Autonomy Vs. Paternalism In Mental Health Treatment
The assignment for this Ethics class was to review Mr. Jacob's treatment, as described by the New York State Commission on Quality of Care for the
Mentally disabled (1994). The class was further asked to comment on the major issues for each of the three perspectives. The agencies, family and review board were to be included. This student will begin with a fourth perspective; that of Mr. Gordon.
In the Matter of Jacob Gordon (1994), is the story of the last eight years of a psychiatrically disabled man's life. Mr. Gordon appeared to vacillate between striving for autonomy and accepting the support of his family.
Unfortunately, it appeared by this account that the families support was not synonymous with autonomy. It did not appear that Mr. Gordon had ever desired or sought agency intervention for himself. Mr. Gordon's association with the mental health system appeared to be marked by power and control issues.
"Consumers/ex-patients often report a feeling of "invisibility"; they sense that their views and desires do not matter (Carling, 1995, p.79 )."
The commission's report (1995) spoke of several incidences where Mr. Gordon eluded to his desire for autonomy. Mr. Gordon did not wish to live in a supervised setting. Mr. Gordon did not wish to attend group day treatment settings. Mr. Gordon did not wish to use medication in the treatment of his mental health disorder. Without medication his behavior was deemed unacceptable and did not permit him the opportunity to have any of these choices. "Choice is a right-not a privilege to be afforded by good behavior (Penny, 1994, p. 29)."
Mr. Gordon's right of choice was limited even though he lived in his apartment independently. The condition of his apartment was scrutinized. His medication was closely monitored; sometimes to the degree that he was directed to leave his home to receive medication that was given to him crushed, in an attempt to insure it's ingestion. "Even peoples liberties in a highly controlled board and care home may be scarcely greater than in a hospital ward (Rubenstien, 1994,
p.54)." In Mr. Gordon's case even within the sanctity of his own home, his liberties were scarcely greater than in a hospital ward.
Other than his autonomy the second issue for Mr. Gordon appears to be the need for safety and suppor...
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"Of two things you can be certain; death and taxes," quoted Benjamin Franklin. Having a humorous outlook on life, Franklin tried to make others' lives better. Benjamin was a man who served others and tried to make the world its best until his death. Benjamin Franklin had many accomplishments. He had a busy and eventful life, he played a major role in defending his country, and he was known for his quotes. Franklin was always working to make something better.
The field of clinical mental health is one of great reward, but also one of grave responsibility. It is the duty of the counselor to provide the client with a safe environment and an open mind, in order to foster a healthy therapeutic relationship. The majority of mental health counselors would never intentionally harm their clients; however; good intentions are not enough to ensure that wrong will not occur. The ethical expectations and boundaries are regulated by both laws and professional codes. When discussing ethics, one must realize there are two categories, mandatory and aspirational. (Corey, Corey & Callanan, 2007)
Everyone is a traveler, carefully choosing which roads to follow on the map of life. There is never a straight path that leaves one with but a single direction in which to head. Robert Frost’s “The Road Not Taken'; can be interpreted in many different ways. The shade of light in which the reader sees the poem depends upon her past, present, and the attitude with which she looks toward her future. In any case however, this poem clearly demonstrates Frost’s belief that it is the road that one chooses that makes him the man he is.
One of his important virtues was humility. It was simply stated: “Imitate Jesus and Socrates.” From the beginning of Franklin’s life, when he went to grammar school he was always interested in learning. His father took him from grammar school and his next move was to be an apprentice to his brother as a printer. With undying love for knowledge he continued to learn how to read and write well. “From a child I was fond of reading, and all the little money that came into my hands was ever laid out in books” (Franklin 13). He continually got books from other print shops and stores to read on the side of working. One of the writings that touched him the most was the Socratic dialogue that he read in the back of a grammar book that he borrowed. He continued his research on Socrates, and therefore the Socratic method became a driving force in his beliefs. That is why he states that we should ‘Imitate Jesus and Socrates’. Their views must have some basis in common in order for him to look up to them that much.
Benjamin Franklin was raised as a Presbyterian by his parents. Although not completely religious some of the teachings stayed on with him. “I never was without some religious principles; I never doubted, for instance, the existence of the deity, that he made the world, and govern’d it by his providence; that the most acceptable service of God was the doing good to man; that our souls are immortal; and that all crime will be punished and Virtue reworded either here or hereafter; these I esteem’d the essentials of every religion, and being to be found in all the religions we had in out country I respected them all” (BF, p65). Franklin later also goes on to say that he did not go to sermons on Sunday that often because that day was his day to study and relax, but when he did go he noticed that all sermons that he was listening to were rather “dry” as he put it and seemed to focus more on being a good citizen and not a person instead. These two instances in from Franklin show were he was coming from when he decided to create his list of virtues that would lead him to moral perfection.
On October 31, 1963, President Kennedy signed the Community Mental Health Act into law with the aim to change the delivery method of mental health care (National Council for Behavioral Health, 2013). The primary aim was to release the mentally ill from institutions and allow them to successfully integrate into functional members of society. In an effort to achieve this goal, delivery of care would be a coordination of effort from a network of outpatient clinics, community services, partial hospitalizations, and when needed emergency services. The funding for these services was to be from a combination of government, private programs and self-pay sources. However, due to the recent recession government sources reduced funds available for mental health services (Thomas). This economic reality coupled with an already fragmented health care system has left mental ill vulnerable. Patients that fall into the cracks in the system often end up in homeless shelters, jails/prisons or the morgue (Szabo, 2012).
Many people face obstacles every day of their lives, but when it comes to getting assistance around these obstacles many people do not have a way to do that. A client for human services will put up their own barriers to avoid having to deal with asking for assistance and until they work through some of those barriers they are not going to be able to get the assistance they need. Some of the barriers that they face include not having money to pay for the services, not having transportation to get to the place where the services are provided, and not having time to be able to travel to receive the services (Woodside & McClam, 2015). Clients in the United States are not the only ones facing these barriers it is happening worldwide
Although about 450 million people in the world currently are suffering from a mental illness, many untreated, the topic still remains taboo in modern society (Mental Health). For years, people with mental illnesses have been shut away or institutionalized, and despite cultural progression in many areas, mental illnesses are still shamed and rarely brought to light outside of the psychiatric community. The many different forms in which mental illness can occur are incredibly prevalent in the world today, and there is a substantial debate about the way that they should be handled. Some people are of the opinion that mental illness is merely a variance in perception and that it either can be fixed through therapy or should not be treated at all, and that treatment can have negative side effects. Other groups of people believe that mental illness is a very serious affliction and should be treated as a disease through a combination of counselling and medication because people suffering from an untreated mental illness are a danger to themselves and society as a whole. This debate is a popular one, discussed everywhere from the medical field to the dinner table, and it is such because of the numerous lives it affects on the well-being of fellow members of society and the economy. People suffering from mental illnesses are afflicted with anything from delusions, to manic periods, to periods of deep emotional darkness due to experiences and brain chemistry (Johnson). Due to the negative effects untreated mental illness has been proven to have on the human well-being and society as a whole, medication should most certainly be seen as a valid and sometimes necessary way to treat those who suffer from mental illnesses.
In 2003 President Bush’s created the, New Freedom Commission on Mental Health which outlines a plan to move forward in increasing early intervention and screening for children and adolescents. The report suggests that no one body or organization is charge of mental health care of children and adolescents. However schools and teachers are in the best position to provide support to young people because of the consistent exposure teachers have with their students. The report also suggests that because one’s mental health is so tightly intertwined with one’s educational success, that teachers play a vital role in identifying warning signs and linking students to services (Hogan et al., 2003, p. 58). These school based services have the potential to reach more vulnerable and potentially underserved populations with better opportunities to engage parents and the community in services. In order to provide optimum services, care, and proper interventions in schools things like stigma attached to receiving mental health services need to be addressed as well for students to feel comfortable obtaining care. The other necessity is also providing the teachers and counselors in schools the proper training and support based on evidenced based practices (Mills et al. 2006, p.155).
In conclusion, offenders are who they are now by nurture. Although some factors of criminals with biological influences make them more likely to commit crime. However, it can clearly be seen that family and media plays a big role in influencing criminal behaviour in this era where it was proven that when violent acts are frequently observed or thought, it will increase the risk factor on normal people and even more on people with aggressive genes to commit a crime. Therefore, it can be clearly seen that the nurture of the offender outweighs their nature to commit deviant crimes.
When contemplating the vastness of social policies that could benefit from advocacy for policy change and a thoughtful, responsive audience, there is one topic that situates itself to the forefront of the list of policies needing major reform. This topic is that of health care resources available to those coping with mental health concerns. Though this population faces a variety of challenges such as housing/ homelessness, employment/ training opportunities and educational attainment to suggest a few, each challenge cycles into the next, effecting one another, disturbing how an individual can cope medically. Health care rights for those with mental health concerns bubbled to the public consciousness around with the acknowledgement of “serious
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The lives of Jacob Moore and Gordon Gekko soon intertwine in ways one wouldn’t expect. True colours of both men are shown in the battle for power and revenge and both Gekko and Moore realise that time is precious commodity. Will greed and ambition rule the decisions these men take? Will Jacob Moore continue living the American dream?
Ethical issues are common in the field of mental health, and so mental health counselors rely heavily on sound ethical decision-making to navigate difficult decisions that affect the client’s wellbeing, law, and the counselor’s own liability. Using ethical decision-making models, counselors can make better decisions, however, there are situations where other factors outside of the counselor’s control can influence these decisions. These factors can include the education and experience of the counselor as well as their current emotions. The purpose of this study is to investigate the effects of emotions, both positive and negative, on ethical decisions.
Mental health has been hidden behind a curtain of stigma and discrimination for a long time. Suffering, burden, and magnitude in terms of disability and costs to individuals, families, and societies are overwhelming. The world has become more aware of the enormous burden and potential that exists to make progress in mental health. We really need to invest substantially more in mental health and we must do so now. In the United States, government health insurance plans exist for eligible patients with these disorders, although they sometimes do not cover everything patients need.