Social Work Ethical Decision Making Model

What are ethical dilemmas in social work?

Ethical dilemmas often happen when social work professionals find themselves torn between multiple decision paths, each with its unique consequence, and regardless of the choice made, some ethical principle will invariably be compromised.

These dilemmas can be as simple as figuring out a disclosure responsibility when a client is at risk to complex ones, such as facing a conflict between a practitioner's personal belief system and their professional responsibilities. These situations might conflict in promoting clients' well-being or certain ethical principles. Ethical dilemmas in social work can be further understood through the following categories:

Self-determination vs. client's welfare

As social workers, we champion the principle of "self-determination". This means respecting clients' rights to make decisions and live according to their terms. However, this principle may sometimes conflict with the duty to promote our clients' welfare, leading to an ethical dilemma. For instance, should one respect a client's decision to stay in an abusive relationship, owing to their right to self-determination, or intervene to ensure their safety?

Confidentiality vs. duty to warn or protect

Confidentiality is a cornerstone of therapeutic relationships. Still, social workers may face dilemmas regarding the decision to breach client confidentiality when they believe a client threatens themselves or others. A classic example is the "Tarasoff rule," where the social worker must balance their role as a confidential helper and their duty to protect others from harmful behavior.

Dual relationships and boundary issues

Dual relationships, whereby social workers have multiple relationships with their clients (professional, social, familial, etc.), can lead to power imbalances and potential harm. While maintaining professional boundaries is vital, in some tight-knit or rural communities, such dual relationships are unavoidable, which can lead to ethical dilemmas.

Cultural and value conflicts

As societal values change and evolve, so do the ethical issues that social workers must navigate. Dilemmas can happen if the social worker's personal values or cultural practices differ from a client's or if societal attitudes on particular issues, such as policies regarding minority rights or abortion, conflict with the social work profession's ethical guidelines.

Resource allocation

Limited resources are a harsh reality for social work. This could bring up ethical considerations such as just and fair distribution. A social worker may face hard choices regarding who gets access to services first or receives more intensive case management.

What are the practice models of ethical decision-making?

Navigating ethical dilemmas does not have a one-size-fits-all solution. The following ethical decision-making models could guide us by providing structure and helping us critically analyze and move through ethical challenges more mindfully.

The NASW Code of Ethics

Integral to social work practice, the National Association of Social Workers (NASW) Code of Ethics sets forth core values, standards, principles, and ethical rules guiding decision-making. While the Code does not provide a step-by-step model for resolving ethical dilemmas, it offers broad ethical principles to consider, including service, social justice, dignity and worth of the person, importance of human relationships, integrity, and competence.

The Social Work Ethics Audit

The ethical audit involves a comprehensive, systematic evaluation of how well the agency or organization’s policies, practices, and procedures are aligned with ethical standards and critical values in the profession. The audit aims to identify ethical issues in practice settings and develop action plans to address the identified problem areas. The audit also involves categorizing ethical conflicts and risks social workers face and developing action plans to mitigate these risks. This can also include ethics consultation processes. The Social Work Ethics Audit is a valuable risk management tool that can help strengthen the integrity of the social work profession.

Elaine Congress' ETHIC Model (2000)

Elaine Congress' ETHIC model aims to provide a directive framework to help social workers in the ethical decision-making process:

• E – Evaluate relevant personal, societal, agency, client, and professional values
  The first step calls for an extensive evaluation of the values that may influence the situation. Here, the worker should consider their values, the implicated societal norms, the policies of the agency they represent, as well as the values and perspectives of the client.
• T – Think about what ethical standard of the NASW Code of Ethics applies, as well as relevant laws and case decisions
  This stage requires a lens where the social worker thinks critically about the ethical standards of the NASW Code of Ethics. They must also deliberate over any applicable laws or case precedents relevant to the matter.
• H – Hypothesize about the possible consequences of different decisions
  Social workers must consider the likely consequences of their actions by conducting a thorough risk-benefit analysis. The objective here is to minimize harm and maximize benefits, considering each decision's short and long-term implications.
• I - Identify who will benefit and who will be harmed, given social work’s commitment to the most vulnerable
  After hypothesizing the outcomes, the next phase is pinpointing who benefits from and who is affected by each hypothetical decision.
• C – Consult with supervisor and colleagues about the most ethical choice
  This peer-review process can help bring in diverse perspectives and accountability and helps to ensure that the decision made is ethically grounded. This can also involve ethics review committees and planning for alternative ethical actions.

How to use this template?

Our comprehensive Social Work Ethical Decision Making Model Template is designed to guide and assist you in analyzing and making ethical decisions in social work. Here's how you can use this resource:

Step 1: Download the template

Download the template using the link on this page. This template is also accessible through the Carepatron app or within our online resources library.

Step 2: Review and understand the template

Take a moment to explore the template and its content. This resource is curated to streamline the decision-making process by considering ethical principles, societal norms, legal guidelines, and the welfare of all parties involved. This is aimed at promoting mindful decision-making and balanced judgments.

Step 3: Write down and reflect on the ethical dilemma

Clearly state the scenario, including all relevant factors, such as the stakeholders involved, the conflicting ethical aspects or guidelines, and other relevant details. It must be as comprehensive and factual as possible to ensure a well-informed analysis.

Step 4: Analyze and weigh options

Use the sections provided to weigh the different courses of action available. This includes considering the potential impacts of each decision on all parties involved, evaluating the alignment with professional values, ethics, and legal standards, and hypothesizing the short-term and long-term consequences.

Step 5: Decide and plan for implementation

Detail a plan for implementing your decision, including specific steps, timelines, and any support you may need. Also, consider how you will communicate your decision to relevant parties and any follow-up actions required to monitor the outcomes of your decision.

What are the steps for ethical problem-solving?

The Ethical Decision-Making Model Template uses the General Decision-Making Model by Dolgoff, Loewenberg, and Harrington (2005). They outline the steps to resolve ethical dilemmas in 11 steps:

1. Identify the problem and the factors that contribute to its maintenance
2. Identify all of the persons and institutions involved in this problem, such as clients, victims, support systems, other professionals, and others
3. Determine who should be involved in the decision-making
4. Identify the values relevant to this problem held by the several participants identified in Step 2, including the client’s and worker’s
5. Identify the goals and objectives whose attainment you believe may resolve (or reduce) the problem
6. Identify alternate intervention strategies and targets
7. Assess the effectiveness and efficiency of each alternative in terms of the identified goals
8. Select the most appropriate strategy
9. Implement the strategy selected
10. Monitor the implementation, paying particular attention to unanticipated consequences
11. Evaluate the results and identify additional problems

They further employ the Ethical Assessment Screen for social workers to clarify the ethical principles involved when making decisions in their practice. This can be used alongside other resources, such as the Social Work Assessment and Social Work Treatment Plans, to integrate insights from reflecting on ethical dilemmas in particular cases.

References

Congress, E. P. (2000). What social workers should know about ethics: Understanding and resolving practice dilemmas. Advances in Social Work Practice, 1(1), 1-25.

Dolgoff, R., Loewenberg, F., & Harrington, D. (2005). Ethical decisions for social work practice. Brooks/Cole – Thomson Learning.