Re-evaluating neo-liberal values in context of the corona virus crisis: greater justice for carers.

There is no escaping the devasting impact of the Covid-19 virus, yet something positive has emerged; it has caused the British public to review its thinking on the way we view and value our health and social care workers and services. We have finally taken notice of our reliance on our keyworkers, and what they do to help the nation to function and to support our well-being. Clapping, placing rainbows in our windows and fund raising for NHS charities are clearly heartfelt gestures; if one NHS worker appreciates it, then that seems like justification enough. The appreciation should be extended to the many other social carers, peer workers and informal carers that all contribute to upholding our nation’s quality of life.

The events surrounding Covid-19 are prompting us to reflect on the taken-for-granted nature of care, but why we haven’t always felt and acted in these ways? The crisis has highlighted the effects of decades of policies influenced by neo-liberal philosophies and political choices, culminating in austerity and marketisation which have been detrimental to our health and to our welfare services. In this short piece of text, I argue a need for a long over-due change to more relational values and practices based on care, in order to protect the nation’s care services.

Neo-liberal philosophies (Rawls, 1971), represent people as rational, autonomous, self-interested individuals (Sevenhuijsen, 2000). The term translates in real terms to consumerism, fragmentation, free market economics, and cuts to public services. The effects of such policies operate through reduced social cohesion, increased income inequality and poverty, and have been shown to affect people’s health negatively, by increasing diseases due the psycho-neuro-biological effects of reduced choice and lower self-esteem (Navarro, 2007; Coburn, 2004). Moreover, this form of representation is simply not suitable for numerous vulnerable populations who require some level of support to live ordinary lives.

As discussed by Fineman (2004), the ‘autonomy myth’, suggests that it suits policy makers to promote individualism rather than a collective responsibility for health and welfare. This is reflected in debates about the provision of care which is framed by perspectives on the costs of care giving; a point further exacerbated by current demographic trends. Independence and autonomy are juxtaposed in opposition to interdependence and relationality. Notions of care are associated with dependence which is regarded as of less worth and therefore backgrounded to autonomy. Dependency is represented as a problem that has to be overcome rather than something that is dealt with on a day to day basis. As ‘need’ is ‘antithetical to the political aim of fostering independence and self-reliance as essential qualities of full citizenship, modern Western societies have devalued care and confined it to the private sphere’ (Lloyd, 2006). Clearly many vulnerable and older people have internalised such associations.

An ethics of care provides a framework for surfacing the negatives effects of neo-liberalism political and philosophical positions, providing a more hopeful alternative. Feminist care ethicists argue that vulnerability and dependency fundamental to the human condition, therefore the need for care emerges (Tronto, 1993; Sevenhuijsen, 2000; Kittay, 2002; Held, 2006). Ultimately ‘care’ is essential in the early stages of human survival, and in the period approaching death it is likely that we will all become emotionally or physical dependent and frail. The need for care permeates all aspects of our lives; the way we relate to one another, our bodies, environments and social well-being, (Barnes, 2006). As Bowden (1997) suggests there is an ‘aura of invisibility’ that envelops care in everyday life; it is simply so integral to the way we live and work, that we overlook its value and significance.

Tronto and Fisher’s definition is suggestive of the breadth of care: ‘On the most general level, we suggest that caring be viewed as a species activity that includes everything that we do to maintain, continue, and repair our world so that we can live in it as well as possible. That world includes our bodies, ourselves, and our environment, all of which we interweave in a complex, life sustaining web’, (in Tronto, 1993 p130). In this way ethics of care provides a framework for understanding care and dependence at an individual and broader political level, it is relevant to the development of welfare services, (Lloyd, 2006).

Ethics of care originates from the work of Gilligan (1982), who ‘challenged gendered assumptions on moral development by proposing a different voice in which moral deliberation might be conducted’. Humans are seen as fundamentally interdependent, and by emphasising care as a relational process, an ethic of care acknowledges that complex practical and moral dilemmas are an unavoidble element of caring relationships involving formal and informal care givers.

By failing to acknowledge how central care is to human life, ‘those who are in a position of power and privilege can continue to ignore and to degrade the activities of care and those who give care’, (Tronto, 1993, p111). However, owing to its attention to the intrinsic rather than instrumental value of caring, ethics of care provides a basis for a critical analysis of these ideas, helping to highlight the problems associated with the extension of marketisation into new areas of social life, (Held, 2006). Care giving and care receiving should not be perceived as a simple binary, more as a process of ‘natural helping’ involving diverse groups of actors with differing motives (Waller and Patterson, 2002).

Ethics of care helps us to consider ‘the lived experiences of giving and receiving care, and how context, conflicts and power impact the difficult moral decisions as well as the practical tasks of care’, (Barnes, 2012, p.40). It enables us to develop of an understanding of the ‘different interpretations of need and of conflicts of interest that exist between those in need of care and those who provide it’ (Lloyd, 2006). Furthermore, Tronto (1993, p.9) argues that care can serve as both a moral value and a basis for the political achievement of a good society.

In this piece of text, I have argued for a need to re-set influential contemporary philosophies and consider an ethic of care as an alternative to help us consider human need. The Covid-19 crisis has shown us that we have moved too far from welfarism, too near to neo-liberal philosophies, and this has been detrimental to health and our quality of life. I argue for return to social democratic values based on ethics of care, in which care workers are afforded the recognition and rewards they richly deserve. Care work in all of its forms deserves justice in terms of ongoing respect, job security, fair pay and working conditions.

Warren Stewart

References

Barnes, M. (2006). Caring and Social Justice. Palgrave Macmillan, Basingstoke.

Barnes, M. (2012). Care in Everyday Life: An Ethic of Care in Practice. The Policy Press, Bristol.

Bowden, P. (1997). Caring: Gender Sensitive Ethics. Routledge, London and New York.

Coburn, D. (2004). Beyond the Income Inequality Hypothesis: Class, Neo-liberalism, and Health Inequalities. Social Science and Medicine. 58. 41-56.

Fineman, M.A. (2004). The Autonomy Myth: A Theory of Dependence. The New Press, New York.

Gilligan, C. (1982). In a Different Voice: Psychological Theory and Women’s Development. Harvard University Press, Cambridge, Massachusetts.

Held, V. (2006). The Ethics of Care: Personal, Political, and Global. Oxford University Press, Oxford.

Lloyd, L. (2010). The Individual in Social Care: The Ethics of Care and the personalisation Agenda in Services for Old People in England. Ethics and Social Welfare. Vol 4, No. 2.

Kittay, E.F. (2002). When Caring is Just and Justice is Caring: Caring and Mental Retardation, in The Subject of Care: Feminist Perspectives on Dependency, Eds E. F. Kittay and E.K. Feeder. Rowman and Littlefield, Lanham, p257-276.

Navarro, V. (2007). Neoliberalism as a Class Ideology; or, the Political Causes of the Growth of Inequalities. International Journal of Health Services, Vol 37, p47-62.

Rawls, J. (1971). A Theory of Justice. Harvard University Press, Boston. Cambridge, Massachusetts.

Sevenhuijsen, J. (2000). Citizenship and the Ethics of Care: Feminist Considerations on Justice, Morality and Politics. Routledge, London

Waller,M. A. and Patterson, S. (2002). Natural Helping and Resilience in a Dine (Navajo) Community. Families in Society: Journal of Contemporary Human Services, 83(1): 73-84.