Autonomy
A term derived from Greek roots meaning "self-rule," and is based on the value of respect for the dignity and worth of all people.
The principle of Autonomy
The term for a client who is mandated by the court to receive services.
Involuntary client
The term for an appropriate third party who has the authority to make decisions on behalf of a person who lacks the capacity.
Substitute decision maker
A social worker meets with a teenager who wants to drop out of high school and start working full-time. The teenager's parents disagree, but the social worker encourages the teen to stay in school without obtaining any further explanation from the teen on why they want to drop out. Is this ethical? Why or why not?
No. The social worker should respect the teen’s autonomy and self-determination by exploring their motivations and providing information about potential consequences while involving the parents respectfully. The social worker should try not to inflict their personal opinion.
Why did Maryam not want to return to supportive housing?
When is it appropriate to limit client autonomy?
When a client's decision will cause harm to themselves or others.
The main critique of self-determination
Societal imbalances and inequality (not all clients have the capacity for self-determination.)
List one of the four components of assessing for mental capacity.
1. “the ability to understand relevant considerations”
2. “the ability to understand and appreciate the risks and benefits of various treatment choices”
3. “the ability to compare decision choices and think rationally about them”
4. “the ability to communicate a stable treatment choice”
An elderly client with early-stage dementia insists on managing their own finances. Their adult child is concerned about their mental capacity and calls adult protection so that the social worker can intervene. What are the next steps that the social worker should take?
The social worker should evaluate the client’s decision-making capacity, involve the client in the discussion, and consider safeguards that respect their autonomy while protecting their well-being.
Emphasized by Browne, what term examines how societal structures create barriers for individuals with disabilities and challenges ableist assumptions?
Critical disability studies
What was our critique of autonomy?
Balancing ethics and law in regard to promoting client autonomy and protection of life (duty to warn)
How does a social worker foster self-determination?
- Mutual Work
- Provide competent information and suggestions
- Facilitate insight
- Validation
What is the difference between consent and assent?
Consent may be given by someone of legal status, while assent is given by someone who does not have legal status as an agreement to participate.
A client undergoing treatment for substance use wants to leave the program early. The social worker advises against it, citing the potential for relapse. The client feels the decision is theirs alone and accuses the social worker of being controlling. How should the social worker reply?
The social worker should provide informed consent about the risks and benefits of staying in treatment while respecting the client’s right to make their own decisions.
How does Browne describe the impact of labelling service users as "risky" or "difficult"?
Browne discusses how there is a reinforcement of negative stereotypes when clients are negatively labelled, which can lead to further exclusion or harm
What does autonomy look like in practice?
- Respecting client's right to self-determination
- Rejection or acceptance of services
- Empowerment
- Ensuring client voices are heard in contexts outside of the service user/provider relationship
- Rejecting liberalism models of agency
An example of when it is ethically and legally justified to infringe on a client's right to self-determination by a higher value.
- When a client could harm themselves or others.
- When the mental capacity of a client is in question.
The three main types of consent requested from research participants suggested by the NASW Code of Ethics.
Written, voluntary, and fully informed consent.
A client whose first language is not English signs a consent form for therapy after translating it VIA Google Translate. A few days later, the client claimed they didn’t fully understand the document and now had some questions regarding the agreement. What should the social worker do to rectify the situation?
The social worker must meet with the client to ensure informed consent with a professional interpreter and verifying the client’s understanding of the consent form.
The approach that Browne takes in her article where she focuses on her own experiences to analyze broader societal issues
Autoethnography
Section 7 of the Canadian Charter of Rights and Freedoms.
"life, liberty, and security of the person."
What is an example of a cultural and social context that must be considered in decisions around self-determination?
- beliefs
- norms
- practices
- behaviours
The specific types of information that should be shared with potential research participants identified by the NASW Code.
- The nature, extent, and duration
- Potential benefits and risks
- Choices regarding technology
- Voluntary nature of participation (the right to withdraw)
- Access to support services
A social worker meets with a pregnant client in an abusive relationship. The client expressed a desire to stay with their partner despite the risks, stating they want their child to grow up with both parents. The client acknowledges the abuse but believes it won’t affect the baby. The social worker feels torn between supporting the client’s autonomy and protecting the unborn child. How should the social worker handle this situation?
The social worker should explore the client’s reasoning and educate them about the risks of abuse on the child. If the situation poses an immediate risk to the unborn child, the social worker must consider their legal and ethical obligations to intervene while continuing to support the client’s autonomy.
What was the supposed reason that Maryam isn't usually present in any collaborative team meetings?
Maryam is "typically out and about in the community without a cell phone, making it hard to communicate with her."