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

  • Suzy Braye
    ,
  • David Orr
    ,
  • Michael Preston-Shoot
Research Output: Contribution to journal Article Peer-review

Open access

Abstract

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 hand. 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.

Publication Information

Output type

Research Output: Contribution to journal Article Peer-review

Original language

English

Pages from-to (Number of pages)

Pages 320-335

Journal (Volume, Issue Number)

Ethics and Social Welfare (Volume 11, Issue 4)

Publication milestones

  • Published - 20/02/2017

Publication status

Published - 20/02/2017

ISSN

1749-6535

External Publication IDs

  • handle.net: 10547/622116
  • Scopus: 85014764689

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