Autonomy Vs. Paternalism In Mental Health Treatment Essay -- essays re

Autonomy Vs. Paternalism In Mental Health Treatment The assignment for this Ethics class was to review Mr. Jacob's treatment, as described by the New York State Commission on Quality of Care for the Mentally disabled (1994). The class was further asked to comment on the major issues for each of the three perspectives. The agencies, family and review board were to be included. This student will begin with a fourth perspective; that of Mr. Gordon. In the Matter of Jacob Gordon (1994), is the story of the last eight years of a psychiatrically disabled man's life. Mr. Gordon appeared to vacillate between striving for autonomy and accepting the support of his family. Unfortunately, it appeared by this account that the families support was not synonymous with autonomy. It did not appear that Mr. Gordon had ever desired or sought agency intervention for himself. Mr. Gordon's association with the mental health system appeared to be marked by power and control issues. "Consumers/ex-patients often report a feeling of "invisibility"; they sense that their views and desires do not matter (Carling, 1995, p.79 )." The commission's report (1995) spoke of several incidences where Mr. Gordon eluded to his desire for autonomy. Mr. Gordon did not wish to live in a supervised setting. Mr. Gordon did not wish to attend group day treatment settings. Mr. Gordon did not wish to use medication in the treatment of his mental health disorder. Without medication his behavior was deemed unacceptable and did not permit him the opportunity to have any of these choices. "Choice is a right-not a privilege to be afforded by good behavior (Penny, 1994, p. 29)." Mr. Gordon's right of choice was limited even though he lived in his apartment independently. The condition of his apartment was scrutinized. His medication was closely monitored; sometimes to the degree that he was directed to leave his home to receive medication that was given to him crushed, in an attempt to insure it's ingestion. "Even peoples liberties in a highly controlled board and care home may be scarcely greater than in a hospital ward (Rubenstien, 1994, p.54)." In Mr. Gordon's case even within the sanctity of his own home, his liberties were scarcely greater than in a hospital ward. Other than his autonomy the second issue for Mr. Gordon appears to be the need for safety and suppor... ... on Quality of Care for the Mentally Disabled. New York State Commission on Quality of Care for the Mentally Disabled. A Pamphlet. What is The Commission? New York: Commission on Quality of Care for the Mentally Disabled. Corey, G., Corey, M.S., Callanan, P. (1993). Issues and Ethics in the Helping Professions. (4th ed.). California: Brook/Cole Publishing Co. Penny, D.J. (1994). Choice, common sense, and responsibility: the systems obligations to recipients. In C. J Sundram (Ed.), Choice & Responsibility (pp. 29-32). New York: NYS Commission on Quality of Care for the Mentally Disabled. Rooney, R. (1992). The ethical foundation for work with involuntary clients. Strategies for Work with Involuntary Clients. (pp. 53-74). New York: Columbia University Press. Sundram, C.J. (1994). A framework of thinking about choice and responsibility. In C. J. Sundram (Ed.), Choice & Responsibility (pp. 3-16). New York: NYS Commission on Quality of Care for the Mentally Disabled. Surles, R.C. (1994). Free choice, informed choice, and dangerous choices. In C.J. Sundram (Ed.), Choice & Responsibility (pp. 17-24). New York: NYS Commission on Quality of Care for the Mentally Disabled.