Work-Based Practice Including Ethics - Case Study Example

Work-Based Practice Including Ethics Teacher’s [Pick the Ethical decision making is an act that social care professionals have to perform on frequent basis while providing care to a patient. Assessment of decisions on ethical ground ensures that patient’s welfare has been placed in the centre of social care regime. The purpose of this assignment is to identify the most appropriate course of action when the ethical values of autonomy and wellbeing conflict while providing necessary care to vulnerable patients with the help of a selected case study (Channel4, 2012). In the given scenario, around eleven caretakers were found causing physical and mental harm to disabled patients. The effect of physical harm and abusive language was traumatic and resulted in emotional distress for the disabled patients. Although the accused were given sentences in jail for around six months time, however the question arises how ethical values conflicted in this scenario and also how fundamental theoretical principles of ethical decision making are applicable here. There are four fundamental ethical principles that cover the social care practice. These values include autonomy, beneficence, non-maleficence, and justice (Gostin, 1991, p. 191). Within these doctrines come other principles such as respect, non-discrimination, well-being, consent and confidentiality (BASW, 2012). Being autonomous include showing respect for other individuals’ independence and also the decisions made by them (Tauber, 2005). In situations, where a certain individual is not capable of making sound decisions or exhibit autonomy, necessary measures are required to be taken to curtail any chances of harm to the clients. On the other hand, beneficence and non-maleficence are complementary values that are applicable together in certain situations (Tauber, 2005). Beneficence includes measures that ensure wellbeing of others and non-maleficence includes not taking any decisions or steps that can cause harm to others especially clients (Robison and Resser, 2002). There can be instances in which these values may conflict. In the given scenario, it was the responsibility of the care home workers to ensure that respect of the patients who were a vulnerable population already remains well-protected and no measures should be taken that can cause harm to them physically or mentally. In the given scenario, discrimination was practiced often and disregard for such patients was given as the reason by the accused staff. More than treatment itself, the reasons behind such behaviour were based on prejudice which is against the gist of social care regime. In the given case, professional autonomy of the caretakers conflicted with their clients’ well-being (Tauber, 2005). Caretakers of this particular organization were fully capable of making informed decisions and aware of the effects of their actions on the patients. This use of professional autonomy that came with the position as a social care professional breached patients’ wellbeing, by abolishing beneficence and non-maleficence which are two most important social care ethics (Gostin, 1991). These two ethical principles act as underpinning philosophies for ethical decisions making and also as a rationale for taking measures that may benefit the client and also refrain from actions that can compromise their current state. The informed decisions made by caretakers targeted a vulnerable group which lead to lack of self-respect and confidence in the future services of that organization (Beauchamp and Childress, 2001). In the given case, along with the gravity of actions, nature and reasons given i.e. prejudice and discrimination aggravated the severity of this case (Channel4, 2012). There are various underlying ethical theories can help in understanding the given from different dimensions. First ethical school of thought represents virtue ethics (Slowther et al., 2004). Virtue ethics highlight the importance of characters and personal traits. It not only emphasizes on the importance of rationale and appropriate decision making but also cover routine behaviour. Traits like being generous, courageous, kind, thoughtful, benevolent, honest etc can be taken as an example of a virtuous behaviour. This concept believes in having habitual tendency of doing good deeds and showing righteous behaviour without connecting it to prevailing laws and morals. This is so because one can be ill-willed and mean in nature without breaking regulations or causing any damage to others’ wellbeing. Hence, a virtuous character helps in having a permanent foundation for an ideal behaviour (Devettere, 2002). Virtues are generally accepted criteria of personal goodness. This concept helps in providing distinction between pleasure and happiness and relate later to a virtuous character. Furthermore, it is important to note that character is not a fluctuating phenomenon. It learns and develops over time, defines one’s identity and parameters within which one can act. Building a virtuous character not only shapes ones behaviour but also has an effect on their wants and needs. Hence, a virtuous character helps in having a permanent foundation for an ideal behaviour. However, this philosophy presents a rigid approach and shuns any idea of good deeds by evil people. If the given case study is evaluated with the help of virtue ethics, it can be said that the accused caretakers were not following the regime of virtuous behaviour. Respecting other’s wellbeing and independence, not practicing prejudice and displaying behaviour that can cause physical or mental harm to a certain individual depicts the regime of a virtuous behaviour. However, this philosophy does not identify if the accused had a character that can be considered as virtuous one or is it only the series of actions that can be called vice behaviour. As far as ethical decision making is concerned, this philosophy not only covers the outcomes of the actions but also the course of action taken. In the given scenario, intent as well as actions lead to conflict of professional independence and autonomy with the wellbeing of patient and resulted in a situation that cannot be named as being ethical. Unlike ethical virtues, deontology emphasizes on doing ones’ duty. Hence, it is totally duty-based approach that leads to fulfilments of tasks and assigned roles. The basis of this approach is given by human reasoning instead of idealistic behaviour (Waller, 2005). According to Kant, there is an absoluteness and uniformity in a person’s conducts when the intention behind any action is to fulfil the duty. Hence, focus on duty gives it an outlook of an obligation that does not consider a possibility of honouring person’s will or need. The only criterion for considering an action or a decision an ethical one is to determine existence of goodwill behind it (Secker, 1999). Therefore, ignoring the outcomes of the decision, if the reason behind it was based on goodwill, then an action can be considered as moral one. Analysis of the selected case study in the light of Kantianisian approach helps in understanding that despite the fact that actions of the accused caretakers caused physical and mental harm to the vulnerable patients, the intention behind their behaviour was ill-willed based on prejudice and contained a willingness to cause harm. Therefore, the element of goodwill was missing according to Kantianisian approach and the resulted actions can be named as immoral ones. Unlike deontological approach that is only duty-driven, based on intentions and morals, and does not give consideration to outcomes, consequentialism emphasises completely on the results. Utilitarianism is an extension of consequentialism as it focuses on spreading as much good as possible. This doctrine also acts as an underlying philosophy for non-maleficance and beneficence which defines parameters for avoiding any harm caused to others and providing them with as much satisfaction and pleasure as possible (Shoemaker, 1991). Hence, it is the outcome that determines moral standing of any act under this philosophical approach. Utilitarianism also points out principle of utility which can provide direction to social workers during ethical decision making. According to this principle, while making a choice, one should consider possible consequences on those who are involved in the situation (Anon., 2012). Therefore, it provides a holistic approach that would consider the best interests of all those who are involved. Correlating this theory to the given case study helped in evaluating the actions of accused caretakers on consequential basis. Where the course of action is out of scope, results indicated vulnerable clients going through distress and pain which not only causes them physical harm but also affects their self-esteem. Although these caretakers had professional autonomy to extend physical contact with the patients however results indicated that this physical and mental harm violated the basic ethics of clients’ wellbeing. Hence, there is clear conflict between two ethical virtues in this regard. Although these three ethical approaches present different notions and are rather conflicting in nature however a combined view of these approaches can help in understanding key ethical concepts and their effects on the practice of social care. A holistic view will indicate that reasons and course of actions followed by the social workers should place patient’s wellbeing in the centre of social care. Therefore, interventions and treatment selected should have clients’ complete consent, must be concerned with their wellbeing, should not be discriminatory and designed to keep patients’ details as much confidential as possible. In order to do so, social workers should use their professional autonomy to ensure that patients are well-respected and well-cared. These three approaches define that social care professionals should refrain from any activity that can cause physical or mental harm to the patients by their actions or activities by third parties that are not in patient’s interest. In this case, there were several caretakers who were either personally causing harm to patients or were witnessing it. These theoretical approaches illustrate that if a physical and mental abuse is known to a caretaker, they must take an action to reduce immediate distress and also future risks of recurrence. This is where the code of conduct by professional bodies of social work like Australian association of social work and British Association of Social Work emerges that provides guidelines to social care professionals regarding handling such situations. These theoretical approaches helped me in understanding the implications of social caretaker’s actions on patient’s wellbeing. Since I am associated with a private organization as a care taker specializing in the care of End-Stage dementia, these theories provided further guidelines for my professional practice. There are several researches that have indicated low-motivation level in social care workers while dealing with dementia patients (Sanders, and Swails, 2011). I have also encountered certain situations where patient was not showing responsiveness to treatment introduced. It has been witnessed that some of the social care professionals abuse their patients out of frustration like one of the caretakers in the given case study did. However, these theories and philosophies underpinned by them indicated that no harm to the patient’s well-being should be intended. Furthermore, the course of care should be only intended to benefit patient considering its impact on the patient and other bodies involved. In the light of case study, it can be said that due to negligence of caretakers, the goodwill of the care home was also affected. However, centre of care and attention should remain patient’s wellbeing. Where the course of action itself is acceptable to the client, it should be ensured that the end results should also be positive and must benefit the patient. Since dementia patients are particularly vulnerable due to lack of cognition and related failures of organs and systems, therefore social care workers have an additional responsibility of undergoing self-assessment which would help them examine the repercussions of their actions on the patient’s wellbeing and professional integrity (Sanders and Swails, 2011). There should not be any conflict between patient’s wellbeing and professional autonomy of the caretaker. In social care, caretakers have to perform decision making on frequent basis while treating their clients. These decisions are often assessed on the grounds of ethical decision making driven by principles of social care. Some basic principles like autonomy, wellbeing, maleficence and beneficence act as a criteria for social care regime and ethical decision making. The given case study helped in understanding the implications of caretakers’ actions which lead to a conflict between professional autonomy and patient’s wellbeing. Theoretical analysis of various ethical approaches like virtue ethics, Kantianism and utilitarianism illustrated that before making any decision, caretakers need to examine the reasons behind such decisions, followed by critical analysis of the course of action and its impacts on related parties. Where these three elements can be considered righteous on theoretical criteria, only then a decision by a caretaker can be named as ethical one. References Anonymous., 2012. Ethical Theory, [online] Available at : http://webteach.mccs.uky.edu/profdent/ethical_theory2.htm [Accessed 1 April, 2013]. Beauchamp, T.L. and Childress, J.F., 2001. Principles of Biomedical Ethics. New York: Oxford University Press. Channel4., 2012. 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