Metselaar S, Widdershoven G.
[published online April 23, 2019]
Bioethics. 2019;33(4):431-438.
Abstract
Working as clinical ethicists in an academic hospital, we find that practitioners tend to take a principle‐based approach to moral dilemmas when it comes to (not) treating patients who feel like a burden, in which respect for autonomy tends to trump other principles. We argue that this approach insufficiently deals with the moral doubts of professionals with regard to feeling that you are a burden as a motive to decline or withdraw from treatment. Neither does it take into adequately account the specific needs of the patient that might underlie their feeling of being a burden to others. We propose a care ethics approach as an alternative. It focuses on being attentive and responsive to the caring needs of those involved in the care process—which can be much more specific than either receiving or withdrawing from treatment. This approach considers these needs in the context of the patient's identity, biography and relationships, and regards autonomy as relational rather than as individual. We illustrate the difference between these two approaches by means of the case of Mrs K. Furthermore, we show that a care ethics approach is in line with interventions that are found to alleviate feeling a burden and maintain that facilitating moral case deliberation among practitioners can supports them in taking a care ethics approach to moral dilemmas in (not) treating patients who feel like a burden.
The info is here.
Showing posts with label Ethics of Care. Show all posts
Showing posts with label Ethics of Care. Show all posts
Thursday, June 13, 2019
Alleviating Burdensome Beliefs Through a Care Ethics Approach
Medical BagOriginally posted May 29, 2019
Compared with a principles-based approach, taking a care ethics approach to patients who believe they are a burden may be more effective for addressing moral dilemmas related to treatment, according to research published in Bioethics.
Two clinical ethicists from the department of medical humanities at VU University Medical Center in Amsterdam, The Netherlands, shared the case of Mrs K, a 66-year-old patient with leukemia, and examined the ways in which physicians can approach treating a patient who feels like a burden.
Mrs K recently received a bone marrow transplant, but because of rejection symptoms, is now taking an antirejection treatment. Although a cure is possible, the treatment is both taxing and extensive and presents a host of physical and mental challenges. Although Mrs K had previously focused on survival, her mindset has shifted: She says that she is burdening her husband and feels that he deserves better. Mrs K feels that life is no longer worth living and has considered stopping her antirejection treatment, which will result in her death.
Noticing that Mrs K’s mood has been poor over a long period of time, the treating physician suggests antidepressant therapy; they believe that by treating the patient’s depression, the patient will be more optimistic about continuing the antirejection therapy. Mrs K’s husband — also a physician — strongly disagrees with this course of treatment. Mrs K’s care team contacts the clinical ethicist to address this moral dilemma.
The info is here.
Monday, August 14, 2017
Moral alchemy: How love changes norms
Rachel W. Magid and Laura E.Schulz
Cognition
Volume 167, October 2017, Pages 135-150
Abstract
We discuss a process by which non-moral concerns (that is concerns agreed to be non-moral within a particular cultural context) can take on moral content. We refer to this phenomenon as moral alchemy and suggest that it arises because moral obligations of care entail recursively valuing loved ones’ values, thus allowing propositions with no moral weight in themselves to become morally charged. Within this framework, we predict that when people believe a loved one cares about a behavior more than they do themselves, the moral imperative to care about the loved one’s interests will raise the value of that behavior, such that people will be more likely to infer that third parties will see the behavior as wrong (Experiment 1) and the behavior itself as more morally important (Experiment 2) than when the same behaviors are considered outside the context of a caring relationship. The current study confirmed these predictions.
The article is here.
Cognition
Volume 167, October 2017, Pages 135-150
Abstract
We discuss a process by which non-moral concerns (that is concerns agreed to be non-moral within a particular cultural context) can take on moral content. We refer to this phenomenon as moral alchemy and suggest that it arises because moral obligations of care entail recursively valuing loved ones’ values, thus allowing propositions with no moral weight in themselves to become morally charged. Within this framework, we predict that when people believe a loved one cares about a behavior more than they do themselves, the moral imperative to care about the loved one’s interests will raise the value of that behavior, such that people will be more likely to infer that third parties will see the behavior as wrong (Experiment 1) and the behavior itself as more morally important (Experiment 2) than when the same behaviors are considered outside the context of a caring relationship. The current study confirmed these predictions.
The article is here.
Tuesday, April 2, 2013
The Ethics of Care: An Interview with Virginia Held
3:AM Magazine
Interview by Richard Marshall
Here are some excerpts:
3:AM: You’ve developed an ethical theory around ‘care.’ You see this as an alternative to the dominant ethical theories of the last couple of centuries. It’s important to you that it isn’t an ethics to be added on to Kantianism or utilitarianism or virtue ethics. Can you say something about why it is so important that a care ethics is not an adjunct but is a fresh start? The Kantian Christine Korsgaard has placed reciprocity and human relations at the heart of Kantianism. Onora O’Neill has argued that justice and care are not opposed. In the light of these views, would you still defend the break, or would you be happier to see it as a continuation?
VH: I don’t find it satisfactory merely to add some considerations of care to the traditional moral theories for reasons similar to why it is not enough to simply insert women into the traditional structures of society and politics built on gender domination. Feminists should understand that the structures themselves have to change. The history of ethics shows it to be a very biased enterprise. Very roughly, what men have done in public life has been deemed important and relevant to moral theory, and what women have done in the household has been considered irrelevant. I think it plausible to see Kantian ethics and utilitarianism as expansions to the whole of morality of what can be thought appropriate for law and for public policy.
I have come to see, in contrast, caring relations as the wider network, and the ethics of care as the comprehensive morality, within which we should develop legal and political institutions. Caring relations should be guided by the ethics of care, which we can best understand and which is most applicable in contexts of families and friendship. But we can and should also have weaker forms of caring relations with all persons, and within these, the more limited institutions of law should be guided, roughly, by Kantian norms, and the more limited political institutions by utilitarian ones. Yes I see the legal and political as importantly different, and both as significantly different from the contexts of family and friendship. This is a very oversimplified statement of a complex position but I try to clarify and delineate these matters in my written work.
3:AM: So ‘care’ is at the heart of this new ethic but it isn’t to replace justice. So how do you get from care to justice in your system? Do we end up losing the common use of ‘care’ for a more term of art, technical use, as is the wont with philosophers? And isn’t that a cheat?
VH: Yes, various Kantians are trying to acknowledge the concerns of care, and various philosophers interested in the ethics of care are trying to combine it with Kantian ethics. I think the ethics of care has the resources to be an alternative moral theory that can include persuasive aspects of Kantian ethics and also of utilitarianism and virtue theory. It’s nevertheless a feminist ethics that includes the goal of overcoming gender domination, in our thinking as well as our institutions. And I see it as the more comprehensive view. Korsgaard and O’Neill are still Kantians, though more persuasive ones than some traditional Kantians. I think ethics should start with a vast amount of experience (the experience of caring and being cared for) overlooked by traditional moral theories, and see how the many important and valid concerns of other moral theories can be brought into care ethics. I think it is a strength of care ethics that it is based on experience. It is experience which everyone has had: no one would have survived without enormous amounts of care, in childhood at least. Most women, and increasingly men, have also had a great deal of experience providing care, especially for children.
The entire interview is here.
Virginia Held has written: Feminist Morality: Transforming Culture, Society, and Politics, Justice and Care: Essential Reading in Feminist Ethics, and The Ethics of Care: Personal, Political and Global.
Interview by Richard Marshall
Here are some excerpts:
3:AM: You’ve developed an ethical theory around ‘care.’ You see this as an alternative to the dominant ethical theories of the last couple of centuries. It’s important to you that it isn’t an ethics to be added on to Kantianism or utilitarianism or virtue ethics. Can you say something about why it is so important that a care ethics is not an adjunct but is a fresh start? The Kantian Christine Korsgaard has placed reciprocity and human relations at the heart of Kantianism. Onora O’Neill has argued that justice and care are not opposed. In the light of these views, would you still defend the break, or would you be happier to see it as a continuation?
VH: I don’t find it satisfactory merely to add some considerations of care to the traditional moral theories for reasons similar to why it is not enough to simply insert women into the traditional structures of society and politics built on gender domination. Feminists should understand that the structures themselves have to change. The history of ethics shows it to be a very biased enterprise. Very roughly, what men have done in public life has been deemed important and relevant to moral theory, and what women have done in the household has been considered irrelevant. I think it plausible to see Kantian ethics and utilitarianism as expansions to the whole of morality of what can be thought appropriate for law and for public policy.
I have come to see, in contrast, caring relations as the wider network, and the ethics of care as the comprehensive morality, within which we should develop legal and political institutions. Caring relations should be guided by the ethics of care, which we can best understand and which is most applicable in contexts of families and friendship. But we can and should also have weaker forms of caring relations with all persons, and within these, the more limited institutions of law should be guided, roughly, by Kantian norms, and the more limited political institutions by utilitarian ones. Yes I see the legal and political as importantly different, and both as significantly different from the contexts of family and friendship. This is a very oversimplified statement of a complex position but I try to clarify and delineate these matters in my written work.
3:AM: So ‘care’ is at the heart of this new ethic but it isn’t to replace justice. So how do you get from care to justice in your system? Do we end up losing the common use of ‘care’ for a more term of art, technical use, as is the wont with philosophers? And isn’t that a cheat?
VH: Yes, various Kantians are trying to acknowledge the concerns of care, and various philosophers interested in the ethics of care are trying to combine it with Kantian ethics. I think the ethics of care has the resources to be an alternative moral theory that can include persuasive aspects of Kantian ethics and also of utilitarianism and virtue theory. It’s nevertheless a feminist ethics that includes the goal of overcoming gender domination, in our thinking as well as our institutions. And I see it as the more comprehensive view. Korsgaard and O’Neill are still Kantians, though more persuasive ones than some traditional Kantians. I think ethics should start with a vast amount of experience (the experience of caring and being cared for) overlooked by traditional moral theories, and see how the many important and valid concerns of other moral theories can be brought into care ethics. I think it is a strength of care ethics that it is based on experience. It is experience which everyone has had: no one would have survived without enormous amounts of care, in childhood at least. Most women, and increasingly men, have also had a great deal of experience providing care, especially for children.
The entire interview is here.
Virginia Held has written: Feminist Morality: Transforming Culture, Society, and Politics, Justice and Care: Essential Reading in Feminist Ethics, and The Ethics of Care: Personal, Political and Global.
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