I have encountered two cases on placement that I felt an ethical dilemma present. The first instance was with a 45 patient in rehab who is living with cerebral palsy and tended to act in an aggressive manner when there were any changes in her daily routine. She had previously been cared for by her mother who is now 72 years old and feeling like she was unable to continue being her daughter’s carer. The dilemma was because the mother was afraid of her daughter’s reaction she asked the staff taking care of her daughter in rehab not to tell her she wasn’t coming home and that she would be moving into supported accommodation. So the medical and allied health professionals and her own mother were essentially leaving a competent woman out of her own discharge planning. I was really surprised they would follow the directions of the mother over the patient and this felt like a real ethical dilemma for me.

The second case was a 21 year old woman from South Korea who was visiting and travelling around Australia on a holiday with her boyfriend. They were involved in a case accident and the boyfriend did not survive. The patient had significant injuries and was in a coma for a few weeks but survived the accident. Her mother flew to Australia to help her daughter with her recovery. When she woke from the coma the mother asked the staff not to tell her daughter that her boyfriend had not survived the accident. Her reasoning was that she didn’t think her daughter was strong enough to deal with the truth and even though I am sure she knows her daughter, is it ethical to lie to the patient when they ask specifically about where her boyfriend is.

While as a student I had no control or say in these cases it has made me realise there are ethical dilemmas all the time and there is not always a cut and dry answer. There are also other members of multi-disciplinary teams who are involved in the decision making process for the patients. All I can do is look to supervision and AASW to follow guidelines and be ethical in my own practice.