The ethics of care

Il·lustració. © Maria Contreras Coll

Everyone has the right to be cared for and everyone has a duty to care. Care has become a basic need that must be covered not just by the family, but also by public policies. The Covid-19 pandemic has made us face up to a reality we were ignoring: we are all fragile and vulnerable, and we depend on each other. Looking after oneself inevitably involves looking after others.

For decades now, ethics has considered care one of its fundamental values. Caring for the people who need it has always been a human endeavour and activity, but it has also always been an invisible act, not recognised as essential work. The explanation for this is simple: care has always been provided by the institution of the family, and within this, by mothers, wives and daughters who, since time immemorial, have taken care of children, the sick, people with disabilities and anyone else unable to cope on their own. The title of Katrine Marçal’s recent book speaks for itself: Who Cooked Adam Smith’s Dinner? Having dinner on the table, clean and ironed clothes, and the children looked after was taken for granted; someone handled all this and there was no need to ask who. These were secondary, unimportant tasks.

Thanks to studies by feminist psychologist Carol Gilligan, care has become a basic concept in applied ethics, especially in relation to health. For Gilligan, care is a value that is just as important as justice. Assigning importance to care and demanding it be explicitly acknowledged is a way of confirming that feminist slogan from the 1970s: ‘The personal is political’. Indeed, care has become a basic need that must be covered not just by the family sphere, but also by public policies.

The task of caring for people with various degrees of dependence is becoming increasingly crucial, especially in view of the ageing of the population. Care for people with disabilities has taken a positive turn in recent years, with a focus on developing autonomy and a state of normality. Nonetheless, scientific progress in the field of health and technological innovations to ensure we lead longer, healthier lives cannot replace human action. Living longer does not guarantee the quality of life we would like: a loss of autonomy, loneliness and a lack of financial resources require company, assistance and protection, both from family and from public institutions. Care is an accompaniment to the healthcare recognised as an essential public service. It goes without saying that the coronavirus pandemic has heightened healthcare needs and made us face up to a reality we were happily ignoring: we are all fragile and vulnerable, and we depend on each other. We need each other, and looking after oneself inevitably involves looking after others.

What does it mean to value care? What changes need to take place to make sure relationships between people are based on care, solidarity and empathy? What has to change for societies to abandon their individualistic ideology in favour of a relational outlook that recognises that we are interdependent beings and that we must view ourselves as both providers and receivers of care, given our vulnerability as humans?

The ethics of care is not a feminine ethics

The first thing that needs to change is the perception of care as a women’s issue exclusively. The ethics of care is not a feminine ethics, because ethics has no gender, and allocating the responsibility of caring for those who need it solely to women and families goes against fairness in its most elemental form. The majority of carers currently are women, but this does not have to continue, nor does it mean that women are especially qualified for these tasks. While only women have been responsible for care, and they have done so for free, care has not been considered work. Looking after children, the sick or other dependent people has never been seen as productive work. Care has just been viewed as a part of reproduction: a feminine area by definition.

For various reasons that will not be analysed here, this view of things is neither sustainable nor fair. Care is a universal responsibility, from which no one should be exempt. Care work must be seen as just that, work (paid or otherwise, depending on the circumstances), recognised as such and with some sort of recompense. The ancient division of roles between men and women cannot continue any further into the twenty-first century: men are not the only providers in the household, and women are not solely responsible for care tasks. Economists have long recognised that the economic value of care is significant and that it should translate as social recognition at least comparable to that granted to productive work.


Care: a universal right and duty

The above reflections give rise to an axiom that should become one of the basic principles of ethics: ‘Everyone has the right to be cared for and everyone has a duty to care’. Everyone means every-one, with no exceptions: nobody should be exempt from a duty that should not necessarily be considered feminine. The fact that care-oriented professions, such as nursing, are dominated by women is a distortion that can only be explained by the cultural inertia that contributes towards reproducing gender stereotypes.

Caring is a universal duty, because it is derived from an equally universal right. If we take them seriously, rights must be guaranteed by the only institution with the power to do so: the State. If we accept that care has become a basic need, deeming it a right is a consequence of this need. It thus becomes another social right, on its own and in tandem with other rights, such as the protection of health, education, housing or work. In fact, to care for people in the least fortunate situations is to ensure they have access to the basics to which everyone is entitled.

The problem with social rights is that, unlike rights to freedom, they require intervention from the State. When the State does intervene, it often does so with significant, well-known shortcomings. Social rights tend to be seen more as programmatic rights – to be ensured in an ideal world, but only where possible – than as ‘positive obligations’ that must be fulfilled. There is no need to list examples. The rights to housing and work are rarely understood as true rights; the Law on Dependence was doomed from the beginning due to a lack of resources to apply it; work-life balance policies, which should make care compatible with paid work, are little more than a declaration of intentions.

All too often, social rights are empty formulas that do not lead to proactive measures designed to guarantee them. Here, we can be relatively satisfied with the implementation of the right to education and the right to health, but we cannot say the same of other social rights, or of a possible right to care. The reality when it comes to most social rights contrasts starkly with the propagandist slogans issue by governments and all kinds of organisations. Take ‘person-centred care’, for example: this is a statement with no concrete purpose if it does not translate as an effective effort to care for, protect and accompany people who require assistance and protection.

© Maria Contreras Coll Illustration. © Maria Contreras Coll

Care: a private and public arrangement

Joan Tronto, one of the most convincing theorists of the ethics of care, insists that care must be an individual and public process consisting of determining needs and distributing responsibilities. This is the goal of the network of so-called caring cities, which have realised that the proximity of municipal politics offers the ideal opportunity for detecting the most urgent needs and fulfilling them from all imaginable angles. A city becomes caring when three things happen: first and foremost, when its residents take on responsibility for looking after the people close to them; when all social and professional agents focus their activity on helping those who require special care; and, lastly, when the public administration becomes a citizens’ service that is local, warm and flexible and really looks out for the needs of the least fortunate people in the city.

For people’s needs to be fulfilled, each individual must be seen as unique. Martha Nussbaum wrote, ‘Seniors exhibit huge variety in their needs, and their needs are also not the same as those of the “average” citizen’. That is why policies must immediately recognise the ‘variety and nonhomogeneity’ of older people’s lives.

Finally, calling for a ‘caring democracy’, as Joan Tronto calls it, should not be reduced to a series of essential ‘services’. Care as a real ethical and political value is not just a set of services. It is an arrangement of people in their mutual relationships. It is the way institutions act towards the people they serve. The social state governed by the rule of law must be compelled to be an attentive, considerate, respectful, friendly state. As well as executing care policies, the public administration must be diligent and close to citizens, provide care, and lead in a ‘caring’ way. A caring attitude is essential, according to Virginia Held, because ‘without some level of caring concern for other human beings, we cannot have any morality’. If we do not feel concerned by existing injustices and committed to fighting them, we will never demand more justice, more fairness and more rights.

Bibliographical references

Gilligan, C., In a Different Voice: Psychological Theory and Human Development. Cambridge, 1982.
Held, V., The Ethics of Care: Personal, Political, and Global. Oxford University Press, 2006.
Marçal, K., Who Cooked Adam Smith’s Dinner? New York, Pegasus Books, 2016.
Nussbaum, M.; Levmore, S., Aging Thoughtfully: Conversations about Retirement, Romance, Wrinkles, & Regret. Oxford University Press, 2017.
Tronto, J., Caring Democracy: Markets, Equality, and Justice. New York University Press, 2013.

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