Rigorous evaluations of the effects of vertical public health enterprises on the health systems of low-income countries usefully identify the public health and ethical costs of those initiatives. They reveal that such narrowly focused public health ventures undermine the efforts of those countries to establish and maintain adequately resourced and well-developed national health systems, including comprehensive primary care programs. This paper argues that the scope of assessments of vertical public health ventures should be broadened to include gender as an (...) additional axis of analysis. When members of socio-economically marginalized populations are sick with conditions that are not covered by fragmented and inadequate public health programs or disease-specific vertical public health schemes, their untreated illnesses add to the gendered familial caregiving responsibilities of the female members of their households. Those women and girls have to perform their ‘normal’ familial care work, work outside the home for pay, and take care of the unwell family members for whom the household cannot afford treatment. Given that women and girls from low-income households already shoulder a disproportionate amount of care work for their families, their health and life prospects are further affected by the amplification of their caregiving responsibilities. This paper argues that analyses of the impact of vertical public health initiatives should also track this gendered consequence of those enterprises because it is a crucial public health and ethical matter. (shrink)

This paper attempts to show how Adorno’s thought can illuminate our reflections on the future of work. It does so by situating Adorno’s conception of genuine activity in relation to his negativist critical epistemology and his subtle account of the distinction between true and false needs. What emerges is an understanding of work that can guide our aspirations for the future of work, and one we illustrate via discussions of creative work and care work. (...) These are types of work which cater to persistent human needs, albeit ones that are distorted under present social conditions. Adorno’s thought helps us to understand why this is the case. (shrink)

How can work be a genuine good in life? I argue that this requires overcoming a problem akin to that studied by Marx scholars as the problem of work, freedom and necessity: how can work be something we genuinely want to do, given that its content is not up to us, but is determined by necessity? I argue that the answer involves valuing contributing to the good of others, typically as valuing active pro-sociality – that is, valuing (...) actively doing something good for others. This makes work better in one way, and may even make work something we are genuinely glad to have in our lives. Contemporary philosophical thinking about good work tends to focus on how work can be good for the person doing it, by providing, for example, self-realization or social relationships, while underappreciating the special importance of valuing social contribution. People will typically only really want work if they want a part of their lives to be about the good of others. This also means that work may be a part of the best life, something we should take into account when discussing work-related policies and the desirability of a ‘post-work’ future. (shrink)

In his paper, ‘What moral work can Nussbaum’s account of human dignity do in the context of dementia care?’, Soofi seeks to modify Nussbaum’s conception of dignity to deal with four key objections that arise when appeals to dignity are made in the context of dementia care. We will not discuss the first of these, the redundancy of dignity talk, since this issue has already been much discussed in the literature. Instead, we will focus on the remaining (...) three issues raised, that of the exclusion of persons with advanced dementia from having dignity, unjustified speciesism as a ground of human dignity, and the unclear practical implications that follow from having dignity. (shrink)

Drawing upon the practice of caregiving and the insights of feminist care ethics, I offer a phenomenology of caregiving through the work of Eva Feder Kittay and Emmanuel Lévinas. I argue that caregiving is a material dialectic of embodied response involving moments of leveling, attention, and interruption. In this light, the Levinasian opposition between responding to another's singularity and leveling it via parity-based principles is belied in the experience of care. Contra much of response ethics’ and (...) class='Hi'>care ethics’ respective literatures, this dialectic suggests that they are complementary in ways that productively illuminate themes of each. I conclude by suggesting that when response and care ethics are thought together through the experience of caregiving, such labors produce finite responsibility with infinite hope. (shrink)

Patient and public involvement is widely thought to be important in the improvement of health care delivery and in health equity. Purpose: The article examines the role of experiential knowledge in service co-production in order to develop opiate substitution treatment services (OST) for high-risk opioid users. Method: Drawing on social representations theory and the concept of social identity, we explore how experts’ by experience and registered nurses’ understandings of OST contain discourses about the social representations, identity, and citizenship of (...) the participants and the effects these may have on developing or hindering inclusive and bottom-up forms of patient and public involvement. Results: The meeting sessions that potentially offer room for creativity and problem-solving fail to provide any new propositions for fixing the system. The health care professionals primarily identify themselves as regulators who protect the correctness of their actions and show little interest in considering experiential knowledge on opioid addiction. Conclusion: The participation of patients has been one of the prominent reforms implemented in health care. The goal of client-centered thinking is often emphasised; however, the implementation is not simple due to the strongly institutionalised knowledge and related working patterns and practices in health care. (shrink)

The concept of work can be understood as a purposeful human activity, which is focused on the processing of natural goods, items and/or information by using tools to meet tangible and intangible needs. Work is the usage of instruments to support the existence of humankind and the social world. Domestic work refers to work of domestic help, which applies to employees, usually individuals who work and often live in the house of the employer. Emotional labor (...) takes place in the public sphere as a social and economic exchange sold for wages during interactions with customers or coworkers. Emotional labor requires certain emotions to be displayed and expressed in line with organizational aims. (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)

In this essay, I depart from the historical exclusion of trans women’s ethical insights from care ethics by focusing on trans literature as a source of knowledge expressed by trans women about care. I open up with the systematic denial of trans women as ethical knowers by analyzing Marilyn Frye's characterization of trans women as mindless servile robots under patriarchy. I then turn to trans literature to counter this portrayal. Specifically, I discuss short stories by Casey Plett and (...) Ryka Aoki as sources of knowledge about assumptive and futurebound practices of care. I begin by arguing that the work of Maria Lugones considers the spatial dimensions of love, and that this suggests that care involves giving space to another on their own terms. I then turn to Plett’s story “Other Women” to unpack assumptive care as a short-circuited form of caring in which a relationship to the other on their own terms is closed off by transphobic assumptions. I contrast this with Plett’s story “Winning,” which describes a futurebound care in which another’s space is kept open, permitting action that allows them to flourish on their own terms. After this, I discuss Aoki’s “To the New World” as an engagement with both racist assumptive care and futurebound care aimed at self-care. I conclude that these stories provide a rich space for considering trans ethical knowledge about care. (shrink)

Migrant women are often stereotyped. Some scholars associate the feminization of migration with domestic work and criticize the “care drain” as a new form of imperialism that the First World imposes on the Third World. However, migrant women employed as domestic workers in Northern America and Europe represent only 2% of migrant women worldwide and cannot be seen as characterizing the “feminization of migration”. Why are migrant domestic workers overestimated? This paper explores two possible sources of bias. The (...) first is sampling: conclusions about “care drain” are often generalized from small samples of domestic workers. The second stems from the affect heuristic: imagining children left behind by migrant mothers provokes strong feelings of injustice which trump other considerations. The paper argues that neither source of bias is unavoidable and finds evidence of gender stereotypes in the “care drain” construal. (shrink)

In this article, we explicate evidence-based nursing (EBN), critically appraise its framework and respond to nurses’ concern that EBN sidelines the caring elements of nursing practice. We use resources from care ethics, especially Vrinda Dalmiya’s work that considers care as crucial for both epistemology and ethics, to show how EBN is compatible with, and indeed can be enhanced by, the caring aspects of nursing practice. We demonstrate that caring can act as a bridge between ‘external’ evidence and (...) the other pillars of the EBN framework: clinical expertise; patient preferences and values. Drawing on an influential EBN handbook, section 1 presents the aims and features of EBN, including the normative principle that EBN should take place within a ‘context of caring’. We aim to understand this context and whether it can be neatly detached from the EBN framework, as the handbook seems to suggest. In section 2, we highlight the grounds for resistance to EBN from the nursing community, before mounting the argument that nursing practices can be understood fruitfully through feminist care ethics and/or virtue ethics lenses. In section 3, we deepen that analysis using Dalmiya’s concepts of care-knowing and care as a hybrid ethico-epistemic virtue, which are ideally suited to the complex practices of nursing. In section 4, we bring this rich understanding of care into conversation with EBN, showing that its framework cannot be adequately theorised without paying proper attention to care. Caring can be neither an innocuous background assumption of nor an afterthought to the EBN framework. (shrink)

The metaphor of “care drain” has been created as a womanly parallel to the “brain drain” idea. Just as “brain drain” suggests that the skilled migrants are an economic loss for the sending country, “care drain” describes the migrant women hired as care workers as a loss of care for their children left behind. This paper criticizes the construction of migrant women as “care drain” for three reasons: 1) it is built on sexist stereotypes, 2) (...) it misrepresents and devalues care work, and 3) it misses the opportunity for a theoretical change about how skills in migration contexts can be understood. (shrink)

Justice in production is concerned with ensuring the benefits and burdens of work are distributed in a way reflective of persons’ status as moral equals. While a variety of accounts of productive justice have been offered, insufficient attention has been paid to the distribution of work’s benefits and burdens in the future. In this paper, after granting for the sake of argument forecasts of widespread future technological unemployment, we consider the implications this has for egalitarian requirements of productive (...) justice. We argue that in relation to all the benefits affiliated with work, other than undertaking social contribution, the technological replacement of work is unproblematic as these benefits could in principle be attained elsewhere. But because social contribution uniquely corresponds to work (when work is understood as more than a paid job), the normative assessment of technological unemployment will turn on the value theories of justice give to contributive activity. We then argue that despite technological replacement being plainly beneficial insofar as it relieves persons from the burdens of work, such as dangerous work or drudgery, because the nature of care work makes it less susceptible to technological replacement, egalitarian concern will require the burdens of care work to be shared equally between individuals. (shrink)

Recent years have seen fresh impetus brought to debates about the proper role of statistical evidence in the law. Recent work largely centres on a set of puzzles known as the ‘proof paradox’. While these puzzles may initially seem academic, they have important ramifications for the law: raising key conceptual questions about legal proof, and practical questions about DNA evidence. This article introduces the proof paradox, why we should care about it, and new work attempting to resolve (...) it. (shrink)

Since Chenyang Li’s (1994) groundbreaking article there has been interest in reading early Confucian ethics through the lens of care ethics. In this paper, I examine the prospects for dialogue between the two in light of recent work in both fields. I argue that, despite some similarities, early Confucian ethics is not best understood as a form of care ethics, of the kind articulated by Nel Noddings (1984, 2002) and others. Reasons include incongruence deriving from the absence (...) in the Chinese texts of a developed account of need, and doubts about whether the parent-child relationship in Confucian thought is best characterized by ‘care’. More importantly, care is merely one value directing the Confucian commitment to family and personal bonds, with different kinds of relationship, including the five relationships presented in the Mencius, entailing different idealized modes of relating to others. (shrink)

The philosophical interest in the nature, value, and varieties of human understanding has swelled in recent years. This article will provide an overview of new research in the epistemology of understanding, with a particular focus on the following questions: What is understanding and why should we care about it? Is understanding reducible to knowledge? Does it require truth, belief, or justification? Can there be lucky understanding? Does it require ‘grasping’ or some kind of ‘know-how’? This cluster of questions has (...) largely set the research agenda for the study of understanding in epistemology. This article will conclude by discussing some varieties of understanding and highlight directions for future research. (shrink)

This essay discusses short-circuited trans care by focusing on failures of t4t as an ethos both interpersonally and within particular trans scenes. The author begins by recounting an experience working at a bar/restaurant that appealed to its identity as a caring trans community space as part of its exploitation of trans workers. This dynamic inspires the main argument, that t4t can become an ethos of scenes and institutions beyond the interpersonal while short-circuiting practices of trans care. Short-circuited trans (...) care is then traced to t4t by drawing from Hil Malatino's work on trans care and t4t, Kai Cheng Thom's work on community dynamics, and trans literature to argue that practices of t4t often include abuse, expulsion, and assumptive care. This short-circuited trans care is linked to trans scenes by discussing the ethos of t4t in the history of Topside Press and trans cultural production. The author does not condemn t4t and to this effect offers a critique of tethering trans cultural production to prestige instead of care. Rather, the goal of this essay is to openly discuss aspects of t4t and trans care that are often obscured through the projection of a highly questionable “we” or universalized “trans community.”. (shrink)

Parenthood is one of the best gifts nature and god has given to humans. Being a parent is a feeling that can be compared to none other but as a baby caretaker a nanny can do this. As a parent, we always strive to provide the best of everything to our children. This however often comes at a price. Mostly it means that both the parents have to be working in order to provide the best facilities and at the same (...) time secure the future of their children and Newborn Baby. Even if one of the parent chooses to sacrifice the career and stay at home, raising a child in a nuclear family set up is still a challenge. -/- This is when an experienced and gentle baby caretaker can be of utmost help. However such caretaker who can be entrusted with the care and security of your child is often hard to find. Especially in cities like NOIDA baby caretaker are available for your service. Well no more. -/- No more is the need to sacrifice your career or professional aspirations. You can peacefully leave to work, entrusting your lovely children in the hands of the baby caretaker. Majority of the time that your child will be spending is with the caretaker and it is therefore absolutely necessary that a baby caretaker possess all the qualities of a good parent. Benevolence, patience, care and attention, all these qualities can be found in the baby caretaker provided by us. Our caretaker ensures the welfare of the child, creating the environment for sound mental, emotional and health development of the children. -/- We need to guarantee that the caretaker has the child's best interest at heart and looks at the security of our child with the same eye as we do. We select the baby caretakers that view this profession as means of contentment and satisfaction in their lives and not just another menial job to earn their livelihood. Children have the inherent need to have somebody always around them in oder to feel secure and wanted, avoiding loneliness and boredom. A Caretaker for baby in Noida not only provides this companion but also ensures that the natural curiosity of a child is kept alive even in the absence of their parents. -/- Big cities with the diverse kind of population, mostly coming to work from various parts of the country, have had some history of violent cases. And that’s why precaution should be taken while hiring Best caretaker in Noida . With thorough background check and verified references, all such apprehensions can be laid to rest.+ . (shrink)

The philosophy of science of Patrick Suppes is centered on two important notions that are part of the title of his recent book (Suppes 2002): Representation and Invariance. Representation is important because when we embrace a theory we implicitly choose a way to represent the phenomenon we are studying. Invariance is important because, since invariants are the only things that are constant in a theory, in a way they give the “objective” meaning of that theory. Every scientific theory gives a (...) representation of a class of structures and studies the invariant properties holding in that class of structures. In Suppes’ view, the best way to define this class of structures is via axiomatization. This is because a class of structures is given by a definition, and this same definition establishes which are the properties that a single structure must possess in order to belong to the class. These properties correspond to the axioms of a logical theory. In Suppes’ view, the best way to characterize a scientific structure is by giving a representation theorem for its models and singling out the invariants in the structure. Thus, we can say that the philosophy of science of Patrick Suppes consists in the application of the axiomatic method to scientific disciplines. What I want to argue in this paper is that this application of the axiomatic method is also at the basis of a new approach that is being increasingly applied to the study of computer science and information systems, namely the approach of formal ontologies. The main task of an ontology is that of making explicit the conceptual structure underlying a certain domain. By “making explicit the conceptual structure” we mean singling out the most basic entities populating the domain and writing axioms expressing the main properties of these primitives and the relations holding among them. So, in both cases, the axiomatization is the main tool used to characterize the object of inquiry, being this object scientific theories (in Suppes’ approach), or information systems (for formal ontologies). In the following section I will present the view of Patrick Suppes on the philosophy of science and the axiomatic method, in section 3 I will survey the theoretical issues underlying the work that is being done in formal ontologies and in section 4 I will draw a comparison of these two approaches and explore similarities and differences between them. (shrink)

Healthcare is becoming increasingly automated with the development and deployment of care robots. There are many benefits to care robots but they also pose many challenging ethical issues. This paper takes care robots for the elderly as the subject of analysis, building on previous literature in the domain of the ethics and design of care robots. Using the value sensitive design approach to technology design, this paper extends its application to care robots by integrating the (...) values of care, values that are specific to AI, and higher-scale values such as the United Nations Sustainable Development Goals. The ethical issues specific to care robots for the elderly are discussed at length alongside examples of specific design requirements that work to ameliorate these ethical concerns. (shrink)

This paper interprets the demonstrative retreat from public life and the promotion of self-improvement in Seneca’s later works as a political undertaking. Developing arguments by THOMAS HABINEK, MATTHEW ROLLER and HARRY HINE, it suggests that Seneca promoted the political vision of a cosmic community of progressors toward virtue constituted by a special form of progressor friendship, a theoretical innovation made in the Epistulae morales. This network of like-minded individuals spanning time and space is open to anyone who shares the other (...) members’ commitment to the improvement of one’s own self and that of others. By advertising such self-care and courting his readers as prospective friends, the author of the Epistulae morales aims to recruit new members for that community, in particular in the first nine letters. (shrink)

This essay considers the dependency of trans youth by bridging transgender studies with feminist care ethics to emphasize a trans wisdom about solidarity through dependency. The first major section of the essay argues for reworking Sara Ruddick's philosophy of mothering in the context of trans and gender‐creative youth. This requires, first, stressing a more robust interaction among her divisions of preservative love, nurturance for growth, and training for acceptability, and second, creating a more nuanced account of “nature” in relation (...) to nurturance for growth to avoid casting transition as contrary to a trans youth's healthy development. In the second major section of the essay, I depart from Ruddick's framework to emphasize the difference of care for trans youth by trans and/or queer communities and through mutual caregiving, stressing a trans wisdom about dependency and solidarity found in the work of Sylvia Rivera and Marsha P. Johnson. Turning to Eva Feder Kittay's links between dependency work and equality, I argue that Rivera and Johnson's work contains a distinct knowledge derived from practice necessitating the connection between solidarity and dependency in particular communities. I then call for more work on trans care ethics, trans ethics, and trans wisdom more broadly. (shrink)

This article engages with the care ethics of Laudato Si’ through the lens of postcolonial ecofeminism. Laudato Si’ speaks of the family of creation where nature is both a nurturing mother and a vulnerable sister, reflecting patriarchal associations of women with nature, fragility, and the virtue of care. This indirectly undermines the need for men to engage in care/social reproduction work as well as the strengthening of women’s agency. While this kin-centric ecology acknowledges the interdependence of (...) creatures, it maintains the hierarchy of humans over nature and underlines this family’s headship by an all-powerful Father. Laudato Si’s family ecology and God language inadvertently reifies women–nature–care connection and reinforces the logic of male domination. This study recommends exploring gender inclusive images of the Trinity and the family of creation in mutual relations to foster care that promotes both the agency of women and nature. (shrink)

This paper will address Foucault’s analysis of the Hebrew and Christian pastor and argue that Foucault’s analysis of pastoral power in Security, Territory, Population neglects an important characteristic of the shepherd/pastor figure: violence. Despite Foucault’s close analysis of the early development of the Hebrew pastor, he overlooks the role of violence and instead focuses on sacrifice. However the sacrificial pastor does not figure in the Hebrew Scriptures. The Hebrew pastor is called to lead, feed and protect the flock, not sacrifice (...) for them. This is not to suggest that the theme of sacrifice is absent in the Hebrew Scriptures but that sacrifice is not a role attributed to the pastor until Jesus’ reinterpretation of the “good shepherd” in Chapter 10 of The Gospel of John.4 In distinguishing the Hebrew and Christian formulations of the pastor, the roles of violence and sacrifice in each can be understood more clearly. Beginning with the Hebrew Scriptures I will demonstrate the importance of violence in the figure of David as the first “shepherd of men”. I will argue that violence and the ability to protect the flock was a significant and determining characteristic of the Hebrew pastor. Contrary to Foucault’s assertion I will demonstrate that sacrifice was not a role attributed to the Hebrew pastor. While the words and life of Jesus provide a new sacrificial paradigm for understanding the “shepherd of men,” it is Paul who provides the foundation on which the practice of the Christian pastor is established in the Church. Therefore I will examine the writing of Paul to demonstrate the way violence operates in the Christian pastorate. I will argue that sacrifice does not replace violence but violence is subsumed in the sacrificial pastor and continues to operate. Finally I will suggest that the introduction of violence into Foucault’s analysis establishes a deeper connection between pastoral power and biopower. Thus, this connection engenders a richer understanding of the tension in Foucault’s work between care and violence in the poles of biopower: to make live and let die. (shrink)

Abstract The values of the healthcare sector are fairly ubiquitous across the globe, focusing on caring and respect, patient health, excellence in care delivery, and multi-stakeholder collaboration. Many individual pharmacists embrace these core values. But their ability to honor these values is significantly determined by the nature of the system they work in. -/- The paper starts with a model of the prevailing pharmacist workforce model in Scotland, in which core roles are predominantly separated into hierarchically disaggregated jobs (...) focused on one professional ‘pillar’: Clinician /Practice Provider; Educator; Leader/Manager; and Researcher. This is the ‘Atomistic’ Model. This skills-segregation yields a workforce of individuals working in isolation rather than collaborating together, and lacking a shared information flow, purpose and identity. Key strategic flaws include suboptimal responsiveness to population and subpopulation needs, inconsistency and inequity of care, an erosion of professional agency, and lower job satisfaction. It is conjectured that this results from a lack of congruence between values, professional ethos, and organizational structure. ‘Atomism’ culminates in a syndrome of widespread professional-level cognitive dissonance. -/- The paper contrasts this with a new emerging workforce vision, The Collaborative Care Model. This new model defines a systems-first-approach, built on the principle that all jobs must include all four professional ‘pillars’. Vertical skills integration, involving education and task sharing, will support sustainability and succession planning. Horizontal skills integration (across practice, leadership and research) is included to improve responsiveness to population need and individual professional agency. The working conditions, supportive ethos, and career structure needed to make the model work are described. Moral theory and workforce theory are used to justify why the model may be more effective for population health, delivering greater job satisfaction for individuals and ultimately helping systematically realize and honor healthcare values. Finally, the paper sketches the first steps needed to implement the model at the national level, starting with the operationalization of new multi-pillar professional curricula across the career spectrum. Potential pitfalls and challenges are also discussed. -/- Co-Authors: 1. Paul Forsyth (PF) Lead Pharmacist Clinical Cardiology, Pharmacy, NHS Greater Glasgow & Clyde. Contribution: Conceptualization; Model Curation; Model Theory; Model Visualization; Writing - original draft (lead author), Writing - review & editing (lead author) 2. Andrew Radley (AR), Consultant in Public Health Pharmacy, NHS Tayside. Contribution: Conceptualization; Model curation; Model Theory; Writing - review & editing 3. Gordon Rushworth (GR), MPharm MSc FFRPS FRPharmS (Consultant). Programme Director, Highland Pharmacy Education & Research Centre, NHS Highland, Inverness. Contribution: Model curation; Writing - review & editing 4. Fiona Marra (FM) National Lead Clinician Scottish Infection and Immunology Network (SPAIIN) / Advanced Pharmacist HCV / HIV, NHS Greater Glasgow & Clyde. Contribution: Model curation; Writing - review & editing 5. Susan Roberts (SR) Associate Postgraduate Pharmacy Dean, NHS Education for Scotland. Contribution: Model curation; Writing - review & editing 6. Roisin O’Hare (RO) Lead Teacher Practitioner Pharmacist, Northern Ireland University Network, Southern Health and Social Care Trust. Contribution: Model curation; Writing - review & editing 7. Catherine Duggan (CD) Chief Executive Officer, International Pharmaceutical Federation (FIP). Contribution: Model curation; Writing - review & editing 8. Barry Maguire (BM) Senior Lecturer, School of Philosophy, Psychology and Life Sciences, The University of Edinburgh. Contribution: Conceptualization; Model Curation; Model Theory; Model Visualization; Supervision; Writing - original draft (senior academic supervisor), Writing - review & editing (senior academic supervisor) -/- . (shrink)

This paper explores the relationship between dignity and robot care for older people. It highlights the disquiet that is often expressed about failures to maintain the dignity of vulnerable older people, but points out some of the contradictory uses of the word ‘dignity’. Certain authors have resolved these contradictions by identifying different senses of dignity; contrasting the inviolable dignity inherent in human life to other forms of dignity which can be present to varying degrees. The Capability Approach (CA) is (...) introduced as a different but tangible account of what it means to live a life worthy of human dignity. It is used here as a framework for the assessment of the possible effects of eldercare robots on human dignity. The CA enables the identification of circumstances in which robots could enhance dignity by expanding the set of capabilities that are accessible to frail older people. At the same time, it is also possible within its framework to identify ways in which robots could have a negative impact, by impeding the access of older people to essential capabilities. It is concluded that the CA has some advantages over other accounts of dignity, but that further work and empirical study is needed in order to adapt it to the particular circumstances and concerns of those in the latter part of their lives. (shrink)

The concept of work–family balance was introduced in the 1970s in the United Kingdom based on a work–leisure dichotomy, which was invented in the mid-1800s. It is usually related to the act of balancing of inter-role pressures between the work and family domains that leads to role conflict. The conflict is driven by the organizations’ views of the “ideal worker” as well as gender disparities and stereotypes that ignore or discount the time spent in the unpaid (...) class='Hi'>work of family and community. Solutions for balance include legislation, flexible workplace arrangements, and the market care services. (shrink)

Vietnam reported its first known case of COVID-19 on 23 January 2020. As of 19 May, the country had 324 confirmed cases, with 263 recoveries and no deaths. In Vietnam, COVID-19 presents a range of contextual challenges including high numbers of migrant workers, high numbers of employees in the garment industry, many people working in the informal sector, and linguistically and culturally diverse ethnic minorities. The impacts of COVID-19 on vulnerable groups, such as migrant workers, informal workers, garment factory workers, (...) and ethnic minorities are further marginalising these groups, exacerbating poverty and inequality and increasing their exposure to other social, economic and protection risks. (shrink)

Vietnam reported its first known case of COVID-19 on 23 January 2020. As of 19 May, the country had 324 confirmed cases, with 263 recoveries and no deaths. In Vietnam, COVID-19 presents a range of contextual challenges including high numbers of migrant workers, high numbers of employees in the garment industry, many people working in the informal sector, and linguistically and culturally diverse ethnic minorities. The impacts of COVID-19 on vulnerable groups, such as migrant workers, informal workers, garment factory workers, (...) and ethnic minorities are further marginalising these groups, exacerbating poverty and inequality and increasing their exposure to other social, economic and protection risks. Women in Vietnam have historically been underrepresented in public decision-making processes, a trend that is reflected in high-level decision-making structures on COVID-19. This means that even as women are disproportionately affected by the crisis, they have less say in how their country should respond to it. (shrink)

Some provisions of the UN’s Convention on the Elimination of Discrimination Against Women (CEDAW) are clearly important from the perspective of business ethics, particularly those calling for equal rights for women to employment and financial security. Some other provisions of CEDAW are equally as important for ethical business practices and Corporate Social Responsibility (CSR), but are frequently overlooked because of the presumption that they are not strictly business concerns: the rights of women to participation in public life, marriage, and family (...) rights; the rights of rural women to adequate living conditions; and general rights to equality. This chapter will discuss the conceptual commitments that underlie the assumption of a clear demarcation between work and life concerns, and examine the criticisms of this assumption made by feminism. It will, in particular, be interested in: -/- • The public/private distinction • The meaning of “work” or “labor” • The relationship between CSR and care ethics • Fostering a broader understanding of the family or familial relations • Examining the connection between fair wages and work/life integration -/- These discussions suggest that the ability for businesses worldwide to uphold the tenets of CEDAW is dependent upon a reconsideration of the character of the Ideal Worker and a nuanced understanding of the effects of workplace policies on the wider communities in which businesses operate. In particular, though work/life integration is not strictly speaking a “women’s issue,” the ethical and policy considerations addressed herein currently have disproportionately negative effects for women; thus, addressing them is crucial for achieving the aims of gender equality. (shrink)

In this interview, Estelle Ferrarese elaborates on her account of vulnerability and care to highlight its political and social, as opposed to its ethical, dimensions. Drawing on, amongst others, Adorno, Tronto, Castell, and Laugier, she argues that vulnerability and care should not be understood ontologically, as an antropological exposure of the body, but rather socially, as the normative expectations and material conditions under which care work takes place. Situating her approach in anglophone and francophone discussions on (...) vulnerability and precarity, she discusses her approach to normative expectations and how it informs her account of vulnerability of living at the mercy of someone else's agency, as well as the politicization of vulnerability. She also discusses the political implications of her account of vulnerability and care with regard to a range of contemporary issues, such as the Men's Right Movement, the posthuman turn and the Antropocene, and mutual aid and the neoliberalization of the welfare state. (shrink)

By setting the focus on issues of dependence and embodiment, feminist work has and continues to radically improve our understanding of Kant’s practical philosophy as one that is not (as it typically has been taken to be) about disembodied abstract rational agents. This paper outlines this positive development in Kant scholarship in recent decades by taking us from Kant’s own comments on women through major developments in Kant scholarship with regard to the related feminist issues. The main aim is (...) to provide an overview of the philosophical resources already available in the literature as well as a sense of where main interpretive and philosophical challenges currently lie. More specifically, I start with a brief summary of the kinds of statements Kant makes about women that give rise to the many interpretive and philosophical puzzles facing anyone who reads his philosophy carefully. I then provide a brief historical overview of many of the pioneering women Kant scholars who made it possible for there to be so many excellent women scholars in the Kant community today and for firmly establishing the condition of woman as a point of inquiry on the philosophical map. The last section is organized in themes to give the reader a sense of the current, related discussions. I provide an overview of the more recent literature regarding Kant on women, embodiment (sexual objectification, sexual activity, sexual violence, abortion), care relations (marriage, dependents, servants), and systemic injustice (poverty, sex work, and oppression). As we will see, these many engagements with Kant’s philosophy not only help us to better understand our inherited women-undermining and problematic dependency-furthering institutions and practices, but also provide ample philosophical resources that can be utilized in our efforts to envision the project of reform such that we can achieve a better future for each and all. (shrink)

In bioethics, the predominant categorization of various types of influence has been a tripartite classification of rational persuasion (meaning influence by reason and argument), coercion (meaning influence by irresistible threats—or on a few accounts, offers), and manipulation (meaning everything in between). The standard ethical analysis in bioethics has been that rational persuasion is always permissible, and coercion is almost always impermissible save a few cases such as imminent threat to self or others. However, many forms of influence fall into the (...) broad middle terrain—and this terrain is in desperate need of conceptual refining and ethical analysis in light of recent interest in using principles from behavioral science to influence health decisions and behaviors. This paper aims to address the neglected space between rational persuasion and coercion in bioethics. First, I argue for conceptual revisions that include removing the “manipulation” label and relabeling this space “nonargumentative]influence,” with two subtypes: “reason-bypassing” and “reason-countering.” Second, I argue that bioethicists have made the mistake of relying heavily on the conceptual categories themselves for normative work and instead should assess the ethical permissibility of a particular instance of influence by asking several key ethical questions, which I elucidate, that relate to (1) the impact of the form of influence on autonomy and (2) the relationship between the influencer and the influenced. Finally, I apply my analysis to two examples of nonargumentative influence in health care and health policy: (1) governmental agencies such as the Food and Drug Administration (FDA) trying to influence the public to be healthier using nonargumentative measures such as vivid images on cigarette packages to make more salient the negative effects of smoking, and (2) a physician framing a surgery in terms of survival rates instead of mortality rates to influence her patient to consent to the surgery. (shrink)

Without doctors being able to explain medical decisions to patients, I argue their use of black box AIs would erode the effective and respectful care they provide patients. In addition, I argue that physicians should use AI black boxes only for patients in dire straits, or when physicians use AI as a “co-pilot” (analogous to a spellchecker) but can independently confirm its accuracy. I respond to A.J. London’s objection that physicians already prescribe some drugs without knowing why they (...) class='Hi'>work. (shrink)

This chapter deals with Thomas Browne’s most famous work, Religio Medici, and especially with his account of Charity. The first paragraph focuses on Browne’s specific account of the relationship between natural and supernatural. This view is inspired by Bacon, Sebunde, and Montaigne, and is crucial to understand the background of Browne’s view about the virtue of Charity. The second paragraph is about Browne’s specific understanding of Charity, which seems to be a middle stage between the traditional, Scholastic doctrine, and (...) the Kantian idea of moral law, independent from the practical law and the desire of the subject. The third paragraph deals with Religio Medici’s reversal of the traditional “order” of Charity, as well as Browne’s accounts of abnegation and friendship as an effective way for a charity to the self which meets many aspects of Foucault’s ἑπιμέλεια έαuτου. The fourth paragraph is about Browne’s analogical understanding of medicine and morality, as well as his use of the meditatio mortis. (shrink)

This article draws upon the work of Timothy Morton and Slavoj Žižek in order to critically examine how mountain bike trail builders orientated themselves within nature relations. Beginning with a discussion of the key ontological differences between Morton’s object-oriented ontology and Žižek’s blend of Hegelian-Lacanianism, we explore how Morton’s dark ecology and Žižek’s account of the radical contingency of nature, can offer parallel paths to achieving an ecological awareness that neither idealises nor mythologises nature, but instead, acknowledges its strange (...) and contingent form. Empirically, we support this theoretical approach in interviews with twenty mountain bike trail builders. These interviews depicted an approach to trail building that was ambivalently formed in/with the contingency of nature. In doing so, the trail builders acted with a sense of temporal awareness that accepted the radical openness of nature, presenting a ‘symbolic framework’ that was amiable to nature’s ambivalent, strange and contingent form. In conclusion, we argue that we should not lose sight of the ambivalences and strange surprises that emanate from our collective and unpredictable attempts to symbolize nature and that such knowledge can coincide with Morton’s ‘dark ecology’ – an ecological awareness that remains radically open to our ecological existence. (shrink)

This is my main contribution to P. Gould (ed.) Beyond the Control of God?: Six Views on the Problem of God and Abstract Objects Bloomsbury. (The other contibutors to this work are: Keith Yandell; Paul Gould and Rich Davis; Greg Welty; William Lane Craig; and Scott Shalkowski.) I argue that, when it comes to a comparative assessment of the merits of theism and atheism, it makes no difference whether one opts for realism or fictionalism concerning abstract objects.

ABSTRACT Objectives There is little research on moral uncertainties and distress of palliative and hospice care providers (PHCPs) working in jurisdictions anticipating legalising voluntary assisted dying (VAD). This study examines the perception and anticipated concerns of PHCPs in providing VAD in the State of Queensland, Australia prior to legalisation of the practice in 2021. The findings help inform strategies to facilitate training and support the health and well-being of healthcare workers involved in VAD. Design The study used a qualitative (...) approach to examine and analyse the perception and anticipated concerns of PHCPs regarding challenges of providing assisted dying in Queensland. Fourteen PHCPs were recruited using a purposive sampling strategy to obtain a broad representation of perspectives including work roles, geographical locations and workplace characteristics. Data were collected via one in-depth interview per participant. The transcripts were coded for patterns and themes using an inductive analysis approach following the tradition of Grounded Theory. Setting The study was conducted in hospital, hospice, community and residential aged care settings in Queensland, Australia. These included public and private facilities, secular and faith-based facilities, and regional/rural and urban facilities. Participants Interviews were conducted with fourteen PHCPs: 10 nurses and 4 physicians; 11 female and 3 male. The median number of years of palliative care practice was 17, ranging from 2 to 36 years. For inclusion, participants had to be practising palliative and hospice care providers. Results PHCPs are divided on whether VAD should be considered part of palliative care. Expectations of moral distress and uncertainty about practising VAD were identified in five areas: handling requests, assessing patient capacity, arranging patient transfers and logistical issues, managing unsuccessful attempts, and dealing with team conflicts and stigma. Conclusions The possibility of having to practise VAD causes moral distress and uncertainty for some PHCPs. Procedural clarity can address some uncertainties; moral and psychological distress, however, remains a source of tension that needs support to ensure ongoing care of both patients and PHCPs. The introduction of VAD post-legalisation may present an occasion for further moral education and development of PHCPs. (shrink)

Shared decision-making involves health professionals and patients/clients working together to achieve true person-centred health care. However, this goal is infrequently realized, and most barriers are unknown. Discussion between philosophers, clinicians, and researchers can assist in confronting the epistemic and moral basis of health care, with benefits to all. The aim of this paper is to describe what shared decision-making is, discuss its necessary conditions, and develop a definition that can be used in practice to support excellence in maternity (...) care. Discussion between the authors, with backgrounds in philosophy, clinical maternity care, health care management, and maternity care research, assisted the team to confront established norms in maternity care and challenge the epistemic and moral basis of decision-making for caesarean section. The team concluded that shared decision-making must start in pregnancy and continue throughout labour and birth, with equality in discourse facilitated by the clinician. Clinicians have a duty of care for the adequacy of women's knowledge, which can only be fulfilled when relevant knowledge is offered freely and when personal beliefs and biases that may impinge on decision-making (defeaters) are disclosed. Informed consent is not shared decision-making. Key barriers include existing cultural norms of “the doctor knows best” and “patient acquiescence” that prevent defeaters being acknowledged and discussed and can lead to legal challenges, overuse of medical intervention and, in some areas, obstetric violence. Shared decision-making in maternity care can thus be defined as an enquiry by clinician and expectant woman aimed at deciding upon a course of care or none, which takes the form of a dialogue within which the clinician fulfils their duty of care to the client's knowledge by making available their complete knowledge (based on all types of evidence) and expertise, including an exposition of any relevant and recognized potential defeaters. Research to develop measurement tools is required. (shrink)

The outbreak of SARS-CoV-2 has exposed a shared condition of vulnerability on a global scale. How can we use vulnerability as an effective paradigm in order to foster collective political initiatives? This essay claims that the idea of care is key to understand the vulnerability framework as being both an epistemic and a political resource to address ethical issues. The first half of the essay recollects several arguments in Adriana Cavarero’s and Judith Butler’s most recent works, insofar as both (...) theorists have insisted on the notion of vulnerability in order to interpret contemporary political mobilizations. The second part of the essay retraces a constellation of practices of care in the works of several Black and decolonial feminist thinkers situated in different socio-political contexts. Whereas for Christina Sharpe and Saidiya Hartman the focus is on the matter of Blackness and Black lives in their constitutive vulnerability, both Cristina Rivera Garza’s and Sayak Valencia’s works remarkably insist on the specific socio-political context of today’s Mexico. These authors urge the readers to adopt a critical posture when encountering official narratives, also because in their texts they exhibit their own vulnerability. For them, writing, their writing is an ethical demand to imagine alternatives and to foster new entanglements between bodies persisting on the margins, at the limits of the norms that regulate legibility. (shrink)

The COVID-19 pandemic led to social restrictions that often prevented us from hugging the ones we love. This absence helped some realize just how important these interactions are to our sense of care and connection. Many turned to digitally mediated social interactions to address these absences, but often unsatisfactorily. Some theorists might blame this on the disembodied character of our digital spaces, e.g., that interpersonal touch is excluded from our lives online. However, others continued to find care and (...) connection in their digitally mediated interactions despite not being able to touch. Inspired by such contrasting cases, we ask if ‘digital hugs’ can work? We use the Mixed Reality Interaction Matrix to examine hugging as a social practice. This leads us to several claims about the nature of our embodied social interactions and their digital mediation: (1) all social interaction is mediated; (2) all virtual experiences are embodied; (3) technology has become richer and more supportive of embodiment; and (4) expertise plays a role. These claims help make the case that quality social connections online are substantially dependent upon the dynamic skilful resourcing of multiple mediating components, what we term digital tact. By introducing and developing this concept, we hope to contribute to a better understanding of our digital embodied sociality and the possibilities for caring connections online. (shrink)

The intersection between virtue and care ethics is underexplored in contemporary moral philosophy. This thesis approaches care ethics from a neo-Aristotelian virtue ethical perspective, comparing the two frameworks and drawing on recent work on care to develop a theory thereof. It is split into seven substantive chapters serving three major argumentative purposes, namely the establishment of significant intertheoretical agreement, the compilation and analysis of extant and new distinctions between the two theories, and the synthesis of (...) class='Hi'>care ethical insights with neo-Aristotelianism to generate a virtue ethical theory of care. In the first two chapters, I outline virtue ethics and care ethics, and argue for considerable agreement over central premises. Chapter 2 summarises the foundational commitments of care ethics, focusing particularly on their relational ontology and its links to the other ethical claims care ethicists universally ascribe to, namely particularism, partialism, the moral salience of emotions, and the rejection of hard public/private distinctions. Chapter 3 lays out the central concepts in neo-Aristotelian virtue ethics, including eudaimonism, virtue, and character traits, and drawing a number of comparisons between virtue and care ethics specifically with regard to relational ontology and the meta-ethical commitments it underpins. In addition to doing the necessary expository work for the remainder of the thesis, Chapters 2 and 3 also argue that care ethics and virtue ethics have much more in common than is typically acknowledged – the first major contribution of this thesis to the literature. Chapters 2 and 3 to provide at least a prima facie justification for pursuit of the questions I confront in the remainder of the thesis. In Chapter 4, I ask what differentiates these two ethical theories. I survey some of the differences which philosophers in either camp have identified and offer some of my own. I suggest that several of those differences either rest on misunderstandings of one ethic or the other, or that in erecting a divide between virtue and care ethics they also disunify ethics of care. I do, however, identify two differences which seem defensible. Specifically, they are that virtue ethics seems to lack an account of care, which I define minimally as a response or responsiveness to need, and that virtue and care ethics organise their meta-ethical and normative concepts differently. This chapter thus presents a second contribution to the literature: a study of the differences between virtue ethics and care ethics. It also serves to set the trajectory for the remaining chapters, where I respond to the claim that virtue ethics lack an account of care. I spend the remainder of the thesis constructing what I take to be a satisfying foundation for a virtue ethical theory of care. In Chapter 5, I offer three initially viable means of incorporating care into virtue ethics, all of which treat care as a virtue. These are the analogical approach, according to which care is analogous to an existing virtue; the additive approach, according to which care is a novel virtue; and the bundling approach, according to which care is a bundle of virtues. I also offer and evaluate reasons to reject the claim that care is a virtue, concluding that the claim is indeed a viable one so long as the concept of care is sufficiently thick, and I contend that analogical approaches, and particularly analogies with charity, outperform the others. Chapter 5 therefore serves two ends. First, it proffers a novel meta-analysis of concepts of care as a virtue, and thus makes a third contribution to the literature. In doing so, it makes an inroad into the second: the development of a neo-Aristotelian theory of care. Chapter 6 continues this project. I attempt to show how care can be construed as an act-type and a practice. I argue in this chapter that practices are a subcategory of actions, and that care qualifies as an Anscombean act-type which aims at the meeting of needs relating to the care-recipient’s flourishing. I go on to consider the implications of this account for ethics which deploy care as a moral concept, maintaining that it not only offers a better account of consequences than theories of care which include success criteria, but also that it affords us interesting insights into the distinction between ‘caring about’ and ‘caring for’ which allow us to make sense of certain tenets of neo-Aristotelianism. This represents a contribution to both discourses, since neither care nor virtue ethicists working at the intersection of their respective normative theories have delved very deeply into the philosophy of action. Chapter 7 discusses caring relations, suggesting that a virtue ethical theory of caring relations can lean on the work care ethicists have done, and adding some necessary refinements, such as a distinction between ideal and non-ideal caring relations, and a theory of caring relations as reasons for action. This final chapter also draws these three concepts of care together by arguing that virtuous caregivers who are invested in the flourishing of those for whom they care are also sensitive to the relations those care-recipients bear to their institutional environment. I argue that because they are caring participants in caring relations, virtuous agents are characteristically motivated by states of need and dependency to engage in certain sorts of conventionally political practices. In other words, the virtue or virtues of caring characteristically manifest in certain sorts of political or social practices, relating specifically to those areas of moral life. This allows us to build upon recent work in feminist virtue ethics of the sort offered by Tessman and Friedman. I also offer a novel analysis of migration, suggesting that the account of care presenting here is analytically useful both when it comes to historical cases of migration such as the underground railroads and escapes from Nazi-occupied Europe, but also for contemporary issues such as the migrations occurring in the Southern United States and in much of Europe. I thus conclude not only that virtue ethicists ought to incorporate care into their normative framework, and that the theory of care presented here is a coherent one, but that this leads us naturally into applied topics such as virtue politics. I conclude the thesis by considering some its implications and by identifying some further avenues for research. (shrink)

While agreeing with the main conclusion of Dominic Wilkinson and colleagues (Wilkinson, Butcherine, and Savulescu 2019), namely, that there is no moral difference between treatment withholding and withdrawal as such, we wish to criticize their approach on the basis that it treats the widespread acceptance of withdrawal aversion (WA) as a cognitive bias. Wilkinson and colleagues understand WA as “a nonrational preference for withholding (WH) treatment over withdrawal (WD) of treatment” (22). They treat WA as a manifestation of loss aversion (...) and refer to Kahneman and colleagues (1991), which defined this effect as follows: “the disutility of giving up an object is greater that the utility associated with acquiring it” (194). In a previous work, Wilkinson and Savulescu understood nonequivalence between treatment withholding and withdrawal as a reflection of slightly different, although related, phenomena: status quo bias or omission bias (Wilkinson and Savulescu 2012, 130–131). In neither of these two papers do they describe precisely the relation between these well-known psychological effects and WA, nor do they explain why they treat these effects as examples of nonrational preferences, despite the fact that these issues have been the subject of wide-ranging discussions on the intersection of psychology, economy, and philosophy. (shrink)

Copyright is at the centre of both popular and academic debate. That emotions are running high is hardly surprising – copyright influences who contributes what to culture, how culture is used, and even the kind of persons we are and come to be. Consequentialist, Lockean, and personality interest accounts are generally advanced in the literature to morally justify copyright law. I argue that these approaches fail to ground extensive authorial rights in intellectual creations and that only a small subset of (...) the rights accorded by copyright law is justified. The pared-down version of copyright that I defend consists of the right to attribution, the right to have one’s non-endorsement of modifications or uses of one’s work explicitly noted, and the right to a share of the profit resulting from the commercial uses of one’s work. I also cursorily explore whether contribution to another person’s work gives rise to moral interests. (shrink)

I am a multifaceted person, as I am sure you are as well. I love philosophy, obviously, but also computer science, programming and video games. I care about robotics, nature, my family and more. However, why is it that I particularly care about writing philosophy when it will most likely not convince anyone? Why care when my writing will most likely fall into obscurity, only to be forgotten in a deluge of other papers, essays, and works that (...) will themselves fall into obscurity, only to also be forgotten? I propose that philosophy is intrinsically important because they are artistic expressions, and artistic expressions are intrinsically valuable explorations into the self. Therefore, philosophy is an intrinsically valuable exploration into the self. (shrink)

As evidence of the unintended consequences of industrial farm animal production continues to mount, it is becoming increasingly clear that, far from being a trivial matter of personal preference, eating is an activity that has deep moral and spiritual significance. Surprising as it may sound, the simple question of what to eat can prompt Christians daily to live out their spiritual vision of Shalom for all creatures--to bear witness to the marginalization of the poor, the exploitation of the oppressed, the (...) suffering of the innocent, and the degradation of the natural world, and to participate in the reconciliation of these ills through intentional acts of love, justice, mercy, and good stewardship. The aim of this work is to understand the cultivation of more intentional "compassionate eating" habits as a form of engaged Christian discipleship that responds to a wide array of practical, moral, and spiritual problems affecting all aspects of creation--human, animal, and environmental. The guiding suggestion is that compassionate eating is a spiritual discipline that offers a symbolically significant and practically effective way to live in faithful anticipation of the "peaceable kingdom" described in Judeo-Christian creation and redemption narratives. (shrink)

The objective of the paper is to explore the issue that despite the absence of adequate formal and systematic ways for the poor and disadvantaged people to get access to health benefit like in a rich liberal society, there are active social customs, feelings and individual and collective responsibilities among the people that help the disadvantaged and poor people to have access to the minimum health care facility in both liberal and non-liberal poor countries. In order to explain the (...) importance and functional contribution of the social norms in this respect, some examples will be illustrated from Bangladesh which is a poor liberal country. There will be two sections of the paper. In the first section, it will be exhibited how the naturally and socially disadvantaged people in a liberal society get benefit following Rawls‟ theory of distributive justice. In the second section, it will be showed that in a poor country where there are less resources of the government to provide enough services to the poor and disadvantaged people, the communal feelings and the informal social institutions play a vital role that helps the disadvantaged and poor people to get access to the health benefit. The traditional social norms impose indirect sanction on its people to come forward to help the worse off people of the country. It is depicted that Rawlsian theory of distribution does not work properly in these countries, rather the communitarian feelings is more welcomed for the benefit of the overall welfare of the society and this will be shown in the conclusion of the paper. (shrink)

Military doctors and nurses, working neither as pure soldiers nor as merely doctors or nurses, may face a ‘role conflict between the clinical professional duties to a patient and obligations, express or implied, real or perceived, to the interests of a third party such as an employer, an insurer, the state, or in this context, military command’. This conflict is commonly called dual loyalty. This chapter gives an overview of the military and the medical ethic and of the resulting dual (...) loyalty problem for medical personnel working in the military. It considers how dual loyalties relate to being a professional, something medical personnel are the paradigmatic examples of, but also something military personnel claim to be. Against that background, the chapter elaborates on the medical rules of eligibility used in Afghanistan, and on the policies concerning military involvement in local healthcare, to see what the existing rules and policies are, and whose interests they serve. (shrink)