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The Decisions We Make In Social Work Social Work Essay

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Published: Mon, 5 Dec 2016

How do we make ethical decisions in social work? Discuss the process illustrating your arguments with specific case examples.

  Ethical awareness is a fundamental part of the professional practice of social workers. Their ability and commitment to act ethically is an essential aspect of the quality of the service offered to those who use social work services. It is an inevitable process that social workers will find themselves within the dimension of ethical issues which will no doubt challenge the individual and bring about some critical reflection of action. Some of the problem areas where ethical issues may arise include;

“The fact that the loyalty of social workers is often in the middle of conflicting interests. The fact that social workers function as both helpers and controllers. The conflicts between the duties of social workers to protect the interests of the people. With whom they work and societal demands for efficiency and utility. The fact that resources in society are limited.” Beckett and Maynard (2006)

      This assignment will address some of the areas where a social worker may run into conflict. To begin this assignment will examine the importance of values personal, professional, societal and organizational; it will further examine the vital need for a shared core base of professional values within social work. It will begin to discuss the complex nature of social work and the guidance found in the code of ethics when social workers face ethical dilemmas. It will support this concept with a case scenario. The assignment will then discuss another area where an ethical dilemmas can arise, in risk assessment, and will discuss using a case scenario how risk can be managed ethically. The core of the assignment will briefly outline an approach to how an ethical decision can be made and will draw on two theoretical aspects within ethical decision making. To finish this assignment will look at ethics within partnership working where a brief scenario will support the importance of anti-oppressive practice and ethics within organisations. The assignment will then conclude with a summary detailing the need for ethical awareness within social work.

Every day social workers are faced with stressful, even traumatic situations, such as domestic violence, child abuse, the homeless, family tension, mental illness and suicide. Therefore it is fair to say social workers work with the most disadvantaged groups and vulnerable individuals in society. Clark, (2000) p1 says “The service that is provided is seen as the most contentious of all the human service professions”.

It is because of the nature of the job, social workers often find themselves dealing with tough decisions about human situations that involve the potential for benefit or harm. Whilst underpinning the decision process is the strong expectation that social workers must be able to balance the tension between the rights and responsibilities of the people who use services and the legitimate requirements of the wider public. They must also be able to understand the implications of, and to work effectively and sensitively with, people whose cultures, beliefs or life experiences are different from their own. In all of these situations, they must recognise and put aside any personal prejudices they may have. According to Pinker, ‘social work is, essentially, a moral enterprise’ Pinker, (1990) p14 whilst Beckett and Maynard, (2006) p189 states “Almost all of the important decisions that are made by social workers have a value component.”

According to Banks, (2006) p6: ‘Values are particular types of belief that people hold about what is regarded as worthy or valuable’.  Values of the client, profession, organisation and society are an intrinsic part of decision making. Traditional values of social work was first introduced in the early 60s by Biestek. His principles outlined the basics of traditional social work and were constructed of a seven-point scheme. The principles consisted of “Individualism, Purposeful expression of feelings, Controlled emotional involvement., Acceptance, Non-judgmental attitude, User self-determination, Confidentiality”.Biestek (1961). Many of Biestek beliefs were very traditional and were criticised for their diversity in their interpretation. Controversies relating to different principles caused many problematic conclusions, for example individualisation and confidentiality. Individualisation could not be possible in the fast moving modern world, people lose their identity and individualisation is not respected. Confidentiality has its limitations to be enforced for example; If a user shares information where someone will be harmed, the social workers duty is to share it as a right to other individuals. It was clear these key issues had to be developed and advanced to help social workers. Furthermore it was considered that there must be guidance on values and ethics for social workers, as they play a major part in their work.

Banks, (2006) p150 says; ‘There is recognition that personal and agency values may conflict and that the worker as a person has a moral responsibility to make decisions about these conflicts’. Therefore the social work profession is guided by the shared values that underpin its practice set out in the (GSCC 2002) code of conduct. The code is criteria to guide practice standards and judge accountability from social care workers. The work load of social workers deals with individuals who are disadvantaged in some form or another so it is important to have a shared value system to reflect the ethical problems and dilemmas they face.  “‘Working from a professional value is a guide to professional behaviours that maintain identity and can protect service users from malpractice’. Parrott, (2006) p17. On their own personal values will be of limited use. Beliefs and good intentions will not give the professional the knowledge and skills they need to make sense of a practice situation and intervene in it. The difference between personal and professional values include, “professional values can be distinguished from personal values, in that personal values may not be shared by all members of an occupational group, for example, a person who works as a social worker may have a personal belief that abortion is wrong, but this is not one of the underlying principles of social work”. Banks, (2006), p 7.

The GSCC codes of practice contain a list of statements that describe the standards of professional conduct and practice required of social care workers. They are as followed; “protect the rights and promote the interests of services users and carers, strive to establish and maintain the trust and confidence of service users and carers, promote the independence of service users while protecting them as far as possible from danger or harm, Respect the rights of service users while seeking to ensure that their behaviour does not harm themselves or other people, Uphold public trust and confidence in social care services and Be accountable for the quality of their work and take responsibility for maintain and improving their knowledge and skills “GSCC (2002)

It is then hardly surprising giving the complex nature of the professional role a social worker may find them self when making decisions within ethical areas facing an ethical dilemma. The ethical dilemma arises when there are; “two equally unwelcome alternatives which involves a conflict of moral principle and it is not clear which choice is right” Banks (2006). When social workers struggle to reach a decision they can be then guided by the code of Ethics. The primary objective of the Association’s code of Ethics is to express the values and principles which are integral to social work, and to give guidance on ethical practice. BASW (2001). Loewenverg and Dolgoff (1996) state that “Ethic are designed to help social worker decide which of the two or more competing goals is correct for their given situational” . However alongside ethical awareness you have to be aware of the publicly stated values of your agency and make skilful judgements based upon your accumulated knowledge and experience. Ethical considerations are rarely the responsibility of one worker; however, agencies’ policies and structures of accountability offer both guidance and a standard against which your practice can be measured. “Accountability, therefore, is the process through which employers and the public can judge the quality of individual workers’ practice and hold them responsible for their decisions and actions.” (Derek Clifford & Beverley Burke 2005)

 

Competing values and multiple-client system are two areas where a social worker may find themselves facing an ethical dilemma. Weather it is the social work values that is competing against agency values or within each a confliction of values, which will leave the social worker in need to decide which value will take priority. Also deciding which role the social worker must take in order to reach the right decision can lead to the dilemma of role confliction. Beckett and Maynard (2006) suggest that the role of a social worker can be put into three groups: Advocacy, Direct Change Agent and Executive. “The advocacy role can be either direct or indirect. Direct change agent being counsellor or therapist, mediator, educator and catalyst, with executive role as almoner, care manager, responsibility holder, co-ordinator and service developer” (Beckett and Maynard 2006 p8).

The GSCC (2002) code of conduct says “As a social care worker, you must strive to establish and maintain the trust and confidence of service users and carers” (s2), which includes “Respecting confidential information and clearly explaining agency policies about confidentiality to service users and carers. Consider the following scenario; whilst on placement a client disclosed sensitive information to a trainee social worker regarding the well-being of her neighbours’ children. After clarification that social worker would have to pass this information on to their manager, the client did not wish to consent to the information being passed on. When the supporting relationship had ended, the social worker had to then make a decision based on where there priorities lay. As they were supporting the client who disclosed, they had a responsibility to uphold the standard of respecting her confidentiality. However they also had a responsibility to the wider society which in this case was the children who were at risk of harm. 

 

When making the decision they assessed all the information and weighed up the outcomes. Do they withhold the information in order to maintain the trust and respect of the client or do they prioritize the needs and risk of the children? They then turned to the agency safeguarding policy and the code of ethics for social workers which clearly states; “we must not promise to keep secrets for or about a child or young person” Agency safeguarding policy, (2010) p10 and further states; “We aim to safeguard children at all times, by delivering our services safely and by sharing information when there is a concern”.p9. Clearly the value of life outweighed the needs and wishes of the client in this circumstance. However to whom did the social worker owe responsibility and which role should they take in this situation. Banks (2006) p48 clarifies this conflict by suggesting : ‘Yet while the social worker may be able to focus largely on one individual service user and take on the role of advocate for the service users rights, often the social worker has to take into account the rights of significant  others in a situation.  In the interests of justice it may not always be morally right to promote the service users rights at the expense of those of others’

 

The social worker if doubting her judgement, would address the BASW (2001) code of Ethics to guide the outcome of her decision, the code states; “Social workers will not act without informed consent of service users, unless required by law to protect that person or another from risk of serious harm”. (4.1.4 p8) Furthermore it guides us by stating; “In exceptional circumstances where the priority of the service user’s interest is outweighed the need to protect others or by legal requirements, make service users aware that their interests may be overridden.” (4.1.1 b p8) As you can see the code of ethics guided the social worker to the right course of action that they should take. They were duty bound by law to act on behalf of the individuals who were at most risk.

 

According to Parrot (2010) p86 Risk refers to the “likelihood of an event happening which in contemporary circumstances is seen as undesirable.”  It is when facing issues involving risk that values become of central importance in enabling practitioners to manage risk. Consider the following scenario; a social worker visits an elderly lady in her home after a referral is made by the ladies niece. The niece is concerned for the safety of her aunt after a recent decline in her aunt’s mobility and health which resulted in a nasty fall. The niece lives quite far away and cannot provide regular care for her aunt. The lady values her independence and does not want to be put in a residential home which her niece thinks would be for the best; however there is a concern able risk that if some form of intervention is not in place the lady is at serious risk of hurting herself further. The social worker is faced with a dilemma. The lady has a right to autonomy and self-determination however there is a risk of potential harm happening. The social worker must risk assess the potential outcomes and measure the risk involved. Which on one hand the individual faces residential care involving losing much personal freedom and autonomy; on the other hand to leave a person in their own home to face social isolation and to be potentially at risk of physical danger may also be unwelcome. Social workers have to look to the consequences of their actions and weight up which action would be least harmful / most beneficial to the user, and which action would benefit most efficiently’  Parrott (2010) p51 While Kemshall (2002) p128 argues,” risk management cannot guarantee to prevent risk. It can attempt to limit the chances of risky situations tuning into dangerous ones or reduce the consequences of such situations. As she suggests, minimization rather than reduction is the key”.

 

In other words to approach this situation the social worker will identify the social work values that is embedded in the their practice which is; “As a social care worker, you must respect the rights of the service users while seeking to ensure that their behaviour does not harm themselves or other people”. (GSCC 2002 s4). For further guidance the social worker will identify with the code of ethics  which states; we may ‘limit clients’ rights to self-determination when, in the social workers’ professional judgment, clients’ actions or potential actions pose a serious, foreseeable, and imminent risk to themselves or others,’ but it also tells us that we are to ‘promote clients’…self-determination’ Code of Ethics (1.02). Weighing up the outcomes of the individual the social worker will be committed to allowing the individual choice and empowerment. And work with the elderly lady to ensure her self-determination remains able whilst also advocating on the ladies behalf to ensure she is able to access services which will allow her to live a safe independent life. Thompson (2005,p170) cited on blackboard says it is the social workers role to enable service users and carers: ” to gain power and control over their own lives and circumstances…..to help people to have a voice…..so that they counter the negative effects of discrimination and marginalization whilst Hatton (2008, p145) cited on(class PowerPoint 2011) “sees social workers role as active change agents to create: ” an empowered and active group of service users and carers who hold us to account, share in our decision making and participate actively in the way we deliver services”

 

Social work decisions span a wide range from safeguarding through to allocation services and advising clients and families on courses of action to improve their lives. As we can see some decisions may involve a breach of confidentiality and assessment of high risks such as a vulnerable adult in need of services to improve their quality of life and prevent harm even death. It is important therefore for social workers to be able to justify their actions.  Social worker therefore must draw upon a variety of professional knowledge – such as law, policy, research, theory, standards, principles and practice wisdom – to inform complex and sensitive judgements and decisions in uncertain situations where harm may ensue. “Much of what social workers do concerns decisions about future courses of action, which puts decision making at the heart of social work as a core professional activity”. Banks (2006) p9

This assignment will now examine how the ethical dilemma can be resolved by discussing an approach to guide the process of ethical decisions in practice. We have identified that social workers are expected to critically examine ethical issues in order to come to a resolution that is consistent with social work values and ethical principles. However how is the social worker able to organize all the components relevant to the decision and outcomes. One example of a model to help assist the social worker reach resolution is Mattison (2000, p.206) His model offers a framework to analyse ethical dilemmas such as: Define and gather information; Once the social worker has identified an ethical dilemma, they begin the process of making a decision by fully exploring case details and gathers needed information to understand holistically the client’s current circumstances. Supporting this is Horner (2005 p97) who says that social workers are to “engage holistically with both the person and their circumstances whilst at the same time recognizing the processes of power dynamics at the play in the helping relationship”

It is then important for the social worker to distinguish the practice aspects of the case from the ethical considerations (so separate practice from how you have learned to think about ethical issues). Identify value tensions The social worker must refer to the professional code of ethics – to help clarify obligations and identify the principles that have a bearing on the dilemma The social worker projects, weighs, and measures the possible courses of action that seem reasonable and the potential consequences of these The social worker after weighing up options must select an action for resolving a dilemma. This involves determining which of the competing obligations are we going to honour foremost (this may mean at the expense of others). The social worker reaches the resolution stage and this means being able to justify the decision.

To further this ideas of influence on decisions It is also vitally important for social workers to take time to reflect on their practice and own values. This is a vital point because although guides and frameworks can be developed to offer social workers a logical approach to the decision making process, to some extent, the use of discretionary judgments is evitable (Mattison, 2000). The value system and preferences of the decision maker ultimately shape the process of working through dilemmas and so it is important for social workers to be ethically aware of their character, philosophies, attitudes and biases. Furthermore, philosophers have argued that elements of deontological and teleological thinking operate in and influences decision making in ethical dilemmas. A deontological thinker is grounded in the belief that actions can be determined right or wrong, good or bad, regardless of the consequences they produce and so adherence to rules is central. Once formulated, ethical rules should hold under all circumstances (Mattison, 2000). On the other hand a teleological thinker is ground in the belief of consequences and so weighing up the potential consequences of proposed actions is central to this way of thinking (Mattison, 2000). So a social worker following a deontological way of thinking will differ in their approach to ethical decision making compared with a social worker following a teleological way of thinking.

As part of the profession social workers often find them self-working collaboratively with other professionals such as doctors, police, nurses, teachers and probation officers to name but a few.  Considering the variety of different professions merging to reach possible outcomes it is not surprising that partnership working becomes a complex problem. “Mainly because of the assumptions that we are all working towards a collective aim”. Bates cited in Parrot (2010.) Different values, ideologies, ethics and culture of working can too lead to confliction of interests.   Effective partnerships require sustained relationships, shared agendas built up over time and a commitment to shared problem solving. “When different professional groupings come together in collaboration then they bring with them their own ways of working, organisational cultures and attitudes, their particular practice experience and their own ethical codes” Parrot (2010)

Consider the following scenario; a social work student commitment to anti oppressive practice is clearly challenged whilst on placement.  The voluntary organisation which they are placed with worked in partnership with the crown court. One day as they were waiting for an expected family, to whom they were supporting, they are then approached by an usher (a worker of the court justice system). He commented on the family jokingly saying; “Oh no not that family again they are low life Jeremy Kyle watching scroungers, they bring the trouble on themselves”.  This use of stereotypical language discriminated and negatively challenged the whole purpose of the organisations aims which is to value diversity, whilst also conflicting with section 5 of the core values of the GSCC “You must not discriminate unlawfully or unjustifiably against service users, carers or colleagues” (GSCC 2002 5.5) Parrot (2010 ) suggests “There is no appropriate way at which a social worker can condone such language weather they choose to confront the issue at hand or make a formal complaint”. Parrott (2010) further states; “what is the point in partnership working with fellow professionals only to result in the dilution of the social workers value base and the demeaning of service users”. The point of partnership working is not to deliver appropriate services to service users only to have them undermined by some partners exhibiting discriminatory attitudes.

What if in the scenario discussed above, the discriminatory attitudes and beliefs of the usher, was an unconscious influence to the social workers approach when working with the individuals involved in the scenario. This could result in an already marginalised group becoming oppressed further.  Thompson, (2005 p34) describes oppression as; ‘Inhuman or degrading treatment of individuals or groups; in hardship and in justice brought about by the dominance of one group over another; the negative and demeaning exercise of power. Oppression often involves disregarding the rights of an individual or group and this is a denial of citizenship’.

Thompson further suggests that oppression can act at three levels, these levels of oppression offers a framework for looking at how inequalities and discrimination manifest themselves. “Personal level which relates to an individual’s thoughts, feelings, attitudes and actions. Cultural level which looks at shared ways of seeing, thinking, and doing. Structural level relates to matters such as policy.” Thompson (2005 p21 -23) Abramson 1996 cited in Mattison (2000) supports this by saying “The process of the decision making is forged by the prejudice and prejudgement brought to the decision making process by the decision maker”. Therefore social workers as agents of change attempt to alleviate inequalities and oppression within societies and need to be aware of the values underlying their work by referring to the code of ethics. By adopting values and anti-oppressive practice such as advocacy; social workers will be able to make informed decisions in addressing aspects, which relate to the provision of services to individuals who may have differing needs. Parrott (2010 p23) describes Anti oppressive practice (AOP) as “a general value orientation towards countering oppression experienced by service users on such grounds as race, gender class age etc’. AOP are also values of working in partnership and empowerment.”

“Social workers and their employers have an ethical duty to ensure that the organisations they work for operate in a just manner” Parrot (2010) Social work organisations therefore must uphold the portrayal that social work is something worthy and the operation of its organisation will lead to positive outcomes. The commitment to social justice ensures public organisations work under legislation to eliminate unlawful discrimination and to promote equality of opportunity and good relations between persons of different racial groups.  Expectations of the social care employee are prompted by the GCSS code of conduct.  For example in the case scenario discussed above if the attitudes of the usher was another social worker within an organization the social worker would act on guidance on policy procedure and ensure the commitment to social justice was withheld. If the other social workers attitudes towards service users resulted in unfair treatment and inequality of services than they are not upholding the ethical principles of effective practice stated in the IFSW (1994)  “Social workers should recognise and respect the ethnic and cultural diversity of the societies in which they practise, taking account of individual, family, group and community differences.” S4.2.2 Therefore the other social worker would have a responsibility to Challenging unjust practices “Social workers have a duty to bring to the attention of their employers, policy makers, politicians and the general public situations where resources are inadequate or where distribution of resources, policies and practices are oppressive, unfair or harmful.”s4.2.1

If the other social worker is ethically aware and challenges injustice it is their moral obligation to bring to the attention of the organisation the other social workers behaviour. The social worker would participate in whistle blowing Parrot (2010) p154 defines whistle blowing as  “The disclosure by an employee, in a government agency or private enterprise, to the public or to those in authority, of mismanagement, corruption, illegality or some other wrongdoing.”  The organisation will then deal directly with the moral character of the social workers discriminatory attitudes.

In conclusion social work can be a challenging subject and one that will actively push the boundaries of all social workers on a personal level and professional level. It is agreed within social work that ethics, morals and values are all an inescapable part of professional practice and ‘Ethical awareness is a necessary part of practice of any social work’ (IFSW, 1994).  However as this assignment has discussed guides can be provided but inevitability it is up to the social workers discretionary judgement of the circumstances. Arguably It is therefore important as a social worker to be aware of the code of ethics, and to talk, discuss, debrief and debate with colleagues and supervisors about dilemmas they may be struggling with. Finally, the onus is on social workers to be reflective about themselves and how ‘self’ influences practice and decision making. To finish we have to be critically aware of personal beliefs and biases, bringing them to light so they do not unconsciously influence our practice decisions, leading to injustice and unfair distribution and access to services. Service users must be put at the heart of social work practice and it is our duty as social workers to take any necessary steps within our organisations to ensure mistreatment and inequality is brought to surface. We can therefore improve public trust within the social service profession and encourage service users to work in partnership to empower their lives.

References

 

Agency Safe guarding Policy, (2010)

Banks, S., (2006). Ethics and Values in Social Work .3rd Ed. Basingstoke: Palgrave Macmillan,

BASW (2001) The Code of Ethics for Social Work,

Beckett, C. & Maynard, A.,( 2005). Values and Ethics in Social Work: An Introduction, London: Sage

Biestek,F. (1971). The Casework Relationship, 7th Ed Unwin: University Books.

Clark, C. (2000) Social Work Ethics: Politics, Principles and Practice. Basingstoke: MacMillan

Class PowerPoint, Values and Ethics, Blackboard (2011)

Clifford, D & Burke, B, Anti-oppressive Ethics, Social Work Education, Vol. 24, No. 6, September (2005), pp. 677-692

GSCC (2002) Codes of Practice for Social Care Workers and Employers, London: GSCC

Horner, N. (2005) “What is Social Work? Context and Perspectives”. Exeter: Learning Matters

International Federation of Social Workers (IFSW) available at; http://www.ifsw.org/p38000324.html, accessed on 12/05/2011

Kemshall, H and Pritchard, J (1996) Good Practice in Risk Assessment and Risk Management. London: Jessica Kingsley Publishers

Loewenberg, F. and Dolgoff, R. (1996) Ethical Choices in the Helping Professions. Ethical Decisions for Social Work Practice, 5th ed., Illinois: Peacock Publishers:

Mattison, M. (2000) Ethical Decision Making: The Person in the Process Social Work Vol.45(3), pp.201-212.

Parrott, L, (2010) Values and ethics in social work practice 2nd ed, learning matters: Exeter

Pinker, R. (1990) Social Work in an Enterprise Society, London:  Routledge.

Thompson, N, (2005). Understanding Social Work: Preparing for Practice. 2nd Ed. Basingstoke: Palgrave Macmillan.

 


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