-
4 An Ecological Ethic
- Johns Hopkins University Press
- Chapter
- Additional Information
70 Ecological thinking allows us to trace the structures and processes that organize long-term care labor and connect people around the world: the elderly and their loved ones (mostly daughters ) in the North; the poor women, increasingly from the South, who support them; and people needing care in source countries. By starting from interconnections and surveying interrelated social and geographical landscapes, we can see more precisely how, under the current organization of long-term care labor, these groups are imperiled and how care resources, revalued as exports under contemporary global economic models, are flowing away from countries in the global South toward affluent countries like the United States and their citizens with long-term care needs—who are in many cases far from flourishing; and we can see how ultimately this arrangement stands to benefit international lenders and for-profit health care and recruitment corporations and their shareholders. Resisting reductive and fragmented analyses of “discrete, disparate beings, events, and items in the world . . . only subsequently to propose connections among them or to insert them into ‘contexts’ conceived as separately given” (Code 2006, 7), ecological thinking suggests new ideas about responsibility for global health equity. Specifically, it helps to shine light on the precise nature of harms CHAPTER FOUR An Ecological Ethic An Ecological Ethic 71 done and their operations, and in turn on the sources and the aims of responsibility. In this chapter I explore how responsibilities—diverse in their nature and extent—to address harms flow from the nature of the relationships that obtain between governments, international lending bodies, the for-profit sector, and the other agents situated in the global structures that organize long-term care work. I argue that the grounding of responsibility can be found not merely in shared humanity, compassion, and participation in the processes that generate injustice but also in our nature as interdependent beings who are, in a profound sense, constitutive of one another. Indeed, the social connections between us—“across distance” as they are often framed—are even tighter than most theorizing about global justice acknowledges. I also want to suggest that, thinking ecologically, the focus of responsibility shifts from individual agents toward ecological subjects , beings who are situated temporally, spatially, and socially and who need particular kinds of habitats in which to become and endure . The idea I argue for, in essence, is that justice in long-term care—and perhaps, also global health equity more generally—calls for ethical place-making for ecological subjects. Long-term Care and Structural Injustice As noted at the end of chapter 3, there is no shortage of ways to describe the wrongs done by the existing organization of long-term care. With the benefit of ecological epistemology we can see more clearly the complexity of the social processes and structures that cause harm in patterned and particularized ways and their operations over time. Structural injustice “exists when social processes put large categories of persons under a systematic threat of domination or deprivation of the means to develop and exercise their capacities, at the same time as these processes enable others to dominate or have a wider range of opportunities for developing and exercising their capacities.” The ethical concern is not merely that structures constrain; “rather the injustice consists in the way [3.235.199.19] Project MUSE (2024-03-19 12:16 GMT) 72 long-term care, globalization, and justice they constrain and enable, and how they expand or contract . . . opportunities” (Young 2006, 114). Social structures serve “as background conditions for individual actions inasmuch as they present actors with options; they provide ‘channels’ that both enable and constrain. These constraints and enablements occur not only by means of institutional rules and norms enforced by sanctions but also by incentive structures that make some courses of action particularly attractive . . . or make other courses of action particularly costly” (Young 2004b, 9).The people described here, especially those in source countries whose health care systems are failing, are harmed not merely because resources are inequitably distributed or because their self-determination is constrained, or because their equal moral worth is denied or, more broadly, because their welfare interests are threatened. More precisely , they are harmed by the ways in which they are situated amid social norms and economic structures, institutional rules, incentive structures, and sanctions, decision-making processes and routines of interaction, and by the ways these serve systematically to expand opportunities for some while contracting them for others (Young...