Recognition Theory and Social Work: Justice, Misrecognition and LGBTQ Surrogate Decision Makers

Social justice is identified in professional codes of ethics and scholarship as a fundamental principle in social work. Historically codes of ethics and social work scholarship have relied heavily upon theories of distributive... [ view full abstract ]

Social justice is identified in professional codes of ethics and scholarship as a fundamental principle in social work. Historically codes of ethics and social work scholarship have relied heavily upon theories of distributive justice to define social justice for the field. Contemporary social work is increasingly concerned with the sociocultural aspects of identity and difference as they relate to social justice, which may not be adequately addressed by theories of distributive justice. This paper draws on the debate between political philosophers Nancy Fraser and Axel Honneth, as well as the social work scholars who have applied their work describing the dimensions of recognition. I argue that recognition theory offers social work a normative framework to justify moral claims of injustice based on identity and difference at the structural and intersubjective levels. This paper aims bridge the conceptual and empirical realms by placing recognition theory in dialogue with case examples from a qualitative study of lesbian, gay, bisexual, transgender and queer (LGBTQ) partners acting as medical surrogate decision makers in hospital settings in the United States. LGBTQ partners have historically been marginalized in the role of surrogate decision maker based on identity and difference. Marginalization has occurred through dominant social structures, such as LGBTQ-exclusive marriage laws, as well as heteronormative assumptions in interpersonal relations, such as clinicians’ failure to acknowledge familial relationships between LGBTQ patients and their partners. This analysis supports the relevance of both Fraser’s structural and Honneth’s intersubjective dimensions of recognition, illustrated through the lived experiences of partners caring for seriously ill patients. Partners’ experiences suggest that an integrated theory of recognition may be required to guide a social work practice grounded by a conceptualization of social justice inclusive of the multi-dimensional aspects of identity and difference, and sensitive to the injustices that occur through misrecognition.