Social workers'' ethical dilemma and value decision in practice

• Main Authors: HSU CHIEN HUI, 徐芊慧
• Other Authors: 施教裕
• Format: Others
• Language: zh-TW
• Published: 2003
• Online Access: http://ndltd.ncl.edu.tw/handle/59983364442873993841

碩士 === 國立暨南國際大學 === 社會政策與社會工作學系 === 91 === ABSTRACT The objective of this research was to understand the ethical dilemmas faced by social workers in handling cases, as well as their ideal solutions and actual decisions under the given situations, then expound the ethical issue and related decision of the social workers. In this vein, this research began with literature review on the social work cases to construct the basis for ethical dilemmas possibly confronted by the social workers; then, conducted in-depth interview with ten social workers to understand the ethical dilemmas they might face, their ideal solutions, and actual decisions while handling the cases. At last, the principle on ethical dilemmas was established based on focus group data. The research findings are as follows: 1. Ethical issues confronted by the social workers Eighteen ethical issues were generalized in this research. 2. The ideal solutions to the social workers and their actual decisions (1)Ideal solutions Most social workers have developed consensus with the values imbedded in the profession of social work, such as holding neutral position, being acceptable to all cases, sustaining impartial treatment, maintaining professional interaction with the case subjects, holding no intention for benefits or accepting no gifts from the case subjects, refusing to provide services in an informal role, explaining the case truthfully to the agency which the case shall be transferred to, developing positive communication and coordination with other professional workers. (2)Actual decisions Most decisions were made based on subjective opinions. Although their unprofessional decision was not the sole cause to the damage to the case subject, the decision made upon pure professional principle may not attend to the best interest of the case subject or may even go against the ethical principle of the social work. 3.Consensus or principles of ethical issues (1)Interference of personal values Reminders or explicit notices from co-workers could help the social workers realizing the interference their own opinions; the feasibility of the method depends on the organizational culture and office environment. In addition, means of self-reflection, such as reflection on one’s belief or attitude based on reactions to a given situation, could be applied. (2)Professional principle and personal relationship The responses to dilemmas could be traced as follows: evaluating the value of the gift; realizing the motive of the case subject behind gift giving, whether accepting the gift would affect the relationship between the social worker and the case subject; the decision should be made based on the local culture and the organizational culture. (3)The interest of the case subject and the social worker The preferential act is to protect the life of the case subject; followed by protecting the rights of the case subject without violating the rights of a third party. The ‘third party’ refers to social workers, the organization, and the public. Finally, the consequence and related responsibility of the decision shall be evaluated. 4.Process-oriented and result-oriented Although consensus may not be achieved on the issue, the social workers have recognized the existence of the ethical issue, and should consider both process-oriented and result-oriented approach. 5. Limitation to the professionalism The preferential consideration should be given to protect the case subject without violating the rights of a third party. The ‘third party’ refers to the social workers, caretakers, nurses, organization, and the public. In other words, the social workers should adjust the interaction with the case subject depending on the situation without harming a third party. 6.Confidentiality and infringement of privacy The social workers have the obligation to report the cases as stipulated by law, and have to evaluate whether the behavior of the case subject constitutes immediate damage or damage to a third party. Therefore, the preferential consideration should be given to protect the life of the case subject; followed by protecting the rights of the case subject without violating the rights of a third party. At last, the focus is placed on maintaining a professional relationship. 7.Self-determination by the case subject and patriarchy Before the case subject obtains complete information, the social worker should provide the case subject with professional evaluation and be obligated to inform the case subject in advance. If the self-determination made by the case subject may harm the rights of the third party or is life threatening to the case subject, the social workers should interfere or stop the act in accordance to law. 8.The requirement of expressiveness of the case subject and regulation of the social workers The preferential consideration shall be the best interest of the case subject and the nature of the problem. If the case subject has no urgent needs yet continued to beg the social workers for assistance, the social workers should evaluate their own attitude toward the problem. Sometime, the lack of motive to change by the case subject may result in negative impression on the case subject by the social workers. The social workers should respect the self-determination made by the case subject after informing all possible consequences. 9.Principles guiding the preferential service and demand of the case subject The social workers may handle specific cases transferred from the Public Representatives to accommodate the request from the organization, but the problem and demand of those cases should still be evaluated in order to determine the most appropriate service and required resources. Interference of personal relationship should be prevented to minimize improper service or unfair case handling. 10.The principle guiding righteousness and kindness among the colleagues Doubts should be raised concerning the improper handling or excessive emotion and negotiation should then be followed. The communication techniques should be carefully chosen to avoid damaging the relationship between the colleagues 11.The social welfare of the case subject and organizational policy The preferential consideration should be given to the best interest of the case subject, even if the governmental or organizational policy is unable to change. The social workers should utilize the social resources to protect the basic rights of the case subject, and exert all efforts to initiate and defend the basic rights of the case subject. 12.Righteousness and cost efficiency The social workers should give preferential consideration to sustaining righteousness, coordinating the conflict between the righteousness and cost efficiency to result in most appropriate solution. 13.Self-determination by the case subject and the protection over the life of case subject or a third party The social workers should first protect the life of the case subject or the third party, while respecting the self-determination by the case study. However, the actual decision should be made based on opinions of the involving parties. 14.Loyalty to the case subject and loyalty to the third party Although the rights of the case subject should be protected, the protection should be given without violating the rights of a third party. The ‘third party’ refers to social workers, caretakers, nurses, volunteers, and important involving parties. 15.The interest of the case subject and other involving parties The social workers should be the mediator to reconcile the interest of the case subject and other involving parties, while the case subject or his/her family members shall be partially responsible for the situation. 16.Autonomy of the case subject and social control The social workers should comply with the laws, but could utilize the social resources to protect the case subject and take the initiative to breakthrough the irrational laws and regulations. In addition, since the social values have gradually vanished and replaced by individual values, the social workers should pay more respect to the autonomy of the case subject. 17.Honesty to other organizations The transfer of the cases should take into account of both the case subject and the rights of the organization receiving the case. Although proper concealment could avoid resistance during the transfer and ensure the demand of the case subject could be met, the rights of the organization receiving the case may be harmed, and the social worker should give a second thought to that approach. 18.Conflicts of different professions Although consensual principle could not be established on ethical issues, the social workers showed a certain level of recognition, such as maintaining negotiation and communication with other professional after the conflict to ensure the rights of the case subjects. Understanding of other professions prior to the service could facilitate the communication afterwards. Based on the forward research findings, the following six suggestions are proposed in regard to the social workers, organization, and school: 1. cultivating self-recognition and self-reflection abilities; 2. improving the self-adaptation ability and reconsidering the responses; 3. encouraging the social workers monitoring and supporting the system; 4. enhancing the social work value and training on ethical issues; 5. promoting the social work value and training on ethical issues; 6. facilitating the exchange and cooperation with service organizations.