CASE STUDY : WHO DECIDES? THE RIGHT OF SELF-DETERMINATION
In your Becoming an Ethical Helping Professional text, the authors discuss the essential responsibility of a professional to ensure that a client has exercised informed consent, allowing for agreement as well as refusal. Self-determination is a principle that underlies the practice of obtaining informed consent permissions from clients. In instances where mental health clients may or may not have an advanced directive and decide to leave a facility because they feel, “I am perfectly alright,” consider who should decide. The question is, can a client be said to have an absolute right to self-determination, or are there circumstances when that principle may not be applicable? What is the supervisor’s response to an employee’s rejection of a client’s invocation of the right of self-determination, when the exercise of that right can harm the client or harm others?
Drawing on your readings, consider this dilemma and offer your decision with an explanation to the employee faced with this circumstance.
RESOLVING ETHICAL DILEMMAS
Human interactions in personal, professional, and community settings can be demanding when questions of ethical expression are required. What do we mean by ethical expression? We mean conscious and unconscious verbal, physical, and emotional responses to social, cultural, intellectual, and physical behaviors that are vocalized, demonstrated physically, and even evidenced by an emotional response.
When there are several ethical or moral choices that are to be made involving persons from rural or urban settings or from different cultural groups, the human services professional is often required to make a decision about how to express an ethical response. Whether the requirement is of a supervisor guiding a subordinate or a service provider engaged in a relationship with a client, a decision must be made.
The decision that a professional weighs requires understanding one’s personal ethics and boundaries, community ethics, cultural ethics, and other diverse conditions that may be defined by the workplace (whether a government agency, for-profit, or nonprofit organization) or by government-established laws and regulations.
The human services professional may need to rely on colleagues with whom to consult, a supervisor or organizational authority, and sometimes the legal and regulatory rules established by the town, city, county, state, and central government.
Based on your readings, discuss the approach you would take to decide whom you would seek to consult to resolve the question of the appropriate ethical expression when considering how you most appropriately direct or inform a subordinate service provider. Suppose the service provider wishes to act more independently with her clients and to set aside the organizational code of ethics, and even city and state laws, since, as she will say, “I know my clients, and they require different needs that are not considered by the organization or the government.” Justify your approach as a supervisor.