Public Policy and the Ethics of Care

Considered here are Eva Feder Kittay's Love's Labor (1999) and Mona Harrington's Care and Equality (1999). Although these books are written from very different disciplinary perspectives, Kittay and Harrington share the conviction that public policy in the United States must be altered to give more support not only to the recipients of care--the young, old, ill, or disabled--but also to those who take care of them. Each presents a thoughtful critique of the individualistic premises of classical liberal philosophy, and offers a persuasive reformulation that incorporates an understanding of human dependency. Each also presents concrete policy prescriptions rooted in that new understanding.

Harrington and Kittay create a wonderfully paired set of books because they support their similar perspectives with radically different materials, a diversity that makes their arguments all the more thought-provoking and convincing. Kittay is a philosopher; Harrington trained as a political scientist and lawyer. At the core of Kittay's work is her contention that John Rawls's theory of justice is deficient because it does not understand that dependency and the need to care for dependents are inescapable aspects of the human condition. The heart of Harrington's work is a provocative interpretation of many of the domestic policy initiatives and political crises of the Clinton administration. Despite their different focuses, the authors share the conviction that philosophy matters to public policy. How we understand the nature of human beings and the principles of justice is reflected in law and social practice, and one of the ways to improve policy is to improve our understanding of the principles of justice.

Kittay argues that the condition of dependency affects not only those persons who are weak, ill, or disabled, but also those who take care of them. Rawls's depiction of the original position fails to recognize that "the conditions of human development, disease, and decline are . . . unalterable, as are the inherent demands of dependency work that prevent the dependency worker from functioning as an unencumbered independent agent" (Kittay 1999, 87). Everyone in the original position must assume that she or he will have such periods of dependency, and may be called upon to do dependency work as well. In making this argument Kittay gives a moving account of her experience raising her profoundly retarded daughter, Sesha; this finely wrought material bears testimony to Kittay's ability to draw significant philosophical conclusions from observation of and reflection on daily life.

Liberal theory's failure to depict properly the nature of individuals embedded in dependency relationships leads to inadequate understandings of what is needed for equality. We cannot achieve equality, Kittay argues, unless we take account of the fact that both dependents and their caregivers will not be able to function in public and economic life as if they were unencumbered agents. We need to "provide conditions that allow others--including those who do the work of care--to receive the care they need to survive and thrive" if we are to have any hope of achieving equality (Kittay 1999, 107; italics omitted).

A well-ordered society--that is, one that sustains its members, provides them the basis for self-respect, and enables them to obtain the means to pursue their conception of the good--must acknowledge that society as a whole has a responsibility to provide care for its members. Kittay analyzes the Family and Medical Leave Act of 1993 and the Personal Responsibility Act of 1996 (the welfare reform act) to show what it would mean to have public policy accommodate caregiving activities. While limited in scope, the Family and Medical Leave Act, requiring employers to grant unpaid leaves for care of a newborn, newly-adopted child, or ill family member, recognizes the imperatives of caregiving. By contrast, the Personal Responsibility Act of 1996, limiting the time period during which mothers in poverty may receive federal aid, turns a blind eye to those imperatives (Kittay 1999, chapter 5).

Mona Harrington, like Kittay, criticizes traditional liberalism for...