Assist with Integrity [PDF]

The Search For Accountability And
The Lives of People With Developmental Disabilities

John O’Brien & Connie Lyle O’Brien


This is written as a polemic, a discussion intended to stimulate contro- versy and dispute. While this style has an honorable tradition in politics and philosophy, it is little used in the world of human services, where inquiry is mostly shaped by middle-of-the-road academic social science with its conventions of detached objectivity and quantification. Con- trary to this more usual style, we will assert strong positions because, based on our experience, we believe them to be true and useful. We have been informed by the meetings and interviews noted on the cover page, but we have not been limited by them. We do not claim to be dispensing objective truth, but only to be telling the truth we can see from where we have been. We welcome thoughtful disagreement and evidence and perspectives we have missed.

This report will be particularly frustrating for people who want to tinker with a few new managerial gimmicks rather than redesign ap- proaches to safety and quality from their foundations. Those who want a few, practical, politically feasible recommendations that, if imple- mented, will assure the safety of vulnerable people while improving the quality and cost efficiency of the existing crazy mix of services can save themselves an hour’s effort and stop now. Of course, we will make suggestions that we think are practical. But we make them tentatively, as an aid to thinking and as an invitation to many small scale experi- ments, not as a grand program.