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Eye on Ethics

The Ethics of Care
By Frederic G. Reamer, PhD
September 2016

The field of professional ethics (also known as applied or practical ethics) emerged in the early 1970s. This profound development laid the foundation for what is now a rich collection of ethical standards, ethical analysis, and decision-making protocols that are central to professions as diverse as social work, medicine, nursing, dentistry, journalism, law, business, and engineering, among others. Today's students are typically introduced to complex ethical dilemmas they may face during their careers and conceptual frameworks they can use to understand, analyze, and address them.

Professional ethics as we know it today started especially with developments in the health care field, commonly known as bioethics. In the early 1970s, growing awareness of moral challenges related to end-of-life care, genetic engineering and selection, organ transplantation, and futile care paved the way for increasingly ambitious efforts to identify and grapple with ethical challenges. Before these developments, the term "ethics"was associated with philosophical luminaries such as Socrates, Plato, Aristotle, Immanuel Kant, Jeremy Bentham, and John Stuart Mill. The inauguration of bioethics changed the way we think about the role of ethics in our lives and broadened moral philosophy's reach.

One of the hallmarks of those early years in the professional ethics field was widespread effort to link classic moral theory to contemporary ethical challenges faced by practitioners. Much of the professional ethics literature in the 1970s and 1980s applied ethical theories and perspectives (known as normative ethics) with lofty names such as deontology, teleology, and utilitarianism to the real-life ethical puzzles in the professions. Deontology refers to a school of thought associated primarily with Kant, which holds that certain actions are inherently moral, such as being truthful and obeying the law. In social work this implies that practitioners should never lie to clients and should never look the other way and ignore a law (eg, onerous welfare regulations) in order to help a client. In contrast, teleology refers to making ethical decisions based on likely consequences. From this point of view, social workers should take those courses of action that are likely to produce the greatest good, even though this may require shading the truth or ignoring legal requirements (utilitarianism). Deontology and teleology often lead to very different conclusions.

These theoretical perspectives, which tend to encourage a cognitively oriented calculus in order to make ethical decisions, have dominated ethical analysis for centuries. As an alternative, some years ago, especially in the 1980s, a handful of scholars, most notably Carol Gilligan, PhD, Virginia Held, PhD, Eva Feder Kittay, PhD, Nel Noddings, PhD, Sara Ruddick, PhD, and Joan Tronto, PhD, proposed what has become known as the ethics of careperspective. This approach, which has its roots in feminist theory, focuses especially on the human dimensions of ethical dilemmas, especially the implications of ethical decisions for the key relationships among the people involved.

The Ethics of Care — Central Assumptions

Proponents of the ethics of care perspective are concerned that the predominant ethical theories—especially deontology and teleology—are too reliant on universal standards that do not take into consideration the critically important role of human relationships and interdependency.

According to philosophers Richard Burnor, PhD, and Yvonne Raley, PhD, in their work Ethical Choices: An Introduction to Moral Philosophy with Cases, there is evidence of two moral perspectives; men tend to employ the justice perspective, while women more often employ the care perspective. Recent attention to the care perspective has given rise to the ethics of care. In presenting and defending this new approach to ethics, care theorists have rejected the universalism, rationalism, and individualism of traditional theories. Instead of focusing upon the universal rights and obligations of individuals, care theorists have built their theory around relationships. They claim that special responsibilities can arise within particular relationships (particularism) that do not hold universally; they also see certain relation-building emotions as being no less important than reason. Finally, they suggest that even our personal autonomy is partly produced by our relationships.

Key themes in the ethics of care include the following: the centrality of caring relationships; the various shared ties of mutuality; the view that caring both establishes and transforms who we are as people; the requirement that genuine caring gives rise to actions that address actual needs; and the fact that as a normative theory, care ethics has important implications for people's relationships, for people as individuals, and for how we might nurture caring values in others.

Implications for Social Work

For good reasons, the ethics of care perspective is compatible with the social work profession's overriding concern about human well-being, relationships, and interdependency. This conceptual framework offers an important adjunct to traditional ethical theories that, at times, can seem formulaic, linear, sterile, and insensitive to the profound emotional consequences of ethical judgments. Consider, for example, a case where a clinical social worker provides counseling services to a 16-year-old adolescent who struggles with depression and anxiety. The teen tells the social worker that she just found out she is pregnant, and implores the social worker to not share this information with her parents.

Using traditional ethical theories, the social worker would consider whether she has a fundamental duty to protect her client's privacy and right to self-determination (a classic deontological view) or whether she should make her decision based on whether she believes telling the parents would or would not produce the best outcome for all involved (a classic teleological and utilitarian view), even if this means violating the client's wishes and trust. These are important, albeit possibly conflicting, considerations, but they do not necessarily factor in the critically important nature of the key relationships in the client's life, including her relationship with her parents and social worker. Viewing this dilemma through the ethics-of-care lens would encourage the social worker to pay very close attention to the ways in which her management of this ethical dilemma would reflect and honor the caring relationship she has with her client, the client's primary relationships, and the impact of the social worker's decisions on her ability to meet her client's needs.

The ethics of care does not produce easy and quick answers to complex ethical dilemmas. It does not substitute for ethical analyses that consider complicated questions about clients' fundamental rights, social workers' fundamental duties, and the consequences of ethical decisions. But, the ethics of care serves to remind us that, as social workers, we must always approach ethical choices with deep awareness of the impact they have on the people we serve and the relationships that are important to them.

— Frederic G. Reamer, PhD, is a professor in the graduate program of the School of Social Work at Rhode Island College. He's the author of many books and articles, and his research has addressed mental health, health care, criminal justice, and professional ethics.