A Kaleidoscope of Musical (Dis-)Engagement: Healthcare Musicians’ Situated Ethical Professionalism as Artistic Alliance for Value-Based Care
June 18th, 2026
Krista de Wit, Beste Sevindik, Karolien Dons
How do musicians navigate the ethical challenges of hospital care? Drawing on a Dutch music-in-healthcare program, this review identifies seven interconnected dimensions, including consent, power, emotional boundaries, and practitioner wellbeing. It calls for clearer roles, ethical training, and collaborative support to make participatory music safe and responsive for patients and musicians alike.
Music & Science
DOI: https://doi.org/10.1177/20592043261458665
Posted bySarah Pearl
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Abstract/Description
This article by examines the ethical responsibilities of professional musicians working in hospitals. It focuses on Meaningful Music in Healthcare (MiMiC), a Dutch program offering personalized, participatory musical encounters for adult patients, families, and healthcare staff. These musicians work as artistic practitioners rather than music therapists, creating opportunities for expression and connection without delivering clinical treatment.
The researchers reanalyzed 14 episodes from previously published qualitative research involving two Dutch hospitals. Drawing on observations, interviews, group discussions, and musicians’ reflective journals, they identified seven interconnected ethical dimensions:
Motivation and fulfillment: Balancing musicians’ personal satisfaction with patients’ needs.
Everyday care decisions: Respecting consent, preferences, and the choice to decline participation.
Power and professional relationships: Recognizing inequalities between patients, musicians, healthcare staff, and novice practitioners.
Emotionally intense encounters: Responding to grief, distress, or personal disclosures while maintaining appropriate boundaries.
The “shock of practice”: Preparing newcomers for unpredictable and potentially upsetting hospital situations.
Safety for everyone: Protecting emotional and physical wellbeing, including musicians’ own.
Overlapping research and practice roles: Managing ambiguity when people act simultaneously as musicians, researchers, or mediators.
A central insight is that caring intentions do not automatically ensure ethical practice. For example, music welcomed by one patient may disturb a roommate, and a moving encounter may require emotional support after musicians leave. Musicians also need to examine whether their interpretations of empowerment reflect patients’ actual experiences.
The authors recommend clearer responsibilities, training in ethical decision-making and emotional boundaries, stronger collaboration with clinical staff, and ongoing reflective support. Suggested “ethics cafés” would provide spaces to discuss dilemmas and rehearse responses. The study highlights ethical learning needs rather than measuring music’s clinical effectiveness or suggesting that the program is generally unsafe.
The researchers reanalyzed 14 episodes from previously published qualitative research involving two Dutch hospitals. Drawing on observations, interviews, group discussions, and musicians’ reflective journals, they identified seven interconnected ethical dimensions:
Motivation and fulfillment: Balancing musicians’ personal satisfaction with patients’ needs.
Everyday care decisions: Respecting consent, preferences, and the choice to decline participation.
Power and professional relationships: Recognizing inequalities between patients, musicians, healthcare staff, and novice practitioners.
Emotionally intense encounters: Responding to grief, distress, or personal disclosures while maintaining appropriate boundaries.
The “shock of practice”: Preparing newcomers for unpredictable and potentially upsetting hospital situations.
Safety for everyone: Protecting emotional and physical wellbeing, including musicians’ own.
Overlapping research and practice roles: Managing ambiguity when people act simultaneously as musicians, researchers, or mediators.
A central insight is that caring intentions do not automatically ensure ethical practice. For example, music welcomed by one patient may disturb a roommate, and a moving encounter may require emotional support after musicians leave. Musicians also need to examine whether their interpretations of empowerment reflect patients’ actual experiences.
The authors recommend clearer responsibilities, training in ethical decision-making and emotional boundaries, stronger collaboration with clinical staff, and ongoing reflective support. Suggested “ethics cafés” would provide spaces to discuss dilemmas and rehearse responses. The study highlights ethical learning needs rather than measuring music’s clinical effectiveness or suggesting that the program is generally unsafe.
