Vosman Frans, Niemeijer Alistair
Department of Care Ethics, University of Humanistic Studies, Kromme Nieuwegracht 29, 3512 HD, Utrecht, The Netherlands.
Department of Social Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
Med Health Care Philos. 2017 Dec;20(4):465-476. doi: 10.1007/s11019-017-9766-1.
Care ethics as initiated by Gilligan, Held, Tronto and others (in the nineteen eighties and nineties) has from its onset been critical towards ethical concepts established in modernity, like 'autonomy', alternatively proposing to think from within relationships and to pay attention to power. In this article the question is raised whether renewal in this same critical vein is necessary and possible as late modern circumstances require rethinking the care ethical inquiry. Two late modern realities that invite to rethink care ethics are complexity and precariousness. Late modern organizations, like the general hospital, codetermined by various (control-, information-, safety-, accountability-) systems are characterized by complexity and the need for complexity reduction, both permeating care practices. By means of a heuristic use of the concept of precariousness, taken as the installment of uncertainty, it is shown that relations and power in late modern care organizations have changed, precluding the use of a straightforward domination idea of power. In the final section a proposition is made how to rethink the care ethical inquiry in order to take late modern circumstances into account: inquiry should always be related to the concerns of people and practitioners from within care practices.
由吉利根、赫尔德、特龙托等人（在20世纪80年代和90年代）发起的关怀伦理学从一开始就对现代性中确立的伦理概念，如“自主性”持批判态度，转而提议从关系内部进行思考并关注权力。在本文中，提出了这样一个问题：在现代晚期的情况下，由于需要重新思考关怀伦理探究，以同样批判的脉络进行更新是否必要且可行。引发对关怀伦理学进行重新思考的两个现代晚期现实是复杂性和不稳定性。现代晚期的组织，如综合医院，由各种（控制、信息、安全、问责）系统共同决定，其特点是复杂性以及降低复杂性的需求，这两者都渗透到关怀实践中。通过启发式地运用将不稳定性概念理解为不确定性的呈现，表明现代晚期关怀组织中的关系和权力已经发生了变化，这排除了对一种直接的权力支配观念的运用。在最后一部分，提出了一个关于如何重新思考关怀伦理探究以考虑现代晚期情况的提议：探究应该始终与关怀实践中人们和从业者所关注的问题相关。
