An Immanent Critique of Care Ethics

Abstract: The concept of care, imported into bioethics from feminist philosophy during the 1980s, has been upheld by its proponents as a tool for analyzing key problematics of modern technological medicine. Care Ethics, the subdiscipline of bioethics which instrumentalizes this concept of care, styles itself as a corrective to the features of modern medicine which isolate patients, substitute technological fixes for interpersonal concern, and permit unjust treatment. It maintains the core idea that altering interpersonal relations of care is a transgressive proposal with the potential to fix much of what is wrong with modern biomedicine. Care Ethics hinges on the assumption that some kind of ahistorical morality, manifesting in interpersonal relationships and exchanges, can change the material conditions which contextualize those interactions. A stronger focus on these social dimensions of healthcare — what amounts to the concept of “care” — would, Care Ethics claims, eliminate the harsh objectification of persons in biomedicine. Such an approach has largely failed, however, to deliver on those goals. Forty years after the inception of Care Ethics, medicine is, if anything, more isolating, driven by technological interventions, impersonal, and prone to “ethical” blunders in the treatment of people. In this paper I argue that Care Ethics is ultimately an ineffective intervention because it does not capture the dialectical nature of care in medicine, instead essentializing care as a discrete and ahistorical entity. Care is in a dialectical relationship with something like control, the “care” and “control” of medicine are so interrelated as to be inseparable.