The Ethics of Care and the Newfoundland Paid Family Caregiver Program: An Assessment

By Murphy, Maggie FitzGerald | Canadian Review of Social Policy, January 1, 2017 | Go to article overview

The Ethics of Care and the Newfoundland Paid Family Caregiver Program: An Assessment


Murphy, Maggie FitzGerald, Canadian Review of Social Policy


Introduction

The province of Newfoundland and Labrador is facing significant challenges in terms of the provision of long-term care for the elderly population. Critical gaps in long-term care services, particularly in rural areas, have resulted from a combination of factors, including shifts in demographic patterns, out-province migration, the decay of the traditional male breadwinner model, and ongoing cuts in social services (Botting, 2001; Government of Newfoundland, 2012). In response to this problem, the provincial Conservative government initiated a program allowing eligible home support clients to pay family members for some personal care and behavioural support services. This program is called the Newfoundland Paid Family Caregiver Program (NPFCP). The pilot project for this program commenced on March 24, 2014.1

This paper examines the NPFCP using a critical ethics of care lens. What is uniquely 'critical' about the ethics of care as used in this analysis is that it emphasizes the importance of locating care within the context of the wider institutions and structures which shape the global order; understood in this way, relational thinking can assist us in exposing the often hidden values and norms which reinforce and reproduce established exclusionary social practices and attitudes. [A critical ethics of care] attempts to show that, when taken as part of a larger, criticalrelational approach to moral exclusion, care transcends its perceived limitations as an ethics which is relevant only in the context of physically and emotionally close personal relationships (Robinson, 1999, p. 110-1).

The analysis put forward here reveals several salient points about this program. It highlights how this program is (re)shaping caregiving, care receiving, and care work by allocating the responsibility for care to the family and (back) into the private sphere. This, it is suggested, indicates that the program works to perpetuate the characterization of care as a private concern. This normative and critical assessment of the NPFCP also explores the consequences of the targeted structure of the program. Lastly, the analysis illuminates how the program fails to consider the wider contexts, including systems of oppression, domination, and exploitation, in which all relations of care reside. This is problematic, for we do not have a full account of people's caring needs if we abstract them from their relationships and circumstances. Based on these issues, the paper concludes that the NPFCP may be failing to facilitate quality, competent, consistent care, and calls for further research in order to explore the consequences of such failures.

Finally, before proceeding to the analysis, a note on normative policy analysis is necessary. There are several approaches to policy analysis; Pal (2010, 19) explains that each approach is based on a type of reasoning. For instance, legal assessments look at public policy through the prism of law, while logical analyses interrogate the inherent consistency and coherence of a policy (Pal 2010, 20). Normative policy analysis, on the other hand, evaluates a policy in reference to a set of basic moral values (Pal 2010, 20). Such analyses provide an important lens from which to understand social policies because not only do they help reveal the (often implicit) normative assumptions embedded in our social policies, but they also create space to consider critically these normative standards themselves. In other words, normative policy analysis encourages reflection and dialogue on the ethical dimensions of specific policies as well as the larger ethical frameworks and sets of values that inform our lives. Such dialogues are necessary if we are to deliberate on our policies and ethical frameworks so that both can be made to better reflect the values we want to shape our lives.

Given that the NPFCP shapes the material lives of its clients (as well as those of their caregivers), the ethics of care provides a unique ethical lens from which to evaluate the program. …

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