Risk and Social Work Practice

Abstract

Risk assessment and risk management have emerged as central organising principles for an increasing number of health and welfare programs. As a consequence, the language, technologies and imperatives of risk have assumed considerable prominence in the practice of many social workers. The present paper addresses three significant and contemporary explanations for the rise of risk in the day-to-day work of many social workers. In the context of these approaches, the paper examines some of the challenges risk presents to professional and ethical social work practice. Four issues with particular meanings and impacts for social work are discussed, namely the priority of risk over need, changing professional roles, relocation of responsibility to individuals, and the culture of blame.     

Preadoption Genetic Testing: Social workers' decision-making process

Abstract

Genetic testing requested by prospective adoptive parents and/or an adoption agency prior to adoption, known as pre-adoption genetic testing, is postulated to help identify the best placement for the child. However, limited data exist about factors impacting social workers’ decision making about genetic testing and their perceptions about positive and negative implications of testing. A survey and semi-structured interview based on a pre-adoption genetic testing scenario of an inherited condition explored social workers’ perspectives and decision-making process (N?=?129). The majority reported limited education in genetics, but favored genetic testing. Results highlight the value of an interdisciplinary team in genetic testing decision making.     

Ethical Dilemmas of Practicing Social Workers Around Psychiatric Medication

Abstract

It is acknowledged that social workers in mental health and other settings routinely experience client-related ethical dilemmas. Further, there is wide recognition of the potential impact of ethical dilemmas on social work practice with clients who use psychotropic medication. Little is know empirically, however, about the experiences of practitioners with these dilemmas. This article describes the results of a national survey of practicing social workers regarding the nature of ethical dilemmas they face related to their work with clients on medication issues. The results make it clear that social workers regularly confront a variety of ethical dilemmas in this type of practice. Many of these dilemmas are related to ambiguities around the knowledge base of practice, appropriate roles of providers, and basic personal and professional values. The authors present implications of these findings for social work practice and further research.     

Evolving Ethical Standards in the Digital Age

ABSTRACT

Ethical standards in social work have matured significantly since the formal inauguration of the profession in the late 19th century. This article traces the global evolution of ethical standards in social work, focusing especially on current challenges in the digital age. The author discusses changes over time in social workers’ understanding of ethical issues and development of conceptual frameworks and protocols for managing them. Social workers’ increasing use of digital technology poses novel and unprecedented ethical challenges pertaining to privacy, confidentiality, informed consent, professional boundaries, conflicts of interest, documentation, client abandonment, and professionalism, among others. The article outlines emerging ethical standards designed to help social workers manage ethical challenges in the digital age.     

Navigating Ethical Challenges in Social Media: Social Work Student and Practitioner Perspectives

ABSTRACT

The portable, accessible nature of technology affords social workers opportunities to venture outside traditional service contexts by engaging in the virtual realm. This qualitative article uses two small-scale exploratory case studies to investigate the concept of ethical challenges in online peer networking and blogging by a social work student and social work practitioner. The article seeks to address the opportunities for and complexities of navigating technology and social media, while also emphasising the need for social workers to acquire a range of skills and competencies, and use well-established frameworks to engage in ethical online practice.     

Social Media and Social Work: The Challenges of a New Ethical Space

ABSTRACT

Social media and other online technologies have transformed communication between social workers and service users, with many practitioners engaging and working with clients through social networking sites. While there are numerous ethical issues associated with online practice related to con?dentiality, dual relationships, and boundary crossing, there is lack of clarity about how to deal with such issues. This article uses a case example to develop a nuanced understanding of ethical issues and ethical behaviour in online spaces. We argue that social workers need to link their knowledge of the complex interplay between discourses that underpin daily practice like those related to power, permanency, authorship, audience, embodiment, and professionalism to social media created spaces. In doing this, social workers must retain their commitment to ethical values and critical reflective practice. We conclude with recommendations for education, research, and practice.     

Morals,Ethics and practice — in search of social justice

Abstract

This paper reports a study of sources of influence on moral and ethical decision-making in social work practice. Practitioners from ten government and five non government agencies kept journals about the main moral issues they faced over a one-month period and were then interviewed about the nature of those issues, their resolution and the influences that shaped those resolutions. Practitioners' personal moral perspectives were found to be the main sources of influence on resolutions to a wide range of dilemmas and most of those resolutions did not conform to accepted social wok ethical practice principles. Even though the results of this study are drawn from a small sample, some implications are suggested for practitioner development, professional ethics and social work education.     

A Model of Comparative Ethics Education for Social Workers

ABSTRACT

Social work ethics education models have not effectively engaged social workers in practice in formal ethical reasoning processes, potentially allowing personal bias to affect ethical decisions.¹ Using two of the primary ethical models from medicine, a new social work ethics model for education and practical application is proposed. The strengths and weaknesses of specific extant social work and medical models are reviewed and addressed by the new model and its educational process. The development, components, and use of the social work model are detailed, and an education process example is provided.     

E-technology and Community Participation: Exploring the Ethical Implications for Community-based Social Workers

ABSTRACT

To date, much of the work on social work, ethics and technology has been focused on clinical social work and micromorality—the ethical practices of the worker and their clients in one-on-one or therapeutic group interactions. In contrast, this article foregrounds social workers engaged in community work and the ethical implications at a macromoral level. Central to community-based social work, also known as social development work, is the principle of participation. In observing the ways e-technology is affecting community participation, the focus is upon communicative and social technologies, rather than assistive technologies, or technology enabled assessment. The article explores the intersection of these three themes of community participation, technology, and ethics to examine the implications for social workers located in the complex context of community work.     

User satisfaction surveys and cognitive question testing in the public sector: the case of personal social services in England

Obtaining feedback from service users is a key element of the UK Labour Government's agenda for modernization of the public sector. This reflects a growing international trend in Europe and North America. Recognized difficulties in taking an approach to performance assessment based on the concept of user satisfaction are outlined. Ascertaining the views of people who use personal social services poses particular challenges which result from the levels of impairment and illness in the population, local variations in service provision and the 'care and control' functions of social care. It is argued that cognitive testing of questions, based on research knowledge about user views, provides a way of overcoming some of the pitfalls of traditional satisfaction surveys, while developing questions that are meaningful to respondents. The origins and principles of cognitive testing are described, followed by an example of their application in the development of a questionnaire for home care users. Strengths and limitations of the approach are identified.     

Medical decision-making: Whose values?

Abstract

Bioethical debates contribute to discussions about the direction of healthcare funding as we enter the twenty - first century. The funding of healthcare is debated by economists, bioethicists and clinicians. Because of their practice experience and knowledge base social workers are also well-placed to contribute to such issues. The debate has taken place at the ‘macro’ rather than the ‘micro’ level. Yet many ethical decisions about healthcare are made at the patient's bedside. Are they procedural or clinical decisions? Are decisions made for a group or class of patient or on an individual basis? Answers for these questions are sought in a study of medical decision-making for head-injured patients admitted to the Intensive Care Unit of a major teaching hospital.

This paper attempts to draw out ethical principles which are part of medical decision-making. The notion of contextual ethics is likened to the ecological approach of Carel Germain which provides a useful framework for ethnomethodological research.     

Confidentiality

Abstract

Confidentiality was the ethical dilemma most frequently encountered by Israeli social workers in a 1998 national survey (Linzer, Conboy and Ain, 2002). A reanalysis of survey responses found the social workers cared about preventing violations of client privacy, promoting client self-determination, and respecting client dignity, especially when challenged by: (1) public institutions' right to know, (2) limitations of protection of client communications and information, including duty to warn, (3) child and family dilemmas, (4) informed consent ambiguities, and (5) computers and technology utilization. Social workers looked to their own counsel, colleagues, and supervisor's advice and their professional code of ethics for guidance.     

Triage and Ethics: Social Workers on the Front Line

ABSTRACT

This article highlights the results of an international qualitative study examining the impact of terrorism and other disasters—both human-made and natural—on social work agencies and their labor force. The study was conducted with focus groups of social workers in health care and social service settings. The major research question concerned the impact of disaster—both natural and human-made—on agencies and social work practitioners. Focus was placed on the ethical dissonance experienced by social workers under pressure to prioritize how services and resources are distributed to those in need.     

Are Codes of Ethics Promoting Religious Literacy for Social Work Practice?

ABSTRACT

As codes of ethics play at least a symbolic, if not educational, role in highlighting and informing professional priorities, 16 codes of ethics for social work practice were examined for references to religion and belief and analysed against the four domains of Dinham’s religious literacy framework. Although religion and belief are mentioned in all but two of the documents, approximately half the surveyed codes only mention religion and belief in respect of either knowledge or skills. Some recognise the need for social workers to be aware of their own biases, but few recognise the need to explain what is meant by religion and belief, despite these terms being in flux. While codes of ethics can contribute to the development of religious literacy among social workers, this requires social workers who already have some religious literacy to actively participate when codes of ethics are being revised.

IMPLICATIONS

• It is an ethical imperative that social workers are able to engage with religion and belief.

• Social workers require religious literacy, including skills and knowledge of different religions, recognition of the fluidity of the concepts, “religion” and “belief”, and understanding one’s own attitudes towards religion.

• Codes of ethics can contribute to the development of religious literacy among social workers, but this potential is often not realised as fully as it might be.

     

Using Social Work Theory and Values to Investigate the Implementation of Community Treatment Orders

Abstract

This paper establishes the value of a social work investigation of good practice with people on Community Treatment Orders in the context of social work's longstanding interest in the ethical challenges of working with involuntary clients. The emancipatory values of social work were used to guide this research, thereby ensuring the participation of consumers and their families or carers. Critical social work theory provided an important theoretical base. A mixed methods approach was undertaken, including a cluster analysis and case studies. Five principles of good social work practice emerged from the qualitative data: (a) use and develop direct practice skills; (b) take a human rights perspective; (c) focus on goals and desired outcomes; (d) aim for quality of service delivery; and, (e) enhance and enable the role of key stakeholders. These principles are briefly presented along with recommendations for practice and service development.     

Minimising Coerciveness in Coercion: A Case Study of Social Work Powers under the Victorian Mental Health Act

The balance between care and control in mental health social work is one of constant tension. In the State of Victoria, Australia, the Mental Health Act 2014 gives coercive powers to social workers employed by public mental health services. These include the power to decide if a person needs to be assessed by a psychiatrist, to “take” a person using bodily restraint, to enter premises, and to search and seize a person’s belongings. This paper applies a doctrinal analysis to examine the law, then argues that the use of these powers by social workers, where safe, may be less restrictive than when they are used by police or paramedics. The exercise of these powers may be less traumatic and stigmatising to the people who are subject to them, and social workers may be both legally and ethically obligated to use coercion when appropriate.

IMPLICATIONS

• More social work literature on the coercive powers under mental health legislation is needed as well as more guidance on using these powers for social workers in practice.

• In some circumstances, these coercive powers may be better exercised by social workers than by other professionals.

• Social workers should carefully consider their legal and ethical obligations to use these powers in some circumstances.

     

The Role of Ethical Theories in Decision Making by Social Workers

This study analyses the arguments provided by a convenience sample of 62 Israeli social workers for their preferred ethical principles in terms of ethical theories. Content analysis of arguments given in four different contexts shows that the large majority of social workers in the study based their arguments on either deontological or utilitarian ethical concepts, less frequently using concepts from virtue theory, rights theory and care theory of ethics. However, the analysis reveals a discrepancy: when social workers were requested to justify their rank ordering of ethical principles without reference to a specific practice situation, they most frequently preferred concepts reflecting deontological theory of ethics, such as right intention, universalism, and duty. In contrast, when confronted with a specific practice situation, the social workers' most frequently chosen concepts were relating to results, consequences, and utility, concepts identified with the utilitarian theory of ethics. In view of the findings, the need for more thorough knowledge of a variety of ethical theories and their potential role in ethical decision making in social work practice and education are discussed.     

Student to Practitioner: A Study of Preparedness for Social Work Practice

Abstract

Australian social work graduates face an increasingly complex work environment where the role of the social worker is often overlooked or misunderstood. In order to examine the anticipated and concrete practice reality for social workers, this qualitative study examined the expectations of social work students preparing to enter the workforce (n=29) and the experiences of new social work graduates in the workplace (n=9). Findings suggest that undergraduates have a realistic understanding of the challenges they would encounter in practice, including anticipated value and ethical conflicts, and allied professions' conceptions of the social work role. They did not anticipate the busyness of the workplace or the level of supervision offered.     

Observing Different Faiths,Learning About Ourselves: Practice with Inter-married Muslims and Christians

Abstract

Advanced care planning and end-of-life decision making are part of contemporary debates about death and dying. A data-mining study reviewing medical records of patient deaths in hospital investigated these issues and the utilisation of social work services. Findings indicated that the majority of records included some form of documentation about end-of-life care, including cardio pulmonary resuscitation (CPR) orders and that family members and surrogate decision makers were more likely to be consulted than patients about these plans. The incidence of referrals to social workers was found to be highest “out-of-hours”. Key social work interventions were identified, including establishing the reliability of surrogates' decisions through social work assessment. This paper discusses elements that contribute to a supportive environment for patients and family members to facilitate the decision making process, including the need for a broader ethical discourse to accommodate the increasing complexity of end-of-life decision making in hospital settings.