"Take care," said the doctor at the end of one of my rare visits to her clinic. I thanked her and went off wondering idly whether this meant, "Keep working on that cholesterol reading," or whether it was just a friendly valediction I was as likely to hear from the butcher or a bank teller. Either way, it was up to me to take care of myself. That, it appears — at the risk of reading too much into a current fashion — is what we most want our family, friends, casual acquaintances and the world in general to do these days.
Fortunately, most of us can look after ourselves. What is in doubt today is whether we can look after anyone else. Life begins and ends in helplessness, and there are people who need to be cared for throughout their lives because of physical or mental disabilities. But the needs of all these people seem to tax contemporary culture in a new way.
In her recent essay, Life Without Children, Barbara Dafoe Whitehead reflects on a veritable crisis of parenthood resulting from the "ever-diminishing proportion of the entire adult life course … devoted to the nurture and care of minor children". Surveys in America reveal lower levels of happiness amongst parents compared to non-parents, and historian Peter Stearns claims that the defining characteristic of American parenthood today is anxiety.
At the other end of the age spectrum another crisis looms as older cohorts increase their share of the total population and live much longer in a dependent state. In his far-sighted report (Taking Care) on the ethical challenges this poses Leon Kass, former chairman of The President’s Council on Bioethics, warns: "While the need for long-term caregivers and proxy decision makers appears to be increasing, the supply of readily available caregivers appears to be shrinking." Among the causes he identifies is the movement of women from home-based work to work outside the home.
Are career women to blame?
The new demography and its psychological effects are clearly related to the changing role of women. Women have always worked, but typically their work after marriage has been centred on the home: caring for children, housekeeping and supplementing their husband’s paid work with home-based industries or, with the advent of the industrial revolution, work outside the home as necessary. This is still true of the majority of women today and, according to British research, it is what most women want.
But — thanks to universal education, the vote for women, feminism, capitalism and not a few other things — a career outside the home has become a competing ideal. Although "careers", as distinct from jobs, are the domain of a minority of women — the well-educated — the idea that women should remain more or less continuously in the paid workforce and "take time out" for a baby or two is pervasive, and a key plank of economic policy in richer countries.
Women do, of course, have the right to work for pay and to compete in the job market without facing unfair discrimination. They have the right to a career in the professions. The defining of these principles was inevitable and good. But it is clear from today’s anguished discussions about "work-life balance" that home life and, in particular, the care of children has suffered.
What is also becoming obvious is that the social work women once did as an extension of raising children is in crisis too. School teachers complain about the devaluing of their profession, and nurses must be recruited from developing countries to do the more menial tasks of theirs. The average amount of time spent on volunteer activities, according to a British survey, is four minutes a day.
Are these problems the inevitable result of the expansion of careers for women, or are they only the consequence of the way those careers have been pursued?
Decline of female altruism
Writing in Prospect magazine earlier this year, British academic Alison Wolf lamented the depressing effect of the new female labour market on childbearing among "professional and elite women" and, with this, the "erosion of ‘female altruism’, the service ethos which has been profoundly important to modern industrial societies — particularly in the education of the young, and the care of the old and sick."
Wolf’s thesis is as follows: "The period from the mid-19th to the mid-20th century was a golden age for the ‘caring’ sector in one major respect. It had the pick of the country’s most brilliant, energetic and ambitious women, who worked in it as paid employees, but who also gave enormous amounts of time for free. Now, increasingly, they do neither."
"Schools have been the big losers." Whereas a century ago almost all the top women graduates entered teaching, "[a]mong girls born in Britain in 1970, about one in ten of those scoring in the top academic decile chose teaching as a career. By the early 1990s, American girls in this top 10 per cent were less than one-fifth as likely to become teachers as their 1964 counterparts had been.
"In health, the pattern is more complex. Many of the ambitious women who once became ward sisters and hospital matrons now look elsewhere, but offsetting this are the growing number of women doctors and specialists." As an aside, anyone who has spent time in hospitals — especially those for the dependent aged — recently will be less inclined to believe that the loss in the nursing sector has been "offset".
Perhaps none of this would matter, Wolf argues, if it were not for the fact that, along with the departure of the "most able" women from certain professions, there has been a waning of the "specifically female public service ethos" that the pioneering female professionals of the 19th and early 20th centuries brought to their work.
Although this is impossible to measure, its main cause is not difficult to trace: it is "surely connected with the retreat of religious belief," says Wolf. "The pioneering female professionals of the 19th and early 20th centuries were imbued, in an unselfconscious way, with the language and values of religion. Duty to God, and duty to their fellow women and men, were inextricably combined."
One thinks immediately of Florence Nightingale’s "divine calling" to commit herself to nursing, raising it to professional status as a result. The great women educators also understood their work as a vocation to "do good" to others, above all in a moral sense. For Dorothea Beale, the headmistress of Cheltenham Ladies’ College and founder of St Hilda’s, Oxford, "moral training is the end, education the means".
Outside the professions as such, the same religiously inspired altruism flowered in a myriad of charitable works — on the eve of the first world war in Britain there were close to 200,000 volunteer "district visitors" linked to one or other of the churches. Today, voluntary organisations are increasingly run by professionals and reliant on government funding. Rather than simply doing charitable work, women are making careers out of it. With unintentional irony, the head of the UK’s Charity Commission has welcomed this change, noting that until recently "the sector still smacked of volunteerism".
Recovering an ethic of service
This is not an argument against professionalism. All work ought to be professional in the sense of being well done. Children ought to be well cared for whether at home or in a day care centre (if the latter is actually possible) and the same applies to aged parents and anyone dependent on the care of others. Nor is it an argument against women being paid for their work, or entering any profession for which they are fitted.
Alison Wolf may have exaggerated the contrast between the ideals of pre-World War II and post-war women, as one critic of her essay alleges. But she is surely is surely right in drawing attention to the fact that, if some women have achieved wealth, power and prestige, society has become just a bit more heartless, less caring, less altruistic than it was when our grandmothers were taking care of things — or, more precisely, people.
This can hardly surprise us when the feminism that has shaped female careerism since the mid-20th century specifically rejected the idea of "female altruism" and replaced it with the idea of "equal power" for women — power until then monopolised by men through the roles they played in society.
To answer the question posed earlier, then, it is not the expansion of women’s careers as such that has precipitated the care crisis but the particular feminist ethos that drove the expansion and interpreted it. The traditional "women’s work" of caring for husband and children in the home was represented as a kind of forced labour, slavery rather than service. The liberation of women required cutting their special tie to the home and to the caring professions, and entering every type of work and profession on the same terms as men.
Though propagated widely through the school system, this ideology has mainly affected middle-class, professional women, and it is from the ranks of this group today that we hear a reassessment of the value of home, motherhood and the care of the extended family. In her 1999 book, What Our Mothers Didn’t Tell Us: Why Happiness Eludes the Modern Woman, American writer Danielle Crittenden points out that the family "has never been about the promotion of rights but the surrender of them — by both the man and the woman". Essayist Caitlan Flanagan of Atlantic and New Yorker fame teases feminists with candid observations about women’s longing for domestic satisfactions and the self-sacrifice this necessarily entails.
What our grandmothers and great-grandmothers imbibed almost unconsciously from their mothers and faith communities, women today are having to figure out for themselves. Family life is impossible without self-surrender and sacrifice. Mothers lead the way in this, love making them experts in the care of the most dependent members of society. They do not have to do it all; husbands and everyone else can learn from them how to do their share of the caring work.
This feminine ethic of service, marked by attentiveness to the person and concern for their integral (moral and cultural as well as physical) good, is the great contribution women can make to professional life and the workplace in general. To grasp this is to see a solution to the work-life dilemma. Once "life" — relationships in the family, with others — is understood in terms of mutual service, work finds its proper purpose and place.
In this way also society can solve the crisis of professional care, since the brightest and best will no longer see the education of children and nursing as beneath their ability and dignity. Then, perhaps, we can stop telling one another to "take care" because we will have a reasonable hope that, when we really need good care, there will be someone around to give it.
Carolyn Moynihan is Deputy Editor of MercatorNet.
 Time Use Survey 2000, Office of National Statistics, UK. Cited in A Wolf, "Working girls", Prospect Magazine, Issue 121, April 2006
 Cited in "Working girls"
 "The Mommy-Wars Insurgency," Kay S. Hymowitz, City Journal, May 9, 2006 http://www.city-journal.org