Sir John Hanson Memorial Lecture explores care ethics and public policy
The 2019 John Hanson Memorial Lecture was given by Professor Jonathan Herring, DM Wolfe-Clarendon Fellow in Law, Exeter College, University of Oxford. The lecture in honour of Sir John Hanson, former Warden of Green College, explored the challenges facing those seeking to implement care ethics into public policy. This lecture was sponsored by Research in Specialist and Elderly Care (RESEC) and organised under the auspices of the Care Initiative. More information about RESEC can be found here.
Green Templeton alumnus Dr Gemma Hughes, who graduated with a DPhil in Evidence Based Health Care this year, reports from the evening:
Professor Jonathan Herring gave an inspiring lecture on the challenges of implementing an ethic of care in law and social policy.
The important things in life
Professor Herring tells us on his website that he works on the important things in life: not money, companies or insurance, but love, friendship and intimacy. In this lecture he took us from the foundations of care ethics through the challenges of implementing care ethics in law and policy to conclude with a vision of a society that centres on care and caring relations. Such a society would not value economic growth above all else; we would not find ourselves working ever-increasing hours in pursuit of material gain, while older people are seen as a burden and become increasingly isolated. Instead, good, caring relations could be society’s primary goal, and not Gross Domestic Product.
Writing our stories with others
Such a society would be based on the ethics of care. Professor Herring gave us an overview of this perspective, drawing on Carol Gilligan’s seminal work on moral development in childhood1. Gilligan’s feminist work, which found that girls spoke ‘in a different voice’ to boys, laid the foundations for new ways of understanding care based on understanding humans as fundamentally relational beings. As such, care is understood as an essential part of human flourishing, it is an essential moral good. Emotions are important. Obligations are emphasised over rights; we should be concerned not so much with ‘do I have a right to act in a certain way?’ and more with ‘what is my proper obligation within the context of this relationship?’ The particularity of relationships is more important than general, abstract principles – a solution that might work in one context might not work in another.
Herring explained that, ultimately, care ethics lead to a reconception of the self from autonomous ‘man’ (and understanding the gendered nature of care is fundamental to care ethics) to relational selves. Herring spoke about three aspects of the self that are integral to this reconception. Firstly we are all inherently vulnerable, no-one is truly self-sufficient, like it or not. Secondly we are, by nature, relational beings. We describe ourselves in relation to others, and our very sense of self emerges out of relationships. Finally we are caring beings. Herring described this reconception as shifting from the notion of ‘writing our own stories’ to ‘writing our stories with others’.
Barriers to ethics of care in law and policy
Herring identified three barriers in applying care ethics in law and policy; autonomy, individualism, and abstraction. The idea of autonomy (that we should be free to live our lives, independent and self-reliant), Herring argued, appears to be valued above all else. The idea that everyone is free to choose to do as they like is challenged by scholars such as Martha Fineman, who writes about the autonomy myth2 and Catriona MacKenzie and Natalie Stoljar3 who work on relational autonomy. Their work on rethinking autonomy places decision-making within relational contexts.
Individualism, which structures legal rights, aims at protecting the individual from external interference and leads to ideas of care as a contract, as an individual rather than a communal responsibility.
Abstraction permeates how systems are managed and measured, whereas (to paraphrase the words of Francis4) it should be patients who count, not numbers. A caring law, argued Herring, would have less emphasis on individualism, autonomy and abstraction. Rather than passing judgement, courts could take mediatory roles, applying contextualised, relational remedies. Contract laws, for example, could be based on good faith between parties to a contract, instead of the adversarial rule of caveat emptor (let the buyer beware).
Revolutionary ideas
Discussion with the audience got to the heart of the revolutionary nature of the implications of care ethics, and to tensions of applying care ethics in practice. The implications of the application of care ethics would not only potentially change who we are (our sense of self) and how we relate to each other, but indicate an enormous political shift – changing the very nature of Western capitalism, based as it is on pursuit of national economic growth. However, more modest applications of care ethics are also possible. Examples from the audience included compassionate communities, and value-driven business models.
Other actions can increase the value of care: sharing care more evenly, and valuing how people enrich relationships when they have different abilities rather than perceiving them as burdens. Eva Feder Kittay’s Learning from My Daughter5 was referenced as a source of philosophical and personal learning about the nature of care and dependency.
Concerns about supporting individuals to achieve autonomy were raised. Not all relationships are positive, so how can people within abusive, or domineering, relationships be supported? Should their autonomy not be enhanced rather than inhibited through relations? Herring’s response was to qualify the definition of ‘caring relations’; abusive relations are not caring. Solutions would be to enable ‘pooled’ autonomies, not simply promoting individual decisions. A more generalised lack of autonomy was also of concern – advocates work to support people to achieve autonomy and so participate in their communities. From this perspective a more sequential approach seems to be more acceptable, where positive, caring relations are facilitated after individuals have achieved a degree of autonomy.
Care ethics changes our understanding of who we are and how we relate to each other. This has profound implications for law and policy whether in healthcare, social care or social policy. Valuing vulnerable caring relations over self-sufficient autonomy implies developing communal responsibilities for care and relationship-centred policy and legal interventions.
Blog author Dr Gemma Hughes is a Health Services Researcher in the Interdisciplinary Research into Health Sciences group at the Nuffield Department of Primary Care Health Sciences at Oxford University. Her research interests include critical analysis of the relationships between health and social care policy, practice and lived experience.
References
1 CG Gilligan, C., 1982. In a different voice: psychological theory and women’s development.
2. Fineman, M. (2004). The Autonomy Myth: A Theory of Dependency.
3. Mackenzie, C., & Stoljar, N. (2000). Relational Autonomy: Feminist Perspectives on Automony, Agency, and the Social Self.
4 Francis, R. (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. London: The Stationary Office.
5 Kittay, E. (2019). Learning from My Daughter: The Value and Care of Disabled Minds.
You can find an audio recording of the lecture here: