When Client Rights and Safety Concerns Collide: Ethical Considerations With Severely Mentally Ill or Intellectually or Developmentally Disabled Clients

Abstract

Many adults that are severely mentally ill or intellectually or developmentally disabled have state- or court-appointed guardians because they are unable to make sound and safe decisions regarding their lives because of impaired functionality or cognitive abilities. This article will use vignettes to illustrate the types of ethical and moral conflicts that can potentially arise between client and guardian and to discuss existing disconnects between basic human rights and issues regarding safety when clients are in service with a supported living agency. Ethical dilemmas abound when an individual makes assumptions and decisions regarding the lives of another, so where that line is or should be drawn can be a difficult one to conceptualize. This article will illustrate how acting as a client-centered agency may often go against the perceived “good” of the client, and who ultimately has the right to determine quality-of-life issues within the theoretical constructs of client-centered support.

Keywords:

• Ethical decision-making
• mentally ill
• developmentally disabled
• client-centered care
• autonomy
• quality of life