The ageing population is increasing worldwide with an increase in chronic disorders. At the same time, person‐centred care has become a policy within both health and social care. To facilitate coordination and collaboration and integrate the older adult's perspective in the decision‐making process the collaborative care planning process with the development of a written care plan can be used. In this study, the result of an interpreted analysis of four empirical studies of the collaborative care planning as a person‐centred practice (...) will be discussed and reflected on. A framework based on the French philosopher Paul Ricoeur's little ethics was used in the synthesis of the studies. The findings revealed two common threads: personhood and power asymmetry. Both challenges in achieving a person‐centred collaborative care planning. Ricoeur's dialogical thinking and description of a person served as an underpinning in discussing and reflecting upon the findings of the interpreted synthesis. Collaborative care planning is a complex process. However, Ricoeur's philosophy contributed to a greater understanding of the collaborative care planning as a person‐centred practice and accentuated that ethics, human values, and the older adults and care partners perspectives need to be given the same importance and considerations as the medical and social sciences perspectives for the collaborative care planning process to truly become person‐centred. (shrink)

Victims of disaster suffer, not only at the very moment of the disaster, but also years after the disaster has taken place, they are still in an emotional journey. While many moral perspectives focus on the moment of the disaster itself, a lot of work is to be done years after the disaster. How do people go through their suffering and how can we take care of them? Research on human suffering after a major catastrophe, using an ethics of care (...) perspective, is scarce. People suffering from disasters are often called to be in distress and their emotional difficulties ‘medicalised’. This brings them often into a situation of long term use of medication, and one can wonder if medication is of help to them in the long run. In our paper, we will explore another moral perspective, focusing on the importance of the victims’ narrative and their lived experiences. We will use Paul Ricoeur’s phenomenological reflections from ‘Suffering is not the same as pain’ for conceptualizing human suffering and how to apply it to victims of disaster. Ricoeur suggests that suffering is not a quantity that can be measured, but a characteristic that should be studied qualitatively in interpersonal and narrative contexts. Above all, the perspective of care and listening could offer an opportunity to reconcile people from their loss and suffering. (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)

Research on the unrepresentability of death in Samuel Beckett’s oeuvre abound in Beckett scholarship, but little attention has been given to the artist’s representation of caregiving to the dying in his plays. With reference to Martin Heidegger’s concept of _care_ and Albert Camus’s idea of the _absurd_, this article analyzes _Endgame_ (1957) and _Footfalls_ (1976) by attending to Beckett’s dramatic representation of caregiving as undergirded by a sense of its absurdity. The almost 20-year gap between the writing of both plays (...) highlights the development of an understanding that this sense of absurdity is never about the caregiver’s questioning of one’s obligation to the dependent but about how one chooses to respond to caregiving as an absurd predicament. The pertinence of such a representation of caregiving by Beckett lies in its poignant articulation of a complex experience that is often left unexpressed by caregivers who prioritize their dependent loved ones over themselves. (shrink)

At a time when the practice of medicine is subject to technical and biopolitical imperatives that give rise to defensive bioethics, it is essential to revitalize the ethical dimensions of care at the very heart of the clinic, in order to give new meaning to the moral responsibility that inhabits it. This contribution seeks to meet this challenge by drawing on the ethical resources of the work of Emmanuel Levinas. In Levinas’ view, ethical responsibility is the response to the injunction, (...) the interpellation, of the other’s face, and humaneness is conceived entangled in the other’s face. Against this background, I suggest that Levinas’ philosophical insight constitutes a turning point from a traditional to a new conception of responsibility that may bear great significance to a renewed understanding of an hermeneutics and an ethics of care. By drawing on this aspect of Levinas’ thought, I would like to reveal the ethical core of an ethics of clinical care that shapes a new insight on medical judgment. (shrink)

Our paper focuses on the philosophical perspective of constructing active caring masculinities agencies in the contemporary feminist discourse. Since contemporary feminisms are not simply anti-essentialist, but more importantly, polyphonic, we believe that it is far more appropriate to talk about ‘masculinities’ as opposed to ‘masculinity’. We are proposing a revised understanding of the self in which the self is not defined primarily in the dichotomous, categorical one-other relationship. We use Paul Ricoeur’s anthropology to describe the self as relational, as well (...) as Joan Tronto’s recent perspective on care which fits well with a Ricoeurian reconstruction of the self. We also engage with Raewyn Connell’s discourse on masculinity and more specifically, hegemonic masculinity. By using ‘caring masculine agencies’ as an alternative to ‘masculinity as reactive anti-femininity’, we are proposing a paradigm shift that hopefully is flexible enough to respect the dynamism inherent to any act of gender-identification. (shrink)

Dependency is fundamental to caring relationships. However, given that dependency implies asymmetry, it also brings moral problems for nursing. In nursing theory and theories of care, dependency tends to be framed as a problem of self‐determination—a tendency that is mirrored in contemporary policy and practice. This paper argues that this problem frame is too narrow. The aim of the paper is to articulate additional theoretical ‘problem frames’ for dependency and to increase our understanding of how dependency can be navigated in (...) practices of long‐term care. It does so by way of an empirical ethical analysis of how care professionals tackle the problem of dependency in group homes for people with intellectual disabilities. The paper refers to these practices of mitigating the problem of dependency as ‘dependency work’, a phrase borrowed from Eva Kittay. The analysis of dependency work suggests that for care professionals, dependency is a threefold problem: one of self‐determination, one of parity and one of self‐worth. These findings suggest that patient autonomy cannot be a full solution to the problem of dependency in long‐term care relations. But they also show that dependency as such is not a problem that can be solved, as attempts to mitigate it only serve to tighten the dependency relationship further. This is the paradox of dependency work. (shrink)

Dealing with soldier enhancement can be challenging for military physicians. As research on the ethics of soldier enhancement is mostly theoretical, this study aims to gain insights into the actual moral issues military physicians encounter, or expect to encounter. To that end, we carried out a qualitative study involving six focus groups of Dutch military physicians (n = 28) in operational roles. The participants voiced their concerns about moral issues concerning soldier enhancement. Based on the group discussions, and using inductive (...) thematic analysis, we ascertained three major themes: (1) Doing no harm in soldier enhancement: uncertainty and high stakes; (2) Dependency relationships and conflicting moral responsibilities; and (3) The risk of ethical slippery slopes. Our findings illustrate that dealing with these moral responsibilities requires considerable skill and acuity to weigh up for all the situated complexities and dependency relationships that go beyond abstract rules or moral principles. A care-ethical approach that acknowledges the contextual and relational aspects of moral complexities along with peer consultation and joint reflective dialogue on moral issues can help military physicians deal with soldier enhancement responsibly. (shrink)