The social work profession is rooted in a set of core values and principles which are applied as standards in determining ethical judgements. This paper will explore an ethical dilemma and how utilizing the ethical decision making model can offer different resolutions. Joseph (1983) discussed how this ethical model “suggests a structure and a systematic process for inquiry into ethical issues that emerge in clinical practice and its organizational contexts.”
Dilemma in Context
Practice Setting
The dilemma transpired in an outpatient community mental health center in a rural area of the state that accepted both children and adults for services. In this area, all mental health facilities prescribe psychiatric medications due to physician
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Maria further explained that she recently moved back to this area as she felt she was a burdened to her children and disrupted their marriages. During the consultation, Maria signed releases of information (ROI) for one child and her current and past physician; additionally we set up for a psychiatric evaluation for medication services per Maria’s request. Over the succeeding month, our agency conducted several home visits where concerns were noted over lack of food within the home, complaints by Maria that her medication had been stolen, etc. After staffing the case, the team decision was to contact Adult Protective Services (APS) for an evaluation. After the initial evaluation, APS reported they would continue to monitor the case, but the agency was not prepared to assume the case.
During the psychiatric evaluation, there was a review of current medication from Maria’s primary care physician (PCP). The psychiatric provider expressed concern over the quantity of pain medication prescribed to Maria. Maria explained she experiences joint discomfort and utilizes the medication for mobility reasons. Our agency offered alternative pain management options, Maria declined. The psychiatric provider prescribed medication to assist with anxiety, but refused to prescribe Xanax which is what Maria had originally been given by her PCP and explained the reasoning behind the denial. Maria acknowledged understanding and accepted the other medication.
1. Is there an ethical violation, dilemma or concern and, if so, what is it?
Social workers encounter ethical dilemmas every day during their work. Banks, in her explanations says these are occurrences whereby a social worker encounters two unwelcoming situations and there is a conflict of moral values, and there is no clear choice as to which decision to make.(Banks, 2006).To elaborate on this , Banks implies
The patient was admitted to the hospital by her daughter after discovering that she had abandoned her medication and was significantly experiencing adverse effects from the withdrawal. The patients’ medical history included renal dysfunction, anemia, malnourishment, back pain, and a family history of mental health. The patient has a psychiatric history of being previously placed in the same clinical structure eight months ago due to related issues including the failure to take her medication and increased levels of mental health conditions that led
Some of the current changes that can be seen in regards to prescription privileges include changes in the ways that physicians and mental health professionals are able to prescribe medications to their patients. According to Brenda Smith of the APA (2012), currently patients receive their medications for psychological conditions by a physician usually without having been evaluated by a mental health practitioner according to the CDC. The trend includes individuals to visit their general health practitioners in order to receive psychotropic medications such as antidepressants and anxiolytics. The problem with individuals receiving these medications from other sources include: deterrence
As a social worker many problems may arise because of the constant grey area of either letting your personal values interfere with your professional opinion. It is essential to provide your client with information and tools to help them succeed and overcome their problems. Following the core values is essential to being a resourceful, competent social worker. In some cases, core values are in conflict. In a situation where more than one core value is in conflict it is considered an ethical dilemma (Hick, 2009). It’s not guaranteed that a perfect solution will arise, therefore one of the core values is subsided because the other has more of an impact on the client.
Ethical dilemmas happen frequently in the social work and how one handles them could be the difference on how a clinician keeps their license or not. The problem is there is no way to prepare a person from knowing what situations will arise. Scenarios arise all the time and new ways to handle them is constantly changing. The ethical dilemma can happen anywhere and at any time with anyone, it could be a client, co-worker, and even supervisors. No social worker is safe from them. One however can practice with scenarios and be aware of personal biases. A social worker needs to evaluate each dilemma with the different frameworks and principals to determine which one applies best, anticipate what possible outcomes could happen, and what interventions a social worker would implement.
Reflection is a process of learning through and from self-analysis, self-evaluation, self-dialogue and self-observation towards gaining new possibilities for self-enhancement. In social work, this learning process is an integral part of applying theory to practice. With the growing influence of postmodernism, social workers also need to be prepared to recognise the eurocentric discourse that grounds and governs their disciplinary knowledge. It is against this background that I will reflect upon Foucault’s power-knowledge axis, particularly as it relates to cultural competence. As will be demonstrated, anti-oppressive practice rests on the ability of social workers to analyse the power dynamics that pervade their encounters
Whether someone is a social worker, doctor, psychologist, etc. it is very likely that at some point in their career they will run into an ethical dilemma that they must address in a respectful and ethically sound fashion. Due to the fact that social workers establish strong relationships with their clients, and at times may be working with people on extremely personal levels (domestic violence, child abuse, homelessness, etc.) it is common in this field of practice to run into an ethical dilemma. An ethical dilemma is defined as “problematic situations whose possible solutions all offer imperfect and unsatisfactory answers” (). It is important for social workers to take the proper steps necessary to address the issue to make the correct decision that will have the best outcome for both themselves and their clients. Fortunately for the
For the importance of this assignment, I had the opportunity of interviewing one of the social services workers. The social service worker in which I interviewed, was once a client but now holds a professional position within the agency. Understanding the demographics of Peoria, IL is one of the reasons, I was certain that I would receive valuable information about the numerous ethical dilemmas she had encountered. She began the interview explaining that due to being born and raised in Peoria, she knows everyone especially the clients. She continued by saying, she is familiar with numerous of clients due her affiliation with substances use. She stated that when she is faced with an ethical dilemma, she typically would meet with the Case Manger, which is a Licensed Clinical Professioal Counselor (LCPC) and would ask her how she should proceed with the client. The Case Manger typically refers her to the NASW Code of Ethics book that she keeps in her office. If the LCPC, could not help the worker find clarity, then they will consult with the Vice President of Mental Health Services to guide their decision making.
There are many ways in which social workers can avoid ethical dilemmas. In regards to the Jones case I will explain five ethical dilemmas. I will explain what 3 core values could have benefitted the Jones family and I will give three strategies I will use to practice ethical behavior in my field of social work in the future.
In the practice of Human and Social Services, professionals are challenged with resolving ethical dilemmas. The decision -making process in addressing ethical issues that professionals needs to highly consider when making decisions it should be based on doing the next right thing. The Human and Social Services professionals has the responsibility to the client/consumer, public, employer, colleagues and the profession to display ethical behavior at all cost. When working within a nonprofit organization (NPO) it is important to do what is knowing ethical right and morally correct.”
REPORTER: The reporter/ Social Services Director (Vernestine) called with concerns for the victim, Tanya. Tanya has had an aneurism, and she has paralysis. The reporter said the victim’s cognition is off, and she cannot perform her daily ADL’s, but she can talk. The reporter said Tanya has two small children, but her mother (Phyllis) may be keeping the children. The alleged perpetrator is Bryan Blakemore (Husband). On Yesterday (03/29/2016), the victim was discharged AMA (on medical advice). The reporter said when the victim is discharged AMA, they are not given any medications. The victim left with out any medications, but Bryan was given a list of all the victim’s medication. Bryan said he was going to see a doctor in Jackson, MS to have
It is a basic principle of law in this country that an adult, mentally competent person has the right to refuse treatment. The court of appeal has emphasised that provided the patient has the necessary mental capacity, which is assessed in relation to the decision to be made, then he or she can refuse to give consent for a good reason, a bad reason or no reason at all (Dimond, 2008). However, in this case it is in the best interest of the patient that the MDT administrated medication covertly. The legal issue identified in this case relates to the issue of consent. Within the case study professionalism had to challenged when it came to the capacity of the patient. The MDT had to resolve the legal issues associated with capacity and consent.
To begin with, the client whose name is Mr. Sam Pilsudski has an obstructed airway secondary to cancer of the larynx. He is a 67-year-old widower, and a father of one son and two daughters, who is unconscious and terminally ill, if not for a much-needed operation to remove both his cancer and larynx to save his life. However, one of Mr. Pilsudski’s daughters has adamantly refused to consent to the surgical procedure despite the physician explaining that although the operation would unfortunately render his patient disabled without a voice consequentially, but ultimately surviving the procedure to live and recover. Moreover, the physician attempted with rational and clear communication to express the gravity of the rather poor prognosis of his illness to his daughter that in the event of foregoing the surgery, his patient would surely die (Ralph Dolgoff, Donna Harrington, and Frank M. Loewenberg (2012), Ethical Decisions for Social Work Practice. 9th Ed; p. 279).
Traditionally, social worker are expected to not impose their own values on their clients, and suspended judgment about client behaviors, even when their own values or society values demand a judgement (Dolgroff, Harrington & Loewenberg, 2012). This can often pose difficult ethical decisions for social workers and clients, as personal value systems are inevitable. Social worker value gap, value neutrality and value imposition are important to consider when analyzing any ethical situation with our clients. Consideration needs to be given to both the social worker and the client as they interact together, although it is the social worker’s role to not impose their own values onto the client. The social worker must uphold the value of self