Dependency, Difference and the Global Ethic of Longterm Care*

P do not spring up from the soil like mushrooms. People produce people. People need to be cared for and nurtured throughout their lives by other people, at some times more urgently and more completely than at other times. Who is available to do the labor of care and who gets the care they require is contingent on political and social organization. Similarly, norms surrounding both the giving and receiving of care, while dictated in part by the nature of human need, is also conditioned by cultural and ethical understandings and by economic and political circumstances. The distribution of care therefore is a question of justice and the interactions between carer, cared for, and the larger community an appropriate matter of ethical inquiry. Demographic alterations due to birth and mortality rates, migration, and employment opportunities (and expectations) can have a profound impact on the availability and quality of care, and on the distributive questions of who does the caring and who gets care. Furthermore these demographic shifts affect the provision of care on a global level, when those who can pay for care buy the services of careworkers in other parts of the world. Care and dependency, particularly in the form of dependency care have been, are, or are likely to be features of all our lives. By “care,” in the context of this article, I mean the support and assistance one individual requires of another where the one in need of care is “inevitably dependent” that is, dependent because they are too young, too ill or impaired, or too frail, to manage daily The Journal of Political Philosophy: Volume 13, Number 4, 2005, pp. 443–469