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群体之家作为道德实验室:追踪荷兰智障人士护理中的自主伦理。

The group home as moral laboratory: tracing the ethic of autonomy in Dutch intellectual disability care.

机构信息

Department Citizenship and Humanisation of the Public Sector, University of Humanistic Studies, Kromme Nieuwegracht 29, 3512 HD, Utrecht, The Netherlands.

Department Care Ethics, University of Humanistic Studies, Utrecht, The Netherlands.

出版信息

Med Health Care Philos. 2021 Mar;24(1):113-125. doi: 10.1007/s11019-020-09991-y. Epub 2021 Jan 4.

Abstract

This paper examines the prevalence of the ideal of "independence" in intellectual disability care in the Netherlands. It responds to a number of scholars who have interrogated this ideal through the lens of Michel Foucault's vocabulary of governmentality. Such analyses hold that the goal of "becoming independent" subjects people with intellectual disabilities to various constraints and limitations that ensure their continued oppression. As a result, these authors contend, the commitment to the ideal of "independence" - the "ethic of autonomy" - actually threatens to become an obstacle to flourishing in the group home. This paper offers an alternative analysis. It does so by drawing on a case study taken from an ethnographic study on group home life in the Netherlands. Briefly put, the disagreement stems from differing conceptualizations of moral life. Put in the vocabulary of moral anthropologist Cheryl Mattingly, the authors propose to approach the group home more from a "first-person" perspective rather than chiefly from a "third-person" perspective. They then draw on Mattingly to cast the group home as a "moral laboratory" in which the ethic of autonomy is not just reproduced but also enacted, and in which the terms of (in)dependence constantly get renegotiated in practice. What emerges is not only a new perspective on the workings of the "ethic of autonomy" in the group home, but also an argument about the possible limitations of the vocabulary of governmentality for analysing care practices.

摘要

本文考察了“独立”理想在荷兰智障人士护理中的流行程度。它回应了一些学者通过米歇尔·福柯的治理词汇来审视这一理想的学者。这些分析认为,“成为独立”的目标使智障人士受到各种限制和约束,从而确保他们继续受到压迫。因此,这些作者认为,对“独立”理想的承诺——“自主伦理”——实际上有可能成为群体之家繁荣的障碍。本文提供了另一种分析。它通过借鉴来自荷兰群体之家生活民族志研究的一个案例研究来做到这一点。简而言之,分歧源于对道德生活的不同概念化。用道德人类学家谢丽尔·马丁利的话来说,作者建议更多地从“第一人称”的角度而不是主要从“第三人称”的角度来接近群体之家。然后,他们借鉴马丁利的观点,将群体之家视为一个“道德实验室”,在这个实验室中,自主伦理不仅被复制,而且被实施,并且(独立)的条件在实践中不断重新协商。由此产生的不仅是对群体之家“自主伦理”运作的新视角,而且是关于治理词汇分析护理实践可能存在的局限性的论点。

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