Ethics and Values

Until the 19th century, abortion law was nonexistent and abortion was not seen as a moral issue. However, by the turn of the 20th century, abortion was legally defined and controlled in most states. The landmark Supreme Court case, Roe v. Wade (1973), marked the legalization of abortion but did not end the controversy that existed. Legislation at both the federal and state levels has added restrictions on abortion, making it difficult for women to exercise their reproductive rights. Social work's commitment to promote the human rights of women compels social workers to be aware of and involved in this issue.

Social work advocacy is “the exclusive and mutual representation of a client(s) or a cause in a forum, attempting to systematically influence decision-making in an unjust or unresponsive system(s).” Advocacy was identified as a professional role as far back as 1887, and social workers consider client advocacy an ethical responsibility. Social workers are increasing the use of electronic advocacy to influence client issues and policy development. As client and societal needs evolve, universities should emphasize advocacy in their curricula, and the National Association of Social Workers should promote electoral and legislative initiatives that reflect an emphasis on social and economic injustices.

Social workers are increasingly working in authoritative settings—that is, settings where they have the power to mandate conformity by the client to the normative and often legal requirements of the organization. Such settings may be residential, such as jails, prisons, and rehabilitation facilities, or community-based organizations that are part of the criminal justice system, the mental health system, the health system, and the child welfare system. The exercise of power derived from the authority vested in the setting’s objectives may and often does alter the total life situation of an individual, such as when a client is compelled to move to supervised care without the client’s consent. Under an outpatient civil commitment order or mental health court supervision, the patient may be told where to live and with whom to associate as well as be required to participate in interactive treatment and to take medication. In authoritative settings, social workers are working with “involuntary” clients—clients who understand, whether or not it is explicitly stated, that the social worker possesses the power to effect unwanted change in their life circumstance. Since the early 1990s, the field has been developing new ideas and skills that are equally useful in working with voluntary and involuntary clients. In the process, social worker authority is now viewed less as a way to gain client compliance and, instead, is understood more as an opportunity to build partnerships with clients that lead to changes that are enduring and more meaningful to clients.

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.

Civil rights are rooted in the English laws that tried to protect citizens from abuses by the state. As the United States matured as a democracy, so did its citizens. Since World War II, there has been a virtual explosion in the awareness of citizens to the diverse needs and rights of individuals that require protection. Citizen awareness and actions have truly moved the civil rights struggle beyond a focus on color. Greater attention is being paid to fundamental protection and expanded understanding of human rights and responsibilities.

Considerable definitional vagueness exists regarding civil society, in part due to the concept's long history and multiple underlying schools of thought. Issues of multiculturalism and social justice are central to the term. Civil society is also a global concept, referring to the supranational sphere. The social work profession can benefit from collaborative action with local civil society associations in working to dismantle structural inequality and enhance opportunities for disadvantaged populations.

Social work values and ethics provide the foundation for social work practice around the world. Almost all countries where social work is a recognized profession have a Code of Ethics. Although there are many similarities among Codes of Ethics in different countries, cultural and societal differences have influenced their content and focus. The extent to which Codes of Ethics have a direct effect on social work practice has been debated. While Codes of Ethics reflect societal and national differences, what is universal and fundamental to social work practice from a human rights perspective should prevail.

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.

Consumers of health and mental health services are afforded numerous legal rights. Broad categories of rights include self-determination, access to health information, protections for mental health consumers who are hospitalized, and a right to community integration. Two areas of consumer rights are emerging: a greater emphasis on human rights, and the right of consumers to participate in developing and implementing programs and services within the organizations from which they receive services. Various means for enforcing rights exist in both the private and the public sectors. Social workers play critical roles in ensuring that consumer rights become a reality.

This entry defines cultural competence and culturally competent practice and focuses on cultural awareness, knowledge acquisition, skill development, and inductive learning as key components. It traces the historical development of cultural competence in the disciplines of psychology and social work, pointing out how cultural competence has become a professional standard. Cultural competence has also been recognized on the federal and state health and human services levels. Cultural competence is viewed on the practitioner, agency, and community levels as well as the micro, meso, and macro dimensions. Among the implications for practice are the issues of cultural competence and cultural competencies, the ethics of cultural competence, social context, and biculturation and multiculturalization.