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In their insightful paper, Newdick and Danbury1 explore some of the issues that they identify as having contributed to the failures of various institutions within the NHS to provide adequate levels of clinical care to their patients. This commentary acknowledges that many of the issues highlighted by Newdick and Danbury may plausibly be said to form part of the explanation of why failures of care—such as those identified within the Mid Staffordshire NHS Foundation Trust and the Bristol Royal Infirmary—occurred. However, it will be argued that any analysis of care (in the context of the NHS or elsewhere) will remain suboptimal in the absence of a clearly articulated and plausible definition of ‘care’.
The claim that a clearly articulated and plausible definition of care is necessary to a successful analysis of care (and institutions that purport to be caring) is motivated by the assumption that the meaning of care is neither self-evident nor uncontentious. If what is meant by the term care is assumed to be neither self-evident nor uncontentious, so-called analyses of care that fail to define care will remain obscure. The obscurity of such analyses is a result of their failure to identify what it is, exactly, they are analysing.
Newdick and Danbury's paper discusses the possible reasons behind serious failures of care within the NHS. However, they fail to stipulate what it is they mean by care. As a result of this failure, it remains obscure what exactly they think a ‘failure of care’ is and, subsequently, how such failures could be avoided. …
Competing interests None.
Provenance and peer review Commissioned; internally peer reviewed.
↵i A similar point regarding the need to provide clear answers to questions such as ‘to what extent do physicians have responsibilities to promote the welfare of their patients’ is made by John Saunders in his excellent commentary on Newdick and Danbury (see reference 4).
↵ii It is assumed that a definition should serve the purpose of providing an understanding of the definiendum that is sufficiently robust so as to remain usefully coherent in the face of challenges to the limits or compatibilities of the term.