Ethical and Risk-Management Issues in Social Work: Essential Knowledge
[email protected] www.familiesinsociety.org 11700 West Lake Park Drive, Milwaukee, WI 53224
Phone: 414-359-1040 Fax: 414-359-1074 A publication of the Alliance for Children and Families
Frederic G. Reamer, Ph.D.Frederic G. Reamer, Ph.D.Professor, School of Social WorkProfessor, School of Social WorkRhode Island CollegeRhode Island CollegeEmail: [email protected]: [email protected]
The Journal of Contemporary Social Services
Core KnowledgeCore Knowledge
Ethical dilemmasEthical dilemmas
Ethical decision-makingEthical decision-making
Ethics risk managementEthics risk management
November 1, 2006 ● Alliance for Children and Families ● 2
Potential Ethics RisksPotential Ethics Risks
Ethical mistakesEthical mistakes
Deliberate ethical decisionsDeliberate ethical decisions
Ethical misconductEthical misconduct
November 1, 2006 ● Alliance for Children and Families ● 3
Key Risk AreasKey Risk Areas
Client rightsClient rights
Confidentiality & Confidentiality & PrivacyPrivacy
Informed consentInformed consent
Service deliveryService delivery
Boundary issues & Boundary issues & Conflicts of interestConflicts of interest
DocumentationDocumentation
Defamation of characterDefamation of character
Client recordsClient records
SupervisionSupervision
Staff development & Staff development & trainingtraining
ConsultationConsultation
Client referralClient referral
FraudFraud
Termination of services Termination of services & Client abandonment& Client abandonment
Practitioner impairmentPractitioner impairment
Evaluation & ResearchEvaluation & Research
November 1, 2006 ● Alliance for Children and Families ● 4
Standard of CareStandard of Care
““What an What an ordinaryordinary, , reasonablereasonable, and , and prudentprudent professional, with the same or professional, with the same or similar training, would have done under the similar training, would have done under the same or similar circumstances.”same or similar circumstances.”
November 1, 2006 ● Alliance for Children and Families ● 5
Standards of CareStandards of Care
Substantive standard of careSubstantive standard of care
Procedural standard of careProcedural standard of care Consult colleagues and supervisorsConsult colleagues and supervisors Review relevant ethical standardsReview relevant ethical standards Review relevant laws, policies, and regulationsReview relevant laws, policies, and regulations Review relevant literatureReview relevant literature Obtain legal consultation, when necessaryObtain legal consultation, when necessary Consult ethics committee, if available Consult ethics committee, if available Document decision-making stepsDocument decision-making steps
November 1, 2006 ● Alliance for Children and Families ● 6
Professional NegligenceProfessional Negligence
A duty existsA duty exists
Dereliction or breach of the dutyDereliction or breach of the duty
Damage or injuryDamage or injury
Causal connection between the breach of Causal connection between the breach of the duty and the damage or injury the duty and the damage or injury (proximate cause or “cause in fact.”)(proximate cause or “cause in fact.”)
November 1, 2006 ● Alliance for Children and Families ● 7
Forms of NegligenceForms of Negligence
MisfeasanceMisfeasance: Commission of a proper act : Commission of a proper act in a wrongful or injurious manner or the in a wrongful or injurious manner or the improper performance of an act that might improper performance of an act that might have been performed lawfully.have been performed lawfully.
MalfeasanceMalfeasance: Commission of a wrongful : Commission of a wrongful or unlawful act.or unlawful act.
NonfeasanceNonfeasance: The failure to perform an : The failure to perform an act that is part of one’s responsibility.act that is part of one’s responsibility.
November 1, 2006 ● Alliance for Children and Families ● 8
Boundary IssuesBoundary Issues
Boundary Boundary crossingscrossings v. boundary v. boundary violationsviolations
Types of dual or multiple relationshipsTypes of dual or multiple relationships Intimate relationshipsIntimate relationships Personal benefitPersonal benefit Emotional & dependency needsEmotional & dependency needs AltruismAltruism Unavoidable & unanticipated Unavoidable & unanticipated
circumstancescircumstances
November 1, 2006 ● Alliance for Children and Families ● 9
Ethics CommitteesEthics Committees
Advisory v. DeliberativeAdvisory v. Deliberative
FunctionsFunctions Case ConsultationCase Consultation
RetrospectiveRetrospective
ConcurrentConcurrent
ProspectiveProspective Policy review and formulationPolicy review and formulation Education & trainingEducation & training
November 1, 2006 ● Alliance for Children and Families ● 10
Ethical Decision-makingEthical Decision-making
Identify ethical issues: Conflicting values Identify ethical issues: Conflicting values & duties.& duties.
Identify individuals, groups, organizations likely Identify individuals, groups, organizations likely to be affected by decision.to be affected by decision.
Tentatively identify all possible courses of action Tentatively identify all possible courses of action & participants involved in each, along with & participants involved in each, along with possible benefits & risks. (cont’d)possible benefits & risks. (cont’d)
November 1, 2006 ● Alliance for Children and Families ● 11
Ethical Decision-making Ethical Decision-making (cont’d)(cont’d)
Examine reasons for & against each possible Examine reasons for & against each possible course of action, considering:course of action, considering: Ethical theories, principles, guidelinesEthical theories, principles, guidelines Codes of ethicsCodes of ethics Legal principlesLegal principles Social work practice theory & principleSocial work practice theory & principle Personal values (religious, cultural, ethnic, Personal values (religious, cultural, ethnic,
political)political) Agency policies, regulationsAgency policies, regulations
November 1, 2006 ● Alliance for Children and Families ● 12
Ethical Decision-making Ethical Decision-making (cont’d)(cont’d)
Consult with colleagues & appropriate experts Consult with colleagues & appropriate experts (e.g., agency staff, supervisors, administrators, (e.g., agency staff, supervisors, administrators, attorneys, ethics experts)attorneys, ethics experts)
Make decision & document decision-making Make decision & document decision-making processprocess
Monitor, evaluate & document decisionsMonitor, evaluate & document decisions
November 1, 2006 ● Alliance for Children and Families ● 13
MetaethicsMetaethics
Exploration of:Exploration of: The meaning of ethical terms (e.g., What do The meaning of ethical terms (e.g., What do
we mean by terms such as “right,” “wrong,” we mean by terms such as “right,” “wrong,” “good,” “bad”)“good,” “bad”)
Criteria to determine what is ethically right & Criteria to determine what is ethically right & wrongwrong
Ethical theories & principlesEthical theories & principles
November 1, 2006 ● Alliance for Children and Families ● 14
Normative EthicsNormative Ethics
Deontological TheoryDeontological Theory: (from the Greek deontos, : (from the Greek deontos, “of the obligatory.”) Certain actions are “of the obligatory.”) Certain actions are inherently right or wrong, good or bad, without inherently right or wrong, good or bad, without regard for their consequences.regard for their consequences.
Teleological TheoryTeleological Theory: (from the Greek teleios, : (from the Greek teleios, “brought to its end or purpose”) The rightness of “brought to its end or purpose”) The rightness of an action is determined by the goodness of its an action is determined by the goodness of its consequences (also known as consequences (also known as “Consequentialism.”)“Consequentialism.”)
November 1, 2006 ● Alliance for Children and Families ● 15
UtilitarianismUtilitarianism
Act UtilitarianismAct Utilitarianism: The rightness of an act is : The rightness of an act is determined by the goodness of the determined by the goodness of the consequences in this individual set of consequences in this individual set of circumstances.circumstances.
Rule UtilitarianismRule Utilitarianism: The rightness of an act is : The rightness of an act is determined by the goodness of the determined by the goodness of the consequences that would occur if this one action consequences that would occur if this one action is generalized to all similar circumstances (e.g., is generalized to all similar circumstances (e.g., this case sets a precedent.)this case sets a precedent.)
November 1, 2006 ● Alliance for Children and Families ● 16
Nontraditional and Unorthodox Interventions in Social Work: Ethical and Legal ImplicationsFamilies in Society, 2006, v. 87, no. 2, page 191-197
Ethical and Legal Standards in Social Work: Consistency and ConflictFamilies in Society, 2005, v. 86, no. 2, page 163-169
[email protected] www.familiesinsociety.org 11700 West Lake Park Drive, Milwaukee, WI 53224
Phone: 414-359-1040 Fax: 414-359-1074 A publication of the Alliance for Children and Families
Frederic G. Reamer, Ph.D.Frederic G. Reamer, Ph.D.Professor, School of Social WorkProfessor, School of Social WorkRhode Island CollegeRhode Island CollegeEmail: [email protected]: [email protected]
The Journal of Contemporary Social Services
Additional Resources by Dr. Reamer:Additional Resources by Dr. Reamer:
Social Work Values and Ethics (3rd ed.). New York: Columbia University Press, 2006
Social Work Malpractice and Liability: Strategies for Prevention (2nd ed.). NY: Columbia University Press, 2003
Tangled Relationships: Managing Boundary Issues in the Human Services. NY: Columbia University Press, 2001
Ethical Standards in Social Work: A Review of the NASW Code of Ethics (2nd ed.). Washington, DC: NASW Press, 2006
The Social Work Ethics Audit: A Risk-management Tool. Washington, DC: NASW Press, 2001