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Practical Ethics for Protective Services Christopher Dubble, MSW Assistant Director of Training Temple University Harrisburg November 30, 2020
Practical Ethics for Protective Services
Christopher Dubble, MSWAssistant Director of TrainingTemple University Harrisburg
November 30, 2020
DisclaimerThe National Adult Maltreatment Reporting System (NAMRS) and the Adult Protective Services Technical Assistance Resource Center (APS TARC) are a project of the U.S. Administration for Community Living, Administration on Aging, Department of Health and Human Services, administered by the WRMA, Inc. Contractor’s findings, conclusions, and points of view do not necessarily represent U.S. Administration for Community Living, Administration on Aging, Department of Health and Human Services official policy.
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About the APS TARCThe mission of the APS TARC is to enhance the effectiveness of state APS programs by:Supporting federal, state, and local partners’ use of data and analytics, Applying research and evaluation to practice, andEncouraging the use of innovative practices and strategies.
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Peer to Peer Calls
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Have you ever wished that you could tap into the expertise of other APS workers, supervisors or state administrators who are struggling with the same issues and concerns that you deal with daily? The APS TARC provides Peer to Peer calls for workers, supervisors and managers/state administrators.
Workers’ Call: The 2nd Wednesday of each month
Supervisors’ Call: The 3rd Wednesday of each month
Administrators’/Managers’ Call: The 4th Wednesday of each month
Register via the link sent out at the end of each month by the APS TARC or email us in order to receive the registration link!
APS & COVID-19https://apstarc.acl.gov/Information-Research/COVID-19.aspx
• Resource Information• Federal brief addressing:Personal SafetyContinuity of Operations
• Summary of State Program and Policy Responses to COVID-19
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Housekeeping• Handouts/Slides are available for download in the
"Handouts" section of your webinar control panel. You may download them at any time.
• Please use your computer speakers to access audio for this webinar. Please make sure the speaker volume is adjusted to your desired volume.
• If you experience audio problems due to internet connection speeds or hardware issues, we recommend exiting the webinar and re-entering.
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Housekeeping• You may ask questions of our presenter at any time by
typing them in the "Questions" box. We will relay as many as we can to the speaker when we pause for questions.
• This webinar is being recorded and all registrants will receive an email when the recording is made available on the APS TARC website.
• All attendees will receive an automatically generated email approximately 24 hours after the webinar ends with a link to a certificate of attendance.
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Quick Attendee PollWhich of the following do you identify the most with?Adult Protective Services ProfessionalOther Social Services ProfessionalMedical ProfessionalLegal ProfessionalOther
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Our Speaker
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Chris DubbleAssistant DirectorTemple University Harrisburg
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Practical Ethics for Protective ServicesChristopher Dubble, MSWAssistant Director for Training
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My Introduction to Protective Services
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“I killed the guy last night!”
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Important Definitions in Ethics
• Ethics
• Morality
• Laws, regulations, and policies
• Professional ethics
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Types of Ethical Issues
• Ethical dilemmas
• Ethical breaches
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Types of Ethical Issues
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Types of Ethical Issues
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Types of Ethical Issues
• Ethical dilemmas
• Ethical breaches
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Ethical Principles
• Nonmaleficence - Obligation to not cause harm
• Beneficence - Obligation to do good and remove harm
• Autonomy - Obligation to respect an individual’s right to decide, act and experience the consequences of their actions
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Ethical Principles
• Justice - Obligation to provide equal treatment for all individuals, by acting in a fair, equitable and just manner and avoiding discrimination in judgment and actions
• Veracity - Obligation to be accurate and truthful
• Fidelity - Obligation to serve the well-being and best interests of an individual without divided loyalties
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Ethical Principles – Bio-medical
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Ethical Principles – Bio-medical
• Justice - Obligation to provide equal treatment for all individuals, by acting in a fair, equitable and just manner and avoiding discrimination in judgment and actions
• Veracity - Obligation to be accurate and truthful
• Fidelity - Obligation to serve the well-being and best interests of an individual without divided loyalties
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Ranking the Principles ExampleSmoking with Oxygen Away from Others Smoking with Oxygen Close to Others
Non-maleficence Non-maleficence
Autonomy Beneficence
Veracity Justice
Fidelity Veracity
Beneficence Autonomy
Justice Fidelity
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Ethical Situational Analysis• When confronting an ethical dilemma, principles are ranked
in order of importance based on the elements of the situation in order to arrive at the best ethical decision.
• The following components of a situation should be considered when ranking the principles:Risk indicationsPreferences of the adultQuality of lifeContextual factors
Adapted from: Mueller, Paul S., Hook, C. Christopher, and Fleming, Kevin C. (2004). Ethical Issues in Geriatrics: A Guide for Clinicians.
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Risk Indications• What is the issue causing the risk?
• What is the time nature of the issue (i.e. short-term, long-term, emergent)?
• What is the probability that the decision will successfully mitigate risk?
• What is the probability of the person being at greater risk from the decision?
• What is the risk to others from the situation?
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Risk Indications
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Risk Indications• What is the issue causing the risk?
• What is the time nature of the issue (i.e. short-term, long-term, emergent)?
• What is the probability that the decision will successfully mitigate risk?
• What is the probability of the person being at greater risk from the decision?
• What is the risk to others from the situation?
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Preferences of the Individual
• Does the person have decision-making capacity?
• If not, is the appropriate surrogate being utilized?
• What are the person’s stated preferences?
• Does the person and/or surrogate have sufficient information to make an informed decision?
• What is the history of the person’s preferences related to the issue?
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Preferences of the Individual
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Preferences of the Individual
• Does the person have decision-making capacity?
• If not, is the appropriate surrogate being utilized?
• What are the person’s stated preferences?
• Does the person and/or surrogate have sufficient information to make an informed decision?
• What is the history of the person’s preferences related to the issue?
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Quality of Life• What is the person’s definition of quality of life?
• What is the probability that the person can meet their definition of quality of life with the decision?
• What is the probability that the person can meet their definition of quality of life without the decision?
• What physical, mental and social deficits will the person experience as a result of the decision?
• What bias exists by professionals regarding whether the person’s current and potential future condition are desirable?
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Quality of Life
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Quality of Life• What is the person’s definition of quality of life?
• What is the probability that the person can meet their definition of quality of life with the decision?
• What is the probability that the person can meet their definition of quality of life without the decision?
• What physical, mental and social deficits will the person experience as a result of the decision?
• What bias exists by professionals regarding whether the person’s current and potential future condition are desirable?
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Contextual Factors• What are the family issues weighing on the decision?
• Are there financial and economic factors?
• What are the religious and cultural factors associated with the situation?
• Are there allocation or resource issues?
• How do applicable laws and regulations affect the decision?
• What conflicts of interest exist for the professionals involved in the decision making?
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Contextual Factors
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Contextual Factors• What are the family issues weighing on the decision?
• Are there financial and economic factors?
• What are the religious and cultural factors associated with the situation?
• Are there allocation or resource issues?
• How do applicable laws and regulations affect the decision?
• What conflicts of interest exist for the professionals involved in the decision making?
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Ethical Decision-Making Pitfalls• The #1 ethical decision-making pitfall is making an ethical decision alone.
The most dangerous and deadly ethical decisions are made alone.
• When addressing an ethical dilemma, agencies should: Give equal consideration to all stake-holders Not rush to judgement Have an accessible ethics committee Not allow authoritarian voices in the process Avoid trying “to fix” problems Be as transparent about the process as possible without violating
confidentiality
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ACL Recommendations• APS systems establish and adopt a set of ethical principles and
codify these in their policies and program manuals.
• APS systems require all employees to sign a code of ethics that includes, at a minimum, restrictive alternative, person-centered service, and supported decision-making.
• Training on ethics should be part of preservice training and ongoing staff education.
• The code of ethics should be reviewed with all staff on an annual basis
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Contact
Christopher Dubble
• Email: [email protected]
• Linkedin: www.linkedin.com/in/chris-dubble/
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Questions?
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