Dan Mushens examines some of the dilemmas that third sector workers can face

I’m a father to inquisitive five year old twins who enjoy exploring then emptying the contents of every drawer and cupboard in the house. They do this most days and leave a trail of destruction in their wake – you can never find the sellotape or a roll of string when you need it.

If Gabriella happens to drop something on the floor, it takes a concerted effort to encourage her to pick it back up. Her answer tends to be "why should I?" And Dylan doesn’t feel any need to share his toys, but fully expects to play with all of Gabriella’s.

Learning the difference between good and bad or right and wrong relates to morality and is dependent on many variable and subjective factors. Such factors could include - but not be limited to - our childhood experiences; parenting styles, cultures, religious beliefs and the law of the land etc. These help to form our own individual value and belief systems.

For those employed in areas such as the healthcare, social care and social work domains, we generally need to adhere to various codes of ethics and standards, based on principles which guide our moral reasoning; and in turn influence our ethical behaviour. All with the fundamental intention of helping us do the right thing for the benefit of the service user.

We all have judgement calls to make in our day to day lives – times when we have to stop and actively think about what decision to make because the outcome may (or may not) have a negative impact on someone. Moral dilemmas arise when our principles become compromised, some may seem like major issues with others seemingly small. Either way, they all need careful consideration and evidence based decision making.

Here’s a selection of my own such dilemmas which I’ve been faced with when supporting people with various mental health illnesses and alcohol related brain damage (ARBD):

- Jim has just moved into a new flat and would like to have broadband installed. He has asked to use his support to research broadband options and asks you to call, on his behalf, some providers to discuss the best deal for him. Coincidentally, he chooses the same provider that you also use. They apply a 5% discount on an existing customer’s monthly bill if they refer someone who sign’s up with them. During the call, the operator simply asks “are you the nominated referrer?” Do you say yes to make a personal financial saving?

- Susan is being supported to the local supermarket. At the checkout, the cashier asks her if she has a store card where points can be collected and discounts earned. She doesn’t but you do. Do you use your own store card to reap these rewards?

- John is using support to order a monthly TV subscription enabling him to watch premium sports and movies on three different devices. You help him set up the account on his TV and tablet and he suggests you add your own personal smartphone for the final device. What do you do?

- You support Charles for the first time and spend time chatting and building good rapport during the initial support session. Now in his fifties, he speaks openly about an incident that happened when he was in his twenties, when he was sexually inappropriate towards a schoolgirl. He goes into specific detail but says the police were involved and it was all dealt with a long time ago. Do you accept this explanation as fact?

- Graham is alcohol dependant and has been supported to maximise his benefits and reduce his outgoings. He is now in receipt of Personal Independence Payment along with his State Pension, meaning he has very good disposable income for the first time in years. He spends very little on anything other than cigarettes and alcohol. You are aware that he is also entitled to claim further benefits which could provide him with greater financial security. However, you feel more money will simply lead to greater alcohol use. Do you tell him of this possible entitlement?

Of course, there are no definitive solutions to these dilemmas but they must be considered within the context of the individual, the organisation you represent and any overarching governing bodies or legislation. Personally, I feel that being able to recognise potential dilemmas is a real skill in itself. As the American existentialist psychologist Rollo May is quoted as saying “the human dilemma is the capacity to see ourselves as both object and subject, at the same time”.

Dan Mushens is a recovery practitioner for Scottish mental health charity Penumbra