Ethical Decision Making and Consumer
Directed Care
Have You Thought About It?
Angie Robinson
November 2013

Aim:
- Provide an overview of the issues facing case managers and consumers
- Raise awareness of the importance of our own value base and influence in practice
- Provide an overview of principles to guide ethical decision making
- Provide a framework for practice

Acknowledge
National Code of Ethics for Case Management developed by the Case Management Society of
Australia (2013)

Ethical decision making in consumer directed care – so what?
• Have we considered this as an inherent part of our practice?
• Do our staff understand what it is?
• Are they able to translate the principles into practice?
• Have we even had the conversation?

When I raise this issue –
What are the first responses do you think I receive?

Concepts of:-
- Choice
- Control
- Balanced Relationships
- Choice
- Citizenship
- Focus on strengths
- Transparency
"Is it that easy to translate into practice?”

What is ethical decision making?
• Making right or good choices and the reasons we give for our choices and actions
• Acting professionally and with integrity
• Values, principles, practice and conduct
• Standards of behaviour

What ethical decision making isn't?
• Not the same as feelings
• Not religion
• Not always following the law
• Not following culturally acceptable norms
• Not science

Why is it a challenge in practice?
• Self-interest
• Boundaries
• Acting out of judgement and conflicts in values
• Doing what is standardly done

Why is it a challenge in practice?
• Conflicts of interest
• Understanding self determination
• Understanding who is the consumer
• Recalcitrant people

Staying true to the intent of CDC and consumer choice and control?
• The right to be a citizen
• The right to be independent
• The right to a quality of life
• Human rights

Understanding our own value base:-
• Am I making decisions for the consumer?
• When do I transfer my values and judgement ?
• Am I listening to the consumer or someone else?
• What is ethical for the consumer?

Principle's to guide decisions and practice?
• Positive obligation and contributing to the welfare of others (beneficence)
• Act so as to do no harm (non malfeasance)
• Promoting justice and fairness (social justice)
• Respect for autonomy (Autonomy)
CMSA 2013

Other principles to guide decisions and practice?
• Common good
• Confidentiality
• Respecting dignity of human beings
• Disclose information that people have a right to

Principles to guide decisions and practice cont.:-
• Respect diversity
• Inclusiveness
• Transparency
• Stewardship

A framework for practice?
asking a should question?
trying to determine the right course of action?
Am I feeling uncomfortable?
Are values and beliefs involved?

A framework for practice?
• Recognise the issue
• Think before you act: –
- Am I making assumptions?
- What are the facts?
• Decide on a course of action
• Test your decision:-
- Review the ethical question?

A framework for practice?
• Implement the course of action and monitor progress
• Share learning's
• Skills of our staff

The importance of having an ongoing conversation and practice reflection…

“ Ethics is knowing the difference between what you have a right to do and what is right to do.”
Potter Stewart

arobinson@integratedliving.org.au