Why Have (Feminist) Philosophers Ignored Nursing Home Incarceration?

My article “Philosophy of Disability, Conceptual Engineering, and the Nursing Home-Industrial-Complex” appears in the recently published special issue of International Journal of Critical Diversity Studies that I guest edited. The article is in partictular the culmination of research that I conducted on nursing homes and other so-called long-term care institutions from early 2000 to mid 2001 in addition to years of interaction with nursing-home residents, staff, geriatricians, and administration. If you are a regular reader or listener of BIOPOLITICAL PHILOSOPHY, you may recall my posts on nursing home incarceration here, here, here, here, and here, for instance.

In the IJCDS article, I draw attention to the fact that (nondisabled) philosophers, including (nondisabled) feminst philosophers, have virtually ignored the carceral character of these institutions and the role that they serve in ableist, ageist, racist, and sexist neoliberal societies in which many subjects are deemed disposable. The article ends by arguing for abolition of these institutions and an abolitionist philosophy more generally. I have copied below a relevant section of the IJCDS article.

IMPORTANT: I have posted in the past about the fabulous work of Sarah Jama and the Disability Justice Network of Ontario (DJNO) (for example, here). Last week, the DJNO circulated a petition to the Canadian government calling for the abolition (rather than merely nationalization) of nursing homes and other carceral “care” institutions in Canada.

Although the horrors of nursing homes and other “long-term care” institutions may have fallen off the front pages of your local newspaper, the elders and younger disabled people confined in these institutions continue to suffer from neglect, dehydration, malnutrition, and contaminated living arrangements, exacerbated by staff shortages due to outbreaks of the Omicron variant. Go here to sign the petition calling for an end to nursing home incarceration.

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Excerpt from “Philosophy of Disability, Conceptual Engineering, and the Nursing Home-Industrial-Complex”

Philosophers have largely ignored the oppressive social, economic, and political features of and circumstances that surround nursing homes, assisted-living centers, and other congregate settings in which older people and younger disabled people are placed, preferring to understand and represent these settings as politically neutral sites of care, love, and benevolence rather than understand and represent them as carceral environments that enable the segregation and management of certain populations deemed to be unproductive and disposable. According to a New York Times report in late September of 2020, 479,000 residents and staff of 19,000 nursing homes in the United States were infected with COVID-19 by mid-September 2020, while more than 77,000 residents and staff of these institutions had, by that time, died of the coronavirus. Residents and staff of nursing homes located in pre-dominantly Black neighborhoods of US cities were disproportionately represented among these fatalities (Serwer, 2020; Center for Disease Control and Prevention, 2020). By October 27, 2020, 84,136 COVID-19 deaths had occurred in nursing homes in the United States and 537,446 COVID-19 cases were recorded in these institutions, figures that do not account for the COVID-19 deaths and cases in group homes, psychiatric hospitals, and other institutions in which older people and younger disabled people live. Nevertheless, philosophers have had little to say about these COVID-19 deaths and cases and the conditions that precipitated them.

For example, Ben Bramble (2020), in his online, open access book, Pandemic ethics, which was published in the summer of 2020 to much acclaim amongst philosophers, makes only two passing references to nursing homes. To take another example, “Feminist responses to COVID-19 and pandemics,” a special issue of the APA Newsletter on Feminism and Philosophy (Freeman, 2020) published in the fall of 2020, does not include an article that addresses the thousands of COVID-19 cases and deaths in nursing homes and other “care” institutions whose precariously employed and underpaid workforces are both gendered and racialized. To be sure, one of the articles in this special issue of the newsletter mentions that COVID-19 has swept through these institutions and refers, in general, to the endangerment of front-line workers, a reference presumably meant to include personal support workers (PSWs) and other nursing home staff. However, an article that comprehensively unpacks the systems of inequality that underwrite the thousands of COVID-19 cases and deaths that have occurred amongst both nursing home residents and staff is noticeably absent from this feminist philosophy publication.

These gaps in feminist philosophical analyses about the pandemic both manifest and reproduce the critical limitations of dominant strains of feminist philosophy and the long-standing epistemic biases of this subfield according to which disability and age(ism) are not central to its subject matter and class is not a pressing consideration for economically privileged feminist academics. Yet in Canada, for example, more than two-thirds of the residents in nursing homes are women, with racialized and newcomer senior, elder, and disabled women constituting a growing sector of nursing home residents (Armstrong & Rochon, 2021). In short, nursing homes and other so-called long-term care institutions should be recognized as a social and political feminist concern, that is, feminist philosophical analysis of the COVID-19 pandemic ought to encompass examination of how and why COVID-19 has run rampant through these institutions globally, decimating their gendered and racialized resident and staff populations. Instead, philosophers, including feminist philosophers, have depoliticized these institutional cases and deaths and seem to take for granted that the bulk of them are attributable to a natural property or characteristic inherent to elder and younger disabled populations themselves. Indeed, these cases and deaths, philosophers seem to imply, are in some sense unavoidable and thus are neither ethically nor politically troubling, nor even philosophically interesting (also Schwartz, 2020).

As these exclusions indicate, furthermore, not even philosophers who advance proposals about how society should respond to COVID-19 have interrogated the relationship between the outbreaks in these institutions and the insidious nature of the institutions. This refusal on the part of (feminist) philosophers to closely examine the social, economic, and political circumstances and contexts in which these COVID-19 cases and deaths occurred has enabled the ageist, ableist, classist, sexist, and racist conditions that precipitated the infections and fatalities in these institutions to remain obscured and unchallenged, including the ableist neoliberal socioeconomic conditions that made possible the very existence of the institutions. Hence, the argument of this article calls upon philosophers to pursue a form of conceptual (re)engineering with respect to nursing homes; that is, to acknowledge that nursing homes, so-called long-term care facilities, supported-living facilities, and other institutions in which elders and younger disabled people are confined constitute the fulcrum of a massive network of governmentality that I call “the nursing home-industrial-complex.”

Find the entire article here.

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