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254 THE ISA HANDBOOK IN CONTEMPORARY SOCIOLOGY

use-values required to look after the body’s about the social or solidarity-based economy
needs; but care work would more signifi- (l’économie solidaire) as a hybrid of
cantly mean the production of relationships, exchange, redistribution and reciprocity.
capacities, mutual well-being – the production I believe that these logics are present well
3
of values that go well beyond immediate beyond the social economy, notably in
utility, the drive to accumulate or the will to health care (although a good case could be
power. made for defining public health care systems
This is of course an ideal type, a sort of as ‘solidarity-based economies’). However,
identical subject-object (Lukács, 1971), I believe that the metaphor of ‘hybridization’
which treats the temporally distinct moments downplays the elements of conflict and com-
of care as simultaneous. Its usefulness petition too much. I wish to go a step further,
resides in the means it affords to judge the by arguing that these different formations are
power asymmetry in care and the strength of not merely juxtaposed, but mediated as
the care effect. aspects of a dialectical whole.
In the absence of perfect co-production, Supposing that kin are even available (not
the three questions addressed to the labour a self-evident assumption in North America
process (who decides? who executes? who today), the combined pressures associated
benefits?) may point to different subjects with the physical and emotional aspects of
(i.e., signify a split between intellectual and care may prove overwhelming within the
manual labour, between coordinators and bounds of kinship. Faced with demanding
workers, between owners and hired hands, situations with which they cannot fully deal
between producers and consumers). The within the existing boundaries of their rela-
relations of production are then likely to tionship, one or both of the parties may
entail asymmetrical power over the labour prefer to turn to a stranger, to resort to a rela-
process, uneven participation in the actual tionship based on giving (e.g., the help of
work, and unequal enjoyment of the fruits of volunteers in formal and informal contexts),
labour. In the context of care, this can mean redistribution (state assistance) or exchange
unequal sharing of its burdens, of its condi- (purchasing health services on the market).
tions, of its rewards, incomplete realization This is true of situations in which taboos and
of the right to care – both to care for another the threat of loss of status preclude certain
(‘to give care’) and to be cared for (‘to forms of intimacy (see above). But it is obvi-
receive care’). ously also true of situations in which the
Miriam Glucksmann’s emphasis on the labour power and means of production are
total social organization of labour reminds not available, that is, all those situations call-
us of the need to include in the analysis all ing for the application of knowledges and
work – intellectual and manual, male and techniques (e.g., surgery, pharmacology) that
female, waged and unwaged, forced and only arise on the basis of significant develop-
voluntary (Glucksmann, 1995). Taking inspi- ment of the productive forces of society and
ration from Polanyi, we can think of health an elaborate division of labour.
care as embedded in a plurality of economic In relations of reciprocity, the creation of
forms: market exchange (capitalist relations debt through giving is a key way of forging
of production), redistribution (state alloca- social relationships; but it is also an affirma-
tion of resources), reciprocity (gift exchange), tion of power. Both parties may welcome the
domestic administration (economic relations expression of this power, because they wish
rooted in the relations of kinship). (On reci- to be ever more bound to each other. It may
procity, redistribution, exchange and domes- also be possible to achieve the virtuous circle
tic administration, see Laville et al., 1993; of giving by ‘giving back’ to someone else
Laville, 1994, 2001; Polanyi, 1957.) than the original giver. This is often the motive
Jean-Louis Laville has written extensively expressed by volunteers. However, because