Responsibility to carers — an ethical dilemma

Abstract

The responsibility the health service owes to relatives who care for mentally ill patients is gradually being acknowledged. The Griffiths Report (1988) makes explicit both that families should care for their ill members and that the health service has a duty to provide some support. The new support for the family is more to enable them to be ‘better carers’ and to cope with the burdens of caring. One area of psychiatry where this support is a growth area is for relatives of people with schizophrenia. Research points to both the impact of some families on the career of the patient, including relapse rates, and the ways in which such negative impact can be reduced (Leff et al, 1989). This paper is concerned with the ethical issues involved in offering a service to relatives. The ethical dilemma of access to relatives is intimately related to the person at whom outcome is aimed.

The differences between health professionals in assessing levels of caregiver burden

“…Services in Britain are not patient orientated and many reasons are given for not involving relatives in the decision making process (Atkinson & Coia 1989). With the increasing emphasis on community care, once a client is discharged back into the community it is more likely that the person to whom the majority of the care provision will fall on is the relative.…”

Carers, the community and the White Paper

“…Consideration must also be given to ethical issues (Atkinson & Coia, 1989). Relatives' rights are rarely addressed but the rights of carers are not always congruent with the rights of the person with long term mental health problems.…”