‘Why Bother?’ Skeptical Doubt and Moral Imagination in Care for People with Profound Intellectual Disabilities

Caring well for people with profound intellectual disabilities is challenging. This challenge is often framed in terms of their complex needs and the ambiguity of interpreting these needs. Based on ethnographic fieldwork, this article argues that behind these challenges lies a more fundamental challenge of doubt: doubt stemming from uncertainties about the mind of the other, and thus about the purpose of care itself. Drawing on Stanley Cavell's notion of skepticism, the article explores how this challenge arises and how caregivers grapple with it. The study finds that skeptical doubt always threatens care for people with profound intellectual disabilities, but often remains unseen. This is because caregivers deftly manage to ward off their skeptical doubt, by 'placing people into life': imagining the people in their care as participants in a shared human everyday life. The article tracks such exercises of 'placing people into life' to document how caregivers manage to retain faith in the purpose of their care. In this way, the article gives ethnographic texture to the challenge of caring well for people with profound intellectual disabilities and gathers clues for improving this care-which can also aid in improving care in other contexts of cognitive difference.