In 2004, Frans Vosman († 2020) published the Dutch-language version of the article Friendship as a Model of Professional Care. An obvious question arises: why would the editorial board now publish an English version of this old and therefore dated article on its international website? In this introduction, we outline why we believe the article remains relevant to contemporary care ethics. First, we briefly discuss the emergence of care ethics as an academic discipline in the Netherlands. We then characterize the issue Vosman raised in 2004 as an urgent matter: the dominant notion of professionalism in the formal care sector. After that, we describe his proposal for a morally appropriate model of professionalism. Finally, we highlight some ideas in Friendship as a Model of Professional Care (1) that we consider important for care ethics as a political theory and ethical practice in Late Modernity—ideas that Vosman later expands, deepens, and sharpens in collaboration with others.
Care Ethics: Social Movement and Academic Discipline
In 2007–2008, Care Ethics and Policy was established as an independent academic discipline at Tilburg University. Frans Vosman, Andries Baart, and Annelies van Heijst played key roles in its foundation (2). In 2008, Baart and Vosman delivered a joint inaugural lecture (3). In the first decade of the 21st century, Dutch care ethicists primarily focused on the formal health and social care sectors. They were influenced by prominent American care ethicists such as Carol Gilligan—who coined the term ethics of care—and Joan Tronto, who developed care ethics into a political theory of care. Care ethicists in both the Netherlands and the US share a critical stance towards modernity. As both a social movement and a scientific discipline, care ethics advocates for people living with suffering. It draws attention to neglected moral knowledge found in concrete, everyday care practices. It critiques the epistocracy of abstract, top-down ethics and instead operates with a bottom-up approach grounded in reality.
In 2012–2013, the field of care ethics moved to the University of Humanistic Studies in Utrecht.
The Problem of Professionalization in 2004
In 2004, Vosman addressed a problem that had emerged alongside increasing professionalization within the formal care sector. Prevailing notions of professionalism among caregivers did not place the good of the patient at the center. Vosman sought an appropriate ethos—an orientation that enables professionals to discover, in relationship with the patient or client, what constitutes good care for this person. By ethos, he meant the modes of action through which professionals express what they deem morally right, good, unjust or not good. He envisioned an ethos that recognizes the suffering of the other and does not suppress emotional resonance as something deemed unprofessional. For various reasons, this sensitivity is absent in dominant conceptions of professionalism.
The ethos manifest in the formal care sector is a complex blend—ranging from striving for the good of the patient to utilitarian or even violent dynamics. Overall, the dominant ethos is one of detachment, expertise-centered thinking, and knowledge dominance, which displaces vital praxis-based knowledge. The relationship between professional and patient is asymmetrical. In formal care general moral principles, codes of conduct, and the societal fiction of autonomy and self-management dominate. Within a broader context, the care sector is undergoing radical change driven by market logic, systematization, standardization, and technologization.
However, that’s not the whole story. A “small ethics” also emerges in care praxis—a tacit etiquette of the good that unfolds in the search for what is the good for the patient in the care relationship. Vosman takes as a starting point the praxis of a psychiatrist who earnestly engages with the loneliness and suffering of her patients. This leads him to consider friendship as a morally appropriate model of professionalism (4). A key feature of friendship is that it centers the good of the other.
A Morally Appropriate Model
In his quest for a proper understanding of friendship, Vosman draws on a historical retrospective, examining various forms and concepts of friendship. From rich, ancient philosophical traditions of thinking about friendship, there is much to learn about what has proven to be good or harmful over time. Premodern philosophers such as Aristotle and Thomas Aquinas developed important ideas about friendship that Vosman revisits and explores. One significant and applicable insight for the care sector is that friendship lies at the intersection of public (political) and private life.
Vosman rejects the modern, romantic idealization and emotionalization of “human-to-human understanding”—a notion that emerged in the 18th century and is apolitical in nature. He also examines several contemporary, modernity-critical thinkers—philosophers, phenomenologists, and ethicists—such as Paul Ricoeur, Nigel Biggar, and Robert Sokolowski. After carefully analyzing what each contributes to a model of friendship, he proposes a suitable form of professional friendship. Key aspects include the absence of an asymmetrical relationship and the presence of a certain equality (fellowship), along with a shared orientation toward the good of the other.
Within the care relationship, the professional may adopt the stance of a temporary, modest form of civic friendship. This is a bounded form of civic friendship with political implications: it envisions both caregiver and patient/client as citizens. More broadly, Vosman argues—even in 2004—that weak forms of friendship are foundational to a politically organized community. In doing so, he presents an alternative model to the prevailing societal fiction of individualism. He refers to the contemporary era as “Late Modernity” but does not elaborate on the term in this article.
Relevance of the Article in 2025
In this early work by Vosman, we recognize several foundational ideas that he, as a care ethicist, later elaborated more broadly and deeply, and also amended. Understanding his intellectual development helps us to more sharply perceive the changes occurring in late-modern society and care practices in 2025. We now place some of these core themes in care ethics within the context of Late Modernity.
Late Modernity
In his later work, Vosman identifies late modernity as a hypermodern era within modernity—an age full of paradoxes, contradictions, and tensions. From a historical perspective, he traces the long lines from premodernity to modernity and late modernity. This framework clarifies the position of care ethics as a critical response—both movement and discipline—to modernity. While its critique remains relevant, it proves insufficient for engaging the emerging realities of this new era. Late Modernity, in part, stems from earlier critiques by feminists and care ethicists. Yet in this era, care ethical insights are culturally, economically, and politically absorbed and distorted (5).
Problematic Understanding of Knowledge
A dominant and deeply rooted understanding of knowledge, established during Modernity, still continues to shape both society and the care sector. However, in Late Modernity, the modern focus on rationality and the homo economicus is now accompanied by a new focus and a new fiction: the focus on emotions and the fiction of the self as a creative entrepreneur. Experiences and emotions are interpreted within a neo-romantic, aesthetic, and psychological framework and are economically exploited. Vosman calls for an ethos that takes the lived, embodied moral knowledge of both the patient (as citizen) and the caregiver (also as citizen) seriously—alongside other forms of knowledge.
Citizenship
Vosman defines citizenship as recognized and unconditional participation in the polis: the political community. In his later work, he critically examines shifts toward conditional citizenship and mere survival. He calls this a late modern idealist discourse of the “successful life” (6).
Facing Suffering
Time and again, Vosman advocates a professional ethos that acknowledges the suffering and loneliness of patients/clients. An ethos that does not turn away from human suffering or become desensitized to it—but rather one in which being emotional moved and involved is considered normal. He continues to search for a basis of equality between professional and patient that transcends their asymmetrical positions and different types of knowledge. Vosman views a shared sense of fragility, mortality, and capacity for deep suffering—applicable to both the healthy professional and the ill patient—as a more fitting foundation for equality than the commonly proposed notion of shared vulnerability (7).
Relating to the Client/Patient
Care ethics critiques the (neo)liberal notion of the individual and instead centers the care relationship. In Late Modernity, client relationships and client-centered and derived patient-centered formulas dominate. These tap into primal human desires for connection and belonging, which paradoxically coexist with increasing individualization. Managerial concepts of “engaging like a friend” with the client/patient operate within a veiled logic of utility. Vosman’s 2005 article helps to illuminate how such utilitarian logic clashes with the model of civic friendship.
Research in Movements and Practices
The philosophical, phenomenological, and modernity-critical approach to reality that Vosman introduces in 2004 is later elaborated in depth—often in collaboration with others such as Andries Baart and Guus Timmerman. They apply this bottom-up methodology to immensely complex formal and informal (care) practices in Late Modernity. There they discover that focusing solely on ethics and good care is too narrow for understanding what actually unfolds in practices where people act in concrete ways. This leads to the insight that a minima moralia approach—a postponement of ethics—enables maximal observation in practices (8).
Texture in Ethos
The moral texture that emerges in care practices later leads Vosman to the concept of the political. This term refers to friction—the potential for conflict. Relationships typically form through friction but may also escalate into violence. This applies to all types of relationships at every level of society (9). Vosman deepens the perception that people are not purely benevolent beings. Ethics must reckon with both good and evil. Vosman envisions a care ethics that reflects more than ever deeply on wrongdoing and violence—alongside the pursuit of the good for the other.
Care Ethics in (Late) Modernity
Vosman advocates a view of care ethics as part of political theory (from the political) and as a provisional and adaptable form of ethical theory-building (from ethos). This requires a searching ethic (ethos) and self-critical reflection—especially when care ethics leans toward codification or applied ethics. Such tendencies risk overriding the embodied knowledge and concerns of those engaged in care practices—like in 2005.
Late-modern Complexity and Uncertainty
Further reasons exist for the continued development and critical self-reflection of care ethics. Late-modern realities such as complexity and precariousness present themselves as new forms of uncertainty in social practices. Additionally, new types of systems dominate late-modern organizations, and relationships and power have taken on new forms (10).
Read the article Friendship as a Model of Professional care here.
References
(1) Vosman, F. J. H. (2004). Vriendschap als model voor professionele zorg [Friendship as a Model of Professional Care]. In F. J. H. Vosman, & B. Molenaar (Eds.), in Perspectieven op vriendschap [Perspectives on Friendship] (pp. 62-73). Journal of Humanistic Studies no. 20 (2004), SWP Publishers, Amsterdam.
[Online: https://www.waardenwerkdigitaal.nl/p/humanistiek-20-2004/7201]
(2) See: Baart, A. (2001). Een theorie van Presentie [A Theory of Presence]. An English-language version, rewritten with Guus Timmerman, is based on presence theory and care ethics: Relational Caring and Presence Theory in Health Care and Social Work: A Care-Ethical Perspective. Bristol University Press/Policy Press, Bristol (2024).
In 2005, Annelies van Heijst published her groundbreaking book Menslievende zorg: Een ethische kijk op professionaliteit [Loving Care: An Ethical View of Professionalism]. Uitgeverij Klement, Utrecht (2005). The English (partially rewritten) version appeared in 2011 as Professional Loving Care: An Ethical View of the Healthcare Sector. Series Ethics of Care no.2, Peeters Publishers, Louvain (2011).
(3) Baart, A., & Vosman, F. (2008). Aannemelijke zorg: Over het uitzieden en verdringen van praktische wijsheid in de gezondheidszorg [Plausible Care: On the Suppression and Displacement of Practical Wisdom in Healthcare]. Boom Uitgevers, Den Haag (2008).
(4) The website of the psychiatrist mentioned in Friendship as a Model of Care is no longer active.
(5) For Late Modernity see:
Vosman, F. (2020). The Disenchantment of Care Ethics: A Critical Cartography. In: Vosman, F., Baart, A., & Hoffman, J. (Eds.), The Ethics of Care: The State of the Art, pp. 17-63. Series Ethics of Care no.8, Peeters Publishers, Louvain (2020).
[Online: https://ethicsofcare.org/the-disenchantment-of-care-ethics-a-critical-cartography/]
(6) Vosman, F. (2018/2023). Surviving as a Form of Life: The Ethics of Care as a Critique of the Ideal of the Successful Life. Eburon, Utrecht (2023).
[Online: The publication is available at the publishers website as paperback and e-book. It is also available there as pdf Open Access.
See also: https://ethicsofcare.org/surviving-as-a-form-of-life/]
(7) Vosman, F., Den Bakker, J., & Weenink, D. (2016). How to Make Sense of Suffering in Complex Care Practices. In: Spaargaren, G., Weenink, D., & Lamers, M. (Eds.), Practice Theory and Research: Exploring the Dynamics of Social Life, pp. 117–130.
[Online: https://www.academia.edu/114539465/How_to_make_sense_of_suffering_in_complex_care_practices]
(8) Vosman, F. (2017). The Moral Relevance of Lived Experience, in: Complex Hospital Practices: A Phenomenological Approach. In: Heuvel, S., Nullens, P., & Roothaan, A. (Eds.), Theological Ethics and Moral Value Phenomena, pp. 65-92. Routledge (2017).
[Online: https://ethicsofcare.org/wp-content/uploads/2018/02/RBR_Vosman-The-moral-relevance-of-lived-experience-in-complex-hospital-practices-Routledge-2017.pdf]
Vosman, F., Timmerman, G., & Baart, A. (2018). Digging into Care Practices: The Confrontation of Care Ethics with Qualitative Empirical and Theoretical Developments in the Low Countries, 2007–17. International Journal of Care and Caring, 2(3), pp. 405-423.
(9) On the political and Late Modernity see:
Vosman, F. (2017/2025). Through the Eye of the Needle: Acknowledging the Political as Primordial to an Ethics of Care.
[Online: https://ethicsofcare.org/through-the-eye-of-the-needle-next-steps-for-care-ethics/]
(10) Vosman, F., & Niemeijer, A. (2017). Rethinking Critical Reflection on Care: Late Modern Uncertainty and the Implications for Care Ethics. In: Medicine, Health Care and Philosophy, 20(4), pp. 465-476.
[DOI: https://doi.org/10.1007/s11019-017-9766-1]
Vosman, F. (2018). The Necessity of Critique of the Critique [Keynote, CEC Conference Portland].
[Online: https://ethicsofcare.org/the-necessity-of-critique-of-the-critique/]
Author of this introduction to Vosman’s Friendship as a Model of Professional Care: Jeannet van de Kamp
Translation from Dutch to English and editing: Isa Schut