Our Responses are a Problem: Consent’s Practical Resistance

The topic was Ethical Decision Making in Social Work. The agency I worked for was hosting a continuing education opportunity for the sector, and the focus was realistic dilemmas that come up in your work.

Within the Code of Ethics that Social Workers follow, there are a set of guiding principles, as well as ethical standards. As I participated in a small group discussion, I asked what felt to me to be a fairly expected question. When two of these guiding principles are in conflict with one another, how do you determine which one to prioritize? And as a client working with you, how is that information shared with me as I make decisions in what I disclose to you?

What happened in that conversation was a dynamic I’ve frequently seen as an advocate, the one where we sidestep the question with a deflection, or reduce the complexities of scenarios we anticipate and address in our responses. In either case, the tension seems to be resolved within our current frame of references.

But what about when the lack of a response can’t be reconciled with your experiences?

A similar dynamic often occurs with doctors, where informed consent is explicitly prioritized, but choice in decision making is removed or expedited. Where in a preop procedure you may be asked to sharpie the word “consent” onto the body part you agree to have operated on, and yet in every subsequent verbal exchange you are not asked before someone touches you. This was my experience in three separate surgical centers with three different surgical teams and nursing staffs over the course of a year.

What’s it called when your doctor can talk about your consent, but won’t actually ask for it?

As we move into Sexual Assault Awareness Month, examples like this have returned to my mind, agitating me to reflect on the dissonance we have in incorporating consent into our daily routines. Making me conscious of how using the language of consent, or even the skills, falls short in most settings where body autonomy isn’t used to being accounted for mutually. Settings like health care, education and classroom management, the work place, parenting, and even advocacy and social work.

What makes me ask for consent when it’s normal not to have to?

I can picture the moment I decided to leave my job. It was my first day back after my second ankle surgery, and I was returning from a three-week leave of absence. It wasn’t a gentle reentrance, but a 16-hour day. The beginning part consisted of a coalition meeting, exploring the question of membership templates. I’d been inadvertently placed in a meeting without necessary context, which is always more complicated as an employee of the hosting agency.

In acting on the directions I had at the time, I leaned into more authentic then politically minded participation, which in retrospect was a foreseeable pitfall. And yet, following three weeks of being removed from politics and mostly alone in recovery, authenticity was easier to clasp. My questions and commentary were reoriented, responsive to ambiguity and value clashes in our dialogue.

What came out were questions that highlighted a lack of transparency that I was noting, and a quickening of a decision-making process that only felt too fast if you’d been there the whole time.

What I felt was a removal of dissonance between consent in practice and as a stated value. I could put into language what I understood intuitively — something is disconnected in how we are applying consent. And more significantly, something is preventing us from applying consent in our practice.

I had shown publicly that something about the decision-making process felt nontransparent, and in hearing myself note that, I couldn’t unhear the questions being invoked in me. Not even as it meant very immediately preparing myself to resign. It didn’t take the whole day to know that fallout was coming.

Because it wasn’t just a stand-alone observation or a one time ignored gut feeling. It was an accumulation that I’d been working up to confronting. It was a test: is consent your stated value, or is consent only your stated value? What compromises are you willing to make, and which ones have you made that you can’t sustain? At what point does the scale tip in either direction?

The scale tipped when just that night I ended my sixteen-hour day by training on emotional labor past ten pm.

As I drove home that night, I could hear two overlapping conversations. My surgeon admonishing me for not devoting enough energy to my physical recovery, and my boss admonishing me for not acting professionally. I noted first my own resentment, and then as the drive waned on, I reframed my emotion for what it really was — a value clash that required my response. It didn’t actually matter if I agreed or disagreed with their words on face value, because what I was grasping finally was that I wasn’t prepared to engage my consent differently. I wasn’t prepared to get used to non-consent culture at work or in recovery. As I held up a mirror, I knew that I was being asked to hold in my critique and ignore it. My heart and mind had been changed, and my work as a facilitator would need a new permanent home.

The work of capacity building involves allowing hearts and minds to be changed, making knowledge and skills available for people to apply alternative responses to various kinds of situations and roles. And yet, it is not merely a symbolic change. It is primarily a practical change, and when done well, a series of them. We can’t symbolically support consent as a value, we have to live it. And we can’t live it while living the exact way we lived without it. Consent disrupts, predicts no consistent boundaries for others, and responds consistently when boundaries are drawn. To resist consent in practice is to resist it as a value, just as any kind of performative gesture sinks below making a change in how something is done.

We have to ask ourselves, if I can’t practice consent here, why not?

Is it because I have more control in this situation?

Is it because my control is marginalized in this situation?

Is it because I have outside liabilities?

Is it because I don’t trust or like the decisions you’ve made in the past?

Is it because my decision making power is conditional?

Is it because there’s a hierarchy in place?

Is it because my mind or heart believes something contrary?

Is it because our norms teach us to do something else in practice?

I challenge you to answer these questions not in the abstract.

To grade yourself on how bought in you are to consent as something you value, and something you are willing to be disrupted for.

I challenge you to acknowledge non-consent in your day to day.

In your procedures, and in your ethical dilemmas, in your use of decision making power and subject matter expertise.

I challenge you to think of consent as something that’s practical, that’s concrete, that’s a dialogue, that’s versatile in when it shows up.

I challenge you to daydream about where we could see it show up if we changed our practices.

For the month of April, I will be writing about consent and how practical resistance shows up. I encourage you to reflect with me, to imagine a changed practice, and to expand your references.