As a leader in an assisted living or a residential care facility, you are responsible for a portion of each resident’s life, primarily their safety. Living on their own, residents may have struggled with medications, falls, home maintenance, navigating daily tasks, or tracking and completing financial responsibilities. While most residents only struggle with one or two of these issues at a time, some struggle with all of them.
Your facility, and facilities like yours, are there to promote independence and fill in where the ability to be independent has slipped away. Maintaining independence and self-determination is a unique benefit of assisted living and residential care, which is not always preserved in other care environments. But in the face of a world-wide pandemic, this benefit can place facility leaders and regulators in a situation where resident rights and independence may have to be evaluated and modified for the good of everyone who live and works in the facility. As the leader you have to make this decision.
Rights vs Responsibility
Residents have the right to leave their facilities despite the fact that most States across the nation are under a shelter in place mandate. If your resident was living in their own home, they could choose to leave their home for any number of reasons, essential or not. Whether they leave their home or leave your facility they could return with Covid 19. If the resident contracts Covid 19 and they live with family members, they will infect them upon their return. If they return infected to your facility, the chances are great that they will infect staff and other residents. While you are not responsible for people who live in their own homes or with their families, as the leader of your facility you are responsible for the resident who left and re-entered the facility sick AND subsequently everyone else who becomes infected.
Rights, Responsibility, Regulations
In addition to being responsible for the individuals who live and work in your facility, you are required to adhere to rules and regulations. Your highest priority right now is to minimize resident exposure to Covid19 by restricting facility foot traffic. Only essential personnel and services should be entering and exiting your facility. Regulators are watching your day-to-day operations to make sure your organizational integrity is not compromised during this pandemic. Yet resident’s have individual rights and their advocates are insisting that they are able to exercise their rights and actions of self-determination despite putting others in the facility at risk.
The Role of Ethics
So who is right? You as the organizational leader charged to protect some of our populations most vulnerable? Or the resident and their advocate? Its really an ethical decision, one founded in either duty or consequence. The philosophy of consequentialist ethics is rooted in actions or decisions taken as good or bad. The philosophy of deontological (duty) ethics is rooted in what is right. In the current climate, regulators are operating off of the deontological philosophy. They have constructed and enforce laws that require you as a leader to protect everyone in your facility, it is your duty. Resident advocates are operating from the consequentialist philosophy. They believe that preventing a resident from entering and exiting the facility when they want to is bad for their individual rights because you have taken or restricted their rights.
I am not sure there is a right answer to this conundrum because it can be justified from both positions. Neither decision is free from the risk of a life altering outcome. However, I do believe at the time when you are required to justify your decision, intent may be the key to defending it.
What are your thoughts about this ethical dilemma and others you are facing? Share them with us by email at email@example.com or leave us a comment on our Facebook or LinkedIn page under this blog.