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6 October 2021updated 27 Sep 2023 12:51pm

Why nation states struggle with social care

Love and care are at the heart of our moral commitments, but they do not fit neatly into the social contract model of political community.

By Alison Gopnik

The pandemic has made the importance of care especially visible. A father stays home all day looking after children who can’t go to school. A daughter has to figure out how to protect her vulnerable mother. And the underpaid, overworked caregivers in nursing homes explain their heroism in terms of their relationship to the specific people they care for – “I couldn’t abandon old Mr Smith.”

Individual relationships of care like these have always been at the heart of some of our deepest moral commitments. But they don’t fit neatly into the standard political frameworks we use to organise our societies, and caregiving has received much less philosophical attention than it should. (Of course, the fact that women have mostly been the caregivers and men the philosophers may also have had a lot to do with it.)

Traditional philosophical approaches to morality are universalist – they apply to everybody equally. The classic division is between “utilitarians” like John Stuart Mill, who argue that we should try to produce the greatest good for the greatest number of people, and “deontologists” like Immanuel Kant, who argue that we should respect universal laws, such as “do not lie”, regardless of the consequences.

A particularly important idea in the utilitarian tradition is the “social contract”. Individual agents try to achieve their goals and, as economists say, “maximise their utilities”. But it turns out we have a better chance of achieving our goals if we agree to trade off our own interests with those of others: ie, I’ll help you get what you want, if you return the favour. These kinds of reciprocal “tit for tat” arrangements make everybody better off than they would be otherwise.

Philosophers, psychologists, political theorists and even mathematicians and evolutionary biologists have used the social contract to explain human morality. Market economics and political democracy, the great inventions of the Enlightenment, expand the logic of individual social contracts to the scale of a city, a nation and even a planet, with important benefits for everyone. You could think of markets and states as a kind of software that allows a large community to aggregate and balance all the disparate individual interests within it, and so to implement the social contract.

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Yet in spite of their strengths, universalist approaches to morality and politics have a hard time dealing with the particular relationships between caregivers and the people they care for. Utilitarianism and deontology leave out our close, immediate, local attachments and commitments – they leave out love. But love and attachment are central to relationships of care. They explain why that particular father cares for his particular helpless baby, why that particular daughter cares for her ageing mother, or why we care for our particular friends, patients, students, colleagues and neighbours.

The social contract, as we have seen, assumes that agents are independent, autonomous, reciprocal decision-makers exchanging goods. But the close attachments that underpin care have a very different structure than contractual relationships. They don’t even implicitly demand reciprocity. When we care deeply for another person, we are no longer just one individual agent with one set of values and interests. Instead, a parent or a partner, or even a good friend, is a person whose self has been expanded to prioritise the values and interests of another, even when those values and interests are different from their own.

Relationships of care may also go beyond adopting the goals of another person. The morality of being a parent is about taking a creature who isn’t autonomous, doesn’t yet have goals and can’t make their own decisions and turning them into someone who can, and the same is true, in a milder way, when we mentor a student. We want our children or our students to be able to formulate and achieve their own independent goals, rather than achieving the goals we think they should have. Caring for the elderly or the ill requires a similarly delicate and difficult balance between taking responsibility for the welfare of another person and respecting their autonomy.

Finally, there is a basic asymmetry in relationships of care that doesn’t fit the social contract model. Parents and other caregivers look after their children with little thought of return, and this is also true when we tend the ill or the old. Think about a mother caring for a child with a severe disability, or a husband caring for his wife with Alzheimer’s. Relationships like these are the most vivid examples of love, care and commitment, precisely because they are so asymmetric. And while the asymmetry of caring relationships rules out the mutual benefit of “tit for tat” contracts, they clearly contribute to the common good.

Since relationships of care are so different from contractual relationships, caregiving doesn’t easily fit into market frameworks. The contractual picture assumes that goods are interchangeable, and this exchangeability explains the success of markets in so far as it allows us to trade off what we want with what others want. But caring and commitment are intrinsically local. We can’t swap out one unit of care or commitment for another. We can’t outsource love or ship it across a country. In fact, we have a strong sense that it is morally wrong to treat close relationships like market commodities. And in a market-driven world, this means relations of care are hidden away as part of a private, domestic sphere that becomes hard to measure or support. 

From the market perspective, using your resources to support children or elderly parents or a sick spouse or a friend becomes simply one more kind of consumer spending. Either parents and other caregivers must forgo work and lose income to find time to care for their dependents, or else find enough money out of their own salary to pay other people to. Either way, the cost of care is completely borne by the person doing the caring.

If the market doesn’t naturally support particular, local, caring relationships neither does the state. There are many valuable goods, from security to healthcare and education, that we don’t leave to markets. Instead, states pay trained professionals – soldiers or doctors or teachers – to provide these services equally to all their citizens. But these same states just don’t dedicate the same level of funding and resources to care.

This is at least partly because relationships of care don’t lend themselves to professionalisation. If caring for children were just a job, another kind of work, we might feel that paid experts ought to do it, rather than parents themselves. But there is something special about the relationship between parents and children, and carers and those they care for. Parents have a special authority over, interest in and responsibility for what happens to their children, and grown children have a special responsibility for elderly parents. And the same is true for partners and friends.

[See also: Can authoritarianism ever be justified?]

Are there different ways to approach the morality and politics of care? Asian philosophical traditions provide alternative ways of thinking about morality that recognise its roots in close relationships. For Confucian philosophers like Mengzi, morality starts with our feelings for our parents, siblings or children rather than with the social contract. The challenge in these traditions is to figure out how to expand these local feelings to the scale of a country, the way that markets and states expand the social contract.

There may be ways to expand the caring impulse beyond the immediate family. Yet figuring them out will take some imagination. Americans are finally receiving the family allowance cheques that more progressive countries have issued for years, and parental leave is part of Biden’s American Families Plan. Marriage is also one of the few political institutions that recognises love, but it has traditionally been limited to sexual and erotic ties – not exactly the most reliable form of commitment. That said, allowances, parental leave and marriage do allow the entire society to support individual relationships of care, so they provide direction going forward.

Imagine expanding family allowances, parental leave and marriage to include support for designated carers of elders or friends, or to allow adults who aren’t biological kin, like traditional godparents, to commit to children. Universal public childcare and eldercare is another good idea, but it too faces the tension between local attachment and impersonal professionalism. Imagine designated and supported childcare centre “grandparents” in addition to teachers, or designated nursing home “grandchildren” in addition to doctors and nurses – individual carers who are committed to individual people in need, even if they aren’t biologically related to them.

Caregiving is complicated both philosophically and politically. But care and commitment, and love and loyalty, are morally valuable if anything is. And they increase the collective good, even if they do it in a very different way than the social contract. We would give up our lives for the people we love. In fact, we do give up our lives for them, in large and small ways, every day, and that very fact makes those lives worth living. We shouldn’t just leave love to songs and sermons, but give it the philosophical and political attention it deserves.

Alison Gopnik is professor of psychology at the University of California, Berkeley. She is the author of “The Philosophical Babyand “The Gardner and The Carpenter”.

This article is part of the Agora series, a collaboration between the New Statesman and Aaron James Wendland. Aaron is vision fellow in public philosophy at King’s College, London and a senior research fellow at Massey College, Toronto. He tweets @aj_wendland.

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