Opinion
LEARNING DISABILITY PRACTICE 11April 2009 | Volume 12 | Number 3
HarrisonPhotography
Applied or normative ethics is a branch
of philosophy that includes righteousness,
rules of conduct, virtues and one's
responsibilities in actions, thinking,
behaviours and relating with others.
ethics is extremely important in working
in a practice or caring capacity, or in
undertaking research with learning disabled
people, because it can offer guidance on
what ought to be done in certain situations.
Actions by professionals and carers
should be of benefit to the client; a
principle known as beneficence. This
principle is associated with medical ethics
(Beauchamp and Childress 2001), but has
equal importance to learning disability care.
Beneficence should be considered at practice
level, for example: do care interventions,
therapies or programmes benefit clients?
A related principle to beneficence is
non-maleficence, which is the principle that
an action should not cause harm. in the
past, admission to a large hospital would
have been considered beneficial to the
individual, however, we now know that long-
term stays in such institutions can lead to
over-dependence and institutional neurosis.
Autonomy
respect for autonomy is another
important principle. A person with
a learning disability should have the
autonomy to make life choices as any
other person of a similar age can. But,
they also need to be empowered to make
choices and a key role of a practitioner/
carer is empowering individuals and
groups to make choices.
empowerment is a noble aspiration
that can lead to increased autonomy.
But it should be kept in mind that,
sometimes, when one group or individual
is empowered, another is disempowered.
Another problem with autonomy is that
sometimes the choices that a person makes
might not be in their best interests.
Informed consent
A key principle within autonomy is
`informed consent' to treatment or therapy.
Some suggest that the `informed' aspect
of consent is not within the cognitive
ability of all learning disabled people.
Nevertheless, most people can make
choices about consent if the facts are
explained to them at the appropriate level
of understanding. For those with limited
verbal communication we should look for
inferred agreement based on their non-
verbal communication and behaviours. it
could be argued that it is unethical not to
obtain consent from those with the least
communication skills because not to do so
results in enforced treatment.
An ethical `virtues' approach has
particular relevance to how carers and
practitioners interact and relate to learning
disabled people. Virtues incorporate
principles such as being truthful with
clients, compassion, caring, respecting
others, fairness and justice, accepting
others and treating people as equals.
Those who care for people with
learning disabilities should engage in
practice that is beneficial and
non-maleficent. learning disabled people
should be empowered to make life
choices, even if at times this means they
make mistakes. No one should be exposed
to care or treatment they do not consent
to and carers should be guided in their
practice by ethical virtues that show
respect for clients as human beings.
Eamonn Slevin is a reader at the Nursing
Research Institute and School of Nursing,
University of Ulster
Reference
Beauchamp T, Childress J (2001) Principles of Biomedical Ethics.
oxford University press, oxford.
The importance
of ethics
It is vital for people working in practice
and caring capacities to understand
how ethics affect their everyday lives,
argues Eamonn Slevin
Those who care for people with learning disabilities should
engage in practice that is beneficial and non-maleficent

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