Vulnerability has emerged as a fruitful concept in recent political discourse. Although care theorists have sometimes framed care ethics in terms of vulnerability, they have most often oriented it around dependency. This article discusses the differences between dependency and vulnerability and argues for a reconceptualization of care ethics in terms of vulnerability. By reframing care ethics around vulnerability, care theorists can not only broaden the scope of issues that care ethics can address and clarify ambiguities in (...) the theory but also strengthen the justification for a responsibility to care. (shrink)

Care Ethics and Poetry is the first book to address the relationship between poetry and feminist care ethics. The authors argue that morality, and more specifically, moral progress, is a product of inquiry, imagination, and confronting new experiences. Engaging poetry, therefore, can contribute to the habits necessary for a robust moral life—specifically, caring. Each chapter offers poems that can provoke considerations of moral relations without explicitly moralizing. The book contributes to valorizing poetry and aesthetic experience as much (...) as it does to reassessing how we think about care ethics. (shrink)

Patients with advanced cancer often experience a reduced ability to eat, which may result in tensions between patients and family members. Often with advanced cancer diagnoses, patients’ appetites decline markedly, while family members focus on nutritional intake with the hope that this will postpone death. This hope might cause tensions between the patient and family; the family may expect healthcare professionals to encourage the patient to eat more, whereas the patient needs to be supported in their reduced ability to eat. (...) When these tensions arise, healthcare professionals can experience challenges in providing good palliative care. To address these challenges in the provision of palliative care, healthcare professionals may adopt a care ethics approach. Similar to palliative care’s focus on patient and family members’ relationships, a care ethics approach emphasizes interdependency and social relationships. Using Joan Tronto’s care ethics approach, we conducted a normative analysis of what caring for patients with reduced ability to eat and their family members should look like. Tronto’s approach includes five phases of care: caring about, taking care of, care giving, care-receiving, and caring with. Based on our analysis and empirical studies on patients with advanced cancer and family members, concerns with their lack of appetite, we assert that healthcare professionals must be mindful of the potential of tensions related to appetite and be adept in dealing with these tensions. We urge that education is needed for healthcare professionals regarding the psychosocial impact of reduced ability to eat on both patients and family members and interprofessional collaboration is of the essence. (shrink)

The discourse on the future of work should learn from a turn in philosophy that occurred in the 1980s, one that recognizes the good life towards which ethics strives can only be reached on a foundation of caring relationships (Gillian, 1982; Noddings, 1984). Care ethics recognizes that human well-being is a group project, one that involves strong relationships, and concern for bodies and emotions. Too often, these features are left out of research exploring robotics in the workplace. (...) This paper outlines the main tenets of care ethics, then applies the moral framework to the context of industrial and retail settings using robots. This approach sees these contexts through a relational lens, helping to identify, evaluate, and improve relationships critical to ensuring workers’ well-being. Second, care ethics considers taking care of people’s bodies beyond mere safety, examining how working with robots can exacerbate societal or economic pressures. Lastly, care ethics takes emotions as an important source of knowledge in building and supporting care. Additionally, this paper contributes to the care ethics literature by applying the framework to the context of robotized industrial workplaces, which has yet to be done. (shrink)

Care ethics takes as central the discerning of needs in those being cared for and attempts to meet those needs. Perceptive caring agents are more likely to be able to identify needs in those for whom they are caring. The identification of needs is no small matter, not least in teaching encounters. This paper modestly proposes that at least some of the needs a caring agent should attempt to meet are a function of the identity of (...) the patient of caring action. Taking Nel Noddings’ account of care ethics as representative, I present it in outline. This leads to the needs-identification problematic. Following this I turn to Soran Reader’s account of needs. I interpret this to offer what I designate as identity as ‘what-ness’. Such an understanding of identity-based needs is a starting point for the caring agent but a more nuanced account, of identity as ‘who-ness’, is argued to be preferable. Identity as ‘who-ness’, as expressed in Paul Ricoeur’s work, advances the discussion, culminating in his concept of the ‘capable human being’. Having brought this aspect of Ricoeur’s thought into conversation with care ethics, I offer an account of identity-based needs conducive to the broader aims of the care ethical project. Finally, I consider what this bolstered account of care ethics might say about a brief and illustrative teaching encounter. (shrink)

Whether practiced by ethics committees or clinical ethicists, medical ethics enjoys a solid foundation in acute care hospitals. However, medical ethics fails to have a strong presence in the primary care setting. Recently, some ethicists have argued that the reason for this disparity between ethics in the acute and primary care setting is that primary care ethics is distinct from acute care ethics: the failure to translate ethics to the primary care setting stems (...) from the incorrect belief that acute care ethics can be applied to the primary care setting. In this paper, I argue that primary care ethics and acute care ethics are species of the same ethical genus, and that the ethical differences are not ones of kind but of circumstance. I do this by appealing to the role obligations that underlie acute care and primary care clinicians’ medical ethical obligations and the shared institutions that ground those obligations. (shrink)

Feminist care ethicshas for some time guided contemporary artists and curators in their search for sustaining and sustainable practices in the current neoliberal backwash and climate crisis. With a focus on current Australian art in the context of recent care ethics scholarship, this article considers what contemporary art – in its processes as well as aesthetic outcomes – can offer in imagining and practising care for the human and more-than-human world. The article focuses on a series of exhibitions that (...) comprised a key exploratory methodology of The Care Project: Feminism and art in neoliberal times (La Trobe University, 2019–2022). The exhibitions featured the work of regionally based artists. This accent on creative practices emerging from the experience of living in regional communities that are often on the frontline of climate change and social inequality offers unique perspectives on care ethics in practice. (shrink)

Ethics consultation has become an integral part of the fabric of U.S. health care delivery. This article summarizes the second edition of the Core Competencies for Health Care Ethics Consultation report of the American Society for Bioethics and Humanities. The core knowledge and skills competencies identified in the first edition of Core Competencies have been adopted by various ethics consultation services and education programs, providing evidence of their endorsement as health care ethics consultation (HCEC) standards. This (...) revised report was prompted by thinking in the field that has evolved since the original report. Patients, family members, and health care providers who encounter ethical questions or concerns that ethics consultants could help address deserve access to efficient, effective, and accountable HCEC services. All individuals providing such services should be held to the standards of competence and quality described in the revised report. (shrink)

Background: The school is a key environment for establishing good health habits among pupils. School nurses play a prominent role in health promotion, since they meet with every single adolescent. Research aim: To describe care ethics in the context of school nurses’ health-promoting activities among adolescents in secondary schools. Research design: An explorative descriptive methodology in which semi-structured interviews were used to collect data and content analysis was performed. Participants and research context: Data were collected from eight school nurses (...) in a municipality in Western Sweden. Ethical considerations: This study was conducted according to the ethical principles of the Swedish Research Council (2011), and the written informed consent of the participants was obtained. Findings/discussion: A caring relation, based on care ethics, is the basis for successful health-promoting activities among adolescents. The school nurses show strong engagement in and commitment to caring for and caring about adolescents by being attentive and listening to their expressed feelings and needs, both spoken and unspoken. Furthermore, the school nurses have a deep sense of responsibility in supporting and empowering adolescents to trust their own capabilities. To enhance health and well-being, school nurses emphasize low-threshold counselling, flexibility, openness, early intervention and continuity, as well as good collaboration with the health team at school and with parents. Conclusion: Strengthening person-centred healthcare can provide adolescents with the recognition and support they need to grow into healthy adults. For successful health promotion, all aspects of the ethics of care should be considered as part of an integrated whole based on the integrity of care. (shrink)

With numerous examples to supplement her rich theoretical discussion, Nel Noddings builds a compelling philosophical argument for an ethics based on natural caring, as in the care of a mother for her child. In _Caring_—now updated with a new preface and afterword reflecting on the ongoing relevance of the subject matter—the author provides a wide-ranging consideration of whether organizations, which operate at a remove from the caring relationship, can truly be called ethical. She discusses the extent to (...) which we may truly care for plants, animals, or ideas. Finally, she proposes a realignment of education to encourage and reward not just rationality and trained intelligence, but also enhanced sensitivity in moral matters. (shrink)

Despite the centrality of the term within the title, the meaning of ?care? in residential child care remains largely unexplored. Shifting discourses of residential child care have taken it from the private into the public domain. Using a care ethics perspective, we argue that public care needs to move beyond its current instrumental focus to articulate a broader ontological purpose, informed by what is required to promote children's growth and flourishing. This depends upon the establishment of caring relationships (...) enacted within the lifespaces shared by children and those caring for them. We explore some of the central features of caring in the lifespace and conclude that residential child care is best considered to be a practical/moral endeavour rather than the technical/rational one it has become. It requires morally active, reflexive practitioners and containing environments. (shrink)

This essay will focus on the moral issues relating to surrogacy in the global context, and will critique the liberal arguments that have been offered in support of it. Liberal arguments hold sway concerning reproductive arrangements made between commissioning couples from wealthy nations and the surrogates from socioeconomically weak backgrounds that they hire to do their reproductive labor. My argument in this paper is motivated by a concern for controlling harms by putting the practice of globalized commercial surrogacy into the (...) context of care ethics. As I will argue, the unstable situations into which children of global surrogacy arrangements are born is symbolic of the crisis of care that the practice raises. Using the Baby Manji case as my touch point, I will suggest that liberalism cannot address the harms experienced by Manji and children like her who are created through the global practice of assisted reproductive technology. I will argue that, if commissioning couples consider their proposed surrogacy contracts from a care ethics point of view, they will begin to think relationally about their actions, considering the practice from an ethical lens, not just an economic or contractual one. (shrink)

Background: As a normative theory, care ethics has become widely theorized and accepted. However, there remains a lack of clarity in relation to its use in practice, and a care ethics framework for practice. Maternity care is fraught with ethical issues and care ethics may provide an avenue to enhance ethical sensitivity. Aim: The purpose of this scoping review is to determine how care ethics is used amongst health professions, and to collate the information in data (...) charts to create a care ethics framework and definition for midwifery practice. Method: The scoping review was conducted according to the Preferred Reporting Items for Scoping reviews (PRISMA-ScR) and Joanna Briggs Institute (JBI) recommendations. The search was applied to the databases CINAHL, MEDLINE, PschInfo and Pubmed which were searched in September 2019 and again in July 2021. The inclusion criteria were guided by the mnemonic for search terms: Participants, Concept, and Context (PCC) and included variations of health care professionals, care ethics and utilization. The search was limited to qualitative studies published in English between 2010 and 2021. A data extraction tool was used to extract and synthesize data into categories. The articles were screened for eligibility by title, abstract and full text review, by two independent reviewers. Ethical Considerations: The scoping review was guided by ethical conduct respecting authorship and referencing sources. Results: Twelve of the initially identified 129 studies were included in the scoping review. Data synthesis yielded four categories of care ethics use by health professionals: relationship, context, attention to power and caring practices. In combination, the evidence forms a framework for care ethics use in midwifery practice. Conclusion: Care ethics use by health professionals enhances ethical sensitivity. A framework and definition for care ethics for midwifery practice is proposed. This review will be of interest to midwives and other health practitioners seeking to enhance ethical sensitivity. (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)

Care Ethics and Political Theory is a collection of fifteen original essays that explore the implications and applications of care to social and political policies, practices, and theories.

Applying Care Ethics to Business is the first book-length analysis of business and economic cases and theories from the perspective of care theory.

The manuscript explores the plausibility of care-based epistemology in a comparative key. Investigating the epistemic virtue of care-giving, the work weaves together insights from care ethics, virtue epistemology and a particular reading of the Mah=abh=arata which, left to themselves, do not appear compatible with one another. Drawing on these traditions, the work goes on to provide a feminist vision of search for truth that is consistent with both ethical relations and interventions for justice.

This article explores the integration of the seemingly disparate notions of care ethics and design thinking. The business community has adapted “design thinking” from engineering and architecture to facilitate innovation and problem solving through participatory processes. “Care ethics” is a relational approach to morality characterized by a concern for context, empathy, and action. Although design thinking is receiving significant attention and application in business practices, care ethics has only achieved limited traction among business ethicists in academia. “ (...) class='Hi'>Caring design” is offered as a mutually beneficial integration of the two ideas. Care ethics and design thinking have much in common. For example, the relational and responsive dimension of design thinking is analogous in some important ways, namely empathy and inquiry, to the relational and responsive approach of care ethics. The shared themes in care ethics and design thinking make the integration of the two plausible and reciprocal advantages make the combination compelling. Explicit ethical language can shape design thinking as more than a tool of productivity while the participatory processes of design thinking can aid in expanding the circle of care ethics as a social and political ethic. Furthermore, caring design may provide a palatable path for greater acceptance of care ethics among business professionals. An overview of design thinking and care ethics is offered prior to exploring how the synergies are mutually beneficial. The article concludes with a focus on how to educate the next generation of business students for caring design. (shrink)

Palliative care is a recent branch of health care. The doctors, nurses, and other professionals involved in it took their inspiration from the medieval idea of the hospice, but have now extended their expertise to every area of health care: surgeries, nursing homes, acute wards, and the community. This has happened during a period when patients wish to take more control over their own lives and deaths, resources have become scarce, and technology has created controversial life-prolonging treatments. Palliative care is (...) therefore faced with more ethical problems that other areas of health care. This book, by a clinician, teacher, and writer on health care ethics, has been written to provide all those who care for the terminally ill--doctors, nurses, social workers, clergymen, physiotherapists--with the concepts and principles which will assist them with difficult decisions. It challenges many received doctrines of palliative care, but its well-illustrated central theme is that technical expertise must be controlled by humane, non-technical judgments. (shrink)

The third edition of Health Care Ethics in Canada builds on the commitment to Canadian content established in earlier editions without sacrificing breadth or rigor.

An ethic of care acknowledges the centrality of the role of caring relationships in moral education. Care ethics requires a conception of ?care? that differs from the quotidian use of the word. In order to teach care ethics more effectively, this article discusses four interrelated ways that teachers? understandings of care differ from care ethics: (1) conflating the term of reference ?care? with its quotidian use; (2) overlooking the challenge of developing caring relationships; (3) tending (...) toward monocultural understandings of care; and (4) separating affect and intellect. Awareness of these conceptions of care supports teacher educators to teach care ethics in more meaningful and relevant ways. We explore stories and their dramatization as a medium to facilitate effective and in-depth teaching of care ethics. (shrink)

Care ethics is often criticized for being incapable of outlining what responsibilities we have to persons beyond our personal relations, especially toward distant others. This criticism centres on care theorists’ claim that the concerns of morality emerge between people, generated through our relations of interdependent care: it is difficult to see how moral duties can be applied to those with whom we do not forge a relationship. In this article, I respond to this criticism by outlining a care ethical (...) justification for an interest theory of human rights. This theory will argue that the demands of global justice include various positive actions that aim toward ensuring the conditions for good caring relations to flourish, which in turn protect and promote the vital interests of all persons. In doing so, I aim to concurrently advance the sparse work on human rights within the care literature, systematizing the ideas of care theorists such as Daniel Engster, Virginia Held, and Fiona Robinson. (shrink)

Many studies have shown that women are more likely than men to be living kidney donors, and the discrepancy is particularly marked in heterosexual couples: wives are more likely than husbands to donate a kidney to their spouse. This ‘ Gender Kidney Donation Gap’ can be understood in terms of Carol Gilligan’s claims about gender differences in ethical decision-making style, making it appropriate to analyse responses to this imbalance using an ethic of care. This article centres the vast majority of (...) living donors, those who donate in the context of a significant pre-existing relationship. A cost-neutral approach is unfair on donors who make society richer and healthier by helping a loved one. However, models of kidney sale fail to offer an acceptable alternative, either (a) compelling donors to sell into a pool where they do not know the recipient or (b) allowing affluent individuals unfair access to kidneys. Drawing on surrogacy law in England and Wales, a model of compensation is proposed that includes a range of non-financial benefits. This option celebrates donation and expresses gratitude to all donors while avoiding the pitfalls of the marketplace, with an emphasis on fair treatment of donors. Nevertheless, if more generous treatment led to a 10% increase in directed donation, then it would be equivalent to doubling ‘altruistic’ stranger donations. As long as the Gender Kidney Donation Gap persists, the best response is to minimise the discomfort and disruption caused to donors by their profound act of kindness. (shrink)

Care Ethics ist eine ethische Theorie, Pflegeethik ein Disziplinbegriff. Aber gerade in der Disziplin der Pflegethik kann die Care Ethics ein wichtiges gedankliches Werkezeug darstellen. In der Care Ethics wird nicht der Prinzipienbezug in den Vordergrund gestellt, sondern das Anerkennen von Kontext, moralischer Verantwortung und Beziehungen. In diesem Denkparadigma spielt es für die Reflexion auch eine Rolle, wer man selbst ist, und mit welcher Perspektive man sich einer ethischen Problemsituation nähert.

The aim of this study was to explore the ethical foundations for a caring conversation. The analysis is based on the ethics of Paul Ricoeur and deals with questions such as what kind of person the nurse ought to be and how she or he engages in caring conversations with suffering others. According to Ricoeur, ethics (the aim of an accomplished life) has primacy over morality (the articulation of aims in norms). At the ethical level, self-esteem (...) and autonomy were shown to be essential for a person (nurse) to act with respect and responsibility. The ethical relationship of a caring conversation was found to be asymmetrical, because of the passivity inflicted by suffering. This asymmetry was found to be potentially unethical if not balanced with reciprocity. In the ethical context, the caring conversation is one in which the nurse makes room through the ethos of caritas for a suffering person to regain his or her self-esteem, and thus makes a good life possible. (shrink)

One of the biggest policy interventions during the last year of the COVID‐19 pandemic was the Coronavirus Aid, Relief, and Economic Securities Act, instituting a novel form of economic relief similar to a universal basic income. The economic impact payments, colloquially known as “stimulus checks,” were distributed based on the socioeconomic status of American citizens and legal residents and provided much‐needed financial aid. However, the distribution of these payments paid little attention to other important factors that might determine the economic (...) security of said individuals, such as race and gender. This article calls for policy‐makers to pay particular attention to how structural inequity and discrimination based on identity could affect the efficacy of proposed policies and demonstrate an ethic of care informed by an understanding of intersectionality. (shrink)

The paper argues that care ethics should be subsumed under virtue ethics by construing care as an important virtue. Doing so allows us to achieve two desirable goals. First, we preserve what is important about care ethics. Second, we avoid two important objections to care ethics, namely, that it neglects justice, and that it contains no mechanism by which care can be regulated so as not to be become morally corrupt.

A dominant area of inquiry within intergenerational ethics concerns how goods ought to be justly distributed between noncontemporaries. Contractualist theories of justice that have broached these discussions have often centered on the concepts of mutual advantage and reciprocal cooperation between rational, self‐interested beings. However, another prominent reason that many in the present feel that they have obligations toward future generations is not due to self‐interested reciprocity, but simply because they care about what happens to them. Care ethics promises (...) to be conceptually well‐suited for articulating this latter reason: given that future generations are in a perpetual condition of dependency on present‐day people's actions, this is precisely the kind of relational structure that care theorists should be interested in morally evaluating. Unfortunately, the care literature has been largely silent on intergenerational ethics. This article aims to advance this literature, offering the blueprints of what a care ethic concerning future generations—a “future care ethic”—should look like. The resultant ethic defends a sufficientarian theory of obligation: people in the present ought to ensure the conditions needed to encourage and sustain a world that enables good caring relations to flourish. (shrink)

In this paper, I want to try to put what has been termed the “care ethics” into a different perspective. While I will discuss primarily the use of that ethic or that term as it applies to the healthcare setting in general and to the deliberation of consultants or the function of committees more specifically, what I have to say is meant to be applicable to the problem of using a notion like “caring” as a fundamental precept in (...) ethical decision making. I will set out to examine the relationship between theoretical ethics, justice-based reasoning, and care-based reasoning and conclude by suggesting not only that all are part of a defensible solution when adjudicating individual cases, but that these three are linked and can, in fact, be mutually corrective. I will claim that using what has been called “the care ethic” alone is grossly insufficient for solving individual problems and that the term can be extremely dangerous. I will readily admit that while blindly using an approach based solely on theoretically derived principles is perhaps somewhat less dangerous, it is bound to be sterile, unsatisfying, and perhaps even cruel in individual situations. Care ethics, as I understand the concept, is basically a non- or truly an anti-intellectual kind of ethic in that it tries not only to value feeling over thought in deliberating problems of ethics, but indeed, would almost entirely substitute feeling for thought. Feeling when used to underwrite undisciplined and intuitive action without theory has no head and, therefore, no plan and no direction; theory eventuating in sterile rules and eventually resulting in action heedlessly based on such rules lacks humanity and heart. Neither one nor the other is complete in itself. There is no reason why we necessarily should be limited to choosing between these two extremes. (shrink)

Feminist care ethics has become a prominent ethical theory that influenced theoretical and practical discussions in a variety of disciplines and institutions on a global scale. However, it has been criticized by transnational feminist scholars for operating with Western-centric assumptions and registers, especially by universalizing care as it is practiced in the Global North. It has also been criticized for prioritizing gender over other categories of intersectionality and hence for not being truly intersectional. Given the imperialist and colonial legacies (...) embedded into the unequal distribution of care work across the globe, a Western-centric approach may also carry the danger of paternalism. Hence, a critical approach to care ethics would require reckoning with these challenges. The aim of this article is first to unfold these discussions and the responses to them from care ethics scholars and then to present resources in Beauvoir’s existentialist ethics, specifically the tenet of treating the other as freedom, as productive tools for countering the Western-centric and paternalistic aspects of care practices. (shrink)

One of the most striking and underexplored points of difference between care ethics and other normative theories is its reluctance to offer a theory of right action. Unlike other normative ethical frameworks, care ethicists typically either neglect right action or explicitly refuse to provide a theory thereof. This paper disputes that stance. It begins with an examination of right action in care ethics, offering reasons for care ethicists not to oppose the development of a care ethical theory thereof. (...) It then considers some potential formulations of a first premise of a theory of right action, both demonstrating the diversity of possible first premises and arguing for a monistic subset of these. It subsequently presents some potential second premises, arguing that a care ethical theory of right action ought to adopt a eudaimonistic approach to care. The paper thereby makes several inroads into a care ethical account of moral evaluation. (shrink)

Through the framework of Ricoeur’s philosophy, Fredriksson and Eriksson develop an influential ethics of the caring conversation, which instructs nurses to have caritas, self-esteem, and autonomy on one hand and to engage respectfully and responsibly in caring conversations on the other. This article brings the ethics of the caring conversation into dialogue with Ricoeur’s philosophy again. While Fredriksson and Eriksson draw upon Ricoeur’s little ethics, this article relies on Ricoeur’s dialectic of love and justice. (...) The dialogue throws light on other aspects of caritas, which is vital in Fredriksson and Eriksson’s ethics. It shows a need for nurses to strike a balance between love and justice and, also, to cultivate love. (shrink)

The purpose of this book is to assist health care professionals in understanding some of the complex contemporary issues that they confront and to provide guidance in making decisions. These issues are described and analyzed in the context of philosophical principles and methods in language that is understandable to the professional who is unfamiliar with the study of philosophy and ethics. -from Preface.

The bioethical principle of respect for a person’s bodily autonomy is central to biomedical and healthcare ethics. In this article, we argue that this concept of autonomy is often annulled in the maternity field, due to the maternal two-in-one body (and the obstetric focus on the foetus over the woman) and the history of medical paternalism in Western medicine and obstetrics. The principle of respect for autonomy has therefore become largely rhetorical, yet can hide all manner of unethical practice. (...) We propose that large institutions that prioritize a midwife–institution relationship over a midwife–woman relationship are in themselves unethical and inimical to the midwifery philosophy of care. We suggest that a focus on care ethics has the potential to remedy these problems, by making power relationships visible and by prioritizing the relationship above abstract ethical principles. (shrink)

BackgroundAs hospitals have grown more complex, the ethical concerns they confront have grown correspondingly complicated. Many hospitals have consequently developed health care ethics programs (HCEPs) that include far more than ethics consultation services alone. Yet systematic research on these programs is lacking.MethodsBased on a national, cross-sectional survey of a stratified sample of 600 US hospitals, we report on the prevalence, scope, activities, staffing, workload, financial compensation, and greatest challenges facing HCEPs.ResultsAmong 372 hospitals whose informants responded to an online (...) survey, 97% of hospitals have HCEPs. Their scope includes clinical ethics functions in virtually all hospitals, but includes other functions in far fewer hospitals: ethical leadership (35.7%), regulatory compliance (29.0%), business ethics (26.2%), and research ethics (12.6%). HCEPs are responsible for providing ongoing ethics education to various target audiences including all staff (77.0%), nurses (59.9%), staff physicians (49.0%), hospital leadership (44.2%), medical residents (20.3%) and the community/general public (18.4%). HCEPs staff are most commonly involved in policy work through review of existing policies but are less often involved in development of new policies. HCEPs have an ethics representative in executive leadership in 80.5% of hospitals, have representation on other hospital committees in 40.7%, are actively engaged in community outreach in 22.6%, and lead large-scale ethics quality improvement initiatives in 17.7%. In general, major teaching hospitals and urban hospitals have the most highly integrated ethics programs with the broadest scope and greatest number of activities. Larger hospitals, academically affiliated hospitals, and urban hospitals have significantly more individuals performing HCEP work and significantly more individuals receiving financial compensation specifically for that work. Overall, the most common greatest challenge facing HCEPs is resource shortages, whereas underutilization is the most common greatest challenge for hospitals with fewer than 100 beds. Respondents’ strategies for managing challenges include staff training and additional funds.ConclusionsWhile this study must be cautiously interpreted due to its limitations, the findings may be useful for understanding the characteristics of HCEPs in US hospitals and the factors associated with these characteristics. This information may contribute to exploring ways to strengthen HCEPs. (shrink)

(2000). Caring at a Distance: (Im)partiality, Moral Motivation and the Ethics of Representation - Manipulation and Exploitation? Western Media and the Third World. Ethics, Place & Environment: Vol. 3, No. 3, pp. 317-319. doi: 10.1080/713665895.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Health Care Ethics: A Comprehensive Christian Resource by James R. ThobabenPaul D. SimmonsHealth Care Ethics: A Comprehensive Christian Resource by James R. Thobaben Downers Grove, IL: Intervarsity Press, 2009. 429pp. $28.00In recent years, a stir has been created by the vocal and aggressive involvement of evangelicals in such issues as abortion, homosexuality, and end-of-life decisions. James Thobaben, the dean of Asbury Seminary, provides what he calls (...) a [End Page 203] “comprehensive resource” for evangelicals, and promises better understandings of their perspectives and commitments for those who are baffled or frustrated by the actions and claims of those on the religious right.Thobaben casts a wide net when defining those he includes as “evangelicals”—Southern Baptists, members of Campus Crusade, Pentecostals, the Holiness movement, neoevangelicals, charismatics, and Anabaptists. These diverse groups are evangelicals because of their “consistency on moral choices,” doctrinal orientation, and styles of social advocacy (24). Although they differ in a number of ways, they all share having been influenced in some way by John and Charles Wesley, Jonathan Edwards, and the Reformation. All stress conversion in that “one must say yes to the divine Jesus Christ” and become identified with the community of faithful believers (57). And in recent decades, they have become a potent political force with regard to the issues of abortion and homosexuality.Thobaben covers a wide range of topics in this book: from a general discussion of theodicy and healing to bioethics, disability, sickness, family and congregational care, professional truthfulness, managing care, end-of-life decisions, assisted reproduction, organ donation, and death. Yet, although he claims to provide a “comprehensive resource” on evangelical Christian health care ethics, he fails to provide a thorough examination of his subject matter. For example, Thobaben pays little attention to the historic beginnings of the religious right. One misses any mention of political action groups or the coalitions formed with or by conservative Christian groups to pursue social reforms, or of why such disparate groups have cooperated for political or social goals under the same umbrella. He focuses solely on identifying and articulating the consensus among those who embrace certain moral values on the current scene. Thobaben’s uncritical approach to his subject matter leaves the impression that this book is essentially an apology for evangelical, right-wing Christian social thought. One searches in vain for any critical discussion of the beliefs and values he presents or any thoughtful engagement with those who might view the stances he presents as an assault against women’s rights or an attack on the rights of gays, lesbians, and transsexuals.Moreover, in a book like this, one would have expected a more careful assessment of biblical passages and historical precedents. Thobaben does not provide much rationale for his method for moving from the Bible to current social issues. For example, no prohibition against abortion is found in the Bible and the few passages about homosexual practices hardly add up to the fierce opposition to gays found among strident evangelicals. Moreover, Thobaben does not mention that in 1965 laws against contraceptives were declared unconstitutional by the Griswold vs. Connecticut decision, the Supreme Court’s rejection of a ban supported by an evangelical crusade led by Anthony Comstock. [End Page 204]It is interesting to note that Thobaben holds a strongly qualified commitment to religious liberty and only a “thin” version of the social contract basic to the Bill of Rights (37). He argues that in at least some situations “intolerance is not only morally understandable but strongly preferable,” as in the examples of the “abolition of slavery and prolife/antiabortion advocacy” (29) or, in another context—where he distinguishes between tolerance toward those outside the church and intolerance toward those within it—with regard to homosexuality and alcohol intoxication (30).The task of Christian ethics is to enlighten believers and the general citizenry by a careful exposition of the sources of wisdom available to those who want to think and think morally about issues of importance to human flourishing. That task is especially important in an age of demagogic hostility toward unpopular groups. Sadly, this book does not engage such critical questions. It may prove... (shrink)

Health Care Ethics examines the way ethical dilemmas are played out in everyday clinical practice and argues for an approach to ethical decision-making which focuses more on patient needs than competing professional interests. While advances in medical science and technology have improved the ability to save and prolong lives, they have also given rise to fundamental questions about what constitutes life and personhood, especially in the context of what are termed 'persistent vegetative state' and 'brain death'. Drawing on the (...) example of intensive care where such questions feature strongly in everyday practice, Kath M Melia examines how decisions are taken within the context of multiprofessional teamworking, including · whether to admit a patient and commence treatment · what the aim of treatment should be (i.e. palliation, care or cure) · when to limit, withhold or withdraw treatment · when to donate organs. As an area in which different professional groups work closely together, the author argues that there are lessons to be learnt from intensive care which can be applied to ethical decision making in all areas of health care for the greater good of patients. The book makes a significant contribution to the literature on ethics in health care and to the development of ethical decision making which prioritises the needs of patients. It is essential reading for ethicists, sociologists and health care professionals. (shrink)

In this essay I examine the relevance of the vocabulary of an ethics of care to ecofeminism. While this vocabulary appears to offer a promising alternative to moral extensionism and deep ecology, there are problems with the use of this vocabulary by both essentialists and conceptualists. I argue that too great a reliance is placed on personal lived experience as a basis for ecofeminist ethics and that the concept of care is insufficiently determinate to explicate the meaning of (...) care for nature. (shrink)

The personalist ethics of Edith Stein and her feminist thought are intrinsically interrelated. This unique connection constitutes perhaps the main novelty of Stein’s ethical thought that makes her a forerunner of some recent developments in feminist ethics, particularly ethics of care. A few scholars have noticed the resemblance between Stein’s feminist personalism and care ethics, yet none of them have properly explored it. This paper offers an in-depth discussion of the overlaps and differences between Stein’s ethical (...) insights and the core ideas of care ethics. It argues that both Stein and care ethicists relocate a certain set of practices, values and attitudes from the periphery to the center of ethical reflection. This includes relationality, emotionality and care. The paper finally argues that it is plausible and fruitful to read Stein’s advocacy of ‘woman’s values and attitudes’ in a critical feminist way, rather than as an instance of essentialist difference feminism. (shrink)

Health Care Ethics: Critical Issues for the 21st Century is built around the four central themes of healthcare ethics: theoretical foundations, issues for individuals, issues for organizations, and issues for society. The text brings together the insights of a diverse panel of leading experts from the fields of bioethics, long-term care, and health administration, among others, and a comprehensive update of the ethics of pandemics.

This article suggests that one means for empathetically and imaginatively engaging the intersectional differences of otherness to find commonality while still honoring, recognizing, and celebrating those differences is found in the notion of embodied care—the framing of feminist care ethics in terms of its physical elements. Because embodiment remains a common denominator among humans despite the strength of intersectional differences, the body is an important means of connectivity and thus a basis for at least partial understanding between embodied beings. (...) However, this is a humble commonality born out of responsiveness and listening because the body is also the site of inscribed differences. Authentic care is always responsive and thus respectful of the one cared for. Framing care as performed bodily actions is an effort to capture a corporal basis for morality that has the potential to help us negotiate powerful narratives of socially constructed otherness in order to engage identity-based injustice without silencing the voices and experiences of difference and dissent. Care is described as a performance of the body/self, and how such performances of the body can spark understanding across intersectional differences. The article suggests dramaturgical exercises for developing skills of caring for unfamiliar others. (shrink)

Over the past three or four decades, the concept of medical ethics has changed from a limited set of standards to a broad field of debate and research. We define medical ethics as an arena of moral issues in medicine, rather than a specific discipline. This paper examines how the disciplines of health care ethics and health care law have developed and operated within this arena. Our framework highlights the aspects of jurisdiction and the assignment of responsibilities. (...) This theoretical framework prompted us to study definitions and changing responsibilities in order to describe the development and interaction of health care ethics and health law. We have opted for the context of the Dutch debate about end-of-life decisions as a relevant case study. We argue that the specific Dutch definition of euthanasia as ‘intentionally taking the life of another person by a physician, upon that person’s request’ can be seen as the result of the complex jurisdictional process. This illustrates the more general conclusion that the Dutch debate on end-of-life decisions and the development of the two disciplines must be understood in terms of mutual interaction. (shrink)

This book advocates for the philosophical import of care in re-evaluating problems of humanitarianism in the context of the ongoing international refugee and forced migration situation. In doing so, it rethinks the human capacity to care about the suffering of distant others. At a time when emotional resources are running low, there is a need to recast what it means to care, with the aim of generating a productive movement against the rise of value fundamentalism globally—embraced in mantras of ‘good (...) and evil’ and ‘us and them’—and to confront xenophobia and oppressive politics. The author draws upon a wide array of rich traditions, including historical and contemporary writings on self-care and care of the other, to re-examine the intersection of care ethics and justice. She also rethinks the relationship between care and contestation, here analyzed in the aesthetic, ethical, political, and religious domains of human experience. From within the context of this contingent historical repetition of political oppression, the book constructs a reminder not only of what it feels like to care, but how and why we should act upon our care. Care Ethics and the Refugee Crisis is an important contribution to the growing literatures on care ethics and immigration/forced migration in philosophy. It will also appeal to scholars and advanced students working in other disciplines such as political science, refugee and migration studies, and social anthropology. (shrink)

The interface of health care and insurance requires not just the medical, legal and financial perspectives, but a clear ethical analysis. A varied team of contributors ranging from experts in philosophy, law, medicine and ethics to actuarial science, underwriting and insurance have contributed a series of essays. The ….

After her curriculum proposal is presented, Noddings' feminine ethics is submitted to a critique through an interpretation of her three books. Her distortion of Gilligan and Chodorow is explained. Indebtedness to male sources is noted. The over-emphasis upon good and upon first-person experience is criticised and traced to feminist rage, which is interpreted as the result of the oppression of women. Noddings' suppressed 'Kantianism' is explicated to maintain the dialectic between so-called male and female voices. Main strengths of her (...) curriculum proposal are interpreted more broadly than her perspective allows to indicate a promising return to normative, macro-theory of education. (shrink)