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Merel Visse

Merel Visse

Interview with Merel Visse, PhD, associate professor, University of Humanistic Studies, Utrecht, The Netherlands.

1. Where are you working at this moment?

Currently I work as an associate professor Care Ethics and Policy at the University of Humanistic Studies in The Netherlands. As a scholar and artist, I combine theoretical and practice-based work to inquire about the moral good in care. In addition to regular scientific output such as publications, I also make installations, objects, drawings, paintings, projects and communities.

I have received a grant of my university and for the next three years I will focus on the meaning of creative and artistic practice for understanding the moral good in care. I prefer to work in close collaboration with scientific and civic partners, like health care and policy institutions and local governments, so my work is always the outcome of a relational process. I also teach several courses for graduate students, such as care ethical qualitative inquiry, narrative inquiry and responsive evaluation.
On my website you can find an overview of my work, activities and inspirations.

2. Can you tell us about your research and its relation to care ethics?

Our view of care ethics is dialectical: we understand and foster good care by dialectically exploring care through both theoretical and empirical, practice-based, lenses (Leget, Van Nistelrooij & Visse, 2017)1)Leget, C., Van Nistelrooij, I., & Visse, M. (2017). Beyond demarcation: Care ethics as an interdisciplinary field of inquiry. Nursing ethics, doi: 10.1177/0969733017707008.. Originally, I began my work in care as an evaluator and qualitative researcher, but I’ve always had a strong focus on theory as well. During the last four years, we have developed a care ethical qualitative inquiry approach that is ‘fed’ by theories and practices of phenomenology, relational ethnography and responsive evaluation approaches. These are approaches that support us in understanding people’s singular and collective experiences with care.

But while working with these approaches, we felt a strong need for a different epistemology and method to enhance our understandings. It’s also due to a new ‘critical turn’ in qualitative inquiry that includes attention for the sensory and affective dimensions of care, and more. The process of drawing or working with photo voice and making artistic objects can be seen as a mode of inquiry. Looking at visual data, and producing visual data help us know differently than knowing through verbalized accounts.

So how to study care by the inclusion of attention for affective, sensory, embodied dimensions of life? I believe this is necessary, because as many care ethicists have emphasized, care is not a virtue, but a practice. And therefore we can only theorize and think ‘care’ by approaches that are congruent with a practice-view.

3. How did you get involved in care ethics?

After the publication of my book and PhD thesis, ‘Openings for Humanization in Modern Health Care Practices’2)Visse, M. A. (2012). Openings for humanization in modern health care practices in 2012, I received a phone call from professor Frans Vosman. He read my work and invited me to join the Care Ethics group in Utrecht. It was the start of a path that has deepened my work and view on care ethics profoundly.

Originally, I was trained by professors Tineke Abma and Guy Widdershoven of the VU University of Amsterdam, Medical Humanities, who introduced me to the fields of responsive evaluation, qualitative inquiry, practice-based work and Gadamerian hermeneutics and empirical ethics. I was introduced to evaluation scholars like Bob Stake, Thomas Schwandt and Jennifer Greene with whom I’ve just developed a special Volume on Evaluation for a Caring Society (in press, to be published by IAP publishers this fall).

In my book from 2012, among other topics, I discussed the meaning of the work of Margaret Urban Walker in the light of several empirical (phenomenological) studies on how caregivers and care–receivers experienced good care. The book consists of published papers that - each in its own way and each based on empirical studies - were built upon the collaborative-expressive model of Walker. Professor Andries Baart, my former colleague, introduced me to a care ethical view on qualitative inquiry. That opened up a whole new way of thinking about ‘practising care ethics’.

4. How would you describe care ethics?

My father is in cultural heritage and as a child, I remember him closely looking at buildings. I learned that the material world embodies many traditions and stories. I remember him telling me about different kinds of mortar in between the bricks and how the mortar (which is tiny and detailed) strongly influenced the outlook of the whole. That is what care does, the performative dimension of care: just like mortar, it is in ‘liminal’ space, holding people together (or not) in ‘life sustaining webs’, to use Fisher’s and Tronto’s words. In addition, I saw my father negotiating with owners, engineers, restaurateurs and representatives of local governments. All these people had different stakes when living in and preserving the built environment. In hindsight I know that this is where my training in responsive evaluation (which is all about negotiation and dialogue) and later on, in care ethics began.

It’s a little bit of a long introduction to show you how my view on care ethics has grown. I see care ethics as a way of knowing and inquiring about what is ‘good’ in historical, aesthetical, temporal and spatial ways. Care ethics is an epistemology that is featured by hermeneutical understanding, listening and experiencing the world around us, together with others. It is about the moral dimensions of living in (and on) our own tapestry of people and relationships. Care ethics  - as described in Leget, Van Nistelrooij & Visse (2017) – asks about the normative in a dialectical way: honoring both theory and practice.

A practice view on care acknowledges that people and their lives are part of an intrinsic and complex tapestry that critically counter-thinks notions like agency, (self) management and  control. Care ethics acknowledges the ambiguity and complexity of everyday situations in care: that is what matters to me profoundly. People ‘undergo’ and ‘accept’ being in certain kinds of positions (e.g. of a caregiver and –receiver). Care ethics is, as my colleague Alistair Niemeijer so aptly phrased it, ‘inherently dialectic’. The dialectic nature of care ethics has been developed by our chair Carlo Leget in his publication on the re-examination on the empirical and the normative (Leget, Borry, De Vries, 2009)3)Leget, C., Borry, P., de Vries, R. (2009). 'Nobody tosses a dwarf!' The relation between the empirical and the normative reexamined. Bioethics. 2009 May;23(4):226-35. doi: 10.1111/j.1467-8519.2009.01711.x.. By keeping theory and practice ‘in tension’, care ethics can be further developed and understood.

5. Whom would you consider to be your most important teacher(s) and collaborators?

Currently, my most important teachers are outside the field of care ethics, if I may speak of an “in- and outside”. For example, I especially admire the work of the philosopher Hans Georg Gadamer and more recently, the French philosopher Jean-Luc Marion. I prefer to work ‘slow’: I learn through careful, slow reading and reflection.

Currently, my most important collaborators and teachers are my colleagues and (former) students of the Care Ethics group. We carry out research in collaboration with several Dutch cities and health care institutions and this work ‘in the mud’ humbles me and shows me new perspectives and challenges. Every project is run by a core team of researchers who I feel privileged to collaborate with.

Co-authoring papers with colleagues is very rewarding. I have written papers with colleagues, such as Alistair Niemeijer, Inge van Nistelrooij and Carlo Leget. With Tineke Abma, I have just developed a special Volume on Evaluation for a Caring Society. Several care ethicists contributed to that Volume, like Helen Kohlen, Karin Dahlberg, Maurice Hamington and Jeannette Pols, as well as several responsive evaluators like Melissa Freeman, Anders Hanberger, Gustaaf Bos, Hannah Leyerzapf and others.

I have always found myself on the intersection of several disciplines and I believe this is vital for the quality of my work. Now, while developing this Consortium, I discovered that there are so many people from a wide range of fields who contribute to care ethics and theory. I look forward to meeting them very much.

6. What publications do you consider the most important with regard to care ethics?

  • Eva Feder Kittay’s Love Labor
  • Joan Tronto’s Caring Democracy


  • Margaret Urban Walker’s Moral Understandings
  • Richard Bernstein’s Beyond Objectivism and relativism. Science, Hermeneutics and Praxis.

And with regards to our dialectical view between they and empirical work:

  • Johnson & Parry’s Qualitative Research for Social Justice.

7. Which of your own books/articles/projects should we learn from?

This depends on your own background and interests. Soon, the special volume on Evaluation for a Caring Society will be published (fall 2017, IAP publishers). In the past, I have published about different topics, mostly related to how to ‘operationalise’ care ethics as a political ethic. On my website, you can find an overview for my publications and projects. Please email me when you would like to receive one of my papers, I’d be happy to share them.

8. What are important issues for care ethics in the future?

I see many opportunities to increase the socio-political impact of care ethics. To do so, we need to build bridges between care ethicists who are conceptually oriented and care ethicists who mainly do empirical work, both empirical research and policy design and programs. By collaboration, we can create synergy. The new Care Ethics Research Consortium will be a platform for that.
I also believe in creativity. That is the topic I’m currently focusing on: creativity in the moral domain.

9. Do you know of any research-based projects in local communities, institutions or on national levels, where 'care' is central? Please describe

Yes: there are so many! Our research group carries out a rich variety of practice-based care ethical projects in close collaboration with several Dutch cities, residential elderly care institutions, hospitals, for-profit organisations (like a pharmacy) and communities. Most of these projects result in peer-reviewed publications as well. One example is a large Dutch elderly care organization that aims to work according to relation centered care. We facilitated an action-research project, based on a care ethical stance, to guide participants towards new understandings on relation centered care.

10. The aim of the consortium is to further develop care ethics internationally by creating connections between people who are involved in this interdisciplinary field, both in scientific and societal realms. Do you have any recommendations for us?

I would especially like to build bridges between conceptually and empirically oriented care ethicists, to develop international research grant proposals together. I believe that by increasing our practice based work, we will put care ethics more centrally on the societal agenda.

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