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Silberman School of Social Work Practice Lab – Feb. 7, 2013 C. Gelman, N. Giunta, S.J. Dodd

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Page 1: Pl 2 ethics_020713_rev

Silberman School of Social Work

Practice Lab – Feb. 7, 2013

C. Gelman, N. Giunta, S.J. Dodd

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What would you do?

…and WHY?

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Obligation or Rule-based

(Immanuel Kant, 1724-1804):There exist absolute moral requirements

regardless of consequences; certain acts are

intrinsically moral, right

Consequence-based (Consequentialism)

(Jeremy Bentham, 1748-1832):

Right or wrong is determined by

the consequences of act/ behavior.

Types of Ethical Theories

Deontological

Teleological

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Types of Ethical Theories (cont’d)

Rights-based (liberal individualism):Liberties and freedoms of individuals should be protected

Community-based (communitarianism):Cooperative virtues supercede individual liberties for the common good – communal values

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Ethical Principles & Values

� Autonomy (self determination)

� Beneficence (act for other’s benefit)

� Nonmaleficence (do not harm)

� Justice (fairness)

These principles create an ideal that we try to achieve. Ethics and ethical codes provide a directive for actions consistent with these ideals. These directives guide practice.

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Definitions

Values� Suggest the importance we place on

certain principles� Something “intrinsically valuable or desirable”

(Dolgoff & Skolnick, 1992, p. 100)Morals� Socially constructed values – “good” or “bad”Ethics� “The systematic exploration of questions about how

we should act in relation to others” (Rhodes, 1986, p. 21)

� Values in action – how you act on your values.

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NASW Code of Ethics

� A profession is defined by specialized knowledge, regulated way of obtaining training, and code of ethics

� The purpose of a code of ethics is to “set forth values, ethical principles, and ethical standards to which professionals aspire and by which their actions can be judged”

(NASW, 1996, p. 4)

NASW Hotline 1-800-638-8799 TU 10-1, TH 1-4

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Values, principles & ethics are what link theory, methods and skills in the practice setting.

Must also consider clinical and legal context.

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Your Turn

� Think about your personal value system. What drives your passion for the field of social work? Are there any principles you can name that you particularly value?

� Think about your field placement organization. What values or principles drive the mission of this organization?

� Based on your experiences thus far, what do you think are the core values of social work as a field that you relate to?

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NASW Code of Ethics

• Value - Service

• Social work’s primary goal is to enhance human well-being and meet basic needs of all, particularly most vulnerable and oppressed• Beneficence - doing good • Non-maleficence - not doing harm

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NASW Code of Ethics

�Value - Social Justice

�Social workers promote social justice and social change with and on behalf of clients

� Non discrimination (advocacy)

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NASW Code of Ethics

�Value - Dignity and Worth of all persons

�Autonomy (Self-determination)

�Privacy (Confidentiality)

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NASW Code of Ethics

• Value - Importance of Human Relationships

• Social workers recognize the central importance of human relationships

• Don’t put clients at risk for exploitation with dual relationships

• Set appropriate boundaries

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NASW Code of Ethics

• Value - Integrity

�Social workers behave in a trustworthy manner

�Veracity (truth telling)

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NASW Code of Ethics

• Value - Competence

�Social workers practice within their areas of competence and develop and enhance their professional expertise

�Reporting the incompetence of others

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Limitations in the Code of Ethics

� “does not specify which values, principles and standards are most important and ought to outweigh others in instances when they conflict” (NASW, 1996, p. 3)

� What are other limitations of the Code of Ethics?

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You are an intern at an agency serving homeless severely mentally ill adults. The setting provides housing and counseling services. A significant portion of the funding supporting the agency comes from a funder who is tying continued funding to having the clients participate in individual and group sessions. Most of your clients do not come to see you and do not attend scheduled groups. Your supervisor is putting some pressure on you to have the clients attend.

What are some of the ethical, clinical, and legal issues involved? What would you do?

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You are an intern placed in a high school that received funding through a private foundation to run programs for students with high rates of absenteeism and tardiness. Your supervisor feels that continued funding is dependent on demonstrating that you are reaching many students. He routinely asks you and your fellow interns (there are 3 of you from Silberman) to record high numbers of participants for your weekly groups, even though there are some weeks when the group isn’t even held because of lack of participation. When you raise concerns about what you consider falsification of documents, he replies that the greater good of maintaining funding to even have these programs available to students supersedes “fudging” of the data.

What are some of the ethical, clinical, and legal issues involved? What would you do?

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You are responsible for running a mutual aid group within a program that utilizes a Clubhouse model for individuals with mental health diagnoses. Because the Club is very diverse with regards to race, ethnicity, age, religious views, gender identity, gender expression, sexuality, mental health diagnosis, and developmental ability, it is to be expected that tensions or conflicts arise. As one member said recently, “We call it a safe space, but we should really just call it a space.” Ace and Marvin are two group members who I accompanied on a weekly grocery shopping trip. Marvin recently began opening up in the group about the stigma he faces from his family about his mental health condition and his sexual orientation. They have different views of personal space and while in the store, Marvin was bothered by Ace being “in my face” and Ace's feelings were hurt by Marvin's coldness. Underlying this tension was Marvin's discomfort with Ace's transgenderism. Marvin and Ace are adults who are all too aware of what it feels like to be talked down to, which makes you unsure of how to relate to this conflict. You are outside of the walls of the club, and you are concerned about accomplishing the grocery needs in time for club cooking that afternoon, a task that brings up stress for you in general.

What do you do?

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Inclusive Model of Ethical Decision-Making (McAuliffe & Chenoweth, 2008)

� Model rests on 4 key platforms:

Accountability

Consultation

Cultural Sensitivity

Critical Reflection

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Inclusive Model of Ethical Decision-

Making

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Inclusive Model of Ethical Decision-

Making

4. Alternative Approaches and Action: what are

available courses of action, alternatives, and

possible outcomes? How do I feel about decision?

How do I implement and document decision?

5.Critical Analysis and Evaluation: what is the impact

of the decision on self and others? What have I

learned? Are there deficits in organizational

policies/ procedures, ethical codes, that need to be

addressed?

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Ethical Principles Screen(Loewenberg, Dolgoff, & Harrington, 2000)

� The protection of life

� Equality and inequality

� Autonomy and freedom

� Least harm

� Quality of life

� Privacy and confidentiality

� Truthfulness and full disclosure

Present ethical

principles in order

of priority, from

higher-order

principles to

lower-order

principles. Pri

ori

ty

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Reisch & Lowe’s Model for Resolving Ethical

Dilemmas (usually applied in Macro settings)

1. Which ethical principles apply to the situation?

2. What additional information is necessary to examine the ethical dilemma? What don’t you know that you need to?

3. Identify any potential conflict of interest and people who are likely to benefit from such conflicts.

4. Identify the relevant ethical principles and/or rules that applyand rank order them in terms of importance.

5. Determine the consequences of applying different ethical rules or ranking these rules differently (p. 26).

6. Who should make a final decision on a resolution?

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10 Most Common Grievances• Sexual activity

• Dual relationships

• Other boundary violations

• Failure to seek supervision/consultation

• Failure to use accepted practice skills

• Fraudulent behavior

• Premature termination

• Inadequate transfer/referral

• Poor record-keeping

• Failure to discuss policies as part of informed consent (Strom-Gottfried, 2003)

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So what should you do?

� Be aware of areas where your personal and professional values may conflict

� Prepare for these situations as well as you can in advance

� Consult the Code of Ethics

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So what should you do?

� Raise conflicts or concerns with your supervisor or field instructor - a key part of supervision

� Talk to other relevant members of the agency if appropriate –colleagues, ethics committee.

� NASW Hotline 1-800-638-8799 TU 10-1, TH 1-4

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So what should you do?

� Talk to your faculty advisor

� If appropriate, due to expertise, discuss with another professor

� Peer consultation - this becomes more useful as your peers develop greater professional experience later in your careers

� Document your process!

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Thank you

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You are recruiting supermarket employees during a union

organizing campaign. One prospective recruit tells you that

she fears she will be fired by her employer or subjected to

on-the-job harassment. She asks you to describe the

protections the union provides to new members. She also

wants you to be candid about the possible risks of taking

action.

You know that during previous organizing attempts at other

stores, union supporters have been fired and the union has

only been able to provide $200 and a few bags of groceries

to each terminated employee.

What do you tell her?

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� A social work group work intern at a high school in

Brooklyn is told by her supervisor that she should not

talk about her sexual identity with her groups. The

student is a lesbian and she is out. The student

appealed to the supervisor’s boss.

� If you were the supervisor’s boss, what would you do?

What really happened: The supervisor’s boss agreed with the

student’s supervisor. The student brought the issue to Hunter

Social Work and the Director of Field changed the student's

placement. And the Field Director insisted that the supervisor in

the school attend a Seminar in Field Instruction where a cultural

competence workshop was offered.

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What do you do if you were the student intern?

An intern was placed at an agency offering

services to the elderly. In a home visit with an

elder, the elder requested that the student (a

woman of color) not send any home

attendants to the elder who “were colored”.

The elder's concern was that “the colored”

home attendants are thieves.