Abusive Care and How to Avoid It
Moving from compliance to a deeply ethical operational ethos.
When the culture within a care setting turns sour, the risks to vulnerable individuals escalate dramatically. An environment where staff feel disempowered, undervalued, and operate under immense pressure without clear ethical guidance fosters conditions where poor practice occurs.
It is precisely here that a conscious and active application of ethical lenses becomes indispensable. It shifts the focus from mere compliance to the cultivation of a deeply ethical operational ethos.
Clark’s Eight Ethical Lenses
Within the Timian Programme, JL Academy uses an adapted version of Clark’s (2015) eight ethical perspectives. This offers a practical toolkit for dissecting workplace dilemmas.
Fairness
Decisions should be acceptable to all. In care, fairness challenges power imbalances that lead to abuse. It demands that interventions be scrutinised for equitable application.
Merit
Focusing on "demonstrated effort" encourages recognizing an individual’s intrinsic worth. It means valuing staff for skillful practice rather than blind compliance.
Markets
Is the exchange in the care relationship positive? Is the individual genuinely benefiting? Are their choices respected to reduce frustration?
Democracy
“No one should be subject to a regime in which they have no say.” We must actively involve individuals in their care plans to reduce imposed measures.
Well-being
Abuse is antithetical to well-being. This lens asks: do interventions genuinely enhance quality of life, or merely control behaviour for convenience?
Rights & Duties
The bedrock of safe care. Any restriction must be lawful, proportionate, and an absolute last resort. We have a duty not to violate others’ rights.
Character
Staff must cultivate virtues such as compassion, patience, and courage—the courage to challenge poor practice. Where expediency prevails, abuse increases.
Legacy
A service that relies on restrictive practices creates a damaging legacy. We must build services that contribute to a future where such outcomes are unthinkable.
The Collective Shield: Employees as Guardians
Sinkkonen and Laulainen (2019) assert the "unnoticed role of employees in ethical leadership." A genuine culture of safety is maintained by everyone.
- Early Warning Systems: Staff act as the conscience of the organisation.
- Challenging Restrictions: An ethically aware workforce advocates for less intrusive alternatives.
- Supportive Culture: Colleagues support each other, fostering openness rather than silence.