Counseling the Ethical Dilemma -- Whistle Blowing

¶ … Counseling

The Ethical Dilemma -- Whistle Blowing

The ethical dilemma I faced occurred just after I graduated from high school, in the summer before I started college. I was hired as an "orderly" at a county facility for elderly people (sometimes called a nursing home). It was called a county "hospital and home" for the very frail and elderly in our community. Most of them had been placed their by families due to the difficulty those families experienced in providing good care for them. Some families visited on Sundays; but many of the patients never received any visitors. It was quite sad, and just outside the day room windows everyone could clearly see where they were headed -- to the cemetery.

I was given no training relative to the real issues these older people (all individuals in the ward I worked in were male) were facing. My job was basically to take these elderly men for walks around the fenced-in yard, to get them seated in the food service area before lunch, bring their lunch trays to them, and keep an eye out for "inappropriate behaviors." My other job was to dispense medications at two specific times during the day. Later I looked up the state regulations regarding the duties I was accountable for, and I had no legal right to dispense medicines. In fact the supervisor on my ward told me, "If any of these fellows get a little frisky, give them a shot of Stelazine. Tell them it's a shot of brandy and they'll gladly down it in a hurry," he said. He had no medical training either, and there was an RN we could call down to our ward if needed, but otherwise we did not have any trained healthcare professionals in our area. My personal research showed me that Stelazine is used for patients with schizophrenia; it is essentially a sedating drug that causes the patient to sink into a near comatose condition; his eyes become vacant and he quiets down almost immediately. The ethical dilemma I faced was twofold: a) I had no legal right to pass these medications (the county could be fined if state healthcare officials knew about this); and b) I knew my supervisor was stealing medications from the supply room on our floor. I considered notifying my state legislator, or a county supervisor that my father knew.

Ethically, morally, I was in a pinch. I didn't want him to lose his job. But I couldn't clear my conscience about those poor men unless I acted. Since I was only there for a bit less than three months, I held my tongue. But shortly after I left my job and started college, I wrote a letter (to a county supervisor with a "CC" to our state senator) exposing the wrongs I had seen in terms of the lack of healthcare offered to these men. There was the medications issue and also some of these poor souls would sit all day in underwear that had been peed in, or worse, and I had been asked not to deal with it until they went to bed. My challenge resulted in a state investigation of the whole facility. Other employees came forward and there was a major overhaul of the administration. I had challenged the status quo, and I felt good about that, but I still harbored guilt deep down because I let the abusive policies go on through the summer.

On page 127 of Chapter 7 (Ethics and Power) the authors assert that by harming clients we act "unethically." I believe I did allow harm to come to those old men (clients, if you will). And in this case the harm I caused came from "acts of omission" (failing to report unethical behavior) and from "acts of commission" (dispensing medications illegally). This was actually a case of professional malpractice. In Chapter 8 (Engage) the authors discuss how counselors engage someone, and I actually feel a little less guilt knowing that I did treat the men with dignity and when they were up to it, I would engage them in conversation. One man in particular, John, always wanted to talk baseball and he shared the same story over and over about the beer truck he used to drive "back in the day."