After having considered questions about empirical research in care ethics, we now turn to issues about theorising in care ethics. We seek to gain an understanding, also on a theoretical level, that can help participants in practices of care – professionals, informal caregivers and those who benefit from the care provided – to come to terms with reality, to act in situations where it is not obvious how best to act, to account for what they have done, to reject ideas that are less helpful and to develop the practice further to make it more conducive to good care, help and support.

Evaluative social science

In Chapter 5, we discussed sides I and II of the triangle that is constituted by empirical research, theory and ethics (see Figure 5.1). Here, we will address side III, the relationship between theory and ethics. Mainstream social science has invested much in being ‘objective’, wishing to free itself from what the sociologist Andrew Sayer has called ‘a kind of dogmatism which would foreclose debate on normative matters by claiming a scientific warrant for some conceptions of the good over others’ (Sayer, 2011: 57). This tendency likes to quote Max Weber's advocacy of ‘value-free’ social science, David Hume's warning against unwarranted transitions ‘from is to ought’ and George Edward Moore's exposure of the ‘naturalistic fallacy’.

‘Objective’ social science has relegated morality to a separate realm, that of ‘values’. The concept of values originates in the economy, where it means the purchase price: the amount of money needed to buy a product or a service. This meaning is reflected in the idea of ‘value-based healthcare’, or, better still, ‘value-based competition on results in healthcare’, where ‘value’ means the health outcomes achieved per dollar of cost compared to peers (Porter and Teisberg, 2006).

The term ‘value’ was introduced in sociology and philosophy at the turn of the 20th century. Over the course of that century, values came to be conceptualised as implying ‘free-floating, seemingly arbitrary ideas about what is good or what one ought to do that can be left to individuals to choose as they see fit’ (Sayer, 2011: 28).