Autonomy and protection in self-neglect work: the ethical complexity of decision-making

Braye, Suzy, Orr, David and Preston-Shoot, Michael (2017) Autonomy and protection in self-neglect work: the ethical complexity of decision-making. Ethics and Social Welfare, 11 (4). pp. 320-335. ISSN 1749-6535

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Self-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.

Item Type: Article
Schools and Departments: School of Education and Social Work > Social Work and Social Care
Subjects: L Education
Depositing User: Deeptima Massey
Date Deposited: 08 Feb 2017 09:31
Last Modified: 08 Mar 2021 15:13

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