Ethical Tensions Related to Social Workers’ Evaluation of Community-Dwelling Elders’ Decisional Capacity
Purpose
Participants
Clients Served
Analysis
Findings
Clinical Uncertainty
Factors Related to Clinical Uncertainty
Partial Cognitive Impairment
Mental Health Problems
Mental Health Problems Especially after [his wife] was placed…He was…more vague, depressed…needed to be coaxed to follow up with the doctor…There just seemed to be his lack of realization that it needed to be done. (T2, 0354-65)
Interplay of Health & Mental Health
Interplay of Health & Mental Health [It’s] more the depression…[She had] high to moderate [cognitive impairment] …had been… diagnosed with Alzheimer's…[She was] very depressed. (T6, 212)
Unclear Etiology
Pressure from Other Professionals
Ethical Tension Related to Clinical Uncertainty and Pressure
Reevaluate when Uncertain
Certainty related to Advocacy
Autonomy: I had this call..from the doctor.. threatening to not have him as a patient anymore..I had to..help her clean up her thinking a little bit. Because you can't do that; you can't just abandon the patient because they don't want to do what you want them to do. (T5, 0781-89).
Implications
Email: thealy@usm.maine.edu
Home Page: http://www.usm.maine.edu/~thealy