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American labor unions are in crisis. Unionization rates have been in decline for decades. Hospital workers' unions, however, are growing. Today, they are among the most potent forces in the American labor movement. The Moral Economy of Care seeks to understand both the historical developments that have led to this state of affairs, and the ethical dilemmas of striking and workplace conflict in hospitals today.

The COVID pandemic laid bare the moral injury care workers suffer due to the burden of balancing patient wellbeing against market incentives. Pablo Gaston argues that these longstanding ethical tensions are linked to care workers' mass scale mobilization, with deep roots in the history of care work in the US. The notable successes of today's hospital workers' unions, Gaston argues, can be explained by their ability to leverage a rhetorical framework that reconciles the tension; care workers strike because they care, whereas capital is uncaring. Following two unions working to organize California hospital workers over the course of seven decades, this book shows how moral conceptions of caring shaped collective bargaining patterns in hospitals in the twentieth century.