Causes of Ethical Dilemmas in Social Work Practice

• Shaun Wharton

Understanding the term ethical dilemma and how such dilemmas arise in social work practice.

The paper will begin by explaining the term ethical dilemma and how such dilemmas arise in social Work practice through; what conditions and components are needed for an ethical dilemma to develop, and by explaining how ethical dilemmas occur within agency policy, law, professional ethics and personal values. Furthermore the paper will apply agency policy and law to the case study of Jack, a 62 year old white man, in order to explore how ethical dilemmas arise within social work. The paper will then explore risk verses autonomy, by weighing up the consequences for and against supporting Jack, through utilitarianism, deontology, and virtue ethics. This will then lead to explore a new proposed action. Finally the conclusion gives a brief summary and critique of the findings. The first part of this essay will explain the conditions and components needed for an ethical dilemma to develop. Firstly there has to be a difficult decision made with two or more unwelcome courses of action available (Banks, 2006, p.8). Secondly no matter what course of action has been undertaken, an ethical principle has been bent or broken (Allen, 2014). Once you have made a decision then the social worker is left responsible for choosing an imperfect answer and the inevitable unwelcome out comes (Banks, 2006, p.9).

This paper will now explain when an ethical dilemma occurs, firstly through agency policy and law, these are integrated into every course of action, and decision made. One important act is the Human Rights Act and is integrated into UK law. This means that every person can protect their rights in court and public organisations have to treat everyone equally. (Minister of Justice, 2006). Social workers often only have one course of action to take and that’s to follow the law and agency policy (hcpc, 2012). Sometimes social workers professional codes of practice might come into conflict with law and agency policy, this is not an ethical dilemma because there is only one course of action to take, for example they should follow the law. Additionally due to the social workers codes of professional practice you are obligated to lobby against such law (hcpc, 2012). In contrast Braye and Preston Shoot (1997) suggest the law is vague, leaving the social workers to decide what course of action to take, producing ethical dilemmas (Banks, 2006, p.8).

Secondly Professional ethics can result in ethical dilemmas for example, when trying to choose the best course of action in relation to a service user (Allen, 2014). Ethics are a professional guide (morals actions) set out to help people in groups or within a professional organisation to make right decisions, when an ethical dilemma presents itself. In social work this is the health and care professions council (hcpc) and offers a set of ethical principles to determine the right course of action and therefore produces a logical thought process, resulting in consistency throughout the profession. (Parrott, 2011, p.79). In contrast, the social workers, hcpc codes of practice covers a large range of codes of behaviour and conduct (Banks, 2006, p.78), therefore blurring professional boundaries, (Banks, 2006, p.16), which result in ethical dilemmas (hcpc, 2012).

Finally Values are something that can produce personal ethical dilemmas. Values are what people hold close to their heart and are seen as valuable to them for instance, someone’s cultural beliefs of right and wrong (Oxford, 2014). It’s very important to understand personal ethics and values through critical-reflection (BASW, 2014). Through identifying personal values, ethics and acknowledging the power a social worker holds, you can expose bias views and dominant discourses (Banks, 2006, p.159). Thompson’s PCS Model can help explore any anti-discriminatory and anti-oppressive practices, not just on a personal level, but cultural and social/structural level too (Barbra, 2010, p.12). It’s then possible to reflect and change further professional judgements (Banks, 2006, p.159). Personal values are used to inform every day practice as long as there are within the hcpc. Therefore making the social workers job very complex, because they have to balance their own moral integrity, to society, service users and the agencies they work with in, causing personal ethical dilemmas (Banks, 2006, p.17).

To understand how ethical dilemmas arise in social work practice, this essay will apply agency policy and law to a case study. Jack is a 62yr old white man who lives alone in a privately rented flat; Jack has asked if his carer could support him to visit a paid prostitute as part of his assessed care plan; paid for by public funds. The first thing to ascertain is whether any laws or agency policies will be broken. The actual act of visiting a prostitute is not illegal (GOV.UK 2014). The second question to ask is whether local authority procedures allow for the payment of a prostitute. Service users receive direct payments, this can be spent on personal care, social activities, respite care and may vary from one local authority to another (Royal Borough of Greenwich, 2014). So the local authority’s payment would likely cover Jack’s suggestion. The local authority also has a legal duty of care to make sure Jack is not financially exploited (The National Archives, 2014). A social worker has to support Jacks autonomy, even if this puts him in danger (Parrott, 2011, p.90). Jack has become socially isolated because of his disabilities and it is the social workers responsibility to promote social inclusion (hcpc, 2012). In contrast even though it’s not illegal to visit a prostitute there are many laws, professional codes of ethics and personal values against actions involving Jack with prostitution. This is especially relevant to Jack as he has already been warned by the police not to get involved sexually with any underage woman. This causes an ethical dilemma (Banks, 2006, p.12), between promoting Jacks autonomy and protecting Jacks welfare (BASW, 2014). Whilst the local authority’s payment would likely cover Jack’s suggestion, this still could cause an ethical dilemma, between the public generally thinking it’s wrong to use public money visit a prostitute, and the local authority who needs to promote Jacks inclusion in society. Also the actual interaction with the prostitute is beyond the help of a social worker and proposes health risks. Several ethical dilemmas have developed (Banks, 2006, p.14).

Whenever a social worker is faced with risk, they would perform a risk assessment (legislation.gov.uk., 2010). The risk assessment would weigh up the consequences for and against supporting Jack. The social worker could use an ethical framework to assist decision making for example, Lowenberg and Dolgoffs, (2005) Ethical Principles Screen, which attempts to put ethical principles in order of importance (Lowenberg and Dolgoffs cited in, Learning Portal, 2013). The social worker would start by examining the risks of not supporting Jack through applying the human rights acts and any other laws. Jacks right to liberty and security would be affected, Article 5; it would also affect his right to the prohibition of discrimination, Article 14 and the right to private and family life, Article 8 (GOV.UK 2014). This would lead to the social worker failing to uphold the Equality Act 2010 (legislation.gov.uk., 2010) and the Local authority would fail in its duty of care (legislation.gov.uk. 2010).

The social worker would then apply professional codes of practice and would be failing in, article five of the hcpc, be aware of the impact of culture, equality and diversity, this is because of Jacks disabilities and a social worker should promote equality for example, equal access to society. The social worker would fail to adhere to article six of the hcpc, also fail to practise in a non-discriminatory manner (hcpc, 2012), this is because the social worker would be withholding funds, not letting him make his own choices, and also limiting his access to society (hcpc, 2012).

The social worker would also apply the British Association of Social Workers codes of ethics (BASW, 2014), for example, BASW outline that all social workers should respect human rights and be committed to promoting social justice (BASW 2014). Under BASW the social worker would be compromising values and ethical principles, through failing to uphold and promote human dignity and well-being, respecting the right to self-determination, promoting the right to participation and treating each person as a whole. A social worker is also expected to promote social justice and would be failing in challenging discrimination, distributing resource and recognising diversity (BASW 2014).

The social worker would then explore the risks of supporting Jack. For instance this course of action could result in a public moral outcry. This is because there have been several media campaigns, to stop local authorities from using public money for prostitutes (Donnelly, Howie, Leach, 2010). Social workers have a duty to protect the reputation of the profession through the British association of social workers (BASW, 2014). Many of the human rights above are not absolute rights; they are qualified rights and in certain circumstances can be broken, for example when protecting public health or when protecting other people’s human rights. This is evident with Jack potentially taking advantage of a vulnerable person (prostitute) (SHRC, 2014).

By applying utilitarianism to the assessment above the theory would suggest finding all the different courses of action available. Second would be to calculate all the positives and negatives that can result from these actions and thirdly this theory suggests to choose the course of action that produces the most benefits and the least damage for all involved (Parrott, 2011, p.54). Supporting Jack would limit for his financial risk, reduced the risk committing an offence, and reduce many of the health risks involved with visiting a prostitute. Also the social worker could make sure the prostitute was making an informed choice (HCPC, 2014). Over all the risk assessment would support Jack, but as mentioned above, the social worker is left with an imperfect answer and the inevitable undesirable effects. But because a risk assessment isn’t an exact science there are additional ways to inform social work practice (Banks, 2006, p.25).

The decision to support Jack could compromise the social worker’s personal values causing an ethical dilemma; between personal values and supporting Jack. The social worker could support the idea that Jack should not just seek pleasure. The social worker would be applying virtues ethics (Banks, 2009, pp.38-49), because this ethical theory is more concerned with character not actions. This theory suggests the individual should avoid extremes, this is not to say Jack should not want sex, it just should not come before everything else (Parrott, 2011, p.58). The social worker could also incorporate Kant’s deontological theory. This is an absolutist theory which argues once something is wrong it’s always wrong, for instance, “you should not take advantage of a vulnerable person” (Parrott, 2011, p.54). This theory is linked to duty. This is called the categorical imperative that indicates we should only conform to an action, when it can be applied to the rest of the world, for instance, if one person lies the rest of the world can lie, this would produce mistrust throughout society. So lying cannot be applied to society universally (Banks, 2006, pp.29-30). In addition there is the concept of reversal, for example, if you were vulnerable would you like someone to take advantage of you? If not, then you shouldn’t do it to anyone else (Parrott, 2011, pp.50-51).

The social worker could use the theories above to propose a new course of action based on personal values, in accordance with the law and the professional code of ethics (HCPC, 2014). This course of action would offer a viable alternative. If Jack refused, new ethical dilemmas would arise, similar to the ones discussed above (The National Archives, 2014). This action would limit the risk above and solve most of the ethical dilemmas. For example, one of BASW ethical principles is to identify and develop strengths (BASW, 2014). Jack could be introduced to a wider network of friends, enabling him to find what he needs through clubs, hobbies and dating agencies etc. The consequences of this action is time related, it could take some time for Jack to fulfil his needs. The actual implementation of the action would be governed by utilitarianism, most benefits and the least damage for all involved (Mill, 2004).

This paper has shown how ethical dilemmas can arise through agency policy, law, professional ethics and personal values. The paper then applied agency policy and law to a case study to show how ethical dilemmas arise in social work practice, by exposing ethical dilemmas between promoting the welfare of the service user verses promoting the service users right to make their own decisions. The paper proceeded to assess the risk of both courses of action by using theories of ethics through, utilitarianism, deontology, and virtue ethics; this led to explore a more viable solution, through personal values, resulting in a new course of action. The paper can conclude that an ethical dilemma results from conflicting laws, agency policies and personal values, to address these issues a social worker will combine several different ethical theories, with this becoming a mechanical matter for some, informed by personal values for others and sometimes mixture of both. (Words 2186)

References

Allen, K, Ph.D. (2014). What Is an Ethical Dilemma?.Available: http://www.socialworker.com/feature-articles/ethics-articles/What_Is_an_Ethical_Dilemma%3F/. Last accessed 15th Dec 2014.

Banks S, (2006) British Association of Social Workers. Ethics and values in social work. Basingstoke: Palgrave Macmillan.

Banks, S, Gallagher, A (2009). Ethics in Professional Life. Hampshire: Palgrave Macmillan.

Barbra, T (2010). An Introduction to Applying Social Work Theories and Methods. Berkshire: Open University Press.

Donnelly, L, Howie, M, Leach, B. (2010). Councils pay for prostitutes for the disabled. Available: http://www.telegraph.co.uk/health/7945785/Councils-pay-for-prostitutes-for-the-disabled.html. Last accessed 12th Dec 2014.

GOV.UK. (2014). Prostitution and Exploitation of Prostitution. Available: http://www.cps.gov.uk/legal/p_to_r/prostitution_and_exploitation_of_prostitution/#a01. Last accessed 11th Dec 2014.

hcpc. (2012). Social workers in England. Available: http://www.hpc-uk.org/assets/documents/10003B08Standardsofproficiency-SocialworkersinEngland.pdf. Last accessed 16th Dec 2014.

Health and Care Professions Council. (2012). Guidance on conduct and ethics for students. Available: http://www.hpc-uk.org/assets/documents/10002C16Guidanceonconductandethicsforstudents.pdf. Last accessed 16th Dec 2014.

J. Leuven,T. Visak. (2013). Ryder’s Painism and His Criticism of Utilitarianism. Journal of Agricultural and Environmental Ethics. 26 (2), 409–419.

Kathleen E. Murphy, Ph.D. (1997). Resolving Ethical Dilemmas. Available: http://www.naswma.org/?114. Last accessed 16th Dec 2014.

Learning Portal . (2013). Ethical Practice – Defining the Process. Available: http://www.elearnportal.com/courses/psychology/ethical-legal-and-professional-issues-in-counseling/ethical-legal-and-professional-issues-in-counseling-ethical-practice-defini. Last accessed 12th Dec 2014.

legislation.gov.uk. (2010). Equality Act 2010. Available: http://www.legislation.gov.uk/ukpga/2010/15/contents. Last accessed 5th Nov 2014.

Mill, S. (2004).UTILITARIANISM. Available: http://www.gutenberg.org/files/11224/11224-h/11224-h.htm#CONTENTS. Last accessed 16th Dec 2014.

Minister of Justice. (2006). Making sense of human rights. Available: http://www.justice.gov.uk/downloads/human-rights/human-rights-making-sense-human-rights.pdf. Last accessed 15th Dec 2014.

Oxford Dictionaries. (2014). Oxford Dictionaries. Available: http://www.oxforddictionaries.com/. Last accessed 29th Nov 2014.

Parrott, L (2011). Values and Ethics in Social Work Practice. 2nd ed. Glasgow: Learning Matters Ltd.

Royal Borough of Greenwich. (2014). Direct payments. Available: http://www.royalgreenwich.gov.uk/info/200050/help_for_adults/262/direct_payments/3. Last accessed 17th Dec 2014.

Scottish Human Rights Commission. (2014). Welcome to Care about Rights. Available: http://www.scottishhumanrights.com/careaboutrights/. Last accessed 12th Dec 2014.

Sokol, B. (2006). What if. Available: http://news.bbc.co.uk/1/hi/magazine/4954856.stm.

The National Archives. (2014). Human Rights Act 1998. Available: http://www.scottishhumanrights.com/careaboutrights/section1-page11. Last accessed 11th Dec 2014.

The National Archives. (2014). National Health Service and Community Care Act 1990. Available: http://www.legislation.gov.uk/ukpga/1990/19/contents. Last accessed 11th Dec 2014.

The Policy, Ethics and Human Rights Committee. (2014). The Code of Ethics for Social Work. Available: http://cdn.basw.co.uk/upload/basw_95243-9.pdf. Last accessed 12th Dec 2014.