SWK 321 - Ethics (Marissa)
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School
Central Michigan University *
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Course
321
Subject
Philosophy
Date
Feb 20, 2024
Type
Pages
8
Uploaded by olmst1ss
Ethics Assignment: Scenario Three
SWK 321
Deana Hunt
Marissa Neveau and Fiona Woodrow
Page 1
Introduction:
Scenario three examines the case of Judy Allison.The ethical dilemma presented
within the scenario shows the concept of client’s rights against a professional’s
judgment. Using the eight steps outlined within the decision making process, we
determined that the best course of action is to let Judy decide what’s best for her
treatment.
Decision Making Steps:
Step 1: Recognize Problem:
Judy was diagnosed with bulimia nervosa, which can be a life threatening eating
disorder. Recently, Judy was admitted into the hospital after her sister found her
unconscious on the bathroom floor. During our first meeting she recognizes that she has
a problem and has self-determined her own treatment plan.
Step 2: Investigate the Variables Involved:
Judy’s treatment plan consists of eating only fruit and vegetables. One of her
friends recommended this treatment stating that she “could be cured” by the diet. We
are unaware of this diet. However, this has become her goal for treatment.
Step 3: Get Feedback from Others:
To offer the best treatment to Judy, we decided to consult with our supervisor
about our concerns for the new treatment plan. We also spoke to Judy about our
concerns and desire to talk with her sister. We decided to consult with her sister, she
was the one who found her lying on the bathroom floor. It is also important to
communicate the execution of treatment plans and the concerns that come with it.
Page 2
Step 4: Appraise What Values and Ethical Standards Apply to the Dilemma:
We as social workers need to understand that every client has rights to
self-determination. Which is why we believe that Judy has the ability to continue with
her desired treatment plan. According to the NASW Code of Ethics, social workers have
to respect and promote the self-determination of clients. Unless, their decision will harm
themselves or other individuals.
Step 5: Evaluate the Dilemma on the Basis of Established Values and Principals:
Even though Judy’s decision goes against professional judgment, we believe
she is not in immediate harm to herself or others. We fully understand how this conflicts
as the NASW Code of Ethics states that social workers should not be endorsing
treatment plans that lack recognized knowledge and approved treatment methods. In
order to comply with the Code of Ethics, we will continue to do research on the new diet.
We will begin to form a better understanding of the risks and benefits that come with it.
Step 6: Identify and Think of Possible Alternatives to Pursue:
We will inform Judy of the other two researched programs that we are aware of.
We recommended to Judy to consider one of these programs and to discuss the
programs with a representative.These programs are both multidisciplinary, offering both
inpatient and outpatient treatment, individual and group therapy, and a follow-up. If she
is unwilling to try one of these programs, we will express our concern about this new
diet. Finding out what the other two programs lack may help us determine why she
chose the diet. This will allow us to try to incorporate different elements of both the diet
and the approved treatment options. Combining both of these options may lead to a
healthier alternative that she’ll compromise with.
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Page 3
A study was done in Sweden that focused on how parents played a role in
treating eating disorders. The results of the treatment varied based on the family
situation. Some found family-based therapy helpful while others had issues sharing
information with each other. Therapists want to involve parents in treatment so they can
better understand the development of the disorder and identify supporting factors.
(Lindstedt et al., 2015). When working on Judy’s case, I think that family should be a
factor considered. Having some family involvement may help determine some causes,
what support she has, and better treatment plans.
Step 7: Weigh the Pros and Cons of Each Alternative:
We understand that Judy has the right to choose this diet. However, we believe
there are more cons than pros with completing this diet. Some of the risks that have a
likelihood of occurring are losing too much weight, becoming anorexic, and damaging
organs. All of these risks are based on the experiences of other individuals that tried this
diet, (EDsupportform.com, 2017). These are not guaranteed outcomes, but could come
into play. However, building trust with Judy by understanding her wishes is an outcome
that we could expect. By establishing trust, we hope that Judy will come back should the
diet prove unsuccessful.
Based on a research study for bulimia nervosa, the common outcomes include
recovery, improvement, chronicity, mortality, and crossover to other eating disorders.
According to the study, the crossover to other eating disorders in the course of bulimia
nervosa is very common. The study states, “the mean rate of crossover diagnoses,
which was between a 10% and 32% range, depending on the criteria for the
outcome”, (Steinhausen & Weber, 2009). Based on the criteria in the study, the average
Page 4
rate for recovery is 45%, improvement is 27%, and chronicity rate is 23%. (Steinhausen
& Weber, 2009).
Step 8: Make your Decision
Our decision is to try to have Judy consider the other treatment plans. However,
if she refuses, we should try to discuss different ways we can compromise with diet and
consultation. If she is still adamant that she only wants to do the diet, we will respect her
wishes. We will also have her follow-up with her primary care physician.
Peer Feedback:
We spoke with Miranda Smith who is a fellow student in the social work program.
Having this discussion with her helped us realize that we forgot to share some
information with Judy. Miranda pointed out that we did not inform Judy that we are
mandated reporters. This is information that we need to tell Judy in case her treatment
is not working and her health begins to decline. The other suggestion that Miranda
provided us was that we should try to not to use our own opinion since she is more than
likely hearing the same thing from everyone else. Instead, we should offer different
resources and inform her that we should see progress within a certain timeframe. If we
do not see progress then we will have to try a new treatment plan. Finally, Miranda
suggested that we include how we know she will follow up with her primary care
physician.
Conclusion:
In conclusion, we determined the decision making process for our client Judy and
had a fellow peer review our work. We used multiple different sources throughout the
eight steps to determine the best care for Judy’s eating disorder. Once we came up with
Page 5
a plan, we had Miranda give us feedback. Having a fellow social work student review
our work was beneficial. We were able to determine what information we missed and
other suggestions to improve the care we can offer Judy.
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Page 6
Works Cited:
Fruit and veggie diet
. Eating Disorder Support Forum. (2017, January 8). Retrieved
February 9, 2023, from
https://www.edsupportforum.com/threads/fruit-and-veggie-diet.1100297/
-
Eating Disorder Support Forum is an online support forum for individuals
diagnosed with eating disorders. Chat logs are moderated by professionals in
order to help analyze any concerning posts. This means that much of the
information is written from a personal stance. However material that could be
considered harmful to an individual's health would not be allowed to be shared
without proper monitoring. While it is not peer reviewed, we decided to include it
due to the knowledge and experiences shared about the fruit and veggie diet.
Kirst-Ashman, K. K., & Jr., G.H. H. (2017).
Empowerment Series: Understanding
Generalist Practice
(8th ed.). Cengage Learning US.
https://bookshelf.vitalsource.com/books/9781337515238
-
We used the Empowerment Series in this essay for the eight decision making
steps. This book gave us the information to fully assess Judy’s case.
Lindstedt, K., Neander, K., Kjellin, L., Aila Gustafsson, S. (2015, March 25). Being
me and being us - adolescents' experiences of treatment for eating disorders.
BioMed Central
.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4381673/pdf/40337_2015_Article_5
1.pdf
-
The BioMed Central article gave detailed information on why it may be beneficial
for parents to be included in treatment plans. We included this information since
we would like to get a better understanding of her family dynamics. This study
gave an insight of how parents may be beneficial or may cause more harm to
treatment.
NASW, National Association of Social Workers. (n.d.). Retrieved February 9, 2023,
from
https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English
-
The National Association of Social Workers provides a Code of Ethics to abide
by. For the case of this paper, we used it as a foundation for examining the
dilemmas. We specifically used promoting self-determination within clients and
seeking out knowledge on treatment methods before condoning them.
Page 7
Steinhausen, H., & Weber, S. (2009, December 12). The Outcome of Bulimia
Nervosa: Findings From One-Quarter Century of Research.
Psychiatryonline
.
https://ajp.psychiatryonline.org/doi/epdf/10.1176/appi.ajp.2009.09040582
-
This article was a cumulation of 79 studies and their outcomes all focused on
Bulimia Nervosa. They examined commonalities between the data in order to find
centralized numbers. This in turn showed what paths an individual diagnosed
with Bulimia Nervosa may go down. Unfortunately the varying studies did use
different diagnosis criteria which makes it possible that the numbers are slightly
off. In order to account for this, many of the numbers presented are put into a
range rather than a concrete median. We included this in order to have a better
understanding of what may happen to Judy depending on what route of
treatment she decides to take.