By Susan Pennings
In her most recent book, The Dignity of Dependence, Leah Libresco Sargeant argues that our society is structured as if everyone is a self-reliant individual.
When people need to give or receive care, society treats this as aberrant, exceptional and sometimes a bit distasteful. However, the reality is that we are all deeply dependent on each other. This is most obviously the case at the beginning and end of life, but also throughout our lives due to illness or a range of other circumstances. The assumption that we are all independent individuals can warp the way that we see ourselves and other people, and can make social institutions function in a way that is inhumane.
While assumptions behind our social institutions affect everyone, they more deeply disadvantage women by disregarding the experience of pregnancy and motherhood. A pregnant woman is profoundly connected to her baby in utero, literally sharing her blood and body with a baby who relies on her for everything. After birth, babies and children continuously need nurture, care and attention. While some of a baby’s needs are ones anyone may assist with, a child still has a specific need for her mother. This can be seen clearly in breastfeeding, but also in other acts of physical and emotional care.
Sargeant argues that because our society sees autonomy as normative, we at best awkwardly accommodate fertility, pregnancy and motherhood, and at times regard these as barriers for women’s flourishing and social equality. In this way, we ‘see the personhood of women and children as competitive’ (p. 41).
Rather than this ‘false ideal of autonomy’, Sargeant writes, we should have a new vision of society. This would recognise the extent to which we all need to receive care and would value the care that we provide to each other. Sargeant notes that ‘We are called, not to accommodate dependence as a brute, unpleasant fact, but to knit dependence deeply into our understanding of what it means to be a human being. Our ties to others are not an obstacle to self-actualisation, they are the foundation for the authentic self. It is the places we are exposed to the world, our vulnerabilities, that allow us to extend ourselves in love and receive love in return.’ (p. 150).
This is a beautifully written book with a compelling message about the limits of autonomy as a social ideal. A strength of this book is its broad interdisciplinary scope. The book is personal at times, discussing Sargeant’s own experience of marriage, pregnancy, and motherhood. But it also demonstrates a familiarity with public policy, economics, feminist philosophy and art. This scope is shown in the discussion of how society quantifies and commoditises care. Sargeant notes that when care is paid for (such as in a childcare centre), it makes the care more visible and quantifiable. However, by treating care in terms of a market transaction, it can obscure the relational complexity of giving and receiving care. Paid caregiving relationships can be vulnerable for both the caregiver and care recipient. This can mean that carers are often required to go beyond the agreed terms of their contracted work – a worker cannot leave a toddler alone if their parent is late to childcare pickup, even if the worker is not paid for the extra time. It also means that it can be distressing for carers when workplace conditions (such as understaffing in a hospital) mean that they cannot provide the quality of care that they want to provide. Sargeant is not in any way opposed to paid care work, but does want to draw attention to how treating caregiving in terms of a ‘professional’ or depersonalised transaction does not properly describe it or do it justice.
Another strength of the book is in its recognition that valuing interdependence requires significant political, social and economic changes. A range of laws and social practices treat the provision of care as suspicious or problematic when it is outside carefully designated boundaries. For example, some jurisdictions have laws which forbid individuals from giving food to the homeless. Other jurisdictions have residential zoning laws which prevent multigenerational families from sharing a house, or prevent people from installing a wheelchair ramp into their own house.
In the United States, where Sargeant lives, employers are, at most, legally required to provide 12 weeks of unpaid maternity leave, and organisations with less than 50 employees are exempt from these requirements. Even Australia’s more generous parental leave provisions are not available to everyone, with people who have worked for their employer for less than 12 months being ineligible. A humane society is one which helps people to provide care to their families and neighbours, not one which puts financial and legal obstacles in their way.
This book can also be somewhat frustrating for the reader, due to Sargeant’s seeming tendency to romanticise complex situations, skating over difficulties. For example, at one point Sargeant suggests that people take painkillers too readily, and that openness to experiencing pain is part of what it means to be in touch with reality and in appropriate relationships of interdependence on others (pp. 57-59). While a balance needs to be drawn between excessive and inadequate pain medication, it seems that at present society is more likely to neglect, dismiss and disbelieve women who are experiencing even debilitating pain, rather than pressure them to take excessive painkillers.
Sargeant also has a tendency to describe caregiving in idealised terms, expressing how very demanding forms of caregiving can bring us in touch with our true selves, which are only found in close relationships with others. However, she only briefly discusses how caregiving can be experienced as exhausting, and that without proper support, even the most highly motivated and ethically exemplary caregivers can be susceptible to burnout. The book also does not properly engage with how to protect vulnerable people from neglectful or abusive caretaking. Given the extent of neglect and abuse experienced by people with disability, children, and the elderly, this seems like a significant oversight.
The book may have perhaps been improved with a longer and more detailed discussion of how people can give and receive care outside the immediate family. This is especially the case given that increasing numbers of people do not have close relationships with immediate family (due to family estrangement, divorce, lower rates of marriage, or lower fertility rates), and given the number of people who experience social isolation and loneliness. However, the book provides a thought-provoking exploration of how we can provide better care for each other, and accept interdependence as part of the human condition.