Warning: health ‘choices’ can kill

Flynn, Margaret; Keywood, Kirsty; Fovargue, Sara

doi:10.1108/14668203200300005

Cited by 8 publications

(14 citation statements)

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“…However, worryingly, there are reports of instances where duty of care has been allowed to be jeopardized as carers believed the person's 'choice' to be more important (Flynn et al 2003). In one instance Flynn reports that a GP was concerned about a conflict between choice and duty of care, sought guidance from the Medical Defence Union and was warned not to intervene (Flynn et al 2003, p. 32).…”

Section: Duty Of Carementioning

confidence: 93%

“…It may become the most frequently chosen option and eventually lead to serious consequences. In practice, for people with learning disabilities, there is growing evidence that this could well be the case (Bannerman et al 1990;Bechtel & Schreck 2003;Bell & Bhate 1992;Flynn et al 2003;Jenkinson 1993;Kelly et al 1986;Messent et al 1999a,b;Rodgers 1998). It is perhaps particularly important to recognize the risk of such harmful consequences for a person with learning disabilities.…”

Section: Choice For People With Learning Disabilitiesmentioning

confidence: 96%

“…Many researchers point out that although choice should be provided for people with learning disabilities, this cannot override the professional duty of care (Flynn et al 2003;Morgan 2000). However, worryingly, there are reports of instances where duty of care has been allowed to be jeopardized as carers believed the person's 'choice' to be more important (Flynn et al 2003).…”

Section: Duty Of Carementioning

confidence: 98%

“…less promising of future wellbeing or possibly with fatal consequences). She suggests ways to advise as to what the person's own best interests are, how to learn about health and how to do this gradually for optimum effect (Flynn et al 2003). Also, teaching selfregulatory skills such as expressing preferences, reading nutrition labels and self-recording calories consumed may be helpful in promoting healthy food choice (Bechtel & Schreck 2003).…”

Section: Ability To Teachmentioning

confidence: 99%

“…In one instance Flynn reports that a GP was concerned about a conflict between choice and duty of care, sought guidance from the Medical Defence Union and was warned not to intervene (Flynn et al 2003, p. 32). This zealous concern for the protection of civil liberties could well result in the harm of vulnerable individuals (Flynn et al 2003). It is when the ramifications of a choice are mistakenly believed to have been understood by the person with learning disabilities that choice can really become a dangerous issue.…”

Section: Duty Of Carementioning

confidence: 99%

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From biscuits to boyfriends: the ramifications of choice for people with learning disabilities

Smyth¹,

Bell²

2006

Br J Learning Disab

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Accessible summary• Choosing can be easy, such as when deciding what biscuit to eat.• Sometimes it is hard to choose, such as deciding on who to have as a boyfriend or girlfriend.• Sometimes even choosing a biscuit can be hard if your doctor says it is not healthy for you.• There are lots of reasons why we choose to do things.• Everyone needs to think about these reasons to help people with learning disabilities make good choices. SummaryChoice plays an important role in a person's quality of life. This paper looks at the issue of choice for people with learning disabilities. It considers the extent to which people with learning disabilities are able to choose and are provided with real choices. It also covers the extent to which true choice may or may not be advantageous for some people with learning disabilities. By concentrating particularly on the issue of choice about food and diet, this paper indicates how seemingly simplistic choices, such as decisions over food consumed, can cause major health problems for the decision-maker and hence be a more complex and vital decision than at times it is perceived to be. Additionally, this paper focuses on important factors surrounding choice for people with learning disabilities that previous research may have overlooked. One such factor is how past experience affects the decision-making process. Another, is the issue of the range of choice that is possible, relative to a person's cognitive ability to be fully aware of this range. In particular, this paper emphasizes the important role of the carer. It addresses the impact which the carer's own, perhaps unconscious personal choices, beliefs and ideologies may have on the 'choices' made by people with learning disabilities, and more worryingly, on the 'choices' offered to them. This paper highlights problems with current research into the area of choice for people with learning disabilities and provides suggestions for future study.

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Section: Duty Of Carementioning

confidence: 93%

Section: Choice For People With Learning Disabilitiesmentioning

confidence: 96%

Section: Duty Of Carementioning

confidence: 98%

Section: Ability To Teachmentioning

confidence: 99%

Section: Duty Of Carementioning

confidence: 99%

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From biscuits to boyfriends: the ramifications of choice for people with learning disabilities

Smyth¹,

Bell²

2006

Br J Learning Disab

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Autonomy, Liberty, and Medical Decision-Making

Coggon

Miola

2011

C.L.J.

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A central tenet to much ethical argument within medical law is patient autonomy.1 Although we have seen a welcome move away from a system governed by largely unchecked paternalism, there is not universal agreement on the direction in which medical law should advance.2 Competing concerns for greater welfare and individual freedom, complicated by an overarching commitment to value-pluralism, make this a tricky area of policy-development.3 Furthermore, there are distinct understandings of, and justifications for, different conceptions of autonomy.4 In this paper, we argue that in response to these issues, there has been a failure by the courts properly to distinguish political concepts of liberty and moral concepts of autonomy.

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Derogation of “duty of care” in favour of “choice”?

Gill

Fazil

2013

The Jnl of Adult Protection

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Purpose -Chronic health conditions such as obesity and type 2 diabetes are higher in individuals with learning disabilities and significantly affect both quality of life and longevity. Healthy eating is an important factor in preventing these chronic conditions. The study reported here explored the role paid carers played in promoting healthy eating and how they managed the daily dilemma of balancing residents' right to make unhealthy food choices against carers' "duty of care". Design/methodology/approach -Semi-structured interviews were undertaken with a purposive sample of six residential paid carers. Interviews were transcribed and then analysed using a thematic approach.Findings -This small study highlights the challenges that staff face when balancing food choice against "duty of care". It highlights that when working with less able residents, carers are motivated by "best interests", to place boundaries and restrictions on food access and choice. It confirms previous studies that increased levels of choice for higher ability residents, often results in less healthy food choices. The study describes a lack of policy, guidance and specific training for paid carers which results in them using their personal subjective values as a basis for decision making. Originality/value -Since the publication of "Valuing People" (Department of Health, 2001) the core principles of residential services changed direction towards independence and choice. This study expands our knowledge on how paid carers make sense of the everyday conflicts between choice and "duty of care" when residents continue to make unhealthy food choices affecting their physical health.

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Warning: health ‘choices’ can kill

Cited by 8 publications

References 1 publication

From biscuits to boyfriends: the ramifications of choice for people with learning disabilities

From biscuits to boyfriends: the ramifications of choice for people with learning disabilities

Autonomy, Liberty, and Medical Decision-Making

Derogation of “duty of care” in favour of “choice”?

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