Infinite Responsibility in the Bedpan: Response Ethics,Care Ethics,and the Phenomenology of Dependency Work

Because Levinas understands ethical response as a response to the radical alterity of the other, he contrasts it with justice, for which alterity becomes a question of equality. Drawing upon the practice of dependency work and the insights of feminist care ethics, I argue that the opposition between responding to another's singularity and leveling it via parity‐based principles is belied in the experience of care. Through a hermeneutic phenomenology of caring for my post‐stroke grandfather, I develop an account of dependency work as a material dialectic of embodied response involving moments of leveling, attention, and interruption. Contra much of response ethics’ and care ethics’ respective literatures, this dialectic suggests that they complement each other 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 dependency work, such labors produce finite responsibility with infinite hope.     

The Decent Care Movement: Subsidiarity,Pragmatic Solidarity,and Cross-Cultural Resonance

Decent Care is the World Health Organization and The Ford Foundation’s joint effort to articulate a healthcare paradigm that makes a patient’s voice equal to the voice of the healthcare provider. In this article, the six tenants of Decent Care are outlined with particular emphasis on subsidiarity. Liberation theology’s preferential option for the poor maxim is presented and compared with other major world religions to demonstrate the cross-cultural focus of “decency.” The power of this paradigm is in its emphasis and proclamation of human flourishing in a healthcare setting, generally speaking, and more specifically, human flourishing in the presence of affliction from chronic disease or dying cross-culturally.     

Dependency and Independence in Young Children

The present study investigated the hypothesis that a positive relation exists between self-concept and moral judgment in young children. In the first experiment 40 kindergarten children between the ages of 5–1 and 6–6 with mental ability scores ranging from 82 to 144 were each administered a self-concept appraisal and a series of Piagetian moral dilemmas. Product-moment correlations and a multiple-regression analysis evaluated the relationship. When the self-concept and moral-judgment scores were collapsed, all of the moral-judgment factors correlated significantly with at least one self-concept factor. A second experiment tested the implications of the first. Eighty-five children between the ages of 5–11 and 8–4 were given the self-concept and moral-judgment measures. An eight-week communications-training session for randomly selected parents of children scoring below the mean on the self-concept measure was held. Posttesting showed no improvement in self-concept for the experimental group. Implications of these experiments are discussed.     

Characteristics of Children in Foster Care,Family-Style Group Care,and Residential Care: A Scoping Review

When risky child and family circumstances cannot be resolved at home, (temporary) 24-h out-of-home placement of the child may be an alternative strategy. To identify specific placement risks and needs, care professionals must have information about the child and his or her family, care history, and social-cultural characteristics at admission to out-of-home care. However, to date information on case characteristics and particular their similarities and differences across the three main types of out-of-home settings (namely foster care, family-style group care, and residential care) is largely lacking. This review compiles and compares characteristics of school-aged children of average intelligence and their families at the time of each child’s admission to one of the three care modalities. A scoping review technique that provides a broad search strategy and ensures sufficient coverage of the available literature is used. Based on the 36 studies included, there is consensus that the majority of normally intelligent children in care demonstrate severe developmental and behavioral problems. However, the severeness as well as the kinds of defining characteristics present differ among the children in foster care, family-style group care, and residential care. The review also identifies several existing knowledge gaps regarding relevant risk factors. Future research is recommended to fill these gaps and determine the developmental pathway in relation to children’s risks and needs at admission. This will contribute to the development of an evidence-based risks and needs assessment tool that will enable care professionals to make informed referrals to a specific type of out-of-home care when such a placement is required.     

军事医学伦理中的友谊、群体和关怀

医学伦理禁止医务人员将患者划分等级.然而,在军事中,特别是战争境遇下,由于医疗资源匮乏,其医学伦理却要求首先救助同胞士兵.社群主义者、关怀伦理提出了针对同盟者、朋友和家人的特殊责任:在小群体成员有医疗关怀需求时,不管谁的伤势更重,道德都会要求优先治疗同胞士兵,而后才是同盟或敌方士兵.     

Bad Mothers and Monstrous Sons: Autistic Adults,Lifelong Dependency,and Sensationalized Narratives of Care

Sensationalized representations of autistic families in film and other media frequently feature violent encounters between mothers and sons. This essay analyzes two media stories and three films that suggest how limited—and therefore misleading—popular representations of the autism family are. Except for one of the films, these representations blame the problem of adult autistic dependency on either monstrous autism or bad mothering. Doing so elides collective social responsibility for autism care and denies the reality that autistic adults continue to have complex dependency needs that families cannot always meet. Narratives that sensationalize youth and adults with autism or scapegoat their maternal caregivers also diminish opportunities for social inclusion and for autistic people to live fully and dependently.     

Graphic Somatography: Life Writing,Comics, and the Ethics of Care

This essay considers the ways in which graphic caregiving memoirs complicate the idealizing tendencies of ethics of care philosophy. The medium’s “capacious” layering of words, images, temporalities, and perspectives produces “productive tensions. . . The words and images entwine, but never synthesize” (Chute 2010, 5). In graphic memoirs about care, this “capaciousness” allows for quick oscillation between the rewards and struggles of care work, representing ambiguous, even ambivalent attitudes toward care. Graphic memoirs effectively represent multiple perspectives without synthesis, part of a structural and thematic ambivalence that provides a provocative counterpart to the abstract idealism of ethics of care philosophy.     

Care Ethics and Confucianism: Caring through Li

The role of li, or ritual, in Confucianism is a perceived impediment to interpreting Confucianism to share a similar ethical framework with care ethics because care ethics is a form of moral particularism. I argue that this perception is false. The form of moral particularism promoted by care ethicists does not entail the abandonment of social conventions such as li. On the contrary, providing good care often requires employing systems of readily recognizable norms in order to ensure that care is successfully communicated and completed through one's care‐giving practices. I argue that li performs this communicative function well and that the early Confucians recommend breaching li precisely when its efficacy in performing this function is compromised.     

Health Care Ethics Consultation: 'Training in Virtue'

In philosophy, intelligence is less important than character, or so Wittgenstein once argued. In this paper, in a similar vein, I suggest that in health care ethics consultation character is of preeminent importance. I suggest that the activity of ethics consultation can be understood as "training in virtue," and what distinguishes the good health care ethics consultant from his/her average colleague are differences in traits of character. The underlying assumption is that one's use of knowledge and abilities are ultimately a function of who one is and how one perceives and confronts situations of moral uncertainty and conflict. In discussing the original case presented by Mark Bliton, I focus on the virtues of wisdom, justice, courage, compassion and humility.     

Ethics and Changing Mental Health Care: Concerns and Recommendations for Practice

Recent developments in health care delivery in the United States have left many professionals baffled by the continuing changes in practice sparked by the relatively new managed care environment. Psychologists who practice in medical settings are struggling to balance the seemingly competing needs to deliver quality care to clients and patients, while meeting the demands of third-party payers and trying to remain true to their ethical responsibilities. Critical elements of managed care, which many suggest compromise the ethical provision of quality care, include utilization review, financial incentives, and threats to confidentiality. Recommendations are proposed so that mental health professionals may be proactive in protecting their ethical responsibilities in this changing environment.     

晚期癌症患者宁养疗护与伦理

晚期癌症患者宁养疗护强调人的生活质量与生命价值,其在实践中得到了长足的发展,正成为姑息医学中的重要部分。随着医学向生物心理社会医学模式转变和姑息医学快速发展,宁养疗护伦理问题日益凸显。宁养疗护伦理在医疗方面强调适度治疗与合理用药,护理方面强调患者生理、心理、灵性、社会和宗教等层面的整体性照顾。梳理宁养疗护伦理有利于在宁养疗护服务中做出最优伦理选择,这种选择需遵循不伤害原则,注重生命质量原则、适度治疗和舒适生存原则、尊重患者意愿原则以及公平正义的原则。     

The Unhappy Marriage of Care Ethics and Virtue Ethics

The proposal that care ethic(s) (CE) be subsumed under the framework of virtue ethic(s) (VE) is both promising and problematic for feminists. Although some attempts to construe care as a virtue are more commendable than others, they cannot duplicate a freestanding feminist CE. Sander‐Staudt recommends a model of theoretical collaboration between VE and CE that retains their comprehensiveness, allows CE to enhance VE as well as be enhanced by it, and leaves CE open to other collaborations.