Criticisms of care ethics have come from writers from the disability movement. These criti- cisms derive from their concern that care has been used oppressively with disabled people whose demand for greater independence may be compromised by an uncritical adoption of such an approach. Shakespeare (2000) has argued that two alternative theoretical models for reforming care are available. The first derives from the disabled people’s move- ment and sets out a model of independent living. The second is the feminist ethic of care. Both criticise the way care has been promoted, but they diverge in their vision for an alter- native. Disabled writers underpin their critique by emphasising the civil rights of disabled people, suggesting that independence can be achieved via personal assistance schemes. Feminist approaches, as identified above, question the whole notion of care and wish to recast it with the recognition that care is not special but forms the normal part of every- day life in which we are all involved and reliant upon.
While the recasting and recognition of care is important, disabled and feminist writers would criticise the tendency to idealise the caring role and the implication that caring may be a natural attribute of women. Users of care services often feel a lack of control over who provides care and how that care is provided. In addition they may feel their voice is minimised and ignored and their very bodies neglected and abused by carers. A disability rights perspective argues for justice in care so that disabled people have the autonomy and independence that some feminists (see Silvers et al., 1998) argue is a patriarchal bar- rier undermining an ethic of care.
Comment
Mrs Davies’s independence is compromised by the way that her care is organised. She is unable to maintain her social contacts and her presence in the wider community as the care provided for her is narrowed to her basic care needs. Her independence is compro- mised further by the way that her assessment was done to her rather than with her. In respect to care, this provision limits Mrs Davies’s options, particularly when the carers are getting her to bed at 8 o’clock.
Feminist writers such as Sevenhuijsen (1998) and Lister (2003) have sought to develop an ethic of care alongside an ethic of justice. They recognise that there is a darker side to care in which frustration, conflict and abuse can be present, unless this is tempered by a con- cern for justice in care. However, there is still considerable tension in these approaches. Disabled people continue to fight for the right of independence and observe that just as women’s dependency is socially constructed so it is for disabled people. The priority for disabled people is to be able to make choices to exert control over their own lives rather than question independence. As Shakespeare (2000) argues:
Rather than challenging the goal of independence, disabled people want to be empowered to become independent. The crucial move is not just to recognise that everyone has needs, but to break the link between physical and social dependency (p80). The goal of independence as a first step for disabled people is crucial but this should not prevent the ethical social worker from questioning independence. A feminist ethic of care
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Let us assume Mrs Davies does not acquire senile dementia but becomes more physically dependent upon her daughter following a series of falls. Mrs Davies, although preferring her daughter to care for her, realises that she cannot ask her daughter to do more for her as she can see how exhausted her daughter gets. Following an assessment of her needs by her social worker, Mrs Davies is given a significant package of care. Mrs Davies did not like to complain but she felt that the social worker was a little brusque in her attitude and seemed to be rushed. A support worker will visit three times a day to help Mrs Davies get up in the morning, visit midday to get shopping and visit at 8 o’clock in the evening to help Mrs Davies into bed. Mrs Davies, although grateful for the care, is unhappy that many of her social needs are not taken into account. She has asked that some of the care hours could be used to enable her to visit her daughter or go to the cinema which she enjoys, but these do not fit into the carers’ rota given they have to organise their time efficiently to meet their commitments to the other people they have to visit.
C A S E S T U DY
3 . 4
In what way does the organisation of Mrs Davies’s care deny her independence? In what way does the nature of the care provided limit Mrs Davies’s care?
does point towards reconciliation between care and justice and an ethic in which all per- sons should have the right to care for and be cared for by others. For some disabled people the severity of their impairment may be such that developing the kind of independ- ence argued for above is difficult to achieve but must always be aspired to. This requires an ethic of justice in attending to the validity of those people’s needs and ensuring their fair treatment, while at the same time recognising the mutual interests and interdepend- ency that we all share. How care and justice is linked can be evidenced by the claims of some disabled people to be supported to have children. In this regard they have the right to be able to bear and look after children if they so choose. In the achievement of such a right we are attending to the necessary development of disabled people as interdependent as care givers and care receivers. Research by Tarleton et al. (2006) shows how problematic this issue is, finding that 50 per cent of the parents with learning disabilities researched have had their children removed into care.
This chapter has explored the range of philosophical approaches to ethics and related these approaches to social work. It has shown the importance of deontological and consequentialist approaches in social work and has emphasised their significance. We have suggested that any philosophical approach has to be applied in a specific context which requires the social worker to assess the validity of each approach for that particular service user. By contrast we have then con- sidered virtue ethics and suggested that character has importance for social workers in reflecting and living out those principles considered important for ethical social work practice. Finally we have considered a feminist ethic of care and shown how this has been an undervalued approach in social work. The advantages and disadvantages of an ethic of care have been investigated using the critique developed by Shakespeare (2000).
Banks, S (2006) Ethics and values in social work. 3rd edition. Basingstoke: Palgrave.
Banks’s book provides good coverage of all the main philosophical approaches identified in this chapter. Porter, E (1999) Feminist perspectives on ethics. London: Longman.
Porter provides a highly accessible introduction to feminist ethics.
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F U RT H E R R E A D I N G