Case Study Analysis: Autonomy vs. Paternalism

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Case Study Analysis
Social workers’ role mainly involves providing aid to vulnerable people to help them cope with the various challenges they are facing in their lives. These challenges social workers help the community with vary and may help an individual cope with substance abuse, a family with a child battling a terminal illness, or the elderly in the hospice receiving palliative care. These are serious matters that truly affect people’s lives, so the right approach and analysis must be made to provide the best aid and care to help the clients cope and improve from their current state. In this paper, an analysis of the case concerning Guiseppe Marchesani will be discussed in detail, including ethical issues, ethical theories, and skills applicable to the given scenario.
The case involves an older man named Guiseppe Marchesani, living alone ever since his wife died five years ago. There was a report from a concerned neighbor about the deteriorating functional and mobility skills of Mr. Guiseppe, and upon the visit to his home, the report was confirmed, and there are already issues with the independent living situation of Mr. Guiseppe which may cause harm to his wellbeing. Mr. Guiseppe has an intense cough, which may be due to his chronic smoking habits. He also demonstrates impairments such as hearing difficulties and increased risk of falls. He can also not perform daily living activities such as washing the dishes and keeping the house sanitary. Mr. Guiseppe's safety is at risk because, at his current state, even old heating machines and repairs in the house may cause him harm.
Autonomy vs. Paternalism
The ethical issue applicable to Mr. Guiseppe's case is autonomy versus paternalism (Bowles et al., 2006). There are already signs that Mr. Guiseppe cannot live independently and that special attention and care are needed to address his health issues and deteriorating functional status. Although it is also evident that help is needed to ensure Mr. Guiseppe’s safety, he does not see it that way and prefers to be left alone. The ethical issue here arises because, as the social worker who witnessed the house's scenario, there is a social responsibility to prevent any harm to Mr. Guiseppe because of his current state. However, acting on this social responsibility and paternalism will interfere with Mr. Guiseppe's freedom, control, and autonomy over himself, particularly in deciding his welfare.
Ethical Theories
The presence of ethical theories provides a foundation for decision-making, especially when the dilemma is present. These theories help broaden the perspective on the situation with careful consideration of the different aspects involved and the factors that may be affected by each possible decision. The case of Mr. Guiseppe will be viewed and analyzed through ethical lenses to help with ethical decision-making. Analysis of the involved's ethical decision-making, specifically the social worker and the local resident/neighbor, will be discussed.
Deontological
In this ethical theory, the duties and obligations are prioritized and are deemed as positive and ethical. In our given case of Mr. Guiseppe, as a social worker, my duty will be to prioritize Mr. Guiseppe's safety and wellbeing, mainly because, based on my visit, there may be a danger with his current living situation (Chakrabarty & Bass, 2015). There are many advantages to this ethical theory, and it also gets the goals done, but a flaw of this theory is its possible conflict with a person’s duty. For Mr. Guiseppe's case, a social worker also should respect the autonomy of an individual, which can become a conflict and depend on whether what the individual himself chooses. If I choose that I have to respect my clients' autonomy, this will decide to choose Mr. Guiseppe's autonomy as an ethical decision despite the possible consequences.
From the perspective of the concerned neighbor who called for social worker services, the ethical decision to make is to inform the appropriate organization that may address Mr. Guiseppe's issues. As a resident with the duty of looking out for other people's welfare in the community, the neighbor should promote Mr. Guiseppe's safety and welfare.
Consequentialism
The consequentialist theory focuses on the result of a decision. The outcome dictates whether it is good or not depending on the reaped benefits and if it was more than any harm or risk has been done (Bowles et al., 2006). In Mr. Guiseppe's case, the ethical decision based on the consequentialism ethical theory will be choosing paternalism, which will somehow disregard the autonomy of Mr. Guiseppe about wanting to live independently alone in his house. This will have more benefits than risks because it will promote Mr. Guiseppe's health and wellness by providing him with proper assistance in his own home and promoting social activities. This will also address the safety concerns with Mr. Guiseppe’s decreased functional mobility, high risk of falls, and hearing impairment while also preventing possible casualties.
The consequentialist ethical theory is also applicable to the resident/neighbor's case, who thinks that the benefits of having the social worker check Mr. Guiseppe’s current condition outweigh not doing anything.
Virtue
The virtue ethical theory, unlike the previous ones discussed, focuses on the individual’s character. In this theory, the action itself will not be the principal basis of judgment, but instead, it will be the person’s reputation, taking his known morals and motivation into consideration (Chakrabarty & Bass, 2015). As the social worker assigned to Mr. Guiseppe’s case, the dilemma regarding the ethical decision to make about autonomy versus paternalism will be based on what other people and my company think of me as an individual and social worker. If I have a good record without any history of immoral behavior and wrongful acts towards clients and co-workers, then whichever decision I choose to make will be seen as ethical. Others will also try to make their reasoning as to why I chose a confident decision, rationalizing that the motivation behind the decision is moral and for Mr. Guiseppe’s best interest. This theory does not consider any possible moral changes that I might have undergone, which may cause faulty ethical reasoning, which then affects my decision-making regarding Mr. Guiseppe's case. On the neighbor's decision-making, the virtue ethical theory applies to depend on the reputation of the neighbor and his/her possible motivation. If the neighbor has a good reputation, telling social services about Mr. Guiseppe will be seen as an act of kindness and concern for the older man's wellbeing.
An inclusive model of decision-making
Step 1: Defining the ethical dilemma
As mentioned previously, the dilemma in Mr. Guiseppe's case involves autonomy versus paternalism because guiding principles are needed to make an ethical decision and a possible approach in this specific scenario. Aside from this dilemma, other considerations need to be seen, such as the culture and language difference due to Mr. Guiseppe’s inability to speak English and my own inability to understand and speak other languages aside from English.
After determining the dilemma, I will also assess where I stand in this dilemma, especially my main goal and duty to Mr. Guiseppe’s case as a social worker. Although I have my own set of knowledge regarding the situation, I will also consult possible people who may help. The communication barrier is also a problem because it prevents the formation of rapport and trust, which may promote better outcome, so aside from the ethical dilemma itself, this ba...