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In A Different Voice: Psychological Theory and Women's Development

Authors:
In a Different Voic
e
Psychological Theory and Women's Developmen
t
Carol Gilliga
n
Harvard University Press, Cambridge, Massachusetts, pp
. 24-39
.
In 1914, with his essay "On Narcissism," Freud swallows his distaste at the thought o
f
"abandoning observation for barren theoretical controversy" and extends his map of th
e
psychological domain
. Tracing the development of the capacity to love, which he equates wit
h
maturity and psychic health, he locates its origins in the contrast between love for the mother an
d
love for the self
. But in thus dividing the world of love into narcissism and "object" relationships
,
he finds that while men's development becomes clearer, women's becomes increasingly opaque
.
The problem arises because the contrast between mother and self yields two different images o
f
relationships
. Relying on the imagery of men's lives in charting the course of human growth
,
Freud is unable to trace in women the development of relationships, morality, or a clear sense o
f
self
. This difficulty in fitting the logic of his theory to women's experience leads him in the end t o
set women apart, marking their relationships, like their sexual life, as "a `dark continent' fo
r
psychology" (1926, p
. 212)
. .
Thus the problem of interpretation that shadows the understanding of women'
s
development arises from the differences observed in their experience of relationships
. To Freud
,
though living surrounded by women and otherwise seeing so much and so well, women'
s
relationships seemed increasingly mysterious, difficult to discern, and hard to describe
. While thi
s
mystery indicates how theory can blind observation, it also suggests that development in women i
s
masked by a particular conception of human relationships
. Since the imagery of relationship
s
shapes the narrative of human development, the inclusion of women, by changing that imagery
,
implies a change in the entire account
.
The shift in imagery that creates the problem in interpreting women's development i
s
elucidated by the moral judgments of two eleven-year-old children, a boy and a girl, who see, in th
e
same dilemma, two very different moral problems
. While current theory brightly illuminates th
e
line and the logic of the boy's thought, it casts scant light on that of the girl
. The choice of a gir
l
whose moral judgments elude existing categories of developmental assessment is meant t
o
highlight the issue of interpretation rather than to exemplify sex differences per se
. Adding a ne
w
line of interpretation, based on the imagery of the girl's thought, makes it possible not only to se
e
development where previously development was not discerned but also to consider differences i
n
the understanding of relationships without scaling these differences from better to worse
.
The two children were in the same sixth-grade class at school and were participants in th
e
rights and responsibilities study, designed to explore different conceptions of morality and self
. Th
e
sample selected for this study was chosen to focus the variables of gender and age whil
e
maximizing developmental potential by holding constant, at a high level, the factors of intelligence
,
education, and social class that have been associated with moral development, at least as measure
d
by existing scales
. The two children in question, Amy and Jake, were both bright and articulate and
,
at least in their eleven-year-old aspirations, resisted easy categories of sex-role stereotyping, sinc
e
1
Amy aspired to become a scientist while Jake preferred English to math
. Yet their moral judgment
s
seem initially to confirm familiar notions about differences between the sexes, suggesting that th
e
edge girls have on moral development during the early school years gives way at puberty with th
e
ascendance-of formal logical •thought°in boys
.
' °
.
.
°
"
The dilemma that these eleven-year-olds were asked to resolve was one in the series devise
d
by Kohlberg to measure moral development in adolescence by presenting a conflict between mora
l
norms and exploring the logic of its resolution
. In this particular dilemma, a man named Hein
z
considers whether or not to steal a drug which he cannot afford to buy in order to save the life o
f
his wife
. In the standard format of Kohlberg's interviewing procedure, the description of th
e
dilemma itself — Heinz's predicament, the wife's disease, the druggist's refusal to lower his price
is followed by the question, "Should Heinz steal the drug?" The reasons for and against stealin
g
are then explored through a series of questions that vary and extend the parameters of the dilemm
a
in a way designed to reveal the underlying structure of moral thought
.
Jake, at eleven, is clear from the outset that Heinz should steal the drug
. Constructing th
e
dilemma, as Kohlberg did, as a conflict between the values of property and life, he discerns th
e
logical priority of life and uses that logic to justify his choice
:
For one thing, a human life is worth more than money, and if th
e
druggist only makes $1,000, he is still going to live, but if Hein
z
doesn't steal the drug, his wife is going to die
.
(Why is
life
wort
h
more than money?)
Because the druggist can get a thousand dollar
s
later from rich people with cancer, but Heinz can't get his wife again
.
(Why not?)
Because people are all different and so you couldn't ge
t
Heinz's wife again
.
Asked whether Heinz should steal the drug if he does not love his wife, Jake replies that h
e
should, saying that not only is there "a difference between hating and killing," but also, if Hein
z
were caught, "the judge would probably think it was the right thing to do
." Asked about the fac
t
that, in stealing, Heinz would be breaking the law, he says that "the laws have mistakes, and yo
u
can't go writing up a law for everything that you can imagine
.
"
Thus, while taking the law into account and recognizing its function in maintaining socia
l
order (the judge, Jake says, "should give Heinz the lightest possible sentence"), he also sees the la
w
as man-made and therefore subject to error and change
. Yet his judgment that Heinz should stea
l
the drug, like his view of the law as having mistakes, rests on the assumption of agreement,
a
societal consensus around moral values that allows one to know and expect others to recogniz
e
what is "the right thing to do
.
"
Fascinated by the power of logic, this eleven-year-old boy locates truth in math, which, h
e
says, is "the only thing that is totally logical
." Considering the moral dilemma to be "sort of like
a
math problem with humans," he sets it up as an equation and proceeds to work out the solution
.
Since his solution is rationally derived, he assumes that anyone following reason would arrive a
t
the same conclusion and thus that a judge would also consider stealing to be the right thing fo
r
Heinz to do . Yet he is also aware of the limits of logic
. Asked whether there is a right answer to
moral problems, Jake replies that "there can only be right and wrong in judgment," since th
e
parameters of action are variable and complex
. Illustrating how actions undertaken with the best o
f
intentions can eventuate in the most disastrous of consequences, he says, "like if you give an ol
d
2
lady your seat on the trolley, if you are in a trolley crash and that seat goes through the window, i
t
might be that reason that the old lady dies
.
"
Theories of developmental psychology illuminate well the position of this child, standing a
t
the juncture' of childhood and
.
adole
e
scence,' at what Piaget describes as
.
the pinnacle of childhoo
d
intelligence, and beginning through thought to discover a wider universe of possibility . Th
e
moment of preadolescence is caught by the conjunction of formal operational thought with
a
description of self still anchored in the factual parameters of his childhood world -- his age, hi
s
town, his father's occupation, the substance of his likes, dislikes, and beliefs
. Yet as his self-
description radiates the self-confidence of a child who has arrived, in Erikson's terms, at a favorabl
e
balance of industry over inferiority -- competent, sure of himself
; and knowing well the rules of th
e
game -- so his emergent capacity for formal thought, his ability to think about thinking and t
o
reason things out in a logical way, frees him from dependence on authority and allows him to fin
d
solutions to problems by himself
.
This emergent autonomy follows the trajectory that Kohlberg's six stages of mora
l
development trace, a three-level progression from an egocentric understanding of fairness based o
n
individual need (stages one and two), to a conception of fairness anchored in the share
d
conventions of societal agreement (stages three and four), and finally to a principled understandin
g
of fairness that rests on the free-standing logic of equality and reciprocity (stages five and six)
.
While this boy's judgments at eleven are scored as conventional on Kohlberg's scale, a mixture o
f
stages three and four, his ability to bring deductive logic to bear on the solution of moral dilemmas
,
to differentiate morality from law, and to see how laws can be considered to have mistakes point
s
toward the principled conception of justice that Kohlberg equates with moral maturity
.
In contrast, Amy's response to the dilemma conveys a very different impression, an imag
e
of development stunted by a failure of logic, an inability to think for herself
. Asked if Heinz shoul
d
steal the drug, she replies in a way that seems evasive and unsure
:
Well, I don't think so
. I think there might be other ways beside
s
stealing it, like if he could borrow the money or make a loan o
r
something, but he really shouldn't steal the drug -- but his wif
e
shouldn't die either
.
Asked why he should not steal the drug, she considers neither property nor law but rather the effec
t
that theft could have on the relationship between Heinz and his wife
:
If he stole the drug, he might save his wife then, but if he did, h
e
might have to go to jail, and then his wife might get sicker again, an
d
he couldn't get more of the drug, and it might not be good
. So, the
y
should really just talk it out and find some other way to make th
e
money
.
Seeing in the dilemma not a math problem with humans but a narrative of relationships tha
t
extends over time, Amy envisions the wife's continuing need for her husband and the husband'
s
continuing concern for his wife and seeks to respond to the druggist's need in a way that woul
d
sustain rather than sever connection
. Just as she ties the wife's survival to the preservation o
f
relationships, so she considers the value of the wife's life in a context of relationships, saying that i
t
would be wrong to let her die because, "if she died, it hurts a lot of people and it hurts her
." Sinc
e
3
Amy's moral judgment is grounded in the belief that, "if somebody has something that would kee
p
somebody alive, then it's not right not to give it to them," she considers the problem in the dilemm
a
to arise not from the druggist's assertion of rights but from his failure of response
.
As the-interviewer proceeds
.
with-the-series-of questions-that follow from-Kohlberg'
s
construction of the dilemma, Amy's answers remain essentially unchanged, the various probe
s
serving neither to elucidate nor to modify her initial response
. Whether or not Heinz loves his wife
,
he still shouldn't steal or let her die
; if it were a stranger dying instead, Amy says that "if th
e
stranger didn't have anybody near or anyone she knew," then Heinz should try to save her life, bu
t
he should not steal the drug
. But as the interviewer conveys through the repetition of questions tha
t
the answers she gave were not heard or not right, Amy's confidence begins to diminish, and he
r
replies become more constrained and unsure
. Asked again why Heinz should not steal the drug
,
she simply repeats, "Because it's not right
." Asked again to explain why, she states again that thef
t
would not be a good solution, adding lamely, "if he took it, he might not know how to give it to hi
s
wife, and so his wife might still die
." Failing to see the dilemma as a self-contained problem in
moral logic, she does not discern the internal structure of its resolution
; as she constructs th
e
problem differently herself, Kohlberg's conception completely evades her
.
Instead, seeing a world comprised of relationships rather than of people standing alone,
a
world that coheres through human connection rather than through systems of rules, she finds th
e
puzzle in the dilemma to lie in the failure of the druggist to respond to the wife
. Saying that "it i
s
not right for someone to die when their life could be saved," she assumes that if the druggist wer
e
to see the consequences of his refusal to lower his price, he would realize that "he should just giv
e
it to the wife and then have the husband pay back the money later
." Thus she considers the solution
to the dilemma to lie in making the wife's condition more salient to the druggist or, that failing, i
n
appealing to others who are in a position to help
.
Just as Jake is confident the judge would agree that stealing is the right thing for Heinz t
o
do, so Amy is confident that, "if Heinz and the druggest had talked it out long enough, they coul
d
reach something besides stealing
." As he considers the law to "have mistakes," so she sees thi
s
drama as a mistake, believing that "the world should just share things more and then peopl
e
wouldn't have to steal
." Both children thus recognize the need for agreement but see it as mediate
d
in different ways — he impersonally through systems of logic and law, she personally throug
h
communication in relationship
. Just as he relies on the conventions of logic to deduce the solutio
n
to this dilemma, assuming these conventions to be shared, so she relies on a process o
f
communication, assuming connection and believing that her voice will be heard
. Yet while hi
s
assumptions about agreement are confirmed by the convergence in logic between his answers an
d
the questions posed, her assumptions are belied by the failure of communication, the interviewer'
s
inability to understand her response
.
Although the frustration of the interview with Amy is apparent in the repetition of question
s
and its ultimate circularity, the problem of interpretation is focused by the assessment of he
r
response
. When considered in the light of Kohlberg's definition of the stages and sequence o
f
moral development, her moral judgments appear to be a full stage lower in maturity than those o
f
the boy
. Scored as a mixture of stages two and three, her responses seem to reveal a feeling o
f
powerlessness in the world, an inability to think systematically about the concepts of morality o
r
law, a reluctance to challenge authority or to examine the logic of received moral truths, a failur
e
even to conceive of acting directly to save a life or to consider that such action, if taken, coul
d
possibly have an effect
. As her reliance on relationships seems to reveal a continuing dependenc
e
4
and vulnerability, so her belief in communication as the mode through which to resolve mora
l
dilemmas appears naive and cognitively immature
.
Yet Amy's description of herself conveys a markedly different impression
. Once again, th
e
hallmarks-of-the preadolescent -child' depict 'a-child-secure-in-her-sense-of herself
;' confident in th
e
substance of her beliefs, and sure of her ability to do something of value in the world
. Describin
g
herself at eleven as "growing and changing," she says that she "sees some things differently now
,
just because I know myself really well now, and I know a lot more about the world
." Yet the worl
d
she knows is a different world from that refracted by Kohlberg's construction of Heinz's dilemma
.
Her world is a world of relationships and psychological truths where an awaremenss of th
e
connection between people gives rise to a recognition of responsibility for one another,
a
perception of the need for response
. Seen in this light, her understanding of morality as arising
from the recognition of relationship, her belief in communication as the mode of conflict resolution
,
and her conviction that the solution to the dilemma will follow from its compelling representatio
n
seem far from naive or cognitively immature
. Instead, Amy's judgments contain the insight
s
central to an ethic of care, just as Jake's judgments reflect the logic of the justice approach
. He
r
incipient awareness of the "method of truth," the central tenet of nonviolent conflict resolution, an
d
her belief in the restorative activity of care, lead her to see the actors in the dilemma arrayed not a
s
opponents in a contest of rights but as members of a network of relationships on whos
e
continuation they all depend
. Consequently her solution to the dilemma lies in activating th
e
network by communication, securing the inclustion of the wife by strengthening rather tha
n
severing connections
.
But the different logic of Amy's response calls attention to the interpretation of th
e
interview itself
. Conceived as an interrogation, it appears instead as a dialogue, which takes o
n
moral dimensions of its own, pertaining to the interviewer's uses of power and to th
e
manifestations of respect
. With the shift in the conception of the interview, it immediately
becomes clear that the interviewer's problem in understanding Amy's response stems from the fac
t
that Amy is answering a different question from the one the interviewer thought had been posed
.
Amy is considering not
whether
Heinz should act in this situation
("should
Heinz steal the drug?"
)
but rather
how
Heinz should act in response to his awareness of his wife's need ("Should Hein
z
steal
the drug?")
. The interviewer takes the mode of action for granted, presuming it to be a matte
r
of fact
; Amy assumes the necessity for action and considers what form it should take
. In th
e
interviewer's failure to imagine a response not dreamt of in Kohlberg's moral philosophy lies th
e
failure to hear Amy's question and to see the logic in her response, to discern that what appears
,
from one perspective, to be an evasion of the dilemma signifies in other terms a recognition of th
e
problem and a search for a more adequate solution
.
Thus in Heinz's dilemma these two children see two very different moral problems — Jake
a
conflict between life and property that can be resolved by logical deduction, Amy a fracture o
f
human relationship that must be mended with its own thread
. Asking different questions that aris
e
from different conceptions of the moral domain, the children arrive at answers that fundamentall
y
diverge, and the arrangement of these answers as successive stages on a scale of increasing mora
l
maturity calibrated by the logic of the boy's response misses the different truth revealed in th
e
judgment of the girl
. To the question, "What does he see that she does not?" Kohlberg's theor
y
provides a ready response, manifest in the scoring of Jake's judgments a full stage higher tha
n
Amy' s in moral maturity
; to the question, "What does she see that he does not?" Kohlberg's theor
y
has nothing to say
. Since most of her responses fall through the sieve of Kohlberg's scorin
g
system, her responses appear from his perspective to lie outside the moral domain
.
5
Yet just as Jake reveals a sophisticated understanding of the logic of justification, so Am
y
is equally sophisticated in her understanding of the nature of choice
. Recognizing that "if both th
e
roads went in totally separate ways, if you pick one, you'll never know what would happen if yo
u
went the other way,
ZZ
she explains that "that's-the-chance you-have-to take, and like I said, it's jus
t
really a guess
." To illustrate her point "in a simple way," she describes her choice to spend th
e
summer at camp
:
I will never know what would have happened if I had stayed here
,
and if something goes wrong at camp, I'll never know if I stayed her
e
if it would have been better . There's really no way around it becaus
e
there's no way you can do both at once, so you've got to decide, bu
t
you'll never know
.
In this way, these two eleven-year-old children, both highly intelligent and perceptive abou
t
life, though in different ways, display different modes of moral understanding, different ways o
f
thinking about conflict and choice
. In resolving Heinz's dilemma, Jake relies on theft to avoi
d
confrontation and turns to the law to mediate the dispute
. Transposing a hierarchy of power into
a
hierarchy of values, he defuses a potentially explosive conflict between people by casting it as a
n
impersonal conflict of claims
. In this way, he abstracts the moral problem from the interpersona
l
situation, finding in the logic of fairness an objective way to decide who will win the dispute
. Bu
t
this hierarchical ordering, with its imagery of winning and losing and the potential for violenc
e
which it contains, gives way in Amy's construction of the dilemma to a network of connection,
a
web of relationships that is sustained by a process of communication
. With this shift, the mora
l
problem changes from one of unfair domination, the imposition of property over life, to one o
f
unnecessary exclusion, the failure of the druggist to respond to the wife
.
This shift in the formulation of the moral problem and the concomitant change in th
e
imagery of relationships appear in the responses of two eight-year-old children Jeffrey and Karen
,
asked to describe a situation in which they were not sure what was the right thing to do
:
Jeffre
y
When I really want to go to my friends an
d
my mother is cleaning the cellar, I think abou
t
my friends, and then I think about my mother
,
and then I think about the right thing to do
.
(But how do you know it's the right thing t
o
do?) Because some things go before othe r
things
.
Kare
n
I have a lot of friends, and I can't always pla
y
with all of them, so everybody's going t
o
have to take a turn, because they're all my
friends
. But like if someone's all alone, I'l
l
play with them
.
(What kinds of things do yo
u
think about when you are trying to make tha
t
decision?)
Urn, someone all alone
,
loneliness
.
While Jeffrey sets up a hierarchical ordering to resolve a conflict between desire and duty, Kare
n
describes a network of relationships that includes all of her friends
. Both children deal with th
e
issues of exclusion and priority created by choice, but while Jeffrey thinks about what goes first
,
Karen focuses on who is left out
.
The contrasting images of hierarchy and network in children's thinking about moral conflic
t
and choice illuminate two views of morality which are complementary rather than sequential o
r
6
opposed
. But this construction of differences goes against the bias of developmental theory towar
d
ordering differences in a hierarchical mode . The correspondence between the order o
f
developmental theory and the structure of the boys' thought contrasts with the disparity betwee
n
existing theory and'the`structure'manifest`in"the thought of the"girls Yet'in neitheryc'omparison doe
s
one child's judgment appear as a precursor of the other's position
. Thus, questions arise concernin
g
the relation between these perspectives
: what is the significance of this difference, and how do
these two modes of thinking connect? These questions are elucidated by considering th
e
relationship between the eleven-year-old children's understanding of morality and thei
r
descriptions of themselves
:
Jake
Am
y
(How would you describe yourself to yourself?
)
Perfect
. That's my conceited side
. What do
You mean my character?
(What do yo
u
you want — anyway that I choose to describe
think?)
Well, I don't know
. I'd describ
e
myself?
myself as, well, what do you mean
?
(If you
had to describe the person you are in a way that you yoursel
f
would know it was you, what would you say?
)
Well, I'd say that I was someone who like
s
school and studying, and that's what I want to
do with my life
. I want to be some kind of
a
scientist or something, and I want to d
o
things, and I want to help people
. And I thin
k
that's what kind of person I am, or what kin
d
of person I try to be
. And that's probabl
y
how I'd describe myself
. And I want to d
o
something to help other people
.
(Why i
s
that?)
Well, because I think that this worl
d
has a lot of problems, and I think tha
t
everybody should try to help somebody els
e
in some way, and the way I'm choosing i
s
through science
.
I'd start off with eleven years old
. Jake [las
t
name]
. I'd have to add that I live in [town]
,
because that is a big part of me, and also tha
t
my father is a doctor, because I think tha
t
does change me a little bit, and that I don'
t
believe in crime, except for when your nam
e
is Heinz
; that I think school is boring
,
because I think that kind of changes you r
character a little bit
. I don't sort of know ho
w
to describe myself, because I don't know ho
w
to read my personality
.
(If you
had t
o
describe the way you actually would describ
e
yourself, what would you say?) I
like corn
y
jokes
. I don't really like to get down to work
,
but I can do all the stuff in school
. Ever
y
single problem that I have seen in school
I
have been able to do, except for ones that tak
e
knowledge, and after I do the reading, I hav
e
been able to do them, but sometimes I don'
t
want to waste my time on easy homework
.
And also I'm crazy about sports
. I think
,
unlike a lot of people, that the world still ha
s
hope
.
.
. Most people that I know I like, and
I
have the good life, pretty much as good a
s
any I have seen, and I am tall for my age
.
7
In the voice of the eleven-year-old boy, a familiar form
. of self-definition appears
,
resonating to the inscription of the young Stephen Daedalus in his geography book : "himself, hi
s
name and where he was," and echoing the descriptions that appear in
Our Town,
laying out acros
s
the coordinatesµof'time-and-space a•hierarchical order in which-to-define one's'place
. Describin
g
himself as distinct by locating his particular position in the world, Jake sets himself apart from tha
t
world by his abilities, his beliefs, and his height
. Although Amy also enumerates her likes, he
r
wants, and her beliefs, she locates herself in relation to the world, describing herself throug
h
actions that bring her into connection with others, elaborating ties through her ability to provid
e
help
. To Jake's ideal of perfection, against which he measures the worth of himself, Am
y
counterposes an ideal of care, against which she measures the worth of her activity
. While sh
e
places herself in relation to the world and chooses to help others through science, he places th
e
world in relation to himself as it defines his character, his position, and the quality of his life
.
The contrast between a self defined through separation and a self delineated throug
h
connection, between a self measured against an abstract ideal of perfection and a self assesse
d
through particular activities of care, becomes clearer and the implications of this contrast extend b
y
considering the different ways these children resolve a conflict between responsibility to others an
d
responsibility to self
. The question about responsibility followed a dilemma posed by a woman'
s
conflict between her commitments to work and to family relationships
. While the details of thi
s
conflict color the text of Amy's response, Jake abstracts the problem of responsibility from th
e
context in which it appears, replacing the themes of intimate relationship with his own imagery o
f
explosive connection
:
Jake
Am
y
(When responsibility to oneself and responsibility to others conflict
,
how should one choose? )
You go about one-fourth to the others and
Well, it really depends on the situation
. I
f
three-fourths to yourself you have a responsibility with somebody else
,
then you should keep it to a certain extent, bu
t
to the extent that it is really going to hurt yo
u
or stop you from doing something that yo
u
really, really want, then I think maybe yo
u
should put yourself first
. But if it is you
r
responsibility to somebody really close t
o
you, you've just got to decide in that situatio n
which is more important, yourself or tha
t
person, and like I said, it really depends on
what kind of person you are and how you fee
l
about the other person or persons involved
.
(
M
T
?
)
Because the most important thing in you
r
decision should be yourself
; don't let yoursel
f
be guided totally by other people, but yo
u
have to take them into consideration
. So, i
f
what you want to do is blow yourself up wit
h
an atom bomb, you should maybe blow
Well, like some people put themselves an
d
things for themselves before they put othe
r
people, and some people really care abou
t
other people
. Like, I don't think your job i
s
as important as somebody that you reall
y
love, like your husband or your parents or
a
8
Jake (cont)
Amy (cont
)
yourself up with a hand grenade because you
very close friend
. Somebody that you reall
y
are thinking about your neighbors who would
care for – or if it's just your responsibility t
o
die also
.
–your-job -or somebody tha
t
,
you barely know
,
then maybe you go first – but if it'
s
somebody that you really love and love a
s
much or even more than you love yourself
,
you've got to decide what you really lov
e
more, that person, or that thing, or yourself
.
(And how do you do
that?)
Well, you've go
t
to think about it, and you've got to thin
k
about both sides, and you've got to think
which would be better for everybody or bette
r
for yourself, which is more important, an
d
which will make everybody happier
. Like i
f
the other people can get somebody else to d
o
it, whatever it is, or don't really need you
specifically, maybe it's better to do what you
want, because the other people will be jus
t
fine with somebody else so they'll still b
e
happy, and then you'll be happy too becaus
e
you'll do what you want
.
(What does responsibility mean?
)
It means pretty much thinking of others when
That other people are counting on you to d
o
I do something, and like if I want to throw a
something, and you can't just decide, "Well
,
rock, not throwing it at a window, because I
I'd rather do this or that
."
(Are there othe r
thought of the people who would have to pay
kinds of responsibility?)
Well, to yourself
.' I
f
for that window, not doing it just for yourself
;
something looks really fun but you might hur
t
because you have to live with other people
yourself doing it because you don't reall
y
and live with your community, and if you do
know how to do it and your friends say
,
something that hurts them all, a lot of people
"Well, come on, you can do it, don't worry,
"
will end up suffering, and that is sort of the
if you're really scared to do it, it's you
r
wrong thing to do
.
responsibility to yourself that if you think yo
u
might hurt yourself
; you shouldn't do it
,
because you have to take care of yourself an
d
that's your responsibility to yourself
.
Again Jake constructs the dilemma as a mathematical equation, deriving a formula tha
t
guides the solution
: one-fourth to others, three-fourths to yourself
. Beginning with hi
s
responsibility to himself
; a responsibility that he takes for granted, he then considers the extent t
o
which he is responsible to others as well
. Proceeding from a premise of separation but recognizing
.
that "you have to live with other people," he seeks rules to limit interference and thus to minimiz
e
hurt
. Responsibility in his construction pertains to a limitation of action, a restraint of aggression
,
guided by the recognition that his actions can have effects on others, just as theirs can interfere wit
h
him
. Thus rules, by limiting interference, make life in community safe, protecting autonom
y
through reciprocity, extending the same consideration to others and self
.
9
To the question about conflicting responsibilities, Amy again responds contextually rathe
r
than categorically, saying "it depends" and indicating how choice would be affected by variation
s
in character and circumstance
. Proceeding from a premise of connection, that "if you have
a
responsibility with'somebody-else,-you-should•keep • it,"
.
she then consider
s
,
the-extent to which sh
e
has a responsibility to herself Exploring the parameters of separation, she imagines situation
s
where, by doing what you want, you would avoid hurting yourself or where, in doing so, you woul
d
not thereby diminish the happiness of others
. To her, responsibility signifies response, an extension
rather than a limitation of action
. Thus it connotes an act of care rather than the restraint o
f
aggression
. Again seeking the solution that would be most inclusive of everyone's needs, sh
e
strives to resolve the dilemma in a way that "will make everybody happier
." Since Jake i
s
concerned with limiting interference, while Amy focuses on the need for response, for him th
e
limiting condition is, "Don't let yourself be guided totally by others," but for her it arises whe
n
"other people are counting on you," in which case "you can't just decide, 'Well, I'd rather do this o r
that
.' " The interplay between these responses is clear in that she, assuming connection, begins t
o
explore the parameters of separation, while he, assuming separation, begins to explore th
e
parameters of connection
. But the primacy of separation or connection leads to different images o
f
self and of relationships
.
Most striking among these differences is the imagery of violence in the boy's response
,
depicting a world of dangerous confrontation and explosive connection, where she sees a world o
f
care and protection, a life lived with others whom "you may love as much or even more than yo
u
love yourself" Since the conception of morality reflects the understanding of social relationships
,
this difference in the imagery of relationships gives rise to a change in the moral injunction itself
.
To Jake, responsibility means
not doing
what he wants because he is thinking of others ; to Amy, i
t
means
doing
what others are counting on her to do regardless of what she herself wants
. Bot
h
children are concerned with avoiding hurt but construe the problem in different ways -- he seein
g
hurt to arise from the expression of aggression, she from a failure of response
.
If the trajectory of development were drawn through either of these childrens' responses, i
t
would trace a correspondingly different path
. For Jake, development would entail coming to see th
e
other as equal to the self and the discovery that equality provides a way of making connection safe
.
For Amy, development would follow the inclusion of herself in an expanding network o
f
connection and the discovery that separation can be protective and need not entail isolation
. I
n
view of these different paths of development and particularly of the different ways in which th
e
experiences of separation and connection are aligned with the voice of the self, the representatio
n
of the boy's development as the single line of adolescent growth for both sexes creates a continua
l
problem when it comes to interpreting the development of the girl
.
Since development has been premised on separation and told as a narrative of faile
d
relationships -- of pre-Oedipal attachments, Oedipal fantasies, 'preadolescent chumships, an
d
adolescent loves -- relationships that stand out against a background of separation, onl
y
successively to erupt and give way to an increasingly emphatic individuation, the development o
f
girls appears problematic because of the continuity of relationships in their lives
. Freud attribute
s
the turning inward of girls at puberty to an intensification of primary narcissism, signifying
a
failure of love or "object" relationships . But if this turning inward is construed against
a
background of continuing connection, it signals a new responsiveness to the self, an expansion o
f
care rather than a failure of relationship
. In this way girls, seen not to fit the categories o
f
relationships derived from male experience, call attention to the assumptions about relationship
s
1
0
that have informed the account of human development by replacing the imagery of explosiv
e
connection with images of dangerous separation
.
1
1
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Background In the Netherlands, the for-profit sector has gained a substantial share of nursing home care within just a few years. The ethical question that arises from the growth of for-profit care is whether the market logic can be reconciled with the provision of healthcare. This question relates to the debate on the Moral Limits of Markets (MLM) and commodification of care. Methods The contribution of this study is twofold. Firstly, we construct a theoretical framework from existing literature; this theoretical framework differentiates four logics: the market, bureaucracy, professionalism, and care. Secondly, we follow an empirical ethics approach; we used three for-profit nursing homes as case studies and conducted qualitative interviews with various stakeholders. Results Four main insights emerge from our empirical study. Firstly, there are many aspects of the care relationship (e.g. care environment, personal relationships, management) and every aspect of the relationship should be considered because the four logics are reconciled differently for each aspect. The environment and conditions of for-profit nursing homes are especially commodified. Secondly, for-profit nursing homes pursue a different professional logic from the traditional, non-profit sector – one which is inspired by the logic of care and which contrasts with bureaucratic logic. However, insofar as professionals in for-profit homes are primarily responsive to residents’ wishes, the market logic also prevails. Thirdly, a multilevel approach is necessary to study the MLM in the care sector since the degree of commodification differs by level. Lastly, it is difficult for the market to engineer social cohesion among the residents of nursing homes. Conclusions The for-profit nursing home sector does embrace the logic of the market but reconciles it with other logics (i.e. logic of care and logic of professionalism). Importantly, for-profit nursing homes have created an environment in which care professionals can provide person-oriented care, thereby reconciling the logic of the market with the logic of care.
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