Discuss about the demonstrate the application of theoretical knowledge in relation to the issue/ dilemma?
Social workers actually take on several varied responsibilities that must ultimately serve all of their clients’ till the best interests. Such workers also try to properly abide by code of the ethics and provide their clients with all required and expected services with proper care and concern. Specially a person who is a worker within the house for autistic people needs to be very careful about each step he/ she takes within the organization. Like in any other human services occupation, social workers also might face several ethical dilemmas within their practice of work. Such an ethical dilemma also involves a vast conflict amid two or even more ethical laws and principles (Anderson and Cushing, 2013). Here in this study one such ethical dilemma is being discussed and way to find out a solution for the same also is being attempted.
I am actually a support worker within a home intended for people suffering autism. This home consist ten residents and amongst them John is also one. John’s sister one day visits john and complaints bout a serious issue that she has observed within the autism home. On a particular visit, when I was on the duty standing with and supporting John, his sister instantly came to me and reported that, she today has seen a nurse in charge beating some other service user named Sam in his face. She told that she saw the entire scene through window while she was just outside smoking. I also saw her very concerned and worried. She also told me that I should not inform this to anybody as she did not want to bring in any kind of trouble in the nurse’s life and felt that the nurse might lose her job after this. But she was also very much worried about incident as it made her feel that even her brother john also might be subject to same treatment.
Dilemmas that I faced are explained below:
This is amongst the guiding principles of the social work and refers to respect for every client’s right and enabling of their self-determination. Such principle always means that all clients are ultimately responsible of making their own decisions as well as finding solutions for the problems they face, regardless of the fact that whether the social worker actually agrees with the course of the action or not (Barnbaum, 2008). Here I thought that I needed to find the reason behind hitting of Sam by the nurse but on the other hand I also thought that whatever be the reason the nurse was not at all allowed to beat any patient in the home and carrying such an action might make patients more fearful and might also contribute towards declining health. On other hand I also understand the level of frustration and irritation nurses in the home need to tackle with while dealing with the patients that might make them agitated at times and enforce them to take such action (Beals, 2003).
Another ethical dilemma that I encountered being a social workers was right towards confidentiality versus right towards self-determination, particularly in this case where I was asked to maintain the confidentiality of the fact that I was informed about whereas I thought that hiding such fact from higher authorities might result in encouragement of the nurse performing such unethical actions and this might enhance her activity in future resulting in conflicts and issues within the home. Being a support worker I was to respect the staff’s as well as the patient’s and also their relative’s client’s privacy plus confidentiality (Dawson and Verweij, 2007). And here as John’s sister did not want me to disclose the issue I was to hide the fact from higher authority because the nurse might lose her job after this. But also providing such privilege to the nurse also might worsen the situation in future.
Every social worker has their personal and internal value scheme plus set of the morals. In spite their most excellent efforts towards keeping their feelings within check and towards respecting the differences, the social workers specially those in autistic homes are generally confronted with situations in which all of their values as well as morals conflict along with those of patients or even other staffs (Edwards, 2008). For instance, if a patient reacts impatiently and makes the situation worse, the nurse or the support workers need to handle them by giving medicines or treating them hardly and scolding them and even at times punishing them (be the punishment in any form). I need to think and analyze what situation made the nurse beat the client and was it really correct to hit Sam.
Not every ethical dilemma within the support work in an autism home involves a direct contact with the client. But some works also demand direct contact as well as good connection with the patient. Autistic patients are always to be handled with utmost care and concern and are to be treated like a child (GILLON, 2005). The nurse might have faced a worse situation but why to hit Sam even if he has irritated her badly, hitting might have different affect on Sam’s mind and on other hand if the issue will not be informed to higher authorities the nurse might continue such action.
If I complain about the incident to higher authorities they might take action against the nurse and also might dismiss her on behalf of hitting Same, but this will inculcate a bad relation amid me and my co-workers and they might take me as complaint box. Also if I won’t further complain and no actions are taken against her the bad and unethical behavior of nurse might increase and this might also affect the reputation of the organization (Griffiths, 2012).
Utilitarianism and Consequential theory- As per this theory of utilitarianism, actions that I will decide to undertake will be evaluated by its consequences. Thus, thus theory also is called the Consequentialism. Consequentiality ethics is a theory that holds views regarding accurate moral answer which is also related to the outcome, as well as consequence, of the action. Major aim is the premise of exploiting the greatest products intended for greatest count. ‘Good [plus services’ referred to can be also uttered in several ways as well as also this might even refer to values plus ‘utility’ such as happiness, and being in any pain (Hofmann, 2002).
Deontology theory- Deontology in reality is on the basis of the duties plus rights as well as also respects all the people. It even places extra value on the intentions of entity other than the results or the outcomes of many actions and even focuses upon rules, obligations as well as duties (Lomas, 2013). Deontology requires absolute devotion towards every of these obligations plus acting from duty is also seen as really acting ethically.
Justice theory- This theory will help me to reconcile the liberty as well as equality and will supply a very fair alternatives and situations for me as I am facing such a circumstance where I need to be fair with both the nurse as well as the patient and also with the patient’s sister.
The codes and ethical principles that I must follow in this situation are as follows:
Yes I must follow my own policies and procedures and must report the situation. As per my view every person on the earth is worthy of the inclusion as well as respect, be whatever his otherwise her support needs and demands. Keeping in view the Autistic society as the one demanding utmost care and love, the inculcation of proper ethics and morale in handling autistic patient must be ensured in the organization (Russell, 2010). Also John is a patient here same as Sam and if Sam has been hurt by the nurse the same could one day happens with John and many others as well. The nurse should be informed about the complaint that has been registered against her and of course the name of John’s sister must not be revealed in this case. Also John’s sister must not be informed about the report to higher authority as she requested me not to do so. Sometime lies are good if they are for good cause. And here the simple lie could save many people from getting into unnecessary conflict and problems.
By looking at this scenario, as per deontology, a person can do things that are right as it owes the person a duty towards care but then being non malfeasance also says not to harm anyone. By analyzing the case and the scenario it can easily be said that harm is yet being continued and if the nurses ubnethical behavior will not be informed to senior authorities it might raise further issues and the nurse might never stop doing so. This may also lead to another problem taking place sometime later and the nurse misbehaving with yet another patient. The code of conduct in the scenario is seen to be poor if the authorities are not informed about the ills taking place within the health care home. Here the client plus many all other users might suffer in hands of nurse which will be totally negative consequences that might take place within the organization and also may affect the name and fame of the place.
Another fact can be that the authorities can be informed and they can be requested to train and counsel the nurse rather than removing her from the post or rusticating her. Here utilitarianism will be applied as the nurse will not lose her job and my desire for informing the authority and keeping my ethics on high will also be fulfilled. The nurse can be given a warning for the action that she took and can be told that any further action of same kind would pull her in some serious problem. The discussion between the authority and the nurse will have to be very calm and cool and no threatening or harsh voice should be used because this might hamper her mental status and also might make her feel that she is not being valued within the organization and might also inculcate a feeling of loosing job (Nedic, 2006). No harm to nurse and neither to patients will lead towards utilitarianism.
Moreover if I actually decide to anyhow not report to the authorities, the rules and laws will be upheld it will be poor practice that I will adopt. Forgiving mistakes without punishments might lead to further undertaking of the mistake and also might tend the nurse to perform same task repetitively. Concern and worry of John’s sister is not at all wrong and of course this is a serious issue and needs to be handled as soon as possible. I respect the thinking and ethics and morals of the nurse and also know that she might loose her job after my report to authority yet I cannot take any risk with the patient’s health and their self respect as well. All the patients in the home are same and must be treated equally whether their attendants are available with them or not. I should consider the fact that the home is made to cure the patients with love and care and make them feel relaxed and also keep them away from the harsh and unbearable world that treats them differently (Wilkins, 2012).
NHS 6c’s courage- Nurse must be informed about the 6 Cs of care that are care, compassion, competence, communication, courage and commitment. Here it is well understood that the 6 Cs are not being fulfilled and the nurse is totally unaware of them. I am to take out a common way through which I will have to respect the confidentiality that has been requested by John’s sister for maintaining the privacy of the incident and complaint made by her and also I will have to take some or other action to stop the nurse undertaking such practice which is harming the patients in the home and making them feel uncomfortable.
Conclusion:
The study included all facts regarding ethics in the healthcare as well as the national plus international frameworks intended for the ethical health care that also enhances decision making procedure in practice. The study also discussed the Code of all the Ethics pertinent towards many health disciplines, as well as has even identified such codes plus the ways for influencing decision making as well as patient’s care. There are several ethical dilemmas that are being faced in the situation and all has been dealt with finely. Also the dilemmas need to be dealt with very carefully and with utmost concern. People all over the organization must be taught to handle patients with love and care and thereby a culture of good ethics and morale must be developed within for making sure that people do never complain in future about any such unethical actions undertaken by any staffs of the home.
References
Anderson, J. and Cushing, S. (2013). The philosophy of autism. Lanham, Md.: Rowman & Littlefield Publishers.
Barnbaum, D. (2008). The ethics of autism. Bloomington: Indiana University Press.
Beals, K. (2003). The ethics of autism: What’s wrong with the dominant paradigms and how to fix them. Mental Retardation and Developmental Disabilities Research Reviews, 9(1), pp.32-39.
Dawson, A. and Verweij, M. (2007). Ethics, prevention, and public health. Oxford: Clarendon Press.
Edwards, D. (2008). Providing practical support for people with autism spectrum disorder. London: Jessica Kingsley Publishers.
GILLON, R. (2005). Toleration and Healthcare Ethics. Cambridge Q. Healthcare Ethics, 14(01).
Griffiths, J. (2012). Promoting Sexual Health with Young People Leaving Care: A Nurse Practice Model. Adoption & Fostering, 36(1), pp.70-73.
Hofmann, B. (2002). Respect for patients’ dignity in primary health care: a critical appraisal. Scandinavian Journal of Primary Health Care, 20(2), pp.88-91.
Lomas, C. (2013). Health care with dignity, courtesy and respect. Nursing Standard, 27(23), pp.16-18.
Nedic, O. (2006). Restoring dignity and respect to health care workers. Med. pregl., 59(11-12), pp.515-521.
Pellicano, L. (2014). Chapter 4. A future made together: new directions in the ethics of autism research. Journal of Research in Special Educational Needs, 14(3), pp.200-204.
Russell, B. (2010). Review of The Ethics of Autism: Among Them, but Not of Them by Deborah R. Barnbaum 1. The American Journal of Bioethics, 10(2), pp.70-71.
Wilkins, D. (2012). Ethical Dilemmas in Social Work Practice with Disabled People: Young Adults with Autism. Ethics and Social Welfare, 6(1), pp.97-105.
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