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What is the problem of dependency? Dependency work reconsidered.

Simon van der Weele1, Femmianne Bredewold1, Carlo Leget1

  • 1University of Humanistic Studies, Kromme Nieuwegracht 29, Utrecht, 3512 HD, The Netherlands.

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Dependency in care relationships presents moral challenges. This study explores

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Area of Science:

  • Ethics in Healthcare
  • Nursing Theory
  • Disability Studies

Background:

  • Dependency is central to care but raises ethical issues in nursing.
  • Current approaches frame dependency primarily as a self-determination problem.
  • This narrow view limits understanding and practice in long-term care.

Purpose of the Study:

  • To propose expanded theoretical problem frames for dependency.
  • To enhance understanding of navigating dependency in long-term care.
  • To analyze care professionals' 'dependency work' with individuals with intellectual disabilities.

Main Methods:

  • Empirical ethical analysis of care practices.
  • Qualitative study of dependency work in group homes.
  • Theoretical exploration of dependency problem frames.

Main Results:

  • Dependency is a threefold problem for care professionals: self-determination, parity, and self-worth.
  • Patient autonomy alone does not resolve dependency issues in long-term care.
  • Mitigation efforts can paradoxically intensify dependency relationships.

Conclusions:

  • Rethinking dependency requires broader theoretical frames beyond self-determination.
  • Dependency is an inherent aspect of care, not a problem to be solved.
  • Understanding the paradox of 'dependency work' is crucial for ethical long-term care.