Evaluating self‐determination: an adult protection case study
| DOI | https://doi.org/10.1108/14668203200100002 |
| Date | 01 February 2001 |
| Published date | 01 February 2001 |
| Pages | 4-14 |
| Author | Michael Preston‐Shoot |
| Subject Matter | Health & social care,Sociology |
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4© Pavilion Publishing (Brighton) Limited The Journal of Adult Protection Volume 3 Issue 1 • February 2001
Introduction
Self-determination is invariably regarded as a core social
work value. Not surprisingly, therefore, it features strongly
in the literature on elder abuse. Indeed, practitioners are
castigated for any tendency to want to rescue victims from
abusive situations rather than to assist them to disclose their
concerns in their own way and to make their own choices
(Pritchard, 2000).
Penhale (1993) asserts that it can be difficult for
professionals, often holding strong protective instincts, to
accept that older people have the right to refuse assessment
and intervention. She does, however, allow an exception,
when an individual is either at very grave risk or severely
mentally impaired. Hargreaves and Hughes (1996) note
that older people are adults and that their rights to self-
determination, including the right to refuse intervention,
therefore demands a different framework from that applied
to children. They comment that some professionals appear to
view self-determination as more of an inconvenience than a
right. However, can the case for protection be so summarily
dismissed?
A clear tension exists between protection and self-
determination, paternalism and autonomy (SSI, 1993).
Equally, a danger exists that values talk can become disguised
as factual discourse and used to justify action when it should
only inform (Cheetham, 1989). The purpose of this article is
to review whether self-determination has been overly inflated
or privileged in theory and practice concerning elder abuse
cases. How might the balance between protection and self-
determination, between individual freedom and professional
intervention be calibrated? Two case studies, drawn from
research on the effectiveness of one set of inter-agency
Evaluating
self-determination: an adult
protection case study Michael Preston-Shoot
Professor of Social Work and Social Care,
Liverpool John Moores University
key words
self-determination
values
consent
elder abuse
abstract
Self-determination is widely
regarded as a core social work value
and as central to work in adult
protection. However, it is not
unproblematic and raises difficult
questions about how to balance
empowerment and protection,
or rights and risks. Inter-agency
procedures and the recent
publication of policy guidance may
reflect these difficult questions
rather than assist practitioners
and managers to resolve practice
dilemmas they encounter.
Policy
discussion
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