This essay will illustrate and discuss “The promise” case study in relation to analysing the impact of professional and organisational environments on the situation, identifying which principles and sections from the AASW code of ethics are most relevant. In identifying sections of the AASW code of ethics this will allow for a discussion on whether or not the code was used to resolve the dilemma, and how might this be used to resolve the situation. The second part of the essay will discuss my personal values related to the professional values expressed in the code related to the situation and what difference exists between my own values and those of the code. By using these questions as basis in relation to “The promise” this will allow for reflection on how I would change my actions in retrospect, and should there be a different outcome justified alongside the AASW code of ethics.
Abstract “The promise”
Jane Smithers is a mother of 2 children who has been diagnosed with depression and subsequently paranoid schizophrenia. Jane has been temporarily admitted to an inpatient unit as an involuntary client. Jane has been uncooperative with her treatment but has concerns with what will happen to her children in the short term. Jane’s situation has come to the attention of Community Services as the school became concerned about their welfare. Following numerous visits from Community Services Jane has been persuaded to put her children in temporary foster care whilst undergoing treatment. Jane has regular contact with her children and the worker from Community Services has assured her that she will soon be reunited with her children.
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During her involuntary stay at the inpatient unit the treating doctor advised the Community Service worker that whilst Jane’s condition can be stabilised the impact of medication will make it hard for Jane to care for her children. Jane has been advised from the social worker that if she continues with her medication regime she will get her children back, yet Community Services is now looking at permanent care for the children.
It has been suggested that social work takes place within an institutional framework of rights and responsibilities defined by the law (Banks, p.128). The impact of professional and organisational environment related to the case study requires a holistic approach to account for the connections between the services and client involved. Bowles, Collingridge, Curry, Valentine (2006, p.5) suggest to think about ethical practice in social work, we first have to consider what social work is, and the impact of the environment. The impact of the environment on an organisational and professional level is an important aspect in being able to identify and appropriately understand the issues faced. The professional and organisational environment effects on the situation can include, but not be limited to the legalities associated with mandatory reporting, accountability to management, dominant discourses associated with power structure related to the recommendations made by the service involved, Janes involuntary status and policy and procedures.
Accountability to management is a major aspect in the professional sphere, Bowles et,al (206, p.32) argue that organisational policies and practices should not automatically be viewed as inimical to the needs and interests of the constituency it seeks to serve. Even though ethics plays an integral role in the helping profession, policies and practice continually have an impact on how situations are resolved. The systematic reasoning process is strongly driven by a medical framework which can assist in how an ethical dilemma can be approached and resolved. Banks (2006, p. 151) argues we as social workers need to be able to recognize that personal, professional, agency and societal values are interlocking, yet in tension’. Actions and judgements based alongside ethical theories and principles are interlinked dimensions associated with the inclusiveness models of social work. Chenoweth and McAuliffe (2005, p. 90) suggest accountability is the ability to make decisions that can be clearly articulated and justified and take onto account the personal, professional, organisational, legal cultural and social contexts.
In understanding the professional and organisational impact associated with Jane’s illness in retrospect of the doctor’s duty and the duty of community services, there is evidence that the discourses used within this framework is pervasive and can greatly influences how we as workers perceive what should and should not happen. With the recommendations made by the doctor based on the medical model framework it is evident that Beneficence associated with this case is about considering the benefits of treatment contrary to the risks and costs. The health professional regardless of the profession they are in, should have a duty of care to act in a way that benefits the client. As many treatments involve some degree of harm, the principle of non-maleficence would imply that the harm should not be disparate to the benefit of the treatment, in certain circumstances respecting the principles of beneficence and non-maleficence means failing to respect a person’s sovereignty. Ridley (1998) argues that the principle recommends no particular kind of action, rather that our actions in general be consistent with one another.
It has been argued that we as social workers may have conflicting duties, because different commitments have been undertaken that are incompatible with each other in a particular situation (Banks, p.125). In considering the foundations of the social work profession and the ethical dilemmas that we as social workers face the AASW code of ethics is a tool that we as social workers can refer to. In relation to the case study it is evident that in the pursuit of determination committed to the five basic values, human dignity and worth, social justice, service to humanity, integrity and competence that there is a contradiction in professional goals and objectives. Numerous sections and principles could be drawn upon in practices however the most relevant to this situation are, section 4 Ethical practices and Section 5 Guidelines for ethical decision making.
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Section 4 and 5 of the AASW code incorporates ethical behaviours which are expected of social workers in carrying out their practice responsibilities. Given the complexity of this case study ethical practice plays a large part not only for the social worker to ethically fulfil commitment to social justice but in also maintaining their professional integrity based on the conflicting issue that has been raised. The conflicting issue that has been raised for the social worker engaged in the case is that they have promised that Jane will have her children back, but without knowledge and informed consent Community Services is looking for permanent care for Jane’s children (section 4.2.2 conflict of interest). Section 4.2.3(2) involuntary clients is a major aspect of this case, as Jane was admitted as an involuntary client thus leading to the removal of her children. For a social worker where ever possible, clients must be notified regarding decisions about them and as a social worker it is evident that we need to beware of the impact and potential impact of oppression towards clients who are forced to undergo life altering changes without choices.
The codes outlined above provide a strong argument in how to resolve the dilemma related to case study. The ethical practices provide a strong argument in how social workers can adequately maintain a strong client focus and ethical decision making skills. It is questionable though whether or not that all the services involved have been able to converse their feelings and their intentions regarding intervention and sustaining suitable provisions to assist Jane in dealing with her ongoing illnesses and care of the children. I feel that these codes were not used to resolve the dilemma as the intervention that is being contemplated does not coincide with client self-determination, commitment to social justice and professional integrity. The code of ethics could have been used to resolve the situation by taking into account the values and principles that underlie ethical practices and providing a foundation for ethical reflection and decision making by taking a holistic approach. The AASW code of ethics can also be used to determine the rights and demands of a client which can incorporate using appropriate channels to resolve issues such as the ethical dilemma in the case study. The AASW codes of ethics guides and directs an individual as a social worker through practice, particularly when the intent of the AASW code of ethics is to assist social workers to mutually and individually act in an ethical manner that can be accountable in the pursuit of the AASW professional aims.
The personal values that I hold in relation to the AASW code of ethics outlined above requires the need for good judgement. Good judgement and values for me encompasses and open-mind, reflectiveness, situational awareness, and the ability to use systematic ways of thinking through ethical dilemmas. My personal values associated with the professional values expressed in the code, are closely linked with how I as a professional would work through the case but on a personal level how I would like to see a justified outcome based on these ethics. This case study entails numerous decisions to be made to justify the appropriate outcome that is best suited for all parties involved. The question that is raised for me is can services providers based on a medical model assume that an individual lacks the capability and autonomy to care for their children, based on their mental health diagnosis that can be treated with medications. Do we as workers have the power to make an individual oppressed, intervene and deem that this individual is vulnerable due to the side effects of the medication? Miley and DuBois (2007, p.32) argue that when social workers only focus on the clinical without regard to ensure a just or caring society, they abandon a core social work purpose and become unfaithful angels. There are minimal differences between my own values and that of the codes used in the AASW. The decisions that I draw upon in relation to the case study is influenced by my values that answer the question how do I as a social worker identify if there is a need for intervention, and what legal and ethical basis of obligations or duty is need to intervene based the principles of the AASW.
With relation to the case study what I acted on was both my own values and professional values. This choice was influenced by working in the field of Mental Health which has led me to see individuals being able to effectively manage their children regardless of their mental health issues even those who rely on anti-psychotic medications to prevent relapse. Miley et.al (2007, p. 34) suggest the social workers code of ethics reflect a multi-dimensional view of change and rather than adopting a singular view we use the ethics of justice.
In using reflection as a tool the actions that have been suggested in the case study is not the intervention that I would have chosen for Jane based on the AASW code of ethics and my own personal values and beliefs. The actions that I would change would include liaising with other services involved and I would not suggest to Jane that she would keep custody of her children if this was not the case. The basic standard of proficiency that is generally applied in legislation in relation to involuntary clients under the mental health law is a rational one. It requires us as the professional to think about does the individual have the ability to understand the decision that is being made including consequences of their actions. This situation for Jane should have an entirely different outcome. Based on ethical decision making where clients have limited decision making skills the social worker will provide adequate and appropriate information and liaise with other consulting professionals to coincide with the requirements of the law and other interested third parties. The third parties could include allowing family such as Kinship care for the children till Jane becomes well enough to look after the children.
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