Organ donation has gained much attention as the need for transplant exceeds the supply of organs. Various proposals have been put forward to address the organ shortage challenge, ranging from offering incentives to donors, addressing family refusals to donations and instituting presumed consent laws. Presumed consent as the favoured approach has not been universally effective in increasing actual transplants despite its appeal. Few considerations have been given to the broader ethical climate influencing the organ donation debate. This paper examines the (...) ethical climate surrounding organ donation and identifies the challenges existing within such environments. It explores care ethics and its application to the donation system, demonstrating how it can influence the organ donation phases. The conclusion drawn from the analysis is that a caring ethical climate in the pre, during and post-transplant system respects donor autonomy, addresses family reluctance to agree to donation, facilitates the needs of the donee and creates an environment that promotes non-maleficence for all stakeholders. (shrink)

COVID-19 deeply affects many spheres of life. Lockdown measures implemented worldwide have accentuated mental wellbeing changes in the population from the perspectives of space and social relations. These changes leave lasting imprints on individuals and communities. This article draws upon solidarity and care ethics in exploring their role in rebuilding mental wellbeing in the light of constraints arising from lockdown. The diversity of responses to physical and social isolation during the pandemic illuminates the distinctly relational nature of human beings, offering (...) the opportunity for care and solidarity to respond to mental wellbeing challenges in an inclusive and context-sensitive way. (shrink)

This article discusses the challenging context that health care professionals are confronted with, and the impact of this context on their emotional experiences. Care ethics considers emotions as a valuable source of knowledge for good care. Thinking with care ethical theory and looking through a care ethical lens at a practical case example, the authors discern reflective questions that shed light on a care ethical approach toward the role of emotions in care practices, and may be used by practitioners and (...) facilitators for care ethical reflection on similar cases, in the particular and concrete context where issues around emotional experiences arise. The authors emphasize the importance of allowing emotions to exist, to acknowledge them and to not repress them, so that they can serve as a vehicle for ethical behavior in care practices. They stress the difference between acknowledging emotions and expressing them limitlessly. Formational practices and transformational research practices are being proposed to create moral space in care institutions and to support health care professionals to approach the emotionally turbulent practices they encounter in a way that contributes to good care for all those involved. (shrink)

To contribute to our understanding of the relationship between philosophical ideas and medical and healthcare models. A diachronic analysis is put in place in order to evaluate, from an innovative perspective, the influence over the centuries on medical and healthcare models of two philosophical concepts, particularly relevant for health: how Man perceives his identity and how he relates to Nature. Five epochs are identified—the Archaic Age, Classical Antiquity, the Middle Ages, the Modern Age, the ‘Postmodern’ Era—which can be seen, à (...) la Foucault, as ‘fragments between philosophical fractures’. From a historical background perspective, up to the early 1900s progress in medical and healthcare models has moved on a par with the evolution of philosophical debate. Following the Second World War, the Health Service started a series of reforms, provoked by anti-positivistic philosophical transformations. The three main reforms carried out however failed and the medical establishment remained anchored to a mechanical, reductionist approach, perfectly in line with the bureaucratic stance of the administrators. In this context, future scenarios are delineated and an anthropo-ecological model is proposed to re-align philosophy, medicine and health care. (shrink)

Nurses have traditionally been regarded as clinicians that deliver compassionate, safe, and empathetic health care (Nurses again outpace other professions for honesty & ethics, 2018). Caring is a fundamental characteristic, expectation, and moral obligation of the nursing and caregiving professions (Nursing: Scope and standards of practice, American Nurses Association, Silver Spring, MD, 2015). Along with caring, nurses are expected to undertake ever‐expanding duties and complex tasks. In part because of the growing physical, intellectual and emotional demandingness, of nursing as well (...) as technological advances, artificial intelligence (AI) and AI care robots are rapidly changing the healthcare landscape. As technology becomes more advanced, efficient, and economical, opportunities and pressure to introduce AI into nursing care will only increase. In the first part of the article, we review recent and existing applications of AI in nursing and speculate on future use. Second, situate our project within the recent literature on the ethics of nursing and AI. Third, we explore three dominant theories of caring and the two paradigmatic expressions of caring (touch and presence) and conclude that AI—at least for the foreseeable future—is incapable of caring in the sense central to nursing and caregiving ethics. We conclude that for AI to be implemented ethically, it cannot transgress the core values of nursing, usurp aspects of caring that can only meaningfully be carried out by human beings, and it must support, open, or improve opportunities for nurses to provide the uniquely human aspects of care. (shrink)

Though the literature on care ethics has mushroomed in recent years, much remains to be said about several important topics therein. One of these is action. In this article, I draw on Anscombean philosophy of action to develop a kind of meta- or proto-ethical theory of caring actions. I begin by showing how the fragmentary philosophy of action offered by care ethicists meshes with Elizabeth Anscombe's broader philosophy of action, and argue that Anscombe's philosophy of action offers a useful scaffold (...) for a theory of caring actions. Following this, I defend an account of caring actions as those that aim to meet needs. I argue that care aims at satisfying eudaimonistic needs, those things without which one cannot flourish. I then consider the place of caring actions in care ethics. I suggest that if caring actions are to be a starting point for an ethical theory, we ought to reject the notion that a caring action must bring about its intended consequences, and I show how the concept of practice better equips us to evaluate caring actions. (shrink)

One of the most striking and underexplored points of difference between care ethics and other normative theories is its reluctance to offer a theory of right action. Unlike other normative ethical frameworks, care ethicists typically either neglect right action or explicitly refuse to provide a theory thereof. This paper disputes that stance. It begins with an examination of right action in care ethics, offering reasons for care ethicists not to oppose the development of a care ethical theory thereof. It then (...) considers some potential formulations of a first premise of a theory of right action, both demonstrating the diversity of possible first premises and arguing for a monistic subset of these. It subsequently presents some potential second premises, arguing that a care ethical theory of right action ought to adopt a eudaimonistic approach to care. The paper thereby makes several inroads into a care ethical account of moral evaluation. (shrink)

In “Conceptions of Care,” Tove Pettersen discusses and articulates select ways in which care can be comprehended. Several difficulties related to an altruistic understanding of care are examined before the author presents the case for a more favorable concept: mature care. Mature care is intended to take into account the interests of both parties to the caring relationship. This understanding of care facilitates the expression of the relational and reciprocal aspects of caring while emphasizing the equal worth of all involved. (...) Also attended to is the embeddedness of care in wider cultural and political contexts. (shrink)

Purpose The purpose of this paper is to provide insight into the reciprocal relations between the caregiving imparted by immigration centre managers and the role of the researcher in responding to the care that is given by managerial caregivers. To enable this, we draw on a feminist theory of care ethics that considers individuals as relationally interdependent. Design/methodology/approach The analysis draws on a semi-structured interview study involving 20 Finnish immigration reception centre managers. Findings Insight is generated by reflecting on moments (...) of care that arise between research participants and the researcher in a study of immigration centre management. We emphasise the importance of mature care, receptivity and engrossment in building caring relationships with research participants by acknowledging the care they give to others. Our findings draw attention to the moral and epistemological responsibility to practice care in organizational research. Originality/value The paper highlights the relationality between practicing care in immigration centre management and doing qualitative organizational research, both of which rely on mature care, receptivity and engrossment in order to meet the other morally. We draw attention to the moral responsibility to care which characterises researcher–researched relationships and emphasise the importance of challenging methodological discourses that problematise or dismiss care in qualitative organizational research. (shrink)

Despite the omnipresence of the fiduciary in business organisations, there is an omission of theorisations of this legal concept within business ethics literature. This is surprising considering its widespread and embedded use, but even more so given that the presence of ethics within the fiduciary is increasingly contested ground. This article addresses both issues by theorising the fiduciary using an ontological analysis—one which subsequently helps identify a suitable ethical framework. The article argues on two grounds that the ontology of the (...) fiduciary is inherently relational; it renders the fiduciary’s implicit ontology explicit. Firstly, the fiduciary is shown to be process-oriented, indicating an open, emergent, and relational ontology at work. Secondly, historical investigation of the development of the fiduciary highlights its core relationship structure, and the interdependency and power dynamic embedded in the fiduciary are revealed. The argument is advanced that by bringing this inherent relational ontology to the fore, we can see how a relational ethical framework—the Ethics of Care—is best placed to explicate the ethics at work in the fiduciary. The article concludes with a discussion outlining how this ontological theorisation offers utility in steering future practice of the fiduciary. (shrink)

ABSTRACTI draw connections between Hegel’s concepts of recognition and morality and demonstrate how they are compatible with an ethic of care. I explore Hegel’s Sittlichkeit and demonstrate the rol...

Die Anforderungen an das ethisch-professionelle Handeln Pflegender und somit auch die Forderungen an die professionelle Ethikkompetenz Pflegender im praktischen Berufsfeld wandeln sich sowohl qualitativ als auch quantitativ. Dies wird auch in den veränderten normativen Rahmungen der Pflegebildung deutlich. Der Lernort Praxis als ein zentraler Ort pflegebezogener Bildungsprozesse rückt somit nochmals stärker in den Fokus der Ethikkompetenzentwicklung professionell Pflegender. Der Beitrag konturiert zentrale Anforderungen und veränderte Bezüglichkeiten für die Ethikbildung im beruflichen Handlungsfeld professioneller Pflege und formuliert davon ausgehend zentrale Prämissen an (...) organisationsethische Rahmenbedingungen mit dem Ziel, eine ethisch fundierte professionelle pflegerische Handlungspraxis zu unterstützen. (shrink)

Die Anforderungen an das ethisch-professionelle Handeln Pflegender und somit auch die Forderungen an die professionelle Ethikkompetenz Pflegender im praktischen Berufsfeld wandeln sich sowohl qualitativ als auch quantitativ. Dies wird auch in den veränderten normativen Rahmungen der Pflegebildung deutlich. Der Lernort Praxis als ein zentraler Ort pflegebezogener (Aus‑)Bildungsprozesse rückt somit nochmals stärker in den Fokus der Ethikkompetenzentwicklung professionell Pflegender. Der Beitrag konturiert zentrale Anforderungen und veränderte Bezüglichkeiten für die Ethikbildung im beruflichen Handlungsfeld professioneller Pflege und formuliert davon ausgehend zentrale Prämissen an (...) organisationsethische Rahmenbedingungen mit dem Ziel, eine ethisch fundierte professionelle pflegerische Handlungspraxis zu unterstützen. (shrink)

Moral questions surrounding suffering tend to focus on obligations to relieve others’ suffering. In this paper, I focus on the overlooked question of what sufferers morally owe to themselves, arguing that they have the duty to self-care. I discuss agents who have been shaped by moral luck to contribute to their own suffering and canvass the ways in which this damages their moral agency. I contend that these agents have a duty to care for themselves by protecting and expanding their (...) agency, which involves precluding further destruction of agency and ensuring the continued ability to self-care. (shrink)

This article is autoethnographic, based upon the authors’ experiences and reflections upon encountered moments of ethical tension whilst conducting research in rural Malawi. Given that knowledge production, as a process, has been marred by colonial forms of power, the project was underpinned by efforts to achieve a decolonial approach to the research, including the research ethics. The authors share of their endeavours to counterbalance the challenges of power asymmetries whilst researching and working with an Indigenous community whose reality can be (...) marginalised by the Western canon. The authors attempted to ensure that the values and customs of the researched community were respected and central to the research approach. When researchers are guided by local culture and customs, the participants are able to drive the research approach, incorporate their voice and share knowledge that is true to their context and reality. In this way, the research study is illustrative of how an ethics of care can help to facilitate decolonial research practice. (shrink)

Many studies have shown that women are more likely than men to be living kidney donors, and the discrepancy is particularly marked in heterosexual couples: wives are more likely than husbands to donate a kidney to their spouse. This ‘ Gender Kidney Donation Gap’ can be understood in terms of Carol Gilligan’s claims about gender differences in ethical decision-making style, making it appropriate to analyse responses to this imbalance using an ethic of care. This article centres the vast majority of (...) living donors, those who donate in the context of a significant pre-existing relationship. A cost-neutral approach is unfair on donors who make society richer and healthier by helping a loved one. However, models of kidney sale fail to offer an acceptable alternative, either (a) compelling donors to sell into a pool where they do not know the recipient or (b) allowing affluent individuals unfair access to kidneys. Drawing on surrogacy law in England and Wales, a model of compensation is proposed that includes a range of non-financial benefits. This option celebrates donation and expresses gratitude to all donors while avoiding the pitfalls of the marketplace, with an emphasis on fair treatment of donors. Nevertheless, if more generous treatment led to a 10% increase in directed donation, then it would be equivalent to doubling ‘altruistic’ stranger donations. As long as the Gender Kidney Donation Gap persists, the best response is to minimise the discomfort and disruption caused to donors by their profound act of kindness. (shrink)

Background: Nurses are the largest professional group in healthcare and those who make more decisions. In 2014, the Committee on Bioethics of the Council of Europe launched the “Guide on the decision-making process regarding medical treatment in end-of-life situations”, aiming at improving decision-making processes and empowering professionals in making end-of-life decisions. The Guide does not mention nurses explicitly. Objectives: To analyze the ethical principles most valued by nurses working in palliative care when making end-of-life decisions and investigate if they are (...) consistent with the framework and recommendations of the Guide; to identify what disputed/controversial issues are more frequent in these nurses’ current end-of-life care practices. Design: Qualitative secondary analysis. Participants/context: Three qualitative datasets including 32 interviews from previous studies with nurses working in palliative care in Portugal. Ethical consideration: Ethical approval was obtained from the Ethics Research Lab of the Instituto de Bioética. Ethical procedures are thoroughly described. Findings: All participant nurses referred to autonomy as an ethical principle paramount in end-of-life decision-making. They were commonly involved in end-of-life decision-making. Palliative sedation and communication were the most mentioned disputed/controversial issues. Discussion: Autonomy was highly valued in end-of-life care and decision-making. Nurses expressed major concerns in assessing patients’ preferences, wishes, and promoting advance care planning. Nurses working in palliative care in Portugal were highly involved in end-of-life decision-making. These processes embraced a collective, inclusive approach. Palliative sedation was the most mentioned disputed issue, which is aligned with previous findings. Communication also emerged as a sensitive ethical issue; it is surprising, however, that only three nurses referred to it. Conclusion: While the Guide does not explicitly mention nurses in its content, this study shows that nurses working in palliative care in Portugal are involved in these processes. Further research is needed on nurses’ involvement and practices in end-of-life decision-making. (shrink)

In Moral Case Deliberation, healthcare professionals discuss ethically difficult patient situations in their daily practice. There is a lack of knowledge regarding the content of MCD and there is a need to shed light on this ethical reflection in the midst of clinical practice. Thus, the aim of the study was to describe the content of healthcare professionals’ moral reasoning during MCD. The design was qualitative and descriptive, and data consisted of 22 audio-recorded inter-professional MCDs, analysed with content analysis. The (...) moral reasoning centred on how to strike the balance between personal convictions about what constitutes good care, and the perceived dissonant care preferences held by the patient. The healthcare professionals deliberated about good care in relation to demands considered to be unrealistic, justifications for influencing the patient, the incapacitated patient’s nebulous interests, and coping with the conflict between using coercion to achieve good while protecting human dignity. Furthermore, as a basis for the reasoning, the healthcare professionals reflected on how to establish a responsible relationship with the vulnerable person. This comprised acknowledging the patient as a susceptible human being, protecting dignity and integrity, defining their own moral responsibility, and having patience to give the patient and family time to come to terms with illness and declining health. The profound struggle to respect the patient’s autonomy in clinical practice can be understood through the concept of relational autonomy, to try to secure both patients’ influence and at the same time take responsibility for their needs as vulnerable humans. (shrink)

This article explores the integration of the seemingly disparate notions of care ethics and design thinking. The business community has adapted “design thinking” from engineering and architecture to facilitate innovation and problem solving through participatory processes. “Care ethics” is a relational approach to morality characterized by a concern for context, empathy, and action. Although design thinking is receiving significant attention and application in business practices, care ethics has only achieved limited traction among business ethicists in academia. “Caring design” is offered (...) as a mutually beneficial integration of the two ideas. Care ethics and design thinking have much in common. For example, the relational and responsive dimension of design thinking is analogous in some important ways, namely empathy and inquiry, to the relational and responsive approach of care ethics. The shared themes in care ethics and design thinking make the integration of the two plausible and reciprocal advantages make the combination compelling. Explicit ethical language can shape design thinking as more than a tool of productivity while the participatory processes of design thinking can aid in expanding the circle of care ethics as a social and political ethic. Furthermore, caring design may provide a palatable path for greater acceptance of care ethics among business professionals. An overview of design thinking and care ethics is offered prior to exploring how the synergies are mutually beneficial. The article concludes with a focus on how to educate the next generation of business students for caring design. (shrink)

This article introduces Designing for Care (D4C), a distinctive approach to project management and technological design informed by Care Ethics. We propose to conceptualize “care” as both the foundational value of D4C and as its guiding mid-level principle. As a value, care provides moral grounding. As a principle, it equips D4C with moral guidance to enact a caring process. The latter is made of a set of concrete, and often recursive, caring practices. One of the key assumption of D4C is (...) a relational ontology of individual and group identities, which fosters the actualization of caring practices as essentially relational and (often) reciprocal. Moreover, D4C adopts the “ecological turn” in CE and stresses the ecological situatedness and impact of concrete projects, envisioning an extension of caring from intra-species to inter-species relations. We argue that care and caring can influence directly some of the phases and practices within the management of (energy) projects and the design of sociotechnical (energy) artefacts and systems. When issues related to “value change” emerge as problematic (e.g., values trade-offs, conflicts), the mid-level guiding principle of care helps evaluate and prioritize different values at stake within specific projects. Although there may be several actors and stakeholders involved in project management and technological design, here we will focus on the professionals in charge of imagining, designing, and carrying out these processes (i.e., project managers, designers, engineers). We suggest that adopting D4C would improve their ability to capture and assess stakeholders’ values, critically reflect on and evaluate their own values, and judge which values prioritize. Although D4C may be adaptable to different fields and design contexts, we recommend its use especially within small and medium-scale (energy) projects. To show the benefits of adopting it, we envisage the application of D4C within the project management and the technological design of a community battery. The adoption of D4C can have multiple positive effects: transforming the mentality and practice of managing a project and designing technologies; enhancing caring relationships between managers, designers, and users as well as among users; achieving better communication, more inclusive participation, and more just decision-making. This is an initial attempt to articulate the structure and the procedural character of D4C. The application of D4C in a concrete project is needed to assess its actual impact, benefits, and limitations. (shrink)

Feminist care ethics has become a prominent ethical theory that influenced theoretical and practical discussions in a variety of disciplines and institutions on a global scale. However, it has been criticized by transnational feminist scholars for operating with Western-centric assumptions and registers, especially by universalizing care as it is practiced in the Global North. It has also been criticized for prioritizing gender over other categories of intersectionality and hence for not being truly intersectional. Given the imperialist and colonial legacies embedded (...) into the unequal distribution of care work across the globe, a Western-centric approach may also carry the danger of paternalism. Hence, a critical approach to care ethics would require reckoning with these challenges. The aim of this article is first to unfold these discussions and the responses to them from care ethics scholars and then to present resources in Beauvoir’s existentialist ethics, specifically the tenet of treating the other as freedom, as productive tools for countering the Western-centric and paternalistic aspects of care practices. (shrink)

Šiame straipsnyje analizuojama ryškėjanti tendencija sutapatinanti rūpesčio etiką su sentimentalizmu. Lyginant šios tendencijos atstovo Michaelo Slote’o ir vienos iš rūpesčio etikos kūrėjų Nel Noddings filosofiją, analizuojamas rūpesčio etikos ir sentimentalizmo santykis, pastarojo galimybės adekvačiai konceptualizuoti rūpesčio / rūpinimosi specifiką. Teigiama, kad sentimentalizmo konceptualinis žodynas, grindžiamas empatijos sąvoka, užgožia reliacinį rūpesčio etikos pobūdį. Straipsnyje empatijos sąvokai priešpriešinama dėmesio sąvoka, kurią nemaža dalis rūpesčio etikos atstovų pasitelkia apibrėžti moralinį rūpestį / rūpinimąsi. Analizuojant Simone Weil ir Iris Murdoch filosofiją, atskleidžiama dėmesio sąvokos reikšmė (...) rūpesčio etikai. (shrink)

I discuss Young’s “asymmetrical reciprocity” and apply it to an ethics of mental health care. Due to its emphasis on engaging with others through respectful dialogue in an inclusive manner, asymmetrical reciprocity serves as an appropriate framework for guiding caregivers to interact with their patients and to understand them in a morally responsible and appropriate manner. In Section 1, I define empathy and explain its benefits in the context of mental health care. In Section 2, I discuss two potential problems (...) surrounding empathy: the difficulty of perspectivetaking and “compassion fatigue.” In Section 3, I argue that these issues can be resolved if examined through the lens of an ethics of care. Reciprocal relationships between patients and caregivers are an important element in the development of an ethics of care. In Section 4, I introduce two models of reciprocity that can be applied to a health care context: Benhabib’s symmetrical reciprocity and Young’s asymmetrical reciprocity. In Section 5, I demonstrate how asymmetrical reciprocity cultivates empathy and, in Section 6 and Section 7, I show how it overcomes the objections of empathy and improves therapeutic relationships. (shrink)