This volume provides a critical introduction to contemporary attempts to base nursing ethics on a feminine 'ethics of care'.

First Published in 1993. Routledge is an imprint of Taylor & Francis, an informa company.

oise Baylis, 1234 Le Marchant Street, Halifax, Nova Scotia, Canada B3H 3P7. Tel.: (902)-494–2873; Fax: (902)-494-2924; Email: francoise.baylis{at}dal.ca ' + u + '@' + d + ' '//--> . Abstract Recently, there has been a growing interest in public health and public health ethics. Much of this interest has been tied to efforts to draw up national and international plans to deal with a global pandemic. It is common for these plans to state the importance of drawing upon a well-developed (...) ethics framework and we argue that this framework should reflect the values and insights of feminist relational theory. More specifically, we argue that pandemic planning must be squarely situated in the larger realm of public health and that an ethics framework for public health will be one that recognizes the need to pay particular attention to the vulnerability of subpopulations lacking in social and economic power. We propose an ethics framework for public health that builds on the notions of relational personhood (including relational autonomy and social justice) and relational solidarity. In this way, we aim for a public health ethics that, as appropriate, promotes the public interest and the common good. CiteULike Connotea Del.icio.us What's this? (shrink)

In a Different Voice is the little book that started a revolution, making women's voices heard, in their own right and with their own integrity, for virtually the first time in social scientific theorizing about women. Its impact was immediate and continues to this day, in the academic world and beyond.

In addition to thinking about the meanings of solidarity, it is important to address how solidarity of the appropriate sort can be cultivated. Possibilities include the transformative power of key individuals or events; and the role of institutions. In health care it is suggested that a combination of the two strategies is required. Professional conduct includes not only acting in 'face to face' delivery, but also engaging with those institutions which enable or disable certain ways of acting, so that they (...) are constantly subject to revision to ensure that they facilitate the provision of decent healthcare. (shrink)

This article defends ‘relational theorizing’ in bioethics and public health ethics and describes its importance. It then offers an interpretation of solidarity and care understood as normatively patterned and psychologically and socially structured modes of relationality; in a word, solidarity and care understood as ‘practices.’ Solidarity is characterized as affirming the moral standing of others and their membership in a community of equal dignity and respect. Care is characterized as paying attention to the moral being of others and their needs, (...) suffering, and vulnerability. The wager of relational theorizing in health care and public health is that substantive ethical visions of solidarity and care will provide support for more just and egalitarian health care and public health policies. (shrink)

Many working in bioethics today are engaging in forms of normative interpretation concerning the meaningful contexts of relational agency and institutional structures of power. Using the framework of relational bioethics, this article focuses on two significant social practices that are significant for health policy and public health: the practices of solidarity and the practices of care. The main argument is that the affirming recognition of, and caring attention paid to, persons as moral subjects can politically motivate a society in three (...) respects. The recognition of solidarity and the attention of care can prompt progressive change toward a democratic willingness: (a) to provide for equal respect for rights and dignity; (b) to provide the social resources and services needed for just health and well‐being; and (c) to focus its creativity and wealth on the actualization of potential flourishing of each and all. Solidarity is discussed as a morally developmental stance that moves from standing up for another, standing up with another, and standing up as another. Care is discussed as a morally developmental stance that moves from the attentive rehabilitation of another, attentive companionship with and for another, and attentive commitment to another. (shrink)

The concept of solidarity has recently come to prominence in the healthcare literature, addressing the motivation for taking seriously the shared vulnerabilities and medical needs of compatriots and for acting to help them meet these needs. In a recent book, Prainsack and Buyx take solidarity as a commitment to bear costs to assist others regarded as similar, with implications for governing health databases, personalized medicine, and organ donation. More broadly, solidarity has been understood normatively to call for ‘standing with’ or (...) assisting fellow community members and possibly also distant others in regard to their needs, whether for its own sake or in order to realize the demands of justice. I argue here that the understanding of solidarity in the existing bioethics literature is unduly restricted by not sufficiently theorizing the notion of structural (or systemic) injustice and its import for understanding solidarity. Extending traditional conceptions of labor and social movement solidarity, I contrast unitary solidarity within a given group with ‘networking solidarities’ across groups. I analyze the meaning of structural injustice and its significance for solidarity, including countering institutionally entrenched inequalities and economic exploitation. I then apply this broadened conception to healthcare, discussing structural problems with the U.S. insurance system and the solidarity movements addressing its deficiencies. I analyze some natural disasters and global health challenges that were aggravated by structural injustices, along with the solidarity movements they engendered. Finally, I revisit the questions of governing health databases and of personalized medicine with the enlarged conception of solidarity in view. (shrink)

In this paper we respond to Angus Dawson’s and Marcel Verweij’s recent editorial on ‘Solidarity: A Moral Concept in need of Clarification’. While Dawson’s and Verweij’s call for a broader solidarity-based research agenda is highly timely, their critique of our Report on ‘Solidarity as an Emerging Concept in Bioethics’ (2011) is based on some mistaken assumptions and misinterpretations of our arguments. These are (1) a fundamental misunderstanding of the importance of practice in our conceptualisation of solidarity; (2) a misinterpreration of (...) the normativity of our concept; and (3) a misrepresentation of our case study of public policy in the context of pandemics and in turn, of the relevance of our concept for policy-making. We correct each of these and in a final section we comment on the model of rational and constitutive solidarity put forward by Dawson and Verweij as an alternative to our conception of solidarity. (shrink)

Some healthcare systems are said to be grounded in solidarity because healthcare is funded as a form of mutual support. This article argues that health care systems that are grounded in solidarity have the right to penalise some users who are responsible for their poor health. This derives from the fact that solidary systems involve both rights and obligations and, in some cases, those who avoidably incur health burdens violate obligations of solidarity. Penalties warranted include direct patient contribution to costs, (...) and lower priority treatment, but not typically full exclusion from the healthcare system. We also note two important restrictions on this argument. First, failures of solidary obligations can only be assumed under conditions that are conducive to sufficiently autonomous choice, which occur when patients are given ‘Golden Opportunities’ to improve their health. Second, because poor health does not occur in a social vacuum, an insistence on solidarity as part of healthcare is legitimate only if all members of society are held to similar standards of solidarity. We cannot insist upon, and penalise failures of, solidarity only for those who are unwell, and who cannot afford to evade the terms of public health. (shrink)

Name der Zeitschrift: Jahrbuch für Wissenschaft und Ethik Jahrgang: 17 Heft: 1 Seiten: 331-344.

In this article I argue that the ethics of care provides us with a novel reading of human relations, and therefore makes possible a fresh approach to several empirical challenges. In order to explore this connection, I discuss some specific normative features of the ethics of care—primarily the comprehension of the moral agent and the concept of care—as these two key elements contribute substantially to a new ethical outlook. Subsequently, I argue that the relational and reciprocal mode of thinking with (...) regard to the moral agent must be extended to our understanding of care. I term this comprehension “mature care”. Citing conflicts of interests as examples, I demonstrate how this conceptualization of care may further advance the ethics of care’s ability to take on empirical challenges. Finally, I discuss political implications that may emanate from the ethics of care and the concept of mature care. (shrink)

This article tries to analyze the meaning and relevance of the concept of solidarity as compared to the concept of justice. While ‘justice’ refers to rights and duties , the concept of solidarity refers to relations of personal commitment and recognition . The article wants to answer the question whether solidarity and liberal justice should be seen as mutually exclusive or whether both approaches should be regarded as complementary to each other. The paper starts with an analysis of liberal theories (...) of justice which are followed by an analysis of the descriptive and a moral understanding of the concept of solidarity. The importance of solidarity lies in its relational aspects, particularly its emphasis on cooperation and commonality. The paper argues that while solidarity is more fundamental than justice, both concepts are important for the arrangement of health care practices. The paper gives special attention to the concept of decent care, reflective solidarity and humanitarian solidarity which is seen as fundamental for all health care policies and care practices. (shrink)

Health care services are constantly assessed by their ability to accommodate values popular in contemporary societies. Autonomy, justice, and human dignity have for some time been among such values in the affluent West. Relative newcomers in the field are the notions of and which seem to attract, in particular, Continental European ethicists. a.

The health care systems are fairly similar in theScandinavian countries. The exact details vary, but inall three countries the system is almost exclusivelypublicly funded through taxation, and most (or all)hospitals are also publicly owned and managed. Thecountries also have a fairly strong primary caresector (even though it varies between the countries),with family physicians to various degrees acting asgatekeepers to specialist services. In Denmark most ofthe GP services are free. For the patient in Norwayand Sweden there are out-of-pocket co-payments for GPconsultations, (...) with upper limits, but consultations forchildren are free. Hospital treatment is free inDenmark while the other countries use a system without-of-pocket co-payment. There is a very strongpublic commitment to access to high quality healthcare for all. Solidarity and equality form theideological basis for the Scandinavian welfare state.Means testing, for instance, has been widely rejectedin the Scandinavian countries on the grounds thatpublic services should not stigmatise any particulargroup. Solidarity also means devoting specialconsideration to the needs of those who have lesschance than others of making their voices heard orexercising their rights. Issues of limited access arenow, however, challenging the thinking about a healthcare system based on solidarity. (shrink)

Solidarity is analysed in contradistinction from two adjacent concepts - justice and sympathy. It is argued that unlike the other two, it is essentially local , partial and reflective . Although not to be confused with justice, solidarity is presented as underlying any contract-based system of justice, since it defines the contours of the group within which the contract is taking place. Finally, due to the fact that health is a typically universal value and being a primary good it is (...) something which should be distributed justly, solidarity seems not to have any central role in bioethics. (shrink)

Drawing on a conception of people as ‘ecological subjects’, creatures situated in specific social relations, locations, and material environments, I want to emphasize the importance of place and place‐making for basing, demonstrating, and forging future solidarity. Solidarity, as I will define it here, involves reaching out through moral imagination and responsive action across social and/or geographic distance and asymmetry to assist other people who are vulnerable, and to advance justice. Contained in the practice of solidarity are two core ‘enacted commitments’, (...) first, to engaging our moral imaginations and recognizing others in need and, second, to responsive action. Recognizing the suffering of displacement and responding through place‐making should follow from even the most simplistic understanding of people as ‘implaced’. Recognition, furthermore, that places are created and sustained, transformed, or neglected in ways that foster or perpetuate inequities, including health inequities, generates responsibilities concerning place‐making. Place‐based interventions, on either count, should be principal and, indeed, prioritized ways of showing solidarity for the vulnerable and promoting justice. Where solidaristic relations do not prevail, place‐making can catalyze and nurture them, and over time advance justice. On the moral landscapes of bioethics, the terrain where care and health are or should be at the center of attention, an ethic of place and place‐making for those who have been displaced – patients, the elderly, urban populations, and asylum‐seekers, for instance – expresses and has rich potential for nurturing bonds of solidarity. (shrink)

The Article focuses on the concept of social solidarity, as it is used in the Report of the International Bioethics Committee On Social Responsibility and Health. It is argued that solidarity plays a major role in supporting the whole framework of social responsibility, as presented by the IBC. Moreover, solidarity is not limited to members of particular groups, but potentially extended to all human beings on the basis of their inherent dignity; this sense of human solidarity is a necessary presupposition (...) for a genuinely universalistic morality of justice and human rights. (shrink)