Interview on December 6th, 2010

1. Where are you working at this moment?
Professor of Philosophy at Calvin College, Grand Rapids, Michigan, USA. I will be spending the Spring of 2011 at the University of St Andrews at the Center for Ethics, Philosophy, and Public Policy.

2. Can you tell us about your research and its relation to the ethics of care?
I’ve been working on three issues over the past several years. First, I am interested in human nature—in what it means to be human and how that is related to our accounts of what good human lives look like. These questions are widely discussed in the virtue ethics literature, and I began to be interested in care ethics in part because of significant areas of overlap between the questions being asked in care ethics and those being asked in virtue ethics.

Both theories are focused on human flourishing, and both want to offer a more holistic account of human life than either utilitarianism or deontological ethics. But many (though certainly not all) virtue ethicists tend to trace their theories back to Aristotle without much focus on how excluding women from an account of human nature distorts the resulting theory. As a feminist, I also wanted to work in a theoretical context that incorporated women’s experiences and perspectives into ethics.

My second area of interest has been health care and medical ethics. The field of health care has changed so dramatically in the just the past twenty years that ethical analysis of new technologies and approaches to health is desperately needed. An ethics of care offers a very natural fit with health care, and has been adopted fairly widely in the nursing literature. I’ve worked on analyses of several issues (assisted reproduction, health care policy) from an ethics of care perspective, and plan to do more of this in the future.

Finally I have been interested in the development of an ethics of care—it is still a very new ethical theory (compared to others) and is still in the formative stage. I do think that making care the central focus of an ethical theory is vitally important for getting ethics right, and for developing a theory that is suited to human life (rather than, say, the lives rational disembodied egos might live), and I’ve been impressed with the fruitfulness of care theorists’ examination of the work that society often allocates to women and its potential for providing philosophical insight into basic ethical questions.

3. How did you get involved into the ethics of care?
I read Nel Noddings Caring while I was in graduate school. At the time none of my classes had ever included any feminist theorists, and I found Noddings’ willingness to take women’s experiences seriously both refreshing and theoretically interesting. Most of my work at the time focused on virtue ethics, and (as I mentioned above) virtue ethics seemed problematic because of its blindness to women’s lives. It also tended to ignore power imbalances in social roles.

After reading Noddings’ work, I also started reading Sara Ruddick, Rosemarie Tong, Virginia Held, Eva Kittay, and Joan Tronto, and it seemed as though care ethics was both an exciting new area for ethics as well as a very natural fit for my interest in human nature and health care ethics.

4. How would you define ethics of care?
The ethics of care begins with the recognition that care is fundamental for ethics. By care I mean both the attitude of empathetic attentiveness and the actual practices of caring that people depend on throughout the course of their lives. Care is a crucial part of ethics for several reasons. First, without care, human life is impossible. Care is this a presupposition for all other ethical concerns. Second, without care, ethics is unmotivated. Unless we do care about others’ well-being, ethical principles are meaningless.

Care ethics, as I interpret it, requires an analysis of what sorts of people we need to become in order to be capable of caring relationships, it requires an analysis of interpersonal relationships of care, and it requires an analysis of what social structures support caring relationships, or fail to support them, or make them difficult to maintain. All three levels are important, and without any of them our analysis will be incomplete.

5. What is the most important thing you learned from the ethics of care?
The importance of distinguishing power that is used to abuse and control others from power used to maintain relationships of care and help the self and others to flourish. Many ethical theories begin with the assumption that humans are all relatively equal because the theory has no good way to address imbalances of power. Care theory begins with the recognition that many of our most important relationships are vastly unequal in power, and that that imbalance is not necessarily bad when the power is used properly, as when parents use their authority and knowledge to make sure children grow up healthy and strong, or when health care professionals use their expertise for the sake of the patient’s health.

Obviously these power imbalances can tempt the powerful to abuse their power, but pretending we’re all equal doesn’t address that issue. Care ethics encourages us to analyze what structures and patterns of relationships maintain care and a proper balance of power between agents in a way that offers a better account of uses and abuses than rival theories can offer.

6. Whom do you consider to be your most important teacher(s) in this area?
For the general structure of an ethics of care, I’ve been heavily influenced by Nel Noddings, Virginia Held, and Joan Tronto. They don’t all agree on every detail, but their development of the central ideas in care ethics has helped me think through so many important issues.

Rosemarie Tong, Eva Feder Kittay, and Selma Sevenhuisjen have generated important analyses of specific issues in health care and related fields, and their work on how care ethics can offer concrete moral guidance represents some of the really vital work that care theorists are currently doing.

In terms of epistemological issues, Sara Ruddick and Lorraine Code have both done important work in thinking about how issues of knowledge are affected by our relationships and particular situations—an aspect of care theory I’d like to see developed further.

7. What works in the ethics of care do you see as the most important?

• Nel Noddings, Caring, as well as Women and Evil, and Starting at Home
• Virginia Held, The Ethics of Care: Personal, Political, and Global
• Eva Feder Kittay, Love’s Labor: Essays on Women, Equality, and Dependency as well as The Subject of Care, edited by Eva Feder Kittay and Ellen K. Feder
• Catriona Mackenzie and Natalie Stoljar, Relational Autonomy: Feminist Perspectives on Autonomy, Agency, and the Social Self
• Lorraine Code, Ecological Thinking: The Politics of Epistemic Location
• Joan Tronto’s Moral Boundaries
• Margaret Urban Walker, Moral Repair: Reconstructing Moral Relations After Wrongdoing

This is just a partial list—there are so many good books in this area. But these are all books I find myself pulling off my shelf again and again.

8. Which of your own books/articles should we read?
Connected Lives: Human Nature and an Ethics of Care. This book develops my argument for the need for an account of human nature, human lives, and human social structures in an ethics of care. I’ve also written an occasional paper for the Erasmus Institute at the University of Notre Dame that examines connections between an ethics of care and the Christian theological tradition. That piece is titled “Theological echoes in an ethics of care.” I don’t think there are too many other theorists working across the secular/religious boundary on this topic, so that’s probably worth looking at.

I’m currently at work on a book that uses an ethics of care as a perspective from which to evaluate underlying social structures in health care—the move from a clinical judgment model of reasoning to an evidence-based model of reasoning, for example—and when I get that written, I hope someone will read it!

9. What are important issues for the ethics of care in the future?
Global cooperation—we need ways to think about our lives together as humans that permit international responses to problems like the AIDS crisis, global migration (and exploitation) of workers and the like, and these are issues that can’t just be addressed within the boundaries of particular countries. Virginia Held has done some good work starting to develop this aspect of care theory, and I hope other theorists begin to work in this area as well.

A second issue I’d like to see care ethics working on is the economics of health care. Here in the US we are facing serious economic problems in our health care systems, but almost every health care system around the globe finds itself faced with the problem of how to provide adequate care without generating unsustainable costs. I think care theory has a lot to offer here, in part because of the spiraling costs of health care are due to the fact that we are trying to meet people’s need for care (at the end of life, and at other times) with technology and better medications. But beyond a certain level, care isn’t always enhanced by technology, sometimes quite the opposite. We need to start articulating what care really means in this context so we can make decisions that are both caring and sustainable.

10. In Tilburg our ambition is to promote ethics of care nationally and internationally. Do you have any recommendations or wishes?
One recommendation is to think about how some of these theories might fit with, or illuminate major belief systems such as religion in the West, or perhaps Confucian thought in some Eastern contexts. An ethical theory has more impact when it is clear to people how it connects with some of what they might already believe. There are a few people beginning to explore the areas of continuity and discontinuity between care ethics and Confucian thought, for example, like Chenyang Li, Ann Pang-White, and Li-Hsiang Lisa Rosenlee. Some of my own work, exploring the ways that care ethics might connect with Christian ethics, likewise fits in this category. This sort of work show how an ethics of care can take up and develop central aspects of a tradition in ways that are both theoretically fruitful and helpful for those who belong to that tradition.