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Prof. PhD A.J. Pols

Position
Associate Professor
Main activities
Research
Specialisation
Empirical Ethics; Socrates professor dept of Antropologie UvA
Focus of research

Until 2006, I designed and conducted philosophically informed ethnographic studies investigating care practices in mental health care and care for the elderly at the Trimbos Institute. My approach was to observe participants ‘in action’ rather than focusing on their accounts. Observing activities allowed me to articulate different ‘tacit theories’ of ‘good care’, which correlate particular forms of ‘tacit ethics’ (depicting what is good to do) with particular forms of ‘tacit knowledge’ (detailing what is the matter with patients). My PhD-research, which was funded by an NWO Ethics & Policy grant, is about this work.

For the AMC I developed innovative theoretically-based ethnographic research into telecare technologies targeting individuals with chronic illness. I discovered that, in contrast to mental health care patients who are well-organised, somatic patients were often socially isolated. I also discovered that the main benefit of telecare technologies was the building of mutually supportive relationships among patients exchanging knowledge, rather than facilitating doctor-patient interaction. This had been completely overlooked in policies supporting ‘self-management. The formation of caring patient communities, the development of patient knowledge, and the role of technologies in achieving this, are central in my current and future research.

Lately, I work on the concept of dignity in palliative care, particularly on the aesthetic values involved in shaping these practices.

Key publications
  • Pols A. J. Care at a Distance; On the Closeness of Technology Amsterdam University Press; 2012. ISBN 9789089643971
  • Pols Jeannette Towards an empirical ethics in care: relations with technologies in health care Medicine, health care, and philosophy 2015;18 (1):81-90 [PubMed]
  • Pols Jeannette, Limburg Sarah A Matter of Taste? Quality of Life in Day-to-Day Living with ALS and a Feeding Tube Culture, medicine and psychiatry 2016;40 (3):361-382 [PubMed]
  • Pols Jeannette Knowing Patients: Turning Patient Knowledge into Science Science, technology & human values 2014;39 (1):73-97
  • Pols Jeannette Analyzing Social Spaces: Relational Citizenship for Patients Leaving Mental Health Care Institutions Medical anthropology 2016;35 (2):177-192 [PubMed]
All Publications
Research programmes

Prof. PhD A.J. Pols (Empirical ethics in healthcare)

My research is in empirical ethics, a form of ethics that merges philosophical reflection (what is good care?) with ethnographic research into what patients and carers do. The research articulates values and dilemma’s that are part of care practices or poses ethical questions in practices in which these questions are relevant (for instance: what does self management mean when you observe how this is shaped in care for older people?). Research in empirical ethics studies questions that are relevant in care practice.

Within empirical ethics my research concentrates on three major themes relating to the use of medical technology by patients.

• The ‘good patient’ and the use of technology in care
The studies in this thematic line analyse existing and normative subject positions that are created in the use of technology in care. Policy for introducing telecare, but also notions of the ‘expert patient’ central in UK health policy and notions of self-management depart from an individualistic ideas on hwo people live, care for themselves and others, and on how they use technology. These highly ideological notions do not resemble what people who live with disease actually do, and what they are able to do. They care for one another in networks of relations, and care for others rather then for themselves. Care is, however, mostly organised around the sick individual, and we know very little about how caring communities may be organised. This line of research analyses how people use medical technology at home, the different values that hence emerge, and supports the development of ‘best practices’ with research.

• Practical knowledge of patients and professionals
People with chronic disease actively use and develop knowledge to live with their disease on a daily basis. This practical ‘patient knowledge’ combines knowledge obtained from professionals, from technologies (medical devices, the internet), from their own experiences and those of others. Notwithstanding its indispensability for living with chronic disease, our academic insight in patient knowledge is remarkably scarce, preventing its development as a valuable source for care. This is particularly harrowing in situations where professional knowledge is insufficient or is difficult to link to daily life practices. This research line aims to articulate the knowledge of patients and professionals as practical knowledge. A theoretical understanding of patient knowledge and the clinical knowledge of professionals is hampered by the existing division of labour between biomedicine (knowledge about the body and its diseases) and social science (knowledge on how patients interpret life with illness), as well as by the recent stress on Evidence Based Medicine, where clinical knowledge is swapped for scientific knowledge. This line of research articulates the practical knowledge of patients and professionals in relation to existing ideas of scientific knowledge.

• Aesthetic values in care
Aesthetic values and considerations in health care and daily life have gained little attention. Aesthetic values are, however, abundant in medicine, and may lead to conflicts and misunderstandings. For example: the doctor praises a ‘beautifully healed wound’, whereas patients see themselves as terribly maimed. Fundamental values such as ‘human dignity’ relate to aesthetic values, sometimes in conflict with ethical values. For instance, the value of ‘cleanliness’ in the practice of washing reluctant patients, could be in conflict with the value of ‘privacy’ or ‘autonomy’. Many people –and some ethicists- see technology as ‘cold’, but empirical studies show that technology may support very good relations. This line of research explores how aesthetical considerations may be incorporated in thinking about and evaluating health care and health care technologies.

 

Postdocs
PhD J.M. Brenninkmeijer
PhD S. Jerak-Zuiderent

PhD Students
T. Ahlin
M. De Langen
A. d'Hoop
A. Driessen
C. Muusse
A.K. Skeide

Prof. PhD D.L. Willems (Health Care Ethics)

 

 

Promotietrajecten:
1. Ongelijke burgers. Burgerschap voor mensen met ernstige psychiatrische beperkingen. Onderzoeker: Drs ST Ootes. Onderzoek naar de vraag in hoeverre mensen met ernstige psychische stoornissen die in de gemeenschap verblijven, kunnen worden aangesproken als burgers.
2. Gift of bijdrage? Vragen rond de ethische toetsing van medisch-wetenschappelijk onderzoek. Onderzoeker: Drs J-P de Jong. Onderzoek naar de manier waarop ethische oordelen over onderzoek tot stand komen en worden gerechtvaardigd.
3. De dynamiek van hoop in de palliatieve fase. Onderzoeker: Drs E. Olsman. Onderzoek naar de vraag hoe in de palliatieve wordt omgegaan met soms irreële hoop van patiënten en familie.
4. Het palliatieve-zorgmodel in de neurologie. Onderzoeker: Drs A. Seeber. Onderzoek naar levenseindebeslissingen en palliatieve zorg bij ernstige neurologische ziektebeelden.
5. Ethische aspecten van klinische zorg. Een kwalitatief onderzoek naar idealen van zorg en hun samenhang. Onderzoeker: Drs B. de Bock. Onderzoek naar de idealen van hulpverleners in het ziekenhuis en de manier waarop zij hun verantwoordelijkheid gestalte geven.
6. Besluitvorming op maat? De betrokkenheid van ouders bij beslissingen rond het levenseinde binnen de kindergeneeskunde. Onderzoeker: Drs M. de Vos-Broerse. Onderzoekt de vraag hoe en in hoeverre ouders een stem krijgen bij het staken of niet-instellen van behandelingen in de kindergeneeskunde
7. Ethical issues in the Indonesian Health Care System. Onderzoeker: N. Mahardinata. Welke ethische vragen doen zich voor in de zorg in opkomende economische macht als Indonesië?
8. Ethische vragen rond telezorg thuis. Onderzoeker: Drs Annemarie van Hout. Over (de wenselijkheid van) veranderingen in de zorg en zorgrelaties bij een toename van zorg op afstand.

Postdoc project: EFORT: Ethical Frameworks for Telecare Technologies for Older People at Home. Onderzoeker: Dr AJ Pols. Europees samenwerkingsproject rond ethische vragen en beleidsvorming met betrekking tot telezorg voor ouderen.

Theme: Public Health

Postdocs
PhD M. Hoogsteyns
PhD H.J. Olsman
Prof. PhD A.J. Pols

PhD Students
B.J. de Bock