Human Rights and End-of-Life Care
Discuss about the Moral Sources and Emergent Ethical Theories.
The choice of scenario for this paper is a case in which a 33-year-old mother of a two-year-old boy named David, born in Australia is admitted to hospital with cancer. Having been at the hospital before, her situation has deteriorated, leading to being readmitted this time for pain management and the end of life patient care. She is initially from China, but has a permanent Australian residence permit; she is therefore treated as an Australian under the relevant laws when surrounded by various circumstances.
In working with Su Yi, it is important to note that she is separated from the child’s father and doesn’t want to involve him in the negotiations of custody in case of an eventuality. Her family is in Hong Kong, and her only supportive sister who lives in Australia wants to take her son back to stay with her parents in Hong Kong. Because of the situation, a social worker has been referred to support the family. Her sister and the social worker have however not met because of the difference in their timings at the hospital’s visiting hours. The only information the social worker has is that her sister intends to return David to stay with his grandparents in Hong Kong.
There are three ethical problems presented by this case.
David’s mother is critically ill and is put on an end of life patient care at the hospital, yet she doesn’t want to involve David’s father in the discussion of their son’s life in case her life comes to an end. She cites abusiveness and that he hasn’t bothered to see their son since their separation as her main reason.
- The second ethical problem presented by this case is that; David is an Australian yet his grandparents are from Hong Kong, and the suggestion by the aunt to send him back to stay with his grandparents in Hong Kong under such circumstances would pose a lot of legal and ethical challenges to the social worker under the Australian laws. According to Kennedy, Richards, and Leiman (2013), the social worker is obligated to contact the relevant authorities and include all the information surrounding the planned sending of the boy to Hong Kong, and the relationship between his parents. There is, however, no law that can be used by the Australian authorities that can compel Sun Yi’s sister to take care of the boy. That is despite having been supportive to the family, but the social worker is under obligation to initiate a conversation aimed at ensuring that the boy stays safe within the Australian soil (Kennedy, Richards and Leiman 2013).
- The third ethical issue presented by the case is Su Yi’s inability to speak on her own regarding the best way she would have wished to have her son taken care of in case of her death. Despite having shared her relationship story with the social worker, the social worker hasn’t had an opportunity to speak to David’s father or Su Yi’s sister on the matter. Therefore the social worker is in a dilemma since there is no one to corroborate Su Yi’s story. According to McAuliffe (2014), the social worker must collaborate with all the organizations and individuals likely to be affected by the case such as the family members, colleagues, and the relevant authorities on this matter before making a final recommendation.
Human rights: Australia is a member of the international community and is therefore bound by the international human rights laws (Steiner, Alston, and Goodman 2008). Hence all the seven treaties on human rights are as applicable in Australia as they are in China. The most applicable treaty to this case scenario is the International Covenant on Civil and Political Rights (ICCPR).
Article 6 – The right to life: The above section of the article explains and guards the sanctity of life. End of life however painful has been argued as an infringement of this section of the human rights laws by various human rights activists. End of life support is aimed at affording critically ill patient an opportunity to die without too much suffering. Doctors and medical practitioners from all over the world are under no obligation to prolong life; they can only save lives. Therefore the end of life care is a personal decision made by the patient under guidance by the relevant stakeholders including the social worker in this case. The only difference is that the social worker is more involved with the emotional support other than the medical assistance.
Legislative Implications in End-of-Life Care
The same chapter also talks about the child rights; it recognizes that every child has an inherent right to life. Therefore anything that is deemed to deny a child an opportunity to live a healthy life is considered abuse on the child’s human rights (Unicef, 1989). Therefore, while dealing with Su Yi, the social worker must recognize the rights of David. Such considerations may include life after the mother’s death concerning family ties, education, and healthcare.
Article 7 – Freedom from inhumane, cruel and degrading treatments. The end of life treatment may be deemed less cruel and degrading to Su Yi, but it is inhumane. It’s been argued as abuse on the sanctity of life. The chapter contravenes David’s rights to family. His only family has been put on the end of life support, despite being young; some of these experiences may live with him throughout his life. Therefore the social worker also needs to appeal to David’s emotions and create an environment of hope and not an assurance of eventual death of Su Yi.
Article 17 – Right to the respect of one’s private life. Su Yi’s private life is guarded by this section of the law. The social worker needs to be aware that any efforts to coarse her into staying with her sister’s son involuntarily would amount to an abuse of her right to privacy.
Article 18 – Freedom of thought, conscience, and religion. It can be assumed that being from Hong, she isn’t familiar with the children’s act and adoption laws. Therefore she cannot be prosecuted for suggesting that her sister’s son should be taken back to China. However, if she acted on her thought, then she would have infringed on David’s constitutional right as an Australian citizen by birth; and she would, therefore, be liable to prosecution for failing to follow due process.
The second human rights document which applies to this case is International Covenant on Economic, Social and Cultural Rights (ICESCR). The treaty in which Australia is a signatory has standard guidelines on the rights to life, education, health, and adequate living standards (Craven 1995). Therefore while dealing with Su Yi, the social worker must ensure that the conditions under which she spends her final days alive are humane, that he son’s future regarding education, standards of living are considered.
The convention is split into five parts: however only part one, two and three are essential to this case. While dealing with Su Yi’s family, it’s important to note that self-determination rights are a human rights provision. It is therefore advisable that Su Yi’s wishes be given the most critical consideration regarding the custody of his son. It is unclear though, whether she shares the same desires as he sister concerning sending David back to Hong Kong to go and live with her parents. The second part guards against racial, nationality, religious, political or opinion discrimination. The social worker, in this case, must be aware of the racial differences in this case; being from a foreign origin doesn’t make her any less than the indigenous Australians, and therefore she must get equal medical care within the facility as a human rights requirement. The social worker must determine whether her decision to accept an end of life care is racially instigated or a personal choice. That is because a previous study has shown that practitioner’s preferences for end of life differ, depending on race (Mebane, E. et al., 1999).
AASW Code of Ethics and End-of-Life Care
However, Volandes, A. et al., (2008) offers contradicting research. In their study, it was concluded that health illiteracy is the primary factor that contributes to the preference for the end of life care. Therefore in handling Su Yi, the social worker needs to be aware of such findings and ensure that they are not major contributing factors in this case (Kennedy, Richards, &Leiman 2016 ed.). Or else the same would be considered human rights infringements. The social worker must ensure that the patient is aware of the treatment she has been put under.
The legislation: The first act which influences the decision made in this case is the children, young people and their family’s act 1997. The Australian constitution defines a child or a young person as “anybody under the age of 18”, which is also the age guideline set by the international human rights commission (Kennedy, Richards, and Leiman, 2013). Anybody within this age bracket is exempted from certain decisions; for example, if David were 18, he would have a right to stop the end of life care administered on her mother. Therefore in this case; the decision rests upon Su Yi and the medical practitioners. The same act also provides. According to section 8 (3) of the statute, the child is also protected from leaving the country in the company of anyone other than legal guardians or parents (Kennedy, Richards, &Leiman 2016 ed.). Therefore. It would be important for the social worker to note, that, at the age of 2, David would not be allowed to travel to China in the company of none other than her mother.
The other legislative act relevant to this case the family act of 1977; which was later amended in December 2017 to increase its scope to cover both immigrants and indigenous Australians effectively. The law handles all issues related to the families of all Australians at both local and international levels. It, however, does not severe relationships between the immigrant families and the families from their home countries. The guidelines are clear on this case; since Australia allows dual citizenships, it would be advisable for the social worker to find out if Su Yi is a dual citizen; which would make David a dual citizen by her parent’s origin. However, the decision to choose which between China and Australia cannot be made until he turns 18.
The same act in section part III, division 1 explains the functions of the family as consultants. The law is critical to the case because the social worker through collaboration must be in a position to consult Su Yi’s family members. This has however not been possible since her only sister in Australia hasn’t been at the hospital at the time when the social worker is on duty. At the same time, David’s father hasn’t been available since their separation.
Ethical Theories and End-of-Life Care
AASW Code of ethics: the first section relevant to this section 3.1 “respect for persons.” This section is important to this case because there have been cases when those who are considered to be dying eventually are subjected to mistreatment. The social workers, in this case, should be the champion of the voice of hope. The second section relevant to this case is 3.2 “Social justice.” The social worker needs to ensure that Su Yi’s and family are treated fairly irrespective of their origin, race or financial status. My decision-making process will be based on the background information gained relatively through credible sources. The decisions would take into consideration the issues of race, the conditions of the patient and valuable relationships to make a decision deemed helpful to the child and for fostering lasting relationships among the family members for the sake of David.
Ethical theories: The ethical theories recommended for this case would be the “individual dimension theory” and are “essential dimension” theory. These two theories are interrelated. After identifying the participants in the first theory, the identification of the case principal is made in the second theory (Gray 2009). There are two people to consider in this case; that is David and his mother. A decision on what to do as a social worker mainly relies on this theory. The other parties to the case are secondary; therefore it would be considered that David lies at the center of all decision making in this case.
Policies: The most critical organizational policy relevant to this case is the policy of equal treatment. The kind of disease Su Yi is suffering from puts her in a disadvantaged position. There are cases where social workers have given preference to those suffering from treatable diseases at the expense of those suffering from terminal illnesses regarding service provision (Ife 2012). The policy, therefore, acts as a guideline and constant reminder that the organization would not tolerate any form of discrimination against its patients.
The first cause of action would be to ensure that David is protected from leaving the country in the company of anyone. The second cause of action would be to ensure that he is under an excellent child care facility. The reason for the former would be to eliminate the chances of him being flown out of the country by his aunt while the reason for the latter would encourage healthy mental and physical development of the child. I would consult with Su Yi’s sister on custody issues before submitting a final recommendation which would involve adoption among other options. I would also consult with colleagues, and other professionals on whether to contact David’s father and the legal and social ramifications of the action.
The viable causes of action would be beneficial to all the parties involved. It would be emotional relieving for Su Yi to know that her son is in good care at child care facility. The same may also help ease the physical pain. It would also be essential to avoid any form of future legal cases as a result of failing to contact David’s father before making any decisions. Ensuring that Su Yi’s son does not leave the country would help reduce the costs incurred in tracing him in case of such an incident. All these actions are aimed at protecting every part involved, legally, socially and economically.
There are also a few risks posed as a result of some of these actions. The first significant risk would be on David whose life may change for the worst should his father come back to his life and prove to be abusive. The other risk will be if her aunt opts to adopt him and prove to be unfit to be a mother. Therefore, irrespective of the decision taken, the child’s well being must be monitored at various time intervals for early intervention should the decision prove to be ineffective.
The main potential conflict between the social worker’s professional, personal values and the organization’s requirements are many and varied. In this case, a social worker may be emotionally involved with a patient; too much empathy may lead to a social worker advising the patient to consider their position on the issue of end of life care. For example, if the organization has succeeded in its recommendation on the end of life care and the social worker advises Su Yi otherwise, it would be considered a conflict between personal values and organizational requirements.
My decision to ensure that David is taken care of under the best child care environment is in accordance with article 7 of International Covenant on Civil and Political Rights (ICCPR), which states that every person is entitled to humane treatment, free from degradation or cruel treatment. The action would ensure that the child leaves and developed under the internationally accepted standards of life and is protected by the Australian laws.
The decision to shield the child from leaving the country is in according to section 8 (3) of the children, young persons and their families act which protects the child from leaving the country in the company of anyone other than legal guardians or parents (Kennedy, Richards, &Leiman 2016 ed.).
The viable causes of action would be beneficial to all the parties involved. It would be emotional relieving for Su Yi to know that her son is in good care at child care facility. The same may also help ease the physical pain. It would also be essential to avoid any form of future legal cases as a result of failing to contact David’s father before making any decisions. Ensuring that Su Yi’s son does not leave the country would help reduce the costs incurred in tracing him in case of such an incident. All these actions are aimed at protecting every part involved, legally, socially and economically.
Craven, M., 1995. The International Covenant on Economic, Social and Cultural Rights: a perspective on its development. Clarendon Press.
Gray, M., 2009. Moral sources and emergent ethical theories in social work. British Journal of Social Work, 40(6), pp.1794-1811.
Ife, J., 2012. Human rights and social work: Towards rights-based practice. Cambridge
University Press. Kennedy, R., Richards, J., and Leiman, T., 2013. Integrating human service law, ethics and practice. Oxford University Press.
McAuliffe, D., 2014. Interprofessional ethics: Collaboration in the social, health and human services. Cambridge University Press.
Mebane, E.W., Oman, R.F., Kroonen, L.T. and Goldstein, M.K., 1999. The Influence of Physician Race, Age, and Gender on Physician Attitudes Toward Advance Care Directives and Preferences for End?Of?Life Decision?Making. Journal of the American Geriatrics Society, 47(5), pp.579-591.
Steiner, H.J., Alston, P. and Goodman, R., 2008. International human rights in context: law, politics, morals: text and materials. Oxford University Press, USA Unicef, 1989. Convention on the Rights of the Child. Child labor, p.8..
Volandes, A.E., Paasche-Orlow, M., Gillick, M.R., Cook, E.F., Shaykevich, S., Abbo, E.D. and Lehmann, L., 2008. Health literacy not race predicts end-of-life care preferences. Journal of palliative medicine, 11(5), pp.754-762.
Order an Essay Now & Get These Features For Free:
Turnitin Report
Formatting
Title Page
Citation
Outline
