All work involves (or ought to involve) some ethical complexity, although this occurs less in some jobs than others. An ethically simple job would be the sale of lawful and non-harmful goods. The salesman is employed to sell, and receives payment to do so. The ethical requirement, therefore, is to meet the terms of his contract with his employer, which usually involves the aim of maximising sales. However, a conflicting ethical demand could arise if the salesman suspects that a customer does not need or cannot afford the product he has persuaded him to buy. The salesman may resolve this dilemma by telling himself that the customer is exercising free choice. This is more convincing if the salesman has taken the trouble to explain the full costs and features of the product. This is now often required by law, as a means of protecting consumers who would otherwise be ‘mis-sold’ products.
At the opposite end of the ethical complexity scale are occupations such as medicine, which require the frequent resolution by individual practitioners of multiple and often conflicting ethical demands. This has generated the academic discipline of medical ethics, to investigate these conflicts and propose rules for their resolution. But similar degrees of ethical complexity can occur in much poorer-paid and less well-trained occupations. For instance, support workers in residential care for people with cognitive impairments face ethical dilemmas on a daily basis. Do they allow their clients to take the kind of risks acceptable for almost all people, or do they protect them from potential harm? In more practical terms, do they allow a client who has no sense of direction and no awareness of the danger of motor vehicles to walk out into the street alone, or do they let them out only if they are accompanied by a member of staff or other responsible person? Should the staff allow a client to eat what they want, even if this results in gross obesity, or do they restrict their access to food? Do they allow a client to repeatedly hit their head against a wall, or do they restrain their limbs and insist they wear a protective helmet?
Faced by these dilemmas, support staff (and the public at large) usually favour exercising a ‘duty of care’, to protect those with severe cognitive impairments from exploitation and harm. Duties of care are most commonly experienced in the way in which we deal with children and people who are ill. It is not surprising, therefore, that some staff talk of their clients as if they are children rather than adults, or sick people rather than disabled and healthy. This is not sign of incompetence or malevolence, but a way of dealing with the real psychological stress involved between treating such a person severe cognitive impairments as an autonomous adult (as specified in numerous policy statements), while at the same time carrying out tasks that emphasise constantly their very lack of autonomy.
At the opposite end of the ethical complexity scale are occupations such as medicine, which require the frequent resolution by individual practitioners of multiple and often conflicting ethical demands. This has generated the academic discipline of medical ethics, to investigate these conflicts and propose rules for their resolution. But similar degrees of ethical complexity can occur in much poorer-paid and less well-trained occupations. For instance, support workers in residential care for people with cognitive impairments face ethical dilemmas on a daily basis. Do they allow their clients to take the kind of risks acceptable for almost all people, or do they protect them from potential harm? In more practical terms, do they allow a client who has no sense of direction and no awareness of the danger of motor vehicles to walk out into the street alone, or do they let them out only if they are accompanied by a member of staff or other responsible person? Should the staff allow a client to eat what they want, even if this results in gross obesity, or do they restrict their access to food? Do they allow a client to repeatedly hit their head against a wall, or do they restrain their limbs and insist they wear a protective helmet?
Faced by these dilemmas, support staff (and the public at large) usually favour exercising a ‘duty of care’, to protect those with severe cognitive impairments from exploitation and harm. Duties of care are most commonly experienced in the way in which we deal with children and people who are ill. It is not surprising, therefore, that some staff talk of their clients as if they are children rather than adults, or sick people rather than disabled and healthy. This is not sign of incompetence or malevolence, but a way of dealing with the real psychological stress involved between treating such a person severe cognitive impairments as an autonomous adult (as specified in numerous policy statements), while at the same time carrying out tasks that emphasise constantly their very lack of autonomy.
