Ethical Dilemma Analysis: Learning Disabilities and Care

This essay delves into the ethical dilemmas presented in a case study involving an individual, John, with learning disabilities, and the concerns of his parents. The essay analyzes the complexities of learning disabilities, which impact cognitive processing and decision-making, highlighting how these challenges can be overlooked initially. The essay examines the perspectives of John, the center manager, and John's parents, providing insights into the ethical considerations surrounding patient autonomy, parental consent, and professional responsibility within a healthcare context. It explores the ethical dilemmas through the lens of deontology and utilitarianism, discussing the responsibilities of the center manager, the rights of the patient, and the role of parental involvement. The essay argues for the importance of adhering to ethical codes, particularly those related to mental health and care, while also highlighting the significance of considering the impact of decisions on all parties involved. The importance of involving medical professionals and family members in the decision-making process is emphasized, particularly when dealing with individuals with learning disabilities, to ensure ethical and legal compliance.

Running Head: Learning Disabilities and Ethical Dilemma
Learning Disabilities and Ethical Dilemma
Essay
System04104
2/10/2020

Learning Disabilities and Ethical Dilemma
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Learning Disabilities and Ethical Dilemma
The essay is about the ethical dilemma in the case of John who is suffering from learning
disabilities and his family members are very worried about his problem. The essay also
includes various analyses of the disabilities and ethical dilemma related with the diseases that
are similar like learning disabilities. The essay considers the viewpoints related to John, the
centre manager, and John’s parents about the learning disabilities of John. The essay also
describes the course of action that is required in such a situation to cope up with the learning
disabilities and action required from the parents and centre’s manager to cope up with
learning disabilities. The essay also describes the ethical dilemmas with the help of ethical
theories that are involved in this case.
The case is about a patient who is suffering from learning disabilities which is a complex
health problem and it is generally ignored by the people in the initial stage of the disease.
Learning disabilities is complex neurological issue in which a person generally feel problem
in reading, writing, analysing, or calculating. This problem also creates problem in taking
instant decisions on time, this type of people generally do not feel any problem in their daily
life stuffs or in decision-making rather they are facing problem in processing information
related to reading and calculating (McDonald and Kidney, 2012). The problem is related to
learning disabilities, which is not a serious concern but proper knowledge and a better doctor
can help the patient to recover early. People who face learning disabilities generally deal with
all the daily life situations, despite being the challenges they face with the disabilities
(Brigham, Scruggs, and Mastropieri, 2011). The major problem arises with learning
disabilities when an adult faces problem in finding jobs and want to support the family with
money and financial support. This type of people generally faces problems in finding
employment. Apart from this, a student or teenager who is suffering from learning disabilities
faces lots of problem in inside and outside of the classroom during study or during preparing
their assignments. The case is about John who is suffering from learning disabilities is a
matter of worried for both family members and a manager who is responsible for picking
John through bus. The case shows the role of cabin manager that how he assesses the
situation of John in the clinic and fined that he is all right to come centre by himself (Freilich
and Shechtman, 2010).

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The first instance of ethical dilemma arise when the centre’s manager assess the situation of
John about his learning disabilities and found that he is alright and can cover the distance
without any transportation help. The deontology theory states that people should adhere the
ethical behaviour and adhere their obligation while they engage with their duties or making
any decision regarding their work that needs ethical decision-making (Geary, 2011).
However, the assessment or thinking of the manager is based on the learning disabilities
stress analysis of John and all the decision were based on that particular assessment program
but it was not ethically right because doctor failed to make proper decision regarding his
decision of leaving transportation facilities. Although, John has requested himself from the
centre to leave the bus and waking by his own and the manager also does the assessment
analysis of the conditions of John then it can be said that centre’s manager was right at his
place and the decision of manager was based on the fact check (Kittay, 2011). The another
ethical dilemma was raised in the case when family members and parents were worried about
the John condition and they are thinking that John cannot be able to reach on the centre as he
was not capable of doing so. Here, parents were also failed to analyse the situation from the
manager’s point of view. As parents of John were looking and take care of him from 26
years, it can be said that they both have knowledge about the John condition and about his
learning disabilities (Atkinson, 2010). The deontology also states that it is the ethical duty of
a person to perform his or her duty in honourable manner and there is no logical or rationale
basis of deciding an individual’s duty. In such a case, it is clear that manager should not listen
the request of John and he should be provided transportation facilities to bring him in the
centre every day. Therefore, any person who is suffering from mental disorder or learning
disabilit9ies is liable to detention even without their consent.
In the first case, it was described that manager listened the John’s request and asked him to
come by own way. However, the Mental Health Act Code of Practice (DoH, 2008a) says that
if a person who is disabled from learning disabilities and present danger for self or for others
compulsory admission should be considered in the health care centre, even the patient
expresses his or her willingness to not come by bus or admitted in the centre. It is also
mentioned in the code of conduct that people who are suffering from learning disabilities
have equal rights like anybody else. According to the Utilitarian theory, person is himself or
herself responsible for taking the decision. The theory says that decision that yields great
benefit to most of the people is ethically correct. In such a situation, the decision of John was
not ethically correct because it affects his parents and they are worried about him (Lerner and

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Johns, 2011). In such a situation, it was the responsibility of the organisation to follow the
ethical behaviour and safety for the people (Geary, 2013). John was assessed by the manager
but he should not be allowed to come by his own rather than leaving the transportation
facilities. The other thing that condition of John should be assessed by a medical professional
who have knowledge about the learning disabilities problem and wide range of experience in
this field. In such a situation, the decision of centre’s manager was totally looking unethical
because he should not consider the opinion of a learning-disabled person (Nelson and
Harwood, 2011).Therefore, as per the utilitarian theory, both john and manager should
consider the impact of their decision on the people who are connected with John. The
decision of the manager should be based on the family decision or request, because they have
enough knowledge about the conditions of John.
In this analysis, it can be said that parents were ethically and legally right and the manager
should not take the consent of John for the legal procedures of removing transportation
facilities (May and Stone, 2010). However, here John was also failed to compare the impact
of his decision and taking relevant decision for his family, which is required in the utilitarian
theory, which is based on the quantity of benefits after making a decision. To remove the
transportation facilities, the manager should first meet with the parents of the John and take
their advices and match the advices with the medical conditions of John and then they should
take the decisions whether to remove the transportation of John or not. The situation of John
was still under danger because the parents of John know him from his childhood and they are
worried about the decision of the centre to remove the John’s transportation facilities (Slade
and Prinsloo, 2013). In such a situation, the ethical decision should be based on the consent
of family members and parents rather than John’s own willingness of removing transportation
to reach the centre.
The major problem in the case is that parents were not kept in the circle by the manager while
taking decision regarding removing the transportation facilities of John. When the case was
considered then it was found that as per the Ethical Codes of Standards for Professional
practice, it is required that the centre for care should have to ask the parents first about to
assess the condition and removing the transportation facilities for John. The organisation
should take the consent of parents in written, oral, or in any form to remove, the facilities and
the consent of parents should be appropriately documented (Montague, Enders, and Dietz,
2011). Parental consent was necessary before any action, which was taken to treat or remove

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facilities, which is provided to the learning-disabled people. If John side will be considered in
this case, then it has been found that John have right to provide his consent for treatment or
any other facilities if he will be in sound mind situation. However, in this situation, John is
facing learning disabilities and it is really unethical for the centre to deny the consent of John
and his family (Tambuyzer, Pieters, and Van Audenhove, 2014). As John cannot take his
responsibility and can harm himself in the situation of learning disabilities because he cannot
read or understand the things, then it is really dangerous to leave in alone and travel by his
own in public places. As the care centre records the consent of John and assesses the situation
after registering his willingness to come by his own, it was against the rulebook or ethical
duty of a psychological profession to take the consent of a learning-disabled person so
seriously (Ulrich, et. al., 2010). Sometimes, using the consent of a patient who is suffering
from learning disable seems to be essential but in the case of John, the consent of parents was
essential than John’s consent. Therefore, the manager should care about this ethical and legal
practice before removing the transportation facilities of John.
The role of parents under this case can also be considered under the ethical dilemma, which is
related to the case responsibility of parents. The role of parents is compulsory in care of a
learning-disabled person. In the healthcare organisation, considering the ethical values is
necessary and raising awareness about the issue is essential for the wellbeing of patient. It has
been found that the organisations generally feeling squeezed while providing treatment for
the disabled people and generally serves as the client’s representative. It is the responsibility
of an organisation to take care of the client or learning disabled person with utmost care and
accountability, which was absence in the case of John. Sometimes, ethical conditions squeeze
the staff to take appropriate action in the organisation (Tambuyzer, Pieters, and Van
Audenhove, 2014). In the conditions of John, the organisation have full responsibility to take
the decision related to John as it comes in their judicial right to care about the patient but the
consent of parents was necessary even in the situation of procedural action to remove the
transportation service of John. The other thing that is crucial to consider in the case that staffs
in the centre assess the case of John instead of professional doctors. The manager was
responsible for it and this was totally against the ethical practice of a clinical health
organisation that cares for the learning-disabled people.
As per the John perspective, he is 26 year old but not sound mind and suffering from learning
disability. Even the age of John permits him to take his own decision and people with

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learning disabilities have same rights and freedom to take decisions like anyone, but they
need assistance in their decision-making. The poor conditions of patient do not allow him to
go outside alone and take his decision by himself in this particular case as per his past record.
However, the rights in UK provides the same freedom to the learning disabled people but it is
also mentioned that they need assistance of other people as well and the same rules and
regulations apply on John and on their parents as well (Kontio, et. al., 2010). This is really a
concern for the centre’s manager whether to consider his opinion or consent for removing the
transportation facilities of John or not. In such a scenario, it can be said the decision of John
was not appropriate neither he was in the condition of taking decision of his daily stuffs. It is
the right of a person to access the basic facility and freedom of life to move where he wants
to move, but the conditions of John do not allow him to take the decision by himself even he
is mentally fit but not certified by the medical professionals. If the provisions related to rights
would be considered in the case of John, then the decision of Centre’s manager will be right
(Johnson, et. al., 2010). However, if the health conditions of the John could not be proved
after assessment then John will not authorised person in this case to give consent to the
centre’s manager neither he can take the decision for removing the transportation facilities
(Dombrowski and Gischlar, 2014). In last few years, the way of providing care to a learning-
disabled person has been change a lot and it has been growing towards recognizing the right
of people, makes use of it, and provides them access to the public health services and primary
care in acute district hospitals. In such a situation, the manager should know about the basic
law and ethical principles that is necessary to know to treat the patient. However, as per the
recent law ‘Mental Capacity Act 2005’ states that the incapacitate adults and their consents
should also be considered while providing them care and various healthcare facilities to them.
As John is learning disabled person and it is really essential for the clinical manager to
provide care for him and ensure his security as well so he cannot harm himself. Therefore, the
responsibility of John is not the matter of concern in the case because he was not liable to
take decisions for his own safety and health. Therefore, removing the transportation facilities
for John was totally a wrong decision, which was taken by the manager and it was ethically
not justified as what parents expect from the centre (Dombrowski and Gischlar, 2014). The
role of parents is also questionable here because they need to know what centre is doing
about the John and how centre can consider the consent of John for procedural actions. It is
pervasive that a person who is suffering from learning disabilities cannot take the decision by
his own until he or she is certified by a medical profession about his sound mind decision and

Learning Disabilities and Ethical Dilemma
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awareness about his own life decisions. In the healthcare organisation, it is the responsibility
of nurses and healthcare professional to provide and deliver better healthcare services to the
patient. However, the role of healthcare organisations and nurses in learning disabilities was a
great matter of debate in last few years (Sleeter, 2010).
As per the theory of rights, which is concern with the rights of people to make decision, John
was right and ethical because he have right to make decision. In such a situation, it can be
said that it was the duty of doctors and manager to analyse the impact of John’s decision. As
people with learning disabilities, share the same rights and freedom in the country, they also
deserve to take their own decision to make their life beautiful and smooth. In such a scenario,
the objection of family members on the centre was unethical. However, as per the
responsibility of the parents it makes sense that they care for their son who is suffering from
learning disabilities (Klassen, Tze, and Hannok, 2013). The rights ethical approach in this
case somewhere protect the centre’s manager and allow John to provide his consensus to the
centre’s manager about removing his transportation facilities. However, this is not accepted
by the parents of John because they know that how they can handle the health issue of John
and aware about the situation of John. As it is clearly mention that people with learning
disabilities can enjoy the same freedom and equity that other people does in the country and
they have right to choose what is best for them. In the above conditions, John is 26 years old
and mature enough to take his decision but he must include his family members before
making any decisions (Lewis, 2014). As per the family point of view, it has been found that it
is the responsibility of both John and Centre’s manager to inform the parents of John about
his request and ask them to clarify the reason to left bus facilities from John. Getting an
environment right and healthy for the learning-disabled people is an essential part of
healthcare organisation and it is essential for the organisation to provide best services to the
patient rather than lacking in providing quality services (Johnson, et. al., 2010). In the above
case, the responsibility of healthcare organisation was somehow questionable because the
manager should first take the consent of John and his parents both in legal and written form
and then after take the assessment decision from the top healthcare professionals in the centre
(Büttner and Hasselhorn, 2011). It is really essential for parents as well to care about the
safety and security of their son even the son is adult in the case but chances of harm or danger
with a learning disabled patient always be high. It is noticeable that safety and security with a
learning-disabled people is the first need and the person must have avail the self-advocacy
and advocacy services to stay safe and secure (Gillespie and Graham, 2014).

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The virtue theory of ethics considers that judges a person from his charater rather than his
action. In such a case, John should not be allowed to make decision because he was not in
sound mind conditions. It is also considerable in the case that John must ensure his parents
about his decision if he was in sound mind condition and take the decision according to his
own consensus and sound mind. The other ethical consideration of the case is related to
parents of John where they have to fulfil their responsibility towards John and provide him
adequate facilities and care (Büttner and Hasselhorn, 2011). It has been seen that client with
serious learning disabilities have severe issues related to their decision making process and in
such situation, they need so much care and protection from the healthcare organisation
(McLeskey and Waldron, 2011). As the parents of John were so worried about the situation
of John, it shows mental situation of people are not good enough. In the condition of John,
the parents and manager of the centre should work and take the decision with consent of John
as well. It will definitely help the John to convince him that walking alone on the road may
be dangerous for him and he should use the bus even he feel better (Emerson, Baines,
Allerton and Welch, 2011).
In conclusion, the parents of the John somewhere responsible to take care of John and the
must consult to the healthcare centre when john request them to remove the transportation. It
was also considerable that they are fully aware about the health conditions of John and they
should care for him and providing them safety and security to take him to the centre. As an
ethical concern for the parents, it can be said that people in the family are equal responsible
for care and support to a learning-disabled person. However, sometimes the ethical behaviour
in both family and healthcare organisation can be compromised under some critical or
pressure situation but all the people should avoid the personal benefit or financial gain from
commercialising the care services in the care centre. The parents and care centre both should
ensure the best care facilities possible to the patient. The role of John is also crucial in this
case because as per the laws, he has full rights to give his consent or think about himself, but
the centre’s manager must have to consider the conditions of John and should inform his
parents before taken off the transport facilities. This is really a challenging situation for the
John because in such a mental condition, he needs to take suggestion of his family and must
tell him what he thinks and how he will manage his daily schedule. Therefore, at last it can be
concluded that the centre must contact with the parents of John and tell them about the
request of John.

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