Ethics and Values
Abstract and Keywords
Social workers' understanding of professional values and ethics has matured considerably. During the earliest years of the profession's history, social workers' attention was focused primarily on cultivating a set of values upon which the mission of the profession could be based. More recently, social workers have developed comprehensive ethical standards to guide practitioners and decision-making frameworks that are useful when practitioners face difficult ethical dilemmas. Today's social workers also have a better understanding of the relationship between their ethical decisions and potential malpractice risks.
Ethics and values are at the heart of the social work profession. Although there has been considerable stability in the core values of the profession, the day-to-day ethical issues that social workers encounter have not remained static. On the contrary, applications of core values in social work have undergone substantial change over the years in response to social, political, and economic developments.
The Evolution of Social Work Ethics and Values
Social workers' thinking about values and ethics has evolved during four major periods (Reamer, 1998, 2013a). The first stage, the morality period, began in the late 19th century, when social work was formally introduced as a profession. During this period social work was much more concerned about the morality of the client than about the morality or ethics of the profession or its practitioners. Over time, particularly during the Settlement House movement and Progressive era in the early 20th century, social workers' attitudes began to shift from concern about the morality, or immorality, of the poor to the need for significant social reform designed to ameliorate a wide range of social problems, for example, those related to housing, health care, sanitation, employment, poverty, and education. During the Great Depression and New Deal years, social workers promoted social reforms to address structural problems.
During the second stage, the values period, concern about the morality of the client continued to recede. During the next several decades, especially during the 1960s and 1970s, a group of social workers engaged in ambitious attempts to develop a consensus about the profession's core values (Biestek, 1957; Gordon, 1962; Keith-Lucas, 1977; Levy, 1973, 1976; McDermott, 1975; Pumphrey, 1959; Teicher, 1967; Timms, 1983). It was during this period that the National Association of Social Workers (NASW; 1960) adopted its first formal code of ethics.
In addition to exploring the core values of social work, some of the literature during this period also reflects practitioners' efforts to examine and clarify the relationship between their own personal values and the profession's values (for example, Hardiman, 1975; Varley, 1968). Not surprisingly, given the widespread social challenges and turbulence in the 1960s and 1970s, social workers engaged in complex debates about values concerning the core constructs of social justice and rights (welfare rights, clients' rights, prisoners' rights, women's rights, patients' rights, and so on).
Until the late 1970s, social work focused primarily on the profession's core values and value base. In the third stage, the ethical theory and decision-making period, social work underwent another significant transition in its concern about values and ethical issues (Banks, 2012; Barsky, 2009, Beckett & Maynard, 2005; Dolgoff, Harrington, & Loewenberg, 2012; Gray & Webb, 2010; Reamer, 2009, 2012a). During the mid- and late 1970s a number of professions (medicine, law, business, journalism, engineering, nursing, social work, psychology, psychiatry, criminal justice, and others) began to explore ethical issues in depth (Callahan & Bok, 1980). During this period the new academic field of applied and professional ethics (also known as practical ethics) emerged. Led especially by developments in the bioethics field, various professions engaged in ambitious attempts to identify key ethical dilemmas, formulate ethical decision-making protocols, and develop guidelines for ethics consultation. During this period the NASW Encyclopedia of Social Work included, for the first time, an article directly exploring the relevance of philosophical and ethical concepts to social work ethics (Reamer, 1987). Unlike social work's earlier literature, publications on social work ethics in the 1980s began to explore the relevance of moral philosophy and ethical theory (for example, theories of metaethics, normative ethics, deontology, and utilitarianism) to ethical dilemmas faced by practitioners.
The most recent stage in the evolution of social work ethics in the United States, the ethical standards and risk-management period, reflects the dramatic maturation of social workers' understanding of ethical issues. This stage is characterized by the significant expansion of ethical standards to guide practitioners' conduct and by increased knowledge concerning ethics-related negligence and professional malpractice. More specifically, this period includes the development of a comprehensive code of ethics for the profession, the emergence of a significant body of literature focusing on ethics-related malpractice and liability risks, and practical risk-management strategies designed to protect clients and prevent ethics complaints and ethics-related lawsuits (Barker & Branson, 2000; Houston-Vega, Nuehring, & Daguio, 1997; Reamer, 2003, 2006).
Current thinking about social work ethics and values is broad in scope. In general, it encompasses three distinguishable, though related, sets of issues. The first concerns the nature of the profession's core values and their relevance to the overall mission, goals, and priorities of social work, especially as reflected in the NASW Code of Ethics (NASW, 2008). The second issue pertains to ethical dilemmas and decisions that social workers encounter as they carry out their professional duties and obligations, particularly their efforts to meet clients' needs and protect them and relevant third parties from harm. The third issue relates to ethics risk management, that is, practical steps that social workers can take to protect clients and prevent ethics-related litigation and ethics complaints filed with state licensing boards and professional associations.
Value Base of Social Work
The subject of social work values has always been central to the profession. Values have several important attributes and perform several important functions: They are generalized, emotionally charged conceptions of what is desirable; historically created and derived from experience; shared by a population or a group within it; and provide the means for organizing and structuring patterns of behavior (Williams, 1968).
Values have been important in social work in several key respects, with regard to (1) the nature of social work’s mission; (2) the relationships that social workers have with clients, colleagues, and members of the broader society; (3) the methods of intervention that social workers use in their work; and (4) the resolution of ethical dilemmas in practice.
Social work’s fundamental aims and mission are rooted in deep-seated beliefs among the profession’s founders and contemporary practitioners concerning the values of helping, aiding, and assisting people who experience problems in living (Reid, 1992). Social work is not mere technology; rather, it is a value-based and value-inspired effort designed to help vulnerable people through the use of sophisticated methods of intervention (Timms, 1983).
Social workers’ values influence the kinds of relationships they have with clients, colleagues, and members of the broader society (Hamilton, 1940; Mattison, 2000; Younghusband, 1967). Social workers make choices about the people with whom they want to work. For example, some practitioners devote their careers to clients they perceive as victims, such as abused children and individuals born with severe physical disabilities. Others choose to work with people living in poverty or clients perceived by many to be perpetrators, such as prison inmates convicted of serious sex offenses.
Social workers’ values also influence their decisions about the intervention methods they will use in their work with clients—whether individuals, families, groups, communities, or organizations (Banks, 2012; McDermott, 1975; Varley, 1968). For example, some social workers prefer to use confrontational techniques in their work with juvenile delinquents and people struggling with addictions, believing that these are the most effective means for bringing about behavior change. Other practitioners who work with these same populations may be critical of confrontational methods that seem dehumanizing and, because of their values, may prefer forms of counseling that emphasize clients’ strengths, clients’ right to self-determination, and the building of therapeutic alliances.
Or a social worker who is an advocate for low-income housing in a poor neighborhood may prefer direct confrontation with public officials—in the form of demonstrations, rallies, and harassment—in an effort to promote affordable housing. For this practitioner the value of providing basic shelter for poor people is paramount, and direct confrontation may be necessary to bring it about. Another practitioner may reject such tactics because of his belief in the value of collaboration and respectful exploration of differences.
This leads to another way in which values are central to social work: They are key to efforts to resolve ethical dilemmas that involve conflicts of professional duties and obligations. Ethical dilemmas ordinarily involve values that clash, for example, when a client’s right to confidentiality conflicts with the social worker’s duty to disclose confidential information, without a client’s consent, to protect a third party from harm. When faced with ethical dilemmas, social workers ultimately base their decisions on their beliefs about the nature of social work values—particularly as they are translated into specific professional duties and obligations—and which values take precedence when they conflict.
As social work has evolved, it has continually stressed the need to attend both to the needs of individual clients and to the ways that the community and society create and respond to those needs. Thus, there has always been a simultaneous concern in social work for individual well-being and the environmental factors that affect it. This unique perspective—which reflects the evolution of scholarly thinking in the profession about the nature of its core values and the professional mission based on them—is stated clearly in the preamble to the NASW Code of Ethics (2008):
The primary mission of the social work profession is to enhance human well-being and help meet the basic human needs of all people, with particular attention to the needs and empowerment of people who are vulnerable, oppressed, and living in poverty. A historic and defining feature of social work is the profession's focus on individual well-being in a social context and the well-being of society. Fundamental to social work is attention to the environmental forces that create, contribute to, and address problems in living….
Social workers' values often shape their professional actions and ethical decisions. Some moral philosophers argue that professionals' own moral virtues and character are at the heart of ethical decisions (MacIntyre, 1984). From the point of view of virtue ethics, an ethical person has virtuous values and character traits—such as integrity, truthfulness, generosity, loyalty, sincerity, kindness, compassion, and trustworthiness—and acts in a manner consistent with them. These core virtues provide the foundation that leads to professionals' deep respect for clients' fundamental right to autonomy and self-determination, commitment to helping people in need and avoiding harming others, and pursuit of justice (Beauchamp & Childress, 2012).
The mission of the social work profession is rooted in a set of core values. These core values, embraced by social workers throughout the profession's history, are the foundation of social work's unique purpose and perspective: service; social justice; dignity and worth of the person; importance of human relationships; integrity; and competence. (p. 1)
The most visible contemporary typology of social work values appears in the current NASW Code of Ethics (2008). The NASW Code of Ethics Revision Committee decided to include in this version of the code, for the first time in social work’s history, a list of core values for the profession. After systematically reviewing many historical and contemporary discussions of social work values in an effort to identify key themes and patterns, the committee generated a list of six core values and developed a broadly worded, value-based ethical principle and brief annotation for each of these values (pp. 5–6):
1. Value: Service
Ethical Principle: Social workers’ primary goal is to help people in need and to address social problems. Social workers elevate service to others above self-interest. Social workers draw on their knowledge, values, and skills to help people in need and to address social problems. Social workers are encouraged to volunteer some portion of their professional skills with no expectation of significant financial return (pro bono service).
2. Value: Social Justice
Ethical Principle: Social workers challenge social injustice. Social workers pursue social change, particularly with and on behalf of vulnerable and oppressed individuals and groups of people. Social workers’ social change efforts are focused primarily on issues of poverty, unemployment, discrimination, and others forms of social injustice. These activities seek to promote sensitivity to and knowledge about oppression and cultural and ethnic diversity. Social workers strive to ensure access to needed information, services, and resources; equality of opportunity; and meaningful participation in decision making for all people.
3. Value: Dignity and Worth of the Person
Ethical Principle: Social workers respect the inherent dignity and worth of the person. Social workers treat each person in a caring and respectful fashion, mindful of individual differences and cultural and ethnic diversity. Social workers promote clients’ socially responsible self-determination. Social workers seek to enhance clients’ capacity and opportunity to change and to address their own needs. Social workers are cognizant of their dual responsibility to clients and to the broader society. They seek to resolve conflicts between clients’ interests and the broader society’s interests in a socially responsible manner consistent with the values, ethical principles, and ethical standards of the profession.
4. Value: Importance of Human Relationships
Ethical Principle: Social workers recognize the central importance of human relationships. Social workers understand that relationships between and among people are an important vehicle for change. Social workers engage people as partners in the helping process. Social workers seek to strengthen relationships among people in a purposeful effort to promote, restore, maintain, and enhance the well-being of individuals, families, social groups, organizations, and communities.
5. Value: Integrity
Ethical Principle: Social workers behave in a trustworthy manner. Social workers are continually aware of the profession’s mission, values, ethical principles, and ethical standards and practice in a manner consistent with them. Social workers act honestly and responsibly and promote ethical practices on the part of the organizations with which they are affiliated.
6. Value: Competence
Ethical Principle: Social workers practice within their areas of competence and develop and enhance their professional expertise. Social workers continually strive to increase their professional knowledge and skills and to apply them in practice. Social workers should aspire to contribute to the knowledge base of the profession.
Ethical Dilemmas and Decisions
Social workers encounter a wide range of ethical dilemmas. Ethical dilemmas occur when social workers must choose among conflicting professional values, duties, and rights that arise sometimes due to their competing obligations to clients, employers, colleagues, the social work profession, and society at large. Moral philosophers and ethicists often refer to these situations as “hard cases”. These are cases that require a difficult choice between conflicting duties, or what the philosopher W. D. Ross (1930) referred to as conflicting “prima facie duties”—duties that, when considered by themselves, social workers are inclined to perform. Eventually, social workers must choose what Ross called an “actual” duty from among conflicting prima facie duties.
In social work many ethical decisions are routine, such as obtaining clients' consent before releasing confidential information and avoiding sexual contact with clients. These prima facie duties are clear. In some instances, however, prima facie duties are unclear and ethical decisions are much more complex and troubling.
Ethical dilemmas in social work occur in three domains: relationships with clients in direct-practice settings (delivery of services to individuals, families, and small groups); social work involving “macro” practice, such as community practice (community organizing and advocacy or social action), administration, management, and policy development and implementation; and relationships among professional colleagues. Examples of challenging ethical dilemmas include the following:
• Privacy, confidentiality, and privileged communication: Under what circumstances do clients forfeit their rights, particularly if the client threatens to harm himself or others, has abused or neglected a child or vulnerable adult, or if a court of law orders social workers to disclose information? How do social workers protect client confidentiality when they communicate using email and store clinical records electronically?
• Client self-determination and professional paternalism: What are the limits to clients' right to self-determination, particularly when they engage in self-harming behavior or threaten others? Is it ever justifiable to lie to clients or withhold information from them, paternalistically, “for their own good”?
• Boundaries and dual relationships: How should social workers handle, for example, personal relationships with former clients, self-disclosure to clients, electronic communications with clients (for example, on social networking sites and via email), bartering for services, relationships in small and rural communities, gifts offered by clients, and clients' invitations to attend life-cycle events?
• Adhering to laws, policies, and regulations: Is it ethically permissible for social workers to violate laws, policies, and regulations that they consider to be unjust or harmful to clients (for example, unusually strict eligibility standards and policies that discriminate against undocumented immigrants)?
• Whistle-blowing: Under what circumstances are social workers obligated to disclose ethical misconduct engaged in by colleagues or agency administrators?
• Distribution of limited resources: What is the most ethical way to allocate scarce resources, such as agency funds or subsidized housing units? Should social workers distribute resources based on need, the principle of equality (in the form of a lottery; first come, first served; or, when possible, equal shares), affirmative action criteria, cost-benefit considerations, or clients' ability to pay?
• Conflicts between personal and professional values: How should social workers resolve clashes between their deeply held personal beliefs and their professional duties (for example, with respect to clients' reproductive rights or end-of-life decisions)?
Ethical Decision Making and Standards
There is no simple, tidy formula for resolving ethical dilemmas. By definition, ethical dilemmas are complex. Reasonable, thoughtful social workers can disagree about the ethical principles and standards that ought to guide ethical decisions in any given case. But ethicists generally agree that it is important to approach ethical decisions systematically, to follow a series of steps to ensure that all aspects of the ethical dilemma are addressed. By following a series of clearly formulated steps, social workers can enhance the quality of the ethical decisions they make and the likelihood that they will protect clients, third parties, and themselves. Typically these steps involve the following: (1) identifying the ethical issues, including the social work values and conflicting duties; (2) identifying the individuals, groups, and organizations likely to be affected by the ethical decision; (3) tentatively identifying all viable courses of action and the participants involved in each, along with the potential benefits and risks for each; (4) thoroughly examining the reasons in favor of and opposed to each course of action, considering relevant ethical theories, principles, and guidelines; codes of ethics and legal principles; social work practice theory and principles; and personal values (including religious, cultural, and ethnic values and political ideology); (5) consulting with colleagues and appropriate experts (such as agency staff, supervisors, agency administrators, agency ethics committee, attorneys, ethics scholars); (6) making the decision and documenting the decision-making process; and (7) monitoring, evaluating, and documenting the decision (Barsky, 2009; Congress, 1999; Dolgoff, Harrington, & Loewenberg, 2012; Linzer, 1999; Reamer, 2001a, 2013a).
Social workers can use several tools—including codes of ethics, ethical principles, and ethical theory—to help make ethical decisions.
Codes of Ethics
Nearly all professions have developed codes of ethics to assist practitioners who face ethical dilemmas; most were developed during the 20th century. Codes of ethics serve several functions in addition to providing general guidance related to ethical dilemmas: They also protect the profession from outside regulation, establish norms related to the profession's mission and methods, and enunciate standards that can help adjudicate allegations of misconduct (Reamer, 2006).
In North America social work has had two prominent codes of ethics: the NASW Code of Ethics and the Code of Ethics of the Canadian Association of Social Workers. Ethics guidelines are also featured in the Code of Ethics of the National Association of Black Social Workers and the Code of Ethics of the Clinical Social Work Association. Social work organizations in many other nations have also adopted codes of ethics. Key examples include codes developed by social work associations in Australia, Denmark, Finland, France, Germany, Ireland, Israel, Italy, Japan, Luxembourg, Norway, Portugal, Russia, Singapore, Spain, Sweden, Switzerland, Turkey, and the United Kingdom. In addition, the International Federation of Social Workers (IFSW) developed a prominent code of ethics that includes important principles pertaining to human rights, human dignity, social justice, and professional conduct. The IFSW Code of Ethics focuses especially on broad ethical concepts related to clients’ strengths and right to self-determination, client confidentiality, nondiscrimination, cultural and social diversity, distributive justice, social action, and professionals’ competence, integrity, compassion, and self-care.
The best-known ethics code to which social workers in the United States subscribe is the NASW Code of Ethics. The organization has published several versions of the code, reflecting changes in the broader culture and in social work standards. The first NASW code was published in 1960, five years after the organization was formed. The 1960 Code of Ethics consisted of a series of proclamations concerning, for example, every social worker's duty to give precedence to professional responsibility over personal interests; respect the privacy of clients; give appropriate professional service in public emergencies; and contribute knowledge, skills, and support to programs of human welfare. Brief first-person statements (such as “I give precedence to my professional responsibility over my personal interests” and “I respect the privacy of the people I serve”) were preceded by a preamble that set forth social workers' responsibility to uphold humanitarian ideals, maintain and improve social work service, and develop the philosophy and skills of the profession. In 1967 a principle pledging nondiscrimination was added to the proclamations.
However, over time some NASW members began to express concern about the code's vagueness, its scope and usefulness in resolving ethical dilemmas, and its provisions for handling ethics complaints about practitioners and agencies. In 1977 the NASW Delegate Assembly established a task force to revise the profession's code of ethics and to enhance its relevance to practice. The revised code, ratified in 1979, was much more detailed; it included six sections of brief principles preceded by a preamble setting forth the general purpose of the code, the enduring social work values upon which it was based, and a declaration that the code's principles provide standards for the enforcement of ethical practices among social workers. The 1979 code set forth principles related to social workers' conduct and comportment, and to ethical responsibility to clients, colleagues, employers and employing organizations, the social work profession, and society. A number of the code's principles were concrete and specific (for example, “The social worker should under no circumstances engage in sexual activities with clients,” and “The social worker should respect confidences shared by colleagues in the course of their professional relationships and transactions”), whereas others were more abstract, asserting ethical ideals (for example, “The social worker should promote the general welfare of society,” and “The social worker should uphold and advance the values, ethics, knowledge, and mission of the profession”).
The 1979 code was revised twice. In 1990 several principles related to solicitation of clients and fee setting were modified after the Federal Trade Commission (FTC) began an inquiry in 1986 concerning the possibility that NASW policies promoted “restraint of trade.” As a result of the inquiry, NASW revised principles in the code in order to remove prohibitions concerning solicitation of clients from colleagues or one's agency and to modify wording related to accepting compensation for making a referral. NASW also entered into a consent agreement with the FTC concerning the issues raised by the inquiry.
In 1992 the president of NASW appointed a national task force, chaired by this author, to suggest several specific revisions of the code. In 1993, based on the task force recommendations, the NASW Delegate Assembly voted to amend the code to include several new principles related to the problem of social worker impairment and the problem of inappropriate boundaries between social workers and clients, colleagues, students, and so on.
Because of growing dissatisfaction with the 1979 NASW code, and because of dramatic developments in the field of applied and professional ethics since the ratification of the 1979 code, the 1993 NASW Delegate Assembly also passed a resolution to establish a task force to draft an entirely new code of ethics for submission to the 1996 Delegate Assembly. The task force, chaired by this author, was established in an effort to develop a new code of ethics that would be far more comprehensive in scope and relevant to contemporary practice. Since the adoption of the 1979 code, social workers had developed a much keener grasp of a wide range of ethical issues facing practitioners, many of which were not addressed in the NASW code. Moreover, the broader field of applied and professional ethics, which had begun in the early 1970s, had matured considerably, resulting in the identification and greater understanding of novel ethical issues not cited in the 1979 code.
The Current NASW Code of Ethics
The current code was adopted by the 1996 Delegate Assembly. In 2008 the Delegate Assembly approved wording changes in standards related to cultural competence and social diversity, respect for colleagues, discrimination, and social and political action. The code contains the most comprehensive contemporary statement of ethical standards in social work and includes four major sections . The first section, “Preamble,” summarizes the mission and core values of social work, the first ever sanctioned by NASW for its code of ethics.
The second section, “Purpose of the NASW Code of Ethics,” provides an overview of the code's main functions and a brief guide for dealing with ethical issues or dilemmas in social work practice. The brief guide in this section of the code to dealing with ethical issues highlights various resources social workers should consider when faced with difficult ethical decisions. Such resources include ethical theory and decision making, social work practice theory and research, laws, regulations, agency policies, and other relevant codes of ethics. The guide encourages social workers to obtain ethics consultation when appropriate, perhaps from an agency-based or social work organization's ethics committee, regulatory bodies (for example, a state licensing board), knowledgeable colleagues, supervisors, or legal counsel.
An important feature of this section of the code is its explicit acknowledgment that instances sometimes arise in social work in which the code's values, principles, and standards conflict. Moreover, at times the code's provisions can conflict with agency policies, relevant laws or regulations, and ethical standards in allied professions (such as psychology and counseling). The code does not provide a formula for resolving such conflicts and “does not specify which values, principles, and standards are most important and ought to outweigh others in instances when they conflict.” (NASW, 2008, p. 3)
The code's third section, “Ethical Principles,” presents six broad ethical principles that inform social work practice, one for each of the six core values cited in the preamble. The principles are presented at a fairly high level of abstraction to provide a conceptual base for the profession's more specific ethical standards. The code also includes a brief annotation for each of the principles.
The code's final section, “Ethical Standards,” includes 155 specific ethical standards to guide social workers' conduct and provide a basis for adjudication of ethics complaints filed against NASW members. The standards fall into six categories concerning social workers' ethical responsibilities to clients, to colleagues, in practice settings, as professionals, to the profession, and to society at large. The introduction to this section of the code states explicitly that some standards are enforceable guidelines for professional conduct and some are standards to which social workers should aspire. Furthermore, the code states, “The extent to which each standard is enforceable is a matter of professional judgment to be exercised by those responsible for reviewing alleged violations of ethical standards” (NASW, 2008, p. 7).
One key trend in professional education and training is to introduce students and practitioners to ethical theories and principles that may help them analyze and resolve ethical dilemmas (Congress, Black, & Strom-Gottfried, 2009; Reamer, 1990). These include theories and principles of what moral philosophers call metaethics, normative ethics, and practical (or applied) ethics. Briefly, metaethics concerns the meaning of ethical terms or language and the derivation of ethical principles and guidelines. Typical metaethical questions concern the meaning of the terms right and wrong and good and bad. What criteria should we use to judge whether someone has engaged in unethical conduct? How should we go about formulating ethical principles to guide individuals who struggle with moral choices? Normative ethics attempts to answer the question, “Which general moral norms for the guidance and evaluation of conduct should we accept and why?”
In contrast to metaethics, which is often abstract, normative ethics tends to be of special concern to social workers because of its immediate relevance to practice. Normative ethics consists of attempts to apply ethical theories and principles to actual ethical dilemmas. Practical (or applied) ethics is the attempt to apply ethical norms and theories of normative ethics to specific problems and contexts, such as professions, organizations, and public policy. Such guidance is especially useful when social workers face conflicts among duties they are ordinarily inclined to perform.
Theories of normative ethics are generally grouped under two main headings. Deontological theories (from the Greek deontos, “of the obligatory”) are those that claim that certain actions are inherently right or wrong, or good and bad, without regard for their consequences. Thus a deontologist might argue that telling the truth is inherently right, and therefore social workers should never lie to clients, even if it appears that lying might be more beneficial to the parties involved. The same might be said about keeping promises made to colleagues, upholding contracts with managed care organizations and insurance companies, obeying a mandatory reporting law, and so on. For deontologists, rules, rights, and principles are sacred and inviolable. The ends do not necessarily justify the means, particularly if they require violating some important rule, right, principle, or law.
The second major group of theories, teleological theories (from the Greek teleios, ‘brought to its end or purpose'), takes a different approach to ethical choices. From this point of view, the rightness of any action is determined by the goodness of its consequences. Teleologists think it is naive to make ethical choices without weighing potential consequences. To do otherwise is to engage in what the philosopher Smart (Smart & Williams, 1973) referred to as “rule worship.” Therefore, from this perspective (also known as utilitarianism and consequentialism), the responsible strategy entails an attempt to anticipate the outcomes of various courses of action and to weigh their relative merits.
A noteworthy problem with utilitarianism is that different people are likely to consider different factors and weigh them differently, as a result of their different life experiences, values, education, political ideologies, and so on. In addition, when taken to the extreme, classic utilitarianism can justify trampling on the rights of a vulnerable minority in order to benefit the majority, an outcome that is anathema to social workers.
Two other ethical theories have important implications for social workers: communitarianism (also known as community-based theory) and the ethics of care. According to communitarianism, ethical decisions should be based primarily on what is best for the community and communal values (the common good, social goals, and cooperative virtues) as opposed to individual self-interest. The ethics of care, in contrast, reflects a collection of moral perspectives rather than a single moral principle. This view emphasizes the importance in ethics and moral decision making of the need to care for, and willingness to act on behalf of, persons with whom one has a significant relationship (Spano & Koenig, 2003). For social workers this perspective emphasizes the critical importance of commitment to their clients.
Ethics Enforcement and Risk Management
Sometimes ethics complaints and lawsuits are filed against social workers. Members of NASW, for example, may be named in ethics complaints alleging violation of standards in the association’s Code of Ethics. In addition, social workers can be named in complaints filed with a state licensing board. Also, disgruntled parties may file lawsuits against social workers alleging they were harmed as a result of practitioners' ethics-related professional negligence (for example, as a result of an inappropriate dual relationship, incompetent service delivery, or unauthorized disclosure of confidential information). Social workers can prevent lawsuits and ethics complaints by conducting an ethics audit, which is designed to assess the adequacy of practitioners' and agencies' ethics-related policies, practices, and procedures (Reamer, 2001b).
NASW and state licensing boards follow very strict procedures when they process complaints filed against social workers to ensure that all parties receive a fair hearing consistent with due process standards. NASW members who are named in ethics complaints have the opportunity to testify, present witnesses, and challenge any evidence that is presented against them. Using a peer review process, an NASW committee decides whether there is sufficient evidence to conclude that a member has violated the NASW Code of Ethics. NASW may impose sanctions or require various forms of corrective action when there is evidence of ethical misconduct, such as suspension from NASW; mandated supervision or consultation; censure in the form of a letter; or instructions to send the complainant a letter of apology. In some cases the sanction may be publicized.
In contrast to NASW ethics proceedings, state licensing boards must determine whether social workers have violated provisions in state licensing laws or regulations. State licensing boards that find evidence of violation can impose a range of sanctions or require various forms of corrective action, such as license suspension or revocation; mandated supervision, consultation, or continuing education; and censure in the form of a letter. Some sanctions are publicized, for example, in local newspapers or the licensing board's Web site.
Lawsuits filed against social workers alleging ethics-related negligence are processed according to legal procedures for civil litigation and related standards of proof (Reamer, 2003). The process may include subpoenas of records, depositions, interrogatories, expert witness testimony, and trial before a judge or jury. Most lawsuits are settled pretrial, often for dollar amounts agreed to by the parties. Cases that go to trial may result in monetary awards.
In a very small percentage of cases social workers are indicted on criminal charges that allege ethical misconduct. Examples include instances when a social worker has submitted fraudulent bills to clients' insurance companies, embezzled funds from an employer, or engaged in sexual misconduct with a client who is a minor.
In some instances social workers involved in ethical misconduct are impaired. Impairment involves problems in a social worker's functioning reflected in an inability or unwillingness to follow professional standards; an inability or unwillingness to acquire professional skills in order to reach an acceptable level of competency; and an inability or unwillingness to control personal stress and emotional problems that interfere with professional functioning (Reamer, 1992; Zur, 2007). Impairment may involve failure to provide competent care or violation of the profession's ethical standards. It may also take such forms as providing flawed or inferior counseling to a client, sexual involvement with a client, or failure to carry out professional duties as a result of substance abuse or mental illness.
It is important for social workers to design ways to prevent impairment and respond to impaired colleagues. They must be knowledgeable about the indicators and causes of impairment so that they can recognize problems that colleagues may be experiencing. Social workers must also be willing to confront impaired colleagues, offer assistance and consultation, and, if necessary, as a last resort, refer the colleague to a supervisor or local regulatory or disciplinary body.
Social workers who become aware of a colleague's impairment or unethical conduct may have to make a difficult ethical decision about whether to “blow the whistle.” In these instances social workers should consult colleagues, supervisors, ethics experts, and guidelines in the NASW Code of Ethics (sections 2.09, 2.10, 2.11) for guidance and support.
In an effort to prevent ethical misconduct and enhance social workers' ethical judgment, NASW chapters and NASW's national office, state licensing boards, social work education programs, and continuing education organizations sponsor ethics education programs throughout the United States. Many states require licensed social workers to take continuing education courses on ethics.
The Future of Social Work Ethics
Social workers have been concerned about ethics and values since the profession began. Social work has a long-standing history of commitment to issues of social justice and to the dignified, fair treatment of people in need of assistance. Although many of the ethical issues of current concern in the profession have been the focus of attention for decades, others have emerged only recently. Future changes in the profession will no doubt lead to new ethical issues and questions.
There is no way to know with certainty what issues are likely to emerge in the future, but several trends are worth noting. First, it will be important for social workers to pay close attention to ethical issues created by technological advances that affect the profession. For example, developments in computer, digital, and other electronic technology will continue to lead to difficult issues related to privacy and confidentiality. The proliferation and widespread use of digital and electronic technology has created novel and unprecedented ethical challenges for social workers, especially related to informed consent, privacy, confidentiality, and boundaries. The popularity of Facebook, LinkedIn, Twitter, email, mobile and smartphones, videoconferencing, and telephone and Web-based therapies has created a wide range of challenging ethical issues that did not exist when many contemporary practitioners concluded their formal education (Gutheil & Simon, 2005; Lamendola, 2010; Menon & Miller-Cribbs, 2002; Reamer, 2012b, 2013b; Zur, 2012). Practitioners who use Facebook must decide whether to accept clients’ requests for friend status. Similarly, practitioners must decide whether they are willing to exchange email and text messages with clients and, if so, under what circumstances; share their personal mobile telephone numbers with clients; or offer clinical services by means of videoconferencing or other cybertherapy options, such as those that allow clients to represent themselves using graphical avatars rather than real-life images.
Considerable controversy surrounds social workers’ use of online interventions, social media, and electronic communications. Some practitioners are enthusiastic supporters of these technologies as therapeutic tools. Others are harsh critics or skeptics, arguing that heavy reliance on online interventions and social media compromises the quality of social work services and could endanger clients who are clinically vulnerable and who would be better served by in-person care. In addition, critics argue that widespread delivery of services using electronic and digital technology may interfere with social workers’ ability to serve people living in poverty and other oppressed people who may have no or very limited access to this technology. Social work licensing boards and regulatory bodies are developing new ethics guidelines for social workers who use digital and other electronic technology.
In addition, developments in medical technology will raise new ethical questions related to the allocation of health care, end-of-life decisions, and the use of novel medical interventions. In response to these advances, many social work agencies have formed ethics committees to consult on difficult decisions, educate staff about ethical issues, and formulate ethics-related policies (Hester, 2007; Reamer, 1987).
Another critical issue concerns employment patterns among social workers themselves. Some social workers resist entering the public social service sector that serves particularly vulnerable, oppressed, and low-income people. This raises important ethical questions about the mission of social work and its value base. To what extent should social work place primary emphasis on the poor and oppressed as opposed to more affluent clients who have ample assets or insurance coverage to pay for services? What portion of the profession's resources should be devoted to clinical issues as opposed to social action, such as advocacy on behalf of the least advantaged?
In addition, as social work develops new specialties, novel questions of ethics and values are likely to emerge. For example, some practitioners are pursuing dual careers as social workers and as lawyers, clergy, and life coaches. These combinations pose unique ethical challenges related to professional–client boundaries, informed consent, confidentiality, and privacy. Practitioners who are both social workers and lawyers or clergy, for example, are accountable to very different, sometimes conflicting, ethical standards pertaining to confidentiality and privileged communication. Social workers who function as life coaches may face complex challenges concerning professional boundaries, particularly if the coaching services involve clients’ disclosure of deeply personal information, home visits, and casual meetings in social settings, such as restaurants. Also, as social workers' involvement in managed care organizations has grown, so too have ethical issues concerning the allocation of limited health care resources.
The future of social work cannot be predicted with precision, but it is certain that ethical and value issues will continue to permeate the profession. Although some of these issues will change in response to new trends and developments, the fundamental issues related to ethics and values in social work will persist, such as the nature of social work's core mission and values, the balance between public and private sector responsibility for social welfare, practitioners' moral duty to aid those most in need, the nature and limits of clients' right to confidentiality and self-determination, management of professional boundaries, and challenges involving the allocation of limited social services resources. Hence, it will always be essential for social workers to examine these issues, which in the end form the very foundation of the profession.
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