Characteristics of the Care-Based Approach to Bioethics

Key Takeaways

1. Client-Centered Focus: Promotes dignity and respect, focusing on individual situations.
2. Emotional and Relational Values: Emphasizes values like emotion, particularity, partiality, and interdependence.
3. Response to Rationalist Principlism: Developed in response to the rationalist approach’s lack of context in bioethics.
4. Moral Significance of Relationships: Stresses moral significance in relationships and dependencies.
5. Practical Rather Than Theoretical: Often seen as a practice or virtue, focusing on caring motivations and emotions in moral deliberation.

The care-based approach to bioethics signifies a paradigm shift in moral reasoning, emphasizing the importance of emotional and relational dynamics in ethical decision-making. This approach, which contrasts with traditional, principle-based frameworks like deontology or utilitarianism, has gained significant traction and evolved into a comprehensive ethical stance with profound implications in various domains, including healthcare, social justice, and political theory.

Philosophical Foundations of Care-Based Bioethics

Origins and Major Contributors: Carol Gilligan and Nel Noddings

• Carol Gilligan: Gilligan’s work, particularly her criticism of Lawrence Kohlberg’s model of moral development, is foundational in care ethics. She argued that Kohlberg’s theory, which posited a progression towards principled thinking, was gender-biased. Gilligan identified a “care perspective” as an alternative form of moral reasoning, one that was obscured by traditional models focused on justice and autonomy. This perspective was not exclusively feminine but was more frequently articulated by women in her studies​​.
• Nel Noddings: Noddings furthered this conversation by developing the idea of care as a feminine ethic, emphasizing real-time, face-to-face moral deliberation and the uniqueness of each caring relationship. She conceptualized caring as an act of “engrossment,” where the carer attentively responds to the needs of the cared-for, prioritizing their well-being over abstract principles​​.

Nel Noddings’ Ethical Perspective

• Emphasis on Immediate Relationships: Noddings highlighted the importance of immediate relationships in ethical decision-making, challenging the abstract, principle-based approaches.
• Caring Relationship Dynamics: She described the dynamics between the “one-caring” and the “cared-for,” advocating for a reciprocal, albeit asymmetrical, caring obligation​​.

Annette Baier’s View

• Trust and Virtuous Traits: Baier, inspired by David Hume, focused on the importance of trust and other sentimental virtues like compassion and sympathy in moral deliberations.
• Integration of Care and Justice: She advocated for a balance between care ethics and principles of justice, stressing the need to develop moral emotions alongside rational moral principles​​.

Virginia Held’s Contributions

• Societal and Global Care: Held extended care ethics from individual relationships to societal and global issues, challenging the limitations of traditional liberal justice theories.
• Concept of Care as a Basic Moral Value: She emphasized care as the foundation of moral values, influencing not just personal interactions but also broader social and political structures​​.

Eva Feder Kittay’s Approach

• Dependency and Equality: Kittay’s work revolves around the concept of dependency, particularly in caring for the disabled, advocating for an egalitarian approach that recognizes and supports care relationships.
• Questioning Traditional Justice Theories: She critiques traditional justice theories for neglecting the realities of dependency and care, proposing care-based principles for a more inclusive understanding of equality​​.

Sara Ruddick’s Maternal Ethics

• Maternal Experience as a Moral Foundation: Ruddick used maternal experiences as a framework for developing a unique approach to moral reasoning and feminist politics.
• Cognitive Capacities in Motherhood: She explored how the practices and cognitive capacities associated with motherhood have broader moral relevance and can inform feminist politics of peace​​.

Joan Tronto’s Political Science Intersection

• Care Ethics and Power Dynamics: Tronto investigated care ethics in relation to feminist theory and political science, focusing on how care ethics can address power imbalances in society.
• Phases of Care: She expanded the concept of care to include various phases like “caring about,” “taking care of,” “care-giving,” and “care-receiving,” highlighting the political and social implications of care ethics​​.

These contributors and their perspectives collectively enrich the care-based approach in bioethics, offering a comprehensive and nuanced understanding of ethical decision-making that emphasizes relationships, empathy, and context.

Philosophical Underpinnings of the Care-Based Approach

The Emergence of Care Ethics

• Response to Conventional Moral Theories: Care ethics arose as a critique of established moral theories like deontology and utilitarianism, which were seen as overly abstract and disconnected from real-life contexts. These traditional theories often emphasized universal principles and rules, which care ethicists argued lacked sensitivity to individual situations and relationships.
• Carol Gilligan’s Critique: Gilligan’s critique was particularly focused on the gender biases inherent in these traditional theories. She argued that they predominantly reflected a masculine perspective, often overlooking or undervaluing relational and emotive aspects that were more prominently featured in women’s moral decision-making.
• Shift Towards Relational Understanding: The proposed care-based approach highlighted the importance of relationships, emotional connections, and personal contexts in ethical deliberations, challenging the impersonal and principle-driven methods of traditional moral reasoning​​.

Nel Noddings’ Perspective on Care

• Care as a Feminine Ethic: Noddings’ concept of care as a feminine ethic does not imply that it is exclusive to women but rather highlights qualities traditionally associated with femininity, such as empathy, attentiveness, and relational understanding.
• Importance of Face-to-Face Interaction: She emphasized the value of direct, personal interactions in moral deliberation, suggesting that ethical understanding and solutions are often best achieved through close relational engagements.
• Contextual Sensitivity: Noddings advocated for a moral approach that is highly sensitive to the specifics of each situation, recognizing that ethical decisions are deeply embedded in the complex realities of human relationships and experiences​​.

Baier’s Connection to Hume’s Moral Theory

• Affinity with Hume’s Philosophy: Baier found similarities between care ethics and the moral philosophy of David Hume. Hume’s emphasis on sentiment and moral feelings resonates with the care ethics’ focus on emotional intelligence and relational dynamics.
• Cultivating Virtuous Traits: Baier highlighted the need to cultivate character traits such as gentleness, compassion, and trust, suggesting that these traits are essential for ethical living and decision-making.
• Integration of Care and Justice: By drawing on Hume’s theory, Baier sought to merge the care ethics’ focus on relationships and emotions with the justice-based approach’s emphasis on fairness and rights, aiming to create a more holistic and nuanced ethical framework​​.

Virginia Held’s Contributions

• Expansion to Societal and Global Issues: Held significantly broadened the application of care ethics from personal relationships to societal and global scales. She proposed viewing care as a central value in shaping political and social policies and structures.
• Fundamental Moral Value of Care: Held argued that care should be recognized as a primary ethical concern, influencing how societies are organized and governed. This involves integrating care-based principles in public policy, social justice, and international relations​​.

Eva Feder Kittay’s Dependency-Based Equality

• Focus on Dependency in Care Ethics: Kittay’s work centered on the concept of dependency, especially in the context of disability. She highlighted how traditional theories of justice often neglect the realities of individuals who are inherently dependent on others for care.
• Advocacy for Social Support Structures: She called for a reassessment of egalitarian principles to include and prioritize the needs of those in dependent care relationships. Kittay emphasized that social and political structures need to recognize and support these relationships as foundational to a just society​​.

Sara Ruddick’s Maternal Ethics

• Motherhood as a Basis for Ethical Reasoning: Ruddick’s approach to care ethics is rooted in the experiences and practices of motherhood, using these as a framework for moral understanding.
• Influence on Political and Ethical Discourse: She explored how maternal thinking and practices could shape broader ethical and political issues. Ruddick particularly focused on how maternal experiences can contribute to peace-building and understanding in diverse social contexts​​.

Joan Tronto’s Interdisciplinary Approach

• Intersection of Feminist Theory and Political Science: Tronto’s work in care ethics delves into its relevance in feminist theory and political science, examining how care ethics can inform and transform these fields.
• Addressing Power Dynamics in Care Relationships: Her research highlights the necessity of understanding and rectifying power imbalances in care relationships. Tronto’s perspective is crucial in acknowledging and challenging the structural and societal factors that shape care dynamics, especially in relation to gender and social inequities​​.

These contributors have significantly expanded the scope and depth of care ethics, highlighting its relevance not just in personal relationships but in broader societal, political, and global contexts. Their work collectively emphasizes the importance of recognizing and valuing care in various aspects of human interaction and societal organization.

Conclusion

The care-based approach to bioethics represents a significant shift in moral philosophy. It prioritizes relational understanding, empathy, and context over abstract principles, offering a more nuanced and inclusive framework for ethical decision-making. This approach not only enriches bioethical discourse but also has the potential to transform how we understand and practice ethics in various aspects of life.

---

Further Reading

1. Stanford Encyclopedia of Philosophy on Theory and Bioethics: Theory and Bioethics
2. Internet Encyclopedia of Philosophy on Care Ethics: Care Ethics
3. Quizlet Flashcards on Ethics: Ethics Quiz