Ethical dilemmas in Habilitation

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What potential social work dilemmas exist in habilitation? One of the biggest ethical issues that might occur is not respecting the dignity and worth of the person. In working with individuals with intellectual challenges, those who have not worked in the field may have preconceived ideas about the abilities of a person we serve. Without realizing it, we may make decisions without consulting the person we are making them about! When I started my internship, Grace (my field supervisor) gave me a journal article titled  Balancing the right to habilitation with the right to personal liberties: the rights of people with developmental disabilities to eat too many doughnuts and take a nap (Bannerman, Sheldon, Shermak, and Harchik, 1990). This was an eye opening article about what a great responsibility habilitation professionals have in honoring the choices of our clients. We're often the choosers of goals and activities, the makers of schedules. How do we balance the right of our clients to make choices, with the need for them to learn life skills they may not be inclined to learn. The choices we often take for granted are relished by those with intellectual disabilities because oftentimes they're not given the option to make these basic choices. Further with habilitation, if a client is not given the choice of what goals they pursue, how will they be inclined to want to work towards it. If the goal is supposed to be independent living, how are do we expect them to make choices if they're never given the opportunity. One example of this involves creating strategies to accomplish goals for habilitation. How do you brush your teeth? Do you wet the toothbrush first or put the toothpaste on straight away? If you do wet it, do you use cold or warm water? What toothpaste do you use? Did you choose it? Did you choose the toothbrush? All of these are choices that we pretty much take for granted. When it was mentioned in the article, I know I had to think about how I actually brushed my teeth. 
      If our goal is to ultimately help our clients accomplish these skills with the intent to have them live independently, it would behoove us to listen to their choices and weigh them with the teaching the importance of responsibilities and duties. However, if our goal is to have goal sheets with  neat data, then we may not be inclined to be concerned with such. As social workers, we are ethically bound to respect the choices and self-determinism for our clients. We must seek to honor their choices as much as we can.

 This journal article corresponds with Competency 1.1: Make ethical decisions by applying the standards of the NASW COE..

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