Posted: December 3rd, 2022

An Ethical dilemma in Social Work Practice

An Ethical dilemma in Social Work Practice
Introduction:
According to the International Federation of Social Workers (order custom written ‘academized’ nursing papers) and International Association of Schools of Social Work in 2001, the social work profession definition is that the social work profession promotes social change, problem-solving in human relationships, and the empowerment and liberation of people to enhance wellbeing (Banks, 2016). Social work intervenes at the points where people interact with their environments. Principles of human rights and social justice are fundamental to social work.
In other words, Social worker means helping the individuals, families, and community overall. It helps them to enrich their skills and wellbeing as an individual. They help them to get justice from every aspect. They mainly focus on vulnerable people of society.
The social work profession involves understanding the laws to help the client in the best way. One social work issue is when they are stuck in an ethical dilemma while dealing with the client (Athena, 2014). That is the most crucial part of the social work profession as a person has to consider many factors, including honesty, confidentiality, laws, codes of ethics, laws, consequences (Athena, 2014). Sometimes, a social worker is torn between ethical issues, ethical problems, and ethical dilemmas. They look almost similar, but they are not. There is a difference between all of them.
In its tightest definition, an ethical dilemma is a decision between two similarly unwanted options identifying with human government Helpance. Nonetheless, ethically problematic situations are innate in social work practice, independent of whether they are constantly recognized (Athena, 2014). Ethically problematic social work practice situations can be recognized as ethical issues, ethical problems, and moral, ethical dilemmas. In view of their differentiation, an ethical issue is any circumstance where a social worker is involved, not just with what they can do from a legitimate or specialized viewpoint but also with what they should do from a moral perspective (Nuttman-Shwartz & Shinar, 2019). An ethical problem is any circumstance where a social worker recognizes what they should do is a good choice but hard to apply (Maidment, 2016). At long last, an ethical dilemma is a point at which a social worker must choose between two similarly unwanted options, which may include a contention of good standards. A moral difficulty can be changed into a moral issue once a choice has been made, and this change will mirror the social worker’s cognizant or oblivious moral decision-making (Maidment, 2016). A change of an ethical dilemma into an ethical problem is moreover conceivable (Nuttman-Shwartz & Shinar, 2019). It may mirror the social worker’s acknowledgment of her numerous ethical commitments and the moral issues’ complexities.
A scope of ethical dilemmas is additionally raised by the strain between the morals of self-sufficiency, self-assurance, and paternalistic practices. These ethical situations drive social workers to consider conditions committed to mediating others’ lives and the limits that such intercessions will have.

Key frameworks and theories related to ethical dilemma in a social work profession:
The social worker has to follow the various code of ethics according to AASW in the social work profession and while dealing with the ethical dilemma and solving it. In the assurance and quest for its points, social work is committed to three guiding principles, which give ascend to general and explicit moral duties (Nuttman-Shwartz & Shinar, 2019). These qualities include respect for people, social equity, and professional uprightness.
The purpose of the code of ethics is to help social workers better understand all the things they have to consider while deciding for clients. It is very useful for social workers.
Ethical dilemma theories
• Deontology Theory:
The term deontology originates from the Greek word deon, which means an obligation. The deontology theory states we are ethically committed to acting as per a specific arrangement of standards and rules, paying little mind to result (Thompson & Wadley, 2018). In this manner, deontological speculations and obligations have existed for a long time. Immanuel Kant, the hypothesis’ praised defender, figured the most powerful type of a common deontological moral hypothesis in 1788.
In addition, deontology theory is the theory in which decisions are made by following a certain set of rules of morals and values. If the rules have been followed, then it will be considered an ethical decision. It depends on the responsibilities and the nature of the right action (Thompson & Wadley, 2018). It focuses not only on the client’s happiness but also on the consequences of the decision and whether the outcome is good or bad.
In other words, when a social worker respects the client, she does this because it is the right thing to do in terms of her professional values and code of ethics. Likewise, with the rule or principle of confidentiality, the social worker’s duty to the client provides the motive to act as this rule requires (Thompson & Wadley, 2018). The action’s object is to keep the client’s confidence to maintain confidentiality accords with the rule that requires her to do so. Hence, this form of ethics is primarily concerned with finding objective moral rules and principles that apply to all people everywhere.

• Utilitarianism Theory:
The original utilitarian ideas come from Jeremy Bentham (1748-1832), who constructed a hedonistic view of utilitarianism (Thompson & Wadley, 2018). Utilitarianism theory is the most popular and well known ethical theory. This theory is a form of consequentialism. Old style utilitarian’s like Jeremy Bentham and John Stuart Mill (just as numerous contemporary utilitarian’s) take ‘the great’ to be joy or prosperity. This theory also focuses on the pleasure that it does not take care of the consequences (Thompson & Wadley, 2018). The most important thing for this theory is the person’s happiness.

Case Study Scenario and how this case scenario became an ethical dilemma:
The client got married to an Indian man in October 2017 in India, and she came to Australia in September 2018. But after a few months, her husband started abusing her and her brother and sister-in-law as well. Finally, one day she reported all things to the police happening with her in that house. She said that she was not allowed to go out and she is also not allowed to talk to her friends, family, or relatives. She said that they abuse her physically and emotionally a lot. Police helped her a lot, and she got the intervention order against her husband. After that, she went to India in August 2019 to attend her brother’s marriage. When she came back, her husband didn’t allow her to come back home. Her personal items were left in her husband’s house. Now, she is seeking help from police and other organizations. Currently, she is living in her friend’s house, and after some time, she got her items back from her husband’s house in December 2019 after informing the police. The immediate actions were taken by Shakti Melbourne to support the client and to make sure she stays in Australia. Shakti is dealing with the client. She is taking counseling sessions from Mrs. Vienna, the counselor. She finally got her permanent residency. Her main concern right now is financial help, a job, and a house.
The two social workers are dealing with the client now and trying to help her fulfill her needs. Due to the covid-19 pandemic, it is hard to find a job for her, but she is lucky to get Centrelink benefit. Meanwhile, she is feeling very emotionally and mentally. She is medicines right now for her mental health. When the social worker first talks to her, they build a good connection as they are from the same culture and talk in the client’s mother-tongue language. The client was hesitating a little bit initially, but when the social worker makes her feel very comfortable, she started to open up in a good way. Then, she mentioned about her sleeping problem. Due to stress and all problems, she is not falling asleep. She is awake almost the whole night. So, she is getting medicines so that she can have a better sleep and relax.
The social worker tried to motivate her and also tried to give emotional support. The social worker also talked about different techniques that can solve her sleeping problem and decrease her stress. But still, she was feeling very low, and the sleeping problem remains the same. One day, when the social worker called the client, she asked about everything. The client told her that she wanted to discuss one thing but promise that you will not tell anyone. She said that she has started taking a double dose of medicine for a few days. So that she will have a better sleep now. Moreover, she was thinking of going back to her husband as she was missing her so much. The situation arouses more risk because if she meets her husband, then there are high chances that her husband can harm her. Furthermore, the medicine that the client was taking is her to make her sleep and for a long period, but if she takes a double dose of medicine, it can act like a drug on her body and lead to serious health issues and death. Everything should be maintained in a balanced way. The social worker got confused after meeting with the client as the client trusted her and told everything to the social worker. The social worker does not want to break the client’s trust, but at the same time, if she didn’t inform this thing to anyone, then there is a risk to the client’s life, which the social worker can’t afford. Two unpleasant situations came in front of the social worker. If she didn’t tell anyone and decide to deal with the client alone and try to convince her. Still, in case she kept on taking more dosage of medicine and went to meet her husband. If she decides to tell anyone, then she will lose the trust of the client. There are chances that the client will never trust her or a social worker, and then she will make a bad impression on social workers in mind and never tell anything, and they will not be able to her in the future. Both are critical and tough options.
According to the National Association of Social Workers (order custom written ‘academized’ nursing papers) (NASW), social workers have codes of principles to follow and have ethical responsibilities towards the client (Abrahams et al., 2007). According to the ethical principle, there is one principle that the social worker has to way a trustworthy manner with the client, which means the social worker has to be aware of the proper mission, values, ethics, and practices (Patil & Ennis, 2018). At the same time, the social worker has ethical standards to follow. In other words, have ethical responsibilities towards the client. But according to NASW, a social worker can break the confidentiality rule under compelling reasons only. Social workers can disclose the information when there is imminent harm to the client or others or pose a serious threat to someone’s life.

How to do ethical decision making and what factors to consider while making an ethical decision:

Ethical decision making is the cycle wherein you mean to settle on your choices in accordance with a code of morals or ethics. Ethical decision-making is an integral part of the social work profession (Teater & ProQuest, 2010). It is a complex and toughest practice to perform as a social worker because, in the end, you have to decide and follow the best decision between two, but the result is not good but better than other decisions (Patil & Ennis, 2018). There are various frameworks and models to solve the ethical dilemma problem, such as ACA ethical decision-making model, Steinman, Richardson, and McEnroe’s Ethical Decision-Making Process, hybrid model. But the simplest and popular model to effectively solve an ethical dilemma is Elaine Congress ETHIC Model of Decision Making (Patil & Ennis, 2018). This model consists of a five-step process that includes examining personal, agency, client, and professional values, thinking about ethical standards and relevant laws, hypothesizing about consequences, identifying the most vulnerable, and consulting with supervisors.

E – Evaluate relevant personal, societal, agency, client, and professional values.
Social workers consider various perspectives before making a decision. So, another social worker and I thought that if we are in the client situation, what will we do? We will take a double dosage of medicines without informing anyone, fearing that doctor will not give more dosage. Should she consider going back to the husband who treated her harshly, and will she control her emotions?

T – Think about what ethical standard of the NASW Code of Ethics applies, as well as relevant laws and case decisions

The social worker has to take care of federal, state, and local laws while deciding. The code of ethics is a document that acts as a safeguard for a social worker that clarifies the social worker what their ethical responsibilities are towards the client and the profession (Lockhart & Danis, 2010). According to the NASW and AASW code of ethics, the social worker has to be honest and make clients feel that whatever he/she will share will remain confidential. But according to ethical standards, we can break the confidential under serious and exceptional reasons. For example, if there is a threat to the client or someone’s life.
Conclusion
It is important to think about the situations differently and see whether maintaining confidentiality is better or breaking it. If we keep the confidentiality, then there is a high risk of harm to the client as she will continue to take double medicine dosage. The dose can lead to serious health and mental issues or death. Moreover, if her husband treated her harshly in the past physically, then for her going alone to meet her husband will be dangerous (Lockhart & Danis, 2010). She should inform the police so they can accompany her. Basically, in keeping confidentiality, it will be dangerous though the client will lose interest in the organization’s services and trust. So, we have to do something which will keep her trust also.
I – Identify who will benefit and who will be harmed given social work’s commitment to the most vulnerable
In this situation, we have two options available, one we can consult the client doctor and tell the whole story and tell the doctor to explain to her the cons of double dosage in a very convincing way and then explain to her that why it was important to tell the doctor all this as we care for her and her life and can’t allow her to go alone to meet her husband if she is so eager to meet her husband. So we don’t want her to suffer any more in her life in any situation. Also, reporting everything to the police and the court can make her case weaker as she is taking more pills and then thinking of going back to her husband, which is a dangerous situation. This decision will not help her as it will lead to more problems for her, and then legal persons or authorities will not trust her anymore.
C – Consult with supervisor and colleagues about the most ethical choice
The most effective and useful tool is your senior colleagues, teachers, or supervisors’ advice as they have more experience. As in social work, everyone deals with a different-different ethical dilemma (Teater & ProQuest, 2010). So, they must have more knowledge of legal things and more ethical dilemma practice and code of ethics, responsibilities, and restrictions.
When we told our supervisors everything, they said that it is a critical case as she has suffered a lot emotionally and mentally. Still, she is going through emotional trauma, where she has no control over her thought processes and feelings. After taking counseling sessions, she is also feeling so alone and low that she is doing all this, and on top of that, she is thinking of contacting her husband for a new start of the relationship and meet her all alone. She is not thinking about her safety and wellbeing at all. So, we have to handle this case very delicately. First of all, call her for a meeting in an office and explain to her that she should think of meeting with her husband alone until and unless she meets us face-to-face. Secondly, please make an appointment with her doctor, tell the doctor everything, and ask for possible solutions to deal with her in these situations as he is a psychiatrist. Thirdly, we have to keep her in a house where we can often visit her and keep an eye on her actions, so her life doesn’t get in trouble. Fourthly, we have to think of more creative ways to boost her self esteem and give emotional support, so she doesn’t feel emotional low or alone. After discussing all these things with seniors, we get more ideas about possible outcomes and decide for her betterment.

Critical Reflection:
In my opinion, the client was not acting right. She wanted to get rid of her problems at any cost. So, she was trying every possible way to get rid of them without thinking about the outcome and whether it is right for her life or not. She is partially right because of the state of mind that does not allow her to think properly. The client is suffering from emotional and mental suffering. But I was feeling good that at least she shared this thing with someone, so we were there to help her. What if she is doing it without sharing it with anyone. So, we did not have any chance to save her life. As an Indian woman, she takes a lot of stand for herself and her life.
Normally, from where we came from and our culture and society, beliefs are very different and narrow-minded. If any woman is suffering all of this in India, she will hardly raise a voice against domestic violence. The first thing that comes into their mind is what society will say and what will happen to my parent’s reputation. If I register a complaint, then this issue will become public, and everyone will talk about it. So in fear of this, they keep on bearing this for their all life, and mostly the result is the death of the women. It’s good she raised voice and fought for her justice, and legal authorities, other organizations, and Shakti helped her in this justice journey.
As a social worker, it is very important to behave professionally and follow all the laws, ethics, values, principles, and understand your responsibility and duty towards the client and the community (Turner & Maschi, 2015).

References
Abrahams, H., & Humphreys, Catherine. (2007). Supporting women after domestic violence : loss, trauma and recovery. Jessica Kingsley Publishers.
Alston, M., McCurdy, Samone, editor, McKinnon, Jennifer, editor, & ProQuest. (2018). Social work : fields of practice (Third editon..). Oxford University Press.
Athena A., M. (2014). Social Workers (order custom written ‘academized’ nursing papers) ‘ Perspectives in the Identification and Resolution of Ethical Dilemmas: Four Case Studies. Australasian Psychiatry, 15(5), 179. https://search-proquest-com.ezproxy.federation.edu.au/docview/1744826224?pq-origsite=primo.
Banks, S. (2016). Everyday ethics in professional life: Social work as ethics work. Ethics and Social Welfare, 10(1), 35-52.
Gao, R., Liu, J., Johnson, R., Wang, J., & Hu, L. (2019). Validating an ethical decision-making model of assessment using authentic scenarios. Studies in Educational Assessment, 62, 187-196.
Lockhart, L. L., & Danis, Fran S. (2010). Domestic violence : intersectionality and culturally competent practice. Columbia University Press.
Maidment, J., Egan, Ronnie. (2016). Practice skills in social work & welfare : more than just common sense (Third edition..). Allen & Unwin.
Nuttman-Shwartz, O., & Shinar, L, O. (2019). Asylum seekers in Israel: Challenges to social work. The British Journal of Social Work, 49(8), 2283-2298.
Patil, T., & Ennis, G. M. (2018). Critically reflecting on the Australian Association of Social Workers (order custom written ‘academized’ nursing papers) Code of Ethics: Learning from a social work field placement. British Journal of Social Work, 48(5), 1370-1387.
Teater, B., & ProQuest. (2010). An introduction to applying social work theories and methods. McGraw-Hill/Open University Press.
Thompson, L. J., & Wadley, D. A. (2018). Countering globalisation and managerialism: Relationist ethics in social work. International Social Work, 61(5), 706-723.
Turner, S. G., & Maschi, T. M. (2015). Feminist and empowerment theory and social work practice. Journal of Social Work Practice, 29(2), 151-162.

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