When an elderly couple refuse home care services offered by a family agency, the ethical issues that arise encompass respect for autonomy and dignity, providing beneficence, and justifying paternalism. This paper discusses each of these ethical principles in the context of determining the decisional capacity of elderly clients. The resolution of the conflict is deeply influenced by the client's decision-making capacity. Social workers need to balance the relative weight of each principle and monitor the couple's changing circumstances as they address the ethical dilemma of whether or not to respect the client's autonomy.
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Norman Linzer (2002) studied this question.
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