1.3. Discuss ethical dilemmas that may arise when balancing individual rights and duty of care

This guide will help you answer 1.3. Discuss ethical dilemmas that may arise when balancing individual rights and duty of care.

Within health and social care, workers face ethical dilemmas when balancing an individual’s rights against their duty of care. These situations arise when the rights of a person conflict with the obligation to care for and protect them. It can be difficult to achieve a balance, as respecting autonomy might sometimes seem to go against protecting safety and well-being. Understanding and addressing these dilemmas is important for anyone working in this sector.

What Are Individual Rights?

Individual rights are the choices and freedoms a person is entitled to. In the UK, these rights are protected under the Human Rights Act 1998. Key examples include the right to:

• Be treated equally and with respect.
• Make their own decisions (autonomy).
• Privacy and confidentiality.
• Live without fear of harm or abuse.

In health and social care, respecting these rights is fundamental. However, allowing individuals complete freedom might sometimes lead to risks, such as harm to themselves or others.

What Is Duty of Care?

Duty of care is a legal obligation to act in a way that protects others from harm. In health and social care, this means workers need to provide a standard of care that prioritises safety and well-being. Acting in someone’s best interests involves:

• Preventing harm, neglect, or abuse.
• Ensuring their needs are met.
• Protecting their health, safety, and well-being.

Duty of care ensures health and social care professionals take action if they believe individuals are at risk. However, acting on this duty doesn’t always align with respecting someone’s wishes or decisions. This conflict often creates ethical dilemmas.

Examples of Ethical Dilemmas

A dilemma happens when there are two or more equally important but conflicting responsibilities. Health and social care workers regularly face these situations. Common examples include:

Respecting Autonomy vs Preventing Harm

Some individuals may make decisions that could harm them. For example:

• A person with diabetes refusing to take their insulin.
• An older adult refusing support despite being unable to manage independently.

In these situations, workers face a dilemma. They want to allow individuals the freedom to make their own choices (autonomy). At the same time, they must prevent harm as part of their duty of care.

Maintaining Confidentiality vs Protecting Others

Confidentiality is an important right. However, workers sometimes need to share private information if someone is at risk. For instance:

• If someone discloses they are planning to harm themselves or another person.
• If there is suspected abuse or neglect.

Here, the dilemma arises between respecting privacy and breaking confidentiality to protect the individual or others.

Supporting Risk-Taking vs Protecting Safety

Health and social care often encourage individuals to take risks to improve independence and quality of life. Examples include:

• Supporting someone with learning disabilities to travel alone.
• Allowing an older adult to live independently despite the risk of falls.

While enabling these risks can empower people, workers may worry about the potential consequences. Protecting safety may mean denying opportunities that individuals have a right to pursue.

Resolving Ethical Dilemmas

Once workers identify dilemmas, they must try to find solutions. This involves ensuring decisions are fair, justified, and informed. Below are some common steps to help resolve dilemmas:

1. Following the Law

The law provides guidance on most ethical dilemmas. For example:

• The Human Rights Act supports individual rights to freedom and privacy.
• The Data Protection Act ensures confidentiality, while exemptions allow workers to share information to safeguard individuals.

Complying with legal requirements ensures actions are supported and defensible.

2. Assessing Risk

Risk assessment is a key part of resolving dilemmas. Professionals need to consider:

• The likelihood of harm occurring.
• The potential severity of harm.
• Whether the individual understands the risks.

This information can help balance individual rights with the duty of care. For example, a worker might support a person to take manageable risks if the benefits outweigh potential harm.

3. Involving the Individual

Listening to the individual helps workers understand their wishes and feelings. For example, if someone refuses medical treatment, ask why. Are they afraid of side effects, or do they feel they do not need it? Open conversations can help tailor solutions to their preferences.

Workers should also assess whether the person has the mental capacity to make the decision. Under the Mental Capacity Act 2005, individuals have the right to make decisions for themselves, unless proven otherwise. If they lack capacity, workers must decide based on their best interests.

4. Seeking Advice

Sometimes, workers need input from others. This could include:

• Discussing dilemmas with a supervisor or manager.
• Consulting the organisation’s policies and procedures.
• Meeting with other professionals during a multi-disciplinary team meeting.

Advice can offer new perspectives and ensure consistent decision-making.

5. Maintaining Documentation

Whatever decision is made, workers should document:

• The details of the dilemma.
• The options considered.
• The reasoning behind actions taken.

This transparency can protect both workers and the organisation from legal or ethical challenges.

The Role of Training and Support

Training in ethics and safeguarding helps workers handle dilemmas sensitively and confidently. Organisations also have a role in supporting their staff, such as through regular supervision, clear policies, and access to legal advice.

Balancing the two responsibilities of protecting rights and fulfilling duty of care is challenging but necessary. Workers who understand the principles behind their decisions can navigate dilemmas in a way that respects individuals while maintaining safety. This ensures care remains professional, ethical, and person-centred.