Chapter 13 Whose responsibility are professional ethics.docx

Chapter 13: Whose responsibility are professional ethics?
Must a SW make an ethical decision all alone?
https://www.youtube.com/watch?v=UeUjAwFI9P0
No! These decisions are just too big to make completely alone!
“Morality is first and foremost a social institution, performing a
social role, and only secondarily, if at all, a field for individual
self-expression”
W. D. Walsh, philosopher (1969)
Support is always available
Social workers are always responsible for their own ethical
decisions
But, she is a participant in a number of networks and social
systems that support – or should support – her ethical decision-
making
The agency employing her
The service delivery team, unit, or office
The professional association
Resources that support ethical decision-making
Client’s Bill of Rights
Agency Risk Audits
Peer Review and Committees on the Ethics of Social Work
Practice
Accountability Systems
Training and Consultation
Agency Appeals Procedures and Ombudsmen

Professional Associations
NASW Professional Complaint Procedures
Client’s Bill of Rights
Brief statements informing people of the type of information
they are entitled to know about their situation
Transmitting this information verbally is not enough; this is not
considered a Bill of Rights
Bills of Rights must be in writing; it can only be issued by the
agency, no the individual SW (unless in private practice)
Often include:
A person should expect to be treated with dignity and respect
He or she will be included in any decision-making practices
related to his/her situation
He or she will be informed about available options
He or she has the right to speak to an ombudsman or other
person if he or she is dissatisfied with his or her treatment
Agency Risk Audits
Many types of audits are conducted in human service agencies:
financial, safety, quality control, utilization review, etc.
An Agency Risk Audit is related to the ethical dimensions of
the work being done
Social workers’ knowledge of identified ethics-related risks
(complaints or law suits filed against the worker, court cases
and updates that are relevant to practice, etc.)
Current agency procedures for handling ethical issues,
dilemmas, and decisions
Agency Risk Audits allow an agency to strengthen their own
ethical performance while also allowing supervisors and

workers to work together to share the burden of ethical
decision-making
Strategies to prevent risk or ways to be proactive in ethical
decision-making:
Assume a proactive stance by considering the preventive aspects
of risk management
Minimize risk through familiarity with policies and procedures
so as to minimize risks that occur because of lack of knowledge
Take a comprehensive look at the context and eliminate or
reduce risk wherever possible
Stress education in the area of ethics, good practices,
transference, and counter-transference
Supervision and consultation should be available
Share the burden of risk by being aware of agency policies and
procedures, and take additional precautions such as carrying
malpractice insurance and arranging to have on-going
consultation and/or supervision
Peer Review and Committees on the Ethics of Social Work
Practice
Peer review permits a social worker to test her ethical decision
making against that of her colleagues – either formally or
informally
Peer review for practice decisions
Peer review for ethical decisions
Peer review especially important for social workers in private
practice
Accountability Systems
Professional social workers working in agencies or in private
practice will always be held accountable for their professional

activities!
Social Agencies are accountable for what their employees do
Internal accountability systems
Information systems and monitoring
Methods of sampling activities and decisions
Clear indicators of desired quality of performance and quality
of ethical decision-making
Feedback systems that permit an early alert to potential problem
situations
Bodies who might hold a SW and/or an agency accountable:
Courts
Third-party payers
Governmental regulators
Empowered clients or patients
Training and Consultation
Most agencies make a heavy investment in providing in-service
training, continuing education opportunities, and consultation
for their staff
Many states now require ethics content as part of the continuing
education requirements for re-licensure
Agency Appeals Procedures and Ombudsmen
Ombudsman - an official appointed to investigate individuals'
complaints against maladministration, especially that of public
authorities. https://www.google.com/webhp?sourceid=chrome-
instant&ion=1&espv=2&ie=UTF-8#q=ombudsman
Many agencies have appeals procedures, but clients are not
aware of them
Clients or patients should have ready access to an appeals
process – and should be able to use it without any risk for
stigma or retaliation
Valuable functions of an appeals process:

Corrects mistakes made by the SW
Sensitizes social workers to the ethical aspects of practice
Allows clients to feel heard and therefore become more willing
participants
Professional Associations
The NASW Office of Ethics and Professional Review provides
ethics consultations to those members who are experiencing an
ethical dilemma
NASW updates the COE
Studies have determined that Local Chapters and the NASW
should strive to:
Collect data on ethical decision-making
Data should include success stories, errors made, unanswerable
questions, and embarrassing situations
This “data bank” should be used to form precedents that will, in
turn, serve to guide future practice and future decision-making
NASW Professional Complaint Procedures
https://www.socialworkers.org/nasw/ethics/ethicsoepr.asp
Requests for professional review (RPRs) may be submitted to
NASW in the event that the COE has been violated by a SW
who is a member of NASW
The SW being accused of a violation must have been a member
of NASW at the time of the offense
If a SW licensing board action requires revocation of the NASW
member’s license, NASW membership will also be revoked
If the NASW member is convicted of a felony, NASW
membership will also be revoked
What if the SW is not a member of NASW?
The revocation of licensure is a great motivation for ethical

conduct
http://dhmh.maryland.gov/bswe/Pages/default.aspx
The Law could have been broken by the SW – and their case
could be referred to the Attorney General for prosecution
http://dhmh.maryland.gov/bswe/Documents/Regs/10.42.01Gover
ningLicensure.pdf
http://law.justia.com/codes/maryland/2013/article-gho/section-
19-311
Ethics Advocacy, Human Services Agencies, and
Interdisciplinary Teams
https://www.youtube.com/watch?v=77UGDj48oHs
What happens when social workers work in interdisciplinary
settings? Sometimes social work is the predominant profession
and sometimes it is not!
Professional power
Professional ethical obligations
Varying degrees of control by profession
But what is the true point of Social Work?
To always…no matter what… act within the law and policies?
To have, as a top priority, the agency’s rules and regulations?
To never question governmental oversight or mandates?
Social work is “increasingly routinized by accountability,
quality control, and risk management…[with] an emphasis on
regulation and duties. This has produced a culture of following
approved or typical processes resulting in defensive forms of
social work wholly uncongenial to the development of human
qualities likely to promote social workers’ engagement in
critique and revision of what counts as best practice…the
integrity of the social worker is not found in consistent action
or maximizing pay-offs across cases, or in carrying out
department policy or the law accurately, rather it is found in the
fundamental orientation or good will towards those who one

works for and works with” (McBeath and Webb, 2002, as cited
in Dolgoff text on page 275).
The true point of social work? To help people…
Chapter 12: Changing World, Changing Dilemmas
Managed Care and Mental Health
Developed as one major strategy devised in an attempt to
control health and mental health costs by monitoring access to,
and the type of, health care patients receive from health care
practitioners
Costs are reduced by controlling the type of health practitioners
used, limiting access to service, and prescribing the type and
length of service provided
Costs need to be managed so that the U.S. budget for social
programs that assist people in paying for medical expenses
(such as uninsured persons or the aged population) can be
reduced
Challenges autonomy of the SW and the patient – by prescribing
service and length
SW can be pressured into providing group rather than individual
therapy as it is more cost and time efficient
Technology
Databases and networks connecting one agency to another -
sharing clients
Physical location of computer monitors and screens; computers
“locked” immediately when not in use
Governmental electronic messages are often considered public
records that can be monitored without prior authorization or

notice
Video surveillance in agencies
Software that can be used in therapy – interactivity
(communication tools, etc.) and persuasive technology
(conditioning, self-monitoring, reinforcement, etc.)
Potential ethical issues: privacy, personal information shared in
software, social justice implications
Research and Evaluation in Practice Settings
SW are encouraged in the COE to keep up-to-date on relevant
and current research in the field; and to add to this body of
research
Many agencies are required to provide outcome data in order to
continue to receive funding
Clients should provide informed consent surrounding this
Research participants should always be informed of research
outcome
Deception should never be used in research
Conflicts of interest should be explored; dual relationship –
researcher and SW to client
Clients should have a choice in whether or not to participate
(autonomy)
Evidence-Based Practice
https://www.youtube.com/watch?v=wqRGBol_ESI
https://www.youtube.com/watch?v=2pJvBNszxIU
SW must be accountable for their methods used in practice and
for their outcomes – COE 4.01 (competency in practice!)
Research knowledge
Clinical expertise
Client values
5 steps to evidence based practice

Convert the information needs related to practice decisions into
answerable questions
Track down the best evidence with which to answer them
Critically appraise that evidence in terms of its validity, clinical
significance, and usefulness
Integrate this critical appraisal of research evidence with one’s
clinical expertise and the patient’s values and circumstances
Evaluate one’s effectiveness and efficiency in undertaking the
four previous steps, and strive for self-improvement
Private Practice
Client Dumping – trying to get rid of a client when he/she can
no longer afford treatment or whose insurance company has set
limits on services
Tell a client that his problem has been solved already
Tell a client that nothing else can be done for him
SW can cancel appointments so frequently that the client loses
interest
SW can refer a client who can no longer afford treatment to an
agency who provides free services
Misrepresentation (page 254 of text) in order to give clients
greater confidence in their ability
COE 4.06c
Is it ethical for a SW to identify herself as something other than
a SW – psychotherapist, marriage counselor?
Is it ethical for a SW to call herself “doctor” when she hasn’t
earned a Ph.D.?
Must a student SW always identify herself as a student?
Practice in Rural or Isolated Settings
Limited services are available
SW might be asked to provide services not within her expertise

Dual relationships more evident
SW have increased visibility in the community
Increased safety concerns?
Limits one’s willingness to advocate for change because of
social acceptability
Macro Practice
COE states that SW should engage in efforts to improve their
communities and society (6.01, 6.02, 6.03, 6.04)
Promote the general welfare of society
Participate in the community to shape policy and institutions
Provide services during emergencies
Engage in social and political action
Community Groups
Ethical dilemmas include: confidentiality, self-determination of
group and individual members, inclusion or exclusion of
members, conflicts of interest
Page 258 of text – examples of group ethical dilemmas
Different views of dual relationships for community organizers
– coffee house meetings, social gatherings after a session
Macro Practice
Community and Societal Issues
Identification of disparities and addressing them
Engagement in social and political action
Reference to ethical considerations are rarely found in macro
textbooks, but macro practitioners may actually encounter more
ethical dilemmas than clinical practitioners – when promoting
the well-being of people and social action
Who is client? To whom is the primary responsibility owed?
Short supply of resources – who has access to them and should
have access to them? What happens when there are several
similarly disadvantaged groups? One should never engage in
deception – what about half-truths that would provide for the

greater good for society?
Community Organizing
Conflicts of interest – are you a member of the community in
which you are working? Are you friends with members of the
community; attend social gatherings?
Choice of tactics – confrontational tactics; do the ends justify
the means?
Some SW reject the idea of social action including
demonstrations, picket lines, boycotts
Macro Practice and Social Action
https://www.youtube.com/watch?v=kLYbhP-p588
https://www.youtube.com/watch?v=Xv6iWCvFda4
Chapter 11 – Select Client Groups
Intimate Partner Violence
Intimate Partner Violence (IPV) – sometimes called DV; refers
to violence between adults who are intimates, regardless of their
marital status, living arrangements, or sexual orientations
Several forms of IPV – sexual, physical, psychological,
economic, social isolation, stalking, and coercive control
The economic cost of IPV has been estimated at $8.3 billion per
year – including medical care, mental health services, and lost
productivity in the workplace
Personal cost for the victims and their families
Societal cost
Women are more likely to be murdered by an intimate partner

than by any other assailant; homicide by intimate partners is the
7th leading cause of premature death for American women
Why would someone not report IPV?
They view the violence as trivial or tolerable or normal
They see violence as a way to resolve conflict
They fear what will happen to their public image if the violence
becomes known
They feel shame
They fear further victimization
https://www.youtube.com/watch?v=V1yW5IsnSjo
Implications for the helping professional…
They often fail to ask about violence…or only ask one partner
about it
The professional needs to balance the need to probe for
information (to assess for safety and risk) and the need to
respect the client’s privacy and self-determination
How do you make it stop? What about treatment?
Some risk factors cannot be changed ever – age, gender, prior
history of violence
Some risk factors can be changed – unemployment, access to
guns, use of alcohol and/or other substances
Short-term effectiveness versus long-term effectiveness
Couples counseling has not been proven effective for the long-
term, without reducing these other risk factors
Even abuser intervention programs (court-mandated) are not
always effective long-term – without reducing these other risk
factors…..Harbel, and other programs that combine substance
abuse treatment and abuser intervention treatment

Many agencies are understaffed, underfunded, have long
waiting lists, etc.
Elder Abuse
https://www.nia.nih.gov/health/publication/elder-abuse
There are estimates that for every reported elder abuse case,
there are 5 more that are unreported
Approximately 2/3 of all elder abuse perpetrators are family
members – most often the victim’s child or spouse
Implications for the helping professional…
Know the elder abuse reporting laws -
http://mgaleg.maryland.gov/webmga/frmStatutesText.aspx?artic
le=gfl&section=14-
302&ext=html&session=2016RS&tab=subject5
Develop rapport with adult protective services workers – they
can answer questions
Develop clear expectations of confidentiality and limits of
confidentiality with clients
Prepare clients for potential reports
Contribute to the research in this area
When conducting support groups on this topic, be sure the
group is aware of reporting laws and the limits of
confidentiality – for both victims groups and potential abuser
groups!
SW Principles Guiding practice
Self-determination
Quality of life
Protection of life
Privacy

Truthfulness and full disclosure
Social Justice
End-of-Life Decisions
http://www.socialworkers.org/practice/bereavement/standards/st
andards0504New.pdf
Strives to enhance quality of life, to encourage the exploration
of life options, and to advocate for access to options
SW have an important role in helping individuals identify the
end-of-life options available to them
Competent individuals should have the opportunity to make
their own choices – after being informed of options and
consequences
SW should not promote any particular means to end one’s life
but should be open to full discussion of the issues and care
options
SW should be free to or not to participate in end-of-life
discussions or assisted suicide discussions
It is inappropriate for SW to deliver, supply, or personally
participate in the commission of an act of assisted suicide when
acting in their professional role; though, they may be present
for it if the client asks them to be (if legally permissible)
The involvement of SW in assisted-suicide case should not
depend on cultural factors
Cultural impact – for the helping professional and the client
People from diverse cultures have different perceptions about
end-of-life care
Traditions, values, beliefs, desires are all different based on
one’s culture
Different definitions of autonomy, death and dying, uncertainty
about whether one is “terminally” ill, communication, truth
telling or not, level of care desired, etc.

End-of-Life decisions
Three different stages of care:
Life-palliative care
Death by choice or otherwise
Grief among survivors
Issues to consider when exploring options:
Assessment of capacity to give informed consent and/or make
important health decisions
The decision-making process including physical pain, suffering,
fear of loss of control, financial concerns, cultural factors,
underlying issues, overall quality of life, etc.
The person’s social support system
Systemic and environmental issues
Final Position Paper
Here we go…
Assisted Suicide
https://www.youtube.com/watch?v=6jMuNSJuJo4 – arguments
against it
https://www.youtube.com/watch?v=D04vRuEDaCU – for it
Supreme Court rulings on physician-assisted suicide for
terminally ill patients left the door open for individual states to
define their own statutes in this area
39 states explicitly prohibit physician-assisted suicide
6 states prohibit suicide through common law
3 states have no laws on this (North Carolina, Utah, Wyoming)
Slippery Slope effect of condoning assisted suicide; defining
acts, who can do it and who cannot, etc.
Ethical Dilemma

Standard 1.02 of the NASW COE (1999) asserts that SW have a
responsibility to limit self-determination when people pose a
serious risk to themselves or others.
The NASW Standards for Palliative and End of Life Care
(NASW, 2006) provides standards that are seemingly at odds
with this stance
Clients living with HIV and AIDS
HIV has now spread to every nation in the world and has
infected millions of people
Some statistics: http://www.amfar.org/worldwide-aids-stats/
A real-life perspective…. http://www.amfar.org/amfAR-Video-
Gallery/
Biases about HIV and AIDS
There is a high degree of stigma associated with AIDS – more
stigma than is associated with any other illness
Stigma has kept many people who are infected quiet – and thus,
they are not seeking much needed help
The AIDS epidemic is widespread – people of all walks of life
and in various positions have become infected:
Spouses of an infected person
Recipients of infected blood
Newborn babies of an infected person
Persons who shared needles
others
Confidentiality and HIV/AIDS
Although complex, the Tarasoff decision provides legal support
for a social worker who learns of a client’s intention to refuse
to inform his/her partner of his/her infection with the virus
But, still, how do you handle this situation?

Areas of Advocacy for Clients living with HIV and AIDS
Childless adults living with HIV typically only qualify for
Medicaid coverage once they become eligible for SSI….and this
only happens if they are deemed “disabled” or have a severely
limited ability to work
Persons with asymptomatic HIV infection are not eligible for
Medicaid until the condition has become fully developed AIDS
Some states have Medicaid waivers for persons with HIV…but
not all states
http://hab.hrsa.gov/about-ryan-white-hivaids-program/about-
ryan-white-hivaids-program
http://hab.hrsa.gov/stateprofiles/State-Overview.aspx
Technology in Direct Practice
Telephone – in 2001, Medicare expanded its coverage of tele-
health services for Medicare beneficiaries to include certain
individual psychotherapy services
Internet – Talkspace, Breakthrough, Online Therapy Institute, 7
cups of tea, etc.
NASW published a Standards for Technology and Social Work
Practice in 2005
https://www.socialworkers.org/practice/standards/naswtechnolo
gystandards.pdf
Social work advocacy for technology access by clients with
special needs or limited access
Compliance with applicable laws and regulations in all states
where the social work services are provided
Appropriate matching of online methods, skills, and techniques
to the cultural and ethnic characteristics of the treatment

population
Accurate marketing practices and verification of client identity
Privacy protection requirements
Knowledge about appropriateness of certain types of online
technologies for specific clients
Development of security policies and procedures, as well as
contingency plans for electronic failures or emergencies
Retention of technology consultants
Potential Ethical Issues
Protection of confidentiality and the misdirection of electronic
transmissions
Are SW sufficiently trained to provide these services, or is their
training only geared towards face-to-face interactions? Do these
skills translate to online or phone treatment?
Can a SW licensed in one state provide services to someone in
another state?
Appropriateness of treatment services
Which presenting issues are appropriate for this treatment?
Sexual abuse?
Violent relationships?
Eating disorders?
Psychiatric disorders that involve distortions of reality?
Benefits – do these outweigh the concerns?
People in rural or isolated areas have more options now
People who are home-bound have options now
Anonymity for those reluctant to see a therapist
24/7 availability
Low cost
Screening and follow-up care
No scheduling problems; someone always available

Easier to record sessions; tracking
Some research has shown that clients feel more open to sharing
in online formats when compared to in-person
Case example to consider (11.2 in text)
A university student used an electronic mail discussion group to
inquire about a drug that could be used for a painless suicide. A
professor in Europe who read this request communicated his
concern to the sender’s university which forwarded this message
to the university’s counseling department. The counselor
assigned to this case obtained more information before deciding
what to do. She contacted the director of the computer center,
who broke into the student’s account where additional messages
on suicide were discovered. At this point, the counselor decided
to contact the student’s parents. (The counselor was not a SW)
Issues to consider
Do you act on third-party information from someone unknown?
Do you think there was reason enough to access this
confidential electronic file?
Does the fact that this was potentially life-threatening
information change things?
Would you have done exactly what this counselor did?
What about talking with the student first, before telling his
parents?
Religion and Spirituality
Religion: an organized, structured set of beliefs and practices
shared by a community related to spirituality (Canda et al.,
2004, text page 231)
Spirituality: the search for meaning, purpose, and morally
fulfilling relations with self, other people, and the

encompassing universe and reality (Canda et al., 2004, text page
231)
Religion and Spirituality inform clients’ worldviews and your
own worldview
Everyone operates on the basis of some worldview, and this
determines how we relate to others and how we understand
others – personally and professionally
Religion, Social Work Values, and Secularism
The “Christian world view” and the “Social Work world view”
are different
NASW positions are based on humanism, postmodernism, and
liberalism
This does not always correspond to Judeo-Christian values
This has led to conflicts within SW schools historically
Other Religions have similar clashes with social work values
But….there are also many similarities between what some
people hold as religious values and social work values
Plus, the COE argues a need to advocate for social justice
through the elimination of religious discrimination
Autonomy
Advocating for marginalized subgroups or vulnerable
populations
Spirituality and Social Work Practice
Some people believe that spiritual matters can be woven into
SW practice
Ritual
Exploration of sacred stories and symbols
Incorporation of art, dance, poetry
Meditation and prayer
Focus on caring for the body
Some people believe that referrals should be made to clergy and
SW should collaborate with them as needed

Value conflicts can occur if a SW introduces her own spiritual
thoughts
Client Self-determination and autonomy must be protected
Culturally competence service must be provided
Religious counter-transference
SW can easily fall into a role of spiritual guidance rather than
focusing on the client’s presenting problem
An interesting thought…..how does one reconcile this in ethical
practice?
Research has shown a distinct link between spirituality and
religion and one’s mental and physical health outcome
Individual Activity
Take out a piece of paper
Get ready to write!
Chapter 9:
Social Justice, Limited Resources, and Advocacy
Commitment to Social Justice
What is social justice?
Everyone gets their “fair share” and receives “fair
opportunities” unless this equality is outweighed by
considerations such as fairness and beneficence
https://www.pachamama.org/social-justice/social-justice-issues
Ethical problems present themselves when the available

resources are so limited that equal distribution is not possible.
How do you decide who gets what?
Resources can be goods or services
Social Workers must maintain their commitment to Social
Justice and must make these difficult decisions….somehow
Example: time
Who gets what?
Some clients might require more time; some clients might
require less time
Is it ethical to spend more time with one client and less time
with another? What about in cases of crisis?
Or should time always be allocated according to fairness
(equity) and equality (equally situated persons receiving equal
treatment)
Inequality and the distribution of scarce resources
Example: Medical Resources (Oregon’s priority system)
Prioritize scarce resources by age? By priority of the service
(i.e. life-saving, non-life-saving, etc.)? Prioritize preventive
care?
Are limits applied equitably to everyone?
Should societal resources be allocated based on the returns that
society gets back?
Should resources be provided unequally (more and better
resources) to persons in the most critical need or persons who
are otherwise “disadvantaged” in some way? So that persons
have equal access to life opportunities?
Societal responses to distribution of scarce resources
Whose needs should take priority?

Baby boomers and their financial support in retirement?
The 41% of children living in low-income families?
Theories to use when determining whose needs take priority
Principle of Justice – decisions should be to the greatest benefit
of the least advantaged members of society; absolutist (follow a
fixed moral rule); are baby boomers or children least
advantaged?
Ethical Relativist – utilitarians; decisions should be based on
potential consequences; what consequences are more costly?
Are the consequences of not helping children and their impact
on society’s future more costly?
Pragmatic Ethics – what the book introduces; the decision must
be a tradeoff; do as much as you can do for everyone; help both
aging and young people
Here’s what really happens in this case:
The U.S. spends almost 2 ½ times as much on older adults as on
children (per capita)
When considering only the federal budget, there is a 7:1 ratio of
spending on older adults to children
Limited resources
What are resources?
What population is receiving the resources?
Individual from one social worker
A certain group of people from an organization or program
Constituents in a government – local, state, federal?
The equality/inequality principle can be aggravated by limited
resources
Who gets what? Why?
Based on equality?
Based on contribution?
Based on equity?

Ethical problems in allocating limited resources
Do you help those who are most needy….or simply allocate
resources equally across the board - fairness (equity) and
equality (equally situated persons receiving equal treatment)
How can people be discriminated against during the allocation
of resources?
Is it the social worker’s job to focus only on resources that she
controls? Or should she become engaged in the societal
allocation process….even advocating for governmental change
when needed or raising awareness that certain discrimination
practices exist?
Partner Activity
Case example (9.2 in text; page 178):
Latoya Jefferson is a social worker in an emergency food pantry
where persons come to obtain needed food for themselves and
their families. The only requirement is that people answer
several questions: name, household size, and source of income,
not subject to verification. No one asks about living situations
(a place to cook, ages of children, or special dietary needs).
There are not enough paid staff and volunteers to run the pantry
as it should be operated. Because of the shortage of supplies,
families can only receive food once a month, but over time the
staff and volunteers still get to know individuals and their
situations.
Latoya Jefferson, the paid director of the pantry, recently
discovered that Keisha Attlee, a volunteer social worker, favors
some clients over others. She chooses favorites who are
especially friendly or who have well-disciplined and cute
children. She also identifies those she thinks abuse the system;

when food is in short supply, she refers the “abusers” to another
pantry while assisting her favorites. When Latoya questioned
Keisha about her discriminating so that some get needed
supplies while others are referred elsewhere, Keisha replied, “In
my view I am giving food to those who are most needy and
cooperative. Aren’t they entitled to the help? I know they will
make good use of the food. Those I refer elsewhere may be
selling the food and buying beer and whiskey. Furthermore, as a
volunteer I don’t want to be supervised. If you keep bothering
me, I will just leave and you can do the distribution yourself.”
Partner Activity
Use the article provided to help Latoya figure out what to do
(http://www.socialworktoday.com/news/eoe_011515.shtml)
Consider: Need, equality, compensation, and contribution
Think about what ethical absolutists, ethical relativists, or
ethical pragmatists would do!
Now YOU make the decision about what to do – justify your
“actions” using the book or article…be able to clearly state the
justification!!
Discrimination
Discrimination is the result of competition for scarce resources
and also prejudices and stereotypes
Prejudging others on the basis of unproven assumptions about
individuals or groups
Preexisting feelings and attitudes that are not relevant to the
actual persons
Discrimination is a societal and professional problem that
directly affects SW practice, the availability of resources, and
the delivery of social services

COE 4.02 …. (page 180 of text)
SW have an obligation to fight discrimination both individually
and as a profession – from individual acts to institutional and
societal discrimination
Class Activity
Do you agree or disagree?
1. Stop and frisk – https://en.wikipedia.org/wiki/Stop-and-
frisk_in_New_York_City
2. North Carolina HB2 -
http://www.theatlantic.com/politics/archive/2016/03/north-
carolina-lgbt-discrimination-transgender-bathrooms/475125/
3. Arizona SB 1070 -
https://en.wikipedia.org/wiki/Arizona_SB_1070
Diversity
The intersectionality of multiple factors including:
Age
Class
Color
Culture
Disability
Ethnicity
Gender
Gender identity and expression
Immigration status
Political ideology
Race
Religion
Sex
Sexual orientation

Consequences of Difference
Oppression
Poverty
Marginalization
Alienation
Privilege
Power
Acclaim
Example: Discrimination and adoptions
Opposite sex couples or straight single parents are often the
ones sought by child welfare agencies
Same-sex couples or gay single parents often encounter legal
and other barriers when attempting to adopt children
This still exists even now – with the diminishing percentage of
“traditional” two-parent families
This still exists even though there are many more children
available for adoption than families who are able or willing to
adopt them
So….children are stuck in foster care, group homes, etc. for
longer…..just waiting….. rather than in permanent homes….all
because of discrimination
Consequences of Difference AND/OR IMPLICATIONS OF
LIMITING RESOURCES
Oppression
Poverty
Marginalization
Alienation
Privilege
Power

Acclaim
13th documentary
This might be difficult to watch……but it’s importance to our
society and to our discussion in this class far outweighs any
difficult scenes…..when watching this, think about the ethical
duty of social workers and how things need to be
changed…..and how advocacy can take form…
Consequences of Difference AND/OR IMPLICATIONS OF
LIMITING RESOURCES
Oppression
Poverty
Marginalization
Alienation
Privilege
Power
Acclaim
LET’S DISCUSS THE FILM……IN RELATION TO THESE
CONCEPTS…..AND IN THE CONTEXT OF DOING THE
“WORK” IN SOCIAL WORK…WHAT DOES THE COE SAY?
Social Work and advocacy
NASW (2008) COE says:
social workers should “advocate for living conditions conducive
to the fulfillment of basic human needs and…promote social,
economic, political, and cultural values and institutions that are
compatible with the realization of social justice” (6.01)
The purpose of advocacy is “to ensure that all people have equal
access to the resources, employment, services, and opportunities
they require to meet their basic human needs and to develop

fully” (6.04a)
…and it goes on…
Case advocacy – potential ethical dilemmas
The objective of advocacy intervention is to obtain a needed
resource or service for an individual client or group of clients
Do you advocate for your client at the expense of other people
or groups of people?
Example: bed in a nursing home
Your client needs a bed but someone else needs it more…what
do you do?
Remember that “Who is your client” question?
Cause/class advocacy – potential ethical dilemmas
The goal of advocacy is to alter the environment through social
policy changes or concessions from resistant or unresponsive
systems
Ex. 9.6 in text (p. 189):
Three children in a family receiving public aid are sent home
from school because, despite the cold winter weather, they are
still dressed in summer clothing. There is no money available at
home because their mother has used every last cent she has to
pay off more pressing bills. You, the family’s social worker,
have no emergency funds available to help these three children
obtain winter clothing.
What do you do?
Quick fixes….or truly addressing the underlying problems?
Advocacy as whistle blowing – potential ethical dilemmas
Whistle-blowing: reporting or informing on a supervisor’s or

organization’s ethical, professional, or legal misconduct
This is not a common phenomenon in SW, but it does happen
https://www.youtube.com/watch?v=Y-S3BCMS5hU
Always raises questions of loyalty…to client? To agency? To
SW as a profession? To social justice?
Advocacy and privatization of services – potential ethical
dilemmas
When a private company or corporation takes over….and the
government no longer runs the social program…..
Does a third-party corporation require a different set of ethical
stances than if the SW works for the government? Even if it is a
for-profit organization?
Cyberactivism (electronic advocacy) – potential ethical
dilemmas
Advocating through the internet or through other technologies
Websites
News groups
E-mail
Social media?
Virtual sit-ins: when a group ties up a website by overloading it
Hacks: when a group attempts to hack into an organization’s
computer system
Can a SW participate in these things?
Social justice and clinical work
https://www.youtube.com/watch?v=0B3DFDfRMX0

Can you incorporate social justice into clinical social work?
What “goods” are essential to goal-oriented action? And, if
strengthened, can lead to a fairer range of opportunities?
Self-respect
Self-esteem
Social skills
Assertiveness
Self-confidence
Self-knowledge
Problem-solving skills
Self-organization
Some people argue that some clinical theories (ones that
pathologize and emphasize deficits) actually go against the
COE….instead, we need to use strengths-based approaches.
Ethnic-sensitive social work practice emphasizes the
significance of race, class, and ethnicity in a person’s daily
experience and his sense of self….these factors must be
acknowledged for successful therapy; power differentials must
be acknowledged, too, and used as a means of collaboration and
cooperation instead of competition
Chapter 5
Client Rights and Professional Expertise
Who is the client?
A frequent source of ethical dilemmas
Sometimes the client is the party paying
Sometimes the client is the person (or system) whose behavior
needs to be modified by the professional’s intervention

Case Example
You are a forensic social worker working as a freelancer for the
OPD. You are asked to interview, evaluate, and write a report to
the Court on behalf of a 24 year-old man recently convicted of
brutally assaulting and raping a 12 year-old girl from his
neighborhood. The OPD is presenting your written report at the
man’s sentencing in the hopes that the Judge will hear
mitigating circumstances and offer a more lenient sentence than
the 30 years being recommended by the SAO.
Who is your client?
Professional Expertise and Self-Determination
Ethical dilemmas sometimes come from conflicting professional
obligations
To support or guarantee a client’s self-determination
To make decisions that will assume a positive outcome or the
most benefit for the client by using one’s knowledge or skill
The NASW COE (2008) states, “social workers may limit
clients’ rights to self-determination [only] when, in the social
workers’ professional judgment, clients’ actions or potential
actions pose a serious, foreseeable, and imminent risk to
themselves or others” (1.02).
Social Workers always know best? They’re the experts? Or,
should clients have a say in their own lives?
Case Example
Should a 38 year-old single mother of 3 young children enter a
Methadone treatment program?
Should she up her dose if having uncontrollable cravings?
Should she slowly wean off of it?
Should she be allowed “take-homes?”

Self-Determination
A person’s right to determine his/her own destiny; to make
his/her own decisions
“real” self-determination requires power and resources. Do most
clients have these?
Who has the right to decide when a client can or cannot make
his/her own decisions at a particular time?
Powers of attorney; competency and treatment decisions;
competency to stand trial; guardianship
Who has control in the relationship?
Case Example – How immediate is the danger?
Figure 5.4 in text
You, a social worker, have been working for one month with an
extremely thin, almost gaunt, reserved 17 year-old college
freshman. She was referred to the Family Counseling Center by
her pastor after she told him of her loneliness and obsessive
thoughts. She came for help with the agreement and support of
her parents. She is passing academically, but has had difficulty
making friends at school. For 5 months, she has had no social
life. Today, she came to you and reported that her menstrual
cycle has stopped. You explore further and discover that she is
on a very restricted diet and exercises 2-3 hours per day to lose
weight. She is slightly depressed, but still able to concentrate in
class; she reports that she is seldom irritable. Based on this
information, you begin to believe that she has Anorexia. You
refer her to the health center on campus for further evaluation
and to consult with a doctor. She listened to your suggestion,
but she rejected it.
Is anorexia a clear and present danger?
Is immediate action needed?
Should parents be contacted?
Is the client still able to make informed decisions?

Informed decisions
Page 100 of text:
“As long as she can make informed decisions, the social worker
has no mandate to interfere, unless (a) it is a question of life
and death for the client, (b) there is serious danger to others…,
or (c) reporting is mandated by law. The social worker’s task is
to enable the client to make an informed decision to the
maximum extent possible.”
Ambiguity and Uncertainty
Ambiguity – the SW has imperfect or incomplete information
about the situation confronted
Keep in mind that the client might not know the problem or
what the goal is…..might just feel crappy
Ambiguity can lead to ethical problems:
Uncertainty about values and goals
Uncertainty about facts of the situation
Uncertainty about the consequences of the intervention
Case Example – a victim of child abuse
based on figure 5.5 of text
A neighbor often hears parents yelling at a 2 year-old child and
the child screaming; one day, the neighbor even sees the child
with significant bruises; she child looks so sad. The neighbor
finally calls the police and CPS; a report was taken, but it did
not rise to the level of an actionable report in that jurisdiction.
One month later, the mom takes the boy to the hospital; the boy
had multiple fractures, but mom said it was from falling down
the stairs; x-rays showed previous fractures, as well. CPS was
called by the hospital and a case was opened. An experienced
worker came to the hospital and interviewed everyone; then
visited the home once; the parents admitted to beating the child
when he misbehaved; the worker discussed with the parents
other ways of disciplining the child. Two weeks later, another

experienced worker visited the home and spoke with the
parents; it was decided that there was no need to remove the
child from the home at this time. 10 days later, the child was
rushed to the hospital and was pronounced dead; the Medical
Examiner determined that the death was directly caused by a
blunt force trauma to the child’s head.
Ambiguities in Case Example
Lack of clarity of social norms – what are the limits of parental
discipline?
Lack of knowledge – what evidence is sufficient to warrant
intervention?
An inability to know what the future will bring – what are
consequences of intervention…or lack of intervention?
The social workers in this case made a judgement that the child
was not at risk….or high enough risk to remove him
Chapter 6
Value Neutrality and Imposing Values
According to the NASW COE (2008)
Social Workers “should be aware of the impact on ethical
decision making of their clients’ and their own personal values
and cultural and religious beliefs and practices. They must be
aware of any conflicts between personal and professional values
and deal with them responsibly.” (Purpose)
A study of Social Workers (Hodge, 2004; page 107 of text)
Social Workers:
Were more likely to identify as Democrats
Were more liberal
Thought too much money was spent on the military

Thought too little money was spent on welfare, solving
problems in big cities, and improving conditions of African
Americans
More likely to endorse the legalization of marijuana
Twice as likely to oppose the death penalty for convicted
murderers
Imposing Values
A difference in values between the worker and client
Power imbalance between worker and client
It is the client’s responsibility to identify the values that will
guide his/her behavioral choices…..it is never the social
worker’s responsibility to do this
Value Neutrality
Suspending one’s own value judgments
What might seem wrong to one person might seem right to
another
What is right today may be wrong tomorrow…..and vice versa
Various schools of thought on this
Some people believe that a value-free stance in inhuman
Some people believe that a social worker’s job is to serve as a
moral agent and challenge “wrongs”
Is this a realistic option for social workers? Or for anyone?
Will values still be unintentionally communicated – non-verbal
exchanges, etc.?
One idea…
“I accept you, but not your behavior”
Switch it up…to get us thinking…

https://www.youtube.com/watch?v=FRvVFW85IcU
Chapter 4
Guidelines for Ethical Decision-Making: The Decision-Making
Process and Tools
The authors’ belief
“Our perspective is that social workers should strive to achieve
personal virtues but that in addition to being of good character,
it is necessary that they be trained and skillful in a systematic
approach to ethical decision-making.”
(Text page 72)
A general decision-making model
(pg. 73 of text)
1. Identify the problem and the people/institutions involved in
the problem
2. Determine who should be involved in the decision-making
3. Identify the relevant values held by all those identified in
step 1 (including the client and worker)
4. Identify the goals and objectives whose attainment you
believe may resolve or reduce the problem
5. Identify alternate intervention strategies and targets and
determine effectiveness and efficacy (ability to produce a
desired or intended result)
6. Select and implement the most appropriate strategy
7. Monitor the implementation and pay attention to
unanticipated consequences; evaluate the results and identify
additional problems or opportunities

A Caution
Every decision is preceded by other decisions and will impact
future decisions
Decision-making models should be used with this in mind –
they usually simplify situations and attack one decision at a
time (this is not always possible in reality)
How do we make ethical decisions in SW practice?
Some “tools” to use…
Ethical Assessment Screen
page 74 of text
1. Identify the relevant professional values and ethics, your own
relevant values, and any societal values relevant to the ethical
decision to be made in relation to this ethical dilemma.
2. What can you do to minimize conflicts between personal,
societal, and professional values?
3. Identify alternative ethical options that you may take.
4. Which of the alternative ethical options will minimize
conflicts between your client’s, others’, and society’s rights and
protect to the greatest extent your client’s and others’ rights and
welfare, and society’s rights and interests?
5. Which alternative action will be most efficient, effective, and
ethical, as well as result in your doing the least harm possible?
6. Have you considered and weighed both short- and long-term
ethical consequences?
7. Final check: Is the planned action impartial, generalizable,
and justifiable?

Protection of client’s rights and welfare
The definition of rights and privileges changes over time; these
changes may create ethical problems
Changes can come from laws or Court decisions, new
technologies, new record-keeping procedures, new
administration, consultation with co-workers, consultation with
other disciplines, responsibilities to supervisors and Courts, etc.
Example: Adoption laws and the “new” rights given to adopted
persons to obtain information about their biological relatives;
how does this impact adoption workers and their relationship to
clients with whom they have spoken about the confidentiality of
their Information…..and then the law changed?
Can we assure clients confidentiality at all given the changes in
electronic record-keeping (hackable) and insurance-related legal
changes?
Protection of society’s interests
Society calls upon Social Workers to have two roles:
The Caring Role – caring human service professionals who are
attentive to individual and societal needs
The Social Control Role – CPS, working in a group home and
setting limits on acting out adolescents, intervening in
substance abuse addictions
How do you balance society’s interests with the client’s
interests? Which one gets priority?
Example: your client is seeing you for therapy and reveals to
you that he has stopped working so that he can spend more time
relaxing with friends; he has decided to apply for public
assistance
The least harm principle
Sometimes there are no positive choices within a particular

problem or dilemma
Least Harm Principle – choose the option that will result in the
least harm, the least permanent harm, and the most easily
reversible harm
Is it sometimes justified to choose an option with greater harm
but a more successful outcome? Yes – but only with the fully
informed consent and agreement of client
Efficiency and Effectiveness
Efficiency criterion – the relative cost (budget, staff time,
agency, community resources) of achieving a stated objective;
the fewer the resources, the more efficient
Effectiveness criterion – the degree to which the desired
outcome is achieved
When both are not present in a situation, which one do you
choose?
Rank ordering ethical principles
There may be conflicts that cannot be resolved through the use
of the previous methods……some people believe that Social
Workers should rank order their principles and proceed from
there
A higher-order principle takes precedence over a lower-order
principle
Consensus has never been reached on how to rank order SW
principles, but it did not stop them!

Rank the Principles!
Open your COE and rank the principles using your own
thoughts, values, and beliefs
What is most important in your opinion?
What is least important in your opinion?
Then, fill in the rest!
Ethical Principles Screen
the authors’ ranking
1. protection of human life
2. social justice
3. self-determination, autonomy, and freedom
4. least harm
5. quality of life
6. privacy and confidentiality
7. truthfulness and full disclosure
Application of ethical decision-making screens
Example from text – Figure 4.4 – The wrong man sits in prison
(page 84)
Raul Lovaas has been enrolled in a drug rehabilitation program
to break his cocaine addiction. The program’s treatment routine
includes pharmacological treatment, group therapy, and
individual therapy. You are his social worker. You have
succeeded in establishing a good relationship with Raul in your
daily treatment sessions. One morning, Raul tells you that, some
years ago, he accidentally injured a bank guard during a holdup.
He was never caught by the police, but another man was
convicted for this crime and now sits in prison on a lengthy
sentence. For several days you have been trying to convince
Raul that he should talk to the police in order to free an
innocent man from prison. Raul not only refused to listen to
your suggestion but said that he expects you to keep what he

has told you in complete confidence. What should you do?
These are some of the thoughts you have been having:
1. The wrong that you may cause by breaking confidentiality is
hardly of the same importance as the wrong inflicted on an
innocent person who is now imprisoned.
2. The effectiveness of the entire program may be compromised
if it becomes known that social workers do not always keep the
information they receive from clients confidential.
3. On the other hand, reporting Raul’s participation in the
holdup could cause the release of a wrongly convicted person.
What is your decision? What SW ethical principles come
first….and how do they impact your decision?
The importance of identifying one’s own hierarchy of principles
The NASW COE does not, itself, specify which values,
principles, and standards are most important and out to
outweigh others when there are conflicts and when making
decisions!
Therefore, each SW must use his or her own values and
judgment; clarifying one’s own hierarchy of principles helps in
this
Over time and through varied experiences, might one’s own
hierarchy change?
Summary and conclusions
Impartiality – would you act the same way if you were in the
other person’s situation?
Generalization – would you undertake this action in similar
circumstances?
Justifiability – can you explain or justify your decision to
others?

Chapter 3
Guidelines for Ethical Decision Making: Concepts, Approaches,
and Values
Day ‘O Theory!
Ethical Decision-Making Theories – 2
Contemporary Approaches to Ethical Decision-Making - 8
Ethical Decision-Making Theories
Ethical Relativism (pg. 52 of text)
Rejecting fixed moral rules
Ethical decisions are based on each situation or on the
consequences that might result
Weighing the risks and benefits in any given situation
Seeking the greatest good
Ethical Decision-Making Theories
Ethical Absolutism (pg. 53 of text)
Stresses the importance of fixed moral rules
Actions are inherently right or wrong, no matter the
consequences
Ethical rules can be set and these rules should hold under all
circumstances
Example: always tell the truth
But, there may be some exceptions to the rule
Example: you may lie to thieves, as they aren’t owed the truth
Contemporary Approaches to Ethical Decision Making

Clinical Pragmatism (pg. 56 of text)
focus is on delivering a high level of professional service; not
solving ethical problems
society should determine the types of service provided, which
problems should be dealt with, and which interventions should
be used…societal ethics are most important
Humanistic Ethics (pg. 57 of text)
Idealistic view of human nature as basically positive; humans
are innately good
Optimistic stance toward the future
Individuals have choice – and everyone is capable of and
responsible for making choices that make sense to him or her
Social Workers must work to help people achieve self-
actualization (to reach one’s potential; fulfillment of the highest
needs of someone….Maslow’s hierarchy of needs)
Religious Ethics (pg. 58 of text)
Implies the belief in the existence of God
There is a set of Divine values, and it is the job of humans to
discover them
Religious faith and ethical morality go hand in hand
Ethical principles are very general typically; therefore, there are
authorized interpreters of religious law who create the practical
application of this law to life
The Ethics of Caring (pg. 59 of text)
Developed in the late 20th century (new to the field)
Individuals only exist and “flourish” within networks of care

One person takes on another person’s problems as his/her own
even if this means acting against one’s own desires or interests
A caring relationship structures morality; tensions within
relationships are what creates moral dilemmas – a breakdown in
human respect
“Spontaneous compassion” is what rebuilds relationships and
regains morality
The “maternal” ethic; women-centered
Feminist Ethics (pg. 61 of text)
Women-centered
Emphasizes the oppressive contexts within which women live
and work
Issues of power and oppression are most important – rather than
what is good or bad
This includes racism, sexism, classism….other isms
Personal situations should be viewed within the context of
public issues
Virtue Ethics (pg. 62 of text)
Originated with Aristotle
There are no general rules for what is good and right
behavior/action
People are taught virtues in youth; only the person in the
situation knows what is best in that situation
Moral training develops personal character – learned through
habits, customs, and mores (accepted ways and behavior)
What would Moses, Jesus, Buddha, or another role model do in
this situation? Asking these questions is moral training….it’s
what develops personal character

Confucian Ethics (pg. 63 of text)
There are no fixed rules or principles
Seeks a just distribution of the burdens and benefits within
society
Emphasizes harmony within relationships
an ideal human life is led when one is virtuous
Virtues must be cultivated within people – courage,
faithfulness, wisdom, kindness, courtesy, respectfulness, etc.
Unexpected and changing circumstances often cause ethical
dilemmas – reasoned judgement, if one is virtuous, is how to
deal with ethical dilemmas
Hindu Ethics (pg. 63 of text)
Derived from Hindu religion and Vedic texts (ancient Indian
texts written in Sanskrit(
A moral code of good behavior
An ethical life is the means to spiritual freedom – right action
liberates someone from the need to be reincarnated
Right action leads to experiencing God and religious fulfillment
Order in the Universe means that human life can be orderly and
in harmony
Because divinity is everywhere, everything must be respected
Two goals of life: liberation and doing one’s duty
Group Exercise!
Break up into small groups of 5-6 and choose a dilemma!
Ethical dilemma: Your 13 year-old client comes to you and
reports that he/she is being bullied at school. He/She wants to
stand up for his/herself; wants to fight back in some way. You
know that if he/she gets into a fight, he/she will get kicked out

of school……but, you know that he/she might slide back into a
depression if he/she feels like not enough is being done. Using
the “Contemporary Approach to Ethical Decision-making”
assigned to your group, decide how to assist your client. Outline
the specific reasons why that approach tells you to take that
action. What values are conflicting?
Ethical dilemma: You are standing at a subway platform and a
man 20 feet away from you is tottering about and appears under
the influence of something. He ends up falling onto the tracks.
There are 5 other people on the platform with you and they are
standing still. A train is scheduled to arrive on that track in 5
minutes. Using the “Contemporary Approach to Ethical
Decision-making” assigned to your group, decide how to
proceed. Outline the specific reasons why that approach tells
you to take that action. What values are conflicting?
Personal, Group, Societal, and Professional Values
“Individual or personal values are values held by one person but
not necessarily by others
Group values are values held by subgroups within a society –
such as religious groups, ethnic groups, disability groups,
sexual orientation groups, language groups, and so forth.
Societal values are values that are recognized by major portions
of the entire social system or, at least, by the leading members
or spokespersons of that system.
Professional values are values proclaimed by a professional
group, such as social workers.”
*taken directly from page 65 of text
Clarifying Personal Values
Personal values can directly affect one’s practice – this can be a
good or a bad thing!
You must be aware of your own values, so that you can

distinguish between your own values and your professional
values – or else bias might affect your work!
Example: gender bias
Clarifying Group Values
Most people belong to more than one group and their values
come from each of those groups – family, community,
profession, religion, etc.
Some clients might be from one of your groups…but you
shouldn’t generalize or automatically think that you know where
they’re coming from
Other clients might be from a different group than
you….stereotyping is difficult.
You must identify these group values and how they shape
you….and therefore, how they might impact your work
Example: some groups value independent decision-making,
others value interdependent decision-making
Clarifying Societal Values
Identifying societal values is increasingly more difficult as
society is growing and changing (influx of diversity)
Some societal values are not universal across society (U.S.
Society or more local societies) and, in fact, divide society
Gay marriage
School prayer
Abortion
Assisted suicide
Clarifying Professional Values
Core Values in SW – service, social justice, dignity and worth
of the person, importance of human relationships, integrity, and
competence

Values are expressed through SW’s primary mission – to
enhance human well-being and help to meet people’s needs
(especially those who are vulnerable or oppressed)
If a SW is not facing ethical decisions, is he or she really doing
his or her job? Or, is she/he just unconsciously making ethical
decisions? Is this okay?
Another exercise
Ethical problem: You are a social worker in the field of public
child welfare. Your client is a 19 year-old mother; her baby girl
is 9 months old. Due to your client’s substance abuse and
subsequent neglect of her baby, the child was removed from her
care and placed with the maternal grandfather. Your client is
pregnant again, still actively using heroin, and trying to get into
a treatment program so that she can regain custody of her
daughter. Your client is thinking about an abortion. She is
wrestling with an ethical dilemma.
• Examine the COE and list applicable professional ethical
behaviors
• Think about your personal values and how they might
impact your thoughts and behaviors in this situation
• Are there any conflicting values for you personally?
Professionally?
• What ethical theories or approaches might apply? How?
Additional considerations: Do these change anything?
• Who is the client? Mom? Child? Unborn child?
• There is an excellent inpatient Substance abuse program
that has 1 bed open right now, but they don’t accept pregnant
women
• She is 20 weeks pregnant
• What is the law in Maryland? Does this affect your
values/behavior towards her?

Values and professional ethics
Chapter 2
values
what are values?
Preference given to something
“guides or criteria for selecting good and desirable behaviors”
(pg. 24 of text)
Something that betters a life or society in some way
Types of values
Individual
Group
societal
Group Activity
Break up into groups of 3-4
Discuss individual values of group members
Name some group values (define group)
Talk about societal values
Do they encompass the other types of values? How?
Read all about it!
Take out your newspapers…..
Look for illustrations of values held by society
Any conflicting values described?

Professional values
Usually a combination of societal values and group values
Profession = group practicing within society
There is a wide agreement about basic professional values
(pg.24 of text)
Core values of the National Association of social workers
(NASW, 2008)
Service
Social justice
Dignity and worth of the person
Importance of human relationships
Integrity
Competence
pg. 24 of text
ethics
Moving from values to behavior (pg. 25 of text)
What guides people to decide what is right or wrong
Values tell us what is good and desirable; ethics help us decide
what action or behavior is right and wrong (pg. 25 of text)
Ethics are derived from values
Example: privacy is a desirable value…confidentiality is an
ethical principle derived from privacy (pg. 25-26 of text)
Professional ethics
Professional ethics are based on professional values
They help to decipher what is right and wrong in various
practice situations
Might differ from societal ethics in priorities placed on certain
behaviors, emphases placed on certain behaviors, or the way

they are applied in certain situations (pg. 27 of text)
Example: The professional value of competence can lead to a
professional code of ethics which states that people should only
practice within their areas of knowledge and expertise.
Competence might not be as important to society at large…but
it is a huge priority for the profession of social work.
Important stuff to remember
Personal values can affect behavior and practice decisions
Values can conflict – individual, group, societal
Codes of ethics help to determine which behavior is appropriate
in a given situation; they help in making decisions about what
to do
Ethical principles and rules are derived from values – either
individual, group, or societal values
Law and ethics
Human service professionals have a duty to keep abreast of laws
that continue to be passed by local, state, and federal
legislatures.
Not knowing the law can, itself, lead to unethical behaviors and
malpractice
Law differs greatly by state
Law changes regularly
Law vs. ethics
Law has an ethical dimension – where did we get our law to
begin with?
Example: The value of privacy and the ethical principle of
confidentiality led to the legal principle of privileged
communication
You must observe the law or threat of punishment

Compliance with ethical principles is voluntary
It is not illegal, unto itself, to violate ethical principles
But violations can be met with professional sanctions
And unethical actions may lead to court proceedings
How can law impact practice?
Reporting laws
Laws that dictate what social workers can and cannot do (ex:
diagnose but not prescribe)
Laws that allow social workers to receive payment for services
Laws that mandate certain services be provided to people who
fit certain criteria
Malpractice suits
Failing to provide “proper professional service” can lead to
malpractice suits
Civil law suits
Criminal complaints
Licensing board complaints
A social worker’s behavior can be unprofessional, unethical, or
both
Unprofessional: departing from the usual practice
Unethical: violating the professional principles and standards of
the profession (in the COE)
Pg. 33 of text
The Most Serious Offenses Identified
Dual relationships
License-related problems
Crimes *Box 2.1 on page 35 of
text

Basic practice
Below standards of care
Personal financial
Billing irregularities
impaired
Supervision below standards
Protection against malpractice suits
Malpractice insurance
Supervision
Documentation of social work practice
Pg. 37 of text
Codes of professional ethics
See page 41 of text
Codes are written in general principles, rather than a set of rules
this is more inclusive and assists with anything that might come
your way in practice
Your own judgment and ability to reason is still required
A brief history of codes of professional ethics
Hippocratic oath
First created over 2000 years ago by Hippocrates – who
demanded that all physicians pledge themselves to a high level
of ethical and professional conduct (pg. 43 of text)
NASW adopted their first COE in 1960, then amended it in 1967
to include a nondiscrimination paragraph, then amended it again
in 1979 to emphasize the welfare of individuals, then amended
it again several more times
The current version of the nasw COE was initially approved in
1996; then it, too, was amended in 1999 and 2008 – the latest
amendment was to add additional emphasis on social diversity

and cultural competence
International codes of ethics
Page 44-47 discuss many examples of international codes of
ethics
There are similarities and differences between the codes
Based on differing societal values?
Ethics in Human Services
Getting to know you…
A little bit about me…
Kelly DaCunha, MSW, LCSW-C
[email protected]
Office Hours: Tu/Th 11/2pm or by appointment
A little bit about you…
Name
Major/Life goal
Year
Syllabus
2 textbooks (one you print yourself; one recommended)
3 Position Papers
Partner Debate
Midterm Exam
Final Exam

Safe space
In this class we will discuss some contraversial topics
Everyone’s opinion is valued here
Is there really a right or wrong answer…..or should we start to
think in terms of spectrum or shades of grey?
What does “ethics” mean?
“Ethics” comes from ethos, a Greek word meaning “custom,
usage, habit, or character.” (pg. 8 of text)
Ethics pertains to what actions are “morally right” and “how
things ought to be” (pg. 8 of text)
Anyone care to share?
Name some ethical problems or dilemmas you have faced
Should I spank my children?
Should I make my kids eat veggies when they don’t like them?
General ethics
“obligations that are owed by one person to another person”
(pg. 8 of text)
These obligations are based on a specific relationship one has to
another person OR on a role that was voluntarily accepted by
someone (pg. 8 of text)
Mother-child relationship: mother has an ethical obligation to
provide food for her child
Someone who chose to become a blood donor has an ethical
obligation to fill out the forms correctly and name any risks to
their blood supply
Professional ethics
“Professional ethics are a codification of the special obligations

that arise out of a person’s voluntary choice to become a
professional, such as a social worker. Professional ethics clarify
the ethical aspects of professional practice. Professional social
work ethics are intended to help social work practitioners
recognize morally correct practice and learn how to decide and
act ethically in any professional situation.” (pg. 8 of text)
Ethics through a social work lens
Is anyone here thinking about Social Work as a future
profession?
What makes Social Work a good lens through which to explore
professional ethics?
Detailed and strict Code of Ethics
Social Work as a profession focuses on human rights
Social Workers are not “mere technicians who solve mechanical
problems (such as providing services or supplying information).
They are, first and foremost, moral agents.” (pg. 9 of text)
There are ethical implications to almost every decision made by
a Social Worker – and therefore risk (pg. 9 of text)
pretest
As I read you these questions, write down your answer of true
or false
No worries….this is just for your eyes!
NASW Code of Ethics
Helps to answer each of these questions
Helps in prioritizing conflicting values (ex: valuing a client’s
interests over those of oneself – COE 1.01)
https://www.youtube.com/watch?v=26N6p9O9HcU (8 minutes)

NASW Code of ethics
Let’s dig in…
Ethical Problem or dilemma?
Ethical problems ask what the right thing to do is in a particular
practice situation. (pg. 9 of text)
Am I required to make a Child Abuse report in this instance?
Ethical dilemmas happen when someone must choose between 2
or more contradicting ethical principles or directives or when
all of the alternatives have undesirable outcomes for someone.
(pg. 10 of text)
This mother has said that she will beat her child again if I
report her actions to CPS.
Causes of ethical problems
Competing values
Competing loyalties
ambiguity
“Ambiguity is an ever-present element in almost all social work
situations.” pg. 15 of text
Is anything ever just black or white? We live and work in the
grey!
Who is responsible for ethical conduct?
Individuals bear responsibility for their ethical conduct
Professional peer groups and agency settings can either support

good ethical decisions or hinder them
Pg. 16-17 of text
A glimpse of what’s to come…
When making ethical decisions, one must always consider the
following:
Who is my client?
What obligations do I owe my client?
Do I have professional obligations to people other than my
client?
What are my obligations to my own family, agency, and
profession?
What are my own personal values? Are these values compatible
with my profession’s values or society’s values?
What are my ethical priorities when these value sets are not
identical or when they conflict?
What is the ethical way to respond when I have conflicting
professional responsibilities to different people?
*taken from page 6 of text
In-class Activity: everyday ethical problems/dilemmas
http://greatergood.berkeley.edu/article/item/right_and_wrong_in
_the_real_world#
Break up into groups of 3-4
I’ll come around and give you an everyday ethical
problem/dilemma to consider
Discuss it within your group
You MUST reach a conclusion about what you would do in this
situation

What values are being jeopardized?
Are any values conflicting?
In-class activity: Part 2
Within your groups, examine the process by which you arrived
at your conclusion
Did you actively name your values?
Did you make a list of competing values?
Did you consider values at all?
Did you write anything down?
Were “moral principles” at play?
Did you “argue” within your group?
Did your “gut” tell you what to do?
Philosophy
Filled with competing theories that offer “moral principles” for
use in ethical dilemmas
Theological ethics – religious sources offer guidance
Consequentialist theories – judges the moral value of an act by
the end results
Rational and Rule-based theories – appropriate intentions are
essential to moral value
Virtue-based theories – focus on character rather than behavior
http://greatergood.berkeley.edu/article/item/right_and_wrong_in
_the_real_world#

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