There are some times when there is no choice but to make decisions with possible ethical consequences at some point in any human services career when an ethical dilemma is faced. If one chooses not to make a decision, it is a decision itself (Keith-Spiegel & Koocher , 2010). In this paper, I am concerned with applied ethics and decision making using framework for a positive decision in presented scenario (Appendix) which guide the conduct for decisions based on theories about what is morally right or wrong (Reamer, 1993). How this situation dealt with relies on how I make sense of what I believe about ‘right’ and ‘wrong’ and what factors I believe are worthy of consideration. In this paper, first the ethical dilemma presented. Then principles and ethics at risk are discussed. Different ethical theories applicable to scenario for acknowledging the influences on decision making are illustrated. After that a framework for ethical decision-making (McDonald, 2001) is presented where discussion and reasoning are made while considering the factors such as emotions, personal vulnerabilities, personality, professional values, legislations and context of situation. I tried here to recognize, approach constructively, and reconcile potential ethical predicaments, while at the same time remaining compassionate and attuned to the well-being of all the parties involved in this scenario.
The Ethical Dilemma
The ethical dilemma is caused due to several factors such as the expectations of the patient, organizational expectations (hospital, governmental regulations and AASW code of ethics) and my personal values (like moral philosophies, the perceived social responsibilities and sense of professional duty) and how they all interact with each other.
The dilemma I face here has three parts: the patient confidentiality, the child care and my position as to go with the patient’s wishes. The confidentiality of patient plays part as if I am breaching this ethical rule or not by informing relevant authorities or by discussing her intention. The child care for the 10 years old son of Mrs. Sara creates another situation which is not possible for Mrs. Sara’s mother in her statement and her mother not seems to be too much interested in the job on her own. The legal aspect strongly stand in between the patients desires to be met. These include Mrs. Sara’s mother as power of attorney, the laws, and my own self facing legal problems like sued for breach of confidentiality.
There are a number of risks which pop up in this scenario, which are to be mitigated by the risk management. The key to the effective risk management here is to scrupulously uphold the tenets of relevant laws, policies, professional standards, and ethics codes provided by AASW. Another central point considered by me is on self-protection against the hazards of modern-day professional services (Bennett, Bryant, VandenBos, & Greenwood, 1990; VandeCreek & Knapp, 2000; Walker, 1999) as the defensive ethics. For this point, I take position for vigilant ethics that the primary rationale for being an ethically aware and sensitive clinical social worker is not for self-protection. Maintaining high standards will allow me to act with benevolence and courage rather than donning protective armor.
The strategies opted by me to manage these risks include the elements of good practice, keeping careful notes, reviewing client file, recording reasons, and consulting with colleagues or appropriate others about the patient (while protecting her identity and not breaching confidentiality) and carefully documenting such meetings (Kennedy, Vandehey, Norman, & Diekhoff, 2003).
Ethical Theories Applicable to Dilemma
I consider theories to be indispensable tools for practitioners. They provide resources that help professionally address human concerns so that people can move forward and live rewarding lives.
Here the well being and confidentiality of the...
References: AASW, (2010). Code of Ethics. Australian Association of Social Workers, 2010, 14, 27-29.
Australian Association of Social Workers, (2010). Code of Ethics. Retrieved from: www.aasw.asn.au/document/item/740
Conolly, M. & Harms, L. (2009). Social Work: Context and Practice. 2nd ed. Melbourne: Oxford University Press.
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Keith-Spiegel, P. & Koocher, G. P. (2010). Responding to research wrongdoing: A user-friendly guide.
Kornblau, B. L. & Starling, S. P. (1999). Ethics in rehabilitation: a clinical perspective. Thorafare (NJ): Slack Inc. 1999, 53-54.
McDonald, M. (2001). A Framework for Ethical Decision-Making: Version 6.0. Ethics Shareware (Jan, ’01).
Reamer, F. G. (1993). The philosophical foundations of social work. New York: Columbia University Press.
Rogerson, M. D., Gottlieb, M. C., Handelsman, M, M, Knapp, S., Younggren, J. (2011). Nonrational processes in ethical decision-making. American Psychologist, 66, 614-623.
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VandeCreek, L. & Knapp, S. (2000). Risk management and life-threatening patient behaviors. Journal of Clinical Psychology, 56, 1335-1351.
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