Friday, December 12, 2014

Academic Milestones: Ethical Decision Making Assignment

Academic Milestones
2.)    Ethical Decision Making Assignment (CORE 581, Fall 2015)
Group Member #1, Group Member #2, Marli Sather
Ethical Decision Making Assignment- #4 Allan
Step 1: Identification of the individuals and groups potentially affected by the decision.
·         Allan
·         Allan’s mother
·         Sara
·         Social worker
·         Support worker
·         The day program agencies
·         The volunteer organizations
Step 2: Identification of ethically troubling issues.

1)      Principle 1.5 non-discrimination: “Act to prevent or correct practices that are unjustly discriminatory, and avoid or refuse to participate in practices that are disrespectful of the legal, civil, or moral rights of others. Not practice, condone, facilitate, or collaborate with any form of unjust discrimination.”
Making and supporting the decision for Allan to change day programs without his consent violates his rights. Assuming that he cannot accomplish much in a community-based support program discriminates against Allan and his disability.

2)      Principle 1.6 Vulnerabilities: “Take extra measures to protect the rights of persons with diminished autonomy or ability to protect their own rights because of their physical, mental or economic status lack of language, age, gender or other condition that contributes to vulnerability for discrimination, neglect or abuse. This may include identifying and working for full participation in society of persons with a disability and/or disadvantage.”
Allan is vulnerable to discrimination due to his developmental disability and he experiences diminished autonomy. Both the support and social workers need to recognize this and should take extra care to help Allan protect his rights instead of participating in undermining his autonomy in making life decisions.

3)      Principle l.7 Community: “Respect families of clients, social and workplace or school networks and enlist their support in achieving rehabilitation goals when the client agrees to such collaboration.”
 The support worker must remember to respect Allan's mother, even it they disagree with her choices and opinion. The support worker should seek to gain the support of Allan's mother, instead of disregarding her decisions and concerns.

4)      Principle I.10: Informed Consent: “Offer clients’ options to make informed choices regarding rehabilitation plans and daily living procedures and fully explain confidentiality issues prior to obtaining formal consent. Informed consent should involve choices rather than consent to a single proposal.”
As the client, Allan should be the one to make informed choices regarding his daily living. The options should be offered to him by the support and social workers involving him in the decision making process rather than coercing him to consent to a single proposal.

5)      Principle II.I General Caring: “Protect and promote the welfare of persons with a disability and/or disadvantage, families, students, research participants, colleagues, and others; avoid doing harm; and make reasonable efforts to correct harm that has been done.”
As professionals the support and social workers have the responsibility to protect and promote the welfare of Allan, and avoid doing harm by taking care not to take control of power that rightfully belongs to Allan.

6)      Principle II.13 client and community rehabilitation: “Work jointly with clients to enhance their abilities and power in undertaking self-advocacy activities. Work jointly with clients to devise integrated; individualized rehabilitation plans consistent with their abilities and circumstances."
Professionals under this principle are committed to the empowerment of Allan to promote equal opportunities for choices and quality of life. The support worker can encourage Allan to exercise control over his life decisions, and support him to make an informed decision by offering and explaining all alternatives.

7)      Principle II.14 Client and community collaboration: “Work co-operatively with clients, team members, other professional disciplines, and community services as appropriate in serving the interests of clients. Participate in implementing collaborative decisions unless such decisions clearly violate the ethical principles and are likely to result in harm to others. Support your position with reasoned argument and in a respectful manner.”
If the decision by the social worker and Allan’s mother violates ethical principles, then the support worker cannot participate in implementing the decision. In this case advocacy on behalf of Allan could be supported by a reasoned and respectful argument.

8)      Principle III.11 Objectivity/Lack of bias: “Evaluate how their personal experiences, attitudes, values, social context, individual differences, and stress levels may influence their activities and integrate this awareness into all attempts to be objective and unbiased in their professional activities.”
The support worker must evaluate their own values, biases and assumptions in this situation to make a decision that is objective and acts in the best interests of Allan. Professionals need to take action to change this aspect and protect vulnerable citizens.

9)      Principle IV.4 Development of society: “Act to promote choice, opportunity, elimination of discrimination and attitudinal barriers, and promote respect of diversity of persons receiving services.”
The support and social worker need to act to promote choice and opportunity for Allan. Actions should work to eliminate attitudinal barriers against his abilities.

Step 3: Identification of how my personal biases, stresses, or self interest may influence the development of courses of action.
·         As he is a 49 year old man I don’t believe that others have a right to make decisions for Allan. With only a mild developmental disability I think that he is likely capable of making his own decisions about where he lives and where he spends his time.
  • I think it is selfish of Allan's mother to place her concern of knowing her son's whereabouts over what might actually be best for Allan
  • Allan's mother has a right to be concerned about her son, but she should not make important life decisions regarding Allan's future without communicating with him.
·         I believe that moving Allan to another program simply because his mother wants to know his every movement is a bit suffocating on her part. He is a grown man so she does not need to be in every aspect of his life. As long as he is happy and safe, that should be enough.
·         I also believe that if Allan wants some input or suggestions from his mother, which should be allowed and supported.
·         I have a bias against facility-based day programs because I believe that they serve to further isolate individuals with developmental disabilities by operating in segregated settings.
·         I believe in community as a first resort. Community-based support programs can offer the opportunities for individuals such as Allan and Sara to develop relationships and be included as citizens in the community.
·         It would upset me to know that someone who was happy and was engaged in meaningful activities and relationships would now be in a structured and segregated program.
Step 4: Development of alternative courses of action.
Alternative A
             I can accept the decision of Allan’s mother and help Allan prepare to move to a
             facility-based program.
Alternative B
I could advocate on behalf of Allan to stay at the community-based agency and contact the local self-advocacy committee for their support and help.
Alternative C
I could talk to the social worker and my agency to set up a meeting to discuss the issue and the violations of the ethical principles. A detailed schedule of Allan’s weekly activities along with a number to reach Allan or the support worker at all times could be offered as a solution to the mother’s worries.
Alternative D
I could discuss the change with Allan and make sure that he is informed of his options. I would then support him to make his own decision and act as his ally if needed. I would help Allan become educated about his rights, and provide him with the right tools and resources to advocate for himself.

Step 5: Analysis of the risks and benefits of each course of action.
Alternative A
Advantages
- Allan's mother would be happy
-The mother’s worries about Allan's whereabouts would be alleviated
- The support worker would avoid initiating conflict between the parties
Disadvantages
­-Allan is discriminated against because of his disability
-Allan’s rights are violated
-The sudden change has the possibility to affect both Allan psychologically due to being removed from a lifestyle that he enjoys
-This alternative avoids the problem
-Sara loses a valued companion
-the support worker would lose a client; all efforts to improve Allan's life would come to nothing
-All ethical principles are violated (see step 2)
Alternative B
Advantages
-The social worker would be acting to promote choice and eliminate discrimination (principle IV.4)
-Principle II.14 is upheld
-Allan will remain in his community program if the advocacy is successful
Disadvantages
­-Allan is still not involved in the decision making process
-The support worker has taken control of Allan’s power instead of empowering the client to act.
-this alternative does not prepare Allan for future situations where advocacy may be necessary
Alternative C
Advantages
-The support worker has the opportunity to give a well-reasoned and respectful argument advocating for Allan’s rights (principle II.14)
 -This course of action is a reasonable effort to prevent harm and correct any harm that has been done so far by the mother and social worker (principle II.1)
-This meeting offers a solution to the problem Allan’s mother has with the community-based program.
-if Allan's mother changes her mind, Allan would get to remain in his community-based program
Disadvantages
­- Allan is still not involved in the decision making process
-This course of action may have no effect on the decisions that have already been made
-The mother might decide to move Allan to a facility-based program anyways
-Allan’s mother may be upset and feel that her authority has been undermined
-The solution of the schedule and cell phone would affect Allan’s privacy and further undermine his autonomy 
Alternative D
Advantages
-Allan is involved in the decision making process and given the opportunity to make an informed choice (principle I.10)
-This course of action empowers Allan to exercise control over his life and promotes equal opportunities for choice (principle II.13)
- None of Allan's rights would be violated
Disadvantages
­-Allan’s mother would be unhappy and may try to force him to leave the agency
-Allan's mother might become upset with me for encouraging Allan to advocate for himself
-There may be negative consequences for the support worker within the agency

Step 6: Choice of a course of action.
Choice: Combination of Alternatives C and D
     After reviewing my own biases and values along with the ethical principles in step 2 I have an obligation to support and empower Allan to make his own decision. I would set up an informal meeting with the Allan, his mother and my agency to discuss the issue and the violations of the ethical principles. We could all work through the options with Allan and support him to make an informed choice

     This alternative supports the values of non-discrimination, vulnerabilities, informed consent, general caring, objectivity/lack of bias, and client and community rehabilitation. It allows Allan to make an informed decision about his program and daily activities and exercise control over his life

Step 7: How will I ensure the plan is acted upon.
     I will immediately talk with Allan to discuss the current decision and ensure he understands all of the consequences. I will then work through all of the options with Allan and his mother to support him to make an informed choice. I would educate Allan about his rights, and support him if he chooses to become a self-advocate (i.e. support worker could introduce Allan to an appropriate self-advocacy agency, introduce him to other self-advocates, etc.).

     I would also work with Allan to come up with a solution to ease his mother’s worries such as regular phone calls (daily or weekly) and visits. A detailed schedule of Allan’s weekly activities along with a number to reach Allan or the support worker could be offered as a solution to the mother’s worries. Or it could be arranged for Allan's mom to tag along with her son during the week, to observe Allan's interaction with others, and see how important it is for Allan to be immersed in the community with other adults who care about and appreciate him. Together Allan and I could come up with a plan to track his accomplishments to keep his mother updated. If necessary I could support Allan and his mother could attend counseling sessions to work through the power imbalance in their relationship.

Step 8: How will I evaluate the results of the action.
     I will ask Allan how he feels about the process and his progress that he is making with this life decision. I will work to give him additional guidance if needed. We can seek out self-advocates and other individuals who have experienced similar situations and look at how they managed their decisions.

     I will also talk to his mother to see how she feels about the solutions that Allan has come up with so she can still be involved in his daily life. If she continues to object to Allan remaining in the community then I will have to review and alter my decision to decide what to do at that time. If this course of action appears to be failing then I will go to my manager at the agency for guidance.

Step 9: Evaluation of the organizational systems in which the issue arose and how they could be remedied.
·         Use a code of ethics and ethics training to guide employees in their practice.
·         Use specific guidelines in the profession and agencies regarding the involvement of parents in client decision to protect the client’s rights and autonomy.
·         Individuals with disabilities should be educated about their rights and empowered to make their own life decisions.
  • Parents of children with developmental disabilities should be educated about their child's rights, so that parent are aware of their limitations in making life decisions for their children
  • There needs to be clearer lines of communication between all parties involved in a clients life (i.e. Allan's social worker should have discussed the issue with Allan and his support worker, instead of just listening to the wishes of Allan's mother. 
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There are two important reasons why I felt this assignment should be picked for this section. The first reason was it was yet another experience of working as a part of a team. Teams are helpful not only because they allow you have more thoughts and interpretations being discussed, but also the support teams can give you. On this particular assignment, my other two group members were so supportive and helpful to me. I was doing my section of the assignment, but I also had some things going on in my personal life. I explained it to my group members and they were so supportive of me and really understood why I was taking as long as I was with my section. As well, whenever one of us doubted ourselves on one of our answers, the other group members would discuss it with them and give them confirmation on their work. It was a really great dynamic between us all.

This experience with my group members taught me how it is important to let people support you when needed, but to also support them back. That is the whole reason behind a team. You are there to help everyone out, not just have the other members help you. Life is not just a one way street. You have to put effort into helping people achieve success and they have to put effort into helping you towards your success. That way, everyone can be all that they can be.

The second reason is for the whole idea behind this assignment. It is about looking at all the options that are available in order to give a client the best opportunity that they can have. In this case, we were looking at a hypothetical problem, but this actual nine step process is used in the real world daily. An ethical problem must be dealt with thoroughly, objectively and decisively and going through these steps helps to ensure that this happens. Thus, these steps can give an individual the resources, opportunities and supports they need to achieve whatever goal they have for themselves.

I will certainly be using this process in my future career if ever an ethical problem arises. Which, I am positive it will at least once in my career. I like that it covers all the angles, ensuring that the best interests of the client(s) are being taken into consideration, while also giving more than on simple option. Sometimes, there is not just one right way to handle a situation and the more time and effort put into figuring it out, the better. Also, the collaboration between different professionals can help to create a holistic perspective of the situation.
           




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