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Autonomy Vs. Paternalism In Mental Health Treatment
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| Term Paper Title | Autonomy Vs. Paternalism In Mental Health Treatment |
| # of Words | 2799 |
| # of Pages (250 words per page double spaced) | 11.2 |
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 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 support. For this, Mr. Gordon turned to his family. Th
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