The Definition of Care

Defining care has proved not straightforward and some of the critics of ethics of care have, understandably, complained that the ambiguity over the nature of care makes the approach unworkable. One of the most cited definitions of care is that of Bernice Fischer and Joan Tronto:

a species of activity that includes everything we do to maintain, contain, and repair our ‘world’ so that we can live in it as well as possible. That world includes our bodies, our- selves, and our environment.10

That seems a very wide definition and could potentially cover so many activities that it would rob care ethics of a distinctive focus.
The UK Government has used the following definition of a carer:

A carer spends a significant proportion of their life providing unpaid support to family or potentially friends. This could be caring for a relative, partner or friend who is ill, frail, dis- abled or has mental health or substance misuse problems.11

In 2018, the UK Government in its action plan on carers updated the definition:

a carer is considered to be anyone who spends time looking after or helping a friend, family member or neighbour who, because of their health and care needs, would find it difficult to cope without this help regardless of age or whether they identify as a carer.12

There are some notable differences with the more recent definition. First, the 2018 defin- ition seems to apply without any restriction as to the time: a few minutes of care would, technically, fall within this definition. By contrast, the 2008 definition required the carer to show they spent a significant proportion of their life caring. Second, the 2018 definition it is not limited to those who care for adults, but would seem to include child care within the

9 T Pettersen, ‘The Ethic of Care: Normative Structures and Empirical Implications’ (2011) 54 Health Care Analysis 51.
10 B Fisher and J Tronto, ‘Towards a Feminist Theory of Caring’ in D Cheal (ed), Family: Critical Concepts in Sociology (Routledge, 1999), 34.
11 HM Government, Carers at the Heart of 21st-Century Families and Communities (The Stationery Office, 2008), 18.
12 Department of Health and Social Care, Carers Action Plan 2018–2020 (DoHSC, 2018), 4.

definition.13 Third, the 2018 definition is broad in terms of those who receive care. There is no need to show that the person is disabled or ill, as required in the 2008 definition, but simply that they will find it difficult to cope without the care. Finally, the 2008 definition only applied to family members and only ‘potentially’ friends. The 2018 definition clearly covers friends, and indeed neighbours. However, it should be noted that it is designed not to apply to ‘professional carers’.
Other definitions seek to list the kinds of activities which might be regarded as care:

washing, feeding, getting in and out of bed, assistance with toileting, giving medication, changing dressings, giving injections or catheritistaion, dealing with incontinence, as- sisting with paperwork and personal business including managing money, negotiation and liaison with ‘professional’ caring agencies and staff, providing transport and undertaking household tasks.14

As is clear from the definitions discussed so far, there is dispute over the extent to which care should be seen as a practice, a value, or a virtue. It is perhaps best understood as a combination of these. Virginia Held15 has suggested that care is best seen as a cluster of practices and values. Tronto appears to take a similar approach and identifies four sub-elements of care: (1) attentiveness, aware of need; (2) responsibility, a willingness to respond and take care of need; (3) competence, providing effective care; and (4) responsiveness, considering the views of others and avoiding abuse.16 Developing these and other writings, I have devel- oped an approach to defining care as being categorized under four key markers:17
• meeting needs;
• respect;
• responsibility; and
• relationality.

These may be exhibited in different degrees. While not providing a definition as such, they provide an indication of the extent to which an activity is or is not care. Where all four markers are clearly present, there is undoubtedly care. When these markers are shown to a lesser extent, the behaviour moves away from the central understanding of care. The terms need further explanation.