practice in the field of elder abuse prevention is guided
by principles that highlight clients' freedom and civil
liberties. In working with victims and vulnerable persons,
professionals look for ways to prevent abuse that promote
autonomy and self-determination. Autonomy, which comes from
the Greek word for "self rule," is the ability or capacity
to make informed choices, free of coercion, based on one's
own personal beliefs and values. All adults are presumed
to have decision-making capacity and are therefore afforded
the right to self-determination, that is, the freedom to
make decisions for themselves in all areas of their lives.
The concept of autonomy reinforces this right to be free
from unwanted interference, which means that there must
be legal justification for any curtailment of autonomy.
to Client Autonomy
Although the principals of autonomy and least restrictive
alternatives apply to most cases, there are two situations
in which clients' personal freedom may be compromised in
favor of other compelling interests. Two legal principles
may come into play in those situations:
individuals are deemed incapable of protecting themselves
from harm, society assumes responsibility for providing
protection. Parens patriae, or the "state as parent,"
is a common law principle, which authorizes the state
to act as a benevolent parent to protect its citizens
who are impaired and cannot protect themselves. It allows
for government entities, including APS, to initiate both
voluntary and involuntary services for individuals who
cannot protect themselves.
right to autonomous decision-making must also be weighed
against the State's interest in preserving and protecting
life and property. The principle of police power gives
police the authority to curtail and control certain personal
behaviors to protect the public welfare, as well as individuals.
Police may intervene to protect individuals and the community
from physical harm or the threat of harm, loss of assets
and property, and public nuisances.
offering service options to their clients, professionals
look for the least restrictive alternatives - interventions
that cause the least disruption or change in the older person's
circumstances and which maximize their independence and
freedom. For example, if an individual is having trouble
managing his or her financial affairs as a result of forgetfulness
or other cognitive impairments, a very effective means for
stopping the abuse would be to petition a court to appoint
a guardian. Guardianship, however, is a very restrictive
alternative in the sense that it strips people of very basic
civil liberties. The principle of least restrictive alternatives
dictates that other less restrictive options, such as informal
money management, be considered prior to considering this
for learning more about autonomy and self-determination:
Johnson, T.F. (1995). Elder mistreatment: Ethical issues,
dilemmas, and decisions. Binghamton, NY: Haworth Press.