1. What kind of institutions do we need for care-ethical case deliberation? Plans for an international research project
Paper presentation dr. Inge van Nistelrooij (UHS Utrecht)
International EACME conference
Louvain, Belgium
8-10 September 2016
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September ,
Het project van de UvH

2. Program Introduction of myself and the research program plans
Presentation of care-ethical epistemological and political-ethical points of departure for caring institutions
Plenary questions / discussion
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EACME, Louvain, 9/2016
Het project van de UvH

3. Introduction
Inge van Nistelrooij (1967), assistant professor Ethics of Care at the University of Humanistic Studies (UHS), Utrecht (Master in Care Ethics and Policy)
Involved in care ethics for 20 years as a lecturer, trainer, supervisor, publicist.
PhD thesis: Sacrifice. A Care-Ethical Reappraisal of Sacrifice and Self-Sacrifice (2015, Peeters, Leuven)
EACME, Louvain, 9/2016

4. Research plans under construction
Bringing together:
Education in our Care Ethics Master’s: how not to deliberate in an abstract, rationalistic, a-political, way, by taking the context,conflicts, affectivity, the body, and power into account;
7 years experience in (teaching, training, moderating) case deliberation (Utrecht, Van Nistelrooij);
Practical Research background: 7 years Action Research Project with hospitals in Germany (Berlin, Kohlen)
Several professional ethicists in hospitals;
EACME, Louvain, 9/2016

5. Research plans under construction
Research partners (up to this point):
Prof dr Helen Kohlen (PTHV, Vallendar, Germany)
Two Berlin hospitals
Two Dutch hospitals
A hospital ethicist
Joan Tronto in a consulting role
A growing network of people involved in theatrical, non-verbal, embodied forms of reflection
EACME, Louvain, 9/2016

6. Care-ethical epistemological and political-ethical points of departure

7. Practices as source of moral knowledge

8. Differently positioned people know,
feel,
experience,
see,
hear,
believe,
are entrusted,
and consider,
different things, and hence see different moral problems and answers.

9. Margaret Urban Walker’s view of moral understandings
A geography of responsibilities
Ethics as a scrutiny of the social practices of responsibilities:
Ethics = geography, tracking the lines of responsibility…
…asking:
“… who gets to do what to whom and who is supposed to do what for whom” (2007, 16)
EACME, Louvain, 9/2016

10. Helen Kohlen’s research among HEC’s n US and Germany
Findings:
Dominance of abstract thinking;
The principle of autonomy was used at the forefront of ALL debates;
I.e. among those HEC-members with clinical ethics education;
The language of care did not evolve;
Palliative care physicians and chaplains struggled the most to express care questions;
EACME, Louvain, 9/2016

11. What makes institutions caring?
Deliberate space and processes to discuss care’s
purpose
particularity and plurality
power relations
Creating a political space for resolving conflict
highly deliberate and explicit
By not only ‘providing care’ but also care about their own ways of working.
EACME, Louvain, 9/2016

12. Helen Kohlen’s care-ethical ethical deliberation model developed in Berlin
Three key elements:
Education following the curriculum for clinical ethics consultation of the Academy of Medicine, integrating care ethics;
starting from the hospital staff’s own model for case deliberation it seeks to identify (a) what they already do and know; (b) what hinders them and (c) what helps to implement this model; and (d) look at power relations and conflicts in the process;
forum sessions: thematising current themes of clinical ethics, presentation and discussion of progression and experiences, centering on the question: ‘Have we done everything we can to keep in touch with the patient and each other?’ x x
EACME, Louvain, 9/2016

13. What is good care, given this particular situation?
The Utrecht Care Ethics
Theoretical and conceptual discussions from an interdisciplinary field of enquiry
(critical insights):
Relationality
Contextuality
Affectivity
Practices
Vulnerability
Bodiliness
Power and position
Meaning / sense
Empirical methods:
Phenomenology
Narrative analysis
Discoursanalysis
Auto ethnography
Institutional ethnography
Visual data analysis
Responsive evaluation
care
lived experience – care practices – the socio-political order

14. Research projects’ aims (preliminary):
Develop a democratic care-ethical form of deliberation:
Relational attuning (patient’s empowerment and ‘talk back’)
Embodied forms of ethical reflection
Research into lived experience of caregivers and care receivers
Further development and implementation of forms of responsive evaluation
EACME, Louvain, 9/2016

15. Discussion, suggestions, and questions
www. zorgethiek.nu / www. care-ethics.org
EACME, Louvain, 9/2016