I.

We live in a world saturated with the injunction to care — about family, community and the planet, about health and appearance and personal growth, about the news and injustice and strangers on the other side of the world. Caring, made legible through gesture and attention, has become the primary idiom through which we perform belonging: it is how we demonstrate that we are good parents, good citizens, good people.

This injunction is so pervasive that it has become invisible, the way grammar is invisible to a fluent speaker: not a demand but simply the texture of a decent life. This grammar of caring was assembled relatively recently, and with it, caring became not one virtue among others but the organising affect of contemporary social life, the idiom in which moral seriousness must now be expressed.

The American political scientist Joan Tronto has argued that care is not simply a feeling or a practice but a political achievement. Who is expected to care, for whom, under what conditions and at what cost, she posits, are among the most consequential questions a society can ask. We have, as a culture, largely avoided asking them, preferring to keep care in the register of the natural — which is precisely the condition of its exploitation.

II.

The complication begins when care enters the vocabulary of capitalism — where something subtle but consequential happens to it. Care is no longer simply a disposition, an ethical orientation toward another person; it becomes a resource. Like all resources under capitalism, it is then expected to be productive — to add value and to distinguish the generic from the genuine.

Consider what we now expect from almost any service interaction. It is not enough that it works; we want it to feel like something — the barista who remembers our order, the nurse who holds our hand, or the teacher who sees in our child what the child cannot yet see. What we want, in a word that keeps surfacing across multiple fields, is for people to care: not to simulate caring, but to feel something for us.

We are living through a peculiar historical moment. Artificial intelligence is rapidly absorbing the tasks we once believed defined human competence and dignity — the ones that required knowledge and judgment. Much of what used to require human technical expertise is increasingly replicable, at speed and scale and by systems that feel nothing. This transformation is exposing something unexpected: not, as we feared, that human beings are merely biological machines, but that what cannot be replicated is the sense of being seen, of being held in another's attention, of mattering to another consciousness. This is care — presence and the willingness to be affected by another person's reality.

What AI cannot do — or cannot yet do convincingly enough to satisfy us — is care about us. In the very moment that machines are colonising the landscape of human competence, care has emerged as the last irreducible human surplus. Demand for it has never been higher, nor the discourse around it more insistent. Emotional labour — the term the American sociologist Arlie Hochschild gave in 1983 to the management of feeling as a form of work — has become perhaps the primary differentiator in economic life, which separates the adequate from the excellent and the transactional from the transformative.

It asks workers — care workers, but also teachers and therapists and hospitality staff, and increasingly most people in most jobs — to bring into the marketplace precisely the emotional investment we normally reserve for our most intimate relationships: the extra mile, the genuine attention, the willingness to be affected by another's distress, to carry something of their situation home. These are the textures of love and friendship and family, in contexts where our own vulnerability is also held.

The injunction to care asks us to export all of this outside the home: to give, professionally and reliably and on demand, what we once gave only freely and selectively. The cruelty at the heart of the demand is that it falls most coercively on the people who are paid the least to meet it. We have identified care as the irreplaceable human thing, and then organised our economy to extract it at the lowest possible price.

III.

There is something else AI cannot do, something even more fundamental than feeling. It cannot touch.

However fluently a machine learns to simulate empathy, it cannot place a hand on a frightened body. It cannot hold the newborn against its chest and let her feel the warmth and rhythm of another living organism — the heartbeat that tells her, before she has the language for it, that she is not alone. It cannot sit with the dying man and let him grip its hand as his breathing changes. It cannot wash the body of someone who can no longer wash themselves, with that particular combination of efficiency and tenderness that preserves, against all the evidence, the person's sense of their own dignity.

We have nursing robots now, monitoring systems and automated dispensers and sensor beds that track a patient's vital signs with more precision than any human attendant could. They are, in their own way, extraordinary. Yet a body in distress needs more than its vital signs monitored; it needs to be touched, it needs the specific and irreplaceable knowledge that another body has chosen to come close, to remain close and not recoil. The hand that steadies the elderly woman as she moves from bed to chair, the arms that hold the person in pain — these are not supplementary to care but what care, at its most elemental, actually is.

This is why care work cannot, in the end, be automated away – not fully, not where it matters most. The body insists on being met by another body, and the insistence is not sentimental but biological, neurological, structural. The most devastating evidence for this comes from studies of infants in institutions who were fed and cleaned and never held, and who failed to thrive – in some cases failed to survive. To be touched with attention and gentleness, with the quality of presence we call tenderness, is among the most fundamental human needs, one that does not diminish with age or illness but, if anything, intensifies.

We are building machines to do everything we once thought required a human being. By doing so, we have discovered, or rather are being forced to rediscover, that the most irreplaceable human labor is also the most ancient and the most bodily. It is the labor of physical presence, of the willingness to bring one's body into contact with another in its most vulnerable states: its beginnings and endings, its sickness and its need.

IV

To understand why care is valued as it is, declared priceless and paid next to nothing at once, we must move closer to the body, because care is not a disposition or a policy framework, but a corporeal practice. It happens in the flesh.

Care is shit and urine, vomit and blood. It is the body that can no longer contain itself, that has lost the capacity to hold the boundaries we spend our lives learning to police — the infant who cannot yet manage her own matter, the elder who can no longer manage his. It is the wound that needs dressing, the bed that needs changing, the body that needs washing and turning and holding. Anyone who has cared for a dying person, or for a very young child, knows this with a knowledge that lives in the hands and the stomach rather than the mind. Care, at its most irreducible, is the willingness to remain present to the body when the body has become, in every social sense, embarrassing.

The British anthropologist Mary Douglas, in her landmark book Purity and Danger, argued that dirt is not a fixed substance but a relational category: not a thing but a displacement. Dirt is matter out of place: it crosses the boundaries a given social order uses to divide the world into the clean and the contaminated, the proper and the transgressive. Excrement is not intrinsically repulsive; it becomes repulsive when it escapes the body that was meant to contain it, marking the failure of the boundary between inside and outside, self and world, the social person and the animal organism beneath.

What care workers manage, professionally and daily, is the boundary violations of other bodies. They change the sheet, empty the catheter, clean the wound; they make it possible for the rest of us to sustain the fiction that we are sealed, self-sufficient beings who do not leak, do not fail, do not dissolve.

What is dangerous about dirt, Douglas argues, is the symbolic contamination: matter out of place threatens the categorical order itself. The care worker does not merely clean up dirt; in the social imagination she becomes proximate to it, is marked by it.

Here the concept of the abject, developed by the Bulgarian-French philosopher and psychoanalyst Julia Kristeva, becomes indispensable. In Powers of Horror, she theorises the abject as something more fundamental than dirt: the category of what must be expelled in order for the self to constitute itself as a self at all. The abject reminds us that we are not sealed, that we are bodies, that the boundary between self and other, life and death, the human and the animal, is not a wall but a membrane. Bodily fluids, excrement, the maternal body, the corpse are abject because they threaten the subject's coherent sense of its own borders, recalling us to a vulnerability we spend enormous psychic energy disavowing.

The care worker, in this frame, professionally inhabits the abject on behalf of the rest of us. She goes where we cannot bear to go and touches what we cannot bear to touch. She manages our terror of what we are.

The uncomfortable question is what we pay her for this.

Because we pay her as little as possible.

The reason for this — ideological, and so thoroughly naturalised that it rarely appears as a reason at all — is precisely the logic we have been tracing. Within the family, contact with the abject body is ennobling. The parent who cleans the sick child, the spouse who tends the failing partner, the adult daughter (and it is almost always a daughter) who washes her father's body as he approaches death: these figures are not diminished by what they touch but elevated by it. Their willingness to remain present to the abject is the measure of their love, and the repulsiveness of the act is not incidental to its moral weight but constitutes it.

The moment that same corporeal work enters the labor market, however, the moral logic inverts. Proximity to the abject no longer ennobles but contaminates. The care worker does exactly what the devoted daughter does, yet is not elevated by the work but, in the social imagination, is diminished by it. She handles what the rest of us have arranged our lives not to see, and she is compensated accordingly: as if her labor cost nothing, as if she had no self to be spent in the spending of it, as if her self were already so proximate to the base that the exposure were simply the natural condition of her existence.

The assignment of care work — particularly its most corporeal forms — overwhelmingly to women, to racialized and minoritized women, to migrants, to those the social order constructs as already closer to the body and further from the mind, is no coincidence but the mechanism of devaluation itself. The work is cheap because the workers are already marked as people for whom abjection is natural rather than sacrificial.

When a middle-class woman tends to her dying mother, it is a sacrifice; when an imported care worker tends to someone else's dying mother, it is merely her job. The devotion is demanded of her just as completely: she is hired and praised on the basis of whether she genuinely cares, whether she brings the emotional investment that separates true care from mere task completion. Yet the moral elevation that devotion earns within the family does not transfer to her. It remains with the family. She absorbs the abjection and surrenders the sanctification.

V.

This logic has a geography. It moves along routes that are economic and colonial at once, and understanding it does not require looking only at the distance between the Global North and the Global South. Sometimes it is enough to look at where we are standing.

Lithuania, like much of Central and Eastern Europe, has been a supplier in the global care chain for decades. Our women, and it is almost always women, have left to tend to other people's elderly parents in German households and Irish nursing homes and Scandinavian care facilities, carrying their devotion and their willingness to inhabit the abject westward. They have gone because the wages there are higher, which is another way of saying that the devaluation of care work is relative: there is always somewhere lower in the chain from which care can be extracted more cheaply. In England and Wales alone, there are more than 10,000 Lithuanian born workers in care and healthcare sectors alone, with another 4,000 in Germany. But these are just fragments of a myriad of those who toil officially and less so, caring for others abroad so the money they send back can care for those they left behind.

Lithuania is now beginning to import labour of its own: from Central Asia, from the Philippines, from the Global South. It is predominantly male and predominantly manual: the labour of construction sites and agricultural fields, of sewers and waste management, of the cold and the mud and the physical infrastructure of a society that has decided it no longer wishes to inhabit those conditions itself.

We are, in other words, beginning to outsource our own abjection, assigning to newly arrived and racialised bodies the work that handles matter out of place — the work that dirties and exhausts and renders invisible.

In both cases what is transferred is bodily exertion in proximity to what Douglas calls dirt — the boundary-violating matter a society needs managed but does not wish to see being managed. In both cases the transfer rests on a prior construction: that these bodies are suited to the work, natural to it, less diminished by it than we would be. The logic is identical whether it governs a care worker washing a dying man or a construction worker laying drainage pipes in February; what changes is only the gender of the body assigned to the task, and the direction of the chain.

What makes our position in this chain unusually revealing is that we inhabit it from both sides at once. Within a single generation we have been the racialised supplier and are becoming the emerging consumer of racialised labour; we know what it is to be the body imported for its willingness to endure, and we are learning, with uncomfortable speed, how to be the society that imports.

This shows us that the devaluation of bodily labour is not a property of the work itself, nor of the bodies that perform it. It is a position, and it travels, always in the same direction: downward, toward whoever has most recently been cast as closer to the body and further from the mind, more natural and more available.

We are watching ourselves, in real time, reproduce the logic to which we were once subjected.

VI.

To understand fully why this inversion holds and why the acknowledgment that care is irreplaceable has not translated into valuing those who provide it, we need to look at two further mechanisms. One is ideological and ancient, the other economic and, in its way, brutal; together they form the invisible scaffolding that keeps the paradox standing.

The first is what we might call the vocation trap.

Care work carries a residue of the sacred, and not accidentally. Before the welfare state, before professional nursing, before the infrastructure of institutionalised care existed at all, the tending of the sick and the dying and the very young was overwhelmingly the work of women under religious vows — nursing nuns, charitable sisterhoods, the vast feminine apparatus of ecclesiastical mercy. These women did not receive wages. They received meaning. Their compensation was spiritual: the grace of service, the sanctification of suffering, the promise that what they endured in this life would be redeemed in the next. The labour was its own reward because it was, in the deepest sense, an offering.

This theological architecture no longer governs our institutions, yet its ghost persists in the language we use about care work — above all in the word vocation, which we still reach for to explain why someone becomes a nurse or an early childhood educator despite the pay. We say they are called to it, that it is not merely a job but a mission, a way of being in the world; and we mean it as the highest form of praise.

What this language does is convert labour into essence. It says that the care worker does not merely perform care but is caring, the way a river is wet, and if care is simply what she is, then it costs her nothing to give. A river is not compensated for being wet; a vocation is not paid but received, answered, honored.

The consequence is that the more genuinely a care worker cares — the more authentic her investment, the more of herself she brings to the work – the more vulnerable she becomes to exploitation, because she will keep showing up. A nurse who withdraws her labour is not, in the social imagination, a worker exercising her rights; she is a person who has decided to stop caring. In a world where not caring is the only unforgivable sin, that accusation is almost impossible to bear.

The vocation trap is, in this sense, an exquisitely efficient mechanism. It takes the most admirable qualities of the care worker — her devotion, her presence, her willingness to remain in the room when others leave — and converts them into the instruments of her own underpayment. Her love is the leverage used against her; her calling is the cage.

This is not only a historical residue but something actively reproduced. One hears the language of vocation in how care institutions recruit, in policy documents and job advertisements and the speeches of health ministers, everywhere doing its quiet work — distinguishing the truly dedicated from the merely employed, establishing the expectation that real care workers give more than they are asked, more than they are paid, more than is sustainable: that they give freely what the institution cannot afford to pay for. The sacred and the economic are not in tension here but in collaboration.

This brings us to the second mechanism, the economic one, where the argument is even more uncomfortable, because it removes the last excuse of ignorance.

The American economist William Baumol identified what he called the ‘cost disease’ of service work. In manufacturing, productivity can be increased — a better machine, a refined process, more output in less time — and wages rise (in theory) because output rises. In certain kinds of work, however, productivity increases are structurally impossible, because the work simply is the time it takes. A person cannot be bathed in half the time without the bath ceasing to be a bath and becoming something else. The hours spent sitting with someone who is dying cannot meaningfully be halved. The developmental attention a two-year-old requires cannot accelerated. The labour is irreducibly slow because the human being at its center is irreducibly present.

As the rest of the economy grows more productive, then, care work becomes relatively more expensive: not because care workers are less efficient but because they cannot be made more efficient without destroying the very thing that makes their work care rather than processing. As wages rise elsewhere, the cost of properly compensating them rises too, and faster than any productivity gain could justify.

Societies face a choice at this point. They can accept that care is expensive and fund it accordingly, through taxation and public provision and wages that reflect the irreplaceability of the work. Or, they can suppress the wages of care workers, import cheaper labour, casualize the workforce, and cut the time allotted to each patient or child or resident until what happens in those rooms is no longer quite care but something that resembles it at a distance.

We know which choice most societies have made. It is visible in the staffing ratios of nursing homes and the waiting lists for early childhood education, and most of all, in the faces of home care workers allocated thirty minutes per client to wash, dress, feed, medicate and, if anything remains — which it rarely does — to simply be present with another human being in need.

What Baumol's framework reveals, and the vocation argument conceals, is that the underpayment of care workers is not an oversight, not a failure of recognition that better awareness campaigns could correct. It is a structural feature of how we have chosen to organize the relationship between the economy and human vulnerability. It is a policy — a collective judgment, made mostly by people who neither perform care work nor depend on its most precarious forms, that tending to human bodies in their most vulnerable states is worth less than managing capital, writing code, or running a meeting.

This is not a natural fact but a decision, and unlike the cost disease, which is genuinely structural, the decision can be unmade. The Scandinavian countries have made different ones – imperfect, incomplete, but meaningfully different — about what care is worth and who should bear its cost. That other societies have not is no economic inevitability. It is a moral choice wearing the mask of one.

VII.

We return, at the end, to the caress. Not as a metaphor but as a fact, the most irreducible unit of everything we have been tracing.

The caress is the gesture care makes when it is most fully itself. It is not the efficient completion of a task, nor the managed smile of emotional labour correctly executed, but something older – the deliberate, unhurried movement of one body toward another in its vulnerability: the hand that cups the newborn's head, the arm that steadies the woman who can no longer trust her own legs, the fingers that smooth the hair of the person who is dying and needs, more than anything in the world, to know that someone is still willing to be close.

The caress cannot be automated, cannot be outsourced without remainder, cannot be optimized for efficiency or decomposed into parts and reassembled by an algorithm. It is, in the most literal sense, irreplaceable — not because it is mysterious or sacred but because it requires the presence of a body that has chosen, against all the pressures of time and exhaustion and inadequate compensation, to come closer.

The caress is where the paradox lives in its most concentrated form. The caress given by the mother to her sick child, by the spouse to the failing partner, by the adult child to the parent who no longer remembers her name is priceless, and we mean the word in its fullest sense, beyond price and beyond calculation.

The caress given by the care worker — by the nursing assistant who has been on her feet for ten hours, who has three more rooms to attend to, who is paid just above minimum wage and told by the rota that she has seven minutes per resident — is also priceless. Yet through the mechanisms we have traced, we have contrived to mean something entirely different by the word: not beyond price because infinitely valuable, but beyond price because we have decided, collectively and with remarkable consistency, that it has no price worth paying.

It is the same gesture, the same quality of presence, the same willingness to come close to the body in its need, to touch what others will not touch, to remain in the room the rest of the world has quietly arranged not to enter. And yet everything about how we organise our societies — our wages and staffing ratios, our immigration policies, our theology of vocation, our convenient confusion of love and labor — conspires to make one of these caresses an expression of the highest human devotion and the other just a job, and a cheap one.

This distinction is not natural or inevitable. It is a choice — the choice of societies that have decided to free-ride on devotion, to consume the caress while refusing to pay for it, to demand the presence of another human being in our most vulnerable moments while organising the economy so that the person who provides it cannot afford her own rent.

We live under the prevailing injunction to care,and with the conviction that not caring is the one unforgivable sin of contemporary life. What we have seen, though, is that the injunction is not evenly distributed. It falls, with the full weight of ideology and theology and economic structure, on the people already most burdened by it. It demands the most from those who have the least. It extracts devotion from the women who cannot afford to withhold it, from the migrants imported for precisely their willingness to endure, from the care workers who keep coming back, not because the system has earned their loyalty but because the people in their care have.

The caress, then, is not only a gesture of love but a site of political contradiction, where the priceless and the cheap meet in the same body, the same movement, the same seven minutes that are never quite enough. It is where we see most clearly, and most painfully, what we actually value – not what we say we value, not what we legislate or celebrate or post about, but what we are willing to pay for.

Until we are willing to pay for it — really pay for it, in wages and policy and the reorganisation of public life around the acknowledgment that human vulnerability is not a problem to be managed cheaply but a condition to be met generously — we are not, whatever we tell ourselves, a society that cares.