Medicine and Morality: A Reprise

A few months back, I wrote a post titled “Medicine and Morality.” In that post, I tried to offer a definition of the anthropological meaning of “morality” that is emerging from ongoing research on religious practices, medicine, and global health. It’s an area of research I find exciting, but since it’s so new, scholars are still working on the terms and definitions they use to describe their work.

Since then, I’ve been thinking and writing about “morality” with respect to medical care, food allergies, and food allergy advocacy. I’ve started to identify some themes within my own research that are more specific than what I laid out before.

One of the words that I find myself using alongside morality is “responsibility.” This is also a word which can take on lots of connotations in the social sciences. There are two meanings that I think are relevant, however.

First is the non-technical, commonsense meaning of one person (or group, or institution) being responsible for another person, group, or institution. That is, one actor/group has a duty to help take care of another. Within philosophy, especially ethics, this kind of responsibility is often treated as a given. Because someone is human, other humans automatically have certain obligations to care for or about that person. This is a perspective that motivates thinking in fields as disparate as human rights, global health, and medical ethics. A more sociological approach to studying responsibility is one that investigates how certain actors come to be made responsible for others. For example, it wasn’t a given that the United States federal government was responsible for the health care of poor children and elderly people until 1965, with the passage of the Social Security Act. The act recognized certain groups of beneficiaries and made explicit the government’s responsibility to care for them in certain ways. A philosophical argument would stress the intrinsic moral duty a government has to take care of its people; a sociological one would stress the people, institutions, and events that led to this duty being recognized and put into action.

This brings us toward the second, more technical meaning of “responsibility” in my corner of the social sciences: one’s ability to respond to another. It is not enough to have two or more actors living alongside each other; there must be some social, institutional, or moral structure which makes the one able to respond to the needs of the other. Importantly, these arrangements are not static. They can change with the mores of the times and with the particular actors involved.

As my project evolves, I’m thinking more and more about who is responsible for providing care for people with food allergies. I outlined some of my thinking on this topic at the end of my guest post on Asthma, Allergies, Children back in September. It continues to develop, however, so what follows is an updated snapshot.

In some situations, an individual is assumed to be responsible for herself. This is especially the case for adults who, in American society, we consider to be the masters of their own fate, including their physical and emotional health. The picture is more complex when it comes to children, since we assume that they are generally not ready to keep track of their essential medical care on a daily basis. For children, parents often bear ultimate responsibility. However, parents generally can’t watch over their kids every moment of the day. Kids are also taken care of my teachers, babysitters, bus drivers, their friends’ parents, tutors or coaches, and other members of the community. For kids with special medical needs, like food allergies, it’s not a straightforward matter of knowing that a non-parent caretaker has experience looking out for kids. There is also a body of specialized knowledge about the particular medical condition, its signs and symptoms, and emergency procedures that the caretaker needs to understand in case of complications or sudden illness.

Teaching caretakers this information can certainly pose technical challenges, but I am coming to understand it as a moral project as well. In order to get the caretaker on board with caring for a food allergic kid, they first need to learn certain skills. But they also need to care about learning and perfecting those skills. They need to be emotionally prepared to honestly evaluate potentially frightening symptoms. They need to be ready to be responsible for administering epinephrine, calmly notifying emergency services, and taking time out of their day to safely escort the child to medical care. In short, they need to both acknowledge the special moral obligation they have to care for food allergic kids, and understand the practical steps they will need to go through to fulfill it.

Responsibility and moral obligation are becoming prominent themes in my dissertation write up. I look forward to talking about these issues more in the coming months. Please share your thoughts on responsibility, morality, and medical care in the comments!

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