The Ontological Primacy of Being-With: Caring as Communion.

BACKGROUND: Caring science has consistently emphasised relationality as central to nursing and human health; however, its ontological grounding remains insufficiently articulated. Prevailing models often rely on interactional paradigms that conceptualise caring as exchanges between discrete individuals, thereby overlooking the deeper existential condition that renders caring encounters meaningful. AIM: This study aims to articulate the ontological primacy of being-with as the foundational ground of caring and to advance the Theory of Communion-in-Caring as its fulfilment. METHOD: A hermeneutic philosophical inquiry was conducted using interpretive analysis, comparative philosophical examination, and conceptual synthesis. Foundational works from Martin Heidegger, Martin Buber, Emmanuel Levinas, Maurice Merleau-Ponty, and Gabriel Marcel were integrated with key caring science traditions to construct a coherent ontological framework. RESULTS: Being-with is conceptualised as a primordial ontological condition expressed through three interrelated structures: Relational co-presence, dialogical openness, and embodied attunement. These structures constitute the ground of caring encounters and converge in communion, understood as a shared field of presence, meaning, and ethical responsiveness. Communion represents the ontological fulfilment of relational existence, wherein caring is enacted as participatory, embodied, and ethically grounded presence. CONCLUSION: The ontology of being-with provides a rigorous philosophical foundation for caring science, reconfiguring caring as a mode of being rather than a set of tasks or interactions. By positioning communion as the fulfilment of relational existence, the Theory of Communion-in-Caring advances theoretical coherence and offers a foundation for future empirical, methodological, and practice-based developments.