The author agrees with the critiques of moral theory offered by such writers as Bernard Williams and Alasdair MacIntyre, and uses ideas from Heidegger and Levinas to argue that caring is an ontological structure of human existence which takes two forms: caring about on self (which he calls our "self-project") and caring-about-others. This dual form of caring is expressed on four Aristotelian levels of human living which the author describes and illustrates with reference to the phenomenon of pain. It is (...) concluded from this analysis that traditional notions of morality as imposing obligations should give way to an understanding of ethics as the social forms given to our caring for ourselves and for others. A number of implications for ethical theory are sketched out with the conclusion that virtue theory should be preferred and that the model could be worked out more fully to show that virtue theory can be internalist, particularist, pluralist, personalist and objectivist. (shrink)

Book reviewed in this article: The Meaning of Illness. By S. Kay Toombs.

Most moral philosophers who have recently expressed sympathy with feminist or ‘care-based’ perspectives on ethical theory have thought that such perspectives can make valuable contributions to more comprehensive ethical theories. Few have thought that an ethics of care can offer a complete normative theory. However, Michael Slote is one of the ambitious few. In his recent book, The Ethics of Care and Empathy, he seeks to show that a care-based perspective can do a lot of service in first-order moral and (...) political theory as well as in metaethics. Here is a quick overview of the book's content: In Chapter 1, Slote explicates the notion of empathy that is central in his ethics of care, which he locates within the sentimentalist paradigm, stemming from philosophers such as Hume and Hutcheson. Slote's account of empathy and moral development draws substantially on work by the psychologist Martin Hoffman. Chapter 2 discusses care ethics and our obligation to help others, including both the near and the distant needy. Chapter 3 aims to show how the notion of empathy can further the case for deontology in ethics. Chapters 4 through 6 discuss the relation of care ethics to pivotal issues in political philosophy, such as autonomy, liberalism, social justice and rights. Slote maintains that autonomy …. (shrink)

This article presents the derivation of moral competence in nursing practice by identifying its attributes founded on Thai culture. In this process moral competence is formed and based on the Thai nursing value system, including personal, social and professional values. It is then defined and its three dimensions (moral perception, judgment and behavior) are also identified. Additionally, eight attributes as indicators of moral competence are identified and selected from three basic values. The eight attributes are loving kindness, compassion, sympathetic joy, (...) equanimity, responsibility, discipline, honesty, and respect for human values, dignity and rights. All attributes are discussed by addressing the three moral dimensions in order to present how to deal with ethical issues in nursing practice. As a summary, a model of moral competence is presented to demonstrate moral competence in nursing practice in Thailand. (shrink)

There is a growing interest in ethical competence-building within nursing and health care practising. This tendency is accompanied by a remarkable growth of ethical guidelines. Ethical demands have also been laid down in laws. Present-day practitioners and researchers in health care are thereby left in a virtual cross-fire of various legislations, codes, and recommendations, all intended to guide behaviour. The aim of this paper was to investigate the role of ethical guidelines in the process of ethical competence-building within health care (...) practice and medical research. A conceptual and critical philosophical analysis of some paragraphs of the Helsinki Declaration and of relevant literature was performed. Three major problems related to ethical guidelines were identified, namely, the interpretation problem (there is always a gap between the rule and the practice, which implies that ethical competence is needed for those who are to implement the guidelines); the multiplicity problem (the great number of codes, declarations, and laws might pull in different directions, which may confuse the health care providers who are to follow them); and the legalisation problem (ethics concerns may take on a legal form, where ethical reflection is replaced by a procedure of legal interpretations). Virtue ethics might be an alternative to a rule based approach. This position, however, can turn ethics into a tacit knowledge, leading to poorly reflected and inconsistent ethical decisions. Ethical competence must consist of both being (virtues) and doing (rules and principles), but also of knowing (critical reflection), and therefore a communicative based model is suggested. (shrink)

Here is a thoroughly updated edition of a classic in palliative medicine. Two new chapters have been added to the 1991 edition, along with a new preface summarizing where progress has been made and where it has not in the area of pain management. This book addresses the timely issue of doctor-patient relationships arguing that the patient, not the disease, should be the central focus of medicine. Included are a number of compelling patient narratives. Praise for the first edition "Well (...) written. . .should be read by everyone in medical practice or considering a career in medicine."---JAMA. "Memorable passages, important ideas, and critical analysis. This is a book that clinicians and educators should read."---New England Journal of Medicine. (shrink)

In At the Will of the Body , Arthur Frank told the story of his own illnesses, heart attack and cancer. That book ended by describing the existence of a "remission society," whose members all live with some form of illness or disability. The Wounded Storyteller is their collective portrait. Ill people are more than victims of disease or patients of medicine they are wounded storytellers. People tell stories to make sense of their suffering when they turn their diseases into (...) stories, they find healing. Drawing on the work of authors such as Oliver Sacks, Anatole Broyard, Norman Cousins, and Audre Lorde, as well as from people he met during the years he spent among different illness groups, Frank recounts a stirring collection of illness stories, ranging from the well-known--Gilda Radner's battle with ovarian cancer--to the private testimonials of people with cancer, chronic fatigue syndrome, and disabilties. Their stories are more than accounts of personal suffering: they abound with moral choices and point to a social ethic. Frank identifies three basic narratives of illness in restitution, chaos, and quest. Restitution narratives anticipate getting well again and give prominence to the technology of cure. In chaos narratives, illness seems to stretch on forever, with no respite or redeeming insights. Quest narratives are about finding that insight as illness is transformed into a means for the ill person to become someone new. (shrink)

What is at the basis of moral action? An altruism acquired by the application of rule and principle? Or, as Noddings asserts, caring and the memory of being cared for? With numerous examples to supplement her rich theoretical discussion, Noddings builds a compelling philosophical argument for an ethics based on natural caring, as in the care of a mother for her child. The ethical behavior that grows out of natural caring, and has as its core care-filled receptivity to those involved (...) in any moral situation, leaves behind the rigidity of rule and principle to focus on what is particular and unique in human relations. Noddings's discussion is wide-ranging, as she considers whether organizations, which operate at a remove from the caring relationship, can truly be called ethical. She discusses the extent to which we may truly care for plants, animals, or ideas. Finally, she proposes a realignment of education to encourage and reward not just rationality and trained intelligence, but also enhanced sensitivity in moral matters. (shrink)

Beginning with a review of the role of placebos in the history of medicine, this book investigates the current surge of interest in placebos, and probes the methodological difficulties of saying scientifically just what placebos can and cannot do.

ACKNOWLEDGMENTS. Among Those Who helped greatly in the initial stages of this project by making constructive suggestions on my first "caring" papers are Nick Burbules, William Doll, Bruce Fuller, Brian Hill, William Pinar, Mary Anne ...

In Comprehending Care, Tove Pettersen subjects the ethics of care, as advanced by Carol Gilligan, to a moral-philosophical examination. More precisely, she extracts the philosophical foundation in this ethics, probes its possible implications for moral theory of a more traditional stamp, and explores its normative plausibility. Pettersen exposes several misconceptions of Gilligan's work.

Eminent moral philosopher Michael Slote argues that care ethics presents an important challenge to other ethical traditions and that a philosophically developed care ethics should, and can, offer its own comprehensive view of the whole of morality. Taking inspiration from British moral sentimentalism and drawing on recent psychological literature on empathy, he shows that the use of that notion allows care ethics to develop its own sentimentalist account of respect, autonomy, social justice, and deontology. Furthermore, he argues that care ethics (...) gives a more persuasive account of these topics than theories offered by contemporary Kantian liberalism. The most philosophically rich and challenging exploration of the theory and practice of care to date, _The Ethics of Care and Empathy_ also shows the manifold connections that can be drawn between philosophical issues and leading ideas in the fields of psychology, education, and women's studies. (shrink)

Nel Noddings argues that hers is not an ethics of agape. I want to argue, on the contrary, that it is, and that this is a problem. My central thesis is that the unidirectional nature of the analysis of one-caring reinforces oppressive institutions.