Ethical Conflicts in the Management of Home Care: The Case Manager's Dilemma

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This book illustrates and analyzes the many ethical issues that face case managers who allocate and monitor services for frail older people at home. Ten case studies are presented, each of which is followed by at least two analytic commentaries by distinguished philosophers, attorneys, or other ethicists, as well as a brief reaction to both case and commentaries from an administrator of a large state-wide case management program.

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Overview

This book illustrates and analyzes the many ethical issues that face case managers who allocate and monitor services for frail older people at home. Ten case studies are presented, each of which is followed by at least two analytic commentaries by distinguished philosophers, attorneys, or other ethicists, as well as a brief reaction to both case and commentaries from an administrator of a large state-wide case management program.

Ten case studies illustrate & analyze ethical issues in allocating & monitoring home care services for the elderly.

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Product Details

  • ISBN-13: 9780826182203
  • Publisher: Springer Publishing Company, Incorporated
  • Publication date: 1/28/1993
  • Edition number: 1
  • Pages: 288

Table of Contents

Preface and Acknowledgments
Pt. I Introduction
Ch. 1 What Is Case Management, and Why Does It Raise Ethical Issues? 3
Ch. 2 Ethics and Case Management: Preliminary Results of an Empirical Study 7
Pt. II Cases and Commentaries
Ch. 3 About the Cases 29
Ch. 4 Risky Business: Who Decides on What Risks? 35
Use of Facts to Resolve Conflicts Between Beneficence and Autonomy 36
Risks and Choices: When Is Paternalism Justified? 45
Perspective From California 53
Ch. 5 You Wouldn't Leave a Five-Year-Old Alone: Care Plans That Do Right by Incompetent Clients 57
Beyond the Double Agent: Toward a Systemic Ethics of Case Management 59
Clinical Determination of Competency and Existential Advocacy 68
Perspective From Minnesota 76
Perspective From Oklahoma 79
Ch. 6 Life-Styles of the Not-So-Rich or Famous: Can Case Managers Serve the Truly Eccentric? 83
Case Managers and Eccentric Clients 85
The Burden of Beneficence 93
Tensions Between Person and Community 101
Perspective From Delaware 108
Ch. 7 Fault Lines: Boundaries of Abuse and Exploitation 111
Abused or Neglected Clients - or Abusive or Neglectful Service Systems? 113
Values and Perspectives on Abuse: Unspoken Influences on Ethical Reasoning 121
Perspective From Pennsylvania 128
Ch. 8 Final Placements: Home or Nursing Home? 131
Can the Case Manager Offer Placement in Good Conscience? 133
Death and the Case Manager 137
Perspective From Oregon 143
Ch. 9 Secrets: Confidentiality and Disclosure in Case Management 145
Uses and Abuses of Confidentiality 147
The Community Need to Know: Comments on a Secrecy Case 158
Perspective From Washington 164
Ch. 10 Bend or Snap: The Case Manager and the Rules 167
When Breaking May Be Keeping 168
Process of Legitimizing Rule Breaking 176
Perspective From Indiana 179
Ch. 11 Case Managers and Providers Should Be Friends: Turf and Control in Case-Managed Services 181
Strained Relationships: When Case Managers and Providers Conflict 183
Charting of Clear Solutions to Complex Problems 191
Perspective From Massachusetts 197
Ch. 12 Pride and Prejudice - and Preferences 205
When Is Being Equal Unfair? 206
View From the Law 215
Free to Be a Bigot 223
Ch. 13 Squeaky Wheels, Luck of the Draw, Clients in Waiting and Other Fairness Issues 233
Fairness and the Squeaking Wheel of (Mis)Fortune 235
Can Familial Caregiving Be Required? 239
Perspective From Wisconsin 245
Ch. 14 Conclusion: Toward an Ethic of Case Management 249
Contributors 263
Index 269
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