Autonomy vs. Paternalism in Mental Health Treatment
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
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
References: Atkinson, J. (1991). Autonomy and mental health. In P. Barker & S. Baldwin (Eds.), Ethical issues in mental health (pp.103-125) P.J. (1995). Quality of Care for the Mentally Disabled, (1995). Press. Sundram, C.J. (1994).