It should not be a surprise in the near future to encounter either a personal or a professional service robot in our homes and/or our work places: according to the International Federation for Robots, there will be approx 35 million service robots at work by 2018. Given that individuals will interact and even cooperate with these service robots, their design and development demand ethical attention. With this in mind I suggest the use of an approach for incorporating ethics into the (...) design process of robots known as Care Centered Value Sensitive Design. Although this approach was originally and intentionally designed for the healthcare domain, the aim of this paper is to present a preliminary study of how personal and professional service robots might also be evaluated using the CCVSD approach. The normative foundations for CCVSD come from its reliance on the care ethics tradition and in particular the use of care practices for: structuring the analysis and, determining the values of ethical import. To apply CCVSD outside of healthcare one must show that the robot has been integrated into a care practice. Accordingly, the practice into which the robot is to be used must be assessed and shown to meet the conditions of a care practice. By investigating the foundations of the approach I hope to show why it may be applicable for service robots and further to give examples of current robot prototypes that can and cannot be evaluated using CCVSD. (shrink)

ABSTRACTOrganization and management researchers praise the value of care in the workplace. However, they overlook the conflict between caring for work and for coworkers, which resonates with the dilemma of care allocation highlighted by ethicists of care. Through an in-depth qualitative study of two organizations, we examine how this dilemma is confronted in everyday organizational life. We draw on the concept of boundary work to explain how employees negotiate the boundary of their caring responsibilities in ways that grants or denies (...) care to coworkers. We argue that the possibility of an ethics of care for coworkers requires boundary work that suspends the separation of personal and professional selves and constitutes the worker as a whole person. We contribute to research on care in organizations by showing how care for coworkers may be enabled or undermined by maintaining or suppressing the care allocation dilemma. (shrink)

Technological developments involving robotics and artificial intelligence devices are being employed evermore in elderly care and the healthcare sector more generally, raising ethical issues and practical questions warranting closer considerations of what we mean by “care” and, subsequently, how to design such software coherently with the chosen definition. This paper starts by critically examining the existing approaches to the ethical design of care robots provided by Aimee van Wynsberghe, who relies on the work on the ethics of care by Joan (...) Tronto. In doing so, it suggests an alternative to their non-principled approach, an alternative suited to tackling some of the issues raised by Tronto and van Wynsberghe, while allowing for the inclusion of two orientative principles. Our proposal centres on the principles of autonomy and vulnerability, whose joint adoption we deem able to constitute an original revision of a bottom-up approach in care ethics. Conclusively, the ethical framework introduced here integrates more traditional approaches in care ethics in view of enhancing the debate regarding the ethical design of care robots under a new lens. (shrink)

It may be the case that the most challenging moral problem of the twenty‐first century will be the relationship between the individual moral agent and the practices and institutions in which the moral agent is embedded. In this paper, we continue the efforts that one of us, Joan Liaschenko, first called for in 1993, that of using feminist ethics as a lens for viewing the relationship between individual nurses as moral agents and the highly complex institutions in which they do (...) the work of nursing. Feminist ethics, with its emphasis on the inextricable relationship between ethics and politics, provides a useful lens to understand the work of nurses in context. Using Margaret Urban Walker's and Hilde Lindemann's concepts of identity, relationships, values, and moral agency, we argue that health care institutions can be moral communities and profoundly affect the work and identity and, therefore, the moral agency of all who work within those structures, including nurses. Nurses are not only shaped by these organizations but also have the power to shape them. Because moral agency is intimately connected to one's identity, moral identity work is essential for nurses to exercise their moral agency and to foster moral community in health care organizations. We first provide a brief history of nursing's morally problematic relationship with institutions and examine the impact institutional master narratives and corporatism exert today on nurses’ moral identities and agency. We close by emphasizing the significance of ongoing dialogue in creating and sustaining moral communities, repairing moral identities, and strengthening moral agency. (shrink)

This chapter delves into the intricate relationships among engineering, technology, ethics, and morality, highlighting their interconnected nature as they shape and are shaped by individual and collective human existence. Exploring the profound philosophical and religious underpinnings that underlie ethical and moral contemplation, the chapter also introduces seven distinct ethical systems, emphasizing three non-Western paradigms: South American Buen Vivir, African Ubuntu, and Asian Confucianism. These ethical systems are examined in the context of their implications for technology and engineering. This exposition illuminates (...) the significance of studying ethics and the philosophy of engineering or technology, particularly in using engineering to help marginalized individuals and communities empower and liberate themselves, fostering alternative social structures and existential meanings. (shrink)

Recently ethical implications of human resource management have intensified the focus on care perspectives in management and organization studies. Appeals have also been made for the concept of organizational care to be grounded in philosophies of care rather than business theories. Care perspectives see individuals, especially women, as primarily relational and view work as a means by which people can increase in self-esteem, self-develop and be fulfilled. The ethic of care has received attention in feminist ethics and is often socially (...) construed as a feminine ethic. Although well developed in the caring professions there remains no model or definition of the care ethic in management literature with little care research undertaken. This paper develops the concept of the care ethic using Heidegger’s philosophy, namely, care is fundamental to human being. To show Heideggerian care, an individual notices, pays attention to another and responds in ways to empower and enable. In a study which aimed to analyze women’s lived experience of career, we applied the philosophically grounded methodology hermeneutic phenomenology. Findings revealed the power of Heideggerian care, Sorge, as a key factor in creating meaning. From this, we propose that care has potential as a theoretical and philosophically based construct with strong practical implications. It provides a way of understanding the care ethic, lies at the heart of our being, and is essential to meaning in our grelationships and undertakings. Crucially, it can provide reprieve from the existential angst that trademarks our being. (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)

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)

Robots as social companions in close proximity to humans have a strong potential of becoming more and more prevalent in the coming years, especially in the realms of elder day care, child rearing, and education. As human beings, we have the fascinating ability to emotionally bond with various counterparts, not exclusively with other human beings, but also with animals, plants, and sometimes even objects. Therefore, we need to answer the fundamental ethical questions that concern human-robot-interactions per se, and we need (...) to address how we conceive of »good lives«, as more and more of the aspects of our daily lives will be interwoven with social robots. (shrink)

How do we theorize the experiences of caregivers abused by their children with autism without intensifying stigma toward disability? Eva Kittay emphasizes examples of extreme vulnerability to overturn myths of independence, but she ignores the possibility that dependents with disabilities may be vulnerable and aggressive. Instead, her work over-emphasizes caregivers' capabilities and the constancy of disabled dependents' vulnerability. I turn to Judith Butler's ethics and her conception of the self as opaque to rethink care amid conflict. Person-centered planning approaches, pioneered (...) by disability rights activists, merge Butler's analysis of opacity with Kittay's work on embodied care, while also inviting a broader network of people to both interpret needs and change communities. By expanding our conceptions of dependency, feminist disability studies can continue the aim of both Kittay and Butler: to humanize unintelligible lives. (shrink)

Care as a concept has long been central to the nursing discipline, and care ethics have consequently found their place in nursing ethics discussions. This paper briefly revisits how care and care ethics have been theorized and applied in the discipline of nursing, with an emphasis on Tronto’s political view of care. Adding to the works of other nurse scholars, we consider that Tronto’s care ethics is useful to understand caring practices in a sociopolitical context. We also contend that this (...) vision can be used specifically to politicize nurses, by encouraging them to think critically about the context in which they work and how they can participate to change the status quo, notably by prompting the democratization of care in institutional settings. We illustrate this by demonstrating how moral distress that can occur with aggressive or futile treatments in the intensive care unit can be reduced if nurses are systematically included in the decision-making process. By showing some ways in which nursing political actions can begin to change the status quo as it pertains to futile treatments at the end of life, we can help empower nurses to strive to be included in political spaces and voice their concerns to have their professional needs met. (shrink)

Accounts of human beings as essentially social have had a long history in philosophy as reflected in the Ancient Greeks; in African and Asian philosophy; in Modern European thinkers such as Mary Wo...

In her 2015 article, Helena Olofsdotter Stensöta notes that ‘the ethics of care is often used as a lens to dissect the current arrangement of care provision (or rather non-care provision) in polici...

Medicine is not merely a job that requires technical expertise, but a profession concerned with making the best decisions and recommendations with reference to, and in consultation with, the patient. This means that the skill set required for healthcare professionals in order to provide good care is a combination of scientific knowledge, technical aptitude, and affective qualities or virtues such as compassion and empathy.

Our study examines managerial vulnerability in a bureaucratic context, namely in Finnish immigration centres. We bring a care ethics perspective to the study of vulnerability and address how managers navigate relationships with vulnerable clients and their own vulnerability. Based on empirical data collected through interviews with immigration centre managers, we show how managers negotiated their (in)vulnerability through two alternating positionalities: (1) professionalism, through which they seek to control negative emotions in order to manage their own experiences of vulnerability and affective (...) relationships with clients, and (2) temporal disconformity, which provides space to engage and manage with a variety of emotions and manoeuvre bureaucratic professional norms. Our study then contributes to the literature on managerial work by demonstrating how managers cope with their vulnerable selves and how different notions of care emerge in complex, ethically sensitive managerial situations. (shrink)

We examine an article of Paul Ricoeur on autonomy and vulnerability. Ricoeur presents the two notions in the field of justice as intricately woven into each other. He analyzes their interdependence on three levels of human agency. Ricoeur’s exposition has a focus on judicial judgment. After presenting Ricoeur’s argument and an analysis of his main points, the author argues that Ricoeur’s reflection lines up with some essential intentions of care ethics. Ricoeur’s contribution to care ethics is given in a delicate (...) balance of autonomy and its vulnerability. (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)

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)

The aim of this analysis was to examine the concept of time to rejuvenate and extend existing narratives of time within the nursing literature. In particular, we hope to promote a new trajectory in nursing research and practice which focuses on time and person‐centred care, specifically of older people with cognitive impairment hospitalized in the acute care setting. We consider the explanatory power of concepts such as clock time, process time, fast care, slow care and time debt for elucidating the (...) relationship between ‘good care’ and ‘time use’. We conclude by offering two additional concepts of time, plurotemporality and person‐centred time (PCT) which we propose will help advance of nursing knowledge and practice. Nurse clinicians and researchers can use these alternative concepts of time to explore and describe different temporal structures that honour the patient's values and preferences using experiential, observation‐based nursing research approaches. (shrink)

Through the vehicle of Nicolas Sarkozy’s so-called “Dakar Address” we will analyse the West’s persisting lack of insight into the need for a Western decolonization. We will try to identify the dangers that come from this refusal, such as the abidance in colonial patterns, the enduring self-understanding as superior com-pared to Africa, and the persisting unwillingness to accept the colonial guilt. Decolonization has to be understood as a two-fold business. Decolonization is over-coming endured and perpetrated violence. It is not only (...) important that the colonial oppressed regain strength, it is equally important that the perpetrator of colonial violence understand their excess of violence and work on effecting its return impossible. We explain how Western thinking remains dangerous and untrustwor-thy if it refuses its own decolonization. Finally, we will draw attention to a fundamental pattern of Western thought that clashes with the fundamental values of the West: contempt. In a final step we suggest how this contempt can be overcome through desuperiorisation and the establishment of elative ethics. (shrink)

In this article, Hannah Arendt's concept of action will be used to problematize current transformations of the health care sector and examine some responses by ethicists in light of those transformations. The sphere of human interaction that should typify health care work is identified as an action of unpredictable praxis in contrast to controllable procedures and techniques which increasingly take place in the health care sector.

This article uses two recent books on whistleblowing authored by political philosophers, to suggest that what political philosophy can contribute to the whistleblowing debate are notions of public interest that can help to enable and delineate responsibilities and protection of different actors. Whilst it is acknowledged that these recent works on whistleblowing offer a welcome articulation of the business ethics scholarship into that of political philosophy, it fails to deliver on its potential contribution. The argumentation proceeds along three objections, (1) (...) use of bad cases, (2) lack of new insights, and (3) conservative positioning. (shrink)

Sister (Sr.) Marie Simone Roach, of the Sisters of St. Martha of Antigonish, Nova Scotia, died at the Motherhouse on 2 July 2016 at the age of 93, leaving behind a rich legacy of theoretical and practical work in the areas of care, caring and nursing ethics. She was a humble soul whose deep and scholarly thinking thrust her onto the global nursing stage where she will forever be tied to a central concept in nursing, caring, through her Six Cs (...) of Caring model. In Canada, she was the lead architect of the Canadian Nurses Association's first code of ethics, and her influence on revisions to it is still profound more than 35 years later. In this paper, four global scholars in nursing and ethics are invited to reflect on Sr. Simone's contribution to nursing and health‐care, and we link her work to nursing and health‐care going forward. (shrink)

Care is a feature of all of our lives, all of the time. An analysis of Scotland's Curriculum for Excellence reveals that care and caring permeate complex dimensions of life in and after school and we ask here, if, on some accounts, care can do the work required of it. Acknowledging the significance of her contribution to care, we focus on the work of Nel Noddings suggesting that she pays insufficient attention to other emotions implicated in the work of morally (...) appropriate care. We argue here that Noddings' version of care would benefit from the support of an ethical theory of the emotions, including a moralized form of compassion, if care in schools is to be both better understood and more likely realised. (shrink)

This paper examines extracts from a daughter’s blog about her father’s time in a care home in the north of England from June 2015 until his death in January 2016. Through these extracts, the author of the paper, who is also the daughter of the title, provokes key ethical issues concerning the identity, agency and voice of an elder in the context of residential care. The wider, rapidly deteriorating, political and economic climate for the care of older people is briefly (...) discussed and the paper makes reference to a feminist ethics of care, in order to both critique and celebrate women’s central place in caring for elders. The paper explores how the ethnographic process of writing about care for another can be considered a route to ethical care practice and it suggests that this blog is part of an autoethnographic analytic tradition [Anderson 2006. “Analytic Autoethnography.” Journal of Contemporary Ethnography 35 (4): 373–395]. Finally, the paper asks questions about the ethics of blogging about and on behalf of an elder that, in this case, played a significant role in bringing not only the daughter-author but also other family members closer to the life of their father, grandfather and great-grandfather. (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)

This paper seeks to describe and evaluate the work of the late Iris Marion Young as a critical reference point for values and ethics in the social professions. Her credentials are both experiential and theoretical, having studied analytical then postmodern and phenomenological thought, publishing a series of influential books on political and ethical concepts from a critical feminist position. Her theory and practice were closely related: she actively campaigned for feminist and related social causes for many years. The aim is (...) to provide a broad review of her work, with special reference to aspects particularly relevant to the social professions, and some discussion of implications for practice. It is not the intention to set out a systematic framework of concepts but to suggest the fruitfulness of some of her ideas, particularly those relevant to social professionals, and encourage the reader to go back to the original work. (shrink)

The prospective robots in healthcare intended to be included within the conclave of the nurse-patient relationship—what I refer to as care robots—require rigorous ethical reflection to ensure their design and introduction do not impede the promotion of values and the dignity of patients at such a vulnerable and sensitive time in their lives. The ethical evaluation of care robots requires insight into the values at stake in the healthcare tradition. What’s more, given the stage of their development and lack of (...) standards provided by the International Organization for Standardization to guide their development, ethics ought to be included into the design process of such robots. The manner in which this may be accomplished, as presented here, uses the blueprint of the Value-sensitive design approach as a means for creating a framework tailored to care contexts. Using care values as the foundational values to be integrated into a technology and using the elements in care, from the care ethics perspective, as the normative criteria, the resulting approach may be referred to as care centered value-sensitive design. The framework proposed here allows for the ethical evaluation of care robots both retrospectively and prospectively. By evaluating care robots in this way, we may ultimately ask what kind of care we, as a society, want to provide in the future. (shrink)

There is now an awakening to and recognition of the emotionally complex lives of some non-human animals. While their forms of consciousness may vary, some are indeed conscious and deserve political consideration. What that political consideration ought to be is the central topic of this article. First, I argue that interspecies justice must be understood in terms of the relationships that foster individual flourishing of all concerned. The obstacles to such flourishing are the five faces of oppression famously identified by (...) Iris Marion Young: exploitation, marginalization, powerlessness, cultural imperialism, and violence. By extending Young’s concept of the social group to intra- and interspecies groups, we become more attuned to differences between and among species. Theorizing the existence of interspecies groups brings forward new avenues to explore oppression and simultaneously theorize its opposite – interspecies justice. Second, I argue that a positive theory of interspecies flourishing can be developed on the basis of Marx’s materialist philosophy and reclamation of species-being. Though Marx uses humanist language throughout the Economic and Philosophic Manuscripts of 1844, attention to his methodological commitments reveals that some non-human animals can no longer be excluded from the capability of flourishing and species-being. Some non-human animals are conscious, act purposefully, and labor creatively and must be included in our circle of moral and political concern. (shrink)

This article considers the moral notion of care in the context of Quality of Care discourses. Whilst care has clear normative implications for the delivery of health care it is less clear how Quality of Care, something that is centrally involved in the governance of UK health care, relates to practice.

Background: The ethics of care and justice represent two modes of moral reasoning that nurses use in solving real-life ethical dilemmas. Research aim: The present study investigated what types of dilemmas nurses encounter in everyday work and to what extent they use care versus justice reasoning to solve them. Research design: The study used a cross-sectional survey design. Participants reported a real-life ethical dilemma and its resolution through an online survey. Open-ended data were analysed with an adjusted taxonomy of real-life (...) moral dilemmas and moral orientations. Quantified data were analysed with statistical methods (χ2-test, analysis of variance). Participants and research context: Participants were 334 registered nurses and 177 practical nurses from four health and social care organisations in Finland. Ethical considerations: The study was approved by the Research Ethics Committee of Finnish Institute for Health and Welfare. Findings: Nurses reported six types of ethical dilemmas. Nurses used more care reasoning on the needs of others and conflicting demands dilemmas than on applying rules, social pressure and reacting to transgression dilemmas. Applying rules and needs of others dilemmas were the most common types of ethical dilemmas in both occupations. Practical nurses reported more non-ethical dilemmas than registered nurses did. Discussion: Ethical dilemmas of nurses are diverse, and the use of care and justice reasoning is differentiated according to the type of dilemma. Care reasoning dominates nurses’ ethical decision-making when responding to the needs of patients. Nurses use justice reasoning when they apply regimens, rules and procedures. In everyday ethics, care and justice reasoning complement each other. Conclusions: Highly regulated healthcare environments prefer rule-oriented justice reasoning that may supersede care reasoning in addressing patients’ situations. Focus on technical-professional expertise may further hamper nurses’ ethical decision-making. Nursing education and management should encourage nurses to use ethical concepts and values in their work. (shrink)

Background A persistent devaluation of care-work, difficult working conditions, and low salaries have led to challenges with staff recruitment and retention in the homecare sector in France. A new homecare organization adopting an innovative organizational model recently experimented an hourly payment method yielding positive outcomes. Objectives Using Tronto’s caring framework, this paper analyzes the strategies used by the founders as they developed their innovative model and the nursing activities performed during home visits. Design A longitudinal qualitative study was conducted between (...) 2017 and 2023. Homecare nursing teams were shadowed for 1–2 days per year yielding detailed field notes on caregiving activities, both before and after the new payment method. Secondary data included reports, videos, articles, and unpublished documents found online. Ethical considerations While there is no requirement in France to obtain ethical approval in non-interventional research, verbal consent was obtained by all participants prior to their involvement in the study; confidentiality and anonymity were strictly maintained; and pseudonyms were assigned to protect identities. Findings 63 interviews and 185 h of shadowing and observations were conducted. Results revealed a virtuous cycle of caring facilitated and encouraged by new incentives that resonated with nurses’ professional ethics. The favorable working environment and the hourly payment method enabled nurses to provide caregiving in accordance with their values. Conclusions As the new hourly payment experiment is scaled-up nationally, it is imperative that it is not isolated from the organizational model. Without the underpinning values and principles, the hourly payment method alone is unlikely to shift the value attributed to caring. (shrink)

A case study of Chinese grandparents’ transnational caregiving experiences in Canada highlights two issues that have received limited attention in the broader feminist care literature: elderly persons are usually positioned as receivers rather than providers of care; and transnational care studies focus on women migrating as part of “global care chains,” rather than on elderly family members migrating to meet the caring needs of adult kin who work in market economies that do not recognize caring responsibilities. The paper concludes by (...) arguing that the distribution of care responsibilities needs to be one of the pillars in the pursuit of transnational social justice. (shrink)

The literature on organizational ethics has paved the way for a situated and intersubjective understanding of ethics through caring practices. In this article, we try to extend this perspective by looking beyond the interactions of caregivers among themselves or with care seekers to reveal ethics as the ongoing collective accomplishment of a variety of actors. We do so by mobilizing Strauss’s theoretical perspective of articulation work in the context of healthcare. Based on an ethnography, we show how actors of care (...) (e.g., nurses, caregivers, or doctors) operate within care arrangements that need to be frequently rearticulated to face ethical threats and protect their patients’ well-being. We distinguish three types of rearticulation corresponding to different degrees of rearticulation, individual actor stance, and specific ways of working things out. We discuss their implications for the maintenance of organizational ethics. (shrink)

Bureaucracy has had few admirers, as a quick perusal of 20th-century political and social theory readily indicates. In recent years, several feminist theorists have also joined this vociferous anti-bureaucracy chorus, denouncing bureaucracy’s excessively hierarchical, impersonal, cold and controlling nature. The goal of this article is to review these charges and to show why the term ‘caring bureaucracy’ is not an oxymoron. In the first two sections, the author considers the various reasons why bureaucratic structures are said to be bad both (...) for the people who work in them and for those who deal with them. The author proposes to discuss these charges in light of some research on feminist organizations and street-level bureaucracy. The intention is not to offer a paean to street-level discretion or to the claims of ‘the heart’ in public service; it is, rather, to underscore at once the beauty and the danger of discretion. It is also noted that feminist theorists ought to be cautious when they call for ‘flattened hierarchies’ and for fewer rules in large institutions – for these might work against the best interests of women. The last part of the article offers the outline of a caring bureaucracy and suggests avenues to be explored in future care ethics research. (shrink)

Care has increasingly been promoted as an element of successful management practice. However, an ethic of care is a normative theory that was initially developed in reference to intimate relationships, and it is unclear if it is an appropriate normative standard in business. The purpose of this review is to bridge the social scientific study of care with philosophical understandings of care and to provide a theoretical justification for care as a managerial value. We review the three different forms of (...) care advanced by the ethics literature: caring relations, organizational care, and care as a virtue. We compare these forms of care to the management litertature. In doing so, we integrate what has previously been a scattered, yet growing, body of research on care. Our review of the literature reveals that care has increasingly been studied in management in relation to an ethic of care. Yet, many of the properties of care have also played a role in other established research domains (e.g., leadership). We discuss and critique the management and ethics literatures on care, paying attention to areas of agreement or disagreeement between the two. We go on to provide a normative justification of care as a value in business. Finally, we close by suggesting directions for future research. (shrink)

Bioethics has increasingly become a standard part of medical school education and the training of healthcare professionals more generally. This is a promising development, as it has the potential to help future practitioners become more attentive to moral concerns and, perhaps, better moral reasoners. At the same time, there is growing recognition within bioethics that nonideal theory can play an important role in formulating normative recommendations. In this chapter we discuss what this shift toward nonideal theory means for ethical curricula (...) within healthcare education. In particular, we contend that more attention to the particularities of historical and social context needs to be incorporated into bioethics training. To make this argument, we focus on two examples: teaching units on race and medicine and those that focus on stigma and coercion in mental health. For both, we show how a pedagogical approach in which educators focus on social injustice could influence how practitioners engage in ethics in the clinic. This chapter, then, demonstrates what a commitment to nonideal theory can mean practically when it comes to bioethics education. (shrink)

Participatory action research (PAR) is a form of community-driven qualitative research which aims to collaboratively take action to improve participants’ lives. This is generally achieved through cognitive, reflexive learning cycles, whereby people ultimately enhance their wellbeing. This approach builds on two assumptions: (1) participants are able to reflect on and prioritize difficulties they face; (2) collective impetus and action are progressively achieved, ultimately leading to increased wellbeing. This article complicates these assumptions by analyzing a two-year PAR project with mothers of (...) disabled children from a South African urban settlement. Participant observation notes, interviews, and a group discussion served as primary data. We found that mothers’ severe psychological stress and the strong intersectionality of their daily challenges hampered participation. Consequently, mothers considered the project ‘inactionable’. Yet, many women quickly started expressing important individual and collective wellbeing transformations. To understand these ‘unlikely’ transformations, a feminist relational account, in particular, that of relational wellbeing, proves essential. We reflect on the consequences of these findings for the dominant PAR methodology and operationalization, and propose to sensitize future PAR with marginalized women by employing relational wellbeing as an overarching ontological awareness. (shrink)

Background Implementing person-centred care (PCC) in nursing homes is challenging due to a gap between theory and practice. Bridging this gap requires suitable education, which focuses on learning how to attune care to the values and preferences of residents and take moral, relational, and situational aspects into account. Staff’s stories about the care they provide (i.e. caring stories) may deliver valuable insights for learning about these aspects. However, there is limited research on using staff's narratives for moral learning. Objective This (...) study aims to provide insight into the perspectives of nursing staff on using their caring stories to learn about PCC. Research design In this qualitative research, we conducted two rounds of interviews with 17 participants working in nursing homes. We wanted to obtain nursing staff’s perceptions of working with their caring stories and the impact on PCC. Ethical considerations Participation was voluntary, and participants provided written consent. The study protocol is approved by The Institutional Review Board of the Medical Ethical Committee Leiden-Den Haag-Delft. Findings Working with caring stories enables nursing staff to provide PCC and improves job satisfaction. It increases awareness of what matters to residents, fosters information rich in context and meaning, and enhances voice and vocabulary. Through in-depth team reflections, nursing staff discussed the significant moments for residents, which centralizes the discussions on the moral quality of care. Discussion Working with caring stories fosters dialogue on PCC and enhances reflection on ethical situations in daily encounters, contributing to the moral development of nursing staff. Putting nursing staff’s narratives at the centre of learning suits their daily practice and intrinsic motivation. Therefore, the outcomes of this study are an addition to the existing literature about using narratives in long-term care. Conclusion Using nursing staff's narratives contributes to PCC and positively impacts nursing staff. We recommend using staff's caring stories as a vehicle for moral learning in the transition to PCC. (shrink)

This article comprises a short case exemplifying ethical challenges arising for a participatory researcher working with Afghan women refugees during the Covid-19 pandemic in Germany. The researcher is an Iranian-German woman, qualified as a midwife, undertaking doctoral research on refugees’ access to reproductive health care. Disclosures about some women’s experience of domestic violence are made, which raise ethical issues for the researcher relating to personal-professional boundaries, roles and responsibilities. Two commentaries are given on this case from participatory researchers based in (...) Germany, UK and Austria. Both commentaries highlight the relevance of the ethics of care for participatory research and for this research in particular, which entails very close relationships between the doctoral researcher and the refugee women with whom she is researching. The first commentary analyses the research process in terms of Tronto’s five phases of care, while the second illustrates the importance of caring institutions in supporting researchers working on sensitive topics. (shrink)

Joan Tronto’s new paradigm of caring democracy bases citizenship on the need to ensure that all people receive and provide care equitably. But how exactly are citizens motivated to take up these caring responsibilities? The writings of Alcoholics Anonymous (AA) co-founder William ‘Bill’ Wilson provide one answer: he pathologizes the alcoholic – dooming him to inevitable relapse and death – to compel AA members to accept shared vulnerability and mutual care as the bedrock of sobriety and AA society. Wilson returns (...) repeatedly to the threat of death to convince AA members to carry out their newfound caring and democratic responsibilities. We use Wilson’s thinking, as well as Michel Foucault’s work on biopower, to forward the concept of biocaring democracy, in which the acceptance of shared pathology compels people to care for each other but also limits their democratic responsibilities. More broadly, our analysis suggests how hinging democracy to shared vulnerability may constrain the radical possibilities that Tronto envisions. (shrink)