Assessment 2:Ethical Decision Making Paper

Task Description:

Students are to choose one person/character in the case study and write this assignment from the professional position of that person. Students are then to use ONE

ethical decision-making model from the literature provided to identify how they would determine the competing ethical dimensions or principles inherent in the case,

what professional positions and values are demonstrated by key stakeholders, what resources would be required to assist a decision-making process, what alternative

courses of action are available, and what decision should ultimately be made about what to do. Justification should be provided for the final decision. The assignment

should conclude with a personal reflection on the dynamics of interdisciplinary professional ethics. NB: This assignment should be written in first person.
7033HSV Interdisciplinary Ethics

Scenario One: The Good, the Bad, and the Seriously Illegal
Setting:
A hospital discharge meeting at an adolescent mental health inpatient unit
Client:
•   Jamie Robinson: 17yo Young person
Stakeholders:
•   Matt: Youthworker from local agency which manages multiple programs including accommodation, employment support, alternative education, social support
•   Detective Pierce: Officer from Child Protection Investigation Unit (CPIU)- plain clothes detective who works primarily with children and young people
•   Dr Bonne: Psychiatrist, registrar for the unit
•   Lucas: Mental health nurse
•   Pearson Reynolds: Lawyer from a youth legal service
•   Elspeth: Youth Justice caseworker
Matt’s chair creaked ominously as he shifted his bulk. He froze immediately and sat up straight. A week earlier, he had personally experienced the spectacular

collapse of one of the rickety hospital chairs and neither his ego nor his bruised tailbone was ready for a repeat performance. He rubbed his eyes and tried to focus

on Dr Bonne’s droning monotone.
“So, in conclusion, the patient was admitted in a state of acute drug-induced psychosis probably related to the continued use of amphetamines and alcohol. After 4

weeks in the Unit his psychotic symptoms have receded and he appears to have some symptoms of organic depression. He is generally personable with peers and staff,

although he can quickly escalate into angry outbursts and threats of violence if he perceives that he is being challenged. I believe that this represents an

underlying anti-social orientation, with an entrenched paranoid fixation…”
“Yes, but what does this mean for Jamie’s ongoing support? Is he likely to keep offending?” interrupted Elspeth. Matt had to admire her courage- it took some real

guts to interrupt a psychiatrist. However, the meeting had been going nowhere for more than an hour.
Dr Bonne fixed Elspeth with a cold glare and stated ”It is my medical opinion that Mr Robinson has no underlying mental health condition and we will not be

recommending any follow up treatment or services. This is clearly a social and behavioural condition linked to drug use.”
“But… but… you just said he had organic depression and… what’s it called- ‘anti-social orientation’ “ Elspeth stammered.
“These are not acute mental health conditions” Dr Bonne repeated with an air of authority.
“Look, can we just focus on the important things for a moment… young Jamie’s already facing half a dozen charges for stealing. Tomorrow he will be out of hospital and

back in the community. I need to make a decision about whether to proceed with a brief of evidence for the prosecutor. Does anything you have seen or heard here

impact on that decision?” offered Detective Pierce.
“From a medical perspective, there is no reason he cannot face the legal process” stated Dr Bonne.
Pearson Reynold’s snort of derision was heard around the room. “We’ll see… he’s obviously endured a lifetime of abuse and rejection, and all we are seeing is the

fruits of an ineffective and overloaded mental health system…”
Lucas chimed in with “I have worked with Jamie every day in the ward. He seems to be an easy going, intelligent young person who has got himself into a bad state with

drugs and crime. He hasn’t seen his parents for years. He was a bit closed at first but once he settled down he has made some friends and shown a real interest in

getting off the gear and back into school. We’ve already set all this up with Matt, I reckon our Jamie’s reached a real turning point.” Lucas favoured Matt with a

conspiratorial wink. “He’s even been showing off all his grandad’s war medals and antique coins. They seem to be the only things he values; god knows how he has

kept them safe all this time, considering he has been homeless and everything…” Lucas trailed off, obviously confronted by the sudden attention focused around the

room.
Matt knew why. He remembered the headlines in the local paper: “Digger’s Memory Desecrated by Cowardly Attack”. There had been a robbery- a home invasion- and an

elderly woman had been knocked to the ground when a group of young thieves ransacked her house, stealing money, food, and her deceased husband’s medals and coins. As

far as Matt knew, she was still in hospital.
The silence was broken by Detective Pierce. “I need to know exactly where the medals are and what he has said about them…”
“Just wait a moment… This isn’t the setting for a police investigation; we are here to look after this boy’s interests. Where will he be living tomorrow?” chipped in

Lucas.
“I need to speak to Jamie immediately, before this goes any further. Possession of the medals is not enough to lay charges, you know this Pierce…” boomed Pearson

Reynolds.
“He had almost finished his youth justice orders, he was home clear… this will put him away for years. He’s just turned 17; he’s in the adult system now. ” mumbled

Elspeth, shaking her head despondently.
“This has nothing to do with his mental health status, we need Mr Robinson discharged immediately so we can use the bed for another patient. This Unit is desperately

short of space…” said Dr Bonne, adding to the chaotic din now taking over the room.
Matt wiggled uncomfortably in his chair, no longer concerned about its structural integrity. Although no-one knew it, he held the key to what was about to happen.

You see, Jamie had presented at the youth service straight after the home invasion, agitated and with specks of blood on his clothes- clothes which, along with the

rest of Jamie’s possessions, were currently stored in a plastic bag in a locker back at the office. At the time, Matt hadn’t understood the big picture…
His thoughts were interrupted by a sudden splintering crash as Dr Bonne’s chair collapsed into shards of wood and fabric. “Thank god it wasn’t me this time…” thought

Matt.
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Scenario Two: Harm on the farm
Setting:
5 hours outside of Brisbane is the town of Bendoo, a rural population centre of about 7000 people. It is a “hub” for the surrounding farming communities with a

relatively large human services infrastructure.
Another hour from Bendoo is Tristam, a township with a smaller population (under 500) and no services except for a police station (with 2 full time officers) and a

state school which runs classes from years 1-10 (referred to as a “P10” school). Tristam services a huge geographical area of farms (broad acre crops, beef cattle,

timber, marijuana).
Another hour outside of Tristam- things start to get a little isolated. This is where the Jenkins family lives.
Clients:
The Jenkins family lives on a farm which has been in the family for 3 generations. Currently, their massive allotment is run by 3 brothers and their families who live

separately on different parts of the property.
•   Beth Jenkins: 16 years old, living at home, recently admitted to Bendoo Hospital after a minor road accident.
•   Bert and Doreen Jenkins: Beth’s mother and stepfather
•   Yoyo Deniz: Farmhand on the Jenkins property- known only as “Yoyo”, no-one knows his full name.
Stakeholders:
•   Kara: Nurse at the Bendoo Hospital, currently caring for Beth during her stay
•   Constable Lex Stable: Officer from the Tristam Police
•   Thom: High school teacher at the Tristam P10 State School
•   Lane: Support worker employed by Disability Services, visits the family as a support to Beth’s younger siblings (who have learning difficulties) and mother

(who is confined to a wheelchair due to a degenerative illness). As a Supports Coordinator, Lane’s role is to assist the family to access supports and services- but

there aren’t any out here so he just visits and offers direct support and advice.
• Meta: Child protection worker in Bendoo
Kara rubbed her eyes and tried to ignore the knot of pain in the base of her neck. Carefully keeping her voice level, she tried again to explain herself: “Yes, he is

expecting my call. We need to link him into a teleconference at the Bendoo Hospital. He knows about it and he said he would be available.”
She held the phone away from her ear as the tinny, shrill voice on the other end screamed “Lexxxxx, there’s someone on the phone from the hospital. She says you’re

expecting her…”
Constable Lex Stable came onto the phone with a gruff greeting and stated “I’ve only got half an hour, I have people coming up from the Stock Squad so I have to be

ready to take them out…”
“OK, we’ll get straight into it. I’m in a conference room at the Hospital with Lane from Disability Services and Meta from Child Safety. On the phone I’ve got Lex up

at Tristam police and Thom is on the other line from the school…this conference phone is a bit dodgy so please speak up and let us know if it fades out at any time.”
Kara cleared her throat. “Beth is ready to go home-her leg is fine. She has some stitches but the dressings are easy to change. However I am worried after some

things she told me yesterday…
When Beth was first admitted, she was asking me about sex and contraception. I had a long talk with her, and she told me she was in a sexual relationship with one of

the farm hands on the property, someone called “Yoyo”. Apparently they live in a shed off from the main house and it seems like it is a de-facto relationship. He’s

in his early 30s.
When I spoke to Beth further, she says she started staying with Yoyo when she was still 14. She remembers when he came to the farm because he was a good worker and

her stepfather really wanted to keep him at the farm. I get the impression there was a bit of wheeling and dealing between the two men…”
Meta spoke up. “We interviewed Beth yesterday and she confirmed that she is in a sexual relationship with Yoyo, and that it had been going for a few years. From her

point of view, she appears to be content with the relationship but it is really obvious that this bloke dominates her and treats her like some kind of sex toy…”
Lex piped up “Did she say that he knocks her around?”
Meta responded “She didn’t mention any domestic violence specifically… it is more the controlling behaviour- she has no money, no social contact outside of the family

system. However, we have an even bigger worry- she said a few times that it was ok because her stepfather ‘showed her how to please a man’ and said that she had been

in a sexual relationship with him as well.. probably for some years. She was really open about it at first. When we pressed her, she says that this stopped when she

started having sex with Yoyo…
About this time she clammed up and said she didn’t want to talk about it any more. She said she was happy, her family was happy, and it ‘had nothing to do with the

welfare or the coppers’. She said she would deny everything she had said if the police asked her any questions. She said no-one except her father knew about the past

and she was going to keep it that way. She also said that, if she was taken away from her family, she would just run straight back.”
“What about the rest of the family?” asked Lex.
Lane chipped in: “There are two younger brothers who have learning difficulties. The mother needs a lot of care but she is mentally ok. Beth has been ascertained as

having a minor intellectual impairment but it isn’t severe enough for her to get any extra services or funding. There is a grandmother on the farm who is well

respected in the community, she seems to make a lot of the big decisions for the family.”
Thom added “She hasn’t been at school for about 3 months and before that, it was a bit on-and-off. It’s a pity because she really seemed to love school and she was

showing a lot of promise in trade skills.”

“What are we going to do?” asked Kara.
“Well, our hands are tied” said Lex. “No complaint, no evidence, no chance of any charges against the farmhand or the stepfather. Her current relationship is legal,

even if it seems a bit off.”
“We’re in the same boat” responded Meta. “We could try to take a Child Protection Order but if she says she wants to be at home then we will find it very difficult to

take her into custody or to keep her in a foster placement.”
“Well I’m stuck” said Kara.
“You know, this is a pretty dark secret to have in a big family” said Thom. “I wonder what would happen if grandma knew about it… It would definitely shake things up

a bit.” His voice took on a conspiratorial tone. “It sounds like the kind of thing that might slip out when, say, a nurse was seeking health history from a family…”
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Scenario Three: Vicious Cycle
Setting:
A community counselling service run buy a local church.
Client:
• Spiro: 24 yo male, lives alone in the community; diagnosed with schizophrenia in his late teens; a member of the Freedom Christian City Church Fellowship.
Stakeholders:
• Thea: Social work graduate, recently employed by the Freedom Christian City Fellowship to act as a coordinator, trainer and professional influence in the

church’s volunteer-based counselling service.
• Pastor Koffken: Pastor of the Freedom Christian City Fellowship for more than 10 years; “grew” the church from a tiny assembly of 10 people to a thriving

social and spiritual hub.
•   Arthur P Wilkes: Church elder and lay counsellor.
•   Jonathon: Specialised mental health nurse an Adult Mental Health outreach service; Spiro’s caseworker.
•   Mick: Disability Support Worker, working with Spiro to enhance his independent living skills, employment options, social support, etc.
“I don’t care whether it’s your fault; you’re there now, you know about it, and you need to stop it from happening”.
Click.
Beep, beep, beep, beep…..
Thea stared at the phone and groaned. She had just spent more than 45 minutes in a long and heated discussion with Jonathon, who seemed like a good guy but… well, he

could get very passionate about his work.
Things were not going according to plan. For years, Thea had worked for a few hours each week as a volunteer in her church’s counselling service while she completed

her degree. She had felt that the church, and the counselling service, could make a real difference in the local community- a place which was, in her experience, both

materially and spiritually impoverished (though she knew “significantly behind the norm in all significant socio-economic indicators” was a more acceptable way of

phrasing it). She should know- she grew up there.
For this reason she had identified funding sources, prepared submissions, and sought the support of the church board so that the service could be properly funded with

a professional coordinator and housed in a shopfront in a local mall. It was with a mix of pride and trepidation that she then accepted the position she now held… it

seemed like the culmination of a long term dream that her professional, personal and spiritual values could come together to really make a difference.
Which made Jonathon’s call all the more difficult. Jonathon identified himself as Spiro’s caseworker. Thea knew Spiro as a troubled and brooding young man who

attended her youth group. He would attend diligently for months, and participate enthusiastically in church activities and services- then disappear from the face of

the earth, only to resurface a month or so later. As far as Thea could recall, this pattern was established over a couple of years.
Now she knew why. Jonathon had informed her that Spiro had schizophrenia, and, during his worst times, Spiro was unable to function in the mainstream community. He

was prone to intrusive delusions and crippling paranoia, and, when he was unwell, he would usually sit alone in his tiny unit staring at the walls until a neighbour or

family member arranged for him to be admitted to hospital. Over the last few years, his “episodes”, hospitalisation and treatment had fallen into a predictable cycle.
In hospital, Spiro was responsive and insightful. The hospital staff would assist him in understanding his illness and maintaining compliance with treatment (both

medication and regular psychotherapy). Balanced, settled, and strong, Spiro would be discharged from hospital.
Within a few weeks Spiro would resume his friendships, supported employment, and social activities. The central pillar of his social world was the church community.

Once he returned to church (looking well and coping well), he would start attending counselling with the church counselling service, seeing the same counsellor- Arthur

Wilkes- each time.
Thea remembered Arthur as a likeable, sociable gent in his 60s who was one of the members of the church board who supported her submission for funding for the

counselling service and who personally encouraged her to apply for the coordinator’s position.
According to Jonathon, Arthur would, with disturbing predicability, counsel and support Spiro to go off his medication. With faith, support, and the grace of God,

Arthur maintained, Spiro could overcome his illness and find a way of living free from psychoactive drugs and psychiatrists. Spiro, feeling strong and confident,

would invariably follow Arthur’s advice.
After a few weeks of “success”, celebrated and encouraged by Arthur and other members of the church, Spiro would start to become unwell. Neither Arthur nor anyone

else would see Spiro in the long, lonely days in his empty room, as his mental health deteriorated and his illness asserted itself.
This was when Jonathon would be called to pick up the pieces, to assess Spiro, take him to hospital, and start the cycle again.
Only this time, things hadn’t taken the same course. Spiro, after release from hospital (and in a seemingly lucid and rational state), had made a suicide attempt. He

was in hospital again and Jonathon was refusing to support any discharge plans until Thea could guarantee that she would prevent any further contact between Arthur and

Spiro. Furthermore, Jonathon was threatening to contact the counselling service’s funding bodies and report that the service was ineffective (at best) and downright

READ ALSO : Financial Acounting

dangerous (at worst).
Thea had also spoken to Mick, a disability support worker who assisted Spiro with day-to-day living skills. Mick had found Spiro unconscious after a massive overdose

and called an ambulance. Mick was tearful and distressed, blaming himself because Spiro appeared to be in great mental health the day before the suicide attempt.

Mick had always praised the role that the church played in Spiro’s life, seeing it as an anchoring social system which provided personal care and a strong sense of

belonging.
Thea had also spoken with Pastor Koffken. The Pastor could acknowledge her concerns about Arthur’s counselling strategies, but reminded Thea that
1   the approach was consistent with the teaching of the church- faith and hope were central beliefs and Spiro could overcome his illness with God’s help;
2   she had been employed by the church because she shared their vision for the service; and
3   Arthur was a church elder who had helped develop the counselling service and who was now the head of its management committee- he had a right to direct the

style of service it offered.
Thea looked down at her hands and groaned again (louder this time, and with a deeper sense of dread). She felt like she didn’t know what she believed anymore. Pastor

Koffken and Arthur were arriving in 15 minutes for a discussion about the service. What would she tell them?
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Scenario Four: The gloves come off
Setting:
A Family Group Meeting in an office of the Department of Chid Safety. The Department has decided to seek a 2 year Child Protection Order in relation to the children

being discussed. A Family Group Meeting includes relevant family members and professionals who work with the family, and is designed to be develop a case-plan through

consensus.
Client:
• Jeannie: A 42 year old mother of 3 children (1, 6 and 8 years of age) who are currently in the care of the Department of Child Safety under a Court Assessment

Order (a 4 week order which allow the Department to investigate concerns of child abuse and neglect). Jeannie’s children were sexually assaulted by her boyfriend, who

is now in gaol. He has a history of drug addiction and has worked in the sex industry.
Stakeholders:
• Patricia: Child Safety Officer, caseworker for Jeannie’s children.
• Georgina: Domestic violence support worker. She has been providing Jeannie with counselling and assisting her to find accommodation. Jeannie is currently

living in a domestic violence shelter where Georgina works.
• Colin: Parole officer from Community Corrections. Jeannie is on his caseload due to charges relating to drugs and fraud. She has been compliant with all

requirements and programs relating to her court orders.
• Don: Family Group Meeting Coordinator. He is chairing the meeting. Although he works for the Department of Child Safety, he does not have any decision-making

role in the case.
• Weldon Antilles: Local lawyer in private practice who specialises in child protection matters- representing Jeannie.
Weldon Antilles’ fist crashed down on the conference table so hard that the walls shook. The resulting sound was so loud that everyone around the table startled, sat

up and opened their eyes wide.
“Let me say this in words that a child can understand: My client’s children are coming home. Either now, by your choice, or after court. You’ve got NOTHING on her,

no evidence and no chance. Accept it…” he boomed as he hunched across the table, wagging his elegantly-manicured finger in Patricia’s face. Then he slumped back in

his chair, folded his arms, and rolled his eyes dramatically.
Jeannie grinned.
Patricia stuttered before responding, which, she guessed, was exactly what Weldon wanted. “These children were sexually abused on multiple occasions…” she began.
Weldon spoke over the top of her. “By a man who is now serving a gaol sentence… as he should be. My client has not caused any harm to these children and was herself

duped by a smooth operator with designs on her children.”
Patricia continued. “But she took them to see him in prison on three occasions; she has told him that he will be coming back to the home when he is released.”
“As you have admitted, this is only hearsay from a counsellor in the prison who refuses to provide an affidavit”. Weldon’s tone expressed disdain.
Don attempted to restore some order. “If we could just hear from Colin, he has to leave soon…”
Colin provided a summary of the programs Jeannie had attended and her participation in each one. He told the group that she had returned a positive drug test for

cannabis on 3 occasions in 6 months but there were no indicators of continued amphetamine dependency. Colin said that he couldn’t really comment on her parenting but

he was very pleased with her progress from his point of view.
Don invited Georgina to comment.
Georgina cleared her throat nervously and looked at Jeannie before speaking. “Jeannie is coming along really well in counselling. We have a Department of Housing

house lined up for her in the next few weeks and we have made sure that it is big enough for the kids to come home. In our last few counselling sessions she has

started to show some understanding of what happened to her when she was a child and how this has affected her choices as a parent.”
“I have already talked to Jeannie about my own assessment. I don’t think she is ready for the kids to come home yet but she is really making progress and I think

we’ll get there in the next 6 months. She has acknowledged to me that things haven’t been good for the kids and she needs to work out her own needs.”
Again, Weldon piped up. “This is rubbish; my client makes no acknowledgements or admissions of any of the lies the Department has cooked up…”
Don raised both his hands in a desperate gesture. “Let’s have a break for 15 minutes and then we’ll try to develop a case-plan together.” His expression made it

clear that he didn’t have high hopes for the process.
As everyone was packing up and heading for a coffee or a toilet, Patricia realised she was left in the room with Weldon, who was adjusting his suit jacket and checking

his messages on his expensive Blackberry. “You know, I don’t know how you people do it,” he said to her in a surprisingly familiar tone of voice.
“Pardon…?” responded Patricia, a little coldly.
“Work day in, day out with these people. I mean, look at this little number. She pimps out her own offspring to some lowlife and then acts like he’s her prince

charming.”
“What do you mean?”
“Look, between you and me, I can’t stand the woman. She’s a conniving bitch. But you’ve got to do your job and I’ve got to do mine, so we’ll slug it out in court.

We both know the Department will get what it wants in court and there’s no way these kids are going back to that woman. I just don’t know how you people do it, that’s

all.”
Patricia nodded and left the room, feeling uncomfortable. She had hoped the Family Group Meeting would go better. She had started to see some real insight in Jeannie

during her last visit and she was hopeful that the children could in fact go home during the next year. She saw Jeannie as a real survivor who had never had the

chance to heal and grow past her own childhood abuse but, with the support of Colin and Georgina, things were coming along for her. However she knew things weren’t

quite there yet. In her opinion, her solicitor was doing more harm than good by raising her hopes and leading her into a conflictual relationship with people who were

trying to help her.
Patricia snuck out the back door of the office. She leaned against the back wall of the building and lit a cigarette, drawing the soothing menthol fumes back into her

lungs, where they induced a sudden spasm of coughing. When she looked up, she saw Jeannie a few feet away by herself. Jeannie seemed to be crying.
“Jeannie, are you ok?” she said with genuine sympathy.
“Get lost!. You people have done enough already to my family,’ Jeannie spat back. “Well I’ll show you now. I’ve got someone on my side. Weldon understands me, and

he respects what I’m going through. He told me that youse haven’t got a chance in court.”
Patricia felt her relationship with Jeannie disintegrating. She knew that every person deserved full representation in the legal process, but…. What would she say to

Jeannie?
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Scenario Five: That’s l’amore
Setting:
A community mental health service intake meeting.
Client:
•   Sam Milkovich: 24 year old man who has been referred to the community mental health service for support and follow-up after discharge from hospital.
Stakeholders:
•   Alexis: A mental health nurse who works as a caseworker at the service.
•   Robert: A social worker who works as a caseworker at the service.
•   Shona: The manager of the service.
•   Dean: A mental health support worker from the hospital who is referring Sami to the service.
•   Constable Doven: A police officer.
Alexis could see a deep red rash creeping up Robert’s neck from under his exquisitely tailored collar. Her colleague was wriggling in his seat and his eyes were

darting backwards and forth nervously. At first she thought he might be having an allergic reaction to the peanut brittle she had brought in for morning tea, but she

thought that after 5 years working together, she would probably know if he had a severe peanut allergy. God knows she knew everything else about her long term

colleague and close friend.
She refocused on Shona, who was leading a discussion about a new referral to their mental health service.
“So, Sam will be added onto your caseload Alexis. He has been in hospital for about 4 weeks. Dean has been kind enough to drive down personally for the referral

meeting to answer any questions.”
Dean began by handing out Sam’s discharge summary. “You will see that Sam has been diagnosed with a borderline personality disorder. Before being taken to hospital,

he was living locally with his parents for about 6 months and before that he lived in Byron Bay for some time. Until he went to hospital he had never had any mental

health treatment or support so we don’t have a lot of history and even his diagnosis is a bit tentative…”
Byron Bay… the little gears and cogs started turning in Alexis’ brain and she looked at Robert again. That Sam… it couldn’t be!!!
About a year ago, Robert had returned from Byron Bay with a wild tale of passion and intrigue. In the space of a 4 week holiday, he had met, fallen in love with,

pledged a lifelong commitment to, and disastrously broken up with, a mystery man named Sam.
Alexis loved Robert’s wild tales, always told with an eye for detail and a self-depreciating twist. Robert had loved and lost- in this case, what he almost lost was

his left eye. Sam had been an attractive, engaging man who had met Robert at a café. Robert had fallen hopelessly in love but after a fortnight of wild romance he

noticed that Sam’s behaviour was quite concerning- obsessive jealousy, unexpected conflicts over mundane things, a need to control and direct Robert’s day-to-day

activities. The relationship ended when Robert found Sam had taken his mobile phone into the spare room at his unit and was talking to Robert’s parents. On the same

day he saw a number of syringes and foil packages amongst his toiletries and he realised that Sam was using amphetamines.
Robert had told Alexis that he attempted to discuss this with Sam but he flew into a rage, hurling abuse at him and throwing things around the room. He hurled a

ceramic bowl at him, which shattered against his left eyebrow ridge. Without going into details, he said that Sam had subsequently made a suicide attempt and ended up

in the emergency room. Alexis remembered him returning to work, nursing a bandaged head and a broken heart.
That Sam.
“…so, to summarise,” Dean continued, “Sam has no known history of violence or drug use. He appears to be compliant with treatment and is keen to get better. He has

been prescribed a mild anti-anxiety medication.”
Now Alexis was squirming in her seat. She knew that this was a pretty big deal, but she also knew that their manager Shona was something of an ethics nazi who would

probably sack Robert on the spot if she knew he had been in a relationship with a client. As it was, Alexis had been threatened with disciplinary action just because

she went to a party and ran into a former client of the service. In that case, it had been a complete accident and Alexis had ignored the person all night.
She was also keenly aware that Robert had always chosen to treat his sexual identity as a private issue. Shona had no idea that Robert was gay, and Alexis had no idea

how her boss would react. Certainly, Shona had never made any overt homophobic comments in the workplace but Alexis knew she had very conservative values generally.
There was a knock on the door and one of the administrative staff poked her head in. “I’m sorry to disturb you… I’ve got a Constable Doven on the phone. He says it

is urgent that he speaks to someone about Sam Milkovich.”
“Good timing,” said Shona. “Put him through to this phone, we’ll put him on speaker.”
Doven was well known to the service staff and he frequently called for assistance when dealing with clients of the service.
After a few preliminaries, Constable Doven got to the point: “It seems like I’ve called at exactly the right time. I’ve just had a call from Mrs Milkovich claiming

that their son is unstable and needs to be taken to hospital. Apparently he is refusing to go, so I can only bring him in to the hospital if he is a serious risk to

himself or other people.”
Alexis looked at Robert again, but Robert just looked down at his feet.
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Scenario Six: It’s only fair… but is it just?
Setting:
A Department of Housing local office in an urban area within a large city. Staff of the office allocate and manage public housing provided to eligible members of the

community.
Client:
• The Moreland family: Members of the Moreland family live in a 3-bedroom house in a suburban street in the catchment area of the Department of Housing local

office. The Morelands are an Aboriginal family with strong family links to North Queensland and South Western Queensland.
Stakeholders:
• Ruby: A community welfare graduate who works as a Housing Officer, with responsibility for about 40 tenancies in the local area. Ruby considers applications

for housing, liaises with housing applicants, assists successful applicants to sign leases and connect utilities etc, regularly visits and inspects the properties, and

deals with any issues that arise with the tenants.
•   Nigel Whitehead: The Area Manager of the Department of Housing- Ruby’s line manager.
•   Grant: The Indigenous Liaison Officer in Ruby’s office. Ruby is Grant’s immediate supervisor.
•   Vicky Thwaites: A nurse who is employed as a Community Health Worker in the local area.
Ruby looked down at her desk, hoping for a miracle… but the offending items were still there, side by side. 3 manila envelopes. 3 folded sheets of white A4 paper.

So much tension. She felt like the universe had conspired to drop these bombshells on her in quick succession. How else could she explain the fact that they all fell

into her in-tray on the same morning? She chewed the inside of her lip and tried to think about a holiday in Bali… calm thoughts. Calm blue ocean. Calm blue ocean.
The first envelope contained a copy of a letter drafted by her Manager, Nigel, which she was expected to countersign and hand-deliver to the Moreland family. It was a

letter of eviction, and it represented the final stage of a long process of complaints and issues.
The letter cited 3 serious breaches of the Department’s tenancy rules, and stated that these issues had not been resolved despite ongoing negotiation. The notice gave

the family 7 days to vacate the premises.
The first alleged breach was that the leaseholder of the property was not a resident of the property and had made no arrangement to transfer or relinquish the tenancy.

Ruby knew this was true. The Department of Housing property had been originally sought by, and leased to, Aunty Beryl Moreland, about 4 years earlier. Aunty Beryl

had subsequently travelled to North Queensland to attend a family event (about 2 years ago) and had not returned. Her son and his wife had remained in the house with

their children and had been living in the house with their Uncle Rennie when Ruby started her job a year ago. She had tried hard to get in contact with Aunty Beryl so

she could sign the lease over to her son, but when she finally got a contact number for family members in North Queensland, she found out that Aunty Beryl had passed

away. She negotiated for the residing family to take over the lease on the house, but by the time she had drawn up a tenancy agreement, the family had moved to

Western Queensland to look after some nieces and nephews whose parents had been incarcerated. The house was currently occupied by Aunty Beryl’s two daughters (Eileen

and Thora) and their children. Ruby had formed a good relationship with the two women and really enjoyed visiting them each month.
So, although the house had been consistently occupied by members of the Moreland family, it was true that no identified person currently held a signed tenancy

agreement in relation to the property and no-one had legal responsibility for the lease.
The second alleged breach was that the number of occupants in the house exceeded the legal number of people who could reside there. Again, Ruby knew this to be true-

sometimes. When she conducted regular visits to the Moreland home, there could be anywhere from 3 to 18 people living there. Sometimes, the household would seem to

consist of a couple of dour teenaged boys who sat in the lounge and wouldn’t answer her questions. At other times, it seemed that Uncle Rennie, Eileen, Thora, their

children, and an entire additional family would be there. Kids would flock around Ruby and often an elderly man or woman would be shooing them and trying to make tea

for her. Over a few months, a solitary older man had set up a tent in the back yard and he would always giver her a wave when she arrived at the house, although he

never spoke to her.
The third breach consisted of a summary of neighbourhood complaints which alleged that the house was too noisy, too messy, that the occupants “caused trouble”, and

READ ALSO : Silk Road

that there were drugs, alcohol, late parties, and violence on the premises.
Ruby knew from her regular visits that the house was rarely tidy and the lawn was not mowed. However she had not encountered any unsafe or unsanitary conditions. The

household was noisy and, on two occasions, she had arrived in the middle of loud arguments occurring in the front yard. She had personally never seen these arguments

become physically violent.
As part of her job, Ruby had cross-referenced these complaints with the police and she was told that there were frequent callouts to disputes but the police had no

serious concerns about violence or drug abuse in the household. As one tactless constable put it, “There are four other houses in the same street which we have

serious concerns about. Around the corner we busted a speed lab last week. These people get a bit loud and a bit rude now and then but frankly, we’ve got better

things to do.”
Ruby and her boss Nigel had some long and heated discussions about the eviction action and she knew that such a severe step was not taken lightly. She argued that the

issues could be addressed with more time, although in her heart she knew that this was unlikely. There would always be a lot of people at the house, there would

always be problems identifying a specific leaseholder, and there would probably always be neighbourhood complaints about noise and mess. Nigel was strongly of the

opinion that, after 2 years of official notices, warnings, meetings and failed attempts at compromise, it was time to take strong action. Ruby argued that there were

not other options for the family if they were evicted. He responded by saying “It’s only fair, we have a long waiting list and a lot of other families who need

housing support. The laws are crystal clear. If these people can’t keep to the rules then they need to go.”
The second envelope contained a letter of resignation from Grant. Ruby had worked as Grant’s supervisor for about 6 months. She remembered when she interviewed him,

along with Nigel and another manager. Nigel had encouraged Grant as a young Aboriginal man entering the public service, and had said “We really need someone who can

help us to understand the needs of our Murri clients- someone who can talk their language and let us know how to give them the responsive, culturally-appropriate

service which they deserve. I’m so glad to see you working for your community…”
Strong, inspiring words… which made it all the more bitter to see Grant disillusioned, frustrated and fed-up. The letter stated simply that “I have decided to pursue

other opportunities and to broaden my career prospects beyond the public service”… but Ruby knew from her supervision sessions with Grant that he was feeling like his

opinion wasn’t valued. He told her frankly that “everyone likes having a blackfella around when I agree with their opinions or when I add a bit of credibility to the

office… but when I try to stand up for our people about something that really matters, no-one wants to hear it. It’s one thing to get me to sign off on a bunch of

protocols for visiting Murris but no-one really wants to mess up their precious rules and procedures.” This issue came to a head for Grant when he tried to advocate

for the Moreland family prior to the eviction notice. Grant had tried to explain that the house was currently full of family members because they had come down from

North Queensland for a funeral. Nigel had argued that the funeral was weeks ago and no-one had left. Grant tried to explain that “sorry time” for some families could

involve months of grieving and support, but Grant just said it was an excuse to break the rules and he wasn’t going to back down.
Grant wrote his letter of resignation the next day.
The third envelope contained a letter from Vicky, a nurse from the community health service who visited the Morelands regularly. She was providing post-natal support

for Thora’s new baby, and doing blood tests for Uncle Rennie’s diabetes. She also supported the family with nutrition advice, and referrals to other health services

when necessary. Vicky had worked with the family for years and had developed a genuine trusting relationship with them.
The letter was brief and direct. It was addressed to Nigel, but marked for Ruby’s attention. It had “private and confidential” stamped all over it. The letter

stated that Uncle Rennie had been diagnosed with cancer of the liver, and would be undertaking frequent visits to the local hospital for treatment over the next 6-12

months. Vicky gave her medical opinion that he required consistent care and routine, and that any disruption to his living arrangements would have a very negative

impact on his health. The letter stated in very strident terms that the heath service opposed any attempts to evict or relocate the family at this time and that they

hoped the Department of Housing would support the family on compassionate grounds.
Ruby was very sure that Nigel would back down when he read the letter, due to the possibility of negative publicity if for no other reason.
She also knew that the letter was misleading. Uncle Rennie had a minor cancer scare a year ago and he had been given the all-clear months earlier. Last time she went

to the house, she had seen Vicky in deep conversation with Eileen, Thora and Uncle Rennie at the kitchen table. Thora had told her afterwards “not to worry about that

eviction thing because Vicky said she would sort it out for us.”
Three letters. Three issues. One big headache.
Top

Scenario Seven: Taking care of business (or the business of care)
Setting:
Golden Years, a privately managed and funded aged care facility.
Client:
• Ava McIntyre: Ava is in her 70s and, until recently, she lived in her own home in the local area. About a month ago she had a fall at home in her kitchen, and

she laid there- conscious but incapacitated- for almost 24 hours before her neighbours found her. They were alerted because her cat was in their kitchen, mewling for

food and attention. Ava was hospitalised for a few days, and has spent the last few weeks in a respite room at Golden Years.
Stakeholders:
•   Lea: An occupational therapist at Golden Years, freshly graduated.
•   Darrian McIntyre: Ava’s adult son.
•   Margo: A clinical nurse with specialisation aged care; Lea’s Team Leader.
•   Trent Steed: Clinical psychologist, contracted by Golden Years for specialist assessments, counselling and other services.
•   Danielle Golden: Managing director and owner of Golden Years. She has decades of experience in the aged care sector in private and public services.
Lea read her assessment again but she couldn’t bring herself to change a single word. She had followed the assessment process precisely, and the Global Assessment of

Functioning (GAF) scores were all calculated correctly and included in her report. She had a detailed social history, a description of the client’s views and wishes,

and a summary of the specific supports and services required for in-home support.
It was clear for her- Ava McIntyre was ready, willing and able to go home. Her ongoing care and support could be provided by the aged care team from the Community

Health service attached to the local hospital.
So why had this become so difficult?
Lea recalled her initial presentation of the report to her team. She had described Ava’s situation and then summarised her findings. She explained that Ava’s

accident had been traumatic and could have resulted in a much more serious outcome- which was a really polite way of saying that Ava would have died if her cat hadn’t

been quite so assertive.
Lea said that the support plan included a range of in-home aids and alarms which would really help Ava to feel safe. With Meals-on-Wheels visiting daily, and a nurse

checking 3 times each week, Lea was confident that Ava could return to her home. However she also acknowledged some of the risks- that an accident could occur again,

that it was likely that Ava would need fairly intensive support, and that it would only be a matter of time- maybe 6 or at the most 12 months- before Ava would need

supported accommodation.
Lea concluded by saying “Ava’s situation is genuinely borderline. There are legitimate reasons why she could be assessed as needing residential care. However, the

main issue which has swayed my assessment is Ava’s own attitude. She has been very clear that she wants to return to her home. She has lived there for more than

forty years and, in her own words, she wants to stay there until she ‘shuffles off’. I think it is vital that we respect her own self-assessment, even if it involves

some risks.”
Margo, as Team Leader, had then led a discussion about the methodology and had used the report to demonstrate some of the new skills and approaches which Lea could

bring to the service. She was the first Occupational Therapist to work at Golden Years and it was hoped that her discipline would assist the staff to take a more

structured approach to assisting the residents with daily living skills and, above all, fostering and enhancing each client’s capacity.
However, by the time she had supervision the following day, Margo had become more critical. “Lea, you have to understand that you are new to this industry… the

assessment you have written is great on paper, but I know the way things really work. Ava’s not going to get 3 visits a week from Community Health, that team is

stretched as it is. We don’t do any outreach here, we cannot support her at home. I believe that things will be better for all concerned if Ava just stays where she

is, here at Golden Years. It might be a bit tough on her at first but I’m sure you can talk her around.”
The next day she was asked to attend a meeting with Margo and Danielle Golden, the owner and managing director of Golden Years Aged Care Residential Facility, Pty Ltd.

Lea had not met with Danielle since her initial job interview, when she had been inspired and excited by Danielle’s obvious passion and commitment to her work.

Danielle had a clear vision for Golden Years as a place which delivered the highest standards of care in a sector which was often plagued with shonky operators and

inhumane practices.
Two other men who were strangers to Lea were also present. Both were middle aged, well dressed, and greeted her with smiles.
Danielle smiled also, and welcomed Lea to a chair. “Lea, let’s get straight to the point. Your assessment of Ms McIntyre shows me that we made a good choice in

hiring you. It is eloquent, professional, and convincing…” Lea smiled graciously.
“But… as much as I respect your process, I must dispute your findings. Ava is clearly an ideal candidate for a residential placement here. She requires consistent

care and supervision and she will never get that in the community.”
“I agree she needs the support but I think she can get it from the Community Health Team… She was very consistent in telling me that she wanted to be at home, that it

was the most important thing in the world..” countered Lea, somewhat bravely in the face of the four other people in the room.
“About that… this is Trent Steed. Mr Steed is a psychologist in private practice who we contract from time to time. He has completed his own assessment of Ava, from

his own professional point-of-view of course”, said Danielle.
Trent cleared his throat and began. “After spending some time with Ava and conducting a series of cognitive tests, I am of the opinion that she is simply not able to

make an informed choice about her future care arrangements. She is fixated on a particular outcome but she is not willing or able to properly consider the risks and

impacts…”
Trent continued in this vein. Lea was eventually able to ask whether Ava had a specific mental health condition or cognitive disorder; or whether there were any

indicators of dementia or impaired brain function. Trent was forced to admit that there were no specific impairments or conditions, but that he was of the opinion

that Ava was not making decisions in her own best interests.
Danielle then introduced the other man in the room as Darrian McIntyre, Ava’s son. Darrian stated that he was concerned about his mother’s safety and he had been

deeply effected by his mother’s accident. Darrian said “I am very clear here… I want the best possible care for my mother and I don’t feel comfortable knowing she is

alone in that house. Any day could see another fall, another accident. I want her here and I want it to happen now.” He looked knowingly at Danielle. “Ms Golden

knows that I am a man of substantial means and that I want to be an active part of my mother’s care. In fact I have already offered to become part of the Board of

Directors of this facility and, in doing so, I will bring significant cash investment into this organisation.”
Lea actually saw his chest puff out as he said that. She never realised that people actually did that- she always thought it was a figure of speech.
The meeting ended with Lea being sent back to reconsider her report and findings. She looked at her report again. So many pros and cons. She knew that a significant

cash investment in Golden Years would subsidise and support the care of many residents, and maybe even allow some places to be offered to aged people who weren’t able

to fully afford a place. She knew there were genuine risks to Ava being at home. She knew that Community Health was understaffed and overworked… But she just kept

seeing Ava’s earnest, pleading face as she clutched her hand and said “I just want to be at home…”
Top

Scenario Eight: Numbers don’t lie
Setting:
A community-based disability support service which delivers in-home care and support for people with disability.
Clients:
• The agency delivers services to people with a diagnosed disability who meet specific means testing and eligibility criteria.
Stakeholders:
• Tarryn: A social work graduate who works in the agency providing coordination, training and professional development for disability support workers. His job

description also includes research and record keeping for the agency.
•   Chris: Service manager, Tarryn’s line manager.
•   Julie: Head of the Management Committee which auspices the service.
•   Liz: Community Funding Officer from the government authority which provides grant money to the service.
Rows of numbers. Columns of numbers. Spreadsheets, workbooks, and notepads full of numbers. Tarryn could see them dancing in his head when he closed his eyes. Four

years of social work education, focusing on human behaviour and emotions, honing his relationship skills and avoiding (at all costs) any of the equations,

calculations, formulae and graphs which had driven him mad at school.
But the numbers had caught up with him.
Tarryn loved his job. He enjoyed meeting with the clients, listening to their stories, and coming to understand their specific strengths and personalities. He loved

being able to invest something meaningful and tangible back into their lives- whether it was employing someone for a few hours each week to do their shopping, or

providing a comprehensive round-the-clock support program.
He also loved the people he worked with- a mix of paraprofessionals and volunteers, of different ages and persuasions, who were united by their absolute commitment to

supporting their clients wholeheartedly. He enjoyed coordinating their activities, training and encouraging them, and, most of all, he enjoyed watching them learn and

grow and become confident and capable workers.
Most of all, he loved his boss, Chris. Chris was a compassionate, dedicated professional who helped Tarryn to believe in his own abilities through his gentle

encouragement. When necessary, Chris also confronted and challenged him in a way which pushed him to be his best. Chris was always willing to listen and it was clear

to Tarryn that Chris poured his life into his work.
The fact that Chris had cerebral palsy was almost irrelevant. At first, Tarryn had not known where to look or how to speak when he was with Chris, and he was sure

that he had come across as a complete jackass during his job interview. However he soon learnt that Chris was as sharp as a knife and could cut through other people’s

imposed limitations with ease. This was brought home on his very first day in the job, when he and Chris attended a meeting with an inept cleaning contractor who

insisted on referring every question to Tarryn. The man spoke so loudly and slowly to Chris that Tarryn cringed. Eventually, with a twinkle in his eye, Chris glared

at the contractor across the table and drawled “You can talk as slow as you want and as loud as you want, but I’m the one who signs your checks. Do your job properly

or we’ll find someone who can.”
Chris had started as a client of the agency at a time in his life when he was working through uni and needed a lot of support. Eventually, he graduated and started

work in the service, eventually becoming the manager. He was well regarded and widely respected.
Tarryn would do pretty much anything for Chris. He was a good boss and a committed practitioner. Tarryn knew that Chris’ disability added credibility to his role,

but he had come to learn that Chris had the competence and dedication to back it up.
Tarryn was pulling together a detailed annual summary of the agency’s services and activities for the preceding year. The service’s triennial funding was due for

renegotiation, and this report would be the crucial document which demonstrated their effectiveness and guaranteed a further three years of funding.
Things were not looking good. By some measures, the agency had been thriving- with a growing client base who depended on the agency as a central, consistent source of

support. Client feedback had been gathered by an independent consultant, who had encountered almost universal praise from the people he had interviewed. On the other

hand- during the past few years, the funding models and requirements had changed significantly and Tarryn found himself repeatedly confronted by the fact that many of

their activities just didn’t “fit” with the new output-based unit costing accountability-driven service standards he was trying to apply.
For example, many of the agency’s services involved, in real terms, employing support staff to spend quality time with clients who were unable to get out and about in

the community- playing board games, reading to them, in some cases, simply sitting and watching TV with them. Tarryn knew that some of these social relationships