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Autonomy and protection in self-neglect work: the ethical complexity of decision-making
journal contribution
posted on 2023-06-09, 05:05 authored by Suzy Braye, David OrrDavid Orr, Michael Preston-ShootSelf-neglect, in which an individual does not attend to their hygiene, health or home surroundings, is one of the most challenging aspects of adult social care practice. In England, its inclusion within the remit of adult safeguarding, as a result of changes in adult social care law introduced under the Care Act 2014, has thrown into relief the ethical dilemmas arising from tensions between respect for autonomy on the one hand and the exercise of a protective duty of care on the other. This paper draws on serious case reviews and safeguarding adult reviews in self-neglect cases, along with findings from adult safeguarding research, to propose that an appropriate balance between these two moral imperatives is not always achieved in self-neglect practice. It considers why autonomy appears to be privileged over other considerations, illustrating the complex interplay between law and ethics that gives autonomy pre-eminence. It then considers how a more nuanced, situated and relational approach to autonomy can enable practitioners to move away from dichotomous interpretations of the moral imperatives present in self-neglect work, and can support more nuanced understandings of the ethics of professional decision-making. Finally it considers the personal and organisational implications of this enhanced ethical literacy.
History
Publication status
- Published
File Version
- Accepted version
Journal
Ethics and Social WelfareISSN
1749-6535Publisher
Taylor & FrancisExternal DOI
Issue
4Volume
11Page range
320-335Department affiliated with
- Social Work and Social Care Publications
Full text available
- Yes
Peer reviewed?
- Yes
Legacy Posted Date
2017-02-08First Open Access (FOA) Date
2018-02-21First Compliant Deposit (FCD) Date
2017-02-08Usage metrics
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