The challenge of caring in a capitalist world.

Abstract

This issue contains some great articles about social care. I read them all on Valentine's Day--that one day a year when the media exalts the wonders of love--and found myself wondering why we don't hear more about this intensely moving subject throughout the year. The articles in this issue reveal aspects of deep intimate connectedness and human love hardly of the romantic kind, but rather of the kind social workers take for--social workers whose wide range of health duties is intense, complex, painful, and sometimes overwhelming. One of the most poignant features of the professions today, and of the individuals and families they for, is the cost of too much and of carrying many heavy responsibilities alone. Where is society in such situations? How is it that society expects professionals to solve problems, especially with medical interventions, that our governments, political candidates, organizations, communities, and institutions all effectively ignore? Inappropriate medicalizing of problems occurs simply to obtain resources. With the gaps between rich people and poor people so great in the United States and resources so maldistributed, unbearably heavy responsibilities are imposed on some individuals, families, organizations, and communities. We could do much better. EXPANDING THE MORAL DOMAIN All human beings need to about others--interpersonally, directly, and indirectly--and moral problems arise when some sectors are allowed to escape that humanizing obligation. Caring, according to feminist political philosophers Berenice Fisher and Joan Tronto (1990), is a positive dimension of our lives that has been devalued socially by a capitalist and patriarchal order. Caring has at least fours distinct aspects or phases, represented by different types of thoughts and actions. The first and most fundamental aspect is simple caring about or attentiveness--noticing when another needs (Tronto, 1999). Family affectional ties, example, cue relatives to recognize the needs of dependent members. Similarly, community surveillance systems that are sufficiently sensitive notice the lonely elderly widow and the neglected hungry child. Individuals and social systems together need to about others, both intimates and strangers. The second aspect of is caring for or taking responsibility the of others (Tronto, 1998, p. 16). This aspect of raises questions about obligations, such as who has and whom are they responsible?. Here the recent tragic examples of younger and younger children wielding guns are instructive. After the tragedies, neither parents, other relatives, or even other children could explain how the troubled children felt. And the child protection, education, or welfare systems did not notice, either. A third aspect of is caregiving, or competence, as in having skills and qualities required giving care, or doing actual work (Tronto, 1998). Everyone must develop skills to carry out a responsibility, and sometimes the failure of a responsible party to develop skills is tantamount to avoiding responsibility--for example, a parent is unable to change a diaper, or a hospital provides only emergency to indigent patients. Society, on the other hand, requires licenses the practice of the professions to ensure competence and public confidence. Finally, there is care receiving or responsiveness by the caregiver so that the person cared is safe and comfortable, and the given improves his or her situation (Tronto, 1998). The caregiver must be sensitive to signs of discomfort, receptive to feedback, and willing to change his or her approach. Care systems, including management information and tracking systems, must be designed to respond quickly to changing needs. Institutional systems must be seamless, with self-correcting or user-activated responses. …