The Will to Care: Performance,Expectation, and Imagination

This article addresses the world's contemporary crisis of care, despite the abundance of information about distant others, by exploring motivations for caring and the role of imagination. The ethical significance of caring is found in performance. Applying Victor Vroom's expectancy theory, caring performances are viewed as extensions of rational expectations regarding the efficacy of actions. The imagination creates these positive or negative expectations regarding the ability to effectively care. William James's notion of the will to believe offers a unique twist on rational expectations in that he regards humans as having the capacity to work within uncertainty to take decisive action. Applying this idea to caring performance is, this article argues that people can have the will to care, beyond strict rational calculations or limits of social norms. Historically, caring has been associated with the imagination's ability to empathize, but the will to care offers another role for the imagination in envisioning effective action. Given the significance of the imagination for ethical behavior, this article explores the implications for cultivating care in terms of what educating for care might look like. The work of feminist care ethicists, particularly Nel Noddings, is discussed, and contemporary case examples of caring performances are investigated.     

Commitment and Partialism in the Ethics of Care

It is plausible to think that practices of caring are partly constituted by a caregiver's commitment to a cared‐for. However, discussions of caring often contain no explicit discussion of such commitments, and do not attempt to draw any philosophical conclusions from the nature of caring relations as committed. A discussion of caring practices that emphasizes the importance of commitment therefore has the potential to generate important new insights for our understanding of caring. This essay begins that project by arguing that a commitment‐centric conception of caring entails the truth of moral partialism. Although many care‐ethicists are sympathetic to partialism, the arguments in its defense remain controversial. As I show in this article, however, partialism is necessarily true given the committed nature of caring. This is because the concept of commitment is itself a necessarily partial one: to say that we are equally committed to everyone or everything is equivalent to saying that we are not committed to anything. Thus, when viewed as a species of commitment, it is part of the concept of caring that it requires us to put the needs of those we care for before the needs of those unknown to us.     

The Commodification of Care

This paper discusses the question whether care work for dependent persons (children, the elderly, and disabled persons) may be entrusted to the market; that is, whether and to what extent there is a normative justification for the “commodification of care.” It first proposes a capability theory for care that raises two relevant demands: a basic capability for receiving care and a capability for giving care. Next it discusses and rejects two objections that aim to show that market‐based care undermines the caring motives essential to care, one of them because of its reliance on contracts and the other because of the corrupting influence of payment on motivation. If market care is in principle legitimate, the commodification question transforms into one about the appropriate combinations of market and non‐market care. This question can be answered only by adding an additional complication: care is to be balanced against other activities, most notably work for the labor market. This brings in the problem of gender inequality, since paid work has been traditionally distributed to men and caring activities to women. I show how the capability theory of caring presented in this paper can help resolve the dispute between competing models for balancing work and caring.     

Rethinking Care Theory: The Practice of Caring and the Obligation to Care

Care theorists have made significant gains over the past twenty‐five years in establishing caring as a viable moral and political concept. Nonetheless, the concept of caring remains underdeveloped as a basis for a moral and political philosophy, and there is no fully developed account of our moral obligation to care. This article advances thinking about caring by developing a definition of caring and a theory of obligation to care sufficient to ground a general moral and political philosophy.     

微创外科手术的人文关怀

医学存在自然和人文双重属性,医疗服务必须体现人文关怀。人文关怀的核心是以人为本,强调对人的尊重、理解、关心和爱护,重视人的作用。微创外科是传统外科的一场深刻的技术革命,其哲学基础是以人为本。微创外科手术以患者为主体和中心,提出对患者的主体地位和自由权的尊重;以减少对患者的创伤和痛苦为目的,强调患者的价值和尊严,重视对患者的无限关怀,其开创和发展充分体现了人文关怀的精神实质。     

Care,Narrativity, and the Nature of Disponibilité

This paper attempts to make more explicit the relationship between narrativity and feminist care ethics. The central concern is the way in which narrativity carries the semantic load that some accounts of feminist care ethics imply but leave hanging. In so doing, some feminist theorists of care‐based ethics then undervalue the major contribution that narrativity provides to care ethics: it carries the semantic load that is essential to the best care. In this article, I defend the narrative as the central medium though which we make sense of and communicate our lives and their attendant hopes and cares. More than just working with the narrative of the cared‐for, caring is about investing in the narrative of the cared‐for in order to meet the needs of this cared‐for and how this narrative might turn out. I will further demonstrate how the attitude of caring or investing in a narrative would amount to what Gabriel Marcel has described as the attitude of disponibilité.     

胎儿产前超声诊断中的人文关怀

随着医学的进步,医学模式的转变,越来越提倡医学对人们心理和社会因素的关怀。同时随着产前诊断技术和超声诊断技术的迅速发展和日臻完善,以及社会、经济的发展和变革,也越来越重视对孕妇及家属的人文关怀。胎儿产前超声诊断中的人文关怀不仅是对人的关怀,也是对技术、对心理健康、对生命的关怀。     

Children with Special Health Care Needs: Impact of Health Care Expenditures on Family Financial Burden

We investigated the relationship between health care expenditures for Special Health Care Needs (SHCN) children and family perception of financial burden. Using 2005/2006 National Survey of Children with Special Health Care Needs data, a multivariate logistic regression model was used to estimate the relationship between the SHCN child’s health care expenditure and perceived financial burden, while controlling for family and child characteristics. Our analysis suggests that health care expenditures for a SHCN child of $250 and more are associated with family perception of financial burden. In addition, families with lower socioeconomic status also perceived financial burden at lower level of expenditures. Members of the health care team who treat children with SHCN have an important role in understanding and assessing family financial burden as part of the care delivery to the child and the family. Our study reinforces the need to treat the whole family as the unit of care, especially when caring for children with special health care needs.     

Different Voices, Still Lives: Problems in the Ethics of Care

ABSTRACT Recent writings in feminist ethics have urged that the activity of caring is more central to women's lives than are considerations of justice and equality. This paper argues that an ethics of care, so understood, is difficult to extend beyond the local and familiar, and is therefore of limited use in addressing the political problems of the modern world. However, the ethics of care does contain an important insight: if references to care are understood not as claims about women's nature, but as reflections on the extent to which moral obligations are both unchosen and conflicting, then an ethics of care can supplement an ethics of justice, and can also provide a more realistic account of both men's and women's moral life.     

Transgender Primary Medical Care

SUMMARY

Transgender medical care involves addressing general medical conditions and those related specifically to transgender issues. This article summarizes existing research in transgender medicine and provides guidance for family physicians and nurses in adapting standard primary care protocols relating to health maintenance, acute illness, and chronic disease management to address trans-specific clinical oncerns. Trans-specific issues in physical examination, health history, interpretation of laboratory tests, vaccination, screening, and treatment are explored, and the role of the primary care provider in caring for patients undergoing hormonal or surgical change is discussed.     

Care in/through the archives: Postcolonial intersectional moves in feminist geographic research

What does a postcolonial ethics of care mean for feminist geographers doing archival work? Feminist geographers have long called for ethical research engagement. This asserts the importance of caring relationships with research mentees, collaborators, participants, and spaces. But care comes both with promise and pitfalls. As postcolonial and antiracist geographers argue, we must emplace care. That is, we must recognize that care, including caring feminist geographic practice, is grounded in colonial past-presents. We must work towards responsible ontologies and epistemologies that attend to and redress these histories. In this article, we draw on feminist postcolonial work on care (namely Raghuram et al. (2009) and Noxolo et al. (2012)) along with intersectional interventions in archival studies (Hartman, 2008; Cifor and Wood, 2017; Sutherland, 2017) to examine the politics of care in and through the archives. We draw on postcolonial interventions to reflect on our own archival geographic practice in the USA, the Dominican Republic, and Uganda. We use these accounts to make visible how caring archival practice, and critical archives of care, can shed light on, reinforce, or salve deep geohistories of heteropatriarchal colonialism and its aftermath. We assert that a postcolonial approach to care denaturalizes and spatializes racial power in feminist geographic practice, here via the archives.     

Pacifism and Care

I argue there is no pacifist commitment implied by the practice of mothering, contrary to what Ruddick suggests. Using violence in certain situations is consistent with the goals of this practice. Furthermore, I use Ruddick's valuable analysis of the care for particular individuals involved in this practice to show why pacifism may be incompatible with caring passionately for individuals. If giving up passionate attach-ments to individuals is necessary for pacifist commitment as Ghandi claims, then the price is too hith.     

Accountability from Somewhere and for Someone: Relating with Care

Abstract

In contemporary care institutions, accountability procedures and devices are increasingly pervasive and considered crucial for monitoring quality. Such accountability practices are based on the idea that accountability and care belong in two separate domains. The distinction between accountability ‘from nowhere and for everyone’ and accountability ‘from somewhere and for someone’ problematises this implicit split. Taking seriously the observations of everyday caring and accounting by care professionals, who resist splitting care and accountability from the outset, demands a reconceptualisation of the relation between care and accountability as reciprocal and co-emerging. Both accountability and care are highly circumstantial, emerging, relational notions and it is not clear-cut who or what cares or accounts for what, whom, where and how. Paying due attention to the generative interweaving of accounting and caring, that is, to the narrative work of care professionals, affords the potential to turn universal abstract norms of what good care should be into meaningful care. Creatively reconnecting care experiences, observations, records and relations generates accountability with care. Care professionals do this by daring to prioritise speculatively what matters most in a specific situation without falling back on the reassurance of clear-cut norms of good care and by daring to admit that even while prioritising a certain course of action, they might not know its consequences. Such a speculative commitment and the inclusion of the researcher's experiences in trying to be accountable are crucial for studying accountability as a matter of care and as relatedness in the making.     

Labor as Embodied Practice: The Lessons of Care Work

In post‐Fordist economies, the nature of laboring activities can no longer be subsumed under a Taylorized model of labor, and the service sector now constitutes a larger share of the market. For Maurizio Lazzarato, Michael Hardt, Antonio Negri, and other theorists in the post‐Marxist tradition, labor has changed from a commodity‐producing activity to one that does not produce a material object. For these authors, this new type of labor is immaterial labor and entails communicative acts as well as added worker agency. This paper reflects on this new paradigm of labor by examining the paid practices of care defined as the activities performed by individuals who have a mandate to help another adult accomplish the tasks of self‐care. Because care workers take care of other bodies, care labor exemplifies an embodied practice. I make use of the corporeality of care to put forward the notion of thin and thick embodiment in order to examine critically the meaning of immaterial labor and to support my claim that immaterial labor, as conceptualized by Hardt and Negri, erases both the materiality and relationality of care labor. Furthermore, typifying care labor as immaterial only serves to maintain its marginalized status. Care Assistant. Required to work within a private residential center to assist nursing staff. Experience desirable, qualifications an advantage, but caring and understanding more important than either. Must have good English to understand instructions and be co‐operative to work in a friendly team environment (Toynbee 2007, 220).     

Care,Commitment and Moral Distress

Moral distress has been the subject of extensive research and debate in the nursing ethics literature since the mid-1980s, but the concept has received comparatively little attention from those working outside of applied ethics. In this article, I defend a care ethical account of moral distress, according to which the phenomenon is the product of an agent’s inability to live up to one of her caring commitments. This account has a number of attractions. First, it places a greater emphasis on the importance of the relationship between the caregiver and her cared-for than that found in previous accounts. Second, it does not make problematic assumptions about the correctness of a caregiver’s moral judgments, as has been claimed in relation to previous accounts of moral distress. Finally, my account allows for a clear conceptual distinction to be drawn between moral distress and other forms of negative moral emotion such as guilt and regret. Earlier accounts draw this distinction by appealing to the causal aetiology of moral distress, but as I show here, such appeals are ultimately unsuccessful unless they are made from an explicitly care ethical starting point. One of the implications of my account is that moral distress has the potential to occur in the context of any caregiving relationship. This claim is explored in the final section of the paper, in relation to student-teacher and parent-child caregiving.     

男科临床工作中的人文关怀

随着现代医学模式的转化和男科学诊治技术的发展,在男科临床工作中应该注重树立人文关怀理念和强化人性化服务意识。实施人文关怀的方法包括：重视心理应激,应用心理疗法;关注患者生活,有效预防疾病;营造人文环境,提供人性化服务;遵循最优化原则,做到适度医疗;关心老年人健康,关注社会特殊群体。在男科临床工作中应提高人文关怀的自觉性。     

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.     

A Fourth Subject Position of Care

Analyses of care work typically speak of three necessary roles of care: the care worker, the care recipient, and an economic provider who makes care materially possible. This model provides no place for addressing the difficult political questions care poses for liberal representative democracy. I propose to fill this space with a new caring role to connect the care unit to the political sphere, as the economic provider connects the care unit to the economic sphere. I call this role that of the “care claimant.” The labor of claiming care consists in the development, expression, and advancement of the interests of the care unit. The argument for employing this fourth care role begins by comparing Nel Noddings's phenomenological care unit to Sara Ruddick's family‐based analysis. It then moves to discuss the way Eva Kittay emphasizes the dependency of the charge and its political ramifications to illustrate the need for a care claimant. After distinguishing the care claimant from the other roles of care, I examine the power relationships in the care unit and the position of the care claimant in the public sphere.     

Using lifeworld philosophy in education to intertwine caring and learning: an illustration of ways of learning how to care

Our general purpose is to show how a philosophically oriented theoretical foundation, drawn from a lifeworld perspective can serve as a coherent direction for caring practices in education. We argue that both caring and learning share the same ontological foundation and point to this intertwining from a philosophical perspective. We proceed by illustrating shared epistemological ground through some novel educational practices in the professional preparation of carers. Beginning in a phenomenologically oriented philosophical foundation, we will first unfold what this means in the practice of caring, and secondly what it means for education and learning to care in humanly sensitive ways. We then share some ways that may be valuable in supporting learning and health that provides a basis for an existential understanding. We argue that existential understanding may offer a way to bridge the categorisations in contemporary health care that flow from problematic dualisms such as mind and body, illness and well-being, theory and practice, caring and learning. Ways of overcoming such dualistic splits and new existential understandings are needed to pave the way for a care that is up to the task of responding to both human possibilities and vulnerabilities, within the complexity of existence. As such, we argue that caring and learning are to be understood as an intertwined phenomenon of pivotal importance in education of both sensible and sensitive carers. Lifeworld led didactics and reflection, which are seen as the core of learning, constitute an important educational strategy here.     

Building Bridges with Accessible Care: Disability Studies,Feminist Care Scholarship,and Beyond

This article uses elements of autoethnography to theorize an in/formal support relationship between a friend with a physical disability, who uses attendant services, and me. Through thinking about our particular “frien‐tendant” relationship, I find the common scholarly orientations toward “care” are inadequate. Starting from the conversations between feminist and disability perspectives on care, I build on previous work to further develop the theoretical framework of accessible care. Accessible care takes a critical, engaged approach that moves beyond understanding “accessibility” as merely concrete solutions to create more inclusive forms of care. Care, in this context, is positioned as an unstable tension among competing definitions, including that it is a complex form of oppression. Accessible care draws on feminist disability perspectives and the feminist political ethic of care to build bridges in four areas: from daily experiences of disability and support to theoretical discussions; across feminist care research and disability perspectives; across divisions and anxieties within disability communities; and from the local to transnational applications. These bridges do not aim to resolve debates but allow us to travel back and forth between differing perspectives and demonstrate the tenuous possibility of accessible practices and concepts of care.