Larry W. Foster
Bioethics and biomedical ethics are defined. Common bioethical concepts, exemplary moral values, fundamental ethical principles, general ethical theories, and approaches to moral reasoning are reviewed. The scope of topics and issues, the nature of practice situations in bioethics, and social work roles on organizational bodies that monitor and respond to bioethical issues are summarized, as are trends in bioethics. Practice contexts, from beginning to end of life, are highlighted with biopsychosocial facts, ethical questions and issues, and implications for social work—a profession uniquely positioned in giving bioethics a social context.
Carolyn I. Polowy, Sherri Morgan, W. Dwight Bailey, and Carol Gorenberg
Confidentiality of client communications is one of the ethical foundations of the social work profession and has become a legal obligation in most states. Many problems arise in the application of the principles of confidentiality and privilege to the professional services provided by social workers. This entry discusses the concepts of client confidentiality and privileged communications and outlines some of the applicable exceptions. While the general concept of confidentiality applies in many interactions between social workers and clients, the application of confidentiality and privilege laws are particularly key to the practice of clinical social workers in various practice settings.
W. Patrick Sullivan
The psychosocial catastrophe that accompanies serious mental illness negatively impacts individual performance and success in all key life domains. A person-in-environment perspective, and with a traditional and inherent interest in consumer and community strengths, is well positioned to address psychiatric disabilities. This entry describes a select set of habilitation and rehabilitation services that are ideally designed to address the challenges faced by persons with mental illness. In addition, it is argued that emphasis on a recovery model serves as an important framework for developing effective interventions.
Frederic G. Reamer
The possibility of practitioner impairment exists in every profession. Stress related to employment, illness or death of family members, marital or relationship problems, financial problems, midlife crises, personal physical or mental illness, legal problems, substance abuse, and professional education can lead to impairment. This article provides an overview of the nature and extent of impairment in social work, practitioners’ coping strategies, responses to impairment, and rehabilitation options and protocols. Particular attention is paid to the problem of sexual misconduct in social workers’ relationships with clients. The author reviews relevant ethical standards and presents a model assessment and action plan for social workers who encounter an impaired colleague.
Practitioners who were presumed to be competent may develop difficulties that interfere with job performance. Such professionals are considered impaired and may suffer from compassion fatigue, substance abuse, mental disorders, and other forms of distress associated with daily living. Practicing while impaired is unethical and can potentially be harmful to clients. Colleague Assistance Programs from professional associations or diversion systems and legal sanctions imposed by state regulatory boards are forms of intervention strategies that are employed. Self-care strategies and consciousness-raising among professionals are the best forms of prevention.
Enola Proctor and J. Curtis McMillen
Assessing and improving the quality of social services is one of the most pressing concerns for social work practice and research. Practice in nearly every setting is affected by stakeholder expectations that agencies monitor and improve quality. This entry addresses the meaning of the phrase “quality of care” with respect to social work services, considers this topic in relation to quality improvement, quality assurance, and evaluation of services, and points to the research that is needed in order to assess and improve quality.
Tomi Gomory and Daniel Dunleavy
Social work is perhaps most distinctive for its clear and outspoken commitment toward improving the well-being of society’s vulnerable and disadvantaged groups, while still emphasizing the importance of respecting and defending personal rights and freedoms. Though there is a fundamental necessity for coercion, or its threat, for eliciting civil social behavior in a well-functioning society, it is professionally and ethically imperative that social workers make explicit our rationales for, justifications of, and the evidence used to support or reject coercive practices in our work. Social work’s engagement with coercion inevitably entails the ethical and social policy arguments for and against its use, as shown in a review of the empirical evidence regarding its impact on the professions’ clients, exemplified by three domains: (1) child welfare, (2) mental health, and (3) addictions. Recommendations for future improvements involve balancing the potential for harm against the benefits of coercive actions.