We have been taught and trained to regard choice and individuality, quite rightly, very highly. Choice is fundamental and giving people choice is a key task in developing strengths. Without allowing choice, we float around in a moral vacuum. Without choice we exercise power and control and continue to oppress those whom we should be working together with.
Giving choices isn’t always easy though. Certainly not as easy as it should be – especially when some (as is usually the case) of these choices have very concrete costs attached to them.
Sometimes I wonder if giving the semblance of choice is more important than the ensuring the actual choices are available.
Last week, I felt very autocratic – particularly in my dealings with one individual. It is easy for me to justify by telling myself that he doesn’t have capacity and the choices that I made on his behalf (via an IMCA (Independent Mental Capacity Advocate) are in his ‘best interests’ – but when I stop for a moment in the flurry of work as it arrives at my desk – and realise that I am, in fact, dictating where someone will be living for possibly the rest of their life – it fills me with discomfort.
This isn’t why I wanted to do this job.
I am often faced with this feeling when I carry out Mental Health Act Assessments. I am responsible for making a decision about someone’s compulsory detention in hospital. Of course, for those assessments to take place, the people are very unwell. Sometimes acutely, sometimes chronically. Often the process is distressing and it never involves choice. Occasionally, and I can count the times on the finger of one hand in the past year, we might be able to think about and consider community alternatives – but usually those choices have been explored to the point of expediency by the time the assessment roles around.
Sometimes when I am faced with my own choices, I become increasingly thankful that I have the liberty and wherewithal to be in a position to make these choices.
Choice is a fundamental aspect of our humanity. I see people who lose this on a day to day basis and I see my role in the loss of this choice.
I don’t feel guilty because there is no responsibility attached to me personally. But I do reflect and think how can I make the process of the restriction of choices less overbearing. Some people don’t want to take a part in the processes and prefer to have decisions made for them. Last week, I visited someone who I have been seeing how regularly for about a year – she asked me to make a decision for her. As soon as I had said what, in my opinion, would be the best outcome, she nodded sadly.
I am not sure it was an answer she wanted to hear but it made me more aware that sometimes it can be easier to have others make choices for you but even choosing to delegate that responsibility to someone who you might know and trust – that is an equal essence of humanity.