Dignity refers to the right of an individual to get respect from people and be valued within society. It is the state of being treated in a moral and ethical manner. In the same manner, respect refers to the possession of admiration for a person or group of individuals and being treated with high esteem and regards (Becker, Wright and Schmit, 2017). It is essential that government, professional agencies and individuals foster dignity and respect for each other at all the times. This report is based upon a case study of two individuals with learning disabilities who married even after hindrance from local adult social care services. Also, this case study covers aspects related to breach of principle of ethics along with effective communication and interpersonal skills that could be utilised to foster greater dignity and respect. Besides this, reflection upon the impact of this case on individual learning and development is covered.
Sarah Thompson Drayton (34 years) and Daniel Drayton (26 years) possessed severe learning disabilities due to which their local adult social care services were willing to restrain them from getting married for almost a whole year. They were of the opinion that in case the marriage took place, Daniel could be charged of rape of his wife. Also, there were high probabilities that the vicar could also get involved in the issue. When the adult social care organisation received the information about Sarah and Daniel's marriage, she received a capacity assessment which she had to underwent against her and her mother's wishes. This test was conducted with the sole motive of ascertaining if Sarah was capable of maintaining sexual relations and get married without being posed to the risk of abuse. Although she failed this test yet the assessors were of the view that Sarah possessed great knowledge of marriage as well as relationships.
Question 1. Principles of ethics affected in the case study
It is essential that every individual is treated in a fair and ethical manner without being discriminated against as it the fundamental right of every personnel. Treating everyone in a moral and ethical manner strives to ensure that the fundamental rights of no individuals are violated due to any reason (Benjamin, 2016). As per the case study, it was noted that Sarah and Daniel had learning disabilities due to which they were believed to be incapable of carrying out sexual relationships and doing marriage as per social care services. It can be seen that there was a significant violation of principles of ethics as social care organisations largely possess the opinion that two persons who have learning disabilities should not have the access to get married as they are incapable of perceiving the difference between consensual and non-consensual behaviour amidst the marital relationship. Also, the capacity assessment was conducted forcefully against the wishes of Sarah and her mother In this regard, it is noted that the case breached the moral and ethical principle which guide and govern the behaviour of individuals within a society. There are various principle of ethics that should be followed by personnel that are an active part of society to ensure that they carry out their living in an ethical manner. The principles of ethics which have been violated in this case are described below:-
Beneficence: The ideology of this principle says to produce benefit for people. It is a basic principle of ethics that reflects that individuals should behave in a manner that carries some sort of good for society (Cleveland, Byrne and Cavanagh, 2015). Yet contrary to this principle of ethics, in the case study, nothing good has happened in any terms. The capacity assessment that Sarah had to undergo was a breach of her freedom and fundamental right of privacy. Also, the intervention of local social care services in restraining the marriage of couple did not possess any benefit for both of them.
Non-maleficence: This principle of ethics focus upon the idea that behaviour of individuals within a society should be such that it does not cause harm to any human being (Crépeau and Purkey, 2016). In contrast to this principle of ethics, the couple with learning disabilities had to face unethical and unjust behaviour from social care services for a whole year before their marriage. Also, Sarah was compelled to undergo a test to determine whether she possessed the capacity to get married and have sexual relationship without getting exploited. This only caused harm to their ethical and fundamental rights as a normal person to get married and have sexual relations like any other being.
Autonomy: This refers to the right of an individual to possess the freedom and independence to take decisions related to them as per their own accord. Also, with regards to healthcare, it is the ethical obligation of every practitioner to give the clients access to take decisions related with their health (Dierksmeier and et. al., 2016). However, the capacity assessment of Sarah took place against the wishes of her and her mother. This was largely because it was a private marital matter. Further, the right to examine whether Sarah possessed the mental capacity to carry on with marriage and have sexual relationship with her husband without being abused is solely her private concern and not a matter of public intervention.
Justice: It is an ethical principle that focuses upon maintaining fairness, impartiality and equality in all the contexts (Evans and Vaandering, 2016). It refers to the obligation of being fair and just with everyone. This principle of ethics was breached in the case of Sarah and Daniel as their marriage was a subject of professional intervention and reflected the extent to which local social care authorities were keen on not letting the couple get married as they possessed learning disabilities. It is the breach pf principle of justice as every individual has the right to get married and have sexual relationship as per their accord. Although the concern of local social care services was regarding the fact that Daniel could be charged of raping Sarah if they got married as both of them did not possess knowledge about the difference between consensual and non-consensual behaviour in marriage.
Human right: These are the rights provided to every human being in relation to right to freedom, liberty, speech, work and education, privacy, opinion etc. All individuals have access to these rights irrespective of caste, creed, nationality, gender, ethnicity, religion (Gotsis and Grimani, 2016). The fundamental human rights of Sarah and Daniel were affected in the case as both of them were being denied access to get married for almost an year as they had severe learning disabilities. Every individual can get married and have sexual relations as pet their own accord. Also, contrary to the basic human rights of privacy given to every person, Sarah was forced to undergo a mental capacity assessment test. This was conducted to assess if she had the capacity to carry out sexual relationship without being posed to the risk of abuse or exploitation. The whole matter related to whether she was mentally capable or not was the private issue of Daniel and Sarah which was violated by local social care organisation.
Duty of care: It is a legal obligation levied upon individuals that require compliance with standards of reasonable care while carrying out any activity that can possibly cause harm to people (Hantzopoulos, 2016). Contrary to this principle of ethics, local social care services continuously tried to stop Sarah and Daniel from getting married. Also, after getting knowledge of the couple's marriage, they sent a capacity assessment to Sarah which she had to undergo to determine if she possessed the mental capacity to have sexual relationship in marriage without getting raped or abused. The whole idea of getting this test done with Sarah was a breach of duty of care and caused harm to the basic rights of privacy and freedom of individuals.
Duty of candour: As per this, it is the moral obligation of every healthcare professional to be open and frank with patients and deliver them required information related to their diagnosis. Also, this indicates that every individual has the right to choose whether or not to undergo a particular diagnosis if they are in a conscious or healthy state (Lohne and et. al., 2017). In contrast to this, Sarah was compelled to undergo a capacity assessment test against her and her mother's wishes which reflects a violation of duty of candour of assessors.
Privacy: It is the right of an individual to live freely and privately without any intervention from anyone (Mazerolle and et. al, 2017). The local social care services violated the right to privacy of Sarah and Daniel by intervening in their marital decision. They were keen upon not letting the couple marry for almost an year. Also, the local authorities got too much involved with the assessment related to the mental capacity of individuals with learning disabilities to marry or have sexual relations. They intervened with privacy rights of Sarah and Daniel by conducting a capacity assessment test of Sarah against her will and determination. The boundaries within which local social care services should strive to intervene in personal matters of a couple were breached when the capacity of lady to be able to have sexual relation without getting abused were assessed by assessors against the wishes of Sarah and her mother.
Regarding: It is associated with giving respect to an individual and considering them worthy of being treated with dignity (McCLEMENT, Chochinov and Kredentser, 2015). The case clearly reflect lack of regards and respect displayed by local social care services towards individuals with learning disabilities. The marriage of Sarah and Daniel went through a whole year of professional interference and substantially reflected the extent to which the local authorities got involved with carrying out the mental capacity assessment test. While doing this, the local social care organisation forgot to strike a balance between valid safeguarding and over solicitous attention towards safeguarding people with learning capabilities duties. Due to this, it lead to limiting people’s ability to exercise their freedom of choice and right to privacy.
Question 2 Effective communication and interpersonal skills that could have been employed to support greater dignity and respect
Communication is an effective tool that helps individuals who are an active part of society to display dignity and respect towards each other (Mikkonen, Kyngäs and Kääriäinen, 2015). For this, various types of communication are available as options for individuals, such as written, verbal or non-verbal communication. In context of present case study also, there could have been better and effective communication employed between local social care services and the couple with learning disabilities so as to display and support greater dignity and respect which every human is worthy of. The manner in which Sarah was conveyed that she had to undergo capacity assessment test could have been improved by employing better communication. Such effective ways of communication could have been:-
Written Communication: This is a type of communication where information is delivered in written and descriptive form (Pless, Maak and Harris, 2017). In the present case, when local social care service received the news of Sarah and Daniel’s marriage, Sarah received a capacity assessment which she was compelled to undergo against her and her mother’s wishes. The local authorities could have employed a more respectable manner of communicating about the assessment to the couple in a written manner. It was a written order that neither Sarah nor her husband or mother could deny. There was no display of dignity and respect here, thus, the written communication could have been done in a more effective manner such that privacy rights of the couple and duty of candour of assessors would not have been violated.
Verbal Communication: It is a form of communication wherein information is delivered by way of spoken words. With regards to the case study, it is noticed that the local social care services were continuously trying to communicate to Sarah and Daniel that they were not capable of marrying each other. This intervention in the couple’s marriage lasted for almost one year. Here, effective verbal communication could have been employed by local social care services to exercise their obligation of social safeguarding yet striking a balance between the moral safeguarding and privacy rights of individuals. Also, Sarah was communicated about the assessment test in a written manner, the local authorities could have used verbal communication to justify the need of this test. This would have ensured greater dignity and respect towards the couple with learning disabilities.
Non-Verbal Communication: This type of communication makes use of non-verbal cues like gesture, eye contact, posture, body movements, facial expressions etc. (Ringold, 2015). With reference to case study, the couple had severe learning disabilities and thus, the local social care services could have employed non-verbal communication to have communication with the couple so as to support greater respect and dignity towards them.
Question 3 Examination and reflection of impact of this case upon you, your practice, individual learning and development
An individual gains knowledge and competence from the experience that they have in the world. A healthcare practitioner has to act and take decisions as per the nature and mental state of patients (Stephens and Kanov, 2017). The case under study of Sarah and Daniel who have severe learning disabilities have left a major impact upon me and my practise. I have used Gibbs Model of reflection to reflect upon my feelings and experience that I underwent during this case:-
Description: The case that I will be reflecting upon is related to Sarah and Daniel, two individuals with severe learning disabilities who were willing to marry each other. However, the local social care services were not allowing them to marry considering the fact that they were not mentally capable of carrying out marriage and having sexual relations without the risk of abuse. When the local authorities got information about their marriage, Sarah was asked to undergo a capacity assessment test against her and her mother's wishes. She failed this test. I think the situation was largely a violation of principles of ethics and fundamental rights of individuals in relation to privacy and freedom.
Feelings: I felt that the local social care services could have displayed a little dignity and respect towards the couple with severe disabilities. This could have helped in ensuring that the rights and principles of ethics are not violated (Sturm and Dellert, 2016). Further, I considered that the local authorities could have employed effective communication and interpersonal skills to communicate the need of carrying out an assessment test with Sarah.
Evaluation: As per my evaluation, the case had both positive as well as negative aspects. The good thing was that the local social care services recognised the need of conducting a capacity assessment of Sarah to gain knowledge whether she was able to live the married life and have sexual relationship without getting abused. This was a reflection of their Business concern towards safeguarding the people with learning disabilities. However, I thought that the negative thing about whole scenario was that the local authorities got over engaged with the assessments that led to violation of privacy rights of Sarah and Daniel.
Analysis: People with learning disabilities often face difficulty in adjusting to new situations and thus, it is necessary for healthcare professionals like me to deal with them in a manner that best suits them. As per the case, I have analysed that Sarah was compelled by local social care services to undergo a capacity assessment against her wishes. This was a breach of her fundamental right of privacy and I think better communication could have been employed to foster greater dignity and respect for the couple.
Conclusion: Looking back on this incident, I feel that the local authorities should have displayed a little dignity and respect towards Sarah and Daniel so as to communicate with them in an effective and respectable manner. Further, I think that the local authorities should have understood that even the couple with learning disabilities are humans and they possess the basic right to get married and have sexual relations. Also, I believe that the capacity assessment that Sarah had to undergo to determine her mental capabilities was a private matter of the couple and not something that needed so much professional intervention.
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Action Plan: On the basis of this incident, I have decided that i will display utmost respect and dignity towards my patients in my practice. Also, I will not carry out any activity which violates principles of ethics or human rights.
This case has largely contributed towards my own development as a potential practitioner because it has provided me knowledge about the way in which patients should be handled. Also, it has displayed that ethics of healthcare should not be breached be me at any cost. Thus, this incident has contributed towards the development of my professional career in a way that is desirable by law and local bodies and which do not cause harm to any patient in any Assignment manner.
From the above discussion, it has been concluded that every individual should behave in a manner that fosters dignity and respect within the society. Also, it is examined that every person should be provided access to basic human rights so that they can carry out their living in a desirable manner. It has also been analysed that there are certain principles of ethics which should not be violated in any situation. Besides this, it has been assessed that optimum communication strategy as well as interpersonal skills should be deployed so as to ensure adequate interaction with people who possess severe learning disabilities. This will foster greater dignity and respect for them.
Becker, C. A., Wright, G. and Schmit, K., 2017. Perceptions of dying well and distressing death by acute care nurses. Applied Nursing Research. 33. pp.149-154.
Benjamin, J., 2016. Non-violence as respect for all suffering: Thoughts inspired by Eyad El Sarraj. Psychoanalysis, Culture & Society. 21(1). pp.5-20.
Cleveland, J. N., Byrne, Z. S. and Cavanagh, T. M., 2015. The future of HR is RH: Respect for humanity at work. Human Resource Management Review. 25(2). pp.146-161.
Crépeau, F. and Purkey, A. L., 2016. Facilitating Mobility and Fostering Diversity: Getting EU Migration Governance to Respect the Human Rights of Migrants.
Dierksmeier, C. and et. al., 2016. Humanistic ethics in the age of globality. Springer.
Evans, K. and Vaandering, D., 2016. The little book of restorative justice in education: Fostering responsibility, healing, and hope in schools. Simon and Schuster.
Gotsis, G. and Grimani, K., 2016. The role of servant leadership in fostering inclusive organizations. Journal of Management Development. 35(8). pp.985-1010.
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