Short Sample Answer
Ethical Decision Making in Health and Social Care Practice
Section 1: Introduction
Case Study 1
Case Study 1 involves a 34-year-old patient, Daniel, who is admitted to an acute psychiatric ward following a severe episode of psychosis linked to schizophrenia. Daniel has been intermittently refusing antipsychotic medication, stating that he believes the staff are attempting to harm him. Nursing staff report escalating agitation and episodes of verbal aggression, although no physical violence has occurred. The treating team is divided, with some professionals believing that medication should be administered under mental health legislation due to risk of deterioration, while others argue that Daniel should be supported through therapeutic engagement until he voluntarily consents to treatment. The situation raises concerns regarding capacity, autonomy, and the use of coercive treatment within mental health care.
Case Study 2
Case Study 2 involves Sarah, a 17-year-old who has disclosed to a school counsellor that she is experiencing physical abuse at home from a parent. Sarah explicitly requests that social services are not informed, as she fears family breakdown and further harm if her disclosure becomes known. The counsellor is legally required to consider safeguarding procedures but is also aware of Sarah’s wishes for confidentiality. Social workers are uncertain whether to intervene immediately or attempt continued engagement to encourage voluntary disclosure. The case raises ethical tensions between safeguarding duties, confidentiality, autonomy, and the welfare of a vulnerable young person potentially at risk of ongoing harm.
Ethical Issues and Dilemmas
Both case studies present ethical dilemmas involving conflict between autonomy, protection from harm, and professional duty of care. In Case 1, the central tension lies between respecting Daniel’s autonomy and ensuring his safety through possible compulsory treatment. In Case 2, the ethical conflict centres on confidentiality versus safeguarding obligations for a minor at risk of abuse.
A key similarity is that both cases involve individuals with reduced or complex decision-making contexts, where professionals must assess risk and capacity while balancing ethical principles. However, the differences lie in legal frameworks and immediacy of risk. Mental health legislation may permit compulsory treatment in Case 1, whereas safeguarding law in Case 2 prioritises protection even when confidentiality is requested.
Both cases require careful ethical reasoning, but Case 1 focuses more on clinical autonomy and treatment necessity, while Case 2 emphasises protection of a vulnerable minor within a family system.