UNIT-4

Theories of Care: towards health and medical care

Theories of care in the context of health and medical care refer to frameworks and
perspectives that guide how individuals and healthcare professionals approach the delivery of
healthcare services, the treatment of patients, and the overall well-being of individuals and
communities. These theories provide a foundation for understanding and improving the
quality of care in healthcare settings. Here are some key theories of care in the field of health
and medical care:

1. Biomedical Model of Care: This traditional model focuses on diagnosing and

treating diseases and medical conditions. It views the body as a machine and aims to
restore physical health through medical interventions. While effective for many
conditions, critics argue that it can be reductionist and overlook the psychosocial
aspects of health.

2. Patient-Centered Care: This theory emphasizes the importance of involving patients

in their care and decision-making. It considers patients' preferences, values, and
needs, aiming to provide care that is respectful, compassionate, and tailored to
individual circumstances. Communication and shared decision-making are central
components.

3. Bioethical Theories: Bioethics provides frameworks for making moral decisions in

healthcare. Principles such as autonomy (respecting a patient's right to make
decisions), beneficence (doing what's best for the patient), non-maleficence (avoiding
harm), and justice (fair distribution of resources) guide ethical healthcare practices.

4. Feminist Care Ethics: This theory highlights the importance of caring relationships
in healthcare. It argues for a shift from a focus on abstract principles to an emphasis
on concrete relationships and the values of care, empathy, and interdependence. It
critiques the impersonal nature of some healthcare practices.

5. Cultural Competence and Cultural Humility: In an increasingly diverse world,

these theories emphasize the importance of understanding and respecting cultural
differences in healthcare. Cultural competence involves acquiring knowledge about
different cultures, while cultural humility involves self-reflection and the recognition
of one's own biases.
 6. The Social Determinants of Health: This theory looks beyond individual health
behaviors and medical treatments to consider the broader social, economic, and
environmental factors that influence health. It recognizes that issues such as poverty,
education, housing, and access to care have a significant impact on health outcomes.

7. Narrative Medicine: This approach encourages healthcare professionals to listen to

patients' stories and experiences to gain a deeper understanding of their illness and
suffering. It values the patient's narrative as a crucial aspect of diagnosis and
treatment.

8. Holistic Care: Holistic care considers the whole person, including physical,
emotional, social, and spiritual aspects of health. It promotes interventions that
address the individual's overall well-being and aims to enhance quality of life.

9. Critical Medical Anthropology: This theory examines how cultural, social, and
economic factors shape health and healthcare practices. It explores the power
dynamics in healthcare systems and the impact of globalization on health.

10. Ecological Model of Care: This theory takes into account the interconnectedness of
health with the environment. It emphasizes the importance of environmental
sustainability and how environmental factors can influence health outcomes.

It's important to note that these theories of care are not mutually exclusive, and healthcare
providers often integrate multiple approaches into their practice to provide comprehensive
and patient-centered care. The choice of theory or approach may depend on the specific
healthcare context and the needs of the patient or community being served.

Introduction-Care in “early” economic thought

The concept of care in early economic thought may not be as prominently featured as
concepts like production, trade, or wealth accumulation, but it has nevertheless played a
significant role in shaping economic ideas throughout history. In the earliest stages of
economic thought, societies primarily focused on survival and subsistence, and notions of
care were often intertwined with economic activities.

In pre-modern and ancient economies, communities relied on collective efforts for survival,
where care for the well-being of the group was essential. This care extended to providing for
basic needs such as food, shelter, and protection from external threats. Economic activities,
therefore, revolved around securing these essentials for the community, and concepts of care
were embedded in these activities.

One of the most notable examples of care in early economic thought can be found in ancient
agrarian societies. Agriculture was a fundamental economic activity, and the care of crops,
livestock, and land was central to ensuring a stable food supply. Concepts of stewardship and
responsible resource management emerged from this care-centric perspective.

Furthermore, early economic thought was often intertwined with moral and philosophical
considerations. Thinkers like Aristotle and Confucius emphasized the importance of ethical
values in economic matters, including the care of the less fortunate and the equitable
distribution of resources within a society.

In the context of early economic thought, care was not solely limited to material well-being.
It also encompassed notions of community, social cohesion, and the broader welfare of
society. As economic thought evolved over time, care continued to be a recurring theme,
though its specific interpretations and applications varied across different cultures and
periods.

In conclusion, care in early economic thought was deeply rooted in the practicalities of
survival and collective well-being. It influenced economic activities, resource management,
and moral considerations within societies, laying the groundwork for more complex
economic theories and philosophies that would emerge in later centuries. Understanding the
role of care in early economic thought provides valuable insights into the historical
development of economic ideas and their connection to broader societal values.
Kenneth Ewart Boulding (/ˈboʊldɪŋ/; January 18, 1910 – March 18, 1993) was an English-
born American economist, educator, peace activist, and interdisciplinary philosopher. [3]
[4]
Boulding was the author of two citation classics: The Image: Knowledge in Life and
Society (1956) and Conflict and Defense: A General Theory (1962). He was co-founder
of general systems theory and founder of numerous ongoing intellectual projects
in economics and social science. He was married to sociologist Elise M. Boulding

Early years

Boulding was born and raised in Liverpool, England, the only child of William C. Boulding
and Elizabeth Ann Boulding.[5] His father was a gas fitter and a lay preacher in the Wesleyan
Methodist Church,[6] and his mother was a housewife. Boulding's middle name Ewart came
from William Ewart Gladstone, of whom his father was a great admirer. [7]: 367 In his
adolescent years Boulding became interested in pacifism and joined the Religious Society of
Friends.[8]

After attending Liverpool Collegiate School on a scholarship, Boulding won a chemistry

scholarship to Oxford University at New College in 1929. He soon transferred to Philosophy,
Politics and Economics.[7]: 367–368 His economics tutors were Henry Phelps Brown, and
Maurice Allen (1908–1988), who would become a director of the Bank of England in the late
1960s. Boulding obtained a First in economics in 1931. In his last year he wrote "The Place
of the 'Displacement Cost' Concept in Economic Theory", which was accepted and published
in The Economic Journal, after extensive comments by its editor John Maynard Keynes.[6]
Economic Analysis, 1941[edit]

Boulding's first major work in economics was his introductory textbook, entitled Economic
Analysis.[10] It was written when he was an instructor at Colgate University in the late-1930s
and first appeared in 1941 from Harper & Brothers in single-volume and two-volume
editions.[3] The book was augmented and republished in four editions, the last in 1966. In a
1942 book review, Max Millikan pointed out that the book was published at the right time
and the right place.[22] According to Millikan:

For some years there has been a yawning gap in the literature of economic theory between the
very elementary text designed for beginning students and the clutter of specialized
monographs and periodical articles accessible only to the fully trained economist. The teacher
attempting to lead his charges over this difficult and dangerous terrain has had to choose
between two unsatisfactory alternatives. He could devote all his time to formal lecturing
about a subject that requires informal discussion and problems for its proper comprehension;
or he could assign and discuss a hodgepodge of advanced books and articles in the hope,
usually vain, that some fraction of the class would struggle through to a comprehension of
some fraction of the material.[22]

Millikan concluded that Boulding's work had filled the gap "neatly and effectively... material
is organized by tools of analysis and the problems in the solution of which those tools are
useful rather than in the conventional manner". [22] In the preface Boulding had explained that
the book was "intended as a text from which the student can learn and the teacher can teach
the methods and results of economic analysis. It also seeks to be a contribution to the
development and systematization of the body of economic analysis itself."[23]

Looking back in 1989, Boulding explained, that "the first edition fundamentally
followed Irving Fisher and Keynes's Treatise on Money. Even though I had read
Keynes's General Theory by that time, I think I had not really understood it. I am not quite
sure that I do now. The second edition, however, in 1948, was a thoroughly Keynesian
general theory."[7]: 373 The first edition was published at the outbreak of World War II and did
not sell well, but the second revised edition did and became "one of the core textbooks used
in college in the United States (and eventually around the world)."[2]: 49

Evolutionary economics[edit]

Main article: Kenneth Boulding's evolutionary perspective

Boulding was an exponent of the evolutionary economics movement. In his "Economic
Development as an Evolutionary System" (1961, 1964), Boulding suggests a parallel between
economic development and biological evolution.

The Economics of the Coming Spaceship Earth, 1966[edit]

Following the publication of Rachel Carson's Silent Spring in 1962, the developing
environmental movement drew attention to the relationship between economic growth and
development and environmental degradation. Boulding in his influential 1966 essay "The
Economics of the Coming Spaceship Earth" identified the need for the economic system to fit
itself to the ecological system with its limited pools of resources.[24]

Cavin Money on Health care from community ties to participation to reciprocity

It seems like you're asking about the connection between money spent on healthcare and its
relationship to community ties, participation, and reciprocity. Let's break down how these
elements are related:

1. Community Ties: Strong community ties can have a positive impact on healthcare
outcomes. When people feel connected to their communities, they may be more likely
to access healthcare services, seek help when needed, and engage in healthier
behaviors. Additionally, communities can provide support systems for individuals
facing health challenges.

2. Participation: Community participation in healthcare initiatives, such as volunteering

at local clinics, participating in health education programs, or getting involved in
community health campaigns, can lead to better health outcomes. This active
involvement can help raise awareness, reduce healthcare disparities, and improve
access to care.

3. Reciprocity: Reciprocity refers to the idea that individuals within a community

support each other, and this support can extend to healthcare. When people feel a
sense of reciprocity within their community, they may be more willing to help each
other access healthcare resources, provide caregiving, or offer emotional support
during health crises.
Now, let's consider the role of money spent on healthcare in relation to these factors:

 Funding for Community Health Programs: Money allocated to healthcare can be

used to fund community health programs that strengthen community ties, encourage
participation, and promote reciprocity. These programs might include health
education initiatives, outreach clinics, or social support services.

 Access to Care: Adequate healthcare funding is crucial for ensuring that community
members can access necessary medical services. Without financial resources,
individuals may struggle to obtain healthcare, which can strain community ties and
hinder participation in health-related activities.

 Healthcare Equity: Equitable distribution of healthcare resources and funding is

essential to prevent disparities within communities. Ensuring that everyone has access
to healthcare resources regardless of their socio-economic status can contribute to
stronger community ties and participation.

In summary, there is a complex interplay between money spent on healthcare, community

ties, participation, and reciprocity. Adequate funding for healthcare can support the
development of strong communities with robust social networks, active participation in
health-related activities, and a sense of reciprocity among members. Conversely, underfunded
healthcare systems can lead to barriers in access to care, strained community ties, and
reduced participation and reciprocity.

Caring labors characteristic human activity: feminist economics

Caring labor is a concept within feminist economics that focuses on recognizing and valuing
the often unpaid or underpaid work that individuals, primarily women, perform in caring for
others, maintaining households, and contributing to the overall well-being of society. This
concept challenges traditional economic models that tend to prioritize market-based activities
and paid labor while overlooking the essential contributions of care work to human welfare
and social reproduction.

Key characteristics of caring labor within the framework of feminist economics include:
 1. Unpaid or Underpaid Nature: Much of caring labor, such as childcare, eldercare,
domestic work, and emotional support, is often unpaid or poorly compensated in
formal labor markets. This economic invisibility perpetuates gender inequalities.

2. Reproductive Work: Caring labor is seen as a form of reproductive work because it

sustains and reproduces the labor force, maintains social bonds, and ensures the well-
being of individuals and communities. Without this work, society could not function.

3. Gendered Division of Labor: Caring labor is typically gendered, with women

disproportionately shouldering the responsibility for these tasks. This gendered
division of labor perpetuates gender inequalities in both the labor market and the
household.

4. Interdependence: Caring labor is interconnected with other forms of economic

activity. It supports the formal economy by enabling people to participate in paid
work, and it is influenced by economic policies, labor markets, and societal norms.

5. Social and Economic Value: Feminist economics emphasizes the importance of

recognizing the social and economic value of caring labor. This includes advocating
for policies that provide fair wages, benefits, and support for caregivers, as well as
recognizing the value of unpaid caregiving within GDP calculations and policy
discussions.

6. Policy Implications: Feminist economists argue for policy reforms that address the
unequal distribution of caring labor. This includes policies such as paid family leave,
affordable childcare, and support for caregivers, which can help reduce gender
disparities in the labor market and promote gender equity.

7. Challenging Traditional Economic Paradigms: Caring labor challenges traditional

economic theories that often overlook the importance of unpaid and informal labor in
the economy. Feminist economics advocates for a broader and more inclusive
understanding of economic activity.

In summary, caring labor is a central concept in feminist economics that highlights the
importance of recognizing, valuing, and redistributing the work of caregiving and domestic
responsibilities. By doing so, feminist economists aim to address gender inequalities, improve
the economic well-being of caregivers, and promote a more equitable and inclusive economic
framework.
Capturing Care: Care of Self

"Capturing Care: Care of Self" seems to be a phrase or title that could be associated with a
concept or initiative related to self-care. Self-care is the practice of taking deliberate actions
to maintain and improve one's physical, mental, and emotional well-being. It involves making
choices that prioritize personal health and happiness.

Here's a brief overview of what "Capturing Care: Care of Self" could entail:

1. Self-awareness: Understanding your own needs, boundaries, and limitations is the

first step in self-care. It involves recognizing when you need a break, when you're
feeling stressed, and when you need to focus on your well-being.

2. Physical Health: This aspect of self-care involves activities like regular exercise,
maintaining a balanced diet, getting enough sleep, staying hydrated, and attending to
any medical or physical needs.

3. Mental Health: Caring for your mental well-being includes practices such as
mindfulness meditation, journaling, therapy, or any activity that helps you manage
stress, anxiety, or depression.

4. Emotional Health: Emotions are an integral part of our lives. Self-care involves
acknowledging your emotions, expressing them in healthy ways, and seeking support
when needed. It also involves nurturing positive relationships and setting boundaries
with toxic individuals.

5. Time Management: Effectively managing your time is a form of self-care. This

means prioritizing tasks, setting realistic goals, and avoiding burnout by creating a
balance between work, personal life, and leisure.

6. Hobbies and Interests: Engaging in activities you love can be a form of self-care.
Whether it's painting, playing an instrument, reading, or any other hobby, dedicating
time to things that bring you joy can recharge your spirit.

7. Rest and Relaxation: Taking breaks and allowing yourself to rest is crucial for self-
care. This can include short breaks during the workday, a weekend getaway, or simply
spending a quiet evening at home.
 8. Setting Goals and Intentions: Having clear goals and intentions in life can provide a
sense of purpose and direction. Setting and achieving these goals can be fulfilling and
contribute to your overall well-being.

9. Seeking Support: Don't hesitate to seek help or support when needed. This could be
from friends, family, or professionals. Speaking to a therapist or counselor can be an
important aspect of self-care.

10. Self-Compassion: Being kind and compassionate towards yourself, rather than self-
critical, is at the heart of self-care. Treat yourself with the same level of care and
empathy that you would offer to a friend in need.

"Capturing Care: Care of Self" could be an initiative, program, or campaign aimed at

promoting and encouraging these self-care practices among individuals or within a particular
community or organization. It's a reminder that taking care of oneself is essential for overall
well-being and can lead to a more balanced and fulfilling life.

The aims of care phases and types of care

The aims of care in healthcare can vary depending on the specific context and the needs of
the patient. However, some common aims of care include:

1. Promotion of Health: One of the primary aims of healthcare is to promote and

maintain the health and well-being of individuals. This can involve preventive
measures such as vaccinations, lifestyle counseling, and health education.

2. Prevention and Early Detection: Healthcare aims to prevent illness and detect
health problems at an early stage when they are more easily treatable. This includes
regular screenings, check-ups, and monitoring of risk factors.

3. Diagnosis and Treatment: When a person becomes ill or has a health issue,
healthcare aims to diagnose the condition accurately and provide appropriate
treatment. This can involve medical interventions, surgeries, medications, and
therapies.

4. Management of Chronic Conditions: For individuals with chronic illnesses, the aim
of care is to manage their conditions effectively, reduce symptoms, and improve their
quality of life. This often involves long-term medication, lifestyle modifications, and
regular monitoring.
 5. Rehabilitation and Recovery: After an injury or illness, healthcare focuses on
helping individuals regain their physical, mental, and emotional health. This can
include rehabilitation programs, physical therapy, and counseling.

6. Palliative and End-of-Life Care: In cases where a cure is not possible, the aim shifts
to providing comfort and improving the quality of life for individuals with life-
limiting illnesses. Palliative care focuses on symptom management and emotional
support, while hospice care provides end-of-life care in a compassionate manner.

7. Patient-Centered Care: A fundamental aim of healthcare is to provide care that is

centered on the individual patient's needs, preferences, and values. This involves
shared decision-making and respecting the autonomy of the patient.

Phases of Care:

Healthcare often involves various phases of care, which can be categorized as follows:

1. Preventive Care: This phase focuses on measures taken to prevent illness or injury. It
includes vaccinations, health screenings, lifestyle counseling, and health education.

2. Primary Care: Primary care is the initial point of contact for most individuals
seeking healthcare. It includes routine check-ups, general medical care, and basic
treatment of common illnesses.

3. Secondary Care: When more specialized care is needed, individuals are referred to
secondary care providers, such as specialists or hospitals. This phase includes
consultations, diagnostic tests, and treatments that require specialized expertise.

4. Tertiary Care: Tertiary care is highly specialized and often provided in specialized
hospitals or medical centers. It is typically reserved for complex and rare conditions
that require advanced treatments, surgeries, or interventions.

Types of Care:

1. Acute Care: Acute care is focused on providing immediate and short-term treatment
for severe injuries or illnesses. It is often delivered in hospitals and emergency
departments.
 2. Chronic Care: Chronic care is long-term care provided to individuals with ongoing
health conditions. It aims to manage and control these conditions to improve the
patient's quality of life.

3. Primary Care: Primary care providers, such as family physicians and general
practitioners, offer comprehensive healthcare services, including preventive care,
routine check-ups, and the management of common health issues.

4. Specialized Care: Specialized care is delivered by healthcare professionals with

specific expertise in certain medical fields. This includes specialists in cardiology,
oncology, neurology, and other areas.

5. Rehabilitative Care: Rehabilitative care focuses on helping patients recover

physical, cognitive, or emotional function after an illness, injury, or surgery. It often
includes physical therapy, occupational therapy, and speech therapy.

6. Palliative and Hospice Care: Palliative care aims to improve the quality of life for
individuals with serious illnesses, while hospice care provides end-of-life care and
support for individuals with terminal conditions.

These are general categories, and the specific type of care a person receives depends on their
individual healthcare needs and the recommendations of healthcare providers.