Frontline Initiative Ethics

This is a one act play in three scenes that depicts the struggles of a consumer, his mother, and Direct Support Professionals (DSPs) in their search for answers to some perplexing issues. They find some help in a new and developing set of standards called the Code of Ethics for Direct Support Professionals. You’ll have some fun and learn a lot through this theatrical adventure.

The Characters (in order of appearance)

Gerry White: Person, 19 years of age, his own legal guardian

Terry White:  Gerry’s Mother

Donna Dooitall: Gerry’s favorite DSP

Curtis Candu: Donna’s “usual” co-worker

Veri Stressed: Donna’s Immediate Supervisor

The Setting

Gerry’s home, one evening in May, when spring is in the air and also in the step of every young heart in the world. This large house has been converted into a duplex. Each unit consists of two bedrooms, a living room, a kitchen, the dining room, and private baths for each resident. Both units share a porch and basement /laundry room. The small sitting room, just off of the front entrance, has been converted into a small office for support staff to use while providing service in the home.

Each scene takes place in one or more of the areas in the duplex.

Act 1 Scene 1

 The front entry, Gerry and his mother Terry have just returned home from the mall and as they enter the entry area they are in the middle of a discussion. Donna is working in the adjacent office.

Gerry: (Pleading) But, Mom, you don’t understand! Shana and I have been seeing each other for 9 months now and we both feel we are ready to have sex. We have developed our relationship over time, we have discussed becoming sexual and want to do it together. Heck! we’ve even taken the classes that teach us how to have safe sex. Mom, we’re ready! (They move towards Gerry’s room just off of the dining room and sit, mother on a chair, Gerry on the bed.)

Terry (Gerry’s mother): (In a matter of fact tone of voice) Gerry, you know what I think of that: If you two want to have sex it’s o.k. with me.…I just worry that safe sex classes won’t be enough. Let’s make an appointment with Dr. Smith and talk about a vasectomy….I would feel much more comfortable with you being sexually active if you weren’t able to have children.

Gerry: (Somewhat exasperated) We’ve talked about that before and you know I don’t want to do that. I may want to have children some day and I should get to make my own choice. Besides, Shana and I like kids. 

Terry: (Frustrated now) Liking children and raising children are two different things. You and Shana couldn’t possibly handle that much responsibility; you can’t even balance your checkbooks.

Gerry: (Agitated and antsy) I have to get ready for my softball game now so why don’t you go home. I don’t want to talk about this anymore. (Gerry goes to his walk in closet to get changed for his gam.. Terry walks out to the office area and stops to talk to Donna.)

 Terry: (Walks in without knocking) Donna, I’m going to leave now even though Gerry’s upset with me. Did you hear any of our discussion?

Donna: (Turns from paperwork) I overheard something about Gerry becoming sexually active but I didn’t listen in on all the details.

Terry: (Calmed down a little) Well…we were discussing setting up an appointment for Gerry to get a vasectomy because I don’t feel the classes that teach safe sex are enough. (Walking slowly towards Donna; in a low, calm tone) You’re his favorite staff person, Donna, he trusts and listens to you. I want you to use your influence to convince him to see things my way. (She turns around quickly and leaves before Donna has a chance to respond).

Narrator: This one act play is an outgrowth and expansion of an activity that occurs at the end of a presentation (Direct Support Professionalism: Ethics, Education, and Respect) that the writers recently conducted at a direct support conference. The activity involved small groups (5-7 people each) of DSPs discussing a scenario about some typical ethical dilemmas they face quite frequently as they provide supports to people with developmental or other disabilities. 

Each of the groups was assigned one of the nine different areas of the Code of Ethics (developed through the National Alliance of Direct Support Professionals, NADSP). Participants were instructed to use the ethical standard and several interpretive statements described for their area to guide their discussion and to develop a plan to address the ethical dilemma. In addition, the groups were asked to talk about and share with the entire group how the code was helpful to their discussions and in what ways was it not helpful.

The purpose of the overall presentation was intended to provide participants with new knowledge and understanding and initial skill development around their roles in direct support. It is about how their work is professional, requires education and training, can be validated through a credentialing process, will be strengthened through local and national professional associations, and can be guided with a code of ethics.

Now, let’s look and listen in on Gerry, Terry, Donna, and the others to see how this ethical dilemma is progressing.

Act 1 Scene 2

 (On the front porch) Donna’s coworker, Curtis, has returned from providing training to Gerry’s housemate on how to ride the bus. Gerry’s housemate will not need Curtis’ support for about an hour. Gerry has left for his softball game and won’t return for at least an hour and fifteen minutes.

Donna: (Looking somewhat puzzled) Curtis, I’ve been struggling with something Gerry’s mother said to me on her way out the door. Do you have a few minutes to discuss it with me?

Curtis: (Looking up while writing in the log book) Sure, I don’t have to leave to help George for half an hour or so.

Donna: Here’s how it played out. I was working in the office earlier when Gerry and his mom returned from their shopping trip. They were discussing Gerry and Shana becoming sexually active. It seemed like they were having a good discussion when passing by me so I just kept working and stayed out of it.

Curtis: (Goes back to writing in the log book) That was probably smart. If Gerry or his mother needed your input they would have asked.

Donna: That’s the thing, Mrs. White did come to me for support on the way out the door and I’m not too comfortable with what she asked me to do.

Curtis: (Looks up slightly) Why? What did she ask you to do?

Donna: She asked me to use my influence as Gerry’s “favorite staff” to encourage him to get a vasectomy if he’s going to become sexually active.

Curtis: (Stands straight up at full attention) Wow! That’s a tough spot for her to put you in. Did you say anything to her about how uncomfortable that request made you?

Donna: (Looks down slightly) No, she didn’t give me time. She was out the door so fast it would make your head spin. Since I didn’t agree to anything, though, it gives me the opportunity to work out what the best response would be.

Curtis: Yeah, I suppose a little time to process this dilemma is a good thing, but we’ll have to come up with something before she starts asking if you had a talk with Gerry yet.

Donna: Do you think I should talk with Veri after our staff meeting tomorrow?

Curtis: I think this is important enough that you should and I would also be willing to sit in since we work as a team.

Donna: Cool. Maybe the three of us sitting down can come up with a solution. I’m still concerned about Gerry, though — he didn’t say much before he went to softball. 

Curtis: Sounds like a good idea….Gotta go help George with the bus, I think he has the routes down well enough now so he can choose to go it alone next time if he wants. See Ya later.

Donna: Ciao.

Narrator: The plot begins to thicken. Does this seem familiar? This type of scenario about sexuality has gotten special attention at all of our workshops. While the topic can be a “sticky wicket,” if you review the entire code (the preamble and each of the nine ethical standards with their interpretative statements), you will have the basis of many positive and challenging dialogues with each other, your supervisors, consumers, and other stakeholders. Let’s see what’s going to happen next.

Act 1 Scene 3

The next day after the staff meeting in the little office off of the entryway.

Donna: Veri, do you have some time to talk about an issue that came up yesterday afternoon when Mrs. White dropped Gerry off after their shopping trip?

Veri: (Flustered) What is Mrs. White’s issue NOW?

Donna: It’s not that she has any issue with our services. She has asked me to do something I’m not comfortable with.

Veri: What’s that? (Her pager goes off and she looks at it as if she’d like to toss it against the wall) Let me look at this and see how urgent it is. (She looks at pager text). It can wait so shoot.

Donna: Mrs. White asked me to encourage Gerry to get a vasectomy. You know Gerry and Shana have become close and have taken sexuality classes that teach them about safe sex.

Veri: And?

Donna: And Gerry says he doesn’t want to go through that surgery, he thinks that he and Shana can be responsible adults and practice safe sex.

Veri: What do you think?

Donna: I think it should be Gerry’s choice since it is his body….And he has gone above what most people do by taking those classes, too.

Veri: But what about the possibility of Gerry and Shana having children?

Donna: I don’t know. My gut tells me that should be their choice… but the challenges they face will make it difficult if it were to happen. I know we will have to talk to Gerry more alone and with Shana. Probably Mrs. White too.

Epilogue

The final scene of this play, The Epilogue (How the team dealt with this ethical dilemma and what sources within the Code they used), will be printed in the next edition of the Frontline Initiative. We encourage you and your team to spend time reviewing the Code of Ethics for Direct Support Professionals, to engage in dialogue around all the issues in this play scenario, and to develop a specific and realistic plan that deals with this ethical conundrum. To assist you in this assignment, you might want to review and use the checklist for considering ethical dilemmas.