This guide will help you answer RQF Level 4 Diploma in Adult Care Unit 3.1 Explain why conflicts and dilemmas may arise between the duty of care and an individual’s rights.
In adult care settings, lead practitioners often face challenging situations involving conflicts and dilemmas between their duty of care and the individual rights of the people they support. Understanding why these conflicts arise is important for effective care delivery. This discussion will provide a detailed examination of these conflicts and dilemmas.
What is Duty of Care?
Definition
Duty of care refers to the legal and moral obligation of care providers to ensure the well-being and safety of those they support. It encompasses actions taken to prevent harm and promote the overall health and well-being of individuals.
What are Individual Rights?
Definition
Individual rights are fundamental freedoms and entitlements every person holds. These include:
- Right to autonomy: Making their own decisions.
- Right to privacy: Controlling their personal information.
- Right to be treated with dignity and respect.
- Right to freedom from unlawful detention and treatment.
Identifying Conflicts and Dilemmas
Differing Priorities
One primary reason conflicts arise is due to the differing priorities between the duty of care and individual rights.
Example
Consider a situation where an individual with dementia wants to go for a walk alone. Their right to freedom and autonomy would support this decision. However, their cognitive impairment raises concerns about their safety, invoking the duty of care to protect them from potential harm.
Autonomy vs. Safety
Example
In instances where an individual refuses a medical treatment that is important for their survival, their right to autonomy may conflict with the healthcare provider’s duty to ensure their well-being. Respecting their choice could lead to adverse health outcomes, putting professionals in a difficult position.
Emotional Well-being
Example
An elderly resident may wish to continue smoking as it brings a sense of comfort and happiness. The care provider’s duty to promote a healthy lifestyle conflicts with respecting the resident’s emotional well-being and right to make personal choices.
Legal Influences
Mental Capacity Act
The Mental Capacity Act provides a framework for making decisions on behalf of those who lack capacity. It aims to protect their rights while ensuring their safety. However, determining whether someone has the capacity can be complex and lead to conflicts.
Example
A person’s fluctuating mental capacity can create dilemmas. At times, they may appear capable of making decisions, but their judgment might be impaired. Balancing their right to make decisions with safeguarding concerns becomes intricate.
Human Rights Act
The Human Rights Act enshrines individual rights into law. It mandates that actions taken by care providers respect these rights. However, in certain situations, fulfilling these legal obligations can clash with delivering safe and effective care.
Example
The right to family life might conflict with safeguarding duties if family members are posing a risk to the individual’s safety. Care providers must navigate between upholding this right and preventing harm.
Ethical Considerations
Beneficence vs. Autonomy
Beneficence refers to actions that promote the well-being of others. This ethical principle often clashes with autonomy, leading to dilemmas.
Example
A care provider might believe that moving an individual to a different living situation would significantly improve their well-being. However, the individual’s right to stay in their current home may oppose this.
Dignity vs. Protection
Preserving an individual’s dignity sometimes conflicts with protective measures.
Example
Requiring constant supervision for someone prone to self-harm could impact their dignity and sense of independence. Balancing this supervision with respecting their dignity creates a delicate situation.
Addressing Conflicts and Dilemmas
Person-centred Approach
A person-centred approach focuses on the individual’s needs, preferences, and rights. Involving the individual in decision-making processes helps balance these conflicting aspects.
Example
Encouraging an open dialogue about acceptable compromises can help. In the case of the individual wanting to walk alone, providing supervised walks or a personal alarm system can offer a middle ground.
Multi-disciplinary Team Meetings
Engaging a multi-disciplinary team ensures a holistic view of the individual’s situation. Input from different professionals can help address the complexities of conflicts and dilemmas.
Example
Involving doctors, social workers, and mental health professionals in reviewing a care plan for someone refusing medical treatment provides diverse perspectives. This can lead to better balanced and agreed-upon solutions.
Family and Carer Involvement
Including family members and carers in decision-making processes respects the individual’s social context while safeguarding their well-being.
Example
They can provide insights into the individual’s history, preferences, and assist in finding mutually acceptable solutions. This support can be essential in addressing conflicts, especially when dealing with individuals who have cognitive impairments.
Training and Professional Development
Continuous training on handling ethical dilemmas and understanding legal frameworks equips care providers to navigate these conflicts effectively.
Example
Role-playing scenarios and workshops on ethical decision-making can enhance the skills of the staff, ensuring they are better prepared to handle real-life dilemmas.
Example answers for Unit 3.1 Explain why conflicts and dilemmas may arise between the duty of care and an individual’s rights
Here are example answers to the question, “Explain why conflicts and dilemmas may arise between the duty of care and an individual’s rights,” from the perspective of a lead practitioner.
Example 1: Autonomy vs. Safety
As a lead practitioner, I often encounter conflicts between the duty of care and an individual’s right to autonomy. For example, we have a resident named Mrs. Thompson who has dementia. She values her independence and insists on going for walks alone. While her right to autonomy and freedom should be respected, her cognitive impairment poses significant safety risks, including the potential for getting lost or injured.
In this scenario, my duty of care involves ensuring her safety, which conflicts with her right to make independent choices. To resolve this, we engage in discussions involving Mrs. Thompson, her family, and the care team to find a balanced solution, such as supervised walks or using a tracking device, ensuring both her safety and autonomy to some extent.
Example 2: Refusing Treatment
Another frequent dilemma occurs when individuals refuse essential treatments. Recently, Mr. Patel, who suffers from diabetes, refused his insulin injections, preferring to manage his condition through diet alone. His right to make decisions about his own health is undeniable.
However, my professional duty of care requires ensuring his well-being, and neglecting insulin potentially endangers his health. In such cases, conflicts arise because respecting Mr. Patel’s autonomy could lead to adverse health outcomes. To address this, we hold multi-disciplinary team meetings, involving medical professionals, mental health specialists, and family members to review his care plan and explore ways to encourage treatment adherence while respecting his decision-making rights.
Example 3: Privacy vs. Preventing Harm
Conflicts between the duty of care and the right to privacy are also common. For example, Mrs. Green, a resident who values her privacy, keeps her room locked and prefers no surveillance. However, she has a history of self-harm. My duty of care requires that I take measures to prevent harm, which might necessitate more frequent checks or even intrusive supervision.
To balance these conflicting needs, I propose regular but non-intrusive visits and seek consent to install discreet monitoring devices. This helps ensure her safety while maintaining as much of her privacy as possible.
Example 4: Legal Frameworks and Mental Capacity
Legal frameworks like the Mental Capacity Act also present conflicts. For instance, Mr. Smith often fluctuates in mental capacity due to a psychiatric condition. On good days, he appears fully capable of making his own decisions. On bad days, however, his judgment is severely impaired.
Determining his capacity at any given moment and making decisions on his behalf involves constant reassessment, leading to potential conflicts. Involving the entire care team, consulting psychiatrists, and maintaining detailed documentation helps navigate these complex scenarios while protecting his rights and ensuring his safety.
Example 5: Smoking and Lifestyle Choices
Lifestyle choices, such as smoking, also pose dilemmas. Mrs. Johnson, one of our residents, finds significant emotional comfort in smoking, a right she is entitled to. However, my duty of care promotes a healthy lifestyle and mandates reducing health risks associated with smoking.
In this situation, potential conflicts arise between her emotional well-being and health risks. We work collaboratively with Mrs. Johnson to provide designated smoking areas and offer smoking cessation programs, aiming to respect her choices while promoting healthier habits.
Example 6: Ethical Considerations in End-of-Life Care
End-of-life care often brings ethical dilemmas. Recently, Mr. Brown expressed his wish to decline life-prolonging treatments. His choice reflects his right to autonomy and dignity in dying. However, my duty of care involves preserving life and providing the best possible medical care.
To address this, we initiate comprehensive discussions with Mr. Brown, his family, and the healthcare team to ensure everyone understands his wishes and the medical implications. An advanced care plan is developed, reflecting his choices while ensuring he receives compassionate and respectful care in his final days.
Final Thoughts
Conflicts and dilemmas between duty of care and individual rights arise from differing priorities, legal, and ethical considerations. A clear understanding and strategic approach are essential to addressing these challenges. Adopting person-centred care, involving multi-disciplinary teams, engaging family and carers, and investing in continuous professional development can help strike a balance between respecting individual rights and fulfilling the duty of care.
By focusing on these strategies, lead practitioners can ensure they provide compassionate, ethical, and legally compliant care that honours both their duty of care and the rights of those they support.
