Merel Visse

Interview with Merel Visse, PhD, associate professor, University of Humanistic Studies, Utrecht, The Netherlands.

1. Where are you working at this moment?

Currently I work as an associate professor Care Ethics and Policy at the University of Humanistic Studies in The Netherlands. As a scholar and artist, I combine theoretical and practice-based work to inquire about the moral good in care. In addition to regular scientific output such as publications, I also make installations, objects, drawings, paintings, projects and communities.

I have received a grant of my university and for the next three years I will focus on the meaning of creative and artistic practice for understanding the moral good in care. I prefer to work in close collaboration with scientific and civic partners, like health care and policy institutions and local governments, so my work is always the outcome of a relational process. I also teach several courses for graduate students, such as care ethical qualitative inquiry, narrative inquiry and responsive evaluation.
On my website www.merelvisse.com you can find an overview of my work, activities and inspirations.

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

Our view of care ethics is dialectical: we understand and foster good care by dialectically exploring care through both theoretical and empirical, practice-based, lenses (Leget, Van Nistelrooij & Visse, 2017)((Leget, C., Van Nistelrooij, I., & Visse, M. (2017). Beyond demarcation: Care ethics as an interdisciplinary field of inquiry. Nursing ethics, doi: 10.1177/0969733017707008.)). Originally, I began my work in care as an evaluator and qualitative researcher, but I’ve always had a strong focus on theory as well. During the last four years, we have developed a care ethical qualitative inquiry approach that is ‘fed’ by theories and practices of phenomenology, relational ethnography and responsive evaluation approaches. These are approaches that support us in understanding people’s singular and collective experiences with care.

But while working with these approaches, we felt a strong need for a different epistemology and method to enhance our understandings. It’s also due to a new ‘critical turn’ in qualitative inquiry that includes attention for the sensory and affective dimensions of care, and more. The process of drawing or working with photo voice and making artistic objects can be seen as a mode of inquiry. Looking at visual data, and producing visual data help us know differently than knowing through verbalized accounts.

So how to study care by the inclusion of attention for affective, sensory, embodied dimensions of life? I believe this is necessary, because as many care ethicists have emphasized, care is not a virtue, but a practice. And therefore we can only theorize and think ‘care’ by approaches that are congruent with a practice-view.

3. How did you get involved in care ethics?

After the publication of my book and PhD thesis, ‘Openings for Humanization in Modern Health Care Practices’((Visse, M. A. (2012). Openings for humanization in modern health care practices)) in 2012, I received a phone call from professor Frans Vosman. He read my work and invited me to join the Care Ethics group in Utrecht. It was the start of a path that has deepened my work and view on care ethics profoundly.

Originally, I was trained by professors Tineke Abma and Guy Widdershoven of the VU University of Amsterdam, Medical Humanities, who introduced me to the fields of responsive evaluation, qualitative inquiry, practice-based work and Gadamerian hermeneutics and empirical ethics. I was introduced to evaluation scholars like Bob Stake, Thomas Schwandt and Jennifer Greene with whom I’ve just developed a special Volume on Evaluation for a Caring Society (in press, to be published by IAP publishers this fall).

In my book from 2012, among other topics, I discussed the meaning of the work of Margaret Urban Walker in the light of several empirical (phenomenological) studies on how caregivers and care–receivers experienced good care. The book consists of published papers that – each in its own way and each based on empirical studies – were built upon the collaborative-expressive model of Walker. Professor Andries Baart, my former colleague, introduced me to a care ethical view on qualitative inquiry. That opened up a whole new way of thinking about ‘practising care ethics’.

4. How would you describe care ethics?

My father is in cultural heritage and as a child, I remember him closely looking at buildings. I learned that the material world embodies many traditions and stories. I remember him telling me about different kinds of mortar in between the bricks and how the mortar (which is tiny and detailed) strongly influenced the outlook of the whole. That is what care does, the performative dimension of care: just like mortar, it is in ‘liminal’ space, holding people together (or not) in ‘life sustaining webs’, to use Fisher’s and Tronto’s words. In addition, I saw my father negotiating with owners, engineers, restaurateurs and representatives of local governments. All these people had different stakes when living in and preserving the built environment. In hindsight I know that this is where my training in responsive evaluation (which is all about negotiation and dialogue) and later on, in care ethics began.

It’s a little bit of a long introduction to show you how my view on care ethics has grown. I see care ethics as a way of knowing and inquiring about what is ‘good’ in historical, aesthetical, temporal and spatial ways. Care ethics is an epistemology that is featured by hermeneutical understanding, listening and experiencing the world around us, together with others. It is about the moral dimensions of living in (and on) our own tapestry of people and relationships. Care ethics  – as described in Leget, Van Nistelrooij & Visse (2017) – asks about the normative in a dialectical way: honoring both theory and practice.

A practice view on care acknowledges that people and their lives are part of an intrinsic and complex tapestry that critically counter-thinks notions like agency, (self) management and  control. Care ethics acknowledges the ambiguity and complexity of everyday situations in care: that is what matters to me profoundly. People ‘undergo’ and ‘accept’ being in certain kinds of positions (e.g. of a caregiver and –receiver). Care ethics is, as my colleague Alistair Niemeijer so aptly phrased it, ‘inherently dialectic’. The dialectic nature of care ethics has been developed by our chair Carlo Leget in his publication on the re-examination on the empirical and the normative (Leget, Borry, De Vries, 2009)((Leget, C., Borry, P., de Vries, R. (2009). ‘Nobody tosses a dwarf!’ The relation between the empirical and the normative reexamined. Bioethics. 2009 May;23(4):226-35. doi: 10.1111/j.1467-8519.2009.01711.x.)). By keeping theory and practice ‘in tension’, care ethics can be further developed and understood.

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

Currently, my most important teachers are outside the field of care ethics, if I may speak of an “in- and outside”. For example, I especially admire the work of the philosopher Hans Georg Gadamer and more recently, the French philosopher Jean-Luc Marion. I prefer to work ‘slow’: I learn through careful, slow reading and reflection.

Currently, my most important collaborators and teachers are my colleagues and (former) students of the Care Ethics group. We carry out research in collaboration with several Dutch cities and health care institutions and this work ‘in the mud’ humbles me and shows me new perspectives and challenges. Every project is run by a core team of researchers who I feel privileged to collaborate with.

Co-authoring papers with colleagues is very rewarding. I have written papers with colleagues, such as Alistair Niemeijer, Inge van Nistelrooij and Carlo Leget. With Tineke Abma, I have just developed a special Volume on Evaluation for a Caring Society. Several care ethicists contributed to that Volume, like Helen Kohlen, Karin Dahlberg, Maurice Hamington and Jeannette Pols, as well as several responsive evaluators like Melissa Freeman, Anders Hanberger, Gustaaf Bos, Hannah Leyerzapf and others.

I have always found myself on the intersection of several disciplines and I believe this is vital for the quality of my work. Now, while developing this Consortium, I discovered that there are so many people from a wide range of fields who contribute to care ethics and theory. I look forward to meeting them very much.

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

  • Eva Feder Kittay’s Love Labor
  • Joan Tronto’s Caring Democracy

Epistemology:

  • Margaret Urban Walker’s Moral Understandings
  • Richard Bernstein’s Beyond Objectivism and relativism. Science, Hermeneutics and Praxis.

And with regards to our dialectical view between they and empirical work:

  • Johnson & Parry’s Qualitative Research for Social Justice.

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

This depends on your own background and interests. Soon, the special volume on Evaluation for a Caring Society will be published (fall 2017, IAP publishers). In the past, I have published about different topics, mostly related to how to ‘operationalise’ care ethics as a political ethic. On my website, you can find an overview for my publications and projects. Please email me when you would like to receive one of my papers, I’d be happy to share them.

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

I see many opportunities to increase the socio-political impact of care ethics. To do so, we need to build bridges between care ethicists who are conceptually oriented and care ethicists who mainly do empirical work, both empirical research and policy design and programs. By collaboration, we can create synergy. The new Care Ethics Research Consortium will be a platform for that.
I also believe in creativity. That is the topic I’m currently focusing on: creativity in the moral domain.

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

Yes: there are so many! Our research group carries out a rich variety of practice-based care ethical projects in close collaboration with several Dutch cities, residential elderly care institutions, hospitals, for-profit organisations (like a pharmacy) and communities. Most of these projects result in peer-reviewed publications as well. One example is a large Dutch elderly care organization that aims to work according to relation centered care. We facilitated an action-research project, based on a care ethical stance, to guide participants towards new understandings on relation centered care.

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 for us?

I would especially like to build bridges between conceptually and empirically oriented care ethicists, to develop international research grant proposals together. I believe that by increasing our practice based work, we will put care ethics more centrally on the societal agenda.

[widget id=”footnotes_widget-2″]

Utrecht Care Ethics

Care ethics is an interdisciplinary field of inquiry, which is driven by societal questions. Since the beginning of the 1980s, in this field various movements and disciplines have an interdisciplinary conversation, among which philosophy, ethics, social sciences, political and policy sciences, and nursing sciences.

The contribution made by the research group at the University of Humanistic Studies is a specific form of ethics. The key question of the Utrecht Care Ethics is: What is good care, given this particular situation? In order to answer this question we use a theoretical framework, which functions as a multifocal interpretative lens.

Theoretical framework

The theoretical framework is built around the concept of care, which is broadly understood. Caring is primarily seen as a social and political practice. This means that people continuously attune to others and themselves, in professional settings or otherwise, and always in an organised society. People ‘attune’ in order to maintain, continue, and repair our ‘world’ so that they can live in it as well as possible. In practices the morally good can emerge and be experienced by those involved. In this process those who receive care play a crucial role.

The theoretical framework, built around the concept of care, is fed by two sources. On the one hand, the interdisciplinary discussions known as ethics of care, which run for more than thirty years now, and various forms of empirical research on the other.

Conceptual and empirical research

These two sources, conceptual and empirical research, are in a dialectical relation to each other. Conceptual and theoretical insights are being questioned and enriched by empirical research and vice versa. In other words: we have a normatively loaded care ethical theory that is simultaneously used as a theoretical framework and as a hypothesis that is tested and adapted on the basis of empirical research and theoretical reflection.[pullquote]What is good care, given this particular situation?[/pullquote]

Within the theoretical framework a number of developed concepts (‘critical insights’) are guiding, such as relationality, contextuality, affectivity, practices, vulnerability, bodiliness, attention to power and position, and meaning.

Methodological toolkit

The empirical research methods used in Care Ethics at the University of Humanistic Studies focus on lived experiences, practices of care, and the way society is organised (the political-ethical dimension). The methodological toolkit, which is used and developed further for this goal, contains the following methods: phenomenology, narrative analysis, discourse analysis, institutional and auto-ethnography, visual data-analysis, and responsive evaluation.

Epistemological position

Summarizing: the theoretical framework, drawing upon the above mentioned ‘critical insights’, directs the empirical research approaches towards the lived experiences of those who are involved in caring practices, on these practices as such and/or their political context. In this way(s) insights are gained about the morally good that emerges here.

Thus, the epistemological position of the Care Ethics research group can be described as expressive-collaborative and embodied. We only get access to the good when we relate different positions, perspectives and types of knowledge to each other, by being in dialogue and using participatory types of research.

Elisabeth Conradi

Elisabeth Conradi started to study philosophy, German literature and educational theory at Heidelberg University and then continued and completed her studies at Frankfurt University where she earned the Master’s degree in philosophy, presenting a thesis on Immanuel Kant’s Philosophy of Right. As a visiting scholar she conducted research at the Political Science Department at the University of Chicago, Illinois, and at the Institute for Human Sciences in Vienna, Austria. Prior to that she was engaged in postgraduate studies with Karl-Otto Apel and Jürgen Habermas, as well as with guest professors Seyla Benhabib, Nancy Fraser, Judith Butler, Iris Young, and Joan Tronto. She also took courses at the Graduate School for Public and International Affairs at the University of Pittsburgh, Pennsylvania.

1. Where are you working at this moment?

Since March 2009 I am Professor of Philosophy and Social Theory and member of the social work faculty at the Baden-Württemberg Cooperative State University Stuttgart. I am also affiliated to the University of Göttingen, where I qualified to supervise doctoral candidates by the process of habilitation in the academic field of Political Science.

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

The two questions at the centre of my work are: How can the reflection of practice and the reflection of theory become systematically connected? And: How can the tension as well as the relation between politics and ethics be understood? Engaging these questions, my current book (Frankfurt 2011) introduces a conception of “social transformation through successful practices” in the context of a “cosmopolitan civil society”.

Both questions – the connection between practice and theory as well as the relation between politics and ethics – have been also discussed in my book “Take Care” (2001). Here I interrogate the deontological foundation of respect through equality, autonomy, and reciprocity as well as the idea of a contractual society. As an alternative I propose a foundation of an ethics of attentiveness and explicate how people take responsibility, and act in a careful and cooperative way.

3. How did you get involved into the ethics of care?

During my graduate studies of philosophy at Frankfurt University I got to know the “discourse ethics” as a predominant moral theory. In this approach Jürgen Habermas and Karl-Otto Apel adopt the justice perspective explicated by Lawrence Kohlberg. This perspective refers to conflicting individual rights, general rules and obligations. In contrast to it, the care perspective developed by Carol Gilligan emphasises communication and personal responsibilities, the situational context, and the preservation of relationships.

During my graduate studies of philosophy at Frankfurt University it was one of my main interests to transfer Gilligan’s critique of Kohlberg to the theories of Kant, Rawls and Habermas. Furthermore it was my concern (and still is) to expand the care perspective from the moral realm to political theory.

4. How would you define ethics of care?

Carol Gilligan as well as Joan Tronto lay stress on the moral requirement ‘not to turn away from someone in need.’ While Gilligan locates the moral problem in the fact that someone is hurt through detachment, Tronto points to the need that should be met.

If care is understood as a perspective, one does have to assume that it is located within the individual subject. If care is understood as an activity, it can be seen as located between subjects. Both aspects of care – relatedness and activity – integrate into the concept of a social practice.

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

In the course of care interactions the persons involved enter into (or continue) a relationship with one another. The relationship is intensified through care.

6. Whom do you consider to be your most important teacher(s) in this area?

At Frankfurt University I became acquainted with the work of Carol Gilligan and Virginia Held through Andrea Maihofer who criticised “discourse ethics” from a gendered perspective. I also participated in a group of graduate students that planned and organized an international guest professorship inviting Seyla Benhabib, Nancy Fraser, Iris Marion Young, and Joan Tronto.

7. What works in the ethics of care do you see as the most important?

I already referred to Carol Gilligan (In a Different Voice 1982, Mapping the Moral Domain (ed) 1988) and Joan Tronto (Moral Boundaries 1993).

Especially for opening the care debate in the direction of global responsibility I further suggest Virginia Held (The Ethics of Care 2005, Justice and Care (ed) 1995) and Margaret Walker (The Curious Case of Care and Restorative Justice in the U.S. Context, in: Hamington 2006 pp. 145-162) as well as Iris Young (Responsibility, Social Connection, and Global Labor Justice, in: Young: Global challenges 2007) and Christine Koggel (Poverty and Global Justice, in: Cragg, Koggel 2004).

For the Debate in German these authors have been especially important: Andrea Maihofer (Geschlecht als Existenzweise 1995), Herlinde Pauer-Studer (Das Andere der Gerechtigkeit 1996), Annemarie Pieper (Gibt es eine feministische Ethik? 1998) and Ina Praetorius (Skizzen zur feministischen Ethik 1995). While I disagree with Silvia Käppeli (Vom Glaubenswerk zur Pflegewissenschaft 2004) I consider her work to be important.

8. Which of your own books/articles should we read?

  • Elisabeth Conradi: Ethik und Politik. Wie eine Ethik der Achtsamkeit mit politischer Verantwortung verbunden werden kann. In: Hartmut Remmers, Helen Kohlen (Hg): Bioethics, Care and Gender. Herausforderungen für Medizin, Pflege und Politik. Universitätsverlag Osnabrück: Vandenhoeck & Ruprecht 2010, S. 91-117.
  • Elisabeth Conradi: Was ist Achtsamkeit? In: Orientierung. Fachzeitschrift der Behindertenhilfe. Heft 3, August 2008, S. 1-4.
  • Elisabeth Conradi: Take Care. Grundlagen einer Ethik der Achtsamkeit, Frankfurt am Main 2001.
  • Elisabeth Conradi: Kosmopolitische Zivilgesellschaft. Wandel zur Weltgesellschaft durch gelingendes Handeln. Frankfurt am Main: Campus Verlag 2011.

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

  • The relationship between the care ethics of attentiveness as a professional ethics (of nurses, social workers, politicians, therapists, assistants etc) and the more comprehensive (philosophical) concept should be reflected in an interdisciplinary dialog between philosophy and pedagogy, social work education and nursing science, disability studies and medical ethics, theology and political science.
  • The secularity of care ethics could be discussed: How can forgiveness be thought in a secular conception (see Walker: Moral repair 2006)? How does the care ethics of attentiveness differ from buddhist meditation?
  • The political importance of care ethics (and its relevance for political theory) should be discussed more intense in an interdisciplinary dialog. Keywords are: citizenship, global communities, global responsibility, state sovereignty, migration, security, forgiveness and restorative justice, responsibility and care for a postcolonial work, peace, poverty (See above point 7: Held, Walker, Koggel).
  • Care ethics should investigate in thinking about (possible ways of and theoretical approaches to) social transformation: How can the practice of care (and care-takers as well as care-givers) increase more respect in society? How to organize (public) need interpretation?
  • Can care ethics offer a concept of (the structure and institutionalisation and politics of) help, support, empowerment, need interpretation (etc.) beyond and beside economic (as well as state-controlled) interests?
  • To what kind of (participative) politics leads the care ethics of attentiveness?

10. Our ambition is to promote ethics of care nationally and internationally. Do you have any recommendations or wishes?

It would be important to also take into account positions from African colleagues, for example the work of H. Odera Oruka or more contemporary for example the thoughts of Fainos Mangena.