There is no singular European view on the ethics of care, as there are too many differences between views and the development(s) with regard to care ethics varies greatly among countries. Even the question what ‘care’ actually means, does not appear to have a straightforward answer. Whether or not we ever get to a uniform definition is perhaps not the most important issue. What matters more is that European care ethicists are trying to both stimulate and promote the development of care ethics in their respective countries. However there is still a long way to go. These are some of the conclusions which can be drawn from the conference on ethics of care, recently hosted by the University of Humanistic Studies in Utrecht, the Netherlands. Care ethicists from various European countries presented their research and focused on recent developments in their own country with regard to the field of care ethics.
After a word of welcome by the hosts Frans Vosman and Carlo Leget, Tove Pettersen kicked off the three-day conference with an inspiring talk.
Pettersen, professor of philosophy at the university of Oslo, reminded us of the fact that Carol Gilligan’s In a different voice was published exactly 30 years ago. Using a feminist perspective on care, Pettersen showed how care ethics has developed over the years and argued that the care relation needs to develop from a traditional relation to a mature one, whereby the caregiver does not only perceive the care receiver, but also him/herself. She focused on the asymmetric nature of care relations, whereby the caregiver assumes the largest share of responsibility, as he or she is the one to ensure the care receiver’s wellbeing rather than putting him/herself first. According to Pettersen there is still not enough attention for the vulnerability and dependency of the caregiver, despite the fact that this is also present in an asymmetric care relation. She therefore wondered who looks after the caregiver and proposed a third party in the care relation, namely the social environment of the caregiver, to ensure that the caregiver is looked after when he or she needs it.
Pettersen argued that we all have a responsibility to care, not only for our kins and friends, but also for people who are strangers to us. There is an ethical justification for sharing responsibilities rather than restricting care giving to family and professionals. Pettersen quoted Eva Feder Kittay, who once posited the maxim: “we all are somebody’s child”. This is about just care which we are obliged to give; a mother does not care for her child because she wants the child to care for her when she is old, but because she was cared for by hér mother. Just like the way professors are generous to their students, because they were also treated generously by their professors. In short: this is not about care in the sense of ” you scratch my back, I will scratch yours”. However, Pettersen continued, it should not only be about the care giver giving care, but also supporting the caregiver to enable him/her to continue to do so. In this way caregivers will not get overburdened and it allows room for his or her vulnerability.
After the opening night, several care ethicists and their graduates took turns in presenting their work over the following two days.
Per Nortvelt from Oslo explained how care ethics is developed in Norway, where a couple of topics are given special attention: the role of altruism in care; the normative nature of moral sensitivity; the
normative meaning of relationships; the relation between care and values and how to find the right balance between institutions and the private sphere. Nortvelt’s argument was supported by two PhD candidates who presented their research. Marit Hem (Mature Care- a conceptual, empirical and critical evaluation.pdf) and paediatrician Elin Martinsen (On the concept of care in medicine.pdf).
Chris Gastmans from Leuven (Belgium) argued that the lived experience (vulnerability) provides a starting point when developing an ethical approach. Consequently both a normative standard (dignity) and interpretive dialogue (care) play an important role. According to Gastmans not all care is good care and the ultimate goal is to arrive at dignified care. His statement that dignity needs to be looked at in an inductive manner provoked a lively debate. PhD candidate Lieslot Mahieu (Care for institutionalized eldery suffering from dementia with regard to their intimacy and sexuality needs.pdf) and Linus Vanlaere researcher at sTimul-project (where people can experience a 1,5 day stay in a simulation nursing home) spoke about their research.
Helen Kohlen and Elisabeth Conradi provided a German perspective. They showed that ethics of care does not yet play a major role in Germany, where bioethics and medical ethics appear to be mainstream. Autonomy remains the dominant value as there is a hierarchical male oriented way of thinking. Conradi broadened her perspective to include Austria and Switzerland, where care is more of less synonymous to nursing. Even though there is empirical research into care being done, this research is not normative. And where normative research ís done, no reference to ethics of care is being made. Important areas of research include family life, home care, nursing and social work. PhD candidates Jorma Heier (Care Unbounded: For a Political Ethics of Repair) and Peiyi-Lu (The logic of care in Diabetes Care.pdf) presented their research.
Frans Vosman and PhD candidate Klaartje Klaver (Attentiveness in hospital care.pdf) from the Netherlands spoke about the Dutch developments with regard to care ethics. Vosman gave a broad overview of developments between 2008 and 2012, in which various perspectives can be distinguished: medical, theological, applied sciences and the Master ethics of care (the only specialised care ethics Master known in Europe). Vosman stated that the empirical research being done in the Elisabeth Hospital in Tilburg has progressed and that after four years lessons have been learnt which have given rise to a revision of earlier viewpoints. For example, more insight has been gained into the relational positions of the care receiver and their kin, as concepts related to practices used in 2008 have proven to be too normative and also the values of institutions have changed.
With the French delegation being absent, Marian Barnes and Lizzie Ward from Brighton (Britain) were the last of the speakers (Working with an ethic of care in the UK.pdf). Barnes showed us that in Britain much of the research being done on ethics of care is in the field of social policy. Care appears to be undervalued in present day policy and in the dominant discourse on elderly and care ‘obligations’ and ‘burden’ play a central role. On the one hand there is a lot of emphasis on ‘getting old actively’, on the other hand on reducing the costs of health care. It is often forgotten that elderly not only are care receivers, but in many instances also care givers. Ward explained how care ethical principles can be applied in research practice. She illustrated this by showing a research study done amongst elder people in which these elderly participated as researchers.
Besides the pleasant mix of lectures by experienced and less experienced researchers, there was ample opportunity for discussion throughout the conference. This made it a veritable exchange of information, differing perspectives and new developments. Next year’s conference will be held in Stuttgart on October 10 and 11, 2013.