Real-Life Decision Making
You are a manual lymph drainage therapist. You have received a referral from a local physician. The referral is a young man with a cognitive deficit (meaning he is intellectually challenged). He is living in a supported care home because he cannot look after himself. This young man has been referred to you for treatment of a lymphatic problem in his lower extremities.
After doing the assessment, you realize that there are two ethical issues to be considered. First, because of the young man's cognitive deficit, he will not be able to do his home care tasks properly. He will need to exercise regularly, apply compression bandages at night and keep his skin scrupulously clean to avoid infections.
His caregivers must be taught what to do so they can help this young man follow instructions. If the home care instructions are not followed, the manual treatment you provide will not be very effective.
Secondly, it is very important that this young man feel safe with you. Therefore, one of his caregivers should always be present when you apply the manual treatment.
You include this information in your report to the referring physician. Next, you contact the caregivers at the group home and explain that their help is essential. The caregivers argue that they are too busy and have many other commitments. You insist that their help is essential. Finally, they agree to your terms.
On the day of the first treatment, a caregiver delivers the young man to your office. However, instead of staying to be present at the treatment, the caregiver says, "I will be back in two hours to pick him up," and then he walks out.
What do you do?