Extreme Caregiving by Lisa Freitag

Author:Lisa Freitag
Language: eng
Format: epub
Publisher: Oxford University Press
Published: 2017-08-15T00:00:00+00:00

CHAPTER 6 | Competence

IN THE PREVIOUS chapter, I reviewed how parenting a child who requires extreme caregiving differs from typical parenting, considering mostly the first two phases of care: “caring about” and “taking care of.” We expect all parents to demonstrate the virtues associated with these two phases—attentiveness and responsibility. However, the heightened level of attentiveness and larger number of responsibilities we place on the parents of a child with special needs increases the emotional and moral work they must perform. In this chapter we consider the third phase of care, caregiving. This is the phase in which the actual hands-on work of meeting needs is done. The virtue associated with the third phase is competence, the ability to do the work which must be done, and to do it well. Given the number of new tasks which must be taken on, it will come as no surprise that parents in this phase must rise to a high level of competence.

Within Tronto’s theory of care, competence becomes a moral action that can be evaluated by its effectiveness at meeting needs. If the actions of caregiving are done incompetently, the care provided is inadequate. “Intending to provide care, even accepting responsibility for it, but then failing to provide good care, means that in the end the need for care is not met” (Tronto, 1993, p. 133). Caregiving is the heart of care, the phase in which the actions necessary to provide for a need are taken. These actions must be done competently or care has not been accomplished.

All parents are expected to care for their children competently, but we have few guidelines to evaluate their effectiveness. There is, of course, no particular training for the task, nor is any organization assigned the responsibility for overseeing it. However there is a point at which parental incompetence triggers societal action, in the form of child protection laws. Parents must not actively harm their children emotionally or physically, neglect their children’s basic needs, or endanger their children’s health or well-being. The punishment for falling below this threshold can involve transfer of responsibility for the child to a guardian or removal of the child from the home.

But most parents aim for higher standards and consider it part of their job to foster growth by meeting, in addition to physical needs, a wide range of emotional and educational needs. Ethicists agree that the well-being of children requires more than maintaining bodily health, but there is little consensus regarding which of many additional needs should take precedence (Malek, 2009). Society judges parents, and parents judge themselves, based largely on the success of their children. However, there is a wide range in parental expectations in this endeavor, and there is no valid definition of either effectiveness in parenting or success in the child.

In health care, our best measurement of parental effectiveness comes from monitoring the child’s growth and development, using charts and guidelines obtained from averaging the measurements of countless children. Many guidebooks provide, along with parenting advice,

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