TY - JOUR
T1 - Autonomy and intellectual disability
T2 - The case of prevention of obesity in Prader-Willi syndrome
AU - Van Hooren, R. H.
AU - Widdershoven, G. A M
AU - Van Den Borne, H. W.
AU - Curfs, L. M G
PY - 2002/10/1
Y1 - 2002/10/1
N2 - Background. The policy concerning care for people with intellectual disability (ID) has developed from segregation via normalization towards integration and autonomy. Today, people with ID are seen as citizens who need to be supported to achieve a normal role in society. The aim of care is to optimize quality of life and promote self-determination. The promotion of autonomy for people with ID is not easy and gives rise to ethical dilemmas. Caregivers are regularly confronted with situations in which there is a conflict between providing good care and respecting the client's autonomy. This becomes evident in the case of prevention of obesity in people with Prader-Willi syndrome (PWS). Method. As part of a study about the ethical aspects of the prevention of obesity, in-depth qualitative interviews were conducted with the parents and professional caregivers of people with PWS. Results. In analysing interviews with parents and formal caregivers, the present authors found that the dichotomy between respecting autonomy and securing freedom of choice on the one hand, and paternalism on the other, is too crude to do justice to the process of care. The stories indicated that caregivers see other options and act in other ways than to intervene without taking into account the wishes of the individual with PWS. The present authors elaborated these options, taking models of the physician-patient relationship as a heuristic starting point. They extended the logic of these models by focusing on the character of the process of interaction between caregiver and care receiver, and on the emotional aspects of the interactions. Conclusion. This approach results in more attention to processes of interpretation, deliberation and joint learning.
AB - Background. The policy concerning care for people with intellectual disability (ID) has developed from segregation via normalization towards integration and autonomy. Today, people with ID are seen as citizens who need to be supported to achieve a normal role in society. The aim of care is to optimize quality of life and promote self-determination. The promotion of autonomy for people with ID is not easy and gives rise to ethical dilemmas. Caregivers are regularly confronted with situations in which there is a conflict between providing good care and respecting the client's autonomy. This becomes evident in the case of prevention of obesity in people with Prader-Willi syndrome (PWS). Method. As part of a study about the ethical aspects of the prevention of obesity, in-depth qualitative interviews were conducted with the parents and professional caregivers of people with PWS. Results. In analysing interviews with parents and formal caregivers, the present authors found that the dichotomy between respecting autonomy and securing freedom of choice on the one hand, and paternalism on the other, is too crude to do justice to the process of care. The stories indicated that caregivers see other options and act in other ways than to intervene without taking into account the wishes of the individual with PWS. The present authors elaborated these options, taking models of the physician-patient relationship as a heuristic starting point. They extended the logic of these models by focusing on the character of the process of interaction between caregiver and care receiver, and on the emotional aspects of the interactions. Conclusion. This approach results in more attention to processes of interpretation, deliberation and joint learning.
KW - Autonomy
KW - Deliberation
KW - Ethics
KW - Interpretation
KW - Joint learning
KW - Prader-Willi syndrome
UR - http://www.scopus.com/inward/record.url?scp=0036775553&partnerID=8YFLogxK
U2 - https://doi.org/10.1046/j.1365-2788.2002.00426.x
DO - https://doi.org/10.1046/j.1365-2788.2002.00426.x
M3 - Article
C2 - 12354312
SN - 0964-2633
VL - 46
SP - 560
EP - 568
JO - Journal of intellectual disability research
JF - Journal of intellectual disability research
IS - 7
ER -