Care-Giving and the Moral Impoverishment of Medicine

Care-giving is a foundational component of moral experience – an act of acknowledgement, empathy, and responsibility. But, aside from skilled nursing, rehabilitation efforts by occupational and physical therapists, and the practical assistance of social workers and home health aides, care-giving has little to do with the contemporary practice of medicine.

CAMBRIDGE – Care-giving is understood by economists as a “burden,” by clinical psychologists as a “coping process,” by health-services researchers in terms of health-care costs, and by physicians as a matter of clinical competency. But, for many people, care-giving is a foundational component of moral experience. It is a practice of acknowledgement, empathic imagination, witnessing, responsibility, solidarity, and the most concrete forms of assistance. It is this moral aspect that makes care-givers, and at times even care-receivers, feel more “present” – and thus more fully human.

But, aside from skilled nursing, rehabilitation efforts by occupational and physical therapists, and the practical assistance of social workers and home health aides, care-giving, especially for victims of health catastrophes and end-stage conditions, has relatively little to do with the contemporary practice of medicine.

To illustrate this point, I draw on my personal experience as the care-giver for my wife, who suffers from a severe neurodegenerative disorder that has impaired her memory and motor functions, restricting her independence. I wake her up in the morning, assist her in toileting, bathing, and dressing, make us breakfast, and help her feed herself. I assist her in walking, placing her in a chair, and getting into our car. I am with her nearly all the time to protect her from injuring herself, because she can neither see nor navigate safely on the street or in our own home.

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