A Kaleidoscope of Musical (Dis-)Engagement: Healthcare Musicians’ Situated Ethical Professionalism as Artistic Alliance for Value-Based Care

In the past years, professional musicians of participatory music practices in healthcare contexts have increasingly worked as artistic allies for care. The musicians shaping these practices have developed ways of engaging with patients and their families, collaborating with healthcare professionals, and potentially also guiding novice musicians. Working with people in a vulnerable situation, care professionals and less-experienced “newcomers” in the interprofessional community of practice, healthcare musicians fulfil various new responsibilities beyond conventional music professionalism. Particularly when coming from a tradition of performance, they are confronted with dilemmas of an ethical nature that require a situated response, especially as they operate in improvised situations with vulnerable patients. Yet, little is known about the nature and types of “ethics work” and how musicians go about solving them. This article explores some typical ethical dilemmas encountered by healthcare musicians in their engagements with people on site, drawing from research underpinning an existing music-in-hospitals practice. Building upon the works of Goldbard and Matarasso, the point of departure is that artists working in any social context will undoubtedly encounter ethical dilemmas but often lack preparedness to deal with them. “Thick” descriptions are analyzed through the framework of care ethics in music-making, and the ethics of participatory arts and community music. The findings present seven intertwined ethical dimensions of musicians working in participatory music practices in hospitals, suggesting that, although the applied situational ethics of their work are partially safeguarded by collaborative means with healthcare professionals, musicians need structural support for building practical skills and awareness of the multidimensional ethics of musical care, also for their own wellbeing.