Defining the Ethical Problem and Relevant Research in Ethics - Essay Example

 Ethical Dilemma Case #21: Analysis and Contingencies Defining the Ethical Problem Case #21 involves a member of a divorced persons therapy group. The scenario in this case involves records requests from the group member, Joseph Gerden, for use in the court system related to probation officer needs. There is another member of this same therapy group who refuses to sign consent forms for the release of information that will include knowledge of the group’s activities with the social worker, thus complicating the NASW Code of Ethics in terms of disclosure. To further complicate the matter, the social worker will be impacting, potentially, the ability for Mr. Gerden to have access to his child based on the level of authority that the probation system has on the client. The social worker in this case must balance the ethical dilemma of conflict of interest and ethical disclosure versus legal system authority over client lifestyle. This is a systems versus systems scenario in which the social worker must consider community needs with individual needs in order to determine his or her responsibility related to group privacy and disclosure ethics. Relevant Research in Ethics Kidder (1995) suggests that placing community needs ahead of individual needs should be a primary ethical consideration. “One of the central ethical dilemmas in human experience is weighing individual rights against community interests” (Kidder, 1995, p.28). Community in this context is representative of each individual within the group and their involvement with broader society and the interests of the probationary system as the community representative. There are certain legal rights that are held by the court system that supersede rights protection based on absolute authority versus moral and ethical authority. The NASW Code of Ethics acts as a moral foundation by which to structure and facilitate practice, however it is not a binding contract in comparison to well-established codes of justice in the court system. The social worker must recognize that community needs are paramount in most issues, especially in relation to the impact that a child on the foster system places on local budgets and labor support. However, this does not mean that the social worker should negate the principles behind the NASW Code of Ethics. Gewirth (1996) produced what is referred to as the Principle of Generic Consistency that recognizes agents must accept rationally that others in the community have the same positive rights as those claimed for himself. One must therefore “act in accord with the generic rights of your recipients as well as yourself” (Gewirth, 1996, p.19). There is a group member that does not wish to have their group involvement presented to a system by which he has no affiliation: the probationary system. However, the nature of divorce versus the nature of parental rights, in terms of privacy, must be balanced and considered by the social worker. Upon self-reflection, the social worker would, under Gewirth’s diagram of ethics, view their own lifestyle and needs associated with probationary living and determine whether a single group member’s consent refusal should supersede basic constitutional rights related to parenthood and parent rights. This then becomes a community issue with each individual acting as a representative of the needs of the broader whole, which should be a guiding force in decision-making as to whether to disclose information. In this role, court orders may have the absolute authority to demand disclosure compliance, however this is unlikely in this case when approaching the situation from a risk management perspective related to disclosure principles. Even the National Association of Social Workers (1992) recognizes that there are only two exceptions when blanketing privacy rules may be superseded by the public’s need to know. Divorce privacy issues and individual child custody information would not be one of the two exceptionary scenarios. Therefore, this is a foundational ethical and moral issue related to obligations spoken and unspoken against the NASW Code of Ethics. Buchanan (2005) offers that in order to justify a rights statement, there must be two elements present. First, identification of relevant interests must be considered. In this case, this involves the individual refusing consent, the social worker and their organizational loyalties, Mr. Gerden, and the community systems with relevant legal authority. Second, Buchanan suggests that to justify rights they must show moral importance to a level where they deserve strong protections through ethical adjustment. This case must consider the nature of divorce and the urgency of maintaining individual privacy and the broader ramifications of denying group information on the community structure, budgets, and general public interest related to child welfare. Supplementing Knowledge with Personal Values It would be realistic and forthright to acknowledge that certain biases in this scenario would be present. There would be interpersonal relationship issues with the client group, as divorce therapy involves complicated emotional structures and relationship-building exercises. Foundational self-concept and esteem issues are included in such group structures, therefore considerable knowledge is maintained about values, lifestyle, personality and needs. The complex emotions experienced by individuals in these group sessions will have some lasting impact on the social worker. Liimatta (2002) describes the importance of maintaining professional distance in practice, as oftentimes, and especially in this type of scenario, the role of worker is that of counselor. Over-involvement with client issues causes a loss of objectivity and may practice favoritism toward some members of the group as a natural progression of exposure and in-depth profiling. Personally, avoidance tactics and high emotional self-awareness are necessary in the role of social worker to avoid over-involvement. There will be some within the group that will manifest favorable characteristics and therefore create, even at the modest level, an attachment that supersedes such emotional favoritism over others. However, having a high emotional intelligence provides that ability to assess the scenario and measure the long-term impact on psychological functioning and the strain that non-disclosure could put on systems and community in a broader view. A balanced consideration for this case would be consideration of chunking relevant records in order to segregate individual performance from group analysis. This commonly occurs in the research process in analysis after a primary study has been conducted. Knowledge gained, in clustered format, is separated and/or collated in order to identify key correlations with intended objectives. Having a comprehension of the basis supporting the NASW Code of Ethics, I would have structured the original assessment and performance tools for group involvement in a way that could be isolated in the event of disclosure needs especially when recognizing that a probationary and legal system could be involved with confidentiality concerns. Using reputable templates for social work sessions, the method by which data was collected would have been for group and individual analysis. However, moving under the assumption that such initial considerations were not formulated in planning for the divorce therapy sessions, I would consider conducting an informal or formalized interview session with the opposing party in the group, attempting to instill a sense of principled generic consistency with this member to help him role play how he might respond in a similar disclosure case, attempting to use psychological principles to instill support. These might include modest elements from cognitive behavioral therapy or generic needs fulfillment under any given sociological model. The National Association of Social Workers (1992) further identifies that clients should be interviewed alone and asked what information they want shared with others. In the interview sessions, I would consider attempting to create a sense of empathy in the client for Mr. Gerden’s position without being aggressive or forceful, rather to draw on known emotional connections that I had observed and/or recorded during the divorce therapy sessions. Relevant Elements of the NASW Code of Ethics This is a conflict of interest scenario and the code of ethics states, in section 1.06, that social workers should avoid conflicts of interest “that interfere with the exercise of professional discretion and impartial judgment” (naswdc.org, 2008, p.5). The code also offers advice on informing clients when a conflict of interest arises. Conflicts of interests are those that might create a biased impression (Lovenheim, 2004). Respect and trust are some of the foundational aspects of social work especially when therapy outcomes or case success is dependent on the worker/client relationship dynamics as would be found in a group support environment for divorced individuals. The conflict of interest in this case is the rights of individuals versus community rights that are supported by tangible legal authority or could be viewed as individual versus individual rights related to self-concept. The refusal of the second party to sign consent forms for disclosure likely represents personal issues associated with reputation or some dynamic of emotional needs fulfillment related to esteem or social belonging. If this principle of avoidance had been part of the structured assessment module created for the group, contingencies relating to possible disclosure scenarios would have been included in the early session curriculum to familiarize the group with potential risk scenarios and attempt to gain rapid support for social worker dilemmas. A secondary element of the NASW Code of Ethics relevant to this case is section 1.03 dealing with confidentiality issues. This section states, “social workers should use clear and understandable language to inform clients of the risks related to the services” (naswdc.org, 2008, p.4). As in similar support to section 1.06, these discussions should have occurred in the earliest part of the group therapy life cycle so that those involved with the group recognized certain legal and lifestyle constraints that others within the group faced. There should be complete understanding expressed, using comprehensive language, until all individuals show a knowledge and recognition (or acceptance) of assuming certain privacy risks. Under Section 1.06 regarding conflicts of interest, it states that in some cases, it might be necessary to terminate the professional relationship with the client to avoid conflicts of interest (naswdc.org). These should have been foundational elements in the divorce curriculum that were part of initial planning if I were to be considered a relevant social worker against this code of ethics. Alan Gewirth’s Hierarchy of Rights is a three-tiered system including most basic foundational rights such as mental health and physical integrity. The second tier involves self-concept related to individual purpose fulfillment based on their perceptions of achievement within the group structure. The third tier involves rights related to defamation of character and the right to not be deceived (ethics.tamu.edu, 2006). In this case study, the basic rights tier is satisfied and there is no risk to the group that relies on others for support. The second tier is facilitated by social worker competence in sociology and psychology and the curriculum developed to improve self-concept and reflect on self-analysis needed for the program. It is the third tier that has impact on this case, referring to defamation of character opportunities with the probationary system. However, the competent social worker understands that those with long-standing history in the court system are used to following structured rules related to privacy. The client refusing consent, if his records are exposed to court representatives, faces limited opportunity for defamation since the likelihood of another systems professional exploiting this information is minimal based on professional standards of conduct associated with these organizations. No tiers of rights are expected to be violated except those at the highest pinnacle of moral scrutiny that are perceptual in nature in some degree. Internal social worker balancing of concepts or contingencies would recognize that risks to the non-consenting group member are marginal and realize that not substantial rights issues actually exist in this situation when compared to broader community needs as suggested by Gewirth. Values of the Affected System “Ethical requirements logically imposed on individual action hold equally for the supportive state as a community of rights, whose chief function is to maintain and promote the universal human rights to freedom and well-being” (Gewirth, 1998, p.68). Social afflictions identified as violating these fundamental rights are homelessness, poverty and unemployment (Gewirth). In this case, prospects for the child include improper foster care (a potential scenario based on system integrity), a scenario that would have long-term psychological repercussions on the youth depending on their home structure without Mr. Gerden’s presence and influence. The values of the client are to maintain contact with the child and gain independence that is currently being curtailed by the probationary system. The fundamental liberties associated with freedom and well-being are complicated by the court system and these needs must be recognized, especially when Mr. Gerden is actively cooperating with system design in the probationary structure. Secondly, the fundamental needs of the third party agency, the court system, must be recognized as a representative of the community, something which should supersede individual need when the outcomes are paramount of community interests. The nature of disclosure will only involve key demographic knowledge that has been documented along with sociological learning provided through group sessions. Most of the information being disclosed would be personal notations or structured behavioral approaches using informal systems to decode messages in a therapy environment. Other than perceptions of defamation, the consequences to the non-consenting individual are far inferior to community needs involving youth mental function and improving those dependent on state labor. Failure to have created a more formalized method of analyzing group members would represent a form of ethical negligence on behalf of the social worker. There should have been a foundational template for engaging group members individually and in group assessment format, with notations reflecting professionalism versus independent analysis. This is part of avoiding the conflict of interest scenario and represents risk planning. In the health care industry, the Detroit Henry Ford Health System invests over 2,500 employee hours in tracking, sorting and reviewing conflict of interest scenarios (Rhea, 2009). The social worker must represent the needs of the agency supporting his or her group activities, even if these costs are incurred by individual practice financial accounts. The labor investment in identifying conflicts of interest and attempting to sort them from the social work curriculum developed is a considerable cost and labor burden on the agency. In many regards, the liabilities created by disclosing information without informed consent by this individual outweigh long-term cost and legal consequences in the long run viewpoint. The role of the social worker is that of moderator between systems and their representatives in similar accord to their individual clients or group participants. If the social worker decided to forgo recognizing perceptual values in the non-consenting group member, using legal knowledge as a guide, it would likely not lead to penalties as the individual would be hard-pressed to justify rights violations when supported systems professionals are the only agencies or individuals maintaining personalized knowledge. Selection of Contingent Options The cost-benefit approach acts as a guide for conflict avoidance and acknowledgement of risks and liabilities associated with decision-making. Community social norms might identify that the needs of a single individual do not supersede those of broader systems integrity, thereby supporting the exchange of this, in some respects, trivial lifestyle information regarding the non-consenting group member. The long-term liabilities associated with legal retribution are minimal if the decision is made to release. Again, the NASW Code of Ethics acts as only a moral code and method by which to structure social work interventions and is not a legally binding contract except in situations where consensual forms have been signed or verbal contracts have been entered that can be justified by clients. The codes clearly identify that these situations should be avoided as a primary goal. The notion of attempting one-on-one interviewing as a step toward gaining empathy and support from the non-consenting member is one which poses the smallest risk to all group members. Benefits are improved social support for the program and avoiding legal complications from bitter parties. A further option is to seek consultation with other ethics or legal professionals to gain insight into the potential outcomes of making disclosure decisions. It is always a good idea to seek additional counsel if there are uncertainties surrounding organizational or personal risk. The benefit of this is improved social worker knowledge and networking skills that will contribute to other clients in future interventions. The cost of this effort are marginal and represent opportunity costs where social worker action could be placed in other curriculum development efforts or strengthening the group relationships. The final option is to transpose collected data on group performance and create an individualized profile for Gerden that summarizes his activities. Allowing the client to access this information and approve its release as a supplementary revision of personal notes adds credence to its release in this format. Creating a communications channel with the court system where the social worker can be contacted as a tool of reference has the benefit of stronger systems relationships that facilitate faster exchange and trust of professionalism. The most appropriate option with the least cost and the most opportunity is to confront the non-consenting group member and discuss the rationale and risks associated with privacy matters. Allowing the non-consenting member to see key file-related assessment templates or commentaries will help the client understand how they are observed by the social worker and also help them to identify with the risks to their own rights and reputation based on educating about professional systems structures. Even if release of this information is decided, it will act as further evidence that the social worker considered multiple options and attempted to balance individual, agency, youth and community needs before making a decision. Plan Implementation The generalist perspective dictates a psycho-social approach to handling this ethical dilemma. Since the objective is to gain empathetic support through concentrated interviewing and use of psychological principles, appropriate skills would include sensitive communications as well as cultural competence. By this point, the social worker should understand the dynamics of behavior and personality with all group members if they are to elicit an effective treatment curriculum. In-depth discussions in an attempt to build social connection and empathy with Gerden are based on principles associated with psychological needs for belonging and attempting to instill a sense of community duty. These are values required in a successful marriage, therefore strengthening the effectiveness of lessons taught in the divorce therapy session. References Buchanan, Allen. (2005). “An Ethical Framework for Biological Samples Policy – Commissioned Paper”, University of Arizona. Retrieved November 29, 2010 from http://temp.onlineethics.org/reseth/nbac/buchanan.html Ethics.tamu.edu. (2006). “Moral Concepts and Theories”, Texas A&M University. Retrieved November 29, 2010 from http://ethics.tamu.edu/ethics/essays/moral.htm Gewirth, Alan. (1996). The Community of Rights. Chicago: University of Chicago Press. Kidder, Rushworth M. (1995). How Good People Make Tough Choices. New York: William Morrow. Liimatta, Michael. (2002). “Issues of Personal Boundaries in Counseling – Part I”, AGRM Director of Education. Retrieved November 30, 2010 from http://www.alcoholicsvictorious.org/faq/distance.html Lovenheim, P. (2004). Becoming a Mediator: Your Guide to Career Opportunities. Berkeley: Nolo. Naswdc.org. (2008). “NASW Code of Ethics of the National Association of Social Workers”. Retrieved November 29, 2010 from http://www.naswdc.org/pubs/code/code.asp National Association of Social Workers. (1992). “NASW Standards for Social Work Case Management”. Retrieved November 30, 2010 from http://www.naswdc.org/practice/standards/sw_case_mgmt.asp Rhea, Shawn. (2009). “Full Disclosure a Full-Time Job”, Modern Healthcare. 39(17), pp.14-16. Read More