Social work and genetic testing: Ethical issues encountered in predictive testing for Huntington disease

Abstract

Recent advances in genetic technology, including the availability of presymptomatic genetic (ie. predictive) testing for untreatable late-onset conditions, have created a number of practice challenges for social workers. This article outlines the social worker's role in the internationally accepted protocol for provision of predictive testing for Huntington Disease (HD) and highlights some of the complex ethical, emotional and practical issues arising from predictive testing for HD and other similar disorders. For social workers in this field, attempts to deal with ethical dilemmas must rely both on the social work code of ethics and on reference to major principles of bioethics such as respect for autonomy, beneficence, non-maleficence and justice. It is acknowledged that in some situations involving a conflict of ethical principles there may be no ideal resolution.     

Toward a Theory of Law in Society

Abstract

Interest group conflict, power, and values have been prominent in recent attempts to analyze law as social control. The role of fact beliefs in creating, interpreting and administering legal norms has been relatively neglected, especially in the few efforts toward theories of law in society. Both fact beliefs and value beliefs are here related to legal norms, and also to group interests, power and conflict. Law is conceived of as the formal social control of the political state, a definition that does not at all require acceptance of Austin's view of law as commands of the sovereign. The forced choice between power elite and structural-functional theories is avoided, since law operates in a wide variety of power situations. The subjective meanings of interest group actions directed toward legal norms are seen as consisting of value and fact beliefs, an approach of particular promise in analyzing law and social change.     

Disability and Spirituality in Social Work Practice

Abstract

In working with social work clients, issues of religion and spirituality are sure to arise. Religious views on disability can have both positive and negative effects on the individual. In our increasingly pluralistic society, these issues must be approached with sensitivity and patience since it is common to work with adherents of minority or non-traditional religious groups or groups whose values conflict with the social work profession. The purpose of this article is to enhance and develop sensitivity to diverse religious views in order to respect the values and life beliefs of the client while enhancing the development of adaptive religious and spiritual views.     

Spirituality and Ethics in Long-Term Care

Abstract

The issues of spirituality and ethics are evoked in a case of an 89-year-old woman resident in a nursing home who refused nutrition and hydration. Clergy representing Catholicism, Protestantism, Judaism, Hinduism and Islam were asked to respond to questions regarding the choice to end life and spiritual resources to help the patient. The clergy agreed that the patient is in a spiritual crisis but her autonomy should be respected, and spiritual resources should be expended to enhance meaning. The ethical dilemma for the social worker, as for the clergy, is whether to support the patient's freedom to end her life or persuade her to continue to live. The dilemma is based on conflicting social work values of self-determination and the preservation of life. Three ethical principles are in conflict: respect for autonomy, the duty to prevent harm, and beneficence. At the end of the process of ethical deliberation, the social worker must be prepared to accept the patient's decision.     

Everyday Conflict and Stress Among Older African American Women

Abstract

Older African American women are at high risk for morbidity due to anger suppression and stress. Yet sources of everyday stress and conflict in the lives of older African American women have not been documented. Such information is essential for developing health promotion programs. A focus group study was conducted with older African American women on everyday stress and conflict. Everyday stress stemmed from worries about functional disability and about accessing transportation. Everyday conflicts occurred with adult children, teen-aged grandchildren, and older neighbors or peers. Conflicts with adult children centered on how the adult child was raising his/her children. Conflicts with grandchildren centered on social respect. Conflicts with neighbors/peers centered on perceived rudeness or past transgressions. Participant strategies for dealing with stress and conflict tended to be avoidant. A training program in constructive conflict strategies for older African American women is presented that draws on information gained in the focus groups.     

Who Is a Jew?

Abstract

When a social worker incurs professional obligations in two different actions, but cannot do both, this is termed “an ethical conflict concerning expectations in concurrently affected arenas” (Levy, 1976, p. 113). This article addresses an ethical dilemma that is centered in one of the most complex and controversial issues within Jewish life today: the question of “who is a Jew.” A case is presented which depicts the complexity of ethical conflicts which may arise from this unanswered question. The values at issue are explored and the process used to clarify, legitimate, and operationalize a plan of action is articulated. Ethical dilemmas invariably arise in social work practice. Resolutions that are clear, easily applied, internally consistent, and that consider the values of all concerned should help in reaching an ethical solution.     

Achieving Shared Meaning in Cross-Cultural Dialogue

Abstract

Based on a qualitative study of the Twin Cities Hmong community, this paper offers a case study of a Hmong family's response to a situation in which a woman who is a member of their family has been chronically physically abused by her husband. The case illustrates the challenges of understanding the family's reactions in light of their cultural context as well as the implications for social work practice. An excerpt of a verbatim interview between the author and a subject from the study is provided. The specifics of the cultural values, protocol for handling conflict and communication patterns that contribute to understanding what has occurred are discussed. The author then discusses the challenges for the social work practitioner of simultaneously maintaining the ethical values of honoring diversity and protection of the oppressed.     

Passing a Mental Health Levy

ABSTRACT

The “devolution revolution” has decreased federal and state roles in the funding of social services and increased the burden on local sources, both public and private. This article describes how a community passed an initially unpopular property tax levy earmarked to support local drug, alcohol and mental health services. The article illustrates how social workers employing specific community practice knowledge provided leadership to the successful campaign. This example of community practice leadership includes building and maintaining coalitions, managing group tension and conflict and demonstrating fundamental social work values.     

Workplace bullying and interpersonal conflicts: the moderation effect of supervisor’s power / Acoso laboral y conflictos interpersonales: el papel moderador de las bases de poder del supervisor

Abstract

Workplace bullying is considered the final stage of a prolonged conflict where there is a power imbalance between the affected parties and where emotional and relational problems exist. Thus, this study aims to explore the role of employee perceptions about the supervisor’s power bases on the relationship of conflict (i.e., task and relationship conflicts) and bullying at work. A cross-sectional survey study was conducted (N = 211). Results support a moderated-mediation model in which relationship conflict mediates the association between task conflict and workplace bullying, suggesting a conflict escalation process in bullying situations. In addition, establishing personal power bases seems to reduce the intensity of the link between task conflict and relationship conflict and, in turn, workplace bullying, whereas establishing positional power bases was not related to this association. Practical implications for bullying prevention are discussed.     

Patient Rights: An Advocate's Perspective

Abstract

The current growing concern about patients' rights and the delivery of student health care precipitates an environment of fear, distrust, and uneasiness within university health services. This paper addresses several selected clinical, ethical, and legal issues which have come into conflict during recent years. Our examination surveys ethical and legal principles of confidentiality, defines areas in which breaches are most likely to occur, and suggests ways of preventing breaches of confidence between students and health services.

While the fundamental ethical principle underlying confidentiality is the individual's right of privacy, many issues of confidentiality are extremely difficult to resolve. University health services have expanded the concept of health care to encompass all the conditions — medical, emotional, social, economic and environmental — which affect the health of students. As a result, health service administrators should be fully aware of the laws and associated legal complexities in their own state which affect confidentiality. Furthermore, student health physicians, and particularly mental health therapists must be sensitive to needs for protecting the privacy of students.

Legal principles of confidentiality discussed in this paper with respect to specific problem situations which might arise in a student health center include: 1) right to privacy; 2) privileged communications; 3) releasing information from the medical record; 4) releasing information to the student; and 5) treating minors without parental consent. Finally, in addition to the responsibilities which must be assumed by the health professional, certain student responsibilities in the selection and utilization of health professionals are recommended.     

A “Nutcracker” Theory of Modern Organizations: A Conflict View

Abstract

This paper presents a point of view toward formal organizations which departs from the equilibrium models contained on both bureaucratic and open system theory. Specifically, a conflict perspective is taken in terms of which organization disequilibrium is understood to be typical of organizations as a consequence of their being continually subject to the threat of withdrawal of monetary and non-monetary supports from both internal members and external publics with which organizations are interdependent. The factors contributing to these circumstances of conflict are attributed to recent maturations of rights of citizenship and participatory democracy, the social organization of these sources of conflict are termed the “nutcracker” effect.     

Understanding the Sustainability of Insurgency Conflict in Thailand

Abstract

This article seeks to model the insurgency conflict in the three southern border provinces of the Kingdom of Thailand: Pattani, Yala, and Narathiwat. In so doing, it will explore the sustainability of the conflict by representing it in terms of a conflict life cycle that is responsive to complexity and change. The cycle arises from the cybernetic viable systems theory of ‘living systems’, and is able to foster a better understanding of what is happening empirically on the social level in these provinces, in respect to a situation characterized as one of incessant conflicts. This conflict model that arises suggests that there is an interconnection between the agents involved, and their individual and interactive dynamics. The conflict involves five types of politically related behaviours that occur between two interactive agents: the state (engaged in searching for and making arrests of insurgents) and the insurgents (engaged in violent acts of shooting, bombing, and arson). These agents are studied to the end of being able to determine the precise interactive nature of the political conflict in which they are engaged. In carrying out this investigation both quantitative and qualitative approaches were used. The research was carried out in three stages. In the first stage, time series techniques were used to determine inferentially whether the conflict is both rational and involves interactive behaviours. Stage two adopts the Weibull distribution technique to assess the political conflict. In the third stage, a statistical analysis is conducted of the conflict situation in political terms. Finally, it is explained how the model and the methods used in this article may be used to deal with intractable conflict in other social environments, incidentally tracking the likelihood of conflicts being sustainable. Other agencies could utilize this approach in examining other political conflicts so as to be better able to prepare suitable approaches for coping with intractable conflicts to the end of fostering sustainable peace processes.     

Parent Conflict as a Mediator Between Marianismo Beliefs and Depressive Symptoms for Mexican American College Women

Abstract

Objective: The purpose of this study is to examine how marianismo is related to the depressive symptoms of Mexican American women with family conflict as a mediator. Participants: During January of 2010, 170 Mexican American women college students in a southern, Hispanic-serving institution were sampled. Methods: A mediation analysis was conducted to determine if parent conflict mediates the relationship between marianismo values and depressive symptoms. Results: Results from Barron and Kenny's¹ mediation analysis method, in conjunction with a Sobel² test indicated that parent conflict significantly mediated the relation between marianismo and depressive symptoms. Conclusion: Findings and implications of the mediation will be discussed for the mental health and treatment of Mexican American women college students.     

The social control of big business

Viewed from a conflict perspective, governmental agencies are tools of power and privilege. Subservient to powerful economic interest groups, regulatory agencies are claimed to exercise little, if any, effective control over the activities of big business.

Four hypotheses derived from a conflict perspective on the social control of big business are set forth: (1) less social control is exercised over big business than small business; (2) since the onset of the consumer movement, big business has been more frequently sanctioned; (3) over time big business “captures” regulatory agencies which results in a general decrease in the percentage of social control efforts directed toward big business; and (4) when big business is sanctioned, the smaller, less powerful of those businesses are sanctioned.

In this study the pattern of sanctioning of big business by a major federal regulatory agency is examined. Specifically, data on the issuance of cease and desist orders to business enterprises by the Federal Trade Commission over a twenty‐three year span of time are analyzed. The implications of the findings for each of the four hypotheses and for conflict theory in general are discussed.     

Building shalom: Integrating social work,peacebuilding and Catholic Social Teaching for transformational change

ABSTRACT

This article argues for greater integration between peacebuilding and social work, based on shared values, complementary practices, and congruence among key underlying theories in both fields. The article also describes how principles of Catholic Social Teaching align with and enhance both social work and peacebuilding. The implications of the ecological model for the three commonly accepted domains of social work practice—micro, mezzo, and macro—find equivalent expression in dimensions of conflict transformation, as well as in Catholic Relief Services’ approach to building social cohesion by working iteratively at individual, intragroup, and intergroup levels. Three case studies illustrate this approach.     

A visual methods approach for researching children’s perspectives: capturing the dialectic and visual reflexivity in a cross-national study of father-child interactions

ABSTRACT

The paper presents a visual methods approach from a cross national methodological project that used digital visual technologies to examine young children's perspectives in father-child interactions. The approach combines capturing the dialectic with visual reflexivity. The notion of ‘capturing the dialectic’ specifically by analysing conflict to gather the child’s intention as their perspective, is underpinned by finding the contradictions in a situation of which children are a part. Visual technologies and in particular digital film does this, because it can identify difference, as it observes and captures the dialectic process. Researchers collected between 5–10 hours of film footage and twenty-four film elicitation interviews from young children and their fathers in twelve families within England, Hong Kong, Norway and India. In the study, participants took footage of routine father-child interactions chosen by the children; and researchers sampled the footage for situations of conflict and emotionally charged moments in order to capture the dialectic. Researchers then conducted film elicitation interviews with the children and fathers, which were recorded for the purpose of visual reflexivity. This visual methods approach can support social science researchers to address differences in representation and truth, for a better understanding of a young child’s perspective in cross-national projects.     

Social Work and Social Justice: What Are We Fighting For?

Abstract

A cardinal value of social work practice is social justice. Social justice ranks as the second of five values that underpin the Code of Ethics of the Australian Association of Social Workers (AASW. However, although social work's commitment to promoting social justice is laudable and, indeed, may even be a distinguishing feature of the profession, precisely what kind of social justice does social work espouse? The answer to this question remains unclear. Views about the nature and scope of social justice stem from broader conceptions of justice that not only differ from, but may also conflict with, each other. Therefore, it is important not only for social work to be clear about the type of social justice that it currently advocates, but also to ensure that it is one that the profession seeks to defend and maximise. It is argued that the choice must be as egalitarian as possible. Indeed, it must be radically so. Otherwise, what is social work fighting for?     

Urban African American Pre-Adolescent Social Problem Solving Skills

Summary

The results of two studies focusing on the social problem solving skills of African American preadolescent youth are detailed. In the first study data from a sample of 150 African American children, ages 9 to 11 years, was used to examine the association between type of youth social problem solving approaches applied to hypothetical risk situations and time spent in unsupervised peer situations of sexual possibility. Findings revealed that children with more exposure to sexual possibility situations generated a wider range of social problem solving strategies, but these approaches tended to be unrealistic and ambiguous. Further, there was a positive association between the amount of time spent unsupervised and youth difficulty formulating a definitive response to hypothetical peer pressure situations. Children with less exposure to sexual possibility situations tended to be more aggressive when approaching situations of peer pressure. In the second study, data from a non-overlapping sample of 164 urban, African American adult caregivers and their 9 to 11 year old children was examined in order to explore the associations between child gender, family-level factors including family communication frequency and intensity, time spent in situations of sexual possibility, and youth social problem solving approaches. Results revealed that children were frequently using constructive problem solving and help seeking behaviors when confronted by difficult social situations and that there was a significant relationship between the frequency and intensity of parent child communication and youth help seeking social problem solving approaches. Implications for research and family-based interventions are highlighted.     

Modelling Mindsets of an Agency

Abstract

This article introduces a culturally based socio-cognitive agency meta-model built from ‘living systems’ theory. The agency is adaptive. It has a normative personality with an epistemic state determined by its three formative traits, which have a control function and can take bi-polar epistemic values (‘enantiomers’). Combined together, they give eight different cognitive types, i.e. eight different types of personality mindset. These personality mindset types are influenced by the culture and the social environment to which the agency is bound. The traits can be used to explain the what, why, and how of dynamic agency behaviour in complex situations.     

Computer Information and Human Knowledge

Summary

Modem ideas in social work are subsumed under the term “new thinking.” Controversies in its concepts directly reflect controversies in attitudes toward computer application. Fundamental to modern problems with technology is the persisting dispute between two philosophical traditions. On one side there is the formal and technically oriented thinking; on the other the reflexive, dialectical and hermeneutical approach. The reappearance of the conflict in actual discussions is described considering data storage, formal methodology and the social impact of computer use.