two artists meet a philosopher


| Autonomy

Bringing together the arts, humanities, philosophy and clinical practice.

We are two artists who work in The Prince & Princess of Wales Hospice. In September 2016 we began meeting regularly with philosopher Ben Colburn, thanks to an introduction from Catriona Forrest, then Public Engagement Officer with the Wellcome Trust-funded research project Global Interventions at the End of Life, University of Glasgow.

Since then Ben has been incredibly generous with his time and we have met fairly regularly over the last 3 years to talk philosophy in relation to the work we do to support patients approaching the end of their lives.

Against the backdrop of the Art Room, our conversations followed a similar pattern. We would discuss different aspects of how we approached practice and Ben would offer relevant bite size chunks of philosophy that related to what we described. Ben shared several key philosophical texts to provide a common reference point and to help us articulate some of the complexity of what we observed for patient's in the Art Room and their personal situations in life. Many of these texts were quite dense in their written style and the depth of the ideas they covered, but Ben was able to clarify the key concepts and together we related these back to the very practical examples we had contributed to our conversations.

Through our conversations we began to apply philosophical ideas in a very practical way. This was hugely supportive to our practice as arts and health practitioners. We could use the philosophical ideas Ben contributed to gain a deeper understanding of what we were doing and how our approach supported the people we worked with through the hospice’s Creative Arts Service.

An understanding of the central ideas of relational autonomy gave us confidence to articulate what approaches to practice supported or undermined autonomy. We were able to apply this thinking while developing the Creative Arts Service’s recruitment process. We were also able to apply some of the underlying principles of autonomy while offering ‘choice’ to patients and when gathering feedback from the people we worked with.

Creatively we were able to ensure that a different approach to producing a high quality, public exhibition of patients’ art work at The Studio Pavilion at House for An Art Lover was in support of the autonomy of the people involved. We were able to monitor the effectiveness of this approach to supporting autonomy by considering how to bring a person on board with us as a colleague. In other words as long as that individual can trace a thread back through the journey of making that they recognise as coming from them, then you can be sure that this process has been in support of their autonomy.

We covered several related philosophical themes over our meetings: autonomy at end of life, threats and ideals to autonomy, voluntary and involuntary choices, conflict, authorship and responsibility and the distinction between limitations and parameters, particularly in relation to disability.

In June 2017 we jointly delivered our first two Tracing Autonomy workshops as practice sharing events during National Creativity & Wellbeing Week. For these workshops our aim was to use creative and practice-based methods to introduce the concept of autonomy and to have an embodied experience of these ideas. This mirrored our creative approach to supporting patients to develop their own art practice in the Art Room.

Our ideas began to galvanise and our conversations gathered momentum. We applied and were successful in being awarded a Knowledge Exchange and Impact Award from the University of Glasgow so we could dedicate time to applying some of these ideas to our practice. We started working on the Tracing Autonomy project in June 2018.

From the outset our aim was to develop a framework for reflecting on practice that used autonomy to underpin practice. As artists working in healthcare settings, we clearly saw the value in having a deeper understanding of autonomy within the wider arts and health sector. As our work developed and was shared with clinicians and colleagues at The Prince & Princess of Wales Hospice and further afield, we learned that this method for reflecting on practice was relevant and transferable to other sectors, such as clinical practice.

The Tracing Autonomy project will formally be completed in Autumn 2019, although we will continue to develop the ideas through our practice as arts and health practitioners and through the wider learning that a deeper understanding of autonomy supports.