Ethical Dilemmas of Social Workers - Thesis Example

ETHICAL DILEMMAS By Location Terms of Reference A report in fulfillment of the requirements for the Access to Social Work course, South Thames College, Merton Campus. Methodology In order to develop this report, numerous secondary sources were consulted. The secondary sources served as reliable materials in analysing the case of case of Mrs. Williams and her family. Evidently, a diverse range of sources were obtained in accordance with the relevance of the sources to the topic. Most of the sources considered for the report analysed different moral and ethical principles that govern social work in the United Kingdom. Notably, secondary sources present a measure of bias. However, during the preparation f the report, a critical review of the sources minimized the level of bias. Abstract The report will focus on discussing some of the critical ethical issues that social workers face in their practice. The report adopts a specific focus of analysing the case of Mrs. Williams and her family and the ethical dilemmas that the professional handling her case must deal with. Worth noting is the fact that the social workers and the general practitioner have contrasting views on the best cause of action regarding Mrs. Williams and her daughter. The report will also highlight some of the strategies that can help social workers make the best decision. Contents Terms of Reference 2 Methodology 3 Abstract 4 Introduction 6 Examples of Common Ethical Dilemmas Faced by Social Workers 7 Summary of the Case Study 8 Discussion of the Ethical Issues 10 Strategies that can Support the Social Worker in Handling the Ethical Dilemmas 13 Justification of the Views of the Social Workers 14 Justification of the Family GP’s Views 15 Conclusion 16 Recommendations 16 Bibliography 18 Introduction Nurses and social workers have to make critical decisions that have the capacity to affect the lives of other people. Notably, both nurses and social workers have the responsibility of taking care of people in need. The responsibilities placed on them can prove to be overwhelming in certain situations. Social workers and nurses have to make decisions that promote the well-being of their clients. However, there are situations when they face ethical dilemmas and it proves extremely difficult to make the right decision and justify it. Despite the ethical dilemmas that they face on a daily basis, they still have to make the critical decisions that affect the welfare of other people. Ethical dilemmas represent complex situations that may trigger a mental conflict in the mind of the nurse. In many cases, ethical dilemmas trigger a conflict between moral imperatives. Unless nurses and social workers rely on specific ethical principles and guidelines, it may prove extremely difficult for them to make the right decision. The right decision in this case should promote the welfare of their clients. Social workers who have the responsibility of protecting children have a sensitive role to play in the society. In many cases, they face the compulsion of making difficult choices in an effort to promote the wellbeing of children. This paper will analyse a case study that relates to the welfare of children and discuss the ethical dilemmas faced by the social workers. Task One Definition of Ethical Dilemmas Many social workers face ethical dilemmas in practice, especially in situations whereby they have to make the right decision, which will promote the best interest of each party. As social workers, they are the agents who have to determine the right course of action. Notably, social workers deal with legal and agency policies that may introduce complex situations. In such situations, social workers have no choice but to make a definitive decision. Worth noting is the fact that ethical dilemmas do not have perfect solutions and each decision compromises an ethical principle (Andrews & Mcmillan 2013, p. 111). For this reason, it is critical for social workers to decide on the best course of action that prevents more benefits. In many cases, addressing an ethical dilemma requires the individual to undertake a critical reflection and promote a “good end”. In many cases, social work interventions must promote the good of the majority. Therefore, it is logical for the social worker to analyse the situation in accordance with the key ethical principles. In addition, the decisions made when social workers face an ethical dilemma should promote justice in all senses (Carey 2013, p. 63). Many social workers are unable to foresee the ethical dilemmas they face, but the nature of the situations they address presents numerous ethical dilemmas. Examples of Common Ethical Dilemmas Faced by Social Workers Some of the ethical dilemmas that social workers face may include; Conflicts between laws, policies, and moral principles Social workers involved in the allocation of resources may believe in utilitarianism while the existing laws and policies do not support the moral principle. In other cases, ethical dilemmas may be between personal values and professional ethics For example, a social worker may hold personal values and beliefs that do not support abortion. However, the social worker may be compelled to help a teenager undergoing an abortion. Such a case would be a direct clash between personal values and professional ethics. Laws versus human rights For example, a social worker may be required by the law to present reports about the welfare of the client. However, the social worker may be afraid of disclosing personal information and choosing to protect the privacy of the client. In such a case, there is an evident conflict between the law and human rights. Freedom of choice versus restriction of liberty For example, a social worker may face a dilemma when a patient’s right of choice conflicts with the restrictions of liberty. It is difficult to determine the point at which a client should no longer exercise the freedom of choice. Safeguarding versus faith and diversity For example, a social worker may face a conflict between the need to safeguard a child and the parent’s rights to exercise their faith and diversity especially when their actions may have a direct impact on the child. Summary of the Case Study In the case study presented, Marsden Layla is a social worker facing a critical dilemma in her practice. One of her clients, Mrs. Williams, has a three-year-old daughter. Mrs. Williams suffers from a mental health condition, a factor that makes extremely difficult for her to take full responsibility for her parenting roles. It is unfortunate that Mrs. Williams has been indulging in alcohol, a factor that makes it difficult for her to take care of the daughter. For this reason, Mrs. Williams does not adequately feed her daughter and the little girl lacks safety because her mother does not show the relevant concern. According to Mrs. Williams’s history, there is evidence that in the past, she has abandoned her two other children and has not exhibited any form of contact with them (Davies & Duckett 2010, p. 65). There is evidence that Mrs. Williams has been indulging in alcohol since she was only eight years old. Mrs. Williams grew up in an abusive family, a factor that triggered her mental health problems. The fact that Mrs. Williams proved to be very engaging and exhibited interest in her daughter served to convince Marsden, the social worker that she would eventually come around and become a responsible mother. Mrs. Williams took steps to improve the welfare of the child. In addition, she ensured that the child had not suffered any serious effects. However, her efforts did not help her to recognize the need for giving her child the care she deserves. The family’s general practitioner opined that with the resources allocated to Mrs. Williams, it was expected that she would improve and register positive outcomes. However, after 18 months, Mrs. Williams did not exhibit any remarkable changes (Davies & Lebloch 2013, p. 34). Therefore, the social workers initiated a management review of the case. According to the practitioners in the review, the social workers needed to initiate the process at an earlier date because Mrs. Williams did not present any hope. Evidently, the key issues highlighted in the case study are that Mrs. Williams has a complex history with one of the outstanding factors being that she suffers from a mental illness. Mrs. Williams also has abandoned her other children in the past a factor that increases her chances of doing the same with Julie the daughter. She lacks parenting skills a factor that places the daughter at a high risk. In the past, Mrs. Williams has been highly dependent on alcohol and had a history of drug abuse. Other agencies are well aware of her conditions a factor that indicates the seriousness of her history. Mrs. Williams has also been diagnosed with borderline learning difficulties a condition that reduces her chances of changing. It is possible that Mrs. William will disguise her compliance while she is incapable of proper parenting in real sense (Dennis, Washington, & Koenig 2014, p. 950). Some of the outstanding ethical issues from Mrs William’s case are: Balancing rights and responsibilities of the mother Balancing competing needs and preferences Support versus intervention to manage the risks to Julie The impact of resources used Discussion of the Ethical Issues Balance between Rights and Responsibilities Apparently, the social workers face critical social dilemmas. One of the dilemmas involves creating a balance between rights and responsibilities. As a mother, Mrs. Williams has the right to protect and safeguard as well as have in custody her daughter. However, the fact that she has certain rights towards the welfare of the child does not translate to her willingness to embrace responsibilities. In such situations, nurses face critical dilemmas because they are compelled by the law to deny such parents of the custody of their children (Dixon & Welbourne 2013, p. 44). In the past, parents had the capacity to determine what happened to their children. However, with the emergence of the welfare principle, the wellbeing of the child may surpass the right of the parents. For this reason, social workers have to critically analyse the situations and understand the existing dilemma. Although the social workers have been trying to help Mrs. Williams to embrace responsibility and exhibit positive parenting skills, it remains difficult for her to take up the responsibilities. Therefore, there is no option but to deny her, her rights (Gilbert 2012, p. 534). In my view, the right cause of action is to deny Mrs. Williams her rights in order to avoid a case similar to that of BABY P, who eventually died in the hands of his mother (Press Association 2010, n.p). The social workers working with the mother had opined that with the relevant support, she would improve as a parent and continue enjoying her rights. The tragic death of the baby highlights that social workers should deny Mrs. Williams her rights as a mother since she cannot embrace full responsibility of the daughter. Support versus Intervention An additional ethical dilemma is whether to continue supporting Mrs. Williams in an effort to ensure that she can take care of her daughter or whether to intervene and place her daughter under welfare. The social workers believe that Mrs. Williams may become a better parent if given the right form of support. The other practitioners opine that Mrs. Williams is incapable of becoming a better parent, a factor that necessitates urgent intervention. There are evident benefits of continuing to support Mrs. Williams because she may overcome her mental health problems and be able to enjoy her rights as responsibilities as a mother (Gough & Spencer 2014, p. 31). However, the practitioners supporting intervention have the conviction that 18 months were such a long time for her to exhibit any potential change. The fact that she has not exhibited any change in such duration serves to necessitate urgent interventions. The children Act of 1989 advocates for intervention if children are not in the right hands. The Act considers the needs of children as a priority in determining the right cause of action. For this reason, the Act considers the needs of children. The Acts advocates for intervention before children can get to a crisis point. In the case of Mrs. Williams, the option of intervening emerges because the further delay of intervention may complicate Julie’s circumstances. For this reason, intervention seeks to protect children and promoting their safety (Griffith & Tengnah 2007, p. 177). Baby P’s case is also applicable in this ethical dilemma. Therefore, I am convinced that the social workers should consider intervention since continued support to the mother may present worse results in the future. Balancing Competing Needs and Preferences An additional ethical issue that the professionals working with Mrs. Williams face is striking a balance between the competing needs and preferences of both the mother and child. Mrs. Williams has evident needs because of her mental health condition. She requires relevant support in order to gain a measure of stability and be able to raise her daughter effectively (Jedynak 2014, p. 40). However, her needs require time if they are to be effectively addressed. On the other hand, Julie has critical needs since she does not receive adequate feeding and is not safe in the custody of her mother. For this reason, Julie’s needs require urgent addressing before they can lead to a crisis. The role of social workers is to promote the safety of children and offer them basic services in an effort to promote their wellbeing. The professionals have to balance the needs of Mrs. Williams and those of Julie. They have to determine which of the needs deserve a priority. If they choose to give the needs of Mrs. Williams a priority, they will compromise the needs of Julie who is a vulnerable young girl (Littlechild 2011, p. 1610). From the examples of cases of baby Daniel Pelka and baby Khyra Ishaq, social workers need to consider the needs of the child as a priority. In the cases of the two children mentioned, the needs of the children were never given a priority hence they were starved to death by the parents assumed to be taking care of them. The Impact of Allocating Resources There is an ethical issue regarding the resources used in helping Mrs. Williams for 18 months. Some social workers feel that the resources would have been used in a better way. Ethical dilemmas surrounding available resources are not new to social work because some cases need a proper consideration before resources can be allocated. Although some of the professionals believe that using the resources on Mrs. Williams may present positive outcomes, the family general practitioner has the conviction that the resources can be used elsewhere. In such a case, determining the best option requires a critical consideration of the available resources and the needs of Mrs. Williams versus the needs of other clients (Masson 2006, p. 26). I have the conviction that the available resources should be used in supporting Julie with the basic needs (BBC News Channel 2010, n.p). From high profile cases of BABY Peter, Daniel Pelka, and Khyra Ishaq, it emerges that intervention is the best approach as it promotes the wellbeing of the child (Patel-Carstairs 2013, n.p). Strategies that can Support the Social Worker in Handling the Ethical Dilemmas The Welfare Principle The social workers may benefit from the welfare principle, which promote the well-being of children as the priority in the decision-making process. According to the welfare principle, all the facts of the case study should be analysed and the risks associated with every option as well as the unique circumstance of the case study. All these factors need to be weighed and the cause of action determined in an effort to promote the interest of the child’s welfare. The children Act of 1989 served to strengthen the welfare principle, placing emphasis on the best interest of the children as the primary consideration. For this reason, the professionals in the case should analyse all the facts and circumstances and determine the best course of action in accordance with the best interest of Julie (Parton, Vincent, & Stafford 2010, p. 56). The Multiagency Approach The multiagency approach may also be an effective guideline in developing solutions to the ethical dilemmas. According to the multiagency approach, the focus should be safeguarding children and protecting them from any form of harm. Different agencies come together in an effort to tailor relevant support channelled to children in an effort to safeguard them. The multiagency approach also promotes offering parents with the relevant support so that they can become better parents. An interesting factor about the multiagency approach is that it focuses on identifying issues early enough to allow for adequate interventions (Pölkki, Vornanen, Pursiainen, & Riikonen 2012, p. 116). Task Two Justification of the Views of the Social Workers The social workers believe that Mrs. Williams deserves another chance, so that she can receive the relevant support and eventually overcome her mental health condition. If Mrs. Williams continues to receive support from the social workers, there is a possibility that she will become more responsible and exhibit better parenting skills. The social workers have the conviction that since Mrs. William has learning disabilities, she deserves more time before she can make any visible adjustments in her parenting. According to the social workers, helping Mrs. Williams achieve more as a parent can serve to safeguard Julie from any form of vulnerability. In addition, the social workers understand the emotional impacts of separating the mother and the daughter. Although the daughter may end up in a facility that gives her the relevant care, she may suffer from distress because of being separated from her mother (Powell 2011, p. 73). As expected, Mrs. Williams will also suffer emotionally if she is separated from her daughter. The separation may serve to worsen her condition. For this reason, opting to offer support to both Julie and her mother seems to be the most viable solution in the view of the social workers. Their views are justified because Mrs. Williams is a client who requires proper support before she can establish herself to become a better parent. Choosing to intervene at that point will only separate Julie from Mrs. Williams affecting them psychologically. However, some of the drawbacks of continuing to support Mrs. Williams without any form of intervention is that the cause of action may compromise Julie’s safety and wellbeing (Reamer 2013, p. 81). Compromising the child’s safety and wellbeing will be a contravention of the existing law passed in 1989. The law also supports the welfare principle, which considers the needs of the children a priority when determining the best cause of action. An additional drawback would be that Mrs. Williams might take too long to learn because of her borderline learning disabilities. With such a condition, it is difficult for Mrs. Williams to exhibit any positive change. In addition, Mrs. Williams has a complex history, one factor being that she abandoned her other children and did not care about them. She may exhibit similar attitudes towards Julie although the social workers claim that she loves the daughter. With the daughter’s welfare at risk, it will be impossible to determine with certainty whether Mrs, Williams will register any positive outcomes after receiving support (Stafford, Smith, & Vincent 2011, p. 56). Justification of the Family GP’s Views On the other hand, the family’s general practitioner has the conviction that intervention is the best solution in Mrs. Williams’ case. The general practitioner believes that the intervention process should have been initiated earlier in order to prevent cases of compromising the welfare of Julie (Falling looked-after numbers not due to early intervention 2013, n.p). Intervention in this case would ensure that Julie is safe, but not with her mother. Since her mother has not been feeding her well, intervention would serve to give her access to better care as well as emotional support (Coughlan 2012, n.p). Currently, Julie is facing negligence from her mother who is highly dependent on alcohol. With the increasing unpredictability of the human behaviour of people with mental disorders and learning difficulties, it is unsafe for Julie to continue staying with her mother. These arguments support the view of the general practitioner who promotes intervention as the best course of action (Stroud & Warren-Adamson 2012, p. 40). Although intervention may serve as a viable solution, it will serve to separate mother and daughter a factor that will hurt both of them emotionally. In addition, intervention will mean that Julie will grow up in a different environment without experiencing the love of her mother. The intervention also denies Mrs. Williams the opportunity of exercising her rights as a mother. It is possible that after the intervention, Mrs. Williams will not be willing to continue with her therapy in order to overcome her mental health condition. Therefore, protecting the best interest of the child serves as a disadvantage to the needs of the mother who is desperate to develop better parenting skills (Parton, Vincent, & Stafford 2010, p. 41). Conclusion As highlighted in an article in the BBC News, more children need to be in care. The case of Mrs. Williams and her alcohol dependence serves to highlight the need for the social workers to take in Julie for care. Although the social workers may choose to continue supporting Mrs. Williams, Julie deserves to be under protection. This acts in conformity to the children Act of 1989 and is the best cause of action after analysing the fact surrounding the case. Recommendations The social workers and the general practitioners should critically analyse the welfare principle and intervene. Apparently, Julie needs to be under proper care and should be separated from her mother who is dependent on alcohol and suffering from a mental condition. Mrs. Williams should only be allowed enjoy her motherhood rights after reviews of her health condition and lifestyle ascertain that she is in a position to take care of Julie. Bibliography Andrews, A, & Mcmillan, L 2013, Evidence-Based Principles for Choosing Programs To Serve Parents in the Child Welfare System, Administration In Social Work, 37, 2, pp. 106-119, SocINDEX with Full Text, EBSCOhost, viewed 4 May 2015. BBC News Channel, 2010, Timeline: Khyra Ishaqs death, BBC News, n.p.,viewed 5th May 2015. Carey, M 2013, Practical Social Work Ethics : Complex Dilemmas Within Applied Social Care, Farnham, Surrey: Ashgate, eBook Collection (EBSCOhost), EBSCOhost, viewed 4 May 2015. Coughlan, S 2012, More children should be in care, say MPs, BBC News, n.p., viewed 5th May 2015. Davies, L, & Duckett, N 2010, Proactive Child Protection And Social Work, Exeter: Sage Publications, Ltd. UK, eBook Collection (EBSCOhost), EBSCOhost, viewed 4 May 2015. Davies, L, & Lebloch, E 2013, Communicating With Children And Their Families : Responding To Need And Protection, Maidenhead, Berkshire, England: McGraw-Hill Education, eBook Collection (EBSCOhost), EBSCOhost, viewed 4 May 2015. Dennis, M, Washington, K, & Koenig, T 2014, Ethical Dilemmas Faced by Hospice Social Workers, Social Work In Health Care, 53, 10, p. 950, Publisher Provided Full Text Searching File, EBSCOhost, viewed 4 May 2015. Dixon, J, & Welbourne, P 2013, Child Protection And Child Welfare : A Global Appraisal Of Cultures, Policy And Practice, London: Jessica Kingsley Publishers, eBook Collection (EBSCOhost), EBSCOhost, viewed 4 May 2015. Falling looked-after numbers not due to early intervention 2013, Community Care. Available at http://www.communitycare.co.uk/2013/02/13/falling-looked-after-numbers-not-due-to-early-intervention/ [Viewed on 5 May 2015]. Gilbert, N 2012, A comparative study of child welfare systems: Abstract orientations and concrete results, Children And Youth Services Review, 34, Comparative Child and Family Policy, pp. 532-536, ScienceDirect, EBSCOhost, viewed 4 May 2015. Gough, J, & Spencer, E 2014, Ethics in Action: An Exploratory Survey of Social Workers Ethical Decision Making and Value Conflicts, Journal Of Social Work Values & Ethics, 11, 2, pp. 23-40, SocINDEX with Full Text, EBSCOhost, viewed 4 May 2015. Griffith, R, & Tengnah, C 2007, Protecting children: the role of the law 2. Legal powers to safeguard children. (cover story), British Journal Of Community Nursing, 12, 4, pp. 175-180, Consumer Health Complete - EBSCOhost, EBSCOhost, viewed 4 May 2015. Jedynak, W 2014, Ethical aspects of the profession of social worker, Social Welfare Interdisciplinary Approach, 4, 2, pp. 38-46, SocINDEX with Full Text, EBSCOhost, viewed 4 May 2015. Littlechild, B 2011, Ethical Dilemmas in Social Work: International Perspective, British Journal Of Social Work, 41, 8, pp. 1609-1611, CINAHL Complete, EBSCOhost, viewed 4 May 2015. Masson, J 2006, Fair Trials in Child Protection, Journal Of Social Welfare & Family Law, 28, 1, pp. 15-30, Sociological Collection, EBSCOhost, viewed 4 May 2015. Parton, N, Vincent, S, & Stafford, A 2010, Child Protection Reform Across The United Kingdom, Edinburgh: Dunedin, eBook Collection (EBSCOhost), EBSCOhost, viewed 4 May 2015. Patel-Carstairs, S 2013, Timeline: harrowing death of Daniel Pelka, The Telegraph, n.p. viewed 5th May 2015. Pölkki, P, Vornanen, R, Pursiainen, M, & Riikonen, M 2012, Childrens Participation in Child-protection Processes as Experienced by Foster Children and Social Workers, Child Care In Practice, 18, 2, pp. 107-125, SocINDEX with Full Text, EBSCOhost, viewed 4 May 2015. Powell, C 2011, Safeguarding And Child Protection For Nurses, Midwives And Health Visitors : A Practical Guide, Maidenhead: McGraw-Hill Education, eBook Collection (EBSCOhost), EBSCOhost, viewed 4 May 2015. Press Association, 2010, Baby P social workers thought his mum was caring, The Guardian, n.p., viewed 5th May 2015. Reamer, FG 2013, Social Work Values And Ethics, New York: Columbia University Press, eBook Collection (EBSCOhost), EBSCOhost, viewed 4 May 2015. Stafford, A, Smith, C, & Vincent, S 2011, Child Protection Systems In The United Kingdom : A Comparative Analysis, London: Jessica Kingsley Publishers, eBook Collection (EBSCOhost), EBSCOhost, viewed 4 May 2015. Stroud, J, & Warren-Adamson, C 2012, Multi-agency child protection: Can risk assessment frameworks be helpful?, Social Work & Social Sciences Review, 16, 3, pp. 37-49, SocINDEX with Full Text, EBSCOhost, viewed 4 May 2015. Read More