PhD defence M. (Marjolijn) Heerings

Dissertation in short:

Values such as self-determination, self-sufficiency and participation are prominent in policy documents, professional competency profiles and websites of care organizations. People with intellectual disabilities, serious mental illness or older persons who receive home care services: all have to make their own choices, live more independent and participate in the community. When support is needed, relatives are expected to step in. These values can be quite complex to put into practice: tensions between values emerge such as with the value of preventing harm. Moreover, in many care situations it is not so straightforward what self-determination entails and professionals, clients and next-of-kin can prioritize these values differently. Clients sometimes experience burdens from the way support is practiced and organized. These ethical tensions and burdens for clients are not sufficiently attended to in policy documents and professionals lack support in providing good care amidst these normative complexities.

The PHD project conducted by Marjolijn Heerings, provides insights into these normative complexities and how they are silences in policy. The insights from this ethnographic research are shared in an original way. Together with Theatre group Babel Rotterdam, Marjolijn developed filmed monologues which make clients, professionals and family members' experiences with normative complexity palpable. She also developed the Ask Us! method, which engages clients, family members and professionals in reflection and co-design on the ethical tensions and burdens part of daily care practices in long term care.