Health care and neoliberalism in Ireland: withholding the gift and corrupting the social contract

The health of a nation tells much about the nature of a social contract between citizen and state. The way that health care is organised, and the degree to which it is equitably accessible, constitutes a manifestation of the effects of moments and events in that country's history. Using four case studies, this thesis uses a historical genealogical approach to explain the evolution of Ireland's particular version of health care provision. The total social fact of the gift relationship, central to all human relations, will be used to form a theoretical and conceptual framework on which to build an analysis of Ireland's health and welfare conditions. Additionally, social contract theory will enable an examination of the role of solidarity in relation to social expectations around health care provision. Through the analysis of these cases, the complex matrix of the influential forces that have shaped current conditions are exposed and revealed, enabling a critical understanding of the extent of acquiescence to the inequitable system that arguably exists. The vulnerability of citizens in need of care to the external and global effects of market forces and neoliberalism, therefore, becomes central to any argument for state-provided health and welfare. The hegemony of such forces can be seen to influence the manner in which the idea of individual self-reliance, in place of collective solidarity, is conceptualised and subsequently infiltrated into a range of aspects of the social world. For example, the particular discourse of the market and of economic concerns succeeds in shaping understandings of responsibilities around central areas of health and welfare. Similarly the 'possessor principle' can be seen to be misplaced within the context of health and social care, but yet has become normalised within this discourse. Within this matrix of complex influencing factors, the welfare state struggles to impose a balance between market values and social values. Responsibilities of the state to support and compensate its citizens for the ills of the market have become devalued, as the core values of classical liberalism have become distorted beyond recognition, leaving instead bare neoliberal concerns. This thesis traces the genealogical origins of this transition within the recent history of Irish health care and thereby reveals the embedding of individualism in place of solidarity, the on going reneging of the social contract and the corruption of the gift relationship.

Towards enhanced divine-human-earth relations: a Christian-Buddhist contribution

The central claim of the dissertation is that lesser known and somewhat neglected, yet influential thinkers, within classical religious traditions have something worthwhile to contribute to the kind of ethos we should adopt in the face of the world’s various environmental crises. Moreover an exploration of such perspectives is best done in dialogue, particularly between Eastern and Western thought. I examine this claim primarily through a dialogue between the Christian philosopher John Scottus Eriugena and the Japanese Buddhist philosopher Kūkai (Kōbō Daishi). This dialogue, framed by the triad of divine-human-earth relations, primarily emphasises the oneness of all reality, and it finds expression in Eriugena’s concept of natura or phusis and Kūkai’s central teaching that the phenomenal world is the cosmic Buddha Dainichi. By highlighting this focus, I contribute to the existing academic field of ecology and religion on the subject of holism. However, I go beyond the materialist focus that generally marks such ecological holism within that field, offering instead a more metaphysical approach. This is indicated through my use of the concept of ‘immanental transcendence’ to describe Eriugena’s and Kūkai’s dynamic, numinous and mysterious notion of reality, as well as my exploration of Eriugena’s concept of theophany and Kūkai’s notion of kaji. I further explore how both philosophers highlight the human role in the process of reaching enlightenment—understood as attaining union with the whole. In that regard, I note significant differences in their positions: in particular, I note that Kūkai’s emphasis on bodily practices contrasts with Eriugena’s more conceptual approach. Finally to bolster my claim, I examine some ecologically oriented understandings of contemporary phenomenological approaches found particularly in the work of Jean-Luc Marion and to a lesser extent Merleau-Ponty, arguing that these reflect notions of reality and of the human role similar to those of the medieval philosophers.