Key Ethical Principles and Moral Concepts in Care: Analytical Essay

Introduction

This assignment will outline key ethical principles and moral concepts that relate to freedom, rights, responsibilities and the use of power in care. Additionally, it will discuss, in detail, the use of effective communication and interpersonal skills and outline key principles and values, including compassion dignity and respect. It will then observe and reflect on personal values held and the impact they might have on practice, individual learning and own development. Finally, it will identify strategic measures for promoting dignity and respect in accordance to people within the health and social care environment.

Ethics, as described by (A. Leathard and S. Mclaren 2007) is a word derived from the Greeks ‘ethos’, this is a person’s character, their nature of disposition. Ethics, in relation to morals, is to choose between right and wrong or good and evil in relation to actions, volitions or the character of responsible beings. Ethical principles are concerned with aspects such as; autonomy, beneficence, non-maleficence and justice, honesty, confidentiality, consent and accountability. Ethics, as described by the English Dictionary, is the code of behaviour of a group, profession, or individual; course of action; the study of moral value of human conduct or the moral fitness of decision. (Collins dictionary, 2009).

There are several principles of ethics that apply to the case, such as:

• Dignity – serious, calm and controlled behaviour or manner. The quality of being worthy of honour by peer group, or society on a whole, a sense of self-importance. (Collins dictionary, 2009). Dignity in care mainly focuses on the value of each person as an individual. To value others; their views, to respect their choices and decisions and not to make assumptions about how a person wants to be treated. It is the ability to work with care and compassion (Skillsforcare.org.uk, 2019). There are several ethical principles, when considering the case study as Sara’s dignity was not preserved as her freedom of choice was not considered.
• Respect – consideration in respect of feelings, an attitude of deference or esteem, the state of being honoured or esteemed, a detailed or characteristic in reference or relation to polite greeting, to have an attitude of esteem towards others and to pay proper attention or consideration to paying attention (Collins dictionary, 2009). Rights to respect for private life also consists of right to respect personal autonomy and dignity. The Human Rights Act 1998, article 8 also protects the physical and psychological integrity of a person. The right to personal advancement, and the right to establish relationships with other human beings and the outside world. When considering the case study Sara’s right to establishing a personal relationship was treated unfairly as her local authority failed to acknowledge her need for love and belonging.
• Freedom – the state of being free, especially from government control freedom liberation, such as from slavery. The privilege or the right of unrestricted freedom, The Human Rights Act 1998 promotes everyone has the right to freedom of expression, freedom of choice. Freedom of thought, conscience and religion, freedom to change their belief and freedom, alone or in a community with others and in public or private (Legislation.gov.uk, 2019). Sara’s freedom of thoughts and choice was not considered as she was told that her partner at the time could be faced with rape charges if they were to get married, she was also told that her vicar could also be charged.
• Rights – one’s own right to having a claim or titles oneself rather than through marriage or other connection, right to consists of justice and orderly arrangements (Collins dictionary, 2009). The rights of the service user within the health and social care environment should be valued and placed the centre of that care. This will be achieved by listening to their views and opinions, showing compassion and being given choice. We should also show respect in the way we address each other, to show empathy, these ensure service users maintain their privacy and confidentiality. (Beauchamp and Childress, 2001 p 70). “Individuals have rights and there are things that no person or group can do to them”, but without a notion of responsibilities, anarchy arises Nozick (1974, p 74).

Some rights are law The Equality Act 2010 legally protects people from discrimination in the workplace and the wider society. It replaced previous anti-discrimination laws is a single Act, the make the law surrounding discrimination easier to understand, it also strengthens protection in some situations, like the Disability Discrimination Acts. Other rights are seen more as aims, such as ‘the right to the highest attainable standard of physical and mental health’. When considering the case study, Sara has a right to marriage and family life. She had a mental capacity assessment, this was designed to determine whether Sara was psychological fit to give consent, to having a sexual relation with Daniel. It was also done to protect Sara from any risk of abuse or exploitation. However, the assessment was done without both her and her mother’s consent. (Ryan, 2019)

Beneficence underlines key principles in the health and social care environment that the well-being of service user’s is well promoted through autonomy. Beneficence is therefore concerned with promoting benefit, that immediately raises the question as to what is to count as benefit, by who, for whom and who should make the assessment. International declaration on human rights and national constitutions set standards regarding relationships between states and citizens. Sub-sets of rights (feminist, gay, black etc.) advance the status and freedoms of minority groups. However, often one person’s ‘rights’ conflict with another’s. In social work, the rights of a child or safeguarded adults might be pitted against their parents’. Some see rights as absolute.

• Responsibilities – the state of being responsible, a person or thing for which one is responsible for. Responsible for having control or authority over, to be accountable for one’s actions and decision: involving duties and accountability (Collins dictionary, 2009). Accountability, to be accountable across health and social care provision concerns the requirement for the services and personnel involved to be accountable, of what has or has not been undertaken on behalf of service users. To enable professional and public accountability to be judged and reviewed, the new accountability places an increasing focus on detailed procedures for undertaking tasks and setting predefined targets; to meet requirements for quantifiable work outputs, to contrast the complexity of accountability across health and social care. (Balloch and Taylor, 2001)

Autonomy is the ability to think, decide and act based on thoughts and decide freely and independently. Deontology, the Kantian perception emphasises that all acts must be viewed as a moral significance in oneself, regardless of the consequences. The treatment of, and for, everyone is of the greatest importance. This approach would oppose any act that involves not sharing information with the service user even if justified as being in their best interest.

The UK’s Human Rights Act 1998 is about respecting and protecting the rights and freedom of everyone; to ensure that everyone’s right and freedoms are properly respected. This is to ensure that one person’s rights will sometimes have to be balanced against another’s. For care practitioners, disentangling rights and freedoms within the care environment can be lot more complex due to the wider interest of the whole community or organisations will also need to be considered. Often these wider interests may take precedence over an individual’s rights and freedom. (Legislation.gov.uk, 2019).

Maslow’s (1943,1954) hierarchy of needs states that people are motivated to achieve certain needs, some needs take priority over others. Our most basic need is for physical survival, and this will be the thing that motivates our behaviour. Once the physical level is fulfilled the next level is what motivates us, and the cycle continues. Maslow’s hierarchy of needs is motivational theory in psychology containing a five-tier model of human needs, often depicted as hierarchical level within a pyramid. From the bottom of the hierarchy upwards, the needs are: physiological, safety, love and belonging, esteem and self-actualisation. Lower needs down in the hierarchy must be achieved before individuals can attend to needs higher up (Maslow, 1987, p.64).

The need for interpersonal relationship motivates behaviour, examples include; intimacy, friendship, acceptance, trust and giving love and affection. Affiliating being part of a group by either, family, friends or work. Autonomy is the ability to think, decide, and act on the basis of thought and to decide freely and independently (Kant, 1966). The case study shows Sara’s need and choice for love and belonging.

Health and social care professionals and providers are required to have a very good level of communication skills to develop positive relationships and share personal information with people using services. Professionals. They’re also required to communicate well with people’s families and/carers and their work peers and other professionals. The health and social care environment use several different forms of communication, however, there are three main forms of communication, verbal, non-verbal and words written, and the use of technology.

Verbal communication refers to the use of words to present ideas, feelings and thoughts. Good verbal communication is having the ability to both explain and present your ideas clearly through spoken/sound words, and to able to listen to others clearly. This involves using a variety of approaches and styles appropriate to the audience you are addressing.

Non – verbal communication – this refers to the message we send to express ideas and opinions without talking or the ability to talk. This could be through the motion of body language, tone of voice, gestures, expressions, touch or contrast, signs, symbols, objects, pictures and other visual aids. It is important to be able to recognise what a person’s body language is saying, especially when as a health and social care worker you are going to be dealing with people who are in pain, worried or upset. you must be able to understand the message you send with your own body language, when working with other people.

Some things can stop the effectiveness of good communication for people who work in the health and social care environment need to understand such barriers so they can overcome them. When using effective verbal skills, you can help overcome barriers that might prevent effective communication. Communication challenges can isolate a person, making them feel cut off, so it is particularly important in a health and social care setting to overcome these challenges. (Hetherington and Rasheed, 2010). The case study shows the lack of listening skills and shows paternalism, whereby social services based their decision over Sara’s preference to get married and alerting them of the possible charges being brought against her fiancé at the time and her vicar. Maslow’s esteem needs classified into two categories the first; esteem for oneself (dignity, mastery, independence, achievement and the desire for reputation or respect from others (e.g., status prestige). Maslow indicated that the need for respect or reputation is most important for children and adolescents and precedes true self-esteem or dignity. (Maslow, 1987, p.64).

The Data Protection Act 1998 law, passed to protect people’s rights to confidentiality. The act provides you with rights for you to be able to refuse to provide information, the data held about you should be accurate and up to date, the right to confidentiality that information held about you should not be accessible to unauthorised personnel. Confidentiality is vital when working with service users within the health and social care sectors, it means keeping information about service users secure and private (Legislation.gov.uk, 2019).

The freedom of information Act 2000 provides statutory rights for the request of personal information. The Health and Social Care Act 2008 demonstrates key principles that are essential in the standard of the quality of care given and that the safety of people using health and adult social care services have a right to expect. Effective communication is very important, it ensures that people using health and social care services are treated respectfully and that their individual needs and rights are met. Views and preference principle were not adhered by social services in this case, as there was a lack of active listening to Sara’s needs.

The Human Rights Act 1998 empowers service users to consent to or refuse treatment, however, the case study does not show the promotion of this act, as social service carried out an assessment on Sara without both her and her mother’s consent.

the key concept of accountability covers the responsibility for the effective and efficient use of public services; who is taking decisions, and how the public can influence the process; the responsibility for wrongful outcomes; and the need for accessible forms of redress. An ethical challenge that needs to resolved concerns representation, accountability and abuse of power. A key ethical lesson has shown the need to enable local collectiveness across interprofessional agencies working practices drive towards a common purpose (A. Leathard and S. Mclaren 2007).

The rights and responsibility principle are expected to work with at the personal, professional and state level and beyond. It is an ideology that stresses the need to balance opposites such as oppression and freedom autonomy and dependence. The case study shows an ethical dilemma of paternalism, as Sara’s freedom of choice was not considered by social services. Social legislation and ethical principles intended to promote the right to equal opportunity no matter what their ethnicity, gender, sexuality, race, social class and religion. Professionals must ensure all service users treated equally, without discrimination and free from the abuse of power. Understanding the principle to be treated in a dignified way is a very important part of an individual’s life and an important aspect of being a service provider is to help people maintain their dignity, so that they can keep their sense of self-respect (Hetherington and Rasheed, 2010).

To be allowed privacy, free from intrusion and disturbance in your private life or affairs. A lack of respect of privacy, as seen in the case study undermines the service user’s self-esteem and make them feel that they have lost their dignity. To be cared for in a way that meets our needs and account of preferences and choices is a very important principle that ensures peoples choices and preferences are maintained so that they can have as much independence as possible. This in term has a positive effect on the individual’s experience and recovery. Empathy is an ethical consideration and a very important value that should be always be followed by health and social care providers. Empathy is to be able to put yourself in the same position as others, especially people using the Health and Social care services. However, this is not always as easy as you might not have experienced what has happened to the person, which makes it hard to put yourself in their position. The case study shows a true reflection of lack of empathy and compassion as towards Sara’s right to a family- life as well as her freedom of choice, as an individual.

Reflection practice is all about learning from experience, to which is an important strategy which allows professional development of the health and social care professionals and institutions. This allows the improvement of quality care being delivered, it involves a lot of thinking and to critically analyse the actions with the aimed goal of improving professional practice. Gibbs Reflective Cycle model is commonly used in health and social care, to avoid, reason and argue ethical dilemmas. This model, when used to argue the ethical dilemma in the case study of Sara and social services.

• The description – this requires a true description from the professional of the incident, the focusing is on the information. to which questions are asked, to get a better understanding of what happened.
• The feeling – of emotions felt during the time the incident was discussed, any questions like, what did you feel before the incident? during, or after. how you thought others felt and how you feel about it now?
• The evaluation – to be empathetic and to objectively evaluate the situation of what went well? what did not go well? what were the negatives and the positives?
• The incident – how did you and the other professionals contribute to it?
• The analysis – think about what might have hindered or helped the situation.
• The conclusion – will allow you to consider what you learn from the situation and what else you could have done in that exact situation. If the outcomes were negative and how would you avoid that in further. If the outcomes were positive and how you could improve it. what skills you need to better equip you if a similar incident was to occur.
• Action plan – deals with the plan of how to effectively manage and improve the situation next time. If any training, skill, or structure that can equip you with handling the situation better and to figure out any areas need work and thrive to improve them (Gibbs, 1988).

Personal values and skills contribute significantly in the way we deliver and provide care, this allows a therapeutic relationship between professionals and service users. It is always important to be friendly and to show empathy, this will develop trust and encourage the service user to more honest about their concerns and feelings. To show compassion to others, whilst respecting the service users own personal value without being judgemental, to maintain an empathetic attitude towards helping people make decision involves good listening and reflective skills. Good interpersonal skills will allow you to voice your concerns, if any.

Ethical values are personal attitudes with oneself or culture; rightness, honesty, respect for life. Personal values such as moral and political belief, attitude towards their own education, marriage and work. Value inconsistency usually occurs when values differ, this as seen be in case study as there no empathy or compassion shown towards Sara and Daniel (Stewart and Glynn, 1975). Professionals are required to maintain good ethical values and to promote the ethical principle of the health and social care setting. The holistic model can be used in a similar situation so as to avoid such ethical dilemmas. This model takes into consideration all the service user needs to help them become more empowered over their own lives.

Conclusion

To conclude, this assignment shows a clear understanding of the ethical values required to be a healthcare professional and the ethical principles used in the health and social care environment. The introduction of the Human Rights Act 1998 was influenced by Maslow’s Hierarchy of needs, to understand individual needs and rights. It also shows a clear understanding of the Responsibility to promote dignity and respect, to held accountability of their professional duty of conduct and to guarantee service users confidentiality. This assignment argues the importance of effective communication, interpersonal skills to reason or avoid conflict. Finally, it reflected on how the case study could have impacted on practice, individual learning and personal development.

Bibliography

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