on consent...

I've recently started a new semester at university, I am taking 2 classes and a practicum. My practicum is at Delta View Life Enrichment Centre, an extended care facility for people with dementia. I intend to do a Child Welfare specialization with my degree, qualifying me to work for the provincial Ministry of Children and Family Development as a designated child protection worker. My degree requires 2 practicums, one at the 3rd year level, and one at the 4th yr level. For me, because I've chosen the specialization, the 4th year practicum will be in an MCFD setting. Thus, I decided my 3rd year practicum would be about broadening my experience of social work as a career. However, I'm finding that there are a lot of connections between gerontological social work and child welfare social work. Both client groups experience ageism. Both groups are considered to lack capacity to consent, to be autonomous and to determine the course of their own lives. Both experience powerlessness that is institutionalized.

I'm finding that social work with patients who have dementia is filled with ethical dilemmas. And I'm finding that these ethical dilemmas center around consent. If the client/patient (this is a medicalized setting, after all, the clients are primarily cared for by nurses and care aids) refuses to take his/her medication, do we (the care team, the institution, the government who makes the legislation) have the right to force that client to take the medication that is prolonging their life? Can we lie to a patient, give them their heart pill and say it's for pain? If they need pain meds, but refuse the pills, do we have the doctor prescribe a 'patch' and put it on the client without his/her informed consent? Basically, although it'd be easier, and in the clients' best interests, we don't have the right. We don't get to say what's in their 'best interest' because that is something that can only be determined by the client, him/herself.

So, with this new flash of insight into consent, I've been reading the forums on the Radical Unschooling Network and Sandra Dodd's Unschooling site. I'm able to see all of this from a new point of view, and it's easier for me to 'get it', whereas before I struggled and I judged myself as somehow lacking as a parent and a woman because I couldn't see myself as able to 'measure up' to unschooling standards.

Of course, there's still more understanding and "aha!" moments to come before I can see myself as able to cope with the radical unschooling lifestyle 100%, but I fell that I'm taking a significant step in that direction. And for the last 4 months, I haven't seen that as being possible.

I'm finding myself engaging in ideas about consent and control in a very different way than I have in the past.