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Medicine, Health Care and Philosophy

, Volume 20, Issue 4, pp 483–493 | Cite as

The sensible health care professional: a care ethical perspective on the role of caregivers in emotionally turbulent practices

  • Vivianne BaurEmail author
  • Inge van Nistelrooij
  • Linus Vanlaere
Scientifc Contribution

Abstract

This article discusses the challenging context that health care professionals are confronted with, and the impact of this context on their emotional experiences. Care ethics considers emotions as a valuable source of knowledge for good care. Thinking with care ethical theory and looking through a care ethical lens at a practical case example, the authors discern reflective questions that (1) shed light on a care ethical approach toward the role of emotions in care practices, and (2) may be used by practitioners and facilitators for care ethical reflection on similar cases, in the particular and concrete context where issues around emotional experiences arise. The authors emphasize the importance of allowing emotions to exist, to acknowledge them and to not repress them, so that they can serve as a vehicle for ethical behavior in care practices. They stress the difference between acknowledging emotions and expressing them limitlessly. Formational practices and transformational research practices are being proposed to create moral space in care institutions and to support health care professionals to approach the emotionally turbulent practices they encounter in a way that contributes to good care for all those involved.

Keywords

Emotions Caregivers Morality Sensibility Care ethics 

References

  1. Abma, T.A., B. Molewijk, and G. Widdershoven. 2009. Good care in ongoing dialogue. Improving the quality of care through moral deliberation and responsive evaluation. Health Care Analysis 17 (3): 217–235.CrossRefGoogle Scholar
  2. Aiken, L.H., W. Sermeus, K. Van den Heede, D.M. Sloane, R. Busse, M. McKee, L. Bruyneel, H.L. Smith, A. Kutney-Lee, A.M. Rafferty, P. Griffiths, M.T. Moreno-Casbas, C. Tishelman, P.A. Scott, T. Brzostek, J. Kinnunen, R. Schwendimann, M. Heinen, D. Zikos, and I.S. Sjetne. 2012. Impact of nursing on patient safety, satisfaction and quality of hospital care in 12 countries in Europe and the United States. British Medical Journal 344: e1717.CrossRefGoogle Scholar
  3. Barnes, M. 2012. Care in everyday life. An ethic of care in practice. Bristol: Policy Press.CrossRefGoogle Scholar
  4. Baur V.E. 2012. Participation and partnership. Developing the influence of older people in residential care homes. ‘s-Hertogenbosch: Uitgeverij BOXPress.Google Scholar
  5. Baur, V.E., and T.A. Abma. 2012. ‘The Taste Buddies’: Participation and empowerment in a residential care home. Ageing and Society 32 (6): 1055–1078.CrossRefGoogle Scholar
  6. Baur, V.E., T.A. Abma, and G.A.M. Widdershoven. 2010. Participation of marginalized groups in evaluation: mission impossible? Evaluation and Program Planning 33(3): 238–245.CrossRefGoogle Scholar
  7. Beauchamp, T., and J. Childress. 2013. Principles of biomedical ethics. 7th Edition. New York: Oxford University Press.Google Scholar
  8. Collins, S. 2015. The core of care ethics. New York: Palgrave Macmillan.CrossRefGoogle Scholar
  9. Demerouti, E., A.B. Bakker, F. Nachreiner, and W.B. Schaufeli. 2000. A model of burn-out and life satisfaction amongst nurses. Journal of Advanced Nursing 32: 454–464.CrossRefGoogle Scholar
  10. Engster, D. 2015. Care in the state of nature. The biologial and evolutionary roots of the disposition to care in human beings. In Care ethics and political theory, eds. D. Engster, and M. Hamington, Oxford: Oxford University Press.CrossRefGoogle Scholar
  11. Engster D., and M. Hamington, eds. 2015. Care ethics and political theory. Oxford: Oxford University Press.Google Scholar
  12. Finlay, L. 2014. Embodying research. Person-Centered and Experiential Psychotherapies 13 (1): 4–18.CrossRefGoogle Scholar
  13. Freidson, E. 2001. Professionalism: The third logic. Chicago: The University of Chicago Press.Google Scholar
  14. Gendlin, E. 1997. How philosophy cannot appeal to reason and how it can. In Language beyond postmodernism: saying and thinking in Gendlin’s philosophy, ed. D.M. Levin, 3–41. Evanston, IL: Northwestern University Press.Google Scholar
  15. Geuens N., E. Franck. 2013. Burn-out in de hulpverlening: wat maakt verpleegkundigen zo kwetsbaar? Eindrapport Expertisecentrum Psychisch Welzijn in Patiëntenzorg. Antwerpen: Karel de Grote-Hogeschool.Google Scholar
  16. Gillam, L., C. Delany, M. Guillemin, and S. Warmington. 2013. The role of emotions in health professional ethics teaching. Journal of Medical Ethics 40: 331–335.CrossRefGoogle Scholar
  17. Gilligan, C. 1982. In a different voice: Psychological theory and women’s development. Cambridge, MA: Harvard University Press.Google Scholar
  18. Grau-Alberola, E., P.R. Gil-Monte, J.A. Garcia-Juesas, and H. Figueiredo-Ferraz. 2010. Incidence of burn-out in Spanish nursing professionals: A longitudinal study. International Journal of Nursing Studies 47: 1013–1020.CrossRefGoogle Scholar
  19. Guillemin, M., and L. Gillam 2015. Emotions, narratives, and ethical mindfulness. Academic Medicine 90 (6): 126–131.CrossRefGoogle Scholar
  20. Gustafsson, G., S. Eriksson, G. Strandberg, and A. Norberg. 2010. Burnout and perceptions of conscience among health care personnel: A pilot study. Nursing ethics 17 (1): 23–38.CrossRefGoogle Scholar
  21. Hamington, M. 2004. Embodied care: Jane Addams, Maurice Merleau-Ponty and feminist ethics. Urbana, IL: University of Illinois Press.Google Scholar
  22. Hamington, M. 2012. A performative approach to teaching care ethics: A case study. Feminist Teacher 23 (1):31–49.CrossRefGoogle Scholar
  23. Hankivsky, O. 2004. Social policy and the ethic of care. Vancouver: University of British Columbia Press.Google Scholar
  24. Hansen, F.T. 2010. The phenomenology of wonder in higher education. In Erziehung. Phänomenologische Perspektiven, ed. M. Brinkmann, 161–179. Würzburg: Königshausen & Neumann.Google Scholar
  25. Hansen, F.T. 2015. The call and practice of wonder: How to evoke a Socratic community of wonder in professional settings. In The Socratic handbook, ed. M.N. Weiss, Vienna: LIT Verlag.Google Scholar
  26. Held, V. 2006. The ethics of care. In The Oxford handbook of ethical theory, ed. D. Copp, 537. New York: Oxford University Press.Google Scholar
  27. Hellinger, B. 2003. Peace begins in the soul: Family constellations in the service of reconciliation (C. Beaumont, Trans.). Heidelberg: Carl-Auer-Systeme Verlag.Google Scholar
  28. Jackson, A.Y., and L.A. Mazzei. 2012. Thinking with theory in qualitative research: Viewing data across multiple perspectives. London: Routledge.Google Scholar
  29. Johnson, C.W., and D.C. Parry. 2015. Fostering social justice through qualitative inquiry. A methodological guide. California: Left Coast Press.Google Scholar
  30. Jourdain, G., and D. Chênevert. 2010. Job demands-resources, burnout and intention to leave thenursing profession: A questionnaire survey. International Journal of Nursing Studies 47: 709–722.CrossRefGoogle Scholar
  31. Kittay, E.F. 1999. Love’s labor: Essays on women, equality, and dependency. New York: Routledge.Google Scholar
  32. Klaver K. and A. Baart. 2011. Attentiveness in care: Towards a theoretical framework. Nursing Ethics 1–8. doi: 10.1177/0969733011408052.
  33. Klaver, K., E. Van Elst, and A.J. Baart. 2014. Demarcation of the ethics of care as a discipline. Discussion article. Nursing Ethics 21: 755–765.CrossRefGoogle Scholar
  34. Klooster, M. and M. Hermans. 2008. Adem en kom tot rust. Aandachtstraining voor maatschappelijk werkers. Maatwerk 9: 14–16.CrossRefGoogle Scholar
  35. Kohlen, H. 2009. Conflicts of care. Hospital Ethics Committees in the USA and in Germany. Frankfurt: Campus.Google Scholar
  36. Ksiazek, I., T.J. Stefaniak, M. Stadnyk, and J. Ksiazek. 2010. Burnout syndrome in surgical oncology and general surgery nurses: A cross-sectional study. European Journal of Oncology Nursing. doi: 10.1016/j.ejon.2010.09.002.Google Scholar
  37. Leget, C., and G. Olthuis. 2007. Compassion as a basis for ethics in medical education. Journal of Medical Ethics 33: 617–620.CrossRefGoogle Scholar
  38. Leget, C., I. van Nistelrooij, and M. Visse. forthcoming 2017. Beyond demarcation: care ethics as an interdisciplinary field of inquiry. Nursing Ethics (in review).Google Scholar
  39. Maben, J., M. Adams, R. Peccei, T. Murrells, and G. Robert. 2012. ‘Poppets and parcels’: the links between staff experience of work and acutely ill older peoples’ experience of hospital care. International Journal of Older People Nursing 7 (2): 83–94.CrossRefGoogle Scholar
  40. Maxwell, B., and E. Racine. 2010. Should empathic development be a priority in biomedical ethics teaching? A critical perspective. Cambridge Quarterly of Healthcare Ethics 19: 433–445.CrossRefGoogle Scholar
  41. Mertens, D. 2009. Transformative research and evaluation. New York: Guilford Press.Google Scholar
  42. Milligan, E., and E. Woodley. 2009. Creative expressive encounters in health ethics education: Teaching ethics as relational engagement. Teaching and Learning in Medicine 21 (2): 131–139.CrossRefGoogle Scholar
  43. Molewijk, B., T.A. Abma, M. Stolper, and G.A.M. Widdershoven. 2008. Teaching ethics in the clinic. Theory and practice of moral case deliberation. Journal for Medical Ethics 34: 120–124.CrossRefGoogle Scholar
  44. Molewijk, B., D. Kleinlugtenbelt, and G. Widdershoven. 2011. The role of emotions in moral case deliberation: Theory, practice, and methodology. Bioethics 25 (7): 383–393.CrossRefGoogle Scholar
  45. Noddings, N. 1984. Caring, a feminine approach to ethics and moral education. Berkeley: University of California Press.Google Scholar
  46. Noddings, N. 2002. Starting at Home. Caring and Social Policy. Berkeley, CA: University of California Press.Google Scholar
  47. Nortvedt, P. 2007. Sensibility and clinical understanding. Medicine, health care and philosophy 11: 209–219.CrossRefGoogle Scholar
  48. Ott, M., P. Paardekooper, and W. van der Windt. 2005. Arbeid in zorg en welzijn. Utrecht: Prismant.Google Scholar
  49. Pettersen, T. 2011. The ethics of care: Normative structures and empirical implications. Health Care Analysis: HCA: Journal of Health Philosophy and Policy 19 (1): 51–64.CrossRefGoogle Scholar
  50. Pulcini, E. 2016. What emotions motivate care? Emotion Review 1–8. doi: 10.1177/1754073915615429.
  51. Ricoeur, P. 1992. Oneself as another. Chicago: University of Chicago Press.Google Scholar
  52. Robinson, F. 1999. Globalizing Care: Ethics, Feminist Theory and International Relations. Boulder, CO: Westview Press.Google Scholar
  53. Ruddick, S. 1989. Maternal thinking: Toward a politics of peace. Boston: Beacon Press.Google Scholar
  54. Rushton, C.H., and M.J. Kurtz. 2015. Moral distress and you. Supporting ethical practice and moral resilience in nursing. Silver Spring: American Nurses Association.Google Scholar
  55. Savel, R.H., and C.L. Munro. 2015. Moral distress, moral courage. American Journal of Critical Care 24: 276–278.CrossRefGoogle Scholar
  56. Sevenhuijsen, S. 1998. Citizenship and the ethics of care: Feminist considerations on justice, morality, and politics. London: Routledge.CrossRefGoogle Scholar
  57. Skei, K. 2007. Collaboration at risk: registered nurses’ experiences on orthopaedic wards. Journal of Clinical Nursing 17: 1907–1914.CrossRefGoogle Scholar
  58. Stenbock-Hult, B., and A. Sarvimäki. 2011. The meaning of vulnerability to nurses caring for older people. Nursing Ethics 18: 31–41.CrossRefGoogle Scholar
  59. Stocker, S. 2014. Staging the moral imagination in the health care setting. Linköping: Linköping University Press.Google Scholar
  60. Thorup, C.B., E. Rundqvist, C. Roberts, and C. Delmar. 2012. Care as a matter of courage: vulnerability, suffering and ethical formation in nursing care. Scandinavian Journal of Caring Sciences 26: 427–435.CrossRefGoogle Scholar
  61. Todres, L. 2007. Embodied inquiry. Phenomenological touchstones for research, psychotherapy and spirituality. UK: Palgrave Macmillan.Google Scholar
  62. Tronto, J.C. 1993. Moral boundaries: A political argument for an ethic of care. New York: Routledge.Google Scholar
  63. Tronto, J.C. 2010. Creating caring institutions: Politics, plurality, and purpose. Ethics and Social Welfare 4 (2): 158–171.CrossRefGoogle Scholar
  64. Tronto, J. 2013. Caring democracy. Markets, equality, and justice. New York and London: New York university press.Google Scholar
  65. Tronto, J.C. 2014. Moral boundaries after twenty years: from limits to possibilities. In Moral boundaries redrawn. Ethics of care. Vol. 3, eds. G. Olthuis, H. Kohlen, and J. Heier, 9–29. Leuven: Peeters.Google Scholar
  66. van Dartel, H. 2014. Gesprek blijven over goede zorg: overlegmethoden voor moreel beraad. Amsterdam: Uitgeverij Boom.Google Scholar
  67. Van Heijst, A. 2005. Menslievende zorg. Een ethische kijk op professionaliteit. Kampen: uitgeverij Klement.Google Scholar
  68. Van Heijst, A. 2011. Professional loving care. An ethical view of the health care sector. Leuven: Peeters.Google Scholar
  69. Van Nistelrooij, I. 2015. Sacrifice. A care ethical reappraisal of sacrifice and self-sacrifice. Leuven: Peeters.Google Scholar
  70. Van Nistelrooij, I., M. Visse, A. Spekking, J. De Lange J. 2017. How shared is shared decision making? A care-ethical view on the role of partner and the family. Journal of Medical Ethics (in press). doi: 10.1136/medethics-2016-103791.Google Scholar
  71. Vanlaere, L., and R. Burggraeve. 2013. Gekkenwerk. Kleine ondeugden voor zorgdragers. Tielt: Lannoo.Google Scholar
  72. Vanlaere, L., M. Timmermann, M. Stevens, and C. Gastmans. 2012. An explorative study of experiences of healthcare providers posing as simulated care receivers in a ‘care-ethical’ lab. Nursing Ethics 19 (1): 68–79.CrossRefGoogle Scholar
  73. Veer de J.A.E., and A.L. Francke. 2010. Werkdruk; meer dan overwerk. Utrecht: NIVEL.Google Scholar
  74. Verhaeghe, R., P. Vlerick, G. De Backer, G. Van Maele, and P. Gemmel. 2008. Recurrent changes in the work environment, job resources and distress among nurses: A comparative cross-sectional survey. International Journal of Nursing Studies 45: 382–392.CrossRefGoogle Scholar
  75. Visse, M. 2012. Openings for humanization in modern health care practices. Amsterdam: Vrije Universiteit.Google Scholar
  76. Walker, M.U. 1998. Moral understandings: A feminist study in ethics. New York: Oxford University Press Inc.Google Scholar
  77. Walker, M.U. 2006. Moral repair: Reconstructing moral relations after wrongdoing. Cambridge: Cambridge University Press.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2017

Authors and Affiliations

  1. 1.Universiteit voor HumanistiekUtrechtThe Netherlands
  2. 2.Universiteit voor HumanistiekUtrechtThe Netherlands
  3. 3.RHIZOKortrijkBelgium

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