Dr. Swamy Donè, University of Verona
The Ethics of Care as Relationship
What does it mean to care for an aging parent in a world where time is scarce and care robots are on the rise? Care is no longer just a private concern – it’s becoming one of the great ethical and political challenges of our time.
This contribution explores the concept of “care” as a relational practice, focusing in particular on elder care and its significance in today’s world. The text briefly examines Italian legislation on the matter, references new technologies in the field of assistance, and finally reflects on ethics and responsibility. The aim is to combine a specific philosophical thought with “care.” In fact, when it comes to care between human beings, it is essential to first question the meaning of relational action and the relationship itself. According to a specific line of thought – particularly the ethics of relationship developed by the Italian philosopher Adriano Fabris – action and relationship are interconnected: «action itself is the becoming of relationships»[1]. For this reason, distinguishing between an “I” and a “you,” or an “I” and the community, becomes redundant: rather, there is a transcendence of dualisms, since action, in this view, is not something individuals do alone – it rather happens through our connections with others. When we care for someone, the relationship itself becomes the action.
This dynamic, which might initially seem abstract, involves and calls for an ongoing effort and a concrete process of mutual recognition between the “nodes” of the relationship – that is, the participants in the care relationship: to recognize another person not only affirms their existence as an essential “node” in the relationship – a key part of it – but also ensures that the one who recognizes is, in turn, recognized, as the Hegelian lesson teaches us. It could not be otherwise: belonging to a relationship, in which every distinction dissolves, necessarily requires the presence of people, or “nodes”. Their being itself is therefore fundamental for the very existence of the relationship. To consider the relationship as “the original” thus means dealing with relationships of recognition, through which value and meaning are attributed to the other: «it is a universal and abstract notion under which different concrete forms of intersubjective relationship can be gathered»[2].
Legal and Social Recognition of Caregivers
Given these premises, as already mentioned, our goal here is to consider the concrete mode of intersubjective relationship in caregiving, which indeed involves what we called “nodes”, namely the caregiver and the care recipient. Before exploring this particular relationship, it is important to emphasize that the term “caregiver” is of recent introduction, appearing only in 1990.
This fact raises a significant issue: the recognition – by no means incidental – of the social, cultural, and other importance attributed to those occupying this role. But how can someone be recognized in a role that has not yet been fully conceptualized or understood? It is worth noting that, with regard to the Italian State, the figure of the “caregiver” was introduced only in 2018[3]. A necessary aside: the caregiver, as the term itself suggests, is generally understood as the one who provides care, while the caretaker as the one who receives it.
However, this distinction applies only on a concrete and specific level, such as the legislative one, since – as already stated – care itself must be actually understood as a network, a relationship, in which relational action constitutes the care itself. The concept of “mirroring” may serve as a useful tool for understanding this issue: through mutual gaze, one enters into resonance with the other, recognizing and affirming their shared humanity. Ultimately, the relationship is the essence of care itself, without which caregiving could not exist.
Technology and the Future of Recognition
It is no mystery that the average age of the population is increasing and that the number of elderly people is steadily growing. These data inevitably challenge the capacity of caregiving relationships: it is enough to consider that elderly care facilities, increasingly sought after and in demand, cannot guarantee a 1:1 ratio between staff and residents. Currently, this problem is partly solved by informal caregiving, carried out by relatives and friends, although it involves significant risks of burnout.
However, in the near future, even this solution may not be sufficient: population aging could reach a level that would make it numerically impossible to ensure a direct and personalized caregiving relationship, especially in informal care settings. In this context, the digital age has provided the opportunity to address this gap through the use of robots in elderly care. Countries like Japan, Ireland, and Finland have explored this possibility, proposing the use of robots in elderly care and considering key factors such as familiarity with such technologies and the ethical acceptability of their use.
However, such a scenario would challenge the recognition relationship outlined so far, as a “human node” or partner in the relationship would be replaced by a “technological node”. Far from wishing to consider the use of these machines in this context, the goal is rather to reflect on the change that the caregiving relationship will likely face in the near future. While robots may provide valuable support in care settings, they cannot replace the human gaze, touch, or presence—those very elements through which recognition occurs. It is undeniable that caregiving work is transforming, in line with the socioeconomic changes of the society in question. On one hand, one could ideally consider the Amparo de los Viejos as the oldest “nursing home” in Europe, established in Seville in 1355; on the other hand, in Italy, it was not until 1988 (cf. the 1988 Financial Law, specifically Article 20) that there was a significant shift in the field of elderly care facilities.
This means that, previously, elderly people were considered fragile and marginalized, like other vulnerable groups, without recognition of their specificity. Furthermore, elderly care was perceived as a private issue, without any real social recognition. Over time, this condition has slowly changed: aging has moved from a private and personal matter to a public issue; what became a public concern is now transforming into a heavy challenge for both the public system and families, as well as the private sector. Not only that, but if the system of time allocation – the specific time that hospital and elderly care facilities devoted to each resident (also used as an indicator of service quality) – was already problematic, it seems that in the near future, this will become a secondary issue, given the increasing shortage of available caregivers.
Considering the issue through the lens of responsibility, drawing from Hans Jonas’s philosophy, it quickly becomes clear that the problem is not solely in the public and private spheres, but extends to a universal level, involving all of humanity, across time and space.
Responsibility Across Generations
The issue raised, then, is that of a possible new configuration of the recognition relationship. It would be natural to think that with aging, the relationship undergoes a transformation, but in some cases, it risks not developing at all: the elderly person may appear distant, rigid in a consolidated identity and a way of being now considered definitive. However, this rigidity risks completely distorting recognition, much like the change that could be brought by the introduction of caregiving robots. What should instead remain is the «movement of aging»[4], that is, the continuous possibility of the making of the relationship and time, which allows for the unfolding of ever-new horizons.
It is in this dynamic that an ethics of relationship and responsibility can be strengthened: the ethical perspective is rooted in caregiving relationships, serving both the individual and the community, not emptied and considered as an abstract entity, but understood as a living relational network. A network that operates not only in the here and now but also projects itself into the future. In this sense, then, ethics and morals would essentially coincide: following Paul Ricoeur, ethics refers to actions deemed good to perform, while morals have a mandatory and universal character. These two dimensions converge in recognition, understood as «an original and foundational experience that ‘enters’ our character and orients our practical dispositions until it becomes a ‘second nature,’ an almost-natural habit, by which, in front of others, we experience moral feelings and obligations»[5].
Over time, recognizing others becomes part of who we are – something we do instinctively, like feeling responsible for the well-being of elderly loved ones. Drawing on Aristotle, the dwelling place of human beings is, therefore, that of ethics and relationships, materializing in the recognition relationship, now extended across different generations and geographical positions. In order for aging not to be ignored or relegated to the margins, it is necessary to claim this making of the relationship from an ethical perspective, capable of embracing both the present and the future. Caregiving, then, is not simply a task – it is a way of being in the world. In recognizing the other, we affirm not only their dignity, but our own. As societies age, the challenge is not merely to provide care, but to preserve human relationships.
[1] «l’agire stesso è il farsi delle relazioni». FABRIS A., RelAzione: una filosofia performativa, Brescia, Morcelliana, 2016, p. 159, my translation into English.
[2] «si tratta di una nozione universale e astratta sotto la quale possono esser raccolte differenti modalità concrete di relazione intersoggettiva». CORTELLA L., L’ethos del riconoscimento, Roma-Bari, Laterza, 2023, p. 7, my translation into English.
[3] Cf. Budget Law of 2018, specifically Law 27/2017. Specifically, Article 1, paragraph 255, of Law 27/2017 defines a “family caregiver” as the person who assists and cares for their spouse, the other partner in a civil union between same-sex individuals, or a cohabitant according to Law 20 May 2016, No. 76, a family member or relative within the second degree, or, in the cases specified by Article 33, paragraph 3, of Law 5 February 1992, No. 104, a family member within the third degree who, due to illness, infirmity, or disability, including chronic or degenerative conditions, is not self-sufficient and unable to care for themselves, is recognized as invalid and in need of global and continuous long-term assistance according to Article 3, paragraph 3, of Law 5 February 1992, No. 104, or is entitled to accompaniment benefits under Law 11 February 1980, No. 18 [emphasis added]. Later, in 2019, with Draft Law 1461 “Provisions for the Recognition and Support of Family Caregivers,” the text of Law 27/2017 was revised. In Article 2 of the draft law, concerning the definition of a caregiver, it states: «A family caregiver is defined as the person who voluntarily assists and continuously cares for their spouse, the other partner in a civil union between same-sex individuals, or a cohabitant according to Law 20 May 2016, No. 76, a family member or relative within the second degree, or, in the cases specified by Article 33, paragraph 3, of Law 5 February 1992, No. 104, a family member within the third degree who, due to illness, including oncological conditions, infirmity, or disability, including chronic or degenerative conditions, is not self-sufficient and unable to care for themselves, is recognized as invalid and in need of global and continuous long-term assistance under Article 3, paragraph 3, of Law 5 February 1992, No. 104, or is entitled to accompaniment benefits under Law 11 February 1980, No. 18» [emphasis added]. Presented to the Senate on 7 August 2019, the text is currently under examination by the commission as of 28 July 2020.
[4] «movimento dell’invecchiare». Cf. FABRIS A., RelAzione: una filosofia performativa, cited., p. 52, my translation into English.
[5] «un’esperienza originaria e fondante che ‘entra’ nel nostro carattere e orienta le nostre disposizioni pratiche fino a diventare una ‘seconda natura’, un abito quasi-naturale, grazie al quale di fronte agli altri proviamo sentimenti e obblighi morali». CORTELLA L., L’ethos del riconoscimento, cited, p. 10. My translation into English.