Social Innovation in Health Care:
Ethical Foundations of Caregiving

© Han Zhang,
Monday, May 05, 2014, 8:00am to 6:00pm
Centre for Social Innovation
Whole Connector, CSI Spadina
215 Spadina Ave, Toronto, ON
A CIHR-funded event organized by Ethical Care Research (ECR)

Morning Session: Institutional Constraints on Care

8:00 – 9:00               Breakfast and Reception
9:00 – 12:00             Welcome and Plenary Address

Alan Blum, York University, University of Waterloo, Culture of Cities Centre

This theme refers to the force of culture as an influence that exceeds medical science, applying to the range of constraints upon caregiving from personal interaction to large scale societal conditions. Since care does not exist in a vacuum but is embedded in different social contexts and situations, we want to examine research that focuses on such constraints upon caregiving in families, organizational settings such as hospitals, schools, correctional institutions, but also in the society at large through institutionalized norms, policies, and laws, and culturally in the influence of official and unofficial bodies of knowledge, and values in circulation.

Morning Session Speakers

Stuart J. Murray, Rhetoric & Ethics Lab, Carleton University

Care and Correctional Constraints: The Solitary Confinement of Mentally Ill Inmates

This paper draws on interviews with mentally ill inmates who have been subject to seclusion as part of their treatment. It draws as well on interviews with nursing staff who care for them in this setting. While the mutually exclusive mandates of “care” versus “corrections” have been well documented in the literature, this paper explores instead patient and nurse narratives with attention to the phenomenology of the body in seclusive space.

Ginette Lafrenière, Wilfrid Laurier University

Who Gets to Construct Survivor Narratives?: A Critical Deconstruction of Power Dynamics in Social Service Delivery

Drawing upon her work with survivors of war and torture, survivors of the residential school system and survivors of family violence, Dr. Lafreniere will attempt to illustrate the dissonance between how survivors are socially constructed by those actors who serve them and how survivors themselves wish to be perceived.

Kieran Bonner, University of Waterloo; Diego Lllovet, Cancer Care Ontario; Philip Walsh, York University

End of Life as a Living Relationship

Three sociologists discuss issues arising from the end of life of patients as more than palliative but as pertaining to the different rights and responsibilities of the family and medical expertise, and contested appeals to law and for legal resolution regarding final authority for decision-making. Special reference will be made to Hannah Arendt’s conception of the social and of the border between public and private life as influences upon care.

12:00 – 12:30            Break
12:30 – 13:30            Morning Roundtable + Lunch (Moderator: Elke Grenzer, Culture of Cities Centre)
13:30 – 13:45            Break

Afternoon Session: Innovation in Care

13:45 – 4:30             Introduction

Alan Blum, York University, University of Waterloo, Culture of Cities Centre

Innovative methods in health care typically focus on  technological modifications facilitated by social media, robotics, skype coaching, telecare, and technical enhancements designed to create more efficient procedures in medical treatment, diagnostics, and surgery, but innovative approaches are also affirmed as new relations to providing service for recipients through arts and performance, or for empowering participation of all parties as in narrative medicine, role playing, and the range of doctrines of well-being that aim to produce peace of mind, wellness, resilience, and tranquility in order to relieve stress and depression.

Afternoon Session Speakers

Carlos Neves, Therapist

Brief Therapy and the Ethics of Care

This discussion will explore how the dominance of solution focused brief therapy models in the field of mental health runs the risk of serving as an ideological justification for ‘managed care’ in the mental health field.  Implications for how clinical work is being reshaped by this trend will be addressed, as well as what it means to ‘care’ and to provide ‘therapy’ in this situation where therapeutic time is contracted / reduced as a matter of course. Clinical vignettes will illustrate how clinicians might work within the constraints of ‘managed care’ whilst subverting the oversimplified notions of care and therapy that are assumed in solution focused approaches.

Han Zhang, York University

Towards a Cultural Discourse of Care

This discussion attempts to examine the cultural discourse of care and to understand the way culture, specifically in the shape of Chinese and Western values, might operate in facilitating and/or inhibiting stress in caregiving experience. “Culturally appropriate care” has been advocated as a core operating philosophy by a number of non-profit organizations that are dedicated to supporting Chinese immigrants in Western countries. Drawing from examples, case studies and interview notes with some of these organizations in Canada, UK, Hong Kong and Mainland China, I try to analyze how culture is understood, appropriated, and formulated for ethical care, the differences in executing such culturally appropriate care among different Chinese communities, and propose another way of formulating such a cultural discourse.

Alan Blum, York University, University of Waterloo, Culture of Cities Centre

Care, Witnessing, Death: Innovation and Sociology of Desperation

I suggest that dementia can be understood not simply as the progressive deterioration of the body and its neurological disintegration but as the process through which a human subject is infected by an awareness of mortality and the images of inevitable limitation and loss that it summons to mind. Far from being a sign of corporeal weakness, the symptoms revealed in dementia can point to a degree of enlightened helplessness for one trying to solve the impossible problem of existence in time between a past that is lost and a future that must appear inscrutable. When caregiving takes its bearings from a neurological framework it tends to foreclose attentiveness to the subjectivity of the suffering, disguising its own inarticulateness and anxiety over mortality in digestible and reassuring formats. Care for the lived experience of the dying body requires something other than palliatives of positive thinking or medical science but a curriculum that can orient to the experience of a self attuned to the inevitable loss of life, care trying in its way to cultivate a shared jouissance of suffering between witness and intimate. I pose the question of how or whether care is possible under such conditions and if it is possible to mobilize affect in both witness and other for an innovative relationship to desperation. I propose that the fundamental perversity of such a relationship and its comic character make it indigestible for many in an age where everyone is encouraged to strive for an experience typically characterized as feeling awesome, that is, being free and unlimited. This  affirms the power of negative thinking as a creative force in living with death, but always in ways that risk appearing perverse and/or psychotic.

4:30 – 5:00               Break
5:00 – 5:45               Afternoon Roundtable and Refreshments (Moderator: Elke Grenzer, Culture of Cities Centre)
5:45 – 6:15               Ethical Care Research (ECR) Inauguration Presentation
6:15 – 7:30               Closing & Cocktail Networking

We invite interested practitioners, students, scholars to participate in this CIHR-funded one-day symposium. There will be two roundtable discussions where all attendees are welcome to contribute. For more information, please visit Spaces are limited; please send your RSVP to by April 15th, 2014.

Download flier here.

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