2.1 Describe dilemmas that may arise between the duty of care and an individual’s rights

This guide will help you answer 2.1 Describe dilemmas that may arise between the duty of care and an individual’s rights.

People working in adult health and social care often face situations where their duty of care does not match an individual’s wishes. These situations are called dilemmas. A dilemma happens when two important things conflict—keeping someone safe, and respecting their right to make their own choices.

Both duty of care and personal rights are protected by law and guidance, so these conflicts happen regularly. Understanding and managing these dilemmas is a key part of professional practice.

What Creates a Dilemma?

A dilemma can occur when you feel pulled in two directions. On one side, you have a duty to protect people from harm and promote their well-being. On the other, individuals have legal rights to make their own decisions—even choices that may not seem safe to you.

Some typical causes of dilemmas in adult health and social care are:

• An adult’s choice conflicts with what you believe is best for their safety or health
• The person’s decision could cause harm to themselves or others
• An individual refuses care or treatment that you see as important
• Rights to privacy and freedom clash with safety measures
• The person wants to do something that goes against policies or risk assessments

Let’s look at common examples and why they are difficult.

Example 1: Refusal of Medication

A person with a mental health condition does not want to take their prescribed medication. Your duty of care says you must promote their well-being and reduce harm, which may mean encouraging them to take their medication. At the same time, people have the right to refuse treatment if they have capacity to decide.

This puts you in a dilemma:

• Respect the person’s right to refuse?
• Or act to protect their health?

If you try to persuade or force them, you may be taking away their freedom. If you do nothing, their health may suffer.

Example 2: Refusing Personal Care

A person refuses help with washing and dressing. They have the right to make choices about their own body and privacy. Ignoring their wishes would not show respect and could damage trust.

But, your duty of care tells you to prevent harm from poor hygiene, skin complaints or infection. You must respect their wishes, but also feel anxious about possible risks.

Example 3: Eating or Drinking Choices

An individual with swallowing difficulties wants to eat or drink food that is high risk. They have been advised to avoid certain foods by healthcare professionals. The person understands the risks, but still chooses to eat what they like.

You must support their freedom of choice, but you also have a responsibility not to put them at harm of choking or illness.

Example 4: Going Out Alone

A person with dementia insists on going for walks by themselves. You recognise their right to independence and freedom of movement. But, you know they could get lost or become distressed, which may put them at risk.

You may feel torn between keeping them safe and not restricting their liberty.

Example 5: Sharing Information

Someone tells you something in confidence, but the information suggests they or someone else may be at risk of harm. Duty of care means sharing this information with the right people. But the person may have asked you to keep it secret, which touches on their right to privacy.

Breaking that confidence might damage trust. But failing to report could put the person or others in danger.

Example 6: Use of Restraint

A person tries to leave the building in unsafe circumstances. To prevent harm, staff may consider using physical restraint. The law says restraint should only be a last resort. Using restraint can violate a person’s right to freedom and dignity.

This dilemma is about:

• Acting to protect from immediate harm
• Respecting the person’s basic rights

Consequences of Dilemmas

When you face these dilemmas, it is common to feel anxious, under pressure, or worried about making the wrong choice. The decisions you make can affect someone’s:

• Health
• Dignity
• Autonomy
• Trust in you or your organisation

They can also affect your own well-being and sense of professional responsibility.

Why Dilemmas Matter

Dilemmas remind us that care is never “one size fits all”. What is safe for one person may not be right for another. The law and best practice expect you to find a balance, not to ignore a person’s wishes just to keep them completely safe.

You must consider:

• Does the person understand the risks and consequences?
• Do they have mental capacity to make the decision?
• Is there a safer way to support their choice?
• What do laws and organisational policies advise?

Respecting rights does not mean ignoring your duty—but duty of care does not mean taking away all rights.

Dealing with Dilemmas: Good Practice

When facing a dilemma between duty of care and an individual’s rights:

• Remain calm, thoughtful and non-judgemental
• Always talk openly and honestly with the individual
• Check if the person has mental capacity to understand and decide
• Discuss the risks and choices available
• Involve advocates, family or other professionals if appropriate
• Record your actions and reasons carefully
• Follow organisational policies at all times
• Seek advice from managers or safeguarding leads if uncertain

Often, the best approach is negotiation and joint problem-solving. Compromise can help support choice, while reducing unnecessary risks.

Final Thoughts

Dilemmas between duty of care and an individual’s rights are common in adult health and social care. They happen when actions needed to keep someone safe conflict with a person’s own choices or freedoms. Recognising these dilemmas—and managing them professionally—is an important part of providing respectful, high-quality, and lawful care. By balancing safety and rights, you help people live fulfilling, dignified lives while protecting their well-being.