Care Professions and Globalization

Theoretical and Practical Perspectives

A. González, C. Iffland, A. González, C. Iffland

• Publisher: Palgrave Macmillan
• Year: 2014
• Print ISBN: 9781349479566, 9781137381163
• eBook ISBN: 9781137376480
• Topic: Social Sciences
• Subtopic: Labour Economics
• Index: Social Sciences

This volume presents an extended reflection on human dependency and the need to 'care' and be 'cared for'. Philosophers, theologians, social theorists, economists, and professional caregivers to discuss the challenges of professional caregiving, analyzing how societies can promote relationships in which individuals can give and receive 'care'.

Theoretical Perspectives

Chapter 1

THE COMPLETION OF CARE—WITH IMPLICATIONS FOR A DUTY TO RECEIVE CARE GRACIOUSLY

Eva Feder Kittay

INTRODUCTION

Only a few care theorists have focused on what Noddings has called “the completion of care” and what Joan Tronto called “the reception of care.” I explore the logic of care as an “achievement verb” as a way to argue for the important but neglected idea that actions intended as care require that the individual being cared for accepts them in order for the actions to be considered care. I argue that the requirement that care be taken up and completed by the cared for results in an obligation to receive care graciously when it is offered in good faith and with the requisite competence.

PRELUDE

Noddings writes, “My caring has somehow to be completed in the other if the relation is to be described as caring.”¹ And Joan Tronto in Moral Boundaries maintains that “the final phase of caregiving recognizes that the object of care will respond to the care it receives.”

And yet care is about the giving of care. Why is there a need to include care’s reception as a phase of the caregiving itself? Caregiving depends only on the intention, whether or not we are successful. Or does it? After the many years I have spent trying to map out the as-yet-not-fully-charted territory of care ethics, I have finally come to appreciate that unless our actions are taken up by another as care, they are not yet care. I wish to ground this claim with an argument and consider the importance of this notion.

What misled me was the model of care that shaped my views. My disabled adult daughter is unable to do anything that falls within the conventional understanding of what it is either to acknowledge another’s care or refuse it. Nonetheless we can care for our disabled daughters. Were I to accept the Noddings thesis, it would seem to imply that what I gave my daughter was something less than care.

Now I also have a different recipient of care: my 92-year-old mother. And I have gained a new appreciation of the importance of the reception of care. What I have realized is that my daughter always did complete my care but that she has done so with such graciousness that this reception was invisible to me. In stark contrast, my mother, feeling powerless and embittered by the loss of her capacities and her independence, responds to my efforts to care with resistance and denial. Faced with the intransigence of someone in need of care but who refuses it, I am moved to reflect on this last moment of care—the completion of care. The moment of completion is not an entirely passive one. Care is not something we do to but for another. This means that there has to be an uptake on the other’s part. Therefore I will speak of the completion of care as the “taking up of care.”

THE Logic of “Care”

Let us begin by considering a very simple act of care: caring for a plant by watering it. I pick up a glass of clear liquid with the intention of watering the plant. Now suppose that unbeknownst to me, it is vinegar instead of water that I have poured into the dry soil. Predictably, the plant begins to wither instead of perk up. Have I cared for the plant? Most of us would answer no.² It was, of course, an error on my part. While some errors result from incompetence or carelessness, this was not one. I had no reason to suspect that someone would leave a glass of vinegar in my vicinity. Moreover, my action was not perfunctory, and it was motivated by real concern for the plant. Yet it could not be said to be caring for the plant. I may not be morally blameworthy for my action, but neither was it morally praiseworthy, for despite my best intentions, I failed to care for the plant. If you can accept that pouring vinegar when I intended to water the plant was not care, then this simple case illustrates that nothing can count as caring if it is ineffectual or produces an ill effect for the being that is cared for.

From this claim we can deduce the following propositions:

• • Proposition 1. Caring is an act.³
• • Proposition 2. Caring is an achievement term.
• • Proposition 3. Caring requires that the object of the care respond in some way that results in the achievement of the act—that is, caring requires the cared for to “take up the action as care.”

Let me take each of these considerations in turn.

Proposition 1: Caring is an act, or it is not yet caring. If we can rule out actions that are intended as care but fail as acts of care, then the intention to care cannot be adequate as a form of care. There are two obvious rejoinders. Even for an action to be called care, it requires an appropriate attitude, one that we speak of as “caring,” “caring about,” or “caring for.” But as our simple example illustrates, no matter how much concern I have for the plant, even if I am motivated by love, I failed to care for it when I poured in vinegar. I suggest that what we call an attitude of care is better thought of as concern. Concern is necessary but not sufficient for care.

The second rejoinder is that the term care is also dispositional. When we speak of a caring person, what is often implied is that this is a person who is emotionally attuned to have the appropriate attitudes, but it is also intended to mean that the person is prepared to act in a certain manner when the occasion demands. The dispositional sense is more closely tied to acts of care than to the emotional component. If a supposedly caring person evinces a lot of emotion in seeing someone in distress and yet fails to act, we question our evaluation of that individual as caring.

A related objection to Proposition 1 notes the distinction between “taking care of” (or “caring for”) another and “caring about” another. While one could concede that taking care of (or caring for) must include acts of care, this need not be true of “caring about.” I agree that the distinction is significant, but action remains central to “caring about” as well. Just as in the use of the term caring to speak of a person’s character, if we claim to care about something or someone, our claim entails our doing certain things when circumstances demand action; otherwise it doesn’t even qualify as “caring about.” To take into account both senses of care as well as the characteristic sense, our proposition should read as follows: To care (for or about) or to be a caring person is to engage in caring activities or to be prepared to engage in actions that such care demands.⁴

Proposition 2: This close tie between care and action is a logical entailment of the fact that “to care” is what Gilbert Ryle, the ordinary-language philosopher, called an “achievement verb.” He drew a distinction between verbs that named tasks (e.g., running), those that signaled failures (e.g., losing), and those that marked achievements (e.g., winning). I may wash windows without achieving the goal toward which window washing is directed—namely having windows that show no dirt. But I cannot be said to have cleaned windows if they remain dirty. Clean and care are “achievement verbs” that include the end result toward which they are directed. Just as all intentions and efforts to win a race will not result in the race being won unless we in fact win, so nothing we intend as an act of care is one unless it hits its mark—that is, unless it either contributes to the well-being of its object or, in the case of a sentient and conscious recipient, is experienced as an act of care by its object.

Proposition 3: Care requires uptake, or it is not yet care. Intention is insufficient because achievement verbs indicate that “some state of affairs obtains over and above that which consists in the performance, if any, of the subservient task activity.”⁵ That state of affairs, which is beyond the performance of all the subservient tasks, is not solely within the control of the actor. No matter how fast you run a race, if someone else runs faster, you do not win. Caregivers will do what they believe is giving care, but if the cared for does not take up the actions as care, then care has not been achieved. The taking up of care is what allows the performed actions to constitute a state of affairs that we call caregiving.

THE TAKING UP OF CARE—SUBJECTIVE and OBJECTIVE CRITERIA

What does the taking up of care entail? It will depend on the capabilities of the cared for. When we can care for insentient objects, such as plants, this activity will be akin to a tropic response; that is, it is without intention, will, or agency. Whether or not the activity was an act of care is determined from an informed third-person standpoint.

Where the cared for is a subject, the second-person standpoint should, as a rule, prevail. An objective measure of the increased well-being of the object of care is insufficient. Subjects in need of care, however, may not be conscious. They may lack adequate information. Their ability to judge what is beneficial for them may be as yet undeveloped, or it may be impaired. Accessing the subjective response will be impossible or indecisive in some of these cases. But where a conscious bein...

Table of contents

• cover
• title
• copyright
• content
• List of Figures & Tables
• Acknowledgments
• A Note on the Social Trends Institute
• Notes on Contributor
• Introduction: The Challenges of “Care”
• 1  The Completion of Care—With Implications for a Duty to Receive Care Graciously
• 2  Carefree in Barcelona
• 3  “Moved by the Suffering of Others”: Using Aristotelian Theory to Think about Care
• 4.  Social Contract Theory and Moral Agency: Understanding the Roots of an Uncaring Society
• 5  Emotional Work and Care as Relationship: SomeParticularities and Consequences
• 6  Socioeconomic Impact of the Work of the Home
• 7  Working in the ICU: A Study on the Normalization of Tension in Health Care Provision
• 8  Professionalizing Care—A Necessary Irony? Some Implications of the “Ethics of Care” for the Caring Professions and Informal Caring
• 9  Domestic Work: Judgments and Biases regarding Mundane Tasks
• 10  The Moral Sense of Nursing Care
• 11  A Professional Perspective on End-of-Life Care
• Ind-1
• Ind