The Bioculture of Caregiving: A Commentary on "Biocultures"

Abstract

It may surprise readers, but caregiving has relatively little to do with medicine. The two helping professions that have made caregiving central to their knowledge and practice are lower in status: nursing and social work. The real experts in caregiving are usually lower still on status ladder: families and sick or disabled themselves. Caregiv ing is, at existential core, a primary quality of what it means to be human. It is telling that it seems inversely correlated with status. I will return to caregiving as a concept for applying a biocultural approach to medical humanities, after I have set out my own way of thinking of biocultural processes and how I see papers in this special issue contributing to humanistic studies of science and medicine Life overflows with many things, yet much of it is about danger and uncertainty. Financial pressure, job problems, accidents, chronic illness, man-made and natural disasters, disappointments in relationships and careers, and fears and anxiety they induce affect just about all of us?the poor most of all. In spite of claims (and splendid achieve ments) of scientists, physicians, and asset managers, most of what is now described as risk management concerns unknowable, unpredictable, and uncontrollable dangers, ordinary and extraordinary, that make liv ing uncertain and very serious. The progressivism central to hyping of science and medicine is balanced by a humanities perspective that is more realistic about disappointment and defeat. In an ethnographic and social-historical sense, one that seems to perplex philosophers, life is moral because living turns on most serious questions of what really matters and what to do.1 These are lived values that define what moral experience means for people in a local world and what moral life is about for individual. The moral, in this existential sense, connects affect with social life, physiology with culture, illness and disability with politics and economics, and medicine with life. Here the moral?the lived values of groups and individuals?is different than ethics?what laypersons and professionals aspire toward in way of doing good, being just, and so on. Thus moral can in practice be injuring or outright destructive.