...) on one level, namely the foundational anthropology level. This personalist approach to care ethics indicates in which direction action must be taken so that human action may be considered ethically sound. (shrink)

Care ethics takes as central the discerning of needs in those being cared for and attempts to meet those needs. Perceptive caring agents are more likely to be able to identify needs in those for whom they are caring. The identification of needs is no small matter, not least in teaching encounters. This paper modestly proposes that at least some of the needs a caring agent should attempt to meet are a function of the identity of the patient of caring (...) action. Taking Nel Noddings’ account of care ethics as representative, I present it in outline. This leads to the needs-identification problematic. Following this I turn to Soran Reader’s account of needs. I interpret this to offer what I designate as identity as ‘what-ness’. Such an understanding of identity-based needs is a starting point for the caring agent but a more nuanced account, of identity as ‘who-ness’, is argued to be preferable. Identity as ‘who-ness’, as expressed in Paul Ricoeur’s work, advances the discussion, culminating in his concept of the ‘capable human being’. Having brought this aspect of Ricoeur’s thought into conversation with care ethics, I offer an account of identity-based needs conducive to the broader aims of the care ethical project. Finally, I consider what this bolstered account of care ethics might say about a brief and illustrative teaching encounter. (shrink)

The perspectives of the dominant Western ethical theories, have dominated the concepts of autonomy and informed consent for many years. Recently this dominant understanding has been challenged by ethics of care which, although, also emanates from the West presents a more nuanced concept: relational autonomy, which is more faithful to our human experience. By paying particular attention to relational autonomy, particularity and Process approach to ethical deliberations in ethics of care, this paper seeks to construct a concept of informed consent (...) from the perspective of ethics of care which is here called relational autonomy-in-informed consent. Thus, providing a broader theoretical basis for informed consent beyond the usual theoretical perspectives that are particularly Western. Care ethics provides such a broader basis because it appeals to a global perspective that encompasses lessons from other cultures, and this will help to enrich the current ideas of bioethics principles of autonomy and informed consent. This objective will be achieved by exploring the ethics of care emphasis on relationships based on a universal experience of caring; and by contrasting its concept of autonomy as relational with the understanding of autonomy in the approaches of the dominant moral theories that reflect rational, individualistic, and rights-oriented autonomy of the American liberalism. (shrink)

The purpose of this paper is to examine the concept of Schadenfreude - the pleasure felt at another’s misfortune - and to argue that feeling it in the course of health care work, as elsewhere, is evidence of a deficient character. In order to show that Schadenfreude is an objectionable emotion in health care work, I first offer some conceptual remarks about emotions generally and their differential treatment in Kantian and Aristotelian thought. Second, I argue that an appreciation of the (...) rationality of the emotions is crucial to our self-understanding as persons in general and nurses in particular. Third, I present a critique of Portmann’s (2000, When Bad Things Happen to Other People. London: Routledge) defence of Schadenfreude with examples from both nursing and medical scenarios. Specifically, I show how his exculpation of the emotion in terms of low self-esteem and a commitment to justice are not compelling. I argue that we are active in the construction of our emotional experiences of Schadenfreude, how we may indeed ‘nurse’ the emotion, and thus become culpable for them in ethical terms. (shrink)

The discourse on the future of work should learn from a turn in philosophy that occurred in the 1980s, one that recognizes the good life towards which ethics strives can only be reached on a foundation of caring relationships (Gillian, 1982; Noddings, 1984). Care ethics recognizes that human well-being is a group project, one that involves strong relationships, and concern for bodies and emotions. Too often, these features are left out of research exploring robotics in the workplace. This paper outlines (...) the main tenets of care ethics, then applies the moral framework to the context of industrial and retail settings using robots. This approach sees these contexts through a relational lens, helping to identify, evaluate, and improve relationships critical to ensuring workers’ well-being. Second, care ethics considers taking care of people’s bodies beyond mere safety, examining how working with robots can exacerbate societal or economic pressures. Lastly, care ethics takes emotions as an important source of knowledge in building and supporting care. Additionally, this paper contributes to the care ethics literature by applying the framework to the context of robotized industrial workplaces, which has yet to be done. (shrink)

This paper aims to critique the phenomenon of advanced patient autonomy and choice in healthcare within the specific context of self-testing devices. A growing number of self-testing medical devices are currently available for home use. The premise underpinning many of these devices is that they assist individuals to be more autonomous in the assessment and management of their health. Increased patient autonomy is assumed to be a good thing. We take issue with this assumption and argue that self-testing provides a (...) specific example how increased patient autonomy and choice within healthcare might not best serve the patient population. We propose that current interpretations of autonomy in healthcare are based on negative accounts of liberty to the detriment of a more relational understanding. We also propose that Kantian philosophy is often applied to the healthcare arena in an inappropriate manner. We draw on the philosophical literature and examples from the self-testing process to support these claims. We conclude by offering an alternative account of autonomy based on the interrelated concepts of relationality, care and responsibility. (shrink)

Within bioethics, Kant’s conception of autonomy is often portrayed as excessively rationalistic, abstract, and individualistic, and, therefore, far removed from the reality of patients’ needs. Drawing on recent contributions in Kantian philosophy, we argue that specific features of Kantian autonomy remain relevant for medical ethics and for patient experience. We use contemporary end-of-life illness narratives—a resource that has not been analyzed with respect to autonomy—and show how they illustrate important Kantian themes, namely, the duty to know oneself, the interest in (...) elaborating universalizable principles, and the emphasis on ideals as points of orientation that guide behavior without ever being fully realized. As Kant does, the patient-authors discussed here perceive the end of life as a moment to reflect on the constitutive principles which have governed that life, thereby offering a privileged moment to pursue self-knowledge. We argue that bioethical conceptions of autonomy stand to gain if they revise their conception of Kantian moral philosophy as too formal, abstract, and detached from emotions and personal relationships to be helpfully applied. (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)