Hee-Kang Kim

Interview with dr. Hee-Kang Kim, University of Korea, South Korea.

1. Where are you working at this moment?

I am working at the department of Public Administration at the Korea University.

2. Can you tell us about your research and its relation to care ethics?

I teach public philosophy, normative policy analysis, and women’s studies at the university. My research interests are social justice, care ethics, feminism, and the normative understanding of public policy. Especially recently, I am interested in re-evaluating public policy and identifying and rectifying the injustice of society from the perspective of care ethics. In 2016, I published a book, Gyubeomjeok Jeongchaek Bunseok [A Normative Policy Analysis], which was selected as an excellent academic book by the Korean Academy of Sciences.

I am currently writing a book on the caring state where care ethics is treated as one of the important normative principles of justice on which laws and major institutions are grounded. In addition, there are three other research projects currently under study.
The first is the study of care as a constitutional value. In this study, I argue that care which is inevitably linked to freedom, equality, and justice should be treated as a constitutional value. In particular, I think this study is very important to contribute to Korean society, which is currently discussing the amendment of the Constitution.
The second is the study of the theoretical elaboration on care ethics. In this study, care ethics as a moral and political theory is referred to as “carism,” and the non-liberal and non-communitarian nature of “carism” is sought.
The third is about the democratization of care. The existing socialization of care has contributed to the challenge of the private/public distinction and the social recognition of care. However, the democratization of care is a study on the quality of the socialization of care which can go a step further in the socialization of care and judge which socialization of care is good.

3. How did you get involved in care ethics?

I have been interested in the literature of care ethics from the viewpoint of social justice and feminism. Recently, I have translated several major books (Joan Tronto’s Caring Democracy, Eva Kittay’s Love’s Labor, Virginia Held’s The Ethics of Care, and Daniel Engster’s The Heart of Justice) on care ethics into Korean and introduced them to South Korea.

4. How would you describe care ethics?

In short, it is a theory that redefines the value of care at the societal and political level.

5. What is the most important thing you learned from care ethics?

On the individual level, I think, care ethics reminds us of our fundamental and nested ethical duty (which is preceded by a priori rights) to others who live together. On the societal level, care ethics provides a normative perspective that helps to identify and rectify the persistent and systematic inequalities and injustices of society. On the global level, care ethics provides a motivation where intimate care for our families and neighbors is transferred (transited) to care for others in distant countries.

6. Whom would you consider to be your most important teacher(s) and collaborators?

I have been largely influenced by Iris Young’s study on structural injustice, although she is not a scholar of care ethics. I also get a lot of inspiration from the studies by Eva Kittay, Joan Tronto, Virginia Held, Daniel Engster, and Selma Sevenhuijsen. In South Korea, there are a few scholars who study care-related theory, and there are a number of scholars who study carework and care-related social policy.

7. What publications do you consider the most important with regard to care ethics?

Joan Tronto’s Moral Boundaries and Eva Kittay’s Love’s Labor.

8. Which of your own books/articles/projects should we learn from?

Much of my existing research is to re-evaluate public policy/social policy from the normative perspective of care ethics. What is written in English includes “Is Long-term Care Insurance in South Korea a Socialising Care Policy?” (Critical Social Policy 36(4), 2016) and “Basic Income and Care Ethics” (unpublished). My current project is a book on the caring state. There are some published articles in Korean related to the subject of this book. It aims at identifying and rectifying the structural inequality of society from the viewpoint of care ethics and drawing the philosophical foundation, system, and policy of government compatible with care.

9. What are important issues for care ethics in the future?

Perhaps in principle, defining the concept of care and formulating the theory of care ethics are likely to be the most challenging issues in future research.
First, although care is a universal experience from which everyone is inescapable, care relationships are very particular depending on the specific context and situation. In particularly, how to define care in different cultural and national contexts would be a difficult task to challenge.
Second, it is about establishing the theory of care ethics. The establishment of the theory of care ethics, which is distinct from other moral and political theories, such as liberalism, communitarianism, and republicanism, would be a major challenge for the future.

10. How may care ethics contribute to society as a whole, do you think?

Care ethics can contribute to making society more just and better. It is because care ethics allows us to know how much individuals and society are exposed to social justice by our negligence of care responsibility, and thus have contributed (un)consciously to social injustice. As a result, care ethics reminds us that we have a shared and collective responsibility for a better society.

11. Do you know of any research-based projects in local communities, institutions or on national levels, where ‘care’ is central? Please describe.

There has not been much care-related research in South Korea. Recently, however, Korean translations of major books on care ethics have been introduced to the public. Apart from the theoretical research on care, many care-related policies are being proposed by central and local governments since the current Korean society faces the serious social problems of low fertility and aging.

12. The aim of the consortium is to further develop care ethics internationally by creating connections between people who are involved in this interdisciplinary field, both in scientific and societal realms. Do you have any recommendations or wishes yourself?

I hope that this consortium can demonstrate the possibility of care ethics outreaching around the world. I am firmly convinced that care has the full potential to do so. Just as the concept of human rights, which emerged from abstract natural law, has contributed to changing the world for the last fifty years, so care, which is not abstract but comes from everyday experiences of everyone, can contribute to making the world better in the near and foreseeable future. What we need to do now is to re-establish the value of care. This is where care ethics plays. I hope the consortium will be the beginning of this.

Interviews

Leslie Swartz

Interview with Leslie Swartz, Stellenbosch University, Stellenbosch, South Africa.

1. Where are you working at this moment?

Most of my work is in the area of disability studies, with a special emphasis on disability rights issues in Southern Africa. I also work on mental health issues.

2. Can you tell us about your research and its relation to care ethics?

It is impossible to work in the area of disability studies and not be interested in some way in care ethics. In our work on disability and access to health care, we are interested in the role played by informal paid or unpaid workers in disability care. In other work on language and access to mental health care, we have come to see the crucial but often invisibilised role played by cleaners and security guards in health care in low income contexts.

These are just two examples. I have also done some reflective work on questions of exploitative relationships with care workers in the context of chronic illness, drawing on my own experience with the illness and death of my mother.

3. How did you get involved in care ethics?

I worked on a project with Vivienne Bozalek and Brenda Leibowitz and others on university transformation issues in South Africa and it was Vivienne and Brenda who introduced me to the field. Vivienne then invited Joan Tronto to South Africa and I grew very interested in her work. I am quite marginal to the field of care ethics – it is not my main area of concern but it has really influenced my thinking.

4. What is the most important thing you learned from care ethics?

Two apparently simple things, but profound for me and my thinking: that we all rely on care all the time, and that care is often made invisible, with this invisibility often linked to exploitation commonly on lines of race, gender, class.

5. Whom would you consider to be your most important teacher(s) and collaborators?

In the care ethics field in South Africa I have been very influenced by Vivienne Bozalek and Brenda Leibowitz, and Joan Tronto’s work is very important to me. More generally, I am very fortunate to have a wide range of people I work with in disability studies and mental health, some of them senior to me but some of them my students and I have learned from them all.

One person who had a huge influence on me personally and professionally was the late Alexander Phiri, who was secretary general of the Southern African Federation on Disability (SAFOD), which represents Disabled People’s Organizations in ten southern African countries. Alexander was a consummate disability activist who was seriously concerned with the political and personal development of people he worked with. He was very open and not doctrinaire, and extremely pragmatic.

He lived in Zimbabwe and witnessed multiple assaults on rights, including the rights of disabled people, and he was able in a range of ways to make changes in difficult contexts. He also had the openness and generosity to accept me as a white non-disabled South African man to do some work for his organization – he was very aware of difference and identity but was able to see past the obvious and to think about what was best for his organization and the people it served. He was not an academic but he knew a lots about care.

6. What publications do you consider the most important with regard to care ethics?

A paper which Joan Tronto does not herself regard as a major contribution, published in Ethics and Social Welfare on what constitutes a caring institution has been very useful indeed for me and colleagues.

7. Which of your own books/articles/projects should we learn from?

I am not an expert in this field but I think that we have used care ethics concepts in slightly different contexts – so our contribution is more about some applications than about bringing new knowledge as such. Here are some examples:

Smith, J., Swartz, L., Kilian, S., & Chiliza, B. (2013). Mediating words, mediating worlds: Interpreting as hidden care work in a South African psychiatric institution. Transcultural Psychiatry, 50, 493-514. DOI: 10.1177/1363461513494993.
Swartz, L., & Kilian, S. (2014). The invisibility of informal interpreting in mental health care in South Africa: notes towards a contextual understanding. Culture, Medicine and Psychiatry, 38, 700-711. DOI 10.1007/s11013-014-9394-7.
Swartz, L. (2015). Care and the luxury of trauma: A South African story. Palliative and Supportive Care, 13, 399-404. doi:10.1017/S147895151400042X.
Swartz, L. (2012). Race, gender, and the impossibilities of care. Medical Humanities, 38, 34-37. doi:10.1136/medhum-2011-010073.

8. What are important issues for care ethics in the future?

I think we need to know much more about men as carers and also about the importance of being a carer for people who are cast as in need of care (for example, disabled people and people with serious mental disorder caring for others). The question of the impact of technology on ecologies of care in low-income contexts is also an important one.

9. How may care ethics contribute to society as a whole, do you think?

I think it is crucial to understand care and interdependence as central to life, public, private and political. The effacing of care from a range of discourses is a serious erasure.

10. The aim of the consortium is to further develop care ethics internationally by creating connections between people who are involved in this interdisciplinary field, both in scientific and societal realms. Do you have any recommendations or wishes yourself?

My work is very interdisciplinary and quite scattered in some ways. I am very lucky to be learning from people who are more clearly focused on care ethics than I am, and I am grateful for this. I think the insights of this approach need to be disseminated to every discipline. Thank you for allowing me to learn from this field.

Conferences

Different perspectives on care work

2017 Carework Summit: coming together of feminist economical, political and sociological views on care work.

This June, scholars, policymakers and members of societal organizations gathered during the three-day conference 2017 Carework Summit in Lowell, Massachusetts in the United States. Together, they inquired and discussed problems in the field of Care Work – a field that focuses on researching, advocating, policymaking and institutional transformation of care work. Inge van Nistelrooij and Merel Visse attended this conference on behalf of the Care Ethics group of Utrecht, The Netherlands. Below, we highlight two conference themes: 1) care on a global level, seen from a United Nations perspective; 2) care from a feminist economist perspective.

Care Work

But let us first explore what the field of Care work is concerned about. Most speakers strive for equality and justice in both paid and unpaid care work in all kinds of areas, like long term elderly care, child care and home-based elderly care either provided by family cares, formal carers, non-migrant and migrant carers. We noticed that the majority of the attendees have a background in sociology, political science or economy.

As care ethicists, we learned about how they perceive and conceptualize care in the context of the research field of ‘care work’. Although there seemed to be little attention for philosophical ethical views on care work, we believe care ethicists could deepen thinking about ‘what care is’ and how to inquire ‘good’ care work.

Care work on a Global Level: United Nations Programs

The keynote address of the conference by Shahra Razavi, Chief of Research & Data Section at United Nations Women, focused on numbers in care work. She is a specialist in gender dimensions of development, with a particular interest on work, social policy and care. The United Nations Program on Sustainable Development proposes an Agenda that explicitly addresses care work and the importance of gender equality.

Concurrent sessions varied from discussions on qualitative methods to research care work, to contributions by feminist economists on the benefits and costs of investing in care. At the UN, a normative framework is being developed to assess and promote care work.

A feminist economist, intersectional perspective

Nancy Folbre, director of the program on Gender and Care Work at Umass in Amherst, was deeply concerned about care work. Her feminist care economist perspective aims to counterbalance developments like outsourcing, offshoring, immigration and privatizing. These threaten the equal division of care work.
Collective identities and interests based on gender, race, income level shape our institutions and economic inequality. According to her, we should begin by rethinking the care paradigm by understanding the origins of patriarchical systems.

Bargaining power

“These developments have reduced the bargaining power of care workers and undermine the democratic apparatus,” according to her. Other factors that reduce bargaining power of care workers, are: the relational vulnerability of care workers (often women); the characteristics of consumers who often have a lack of agency and even if they have agency, it’s often difficult for them to access the right information; characteristics of the services themselves.

The bargaining power of care workers is not just determined by assets, information or income level, but by social norms as well. These social norms should be collectively contested and re-negotiated. Attention for an intersectional approach is crucial here, she argued. These can have risks, but can also be seen as an opportunity to create progressive alliances: e.g. create beter rules for distribtion of care work.

Focus on high power groups?

To solve problems in care, Folbre searches for how we can bargain collectively with powerful groups to reduce inequality. “We have a tendency to focus on low paid, marginalized groups. Now we need to focus on how to challenge groups with high power”. This could be interesting for us as care ethics, as we are often focused on processes of inclusion by providing marginalized groups with power.

Social spillovers

As care ethicists, we noticed that just a few of the speakers during the conference, actually spoke about what ‘care’ is. Folbre was one of them. She clarified care as ‘not just relational work’ motivated by concerns for others, not just ‘work’, but as also inclusive to financial support and other resource transfers. She stressed that care is tending to the needs of those who cannot care. Care work is not tangible.
Folbre speaks about ‘social spillovers’: “the marginal social product of care is far greater than marginal private products”. Care gives numerous contributions to human and social capital.

Soon: the global meaning of Tronto’s Caring Democracy, with a contribution by dr. Inge van Nistelrooij.

Interviews

Joan Tronto

Interview with Joan Tronto, Professor of Political Science, University of Minnesota, Minneapolis, Minnesota, USA.

1. Where are you working at this moment?

At the University of Minnesota.

2. Can you tell us about your research and its relation to care ethics?

I’ve been writing about care ethics for about thirty years. My current research involves thinking about care from a global perspective.

3. How did you get involved in care ethics?

Two ways. As a feminist scholar, I kept thinking about the political cost if women decided that they should join “the mainstream of American society” in “equal partnership with men” (as the National Organization for Women’s founding document put it). What would we lose as a society if middle-class women became just like middle-class men?

I began talking to my students about my “feminist nightmare” when women, no longer constrained by the caste barriers that had kept them out of some occupations and professions, passed the caring work in society over to poorer women and men and people of color. So I was paying attention to care as work.

On a more philosophical level, and I am trained as a political theorist, I was part of a feminist faculty development seminar at Hunter College in 1983. When we read Carol Gilligan’s just-published book, In a Different Voice, I was struck that the care-justice distinction there seemed parallel to a different philosophical moment. I was struck by the similarity between this difference and the one between Scottish Enlightenment philosophies and Kantian ethics. This parallel led me to think more systematically about care, as Gilligan and others were describing it, and non-Kantian models of ethics.

4. How would you describe care ethics?

Care ethics is both a moral and political concept that emphasizes the centrality of care in human life. Democracies should support democratic care.

5. What is the most important thing you learned from care ethics?

Oh my gosh, there is so much to say here.
First, that ethics comes out of daily life, not in huge pronouncements of right and wrong from the sky.
Second, that one must look at all care activities from various perspectives, from the standpoint of receivers as well as givers of care.
Third, that there are not singular but plural answers to questions about what it means to care well.
Fourth that bad forms of care can deceive us into thinking unjust things are OK.

6. Whom would you consider to be your most important teacher(s) and collaborators?

My most important teacher in political theory was my dissertation adviser, Sheldon Wolin, whose work on the important of theory in an age in which thought becomes increasingly dessicated remains with me everyday.

I have learned immensely from Hannah Arendt, and Simone Weil, and my dear friend Mary Dietz, who is a scholar of their thought. Carol Gilligan, Sara Ruddick, Virginia Held, Nel Noddings, and Eva Kittay have taught me so much.

My first most important collaborator was Berenice Fisher. It took us two years to write the essay ‘Toward a Feminist Theory of Care’, in which we defined care and discussed the first four phases of care. Selma Sevenhuijsen was my close interlocutor for decades and raised basic questions and brought insights to the study of care that are with me everyday.

Henk Manschot taught me to think about care from the perspective of the care-receiver. Guy Widdershoven has kept me well educated about developments of care ethics in bioethics. Fiona Robinson’s application of care in international relations helps me to think more globally. Fiona Williams’s fantastic work on social policy is so insightful. Olena Hankivsky’s way to reorganizing care was important to me, as is her critique of care from an intersectional perspective.

Truthfully, I have learned so much from my graduate students and younger colleagues, too. Among graduate students with whom I have worked on care ethics, Dan Skinner, Jocelyn Boryczka and Vivienne Bozalek have taught me so much. And I keep meeting scholars from whom I learn so much all the time. I’m afraid I’ve left some people out…

7. What publications do you consider the most important with regard to care ethics?

I’ll leave my own work off this list; Carol Gilligan, In a Different Voice. I learn something new every time I re-read Ruddick’s Maternal Thinking. Held, An Ethic of Care Kittay, Love’s Labor. Sevenhuijsen’s Citizenship and the Ethics of Care (though I like the Dutch title, “Judging with Care” better). Dan Engster’s The Heart of Justice. Among recent books, I am fond of Stephanie Collins, The Core of Care Ethics.

8. Which of your own books/articles/projects should we learn from?

Even though it is over twenty years old, Moral Boundaries is still worth reading in its entirety; and Caring Democracy shows what care should look like in a more democratic society.

9. What are important issues for care ethics in the future?

In the most immediate future, there are a couple of key issues, all of which have to do with expanding the arena of care:

Recognizing the connection between care and the struggles of disabled people, indigenous people, and others who are not fully included in society.
Overcoming the parochialism and tribalism of the recent turn to the right in Europe, the USA, and elsewhere, which, of course, can be expressed as a care discourse.
Recognizing the danger to care givers and receivers everywhere (that is, all of us) from neoliberal economic orders.
Understanding how care operates to meet need differently everywhere in the world and trying to be attentive to all such forms of care.
Finally, perhaps most importantly, our need to care for the earth.

10. How may care ethics contribute to society as a whole, do you think?

By reorienting us towards the things that really matter.

11. Do you know of any research-based projects in local communities, institutions or on national levels, where ‘care’ is central?

There are movements growing up everywhere, to improve the conditions of care workers, to strengthen the voice and rights of disabled people, indigenous people, to stop religious persecution, to make all feel welcome. Many of my undergraduate students have become more politically aware in recent months; we can hope that this continues.

12. The aim of the consortium is to further develop care ethics internationally by creating connections between people who are involved in this interdisciplinary field, both in scientific and societal realms. Do you have any recommendations or wishes yourself?

I am an optimistic person by nature. I hope that the Consortium can reach an international audience at both the scholarly and political level.

Earlier, in 2009 we interviewed Joan Tronto on similar topics.

Interviews

Maurice Hamington

Interview with Maurice Hamington, Portland State University, Portland, Oregon, USA.

1. Where are you working at this moment?

I work at Portland State University where I am a Professor of Philosophy and the Executive Director of University Studies which is an interdisciplinary integrated undergraduate general education curriculum. Our community of 50 full time faculty, hundreds of part-time faculty, and 100 peer mentors emphasize inclusion and justice in a caring culture for ourselves and the students we work with.

2. Can you tell us about your research and its relation to care ethics?

I am a feminist ethicist who addresses both theoretical and applied elements of care ethics. In particular, I have emphasized the embodied and performative aspects of care in contending that care ethics is more than a normative theory of morality. For me, care has ontological and epistemological dimensions in addition to its ethical significance.

In terms of books, I most recently co-edited the volume Care Ethics and Political Theory with Dan Engster (Oxford 2015). In 2017, I have published articles on care ethics and design thinking (Journal of Business Ethics) as well as on care ethics and haiku (Juxtapositions: The Journal of Haiku Research and Scholarship with Ce Rosenow).
Also in 2017, I have contributed chapters on care ethics to Compassionate Migration and Regional Policy. Steven W. Bender and William Arrocha, eds. (Palgrave Macmillan), Evaluation for A Caring Society, Merel Visse and Tineke Abma, eds. (Information Age Publishing, Routledge Handbook of Philosophy of Empathy, Heidi Maibom, ed., (Routledge), and Pets and People, Christine Overall, ed. (Oxford University Press).

As one can see, my research interests are quite varied. At this time, I am working on chapters on care ethics and phenomenology as well as care ethics and performance. I will be editing a special issue of the International Journal of Care and Caring on care ethics.

3. How did you get involved in care ethics?

I was introduced to care ethics in a graduate feminist theory course. I was attracted to the idea from my first exposure. I can remember where I was when in the early 1990’s I first read Nel Noddings’ Caring. I wrote my philosophy Ph.D. dissertation on care ethics and embodiment.

4. How would you describe care ethics?

Care ethics is a relational approach to morality that emphasizes understanding the context of others to better deliver responsive care. More than a normative ethical theory, care ethics has ontological and epistemological dimensions. It is founded in a relational ontology and human corporeal existence. Rather than abstract rules or rights, all care recenters ethics on our humanity and its fundamental relational existence.
Furthermore, all care originates and is experienced through the body. In this manner, I have argued that care can be described as a performance, the iterations of which can develop skill, habits, and sense of identity.

people in conversation — Listening and exchange are necessary for care

5. What is the most important thing you learned from care ethics?

I have learned so much from exploring care ethics that I could respond to this question in many ways.
One response is in regard to how important listening is to care. Authentic and active listening is a skill of inquiry that is crucial for effective care. Without listening, caring actions are undertaken without complete understanding of context and are more likely to be ineffective and off the mark. Listening is not given much attention in ethical theorizing but it is hard to imagine caring without the attentiveness of listening.

6. Whom would you consider to be your most important teacher(s) and collaborators?

I have had the good fortune of working with a number of outstanding care theorists including Nel Noddings, Joan Tronto, Fiona Robinson, Dan Engster and Michael Slote on various publications. Care is such a rich field of exploration that I find all of these scholars and their unique approach to care ethics as contributing to my understanding of care. I am particularly attracted to theorists who view care ethics as something more than an alternative way to adjudicate ethical dilemmas. Although care has important normative implications, it is much more than just another ethical theory.

7. What publications do you consider the most important with regard to care ethics?

This was an easier question to answer twenty years ago than it is today given the burgeoning number of publications in this area. For me, foundational texts include Nel Noddings, Caring: A Feminine Approach to Ethics and Moral Education (1984); Joan Tronto, Moral Boundaries: A Political Argument for An Ethic of Care (1993); and, Fiona Robinson, The Ethics of Care and Global Politics (1999). Each of these authors has sharpened their arguments about care in subsequent books. The number of care authors that I am interested in has grown tremendously in recent years including the works of Daniel Engster, Maria Puig de la Bellacasa, Elena Pucini, and Vrinda Dalmiya.

Given my interest in the performativity of care, I am interested in seeing where James Thompson takes the notion of care and aesthetics after his article, “Towards An Aesthetics of Care” Research in Drama Education: The Journal of Applied Theatre and Performance (2015). This is a very generative time in care ethics and I look forward to seeing what new insights will emerge.

8. Which of your own books/articles/projects should we learn from?

Although it is a bit dated now, Embodied Care (2004) lays out an understanding of care ethics grounded in embodiment.
“Care Ethics and Confronting Intersectional Difference through the Body,” in Critical Philosophy of Race 3:1 (2015) is an article that endeavors to apply the embodied care framework to issues of race.
“Knowledge, Competence and Care” in Merel Visse and Tineke Abma, eds., Evaluation for A Caring Society. Information Age Publishing, 2017 is a chapter that addresses issues of both epistemology and the effectiveness of care.

Given the range of applications and theoretical concepts I have endeavored to address, I recommend checking out my works at Adacemia.edu and seeing if there are subjects of interest.

9. What are important issues for care ethics in the future?

Care ethics is no longer a boutique theory of a few people in one or two disciplines. It has garnered world-wide attention across many fields. As such, theorists are framing care within their own discipline or branch of discipline. Although the widespread interest is exciting, it also means that many scholars are endeavoring to describe care in definitive ways.
I worry that care will lose its critical and postmodern edge if it is boxed into certain theoretical constraints. So, I think an important issue for care ethics is how its definition evolves as it moves into mainstream academic discussions.[pullquote]How will care ethics make its way into narratives outside of academia?[/pullquote]

Another, major issue is how will care ethics make its way into narratives outside of academia. Today, care ethics is almost exclusively an intellectual narrative. To make a significant difference in the world, scholars will need to translate care into accessible discourse for a wider audience.

10. How may care ethics contribute to society as a whole, do you think?

The potential of care ethics to positively impact the world is enormous. Deep authentic care is a product of inquiry in an attempt to really understand the other. If societies and their leaders and institutions adopted this approach as their guiding moral framework then there would be less stereotyping and scapegoating of groups of people.

We could learn from our differences and build stronger communities committed to the welfare of all members. Care can be a grassroots revolution that leads policy change as societies adopt a disposition of understanding rather than fear of difference. Ultimately, violent action would be seen as more of a last resort than it is today.

11. Do you know of any research-based projects in local communities, institutions or on national levels, where ‘care’ is central?

One of the challenges of this question is definitional. Care is a ubiquitous term. There are many institutions, including for-profit corporations, that have placed care as their central theme, such as in the field of health care. However,” care ethics” has a more precise understanding as a relational moral approach responsive to the contexts of individuals.

I am only aware of a few institutions that have taken care ethics seriously in their work. The University of Humanistic Studies and its graduate programs in care ethics headed by Carlo Leget is one of those institutions. Another is the care ethics laboratory in Belgium, sTimul. I am hoping that the efforts of the new The International Journal of Care and Caring is a sign that more such research efforts grounded in care ethics will emerge.

12. The aim of the consortium is to further develop care ethics internationally by creating connections between people who are involved in this interdisciplinary field, both in scientific and societal realms. Do you have any recommendations or wishes yourself?

I am humbled and honored to participate in the consortium. There are many possibilities for collaborative projects to emerge from such a gathering. Perhaps one recommendation is that the group consider the possibility of public scholarship projects. In other words, are their means by which this important care ethics scholarship might be translated for public consumption so as to infuse care ethics language and thinking into social narratives rather than just academic discourse.

Earlier, in 2012 we interviewed Maurice Hamington on similar topics.
Interview Maurice Hamington in 2016, while visiting the University of Humanistic Studies on Care Ethics and the body.

News

Featured article: The sensible health care professional

Recently, two Dutch and one Belgium care ethicist published a paper on “The sensible health care professional: a care ethical perspective on the role of caregivers in emotionally turbulent practices” in Medicine, Health Care and Philosophy.

Are you working in the field of care ethics and would you like your paper to be in the spotlight? Please let us know!

Abstract

Vivianne Baur, Inge van Nistelrooij and Linus Vanlaere discuss the challenging context that health care professionals are confronted with, and the impact of this context on their emotional experiences.

Care ethics considers emotions as a valuable source of knowledge for good care. Thinking with care ethical theory and looking through a care ethical lens at a practical case example, the authors discern reflective questions that

shed light on a care ethical approach toward the role of emotions in care practices, and
may be used by practitioners and facilitators for care ethical reflection on similar cases, in the particular and concrete context where issues around emotional experiences arise.

The authors emphasize the importance of allowing emotions to exist, to acknowledge them and to not repress them, so that they can serve as a vehicle for ethical behavior in care practices. They stress the difference between acknowledging emotions and expressing them limitlessly.

Formational practices and transformational research practices are being proposed to create moral space in care institutions and to support health care professionals to approach the emotionally turbulent practices they encounter in a way that contributes to good care for all those involved.

News

Coming up: Dutch care ethicists’ exchange with Danish scholars

This June, care ethicists Carlo Leget, Alistair Niemeijer and Merel Visse of the Dutch care ethicist group visit Aalborg University and Roskilde University in Denmark to exchange thoughts on two important research approaches to understand care: phenomenology and relational etnography.

In Aalborg they will speak with Finn Hansen at Aarhus University, well-known for his Wonder Labs and practical approach to phenomenology. Finn Hansen and Carlo Leget have been collaborating for some time. Last year, Finn visited the Graduate School of the University of Humanistic Studies to speak about Practising Philosophy and Wondering. His approach to phenomenology is unique and important to the Dutch care ethicists, as it provides an epistemological framework and empircal approach to understand lived experiences of people with care.

At the Roskilde University, they will meet again with Christina Hee Pedersen, Lisbeth Frølunde and Louise Jane Phillips of the Department of Communication and Arts. Alistair Niemeijer and Merel Visse met with these scholars several times before at methodological conferences, like the International and European Conference on Qualitative Inquiry. At the time, they exchanged about a new approach they have been developing on relational etnography as a praxis for care and autoetnography in relation to humane care. Now, this June, they will dive deeper into the challenges and promises of this approach, and explore the possibilities of arts-based work like visual etnography. Please check this website again in July for an update.

More information on these connections:

Institute for Communication, Aalborg University:
Finn Hansen

Roskilde University,The Department of Communication and Arts:
Christina Hee Pedersen
Louise Jane Phillips
Lisbeth Frølunde

News

Late modern uncertainty and beyond demarcation

This week, two new papers of Dutch care ethicists have been accepted and published in peer-reviewed journals.

Rethinking

Frans Vosman and Alistair Niemeijer published their paper on ‘Rethinking critical reflection on care: late modern uncertainty and the implications for care ethics’ in Medicine, Health Care and Philosophy ((Vosman, F. & Niemeijer, A. Med Health Care and Philos (2017). doi: 10.1007/s11019-017-9766-1)). In their paper, Vosman and Niemeijer rethink care ethics through complexity and precariousness.

Late modern organizations, like the general hospital, codetermined by various (control, information, safety, account ability) systems are characterized by complexity and the need for complexity reduction, both permeating care practices.

By means of a heuristic use of the concept of precariousness, taken as the installment of uncertainty, it is shown that relations and power in late modern care organizations have changed, precluding the use of a straightforward domination idea of power.

A proposition is made how to rethink the care ethical inquiry in order to take late modern circumstances into account: inquiry should always be related to the concerns of people and practitioners from within care practices.

Abstract

Care ethics as initiated by Gilligan, Held, Tronto and others (in the nineteen eighties and nineties) has from its onset been critical towards ethical concepts established in modernity, like ‘autonomy’, alternatively proposing to think from within relationships and to pay attention to power. In this article the question is raised whether renewal in this same critical vein is necessary and possible as late modern circumstances require rethinking the care ethical inquiry. Two late modern realities that invite to rethink care ethics are complexity and precariousness. Read more >>

Beyond demarcation

The newest paper on ‘Care ethics as an interdisciplinary field of inquiry’ of Carlo Leget, Inge van Nistelrooij and Merel Visse has been accepted for publication by Nursing Ethics and will appear soon. This paper is a contribution to the ongoing discussion about the status and nature of care ethics.

Responding to ‘Demarcation of the ethics of care as a discipline’ by Klaver et al. (2014)((Klaver, K., Elst, E. van, Baart, A. Nursing Ethics, Vol. 21-7, 755-765 (2014). doi: 10.1177/0969733013500162)) and ‘Three versions of an ethics of care’ by Edwards (2009)((Edwards, S. Nursing Philosophy, Vol.10-4, 231-240 (2009). doi: 10.1111/j.1466-769X.2009.00415.x)), Leget et al. propose to conceive care ethics as an interdisciplinary field of inquiry, incorporating a dialectical relation between empirical research and theoretical reflection.

Departing from the notion of caring as a practice of contributing to a life sustaining web, they argue that care ethics can only profit from a loosely organised academic profile that allows for flexibility and critical attitude that brings us close to the good emerging in specific practices.

This asks for ways of searching for a common focus and interest that is inherently democratic and dialogical, and thus beyond demarcation.

Please check the website of Nursing Ethics or email the authors via info@care-ethics.org.

Abstract

For many years the body of literature known as ‘care ethics’ or ‘ethics of care’ has been discussed as regards its status and nature. There is much confusion and little structured discussion. The paper of Klaver et al. (2014) was written as a discussion article to which we respond.

We propose to conceive care ethics as an interdisciplinary field of inquiry, incorporating a dialectical relation between empirical research and theoretical reflection. Departing from the notion of caring as a practice of contributing to a life-sustaining web, we argue that care ethics can only profit from a loosely organized academic profile that allows for flexibility and critical attitude that brings us close to the good emerging in specific practices. This asks for ways of searching for a common focus and interest that is inherently democratic and dialogical and thus beyond demarcation. Read more >>

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Publications

Art of Living, Art of Dying

Spring 2017 a new book by Carlo Leget was published, Art of Living, Art of Dying. Spiritual Care for a Good Death, by Jessica Kingsley Publishers in London/Philadelphia. Care-ethics.org had an interview with the author.

A new book about spiritual care, why did you write it?

For some time I had been thinking that it would be good to publish a book on the art of dying in English. The two Dutch books that I had written, Ruimte om te sterven and Van levenskunst tot stervenskunst, have been reprinted many times and every time when I was giving a lecture abroad people would be very interested to read them.
Last year I gave a lecture in San Diego at the annual conference of the Health Care Chaplaincy Network, and a Publisher came to me offering to make a book with me. This is when I took my chance.

When does a professor find the time to write a book nowadays?

Last summer I spent some time in Germany and I had given myself 4 weeks. I had already thought out what I wanted to write. Every morning I stood up early, searched for a spark of enthusiasm in myself about the subject I wanted to write about, and when I had reached 3000 words, I would stop. That should be enough for that day.

“Expertly grounded in an academic theological and philosophical discourse, Professor Leget guides the reader through a contemporary reading of the medieval Ars moriendi, blending the wisdom of the past with a real-world understanding of the present.” ~ Philip Larkin

Did you succeed in writing down everything in such a short period of time?

No, I didn’t. When I was writing the last chapters my brother-in-law called me from the Netherlands. My eldest sister appeared to have come back from her holiday in a very bad condition. She had been admitted to the hospital immediately and she died a week after her return in the Neterhlands, 50 years old.
I travelled back to the Netherlands and I was lucky to be able to say goodbye to her. It was hardly conceivable what had happened. Suddenly I was painfully cast from theory into practice. There are no words for how bizarre this was. The world stood still. From that moment on also my writing had been interrupted for a while.

Did what happened have any impact on the content of your book?

When I began to write again after a couple of weeks, I was afraid that I would look with new eyes at everything I had written so far, and that it would no longer be in tune with my feelings. This appeared not to be so, luckily. I could still agree with what I had written. At that moment I knew that I would dedicate the book to her.

You have written two books about the art of dying already. Is there for the people who are familiar with your previous work anything new to discover in this English book?

Yes, definitely. The first version of my book Ruimte om te sterven was written almost 15 years ago. Since then my thought has developed further and care ethics has had a great influence on the way I look at the world. But also the many lectures and presentations on the art of dying, and the many contacts with care givers of various disciplines have changed my way of thinking. I have learned to think in a more concrete and practical way. At the same time I remain someone who loves to analyze and think theoretically.

Can you give concrete examples of what is new in this book?

The book is crafted better and the development of thought is done more thoroughly. Also the idea of inner polyphony has been developed further. I call this the ‘polyphonic self’. For this I was inspired by the work of Gettie Kievit-Lamens, who has been chaplain at academic hospice Demeter in De Bilt, The Netherlands, and who wrote a dissertation in which she brings my central metaphor of ‘inner space’ in resonance with the work of Hubert Hermans on the ‘dialogical self’.

But also the work of my PhD-students Eric Olsman and Els van Wijngaarden have put me on this track. Finally, things that have happened in my own biography these past few years have confronted me with the importance of listening to this inner polyphony.

Does this mean that the new book is more complex than the previous ones?

I don’t think so in the end. I have tried to keep the balance between simplicity and complexity by creating space for this complexity on the one hand, but keeping complex issues accessible and concrete on the other. In this way I have summarized the core of the art of dying in five essential questions that every human being could ask him- or herself sooner or later.

“I recommend this book not only for chaplains and clergy, but also for others on the healthcare team, including counsellors, doctors, nurses, allied healthcare workers and other professionals who come into contact with patients in hospitals and hospices.” ~ Christina Puchalski

What adds this book to all that has already been written about spirituality in palliative care?

I think my approach is one of the few that considers the art of dying as a practice that is shaped by the people involved in their interaction, and that in the end it is the art of the one who is dying. Much literature aims to put the severely ill or dying person at the centre, but ends with writing what care givers can or should do. Moreover I have tried to not tell people what is wrong and what is right, aiming to open up a space that enables one to listen what really matters in life.

Finally: how is this book related to the rest of your scientific work?

The book has helped me to retrieve a number of central thoughts, thinking them through and articulating them better. It is part of the theoretical framework of a research project funded by the government that I am going to do in collaboration with Saskia Teunissen, professor in hospice care at Utrecht University. Next to this I have further plans for the next round of the state funded ZonMW programme Palliantie. But this summer I will take four weeks of vacation.

Carlo Leget

Chair holder, full professor in Ethics of Care and Spiritual Counseling and extraordinary professor Palliative Care at the University of Humanistic Studies.

His academic works focuses on ethics and spirituality in palliative care, and he is involved in many discussions in the Netherlands about end-of-life issues. He wrote, edited or co-edited 20 books and published more than 50 refereed papers and more than 40 contributions to books. He is in the editorial board of a number of international and Dutch journals.

He chairs the national working group on ‘Ethics and spiritual care’ in his country and is first author of the first national consensus based guideline on spiritual care in palliative care (2010). He also co-chairs the EAPC-Taskforce on spiritual care, is a board member of Palliactief, the Dutch Association for Professional Palliative Care. He takes also part in the Global Network on Spirituality and Health.

Publications

Older people on self-chosen death

Caught between intending and doing: older people ideating on a self-chosen death

Els van Wijngaarden, Carlo Leget and Anne Goossensen (( University of Humanistic Studies, Utrecht, Netherlands))

Abstract

Objectives
The aim of this paper is to provide insight into what it means to live with the intention to end life at a self-chosen moment from an insider perspective.

Setting
Participants who lived independent or semidependent throughout the Netherlands.

Participants
25 Dutch older citizens (mean age of 82 years) participated. They were ideating on a self- chosen death because they considered their lives to be no longer worth living.
Inclusion criteria were that they:

considered their lives to be ‘completed’;
suffered from the prospect of living on;
currently wished to die;
were 70 years of age or older;
were not terminally ill;
considered themselves to be mentally competent;
considered their death wish reasonable.

Design
In this qualitative study, in-depth interviews were carried out in the participants’ everyday home environment (median lasting 1.56 h). Verbatim transcripts were analysed based on the principles of phenomenological thematic analysis.

Results
The liminality or ‘in-betweenness’ of intending and actually performing self-directed death (or not) is characterised as a constant feeling of being torn explicated by the following pairs of themes:[pullquote]”I don’t want to die, but my life is simply unliveable.” [/pullquote]

detachment and attachment;
rational and nonrational considerations;
taking control and lingering uncertainty;
resisting interference and longing for support;
legitimacy and illegitimacy.

Conclusions
Our findings show that the in-between period emerges as a considerable, existential challenge with both rational and non-rational concerns and thoughts, rather than a calculative, coherent sum of rational considerations. Our study highlights the need to take due consideration of all ambiguities and ambivalences present after a putatively rational decision has been made in order to develop careful policy and support for this particular group of older people

Strengths and limitations of this study

This study gives voice to older people who wish to die — preferably with medical assistance —
although they do not suffer from a lifethreatening disease or a psychiatric disorder.
This study is the first to elucidate what it means to live in-between intending and actually per-
forming a self-chosen act leading to death (or not).
This study introduces empirical evidence into the largely theoretical debate on rational suicide.
Our study highlights the need for due consideration of all ambiguities and ambivalences present after a putatively rational decision has been made, in order to develop careful policy and support for this particular group of older people.
Although transferability to other countries is limited due to cultural differences, the Dutch discussion
may inform the debate on (legalisation of ) assisted dying in other Western countries.

Article:

van Wijngaarden E, Leget C, Goossensen A. Caught between intending and doing: older people ideating on a self-chosen death. BMJ Open 2016;6:e009895. doi:10.1136/bmjopen-2015-009895

Photo credit: Simon & His Camera Life Is But A Walking Shadow – Syon Park London by Simon & His Camera via photopin (license)