Bruce Jennings

This chapter discusses the notion of “care” as a supporting ethical rationale for policies and efforts to mitigate and adapt to global climate change. A conception of care as paying attention to the moral dignity, standing, and needs of others is presented. It then asks how care, so understood, can contribute to a new understanding of the appropriate relationship between humans and nature. How can ecological care and recognition avoid the pitfalls of a human-centered (anthropocentric) understanding of that relationship and provide instead an understanding based on the symbiosis and interdependence of humanity and the broader web of all life and the planetary systems on which it relies? Philosophical, ethical, and political challenges posed by climate governance and climate action are discussed. Using a relational mode of normative theorizing, the chapter identifies what may be emerging as a new worldview or political morality centering around social practices of right recognition. Two examples of recognitive and relational practices are discussed from the point of view of bridging social ethics and ecological ethics: care and solidarity.

This chapter discusses system design issues in end-of-life care. Two basic approaches to system design have prevailed since the 1970s—an autonomy and patient empowerment strategy and a quality of life model of palliative and holistic care. The chapter examines practical and conceptual problems arising in these two strategies. It discusses an emerging alternative system design with emphasis on relationality and communication concerning the goals of end-of-life care. In this relational and communicative design, the use of life-sustaining medical treatments may not fall prey to the technological imperative. Caregiving services can be appropriately managed and provide continuity of care across the trajectory of incurable, progressive chronic illness, especially during the last year or two of life. Hospice and palliative care programs, suitably reorganized and financed, will play a key role in that new system design.

ABSTRACT:Democracy—as a form of governance, a moral community, and a way of life—is under great stress. The prospects for democracy and bioethics are linked because bioethics relies on an open society and a democratic cultural environment in order to flourish. For its part, democracy can be restored and strengthened by widespread cultural and psychological support for the values of mutual recognition, equal dignity and respect for persons, and solidarity, interdependence, and the common good. Promoting values such as these is in keeping with the founding vision of bioethics, which was a civic vision. At the present time, bioethics can and should continue to be a bioethics for democracy by engaging directly in civic learning and civic place-making. These have a significant impact on health as well as on democracy.