The ethical dilemma discussed in the article by Bannerman, Sheldon, Sherman, and Harchik (1990) focuses on people with disabilities and their liberties associated with their health conditions. On the one hand, the exercise of personal choices by patients seems to be their inherent right. In its turn, the option of patients poses the threat of hindering habilitation. On the other hand, service providers often select their clients’ habilitation goals and activities without clarifying them with them, which gives a raise to ethical concerns associated with abridging their choices. In order to better understand the identified dilemma, it is essential to define the concept of habilitation.
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Bannerman et al. (1990) regard it as teaching the skills that are critical to living independently to the extent one’s health is pertinent. People with developmental disorders often encounter problems in using as many napkins as they want or eating food they like, and the key question is whether they should be provided with free will or not.
Personally, my reaction to the described ethical dilemma was ambiguous since I was confused by the potential solution. At the same time, I was surprised by the number of cases noted in the article, which show that this topic is of great interest to health practitioners and researchers. Critically examining the article, I learned that there are both advantages and disadvantages of offering patients their liberties. For example, one of the key arguments that support the right to choice refers to the fact that legislation guarantees it. This right is provided by the government to all people regardless of their developmental abilities to protect their individual preferences.
The most important argument that opposes the right to select is that such people can make negative actions, for instance, while walking independently, they may damage their body due to a lack of leisure skills.
The awareness of a person that she or he can make a choice is likely to lead to better treatment outcomes. I agree with Bannerman et al. (1990), who claim that children who are given intervention options are more likely to memorize words or recall events, and, accordingly, their performances improve. In my future professional setting, I can apply the findings of this article to better navigate through ethical dilemmas faced by patients with disabilities.
For example, it seems to be significant to educate the staff on the positive impact of some extent of choice provided to patients. It is evident that liberties can be limited by the abilities of a particular patient, yet there are always some alternatives that can be considered. Among others, one may note offering alternative opportunities for regular meals and snacks, which may improve appetite and increase motivation to their own health.
The promotion of both the right to choice and the right to habilitation is the best solution that I can implement in my professional area. First, I will stress the role of teaching the functional skills to patients to ensure that they have a set of strategies to control their selections. Second, the preferences of clients regarding the skills they need should be taken into account by nurses who will educate them. Third, the prevention of inappropriate behaviors will be achieved by instructing patients how to choose, so that they can be aware of the consequences. Thus, the integration of both sides of the dilemma is the most relevant solution, which I plan to use in my future practice.
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Bannerman, D. J., Sheldon, J.B., Sherman, J.A., & Harchik, A.E. (1990). Balancing the right to habilitation with the right to personal liberties: The rights of people with developmental disabilities to eat too many doughnuts and take a nap. Journal of Applied Behavior Analysis, 23, 79-89.