Navigating Ethical Dilemmas in Social Work Practice

Ethics in Practice ETHICAL BEHAVIOR The director of a local social work agency was called by a man, Don, who volunteered to give the agency money to help the needy. The director, a licensed social worker, arranged to meet him at a local cafeteria. They met and had a long conversation about what the agency did, what more money could do, and what he was willing to provide. The director was struck by the man's appearance when he came up to her; he did not look like someone who could afford t o give money: ″He looked like one of the people we tried to help.″ Think about it: How you would handle this situation if you were the social worker in this case? WHAT IS ETHICAL AND WHAT IS NOT? Ethics are a major part of our professional practice. We are held to a particular standard by our profession (and license, when applicable) that defines exactly what we must do in our professional practice to remain ethical. But determining the ethical choice is not always easy.

Social Work and Ethics in Practice ETHICS AND VALUES Ethics Gone Wrong When social workers do not follow the Code of Ethics, serious consequences can follow. 1. You may be harming another individual and yourself. 2. You could lose your license. 3. You could go to jail, depending on the offense. Social Work Values Our Social Work Code of Ethics was developed by the National Association of Social Workers (NASW). It is based on the social justice framework we practice and professional values. As you explore each value below, think about your own personal values and ethics. What is your moral compass on each of these? [Flow Chart interaction. Students click a down arrow to expand further details about the topic. Expanded information is shown below.]

Competence Practice in your scope. Integrity Operate as an ethical professional (follow up, work in collaboration, and mutual respect with others). Dignity Honor and value others, because we are all humans. Right to human relationships Understand the importance and impact of connection to others. Social Justice Stand and advocate for fair and equitable standards, regardless of socio- economic status. Service See value in service provision with clients, organizations, communities, etc. Values and Ethics Ethics are the guidelines, but our professional values are how we operationalize our behaviors. Learning these simple ethical principles will keep you safe and your client in a healthy social worker/client relationship. [Accordion interaction. Students click a headline to expand the topic and reveal further details. Headlines are bolded and underlined, with their contained information below.] Self-determination Clients have the right to make their own decisions.

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Providing informed consent Clients should always participate in the work willingly and sign an informed consent form indicating affirmation. Preserving professional boundaries Maintain appropriate relationship boundaries: no advice giving, no friending or following on social media, etc.

Safeguarding confidentiality Clients always have the right to confidentiality; the general exception is a risk of harm to self or others. Let’s revisit Don from our opening segment. In the conversation with Don and the social worker, Don seemed somewhat confused; so, the social worker thought he might be somehow mentally impaired, though in a minor way. After the conversation, she received a check from a local bank for several hundred dollars, with a note that the contribution was from Don and that a like amount would be provided every month. She was concerned that Don could not afford such a gift and called the bank to check. She was told that the

information she requested about his financial status was private and that she would have to ask Don. He called her several days later and asked to meet her for lunch. She went to explain to him her concerns. She did, and he brushed them off, saying that he had enough money and that he wanted her to have it. That lunch was followed by more invitations to lunch and by phone calls, in which he called her his girlfriend. She went to several lunches with him, explaining that she felt that she owed that to him, but she got more and more uncomfortable with going to lunch and with what he apparently expected from the relationship. At the same time, she felt that he was more like a client who seemed to need help and that she might be able to help him. How many ethical considerations are within this scenario, and has the social worker violated any? Ethical Situations In this activity, we are going to give you some real-life situations where ethical principles come into play. As you read each card and flip it for the behavior, determine what you would do in this situation. [Flip card interaction. Students click a card to reveal further details on the back. The table below displays the fronts and backs of each card.]

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Flip Card (Front) Flip Card (Back) Providing Informed Consent What about the person mandated by Drug Court to seek intervention or risk going to jail? Is that really a choice? Involuntary clients can feel coerced. Preserving Professional Boundaries Consider that some clients may try to find you on social media and want to be friends. Or, a client may ask you for personal advice. How will you handle this? Safeguarding Confidentiality Clients always have the right to confidentiality; the general exception is the risk of harm to self or others. How do you know what to keep confidential and what not?

Social Work and Ethics in Practice ETHICAL DILEMMAS Resolving Ethical Dilemmas Learn about Henry's case and a potential ethical dilemma it presents. Video: Resolving Ethical Dilemmas Transcript: You ever received an intake for Henry a 14 year old Latino adolescent who presents to therapy. You already have issues working with adolescents, but there is no one else to take this case. You also aren't super comfortable working with Latino clients. You meet Henry. We all have implicit biases. It's necessary to understand what your implicit bias or biases are, or maybe so that we might be mindful and attentive of these areas. This self-reflection awareness is necessary not only for ethical practice, but for the implementation of professional practice behaviors like boundary setting and engagement and anti-oppressive practices. Particularly if you find that you're not comfortable working with certain populations, presenting problems etc. You will need to engage in self-awareness exercises and a management plan to understand and control it in an ethical manner. What could that management plan include? What are your next steps? Explore additional implicit biases you may have and discuss in supervision. Review the code of ethics and implement in your practice. Continue to engage in self- awareness assessments and attend to issues as they arise. REFLECT Ethical Behavior In your journal, consider the case study above and reflect on the following: • Is this an unethical situation? Why or why not?

• Did the social worker act in accordance with the NASW Code of Ethics? Why or why not? • What would you have done differently? ETHICAL DILEMMAS Resolving Ethical Dilemmas Your text provides a good understanding of identifying, and steps to resolving, ethical dilemmas. Most commonly, dilemmas are not ethical in nature, but are more likely a conflict with personal values or a practice dilemma. It is important to identify these, because they can cause burnout, frustration, ambivalence, and so on. Social workers can have personal values that differ from professional values, but they must always embody and maintain professional values when working with clients. Self-awareness helps to understand when values are in conflict, to address and resolve the issue.

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Solving Ethical Dilemmas — Case Study Here is a case study to walk you through the process of dealing with ethical dilemmas. Ethical dilemmas are not always clear and straightforward. They require tools to work with, application of the Social Work Code of Ethics, and a view of the problem from many different perspectives. Read here as we present a case in ethical dilemmas, and the step-by-step process for dealing with the dilemma. ETHICS AND VALUES Cases of Potential Ethical Pitfalls Think about how you would handle the given situation, then flip the card to see the ethical answer. [Flip card interaction. Students click a card to reveal further details on the back. The table below displays the fronts and backs of each card.]

Flip Card (Front) Flip Card (Back) You have a client who is pregnant and weighing her options to keep or terminate the pregnancy. You are pro-life. How do you resolve this issue? Answer: Even if you disagree with the client's choices, clients have the right to self-determine, and, as such, our role is to provide them with educational resources for ALL available options and to allow them to select what they see as the best choice, regardless of your views. You cannot withhold information about abortion services based on the idea that you do not agree. You are working with a 15- year-old client who discloses they are smoking weed. Do you disclose this information to parents? Answer: You must first consult your agency, state, and federal laws regarding consent and confidentiality limits when working with a minor. If you are not legally responsible for disclosing, then you should use an ethical decision-making process to determine if the use is placing the client at safety risk. If they are smoking in their room vs while driving, you can make determinations based on this type of evaluation. However, you cannot disclose the information to the caregivers based on the sole fact that you disagree.

Anti-Oppression and Racism ETHICS AND VALUES When we think about ethical practices, particularly from a social justice framework, it is necessary for us to engage in a conversation around anti- oppressive practices as a guiding framework for the work we do with clients. We must inhibit principles of anti-oppressive practice within our work as social work practitioners. Anti-oppressive practices rely on a deep critical analysis and understanding of how clients are positioned within the systems where they interact: within their family, community, school or educational system, healthcare system, and the social hierarchies within groups and their experiences within those.

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ANTI-OPPRESSION AND RACISM Anti-Oppression There are many models to deal with issues related to oppression. In social work, we deal with anti- oppression and racism from two different lenses. Cultural humility looks at them from a relational standpoint, whereas anti- oppressive practices look at them more structurally. There has been a critique of anti-oppressive social work practice, particularly because it doesn't encompass a more relational-based aspect or position related to the work we do as social workers. [Flow Chart interaction. Students click a down arrow to expand further details about the topic. Expanded information is shown below.] Anti-oppression in social work: Encompasses a much more relational approach, because it's honoring the variety of cultures and experiences that our clients bring to the table. Intently focuses on the relational aspect of social work practice as we understand power and positionality. Overlaps conceptually with anti-racist practices. The bottom line is that we must look at the relational aspect and the importance of honoring cultural humility within our work, so that we are providing the most inclusive practices to our clients.

Racism Anti-oppressive practices discuss racism, among a lot of other topics of concern. Some advocates within the field will say that when you explicitly focus on anti-racist practice, you can get too detailed. Others will say that when you focus just on anti-oppressive practices, you can be too broad. Professional behaviors that we exhibit as social workers should come from two perspectives: 1) anti-oppressive and 2) anti-racist . If we operate in these two areas by honoring cultural humility through our code of ethics and social justice framework, we should be within the ethical practices of our work. ETHICS AND VALUES Within Our Agency Sometimes we may discover that our team members in our agency, or other support systems, do not practice the same values as we do, or honor the same frameworks and cultural humility. We are responsible to talk to our colleagues, or go to our supervisors, if we are unable to remediate the issue. Have a discussion with your colleague, and you know what our Code of Ethics says. It is important to critically analyze both anti-racist and anti-oppressive practices and to work to exhibit this within the work you provide to your clients.

Wrap Up SOCIAL WORK ETHICS, ANTI-OPPRESSION, AND RACISM Key Takeaways 1. Social workers are mandated to know, apply, and adhere to the NASW Code of Ethics in all roles and functions of social work practice. 2. We have an ethical responsibility, not only to our clients, but to our colleagues; the practice setting; as professionals, to the social work profession; and to broader society. 3. Ethical decision-making and engagement in anti-oppressive practices must always be at the forefront of your social work practice; seeking supervision and consultation is a necessary step to this process. Credit Attribution and Copyright Details Attribution is provided in-line except as follows: • fizkes / Shutterstock • Monkey Business Images / Shutterstock • Vitalii Vodolazskyi / Shutterstock • fizkes / Shutterstock • Jacob Lund / Shutterstock • Rose Marinelli / Shutterstock • All remaining images are copyright of the University of Kentucky or are in the public domain.

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