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Saturday, 17 December 2011

Decisions, decisions...

Elizabeth McClung and I have been having a conversation via comment on my essay "Get Up" (from my 2006 book "Run, Run Because You Can"), which I recently posted last week. It's got me thinking about decisions. Specifically, it's got me thinking about how everyone has the right to make bad decisions.

Elizabeth Said:


"Trying 10 times and failing might mean setback right?

I can't stop thinking about the complicit attitude and acts of visitors, nurses, and others in keeping this man who wanted to not be in a wheelchair to force him to be there.....for his own good (determined by others).

You wrote that your safety when climbing a mountain is not assured. So why did you get to climb and he got locked down against his will? Without further information I don't know but it doesn't amuse me or delight me, it makes me alternate between nausea and anger, as it seems a recorded discrimination based on age, not on will."

I always appreciate Elizabeth's feedback, because she often helps me to view things in different ways. I'd never viewed the story in the way she suggested. I'd always assumed that the staff had what they considered a good reason for keeping this gentleman from leaving, which was obviously what he wanted to do. Her comments made me start to think about what I would I would have done as this man's worker if he was person with an intellectual disability.

What Would I Have Done?


It's difficult to say, truthfully, because there's a lot of information that I don't have. Perhaps, like I was right after my stroke, he was confused about the new limitations on his body and didn't realize that he couldn't walk anymore.  Perhaps he had severe dementia and didn't even realize where he was. Perhaps he was simply too ill to go home and didn't want to accept it.

I realized after thinking about this that I really don't know much about the policies for keeping someone in the hospital who doesn't have awareness of how ill he or she is. If there are psychiatric factors associated with the person's diagnosis, then the doctor may choose to keep him or her in the hospital on that basis.  This man may also have had a power of attorney making decisions for him. Or he may have been waiting for transfer to a physiotherapy unit. I had to wait awhile.

But, assuming that none of these were variables, did the hospital really have a right to keep him in when he'd so strongly expressed a preference to leave? Plenty of people without disabilities choose, for a variety of reasons (some of them not-so-logical)  to leave hospitals against medical advice.

The Right to Make Bad Decisions


I'd need someone who works in a hospital to answer me for sure. And I know that on some days I certainly wished I could "save" the people I worked with from making decisions that I knew were going to make life infinitely harder for them, especially if I couldn't understand why they were making those decisions. But making decisions for people wasn't my role, ever, and I would never want it to be.  It wouldn't be fair of me to say, "This is better." I just tried to present options, emphasizing that the choice was the person's.

Everyone's allowed to make bad decisions, no matter how much we wish they wouldn't. I hope that if I'd been this man's worker, I'd have fought for his right to make the decisions he wanted, even if they were ones with which I didn't agree.

And I certainly would have had a conversation with the staff about the belt restraint on the wheelchair. Restraints should *always* be a last resort.

Thank you for the conversation, Elizabeth. I always enjoy talking with you.

Check out Elizabeth's blog at http://elizabethmcclung.blogspot.com/

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