A long time ago, when I was earning my BSW degree, we had a journal assignment to complete each day during our internship.  Basically, I was to identify and discuss an ethical dilemma I encountered each I time I worked.  Social workers come across ethical dilemmas every day. They interact with complicated systems and people.  The decisions of a social worker impacts individual’s lives and the answers are rarely black and white.  It takes work to practice as an ethical social worker.

What are ethics?  What does it mean to be ethical?   Ethics are different than the law.

The law is about what is legal.  For example, everyone talks about the Health Insurance Portability and Accountability Act (HIPPA.)  This is a law.  Choosing not to follow this or other laws could lead to criminal charges, convictions, prison and/or monetary fines and other penalties.

Ethics are about the “should.”  Ethics are what choice a person “ought” to make.   There are not necessarily legal ramifications for not being ethical (although there could be professional or moral consequences.)  Ethics are where a person asks- “What is the best decision in this situation.”  Unfortunately, when you are working with complex clients the best choice isn’t always obvious.  Many times a professional will have to choose between several not so ideal choices and decide which choice is least harmful.

As a social worker your ethical quandaries will be many.  One of my jobs is assisting individuals transitioning out of a nursing home into the community.  An ethical dilemma I might have is deciding where the line is between the individual’s right of self-determination to decide their own life and decisions that are adversely affecting their safety. If a person wants to live in the community and I don’t think they are going to be successful I would have to scrutinize if they are able to cognitively understand the ramifications of moving to the community or if they are not able to reasonably make a decision.

Another ethical dilemma might be when working with a teen in private practice.  Maybe the youth discloses their use of illicit drugs.  In my state, youth over 12 have the right to confidentiality in therapy – even from their parents – unless very specific circumstances are present.   My ethical question might be figuring out when the youth’s drug use is covered under confidentiality and when it becomes a situation where I need to break confidentiality.  Ethical dilemmas come in all shapes and sizes.  A dilemma may be wondering if you should accept food from a client or if it is OK to do a session at the coffee shop just this one time because the client’s car broke down and they can walk there.  Every day in the social work field you will have to use your judgment to make ethical decisions.

Some ideas to help with making ethical decisions.

• Training – Take continuing education classes and seminars. Learn about the populations you work with.  Learn about the presenting problems and learn about quality interventions.  A professor once mentioned in my classes that there will always be more to learn about people.  There is no way to no everything there is to know about people.  A social worker’s practice is people.  Don’t stop learning.
• Supervision – Especially for newer therapists having a supervisor provide feedback on your cases can be beneficial. Consider supervision from a more experienced Practioner whenever you start a new specialty or undertake a new field.
• Consultation – Talk to other therapists and receive feedback about your interventions. Every month I meet with a group of therapists to discuss the cases with which we struggle.  This is so invaluable.  Another therapist can provide just the added insight to give a better perspective.
• Be open to feed back. I know a therapist who doesn’t really consult.  She sometimes asks other therapists for their opinions on a case but she isn’t really looking for honest feedback.  She is looking for validation in her choices.   Having someone just agree with all your choices is not going to ensure you are practicing ethically.
• Keep adequate records of interventions.  The member deserves an appropriate health record.  It also ensures that you have a place where your reasoning and decisions are noted.
• Join a professional organization. If you are a social worker one option is that you can join the National Association of Social Workers.  In almost every specialty there is a professional association providing support.  These professional organizations can assist you with keeping up to date with best practice and standards for your chosen area.

In your day to day work it may be beneficial to identify the different ethical dilemmas that pop up and examine how you made your choices.  If you have other ideas on ways to maintain an ethical practice please share!