Recently, I received a phone call from a seasoned social worker seeking
consultation. The social worker is employed by a community mental health center where she provides clinical services to people with chronic mental illness. Two days earlier, one of her clients, Alice M., committed suicide. According to the social worker, Alice struggled for many years with depression and cocaine addiction.
Immediately following the suicide, Alice's parents—who had participated in her treatment at various times in the context of family counseling—contacted the social worker to discuss this tragic turn of events. The social worker met with her parents, with whom she had considerable rapport, and they talked about Alice's lifelong triumphs and challenges. Alice's parents spoke at length about how much they appreciated the social worker's earnest efforts to help their daughter. The parents also talked about how difficult it would be for them to bury their daughter the following day.
Toward the end of the conversation, Alice's parents told the social worker that they wanted to ask a special favor. They explained that the social worker was an important person in their family's life and that it would mean a lot to them if the social worker would deliver a eulogy at their daughter's funeral.
The social worker was touched by the parents' sentiments and their poignant request. She felt close to the family and wanted to be supportive. At the same time, however, the social worker quickly recognized the ethical dilemma facing her. She was especially concerned about violating Alice's privacy and confidentiality. The social worker was also concerned about managing the boundaries in her relationship with the family; she wanted to avoid entering into an inappropriate "dual relationship." The social worker was deeply ambivalent and unsure about how to resolve this ethical dilemma—a situation in which professional values, duties, and obligations clash.
In recent years, social workers have refined their approach to ethical decision making. Although many practitioners completed their formal education at a time when content on ethical dilemmas and ethical decision making was not a prominent component in the social work education curriculum, continuing education on the subject is now common. Today's social workers and social work students are being introduced to state-of-the-art frameworks to help them identify ethical dilemmas and make difficult decisions.
Ethical dilemmas come in all shapes and sizes. Many involve social workers' delivery of services to individuals, families, couples, and small groups. Typical examples involve disclosing confidential information without a client's consent (for example, when a client threatens to harm himself, herself, or someone else); limiting a client's right to self-determination against his or her wishes (for example, when a social worker pursues involuntary psychiatric hospitalization of a troubled client); or social contact with a former client.
Other ethical dilemmas pertain to agency administration, community work, social policy, and research. Examples include administrators' decisions about the allocation of scarce or limited agency resources (what moral philosophers refer to as distributive justice issues), conflicts of interest among staff, and the use of ethically questionable marketing strategies to solicit clients. Still other ethical dilemmas involve relationships among professional colleagues. Common examples involve a social worker's response to a colleague who has behaved unethically or who is impaired or incompetent (the ethics of "whistle-blowing").
The literature in most professions now contains thoughtful discussions of conceptually based frameworks designed to guide practitioners' ethical decisions. These frameworks do not guarantee easy solutions to hard ethical choices, of course; rather, they provide useful guideposts to help professionals who face daunting ethical circumstances. Although the frameworks vary, they tend to contain common elements.
Answer the questions using the diallog
-What is the dilemma?
-What are the relevant social work values and ethical principles that conflict?
-Who is likely to be affected by the ethical decision? (Individuals, groups, communities, agencies)
-Identify all possible courses of action and the participants involved in each potential action
-Identify possible benefits and risks for each potential action.
-Thoroughly examine the reasons you are in favor of and opposed to each possible course of action, considering relevant
-(a) ethical theories, principles, and guidelines;
-(b) codes of ethics and legal principles;
-(c) social work practice theory and principles; and
-(d) personal values (including religious, cultural, and ethnic values and political ideology).
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