Interview on September 4th, 2011.

1. Where are your working at this moment?

In my work as clinical ethicist in a group of seven nursing homes for elderly, I try to enhance the ability of professionals to engage in ethical reflection on their practice. sTimul, a ‘care-ethics lab’ is crucial here. In sTimul, the context of elderly care is simulated, with student nurses giving care for two days, including a night, to experienced caregivers who are, for this period, in the role of elderly patients. This simulation aims to foster ethical reflection for both parties. Through the simulation, the veteran caregivers experience how dignity is at stake in daily care situations and in communication. The experience of being helpless or dependent and deprived of privacy offers caregivers incentives to reflect ethically on their own caring practices. During the ethical reflection at the end of the second day, we try to help them to attain a heightened moral sensitivity to the vulnerabilities, values and responsibilities in their work; to make explicit norms and values that guide their actions in practice, and to evaluate this via their new experiences. Students, who take up the role of caregivers in the ‘care-ethics lab’, are stimulated to reflect ethically on their practices. The feedback they receive from their “patients” enables them to rehearse interactions and to be guided in their reflection in a ‘safe’ environment. More empirical research is needed to verify the effects of this ethical learning programme on the ethical reflection and ethical practice of caregivers in the care of older people.

2. Can you tell us about your research and its relation to the ethics of care?
My PhD concerned a philosophical-ethical research to care as concept. This started with the phenomenon ‘care’ in the life of humans. Care as moral value is the point of departure of the ethics of care, so I tried to map the different perspectives on the concept of care in the work of different care ethicists. I also make a link between the viewpoints of the Louvain tradition of personalism and a few basic principles of care ethics.
At the moment, I am involved in an empirical research to the effects of our ‘simulation learning in ethics’ on the veteran caregivers who are the ‘patients’ for two days. With this research, we want to verify the effects of this ethical learning programme on the ethical reflection and ethical practice of caregivers in the care for older people. The research can give us a more adequate view to the value of ethical reflection for the ethical attitude of caregivers. This research also possibly brings us to a better understanding of the ethical concepts used in care ethics.

3. How did you get involved into the ethics of care?
I studied theology at the Katholieke Universiteit of Leuven, where the course of ‘Feminist Studies’ brought me in contact with the work of Carol Gilligan and Joan Tronto. I finished my Master studies with a research paper about a care-ethical view on suicide. Chris Gastmans, at that time assistant professor at the Center of Biomedical Ethics and Law, evaluated this paper and invited me to work on a research project about the concept of care. He gave me the opportunity within this project to elaborate a care-ethical view on suicide in the elderly. By this project I got involved into the ethics of care, but also into the ethics of care into the perspective of elderly care.

4. How would you define ethics of care?
I think I am defined by the ethics of care more then I can define ethics of care. Crucial in defining ethics of care is the contextual and relational sensitivity; the fact that the care ethics perspective starts from the context wherein care takes place.

5. What is the most important thing you learned from the ethics of care?
The most important thing that I learned from the ethics of care is that it is impossible to ‘do ethics’ in a detached, abstract, academic way. To stand in “the mud” of the caring practices, to know the context of care, to reveal and to reflect on your own intuitions and emotions and these of the other people involved, all this are very important insights of the ethics of care.

6. Whom do you consider to be your most important teacher(s) in this area?
Referring to my answers above, I would say that the caregivers on the one hand, and the care-receivers (the elderly) at the other hand, are both my most important teachers. They can learn me a lot about care and care ethics, because they experience daily what it is to give and/or to receive care, what ‘good’ care is, what ‘reciprocity’ in care means and how important it is in a view on good care…

7. What works in the ethics of care do you see as the most important?
I must say that novels have learned me the most about care ethics. Novels as ‘Slow Man’ (Coetzee) or ‘Everyman’ (Roth) for example, stimulated my thinking about some fundamental concepts of the ethics of care and made these concepts very clear to me through the narratives of ‘real life experiences’. In this way, novels help me to sharpen my ethical reasoning more then some academic works. But of course, ‘Moral Bounderies’ is important to me; Tronto’s view on care as a moral value and as a basis for the political achievement of a good society is crucial for care ethics. The work of Stan Van Hooft, and more especially his older book ‘Caring’ – where he starts from ‘deep caring’ as ontological structure – is also very important to me.

8. Which of your own books/articles should we read?
Maybe the stories of people about care that I will write down somewhere in the future. Meanwhile I would refer to ‘Cirkels van zorg’ (Cercles of care), where Chris Gastmans and I applied a care ethics perspective on elderly care.

9. What are important issues for the ethics of care in the future?
The issue of the place of care as moral value in a normative perspective seems the most important issue for me. There is still a great deal of confusion and uncertainty surrounding the notion of care. One of the focal points of critics is the normativity of care. To what extent does care have an obligatory character? Only when the objective normative basis of care is sufficiently clarified, care practices can be evaluated and optimised from an ethical perspective. For this issue, I refer to our article in ‘Bijdragen. International Journal in Philosophy and Theology’ 69 (4), 443-469.

10. In Tilburg our ambition is to promote ethics of care nationally and internationally. Do you have any recommendations or wishes?
Of course I refer to our care-ethics lab sTimul as a creative and innovative tool in facilitating and promoting ethics of care. It is my dream to set up an international network of ‘care-ethics lab’ in ethics education…