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Erschienen in: Medicine, Health Care and Philosophy 1/2015

01.02.2015 | Scientific Contribution

Towards an empirical ethics in care: relations with technologies in health care

verfasst von: Jeannette Pols

Erschienen in: Medicine, Health Care and Philosophy | Ausgabe 1/2015

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Abstract

This paper describes the approach of empirical ethics, a form of ethics that integrates non-positivist ethnographic empirical research and philosophy. Empirical ethics as it is discussed here builds on the ‘empirical turn’ in epistemology. It radicalizes the relational approach that care ethics introduced to think about care between people by drawing in relations between people and technologies as things people relate to. Empirical ethics studies care practices by analysing their intra-normativity, or the ways of living together the actors within these practices strive for or bring about as good practices. Different from care ethics, what care is and if it is good is not defined beforehand. A care practice may be contested by comparing it to alternative practices with different notions of good care. By contrasting practices as different ways of living together that are normatively oriented, suggestions for the best possible care may be argued for. Whether these suggestions will actually be put to practice is, however, again a relational question; new actors need to re-localize suggestions, to make them work in new practices and fit them in with local intra-normativities with their particular routines, material infrastructures, know-how and strivings.
Fußnoten
1
The classic reference is to Beauchamp and Childress (2002).
 
2
Some care ethics take the mother-child relation as exemplary (Noddings 1984). Other kinds of caring relations have dynamics that differ from the professional caring relation. See for instance studies in care for animals (Folker et al. 2009), for the dynamics of care at home rather than in the hospital (Milligan 2009); for older people Ceci et al. (2011); care for patients in combination with training doctors (Wallenburg et al. 2013); and care by managers (Grit 2004) or for science (Puig de la Bellacasa 2011).
 
3
There are other forms of empirical ethics, see Willems and Pols (2010), Molewijk et al. (2004).
 
4
See for the empirical turn in epistemology: Latour (1987a, b), Law (1999), Mol (2002), and for the empirical turn in ethics: Mol (2010), Pols (2008, 2012, 2013), López and Domènech (2009), Willems (2010), Winance (2010), Willems and Pols (2010).
 
5
This is the fruit of two 3 year projects. The research started in 2005 with a grant from NWO, The Netherlands Organisation for Scientific Research, from the program Ethics, Research and Policy: Care at a distance. A normative investigation into telecare. The second project was called EFORTT, a research program funded by the European Community, seventh Framework program: Ethical Frameworks for Telecare Technologies for older people at home.
 
6
This is a good example of the re-scribing of one’s object of research right away. By turning the stories and practices of many into two narratives, I hope to bring the cases to life for the reader, at the cost of particular nuances and perspectives, and at the favour of others.
 
7
Different from Schicktanz et al. (2012) I do not see this as a correction of a lack of epistemological grounds for ‘making ethicists speak’, but as a way of showing the complexity of making weak voices heard.
 
Literatur
Zurück zum Zitat Beauchamp, T.L., and J.F. Childress. 2002. Principles of biomedical ethics. New York: Oxford University Press. Beauchamp, T.L., and J.F. Childress. 2002. Principles of biomedical ethics. New York: Oxford University Press.
Zurück zum Zitat Ceci, C., K. Björnsdóttir, and M.E. Purkis (eds.). 2011. Perspectives on care at home for older people. New York: Routledge. Ceci, C., K. Björnsdóttir, and M.E. Purkis (eds.). 2011. Perspectives on care at home for older people. New York: Routledge.
Zurück zum Zitat Folker, M.P., M.N. Svendsen, and L. Koch. 2009. Lifeworlds of the pig: Towards a carthography of porcine/human entanglements. In Investigating human/animal relations in science, Culture and Work, ed. T. Holmberg, 142–153. Uppsala: Centrum för Genusvetenskap, Uppsala Univaersitet. Folker, M.P., M.N. Svendsen, and L. Koch. 2009. Lifeworlds of the pig: Towards a carthography of porcine/human entanglements. In Investigating human/animal relations in science, Culture and Work, ed. T. Holmberg, 142–153. Uppsala: Centrum för Genusvetenskap, Uppsala Univaersitet.
Zurück zum Zitat Grit, Kor. 2004. Corporate citizenship: How to strengthen the social responsibility of managers? Journal Business Ethics 53(1&2): 97–106.CrossRef Grit, Kor. 2004. Corporate citizenship: How to strengthen the social responsibility of managers? Journal Business Ethics 53(1&2): 97–106.CrossRef
Zurück zum Zitat Haraway, D. 1991. Situated knowledges: The science question in feminism and the privilege of partial perspective. In Simians, cyborgs and women. The reinvention of nature, ed. D. Haraway. New York: Routledge. Haraway, D. 1991. Situated knowledges: The science question in feminism and the privilege of partial perspective. In Simians, cyborgs and women. The reinvention of nature, ed. D. Haraway. New York: Routledge.
Zurück zum Zitat Harbers, H. 2005. Epilogue: Political materials–material politics. In Inside the politics of technology. Agency and normativity in the co-production of technology and society, ed. H. Harbers, 257–272. Amsterdam: Amsterdam University Press.CrossRef Harbers, H. 2005. Epilogue: Political materials–material politics. In Inside the politics of technology. Agency and normativity in the co-production of technology and society, ed. H. Harbers, 257–272. Amsterdam: Amsterdam University Press.CrossRef
Zurück zum Zitat Kohlen, Helen. 2009. Conflicts of care, hospital ethics committees in the USA and Germany. Frankfurt: Campus Verlag. Kohlen, Helen. 2009. Conflicts of care, hospital ethics committees in the USA and Germany. Frankfurt: Campus Verlag.
Zurück zum Zitat Latour, B., and Woolgar, S. 1986. Laboratory life. The construction of scientific facts. Princeton Unviversity Press. Latour, B., and Woolgar, S. 1986. Laboratory life. The construction of scientific facts. Princeton Unviversity Press.
Zurück zum Zitat Latour, B. 1987a. The pasteurization of French Society. Cambridge, MA: MIT Press. Latour, B. 1987a. The pasteurization of French Society. Cambridge, MA: MIT Press.
Zurück zum Zitat Latour, B. 1987b. Science in action: How to follow scientists and engineers through society. Cambridge, MA: Harvard University Press. Latour, B. 1987b. Science in action: How to follow scientists and engineers through society. Cambridge, MA: Harvard University Press.
Zurück zum Zitat Law, J. 1999. After ANT: Complexity, naming and topology. In Actor network theory and after, ed. J. Law, and J. Hassard, 1–14. Oxford: Blackwell. Law, J. 1999. After ANT: Complexity, naming and topology. In Actor network theory and after, ed. J. Law, and J. Hassard, 1–14. Oxford: Blackwell.
Zurück zum Zitat Leget, C., C. Gastmans, M.A. Verkerk (red.). 2011. Care, compassion and recognition: An ethical discussion. Leuven: Peeters Publishers. Leget, C., C. Gastmans, M.A. Verkerk (red.). 2011. Care, compassion and recognition: An ethical discussion. Leuven: Peeters Publishers.
Zurück zum Zitat López, D., and M. Domènech. 2009. Embodying autonomy in a home telecare service. The Sociological Review 56: 181–195.CrossRef López, D., and M. Domènech. 2009. Embodying autonomy in a home telecare service. The Sociological Review 56: 181–195.CrossRef
Zurück zum Zitat Milligan, C. 2009. There’s no place like home: People, place and care in an ageing society. Aldershot: Ashgate Geographies Health Book Series. Milligan, C. 2009. There’s no place like home: People, place and care in an ageing society. Aldershot: Ashgate Geographies Health Book Series.
Zurück zum Zitat Mol, A. 2002. The body multiple. Ontology in medical practice. Durham: Duke University Press.CrossRef Mol, A. 2002. The body multiple. Ontology in medical practice. Durham: Duke University Press.CrossRef
Zurück zum Zitat Mol, A. 2010. Care and its values. Good food in the nursing home. In Care in practice. On tinkering in clinics, homes and farms, ed. A. Mol, I. Moser, and J. Pols, 215–234. Bielefeld: Transcript Verlag. Mol, A. 2010. Care and its values. Good food in the nursing home. In Care in practice. On tinkering in clinics, homes and farms, ed. A. Mol, I. Moser, and J. Pols, 215–234. Bielefeld: Transcript Verlag.
Zurück zum Zitat Molewijk, B., A.M. Stiggelbout, W. Otten, H.M. Dupuis, and J. Kievit. 2004. Empirical data and moral theory. A ple a for integrated empirical ethics. Medicine, Health Care and Philosophy 7: 55–69.CrossRef Molewijk, B., A.M. Stiggelbout, W. Otten, H.M. Dupuis, and J. Kievit. 2004. Empirical data and moral theory. A ple a for integrated empirical ethics. Medicine, Health Care and Philosophy 7: 55–69.CrossRef
Zurück zum Zitat Moser, I. 2010. Perhaps tears should not be counted but wiped away. On quality and improvement in dementia care. In Care in practice. On tinkering in clinics, homes and farms, ed. A. Mol, I. Moser, and J. Pols, 277–300. Bielefeld: Transcript Verlag. Moser, I. 2010. Perhaps tears should not be counted but wiped away. On quality and improvement in dementia care. In Care in practice. On tinkering in clinics, homes and farms, ed. A. Mol, I. Moser, and J. Pols, 277–300. Bielefeld: Transcript Verlag.
Zurück zum Zitat Moser, I., and J. Law. 1999. Good passages, bad passages. In Actor network theory and after, ed. J. Law, and J. Hassard, 196–219. Oxford: Blackwell. Moser, I., and J. Law. 1999. Good passages, bad passages. In Actor network theory and after, ed. J. Law, and J. Hassard, 196–219. Oxford: Blackwell.
Zurück zum Zitat Noddings, N. 1984. Caring: A feminine approach to ethics and moral education. Berkeley: University of California Press. Noddings, N. 1984. Caring: A feminine approach to ethics and moral education. Berkeley: University of California Press.
Zurück zum Zitat Pols, A.J. 2006. Washing the citizen: Washing, cleanliness and citizenship in mental health care. Culture, Medicine & Psychiatry 30(1): 77–104. Pols, A.J. 2006. Washing the citizen: Washing, cleanliness and citizenship in mental health care. Culture, Medicine & Psychiatry 30(1): 77–104.
Zurück zum Zitat Pols, J., 2008. Which empirical research, whose ethics? Articulating ideals in long-term mental health care. In Empirical Ethics in Psychiatry (eds) G. Widdershoven, T. Hope, L. Van der Scheer, & J. McMillan, 51–68. Oxford University Press. Pols, J., 2008. Which empirical research, whose ethics? Articulating ideals in long-term mental health care. In Empirical Ethics in Psychiatry (eds) G. Widdershoven, T. Hope, L. Van der Scheer, & J. McMillan, 51–68. Oxford University Press.
Zurück zum Zitat Pols, J., Schermer, M., and Willems, D. 2010. Telezorgvisie essay over ontwikkelingen en beloften van telezorg in de nederlandse gezondheidszorg (Essay for policymakers on telecare, for NWO project care at a distance). Amsterdam: AMC. Pols, J., Schermer, M., and Willems, D. 2010. Telezorgvisie essay over ontwikkelingen en beloften van telezorg in de nederlandse gezondheidszorg (Essay for policymakers on telecare, for NWO project care at a distance). Amsterdam: AMC.
Zurück zum Zitat Pols, J., 2012. Care at a distance. On the closeness of technology. Amsterdam: Amsterdam University Press. Pols, J., 2012. Care at a distance. On the closeness of technology. Amsterdam: Amsterdam University Press.
Zurück zum Zitat Puig de la Bellacasa, M. 2011. Matters of care in technoscience: Assembling neglected things. Social Studies of Science 41(1): 85–106.CrossRef Puig de la Bellacasa, M. 2011. Matters of care in technoscience: Assembling neglected things. Social Studies of Science 41(1): 85–106.CrossRef
Zurück zum Zitat Schicktanz, S., M. Schweda, and B. Wynne. 2012. The ethics of ‘public understanding of ethics’—Why and how bioethics expertise should include public and patients’ voices. Medicine, Health Care and Philosophy 5(2): 129–139.CrossRef Schicktanz, S., M. Schweda, and B. Wynne. 2012. The ethics of ‘public understanding of ethics’—Why and how bioethics expertise should include public and patients’ voices. Medicine, Health Care and Philosophy 5(2): 129–139.CrossRef
Zurück zum Zitat Sevenhuijsen, S. (1998) Citizenship and the ethics of care feminist considerations on justice, morality and politics new York: Routledge. Sevenhuijsen, S. (1998) Citizenship and the ethics of care feminist considerations on justice, morality and politics new York: Routledge.
Zurück zum Zitat Sevenhuijsen, S. 2000. Caring in the third way: The relation between obligation, responsibility and care in third way discourse. Critical Social Policy 20: 5–37.CrossRef Sevenhuijsen, S. 2000. Caring in the third way: The relation between obligation, responsibility and care in third way discourse. Critical Social Policy 20: 5–37.CrossRef
Zurück zum Zitat Shapin, S., and Schaffer, S. 1985. Leviathan and the air-pump. Hobbes, Boyle and the experimental life. Princeton: Princetone University press. Shapin, S., and Schaffer, S. 1985. Leviathan and the air-pump. Hobbes, Boyle and the experimental life. Princeton: Princetone University press.
Zurück zum Zitat Tonkens, E.H., and J. Newman. 2010. Active citizenship: Responsibility, participation and choice. Amsterdam: Amsterdam University Press. Tonkens, E.H., and J. Newman. 2010. Active citizenship: Responsibility, participation and choice. Amsterdam: Amsterdam University Press.
Zurück zum Zitat Tronto, J. 1993. Moral boundaries: A political argument for an ethic of care. New York: Routledge. Tronto, J. 1993. Moral boundaries: A political argument for an ethic of care. New York: Routledge.
Zurück zum Zitat Verkerk, M.A. 2007. Care ethics as a feminist perspective on bioethics. In: New pathways for European Bioethics. Gastmans, C.E.A. (ed) Antwerpen/Oxford: Intersentia, 65–81. Verkerk, M.A. 2007. Care ethics as a feminist perspective on bioethics. In: New pathways for European Bioethics. Gastmans, C.E.A. (ed) Antwerpen/Oxford: Intersentia, 65–81.
Zurück zum Zitat Walker, M.U. 2007. Moral understandings: A feminist study in ethics, 2nd ed. Oxford: Oxford University Press. Walker, M.U. 2007. Moral understandings: A feminist study in ethics, 2nd ed. Oxford: Oxford University Press.
Zurück zum Zitat Wallenburg, I., A. de Bont, M.J. Heineman, F. Scheele, and P. Meurs. 2013. Learning to doctor: Tinkering with visibility in residency training. Sociology of Health & Illness 35(4): 544–559.CrossRef Wallenburg, I., A. de Bont, M.J. Heineman, F. Scheele, and P. Meurs. 2013. Learning to doctor: Tinkering with visibility in residency training. Sociology of Health & Illness 35(4): 544–559.CrossRef
Zurück zum Zitat Willems, D., and J. Pols. 2010. Goodness! The empirical turn in health care ethics. Medische Antropologie, 22(1):161–170. Willems, D., and J. Pols. 2010. Goodness! The empirical turn in health care ethics. Medische Antropologie, 22(1):161–170.
Zurück zum Zitat Willems, D. 2010. Varieties of goodness in high-tech home care. In Care in practice. On tinkering in clinics, homes and farms, ed. A. Mol, I. Moser, and J. Pols, 257–276. Bielefeld: Transcript Verlag. Willems, D. 2010. Varieties of goodness in high-tech home care. In Care in practice. On tinkering in clinics, homes and farms, ed. A. Mol, I. Moser, and J. Pols, 257–276. Bielefeld: Transcript Verlag.
Zurück zum Zitat Winance, M. 2010. Care and disability. Practices of experimenting, tinkering with, and arranging people and technical aids. In Care in practice. On tinkering in clinics, homes and farms, ed. A. Mol, I. Moser, and J. Pols, 93–118. Bielefeld: Transcript Verlag. Winance, M. 2010. Care and disability. Practices of experimenting, tinkering with, and arranging people and technical aids. In Care in practice. On tinkering in clinics, homes and farms, ed. A. Mol, I. Moser, and J. Pols, 93–118. Bielefeld: Transcript Verlag.
Zurück zum Zitat Wittgenstein, L. 1953. Philosophical investigations/Philosophische Untersuchungen. Oxford: Blackwell. Wittgenstein, L. 1953. Philosophical investigations/Philosophische Untersuchungen. Oxford: Blackwell.
Metadaten
Titel
Towards an empirical ethics in care: relations with technologies in health care
verfasst von
Jeannette Pols
Publikationsdatum
01.02.2015
Verlag
Springer Netherlands
Erschienen in
Medicine, Health Care and Philosophy / Ausgabe 1/2015
Print ISSN: 1386-7423
Elektronische ISSN: 1572-8633
DOI
https://doi.org/10.1007/s11019-014-9582-9

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