In further examination of the Code, Section 1.07 Privacy and Confidentiality, paragraph (c) is instructive.

Social workers should protect the confidentiality of all information obtained in the course of professional service, except for compelling professional reasons. The general expectation that social workers will keep information confidential does not apply when disclosure is necessary to prevent serious, foreseeable, and imminent harm to a client or other identifiable person.

This paragraph seems to suggest intervention in the situation with Mary is not appropriate. Do not break confidentiality. However, it also says that there are situations in which confidentiality is not the primary concern. Disclosure of confidential information may be made when it is crucial to “prevent serious, foreseeable, and imminent harm to a client or other identifiable person.” But could I argue that there was such serious, foreseeable and imminent harm to anyone? Would it be appropriate, with the knowledge that I had, to suggest such harm would occur? If the answer to the last question is affirmative, what does that infer about persons with a mental illness?

Other paragraphs in Section 2.09, Impairment of Colleagues, are also on point.

(a) Social workers who have direct knowledge of a social work colleague’s impairment that is due to personal problems, psychosocial distress, substance abuse, or mental health difficulties and that interferes with practice effectiveness should consult with that colleague when feasible and assist the colleague in taking remedial action.

(b) Social workers who believe that a social work colleague’s impairment interferes with practice effectiveness and that the colleague has not taken adequate steps to address the impairment should take action through appropriate channels established by employers, agencies, NASW, licensing and regulatory bodies, and other professional organizations.

I did have knowledge of Mary’s impairment. However, to infer that her impairment would interfere with her work as a professional social worker could be seen as prejudiced toward persons with a mental illness. Did I have enough information about Mary to “consult” with Mary as paragraph (a) suggests?

Further, Section 4.02, Discrimination, states that: “Social workers should not practice, condone, facilitate, or collaborate with any form of discrimination on the basis of race, ethnicity, national origin, color, sex, sexual orientation, age, marital status, political belief, religion, or mental or physical disability.” (Italics added.) This suggests that revealing anything about Mary’s condition or even confronting Mary with the situation would be discriminatory.

Finally, since Mary was a professional, didn’t she have the responsibility to make sure her “mental health difficulties” did not interfere with her professional judgment and performance as is stated in Section 4.05, Impairment, paragraph a?

(a) Social workers should not allow their own personal problems, psychosocial distress, legal problems, substance abuse, or mental health difficulties to interfere with their professional judgment and performance or to jeopardize the best interests of people for whom they have a professional responsibility.

Paragraph b. of Section 4.05, Impairment goes on to say, in part, that social workers whose “mental health difficulties interfere with their professional judgment and performance” need to seek help, make adjustments in their work situation, or quit practicing.

Doesn’t this mean that since Mary is a professional, she needs to deal with these issues? If that is the case, what is my role?

Obviously, the Code is not a clear set of rules. Rather, it gives guidance to social workers. While it is instructive, the Code does not specify what course of action is best in all instances. As stated in the Preamble, “Core values, and the principles that flow from them, must be balanced within the context and complexity of the human experience.” Professional judgment also comes into play in making ethical decisions.

In summary, there seemed to be no ideal course of action in this situation. I did not know how to predict what would happen if I talked with Mary. It is conceivable that I would have a colleague who was less than happy with my reminding her of her illness. If I did intervene by reporting to persons responsible for hiring, confidential information would be divulged. I could be identified as practicing discrimination toward persons with a mental illness. If I did not intervene, and she was hired, harm could come to clients.

There seemed to be no ideal answer and no way to avoid the situation. There may have been other options, but none seemed apparent to me at the time.

When I relate this case in class, I ask students to work in groups, make a decision, and explain to the rest of the class how they came to their conclusion. Obviously, the Code of Ethics should be a guide in such decisions. But other questions about how to make these types of decisions are also important. Is it appropriate to discuss such issues with my other colleagues? If yes, under what circumstances should such issues be discussed, formally or informally? Should a professional social worker consult with the National Association of Social Workers about such a decision? In general, should a supervisor be consulted about such decisions? In this instance, this would not have seemed appropriate, as the supervisor was also the person in charge of hiring.

In conclusion, there are times in social work practice when professionals are placed in situations, through no wrongdoing on anybody’s part, in which dilemmas occur because of a conflict in values or ethical principles within the situation itself. In those situations, it is not a matter of choosing good versus evil, or choosing right versus wrong. It is a matter of choosing between the better of two goods or, possibly more often, the lesser of two evils. Making those decisions is often not pleasant. In fact, it can be quite anxiety provoking. But it is also impossible to side step the issue when doing nothing will predictably yield a certain outcome.

I would welcome a discussion about this case. What would you do? How would you decide what you would do? What besides the Code of Ethics should aid one in making this decision? These are some of the questions that we could discuss together.

Reference

National Association of Social Workers. (1999). NASW Code of Ethics. Available online at http://www.socialworkers.org/Code/ethics.htm.

Lee J. Zook, Ph.D., is Associate Professor of Social Work at Luther College in Decorah, Iowa.

Copyright © 2001 White Hat Communications. All rights reserved. From THE NEW SOCIAL WORKER, Winter 2001, Vol. 8, No. 1. For reprints of this or other articles from THE NEW SOCIAL WORKER (or for permission to reprint), contact Linda Grobman, publisher/editor, at P.O. Box 5390, Harrisburg, PA 17110-0390, or at This e-mail address is being protected from spam bots, you need JavaScript enabled to view it .