Analysis of Fostering Dignity and Respect: A Case Study Report

This report presents a case study concerning Sarah and Daniel, individuals with learning disabilities, whose marriage was hindered by local adult social care services due to concerns about their capacity. The study examines the ethical principles violated, including beneficence, non-maleficence, autonomy, justice, human rights, duty of care, duty of candour, privacy, and respect. It also explores the use of effective communication and interpersonal skills that could have fostered greater dignity and respect for the couple. The report highlights the importance of ethical conduct, fair treatment, and the right to make personal decisions, particularly within the context of social care. It also reflects on the impact of the case on individual learning and development, emphasizing the need for ethical awareness and improved communication practices to protect the rights and dignity of individuals with disabilities.

FOSTERING
DIGNITY AND
RESPECT

Table of Contents
INTRODUCTION...........................................................................................................................1
Case Study...................................................................................................................................1
Question 1. Principles of ethics affected in the case study.........................................................1
Question 2 Effective communication and interpersonal skills that could have been employed
to support greater dignity and respect.........................................................................................4
Question 3 Examination and reflection of impact of this case upon you, your practice,
individual learning and development..........................................................................................5
CONCLUSION................................................................................................................................7
REFERENCES................................................................................................................................8

INTRODUCTION
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.
Case Study
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
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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
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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.
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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
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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.
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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 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
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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.
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 manner.
CONCLUSION
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.
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REFERENCES
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