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Alter - European Journal of Disability research
Volume 9, n° 3
pages 236-248 (juillet 2015)
Doi : 10.1016/j.alter.2015.05.002
Received : 13 May 2015 ;  accepted : 13 May 2015
Empowerment through care: Using dialogue between the social model of disability and an ethic of care to redraw boundaries of independence and partnership between disabled people and services
Empowerment par le « care » ? Redessiner les frontières de l’indépendance et du partenariat entre les personnes handicapées et les services d’aide et de soin en faisant dialoguer les conceptions du modèle social de l’empowerment et une éthique du « care »

Sarah E. Keyes a, , Sarah H. Webber b, Kevin Beveridge c
a Chancellor's Fellow, School of Health in Social Science, University of Edinburgh, Doorway 6, Teviot Medical Quad, EH8 9AG Edinburgh, United Kingdom 
b Associate Lecturer, Open University, United Kingdom 
c Commissioning and Contracts Manager, East Renfrewshire Community Health and Care Partnership, United Kingdom 

Corresponding author.

Our approach – empowerment through care – emerges from dialogue between social model understandings of empowerment and ethic of care based understandings of care. Whilst maintaining the principles underpinning empowerment as a challenge to disabling practice within health, social care and voluntary sector organisations, empowerment through care challenges a rejection of “care” as necessarily oppressive. We emphasise that relationships characterised by Tronto's (1993) elements of care can facilitate individual empowerment by redrawing boundaries of independence and partnership between people accessing support, professionals and the organisations within which they operate. Alongside a theoretical argument for our approach, we draw upon empirical evidence from two practice-based settings. Both settings demonstrate the importance of relational autonomy, based on Tronto's framework, in realising service imperatives rooted in empowerment. We also draw upon seminar discussion data, which demonstrates a pathway to empowerment: beginning with the individual, rooted in dialogue and embedded in whole organisations. Our approach establishes fresh ways for disabled people and services to work together in establishing innovative approaches to support and relationships at all levels of services.

The full text of this article is available in PDF format.

L’approche que nous proposons – l’empowerment par le « care » – est issue d’un souci de faire dialoguer une conception de l’ empowerment fondée sur un modèle social et une éthique du « care » soutenue par la conception du « care » de Tronto. Tout en maintenant que l’empowerment s’oppose dans ses principes aux pratiques handicapantes des organisations des secteurs sanitaire, social et associatif, cette approche réfute l’idée que le « care » est inévitablement source d’oppression. Nous insistons sur le fait que les relations caractérisées par les composantes du « care » énoncées par Tronto (1993) peuvent favoriser l’empowerment individuel en redessinant les frontières entre l’indépendance et le partenariat entre les bénéficiaires d’une aide, les aidants professionnels et les organisations dans lesquelles ceux-ci exercent. La discussion théorique de notre approche s’associe à la mobilisation de données empiriques issues de deux terrains. Ces deux situations pratiques démontrent l’importance de l’autonomie relationnelle, au sens défini par Tronto, dans la mise en œuvre des impératifs d’un service fondé sur l’empowerment. Nous mobilisons également des données issues de discussions en séminaire qui ont conduit à identifier un cheminement vers l’empowerment : débutant par l’individu, celui-ci s’enracine dans le dialogue et s’intègre aux organisations dans leur ensemble. Notre approche propose aux personnes handicapées et aux services de nouvelles manières de travailler ensemble à la création d’approches innovantes de l’aide et de relations qui jouent à tous les niveaux de l’offre de services.

The full text of this article is available in PDF format.

Keywords : Empowerment, Social model of disability, Ethic of care, Interdependence, Partnership, Health and social care services

Mots clés : Empowerment, Modèle social du handicap, Éthique du care, Interdépendance, Partenariat, Services sociaux et de soins

1  Conceptualised as a ‘nodal’ and ‘paradigm’ model, where an independent, rational individual makes choices that will fulfil their desires, chooses between options which are clearly delineated and placed in conflict, and ethical dilemmas are often focused on large, not every day, decisions.
2  Conceptualised as relational, recognising that people's preferences and desires are bound up with those around them. Rather than the conflict inherent within the nodal/paradigm model, actual autonomy looks at every day negotiation, coordination and accommodation between parties who have a shared history.
3  Trace is divided into four stages: tracing the normative frameworks which underlie the text examined; evaluating the values identified; renewing policies or practices by identifying the implications of a shift towards ethic of care perspectives; and concretizing the impact on the surrounding care context.
4  In LA1, the self-assessment tool is a substantial booklet with tick-box sections for the service-user to rate their needs and a small number of open sections for more detailed description. This is sent to service-users to complete before a face-to-face assessment with a social worker. The social worker's assessment is then shaped around a discussion of the answers in the booklet with the service-user and they then add their own assessment of the person's needs in the tick-box section of the form alongside the views of the service user.
5  In LA2, there are two different approaches to self-assessment. Service-users complete a 24-page tick-box self-assessment form, although this is then used to decide priority on the waiting list and does not form part of the social worker's assessment of need. In addition, the Princess Royal Trust (PRTC) are funded by the LA to support carers to fill in a self-assessment.

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