Ethical Dilemma Case Study: Enabling Autonomy For a Child With Downs Syndrome

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Ethical dilemmas faced by the Allen family Slide 1: Ethical dilemma: Enabling autonomy for a child with Downs Syndrome Gary: Pam and Clifford's child Realistic goals Parental support of autonomy within Gary's range of capabilities Future outlook Speaker's Notes: Dealing with a child with Downs Syndrome is difficult for many families, but the Allen family has shown remarkable resilience in coping with their son Gary's challenges. One of the reasons that Gary has made such a successful transition from childhood to adulthood is the Allens' willingness to support Gary's independence. This willingness is still informed with an awareness of Gary's limitations. For example, Gary has a very carefully-observed structure and routine which governs his daily activities. He has a job at a supermarket within his capabilities that he enjoys and which gives him a sense of purpose. This job brings him out into the public with people other than his family. Gary is also capable of preparing his own foods and helping with household chores, although his parents do not require him to prepare extensive meals that could be complicated or dangerous if Gary was left in the kitchen alone. There are also contingency plans if Gary cannot be driven to work: he knows how to take the bus. From the nurse-practitioner's point of view, to help the family, some concerns which might arise regarding Gary are what might happen to Gary if his parents were unable to provide him shelter. Also, Pam has made

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