No Place Like Home?
Feminist Ethics and Home Health Care
Publication Year: 2003
"No Place Like Home? combines the rigorous scholarship of an academic feminist philosopher with the 'close to the ground' insights that come from bathing, feeding, and caring for older people as a home care aide. This book develops recent work in feminist philosophy that attends to both care and justice to propose a way to reform home care to reduce its exploitative qualities while assuring that it is more than 'bed and body' work." -- Martha B. Holstein, Visiting Scholar, Center for Research on Women and Gender at the University of Illinois, Chicago and co-editor, Ethics and Community Based Elder Care
"For a scathing critique of how American society abuses both those who receive home-based care as well as those who provide it, and a sophisticated vision of how we might move toward a more just future, there's no book like No Place Like Home?." -- James Lindemann Nelson, co-author of Alzheimer's: Answers to Hard Questions for Families
critique of current practices and institutions is thorough and accurate, benefiting
both from her own experience as a homecare worker and the philosophically
sophisticated tools she brings to bear on it." -- Laura Purdy, Professor of
Philosophy, Wells College
In this provocative new book, Jennifer A. Parks analyzes practices in the home health care industry and concludes that they are highly exploitative of both workers and patients. Under the existing system, underpaid workers are expected to perform tasks for which they are inadequately trained, in unreasonably short periods of time. This situation, Parks argues, harms workers and puts home health care patients at risk. To the extent that the majority of patients and workers in home health care are women, she turns to feminist ethics for an alternative approach. Through an understanding of individuals as social beings with obligations to others, and of home health care as a public good, Parks explains how to develop the social benefits of good home health care and increase the role of government in providing financial support and regulatory oversight.
Published by: Indiana University Press
Series: Medical Ethics
This book could not have been written without the input and support of certain key persons and institutions. I would like to thank Loyola University for funding my summer research in 1999; the paper I wrote that summer went a long way toward developing my thinking on ethics and home health care. I am also grateful to Jim and Hilde Lindemann Nelson...
This book on home care has been a work in progress for almost eleven years. I became interested in writing on the theoretical ethical issues in home care only six years ago, but I had been a home care aide for five years during my graduate education. Indeed, it was as a home care worker,and not as a philosopher, that I learned most about the ethics of home care, for I experienced in the field the best and worst aspects of caretaking. The...
1. Why Home Care? The Genesis of Home or “Community-Based” Care
The answer to the question “Why home health care?” involves a panoply of considerations. This chapter will treat the rising popularity of home care, that is, the circumstances that have led to its ascendancy through the 1980s and 1990s, and what I see as the largely exploitative bases for its practice. Throughout this chapter and the rest of the book, I will treat home...
2. Examining Philosophies of Home Care
The preceding chapter detailed home health care as it is currently practiced. As I indicated, home care is premised on the notion that it is a cheaper alternative to institution-based care, that people prefer to be cared for in their homes rather than in institutions, and that home care services must follow the example of the broader U.S. managed care system....
3. Women’s Care Work as a Subsidy to the State
In chapter 1, I argued that the home care system, in its current state, is morally lacking: It is founded on the broader system of managed care in the United States and is informed by the value of acute care that infuses health care practice at the macro level. Chapter 2 concerned the philosophy of home care and argued that there are competing and warring...
4. Caring about the Cared-For
The previous three chapters have considered ethical issues in home health care with regard to caretakers. As I have argued, home health care is founded on the free and low-cost care labor provided by women. Ideologies that connect family with the private sphere, and that treat home care issues as private family matters, result in the depoliticization of its practice. Yet if...
5. The Personal Is Political: Negotiating Relationshipswithin the Home Care Setting
As I argued in chapter 4, a feminist conception of relational autonomy best characterizes the home care relationships between clients, families, and paid caretakers. But such a conception of autonomy also impacts the moral judgments we make about home care. If human beings are, as feminists claim, interdependent beings, and if our very identities come out...
6. Looking Ahead: Can Home Care Be Reformed?
This chapter is perhaps the most important in this book. It lays the grounds for what I take to be a minimally decent system of home health care. In light of the criticisms I have leveled against home care in its current condition, I will herein consider what needs to be done to make the home care enterprise an ethical one. The arguments I construct will come from...