An ethics of care: new perspectives, both theoretically and empirically?

Abstract

Five articles in this volume of Nursing Ethics deal with empirical as well as theoretical perspectives on an ethics of care. In 2011, Nursing Ethics, following a workshop on an ethics of care in Rome 2010, already has published nine articles on normative issues in care ethics. In 2012, the Ethics of Care research group at Tilburg University, the Netherlands, arranged an invited workshop in Utrecht, presenting various perspectives on care ethics from several European countries. The Tilburg group took the initiative for publishing these articles in the Journal of Nursing Ethics. The field of care ethics is expanding rapidly within the European context, much as a result of very strong research groups in the Netherlands, Belgium and Germany. What we see in Europe and perhaps in some contrast to the United States and Canada is a growing emphasis on empirical research, related to care ethical theories. There is a parallel there with bioethics going empirical. The ethics of care, however, has its own epistemological reason to do empirical research, that is, qualitative empirical research with a strong emphasis on the perspective of vulnerable people. The first person’s knowledge of vulnerable people is of importance according to the ethics of care. The five articles in this volume of the journal reflect this tendency, with three articles more clinically oriented, while two deal with conceptual and theoretical issues. Our view is that overall, a balance between theoretical and empirical work in care ethics is very fruitful for the development of care theories in general and care ethical theories in particular. It is natural that experiences within clinical and professional context of care are reflected upon in the philosophical and conceptual work in care ethics. Great parts of ethics are far removed from the particular context of clinical care work. Knowledge as it emerges in care practice is not taken into account by that type of ethics. This distance makes philosophy irrelevant and less plausible. On the other hand, clinical ethical work in healthcare must have a solid basis in theory, to co-create critical reflection. Therefore, the theoretical basis of an ethics of care has to be strengthened as well, in order to become a full-fledged normative theory. It is not sufficient that ethics of care claims that it is ‘relational’ or is based even upon a ‘relational ontology’, without more concretely specifying what this, normatively speaking, amounts to. Competing ethical theories from the virtue ethical tradition as well as from ethical consequentialism would claim that it has a relational normative orientation and can encompass care ethical concerns. The question is about the relevance of relational considerations as normatively significant. The same goes for the relevance of context and of power issues, two more ideas dear to the ethics of care. Theoretically and empirically, the ethics of care thus face a challenge to strengthen its claims about the necessity to use the perspective of vulnerable people, to use relational and contextual knowledge.