Freedom
The client should have the right to choose freely whether to participate in the services
offered and also to withdraw from those services at any time. In order to exercise this
freedom the client should be free from any extraneous forces real or perceived that
may potentially force them to cooperate.
The VR practitioner should be aware that any agreement to cooperate with the
intervention may not be valid cooperation but in fact as a result of pressure, real or
perceived, applied on the client to force their cooperation. Such things may seem
extreme but as practitioners we often have a certain status or seem to be in a position
of power over the client. Pressure to simply cooperate without exercising full informed
decision making is therefore a very real and not an extreme circumstance for us.
The position is doubly problematic when working on employment retention cases, with
insurance companies, statutory programmes or as part of a court case. It is very easy
for the client to see us as representing the interests of the employer, Government,
case handler or opposing party rather than as a neutral agent working in the interests
of the client. In any of the cases mentioned above the client can unduly accept but
also unduly withdraw their cooperation, either of these may be because of the client’s
perception of extraneous influences. Therefore they cannot be truly accurately
described as exercising informed consent as the action may bring consequences that
in other circumstances the client would want to avoid or deny benefits that they
would ordinarily wish to have.
Others outside of the VR practitioner’s immediate relationship with the client may also
exert undue influences like partners, managers, other practitioners, family or friends.
The practitioner needs to account for the potential for this and to try to ensure that the
client is making the best decision for them by not contributing any additional undue
pressures on the client for compliance. Apart from directly applying pressure for the
client to agree to receive the service, the practitioner should avoid coercing the client
into agreement by giving only partial information, minimising the risks or by over-
promising the effectiveness or benefits of their services.