Ethics and Decision Making for Social Workers

Michael Gary Meacham, Ph.D., LCSW, DCSW

Valdosta State University

Journal of Social Work Values and Ethics, Volume 4, Number 3 (2007)

Copyright © 2007, White Hat Communications

This text may be freely shared among individuals, but it may not be republished in any medium without express written consent from the authors and advance notification of White Hat Communications.

Key Words:   ethical standards, operationalizing values, philosophical foundations, ethics

Abstract

The purpose of this article is to encourage deeper consideration of the ethical standards of social work and, especially, to assist the reader with making quality decisions about ethical dilemmas.  The difficulty of operationalizing values into actions is considered.  Various philosophical foundations concerning ethics are reviewed and two of the better known decision-making processes from social work are presented.   The article ends with a summary of various systematic critical thinking paradigms based on the assumption that no matter what philosophical view, written code, or social policy a social worker may use to assist in decision making, the final decision is the responsibility of the critical thinking of the worker.

1. Introduction

The National Association of Social Workers Code of Ethics (1997) is considered by the vast majority of social workers to be our professional standards.  There are standards of conduct and inquiry suggested by the Council on Social Work Education that affect professional standards in social work education and, thereby, all of us, as well.  Beyond these two organizations there are smaller ones within the social work profession in the United States, other nations’ social worker organizations, and the International Federation of Social Workers, each of which has its own ethical codes and standards.  We are also affected by and obligated to abide by codes that govern our particular employers and other organizations with whom we interact.  Finally, there are consequences for violating legal statutes within our nation.  Furthermore, we may select as a personal code the precepts of an ideology, particular international decrees and statements, a religion, or a voluntary organization. 

There are many definitions of ethics, but for our purposes, we will define ethics as professional obligations and rules of conduct.  We also have moral judgment, “a choice made about right or wrong behavior . . .” (Barker, 1999).  Other important concepts we should consider for this article include beliefs, which are ideas people hold about reality and morality, and values, defined as “culturally defined standards by which people assess desirability, goodness, and beauty, and which serve as broad guidelines for social living” (Macionis, 1997).

Even if we were able to completely believe in and follow social work ethical guidelines under all circumstances and held them as part of our personal morality and values, there still would be dilemmas.  When we express a value or put one into action, many dilemmas and paradoxes become apparent.  “It is no easy task to be good” (Aristotle, 1972). 

The goal of this article is to assist the reader in making choices that better assist our clients, our profession, and us.  The social work profession constantly reviews its ethical standards and makes important changes, but in the final analysis, the choice lies with the social worker him or herself.  Organizations tend to defend their members only when the member is in agreement with the organization and then frequently only if the organization is not threatened.  Therefore, when seeking to resolve many ethical dilemmas and choices, we must look to ourselves.

Here we will look at our ethics and their relation to our beliefs, morality, and values.  We will learn different philosophical perspectives on these concepts. A major part of gaining insight into ourselves, others, situations, and writings involves critical thinking. Critical thinking is extremely important in social work, but critical thinking without some method may rather quickly become mere justification of our own views.  To assist us in using critical thinking, we will review some (more or less) structured methods of critical analysis.  These methods may help us make better ethical decisions.

2. Discussion

Among the first considerations necessary to understanding values and ethics, either in the abstract or in action, is to consider their parameters or their scope.  Many of the dilemmas social workers face involve the scope of our ethics.  For example, we have ethical standards supporting confidentiality, but the scope does not include legal statutes on reporting in many states (e.g. child abuse, domestic abuse, and danger to self or others).  Another example is our support of self-determination, but this does not include important situations (e.g. homicidal/suicidal behavior, allowing abuse to continue).  

The above examples are selected to demonstrate that even some of the ethics we cherish most have parameters.  Furthermore, modern theorists since at least Berger and Luckmann (1966) and many postmodernists have shown how our interpretation of language has an impact as dramatic as language per se. Words such as “appreciation” and “violence” mean very different things to many different groups and people.  Consider how a particular social worker may face the dilemma of what (s)he considers “appreciation.”  We may appreciate the problems a client has from being a part of a drug subculture, but how much should we demonstrate appreciation of such a culture?  Also consider “violence.”  Even physical violence is accepted in some forms by some excellent social workers (e.g. controlled spanking).   The dilemma with the term becomes even more pronounced if we consider state violence.  Social workers frequently are asked to remove children from their homes despite their wishes, and we must, at times, suggest that particular clients be confined for their own or others’ safety.  The anti-violence ethic may be most problematic in situations of self-defense.

It is important to note that few, if any, of us would argue to change these standards.  However, these standards have parameters—some well defined and others not so well. 

2.1. Resisting ethical decision-making

There are many reasons for not acting to change inconsistencies.  Some of these arise from the micro level, but affect our involvement in mezzo and macro level organizations and professions.

One explanation is advanced by Yablonsky (1972), who writes about a state of “mental inertia,” in which we rely on tradition and act conservatively.  We have little motivation to work toward change, learn new things, or try new ways.  He labels this robopathy.        

Robopathy affects us all to a degree, because there are areas of life that interest us very little.  However, in our profession, we should be very aware of this set of attitudes, because it allows others to make decisions for us.  The number of extremely active members in most large organizations is few, but their values may easily become the standards of those organizations.  We must be vigilant about our own attitudes and the activities of our organizations.

Another reason for not acting toward change involves our thinking.  Festinger (1957) writes about cognitive dissonance, which he writes is the condition that occurs when two opposing ideas in a person are held simultaneously. In the beginnings of modern clinical work, Sigmund Freud (1976) and Anna Freud (1979) developed the idea of defense mechanisms, which defend the ego from excessive anxiety by distorting reality.   One mechanism discussed by later writers (Goldstein, 1986) is splitting, which separates two ideas, beliefs, ego states, or feelings.  The concepts of “cognitive dissonance” and “splitting” are similar, but not synonymous. For our purposes, their similarity will suffice. In many ways, cognitive dissonance and splitting (as well as other defense mechanisms) allow us to be satisfied and not satisfied with our profession at the same time. These activities become important for social workers when our professional acts are affected by beliefs outside of our ethical system.  For example, we know that spouse abuse is epidemic for both spouses, but many writings continue to use the words “male” for perpetrator and “female” for victim, an attitude developed through the culture in which we live (one idea), but which ignores studies indicating this may be erroneous (an opposing idea).  This and similar splitting may prejudice intervention.

The various theories and concepts above give some indication for why we do not act on ethical issues.  Perhaps we should add as a warning that historically people have had little trouble in justifying nearly any attitude or behavior. However, there are times when we must make ethical and moral decisions as professionals.  We now consider such decision making.

2.2.         Decision making in ethics

One characteristic of most social workers is that we are not prone to merely accept situations as they are.  Part of our task in social work research is to describe reality, but as Marx (1970) reminds us, “The philosophers have only interpreted the world in various ways; the point, however, is to change it.”  Social work begins as a science and a profession, but to paraphrase Tolstoy (1991), science cannot answer our greatest question – what shall we do?  These remarks from Marx and Tolstoy seem to lie at the heart of the social work profession.  We grew as a profession of practice, and we continue to focus on practice in our work.  Below are a few of the common concepts that help explain reasons to take action (or practice).

2.2.1. Emotivist Theory

Emotivist theory (very similar to noncognitivism) assumes that ethics and morality arise from our emotions.  For emotivists (Hume, 1974), we do not think morally, but we feel morally.  Emotivist ethical dilemmas appear quite often.  Consider reasons people become social workers.  It is not the money.  It seldom is for employment security.  The majority of social workers are attracted to social work because we felt it was good to help people.

Durkheim’s (1951) concept of Social Facts helps contain emotivists’ actions. Durkheim proposes that societies have concepts and beliefs that respond to as if they are objective facts.  A code of ethics thereby becomes a social fact.  An analogy, for clarification, may be that if we walk into a wall, we will be knocked back (a physical fact), while if we purposely and publicly break confidentiality without good cause, we will lose our license (a social fact).  Although we may feel that a particular situation is bad, we must consider the consequences of violating the code to correct  the situation.

Another stance is labeled ethical objectivism, which purports that there are objective morals by which all humans should live.  When we closely consider our own morality, we find that all of us have some beliefs that we consider unassailable. Kant’s (1781/1999) categorical imperative, which is to act in all situations as if your act would become a universal law, is called a deontologist argument, which claims that we are obliged to certain objective moral duties without concern to consequences.  The majority of us have moral standards that we consider to be inviolable.  The dilemma then becomes deciding if they are so important to us that we are justified in breaking the code of ethics.  Acting outside of the code in professional work is not part of social work, and if we decide our morals are more important, we already should be aware of the consequences.

2.2.2. Pragmatism

Pragmatism (see James, 1907) is the proposal that we should consider what we do on the basis of its consequences.  Pragmatically, social workers would tend not to violate the code, because the consequences may be loss of license and professional status.  Pragmatic dilemmas arise under at least two conditions.  Sometimes we must consider the consequences for two entities, with opposing needs.  Suppose, for example, a couple with a severely emotionally disturbed child disagree about placement. One prefers home care so the child will have the loving attention provided there, and the other prefers institutionalization, to obtain the best care and supervision possible. The decision, therefore, will result in poor consequences for one entity.  Also, frequently, we are unable to foresee the exact consequences of an action.  For example, we may remove a child from a home and unwittingly place him or her in an abusive foster home. 

2.2.3. Utilitarian

A utilitarian view (Bentham, 1961, o. 1789) supposes that we should act for what is best for the most people.   This level assists in many mezzo and macro level decisions.   However, utilitarianism tends to discount the needs of the minority and the needs of any particular individual.  Many of social workers’ clients consist of those categories and, in fact, we have a tendency to focus more on those who are not in a majority status. 

One view places total responsibility for decisions on the individual. Nihilism is the proposition that there are no ethics, moralities, or values.  Schopenhauer (1966, o. 1819, 1844) suggests that we must liberate ourselves from considerations other than compassion for others, which will overcome our egotistical desires.  This form of nihilism conforms to social work ethics in many ways.  Dilemmas arise when our personal compassion begins to supersede professionalism.  For example, social workers have become so compassionate that they form dual relationships to assist their clients in various ways.  Caveats against such relationships are part of the code.

As we ponder these ethical/moral systems, we may realize that any one of them could be wrong for the situation.  There have been efforts to universalize moral considerations and these may prove helpful in considering dilemmas.  Thiroux (1986) gives some insight by stating that any moral system should have the following characteristics:

1.      Rationally based, but not devoid of emotion

2.      Logically consistent, but allow flexibility

3.      Must be generally applicable, as well as applicable to particular individuals and situations

4.      It should be teachable

5.      It must have an ability to resolve conflicts 

He (1986) then establishes a “System of Humanitarian Ethics,” listed below in order of importance:

1.      The value of life

2.      The principle of goodness – what we do should promote a better circumstance for those involved

3.      Principle of justice

4.      Principle of honesty

5.      Principle of individual freedom

We may note that these principles fit well with our own Code of Ethics and may provide a general beginning to decision-making concerning how our morality conforms or conflicts with the code. 

2.2.4. Some more systematic guides to ethical decision-making    

The examples in the previous section focused on philosophical foundations of decision-making with examples of how dilemmas of these may arise.  In this section, we will look at specific guidelines that assist in making decisions.   Maslow’s (1954/1971) hierarchy of needs gives some basic insight as to what needs are more important to a client and may be used as a general beginning.  For example, our ethic of self-determination (comparable to Maslow’s Esteem Needs) is not as important as our value of protecting those unable to protect themselves (Maslow’s Safety Needs).  Those below give greater insight. 

There are several very well-conceived guidelines for ethical decision-making, and I have selected two to list below.

Reamer (1999) offers a systematic approach:

1.      Protection of the necessary preconditions of individual action – such as life, health, food, shelter, mental equilibrium – take precedence over protection against the harm resulting from lying, engaging in deception, of breaking a confidence, or from threats to items that enhance the quality of life but are not necessary to it, such as recreation, excessive, and artistic artifacts.

2.      An individual’s right to the necessary preconditions of action takes precedence over another individual’s right to freedom.

3.      An individual’s right to freedom takes precedence over his or her right to basic well-being.

4.      The obligation to obey laws, rules, and regulations to which one has voluntarily and freely consented overrides one’s right to engage voluntarily and freely in a manner that conflicts with these laws, rules and regulations.

5.      In cases of conflict, individuals’ rights to well-being may override rules or arrangements of voluntary associations.

6.      The obligation to prevent basic harms such as starvation and to promote the public good takes precedence over complete control of one’s property. 

Lowenberg et al (2000) suggest the following “Ethical Assessment Screen”:

1.  Identify your own relevant personal values in relation to the ethical dilemma which faces you.

2.  Identify any societal values relevant to the ethical decisions to be made.

3.   Identify the relevant professional values and ethics.

4.   Identify alternative ethical options that you may take.

5.   Which of the alternative ethical actions will protect to the greatest extent possible your client’s rights and welfare, as well as the rights and welfare of others?

6.   Which alternative action will protect to the greatest extent possible society’s rights and interests?

7.      What can you do to minimize any conflicts among1, 2, and 3?

8.      What can you do to minimize any conflicts between 5 and 6?

9.      Which alternative action will result in your doing the “least harm” possible?

10.  To what extent will alternative actions be efficient, effective, and ethical?

11.  Have you considered and weighed both the short-term and long-term ethical consequences of alternative actions?

The writings under the heading “Discussion” are meant to provide the social worker with better understanding of some of the dilemmas all of us face in decision making and to provide social workers with systematic methods to assist us in making these difficult decisions. 

3. Critiquing and assessment

Another aspect of sound decision-making is to develop skills in critical thinking.  Few of us blindly follow directives, but all of us need more skill at determining what writings or statements are important under particular conditions.

An important aspect of critical thinking is self-examination.  Many documents and situations appear to be outstanding until we perceive that they appear that way to us because they agree with our position.   The opposite is true, as well.  To be good critical thinkers, we must know our own biases.  It is important to remember that ethnocentrism and egoistic tendencies are part of all of us, and we must seek to overcome them. 

A general definition of critical thinking may be found in Hastings (1979). He discusses understanding social problems using what he calls serious thinking, which he defines as “deliberately using your mental abilities to achieve a goal of understanding social problems.”  This also is a good basic definition of critical thinking.

There are some good writings available to introduce critical thinking.  Paul and Elder (1999) examine critical thinking from a variety of perspectives.  One of their concepts is “A Template for Assessment,” which follows:

1.      Clarify exactly what you are assessing and why.

2.      Ask probing, evaluative questions that reflect a deep analysis of the logic of that which you are evaluating.

3.      Specify the information you need to collect to accurately assess and what you want as your criteria or standards. Decide how you are going to apply them in a practical and reasonable way.

4.      Reflect on the kind of judgments you will need to make.

5.      Cross-check the implications as you begin to make your judgments.

6.      Review your evaluation globally.  Is it coherent, logical, realistic, and practical?

Critical methods of thinking appear in the social work literature, and social workers may benefit from a brief description of these.  More important, we may use these to more precisely make decisions on our own attitudes, about the methods we use, and the writings we consider.

3.1. Hermeneutics

Modern hermeneutics has been attributed to Dilthey and to Hegel (see Chessick, 1990), and has been developed even more recently by Gadamer (1977), Heidegger (1998), and Hoy (1982).  Hermeneutics may be understood as a general term for the art and science of interpreting, but there are methods more or less specific to hermeneutics that may be considered separately.  Heidegger believes that understanding arises from preconceptions developed from activities within our lives.  Biography, culture, and history so deeply affect our activities and preconceptions that we hardly are aware of them.  Heidegger demonstrates the need to understand the culture of our clients before we make assumptions about their behavior.

Gadamer begins with Heidegger’s concepts and adds his phenomenological approach that for us to understand, we must combine our horizon with that of the other (a person, a group, or a text).  Our new joint perspective creates a new horizon and a deeper understanding.  By adding Gadamer, we know that the therapeutic relationship consists of more than one person’s (client or therapist) perspective, but is an interactive process of the relationship.  We bear in mind that our intervention must be adjusted to the client’s perspective.

3.2. Verstehen

Dilthey (1989, o. works 1883) developed verstehen in philosophy, and it was developed for the social sciences by Weber (1904/1949).  Verstehen is a method of analyzing history and other data by focusing on the meanings of reality experienced in situations.  Social workers realize that a client’s situation seldom is a completely objective one.  Forces outside and the client’s own experiences combine to make each situation unique.

3.3. The Frankfort School

An assumption of this thought is that change should be the goal of any social theory.  The Frankfort School (see Adorno, 1950; Fromm, 1969, o. 1941; Habermas, 1973, o. 1963; Horkheimer, 1974, o. 1947) uses Freudian, Marxian, and other theory in combination to explain motivations behind behaviors that had been merely described by positivists.  The Frankfort school recognizes the importance of going beyond descriptive analysis of a problem or person and teaches us to remember that change, as the client determines it, is the goal of much of social work.

3.4. Post-modernism, et al.

Various subsystems of ideas may be subsumed under the label of post-modernism, which critiques objectivity and modern society.  Much of post-modernism is concerned with language and legitimations.  White (1987) uses a post modernist approach in his Narrotology, and Friere (2000, o. 1970) proposes post modernist critiques to help empower the oppressed.  They seek to redefine the perception of reality to encourage positive change.

Derrida (1998) states that reality is based on the occurrence and we must understand them in their social and cultural content. He is called a post-structuralist.  

Others deconstruct texts for their original meaning.   This process is called deconstruction, as was part of Foucault’s (1988, o. 1965) work on the history of mental illness.  In general, post-modernist critiques seek to find how various structures and attitudes are made to legitimate existing belief system. 

Post-colonialists (Hutcheson, 1995) propose that the long period of colonialism continues to affect our attitudes toward ourselves and others.  Social workers may find these critiques important when advocating for populations-at-risk and other oppressed peoples.

3.5. Feminism

A large part of feminists’ critiques (Tavris and Wade, 1984) employ determining how societies’ structure and language surrounding gender and sex roles is oppressive.  They advocate redefining these roles.  They further advocate for equal access for all people.

4. Summary

This is essentially an article in two parts.  Ethics involve our profession, in that decisions we make regarding them affect our professional demeanor, development, and licensing.  On a broader scale, this involves ethics, morality, and values. What we decide to do may be based in various philosophical foundations, but in the end, we must live with the consequences. 

The second part is meant to assist in these decisions by presenting various philosophical concepts and ideas.  Systematic methods provide us with more precise guidelines for what to be aware of in ethical decision-making.

However, ethical decision-making most often involves character and integrity.  The willingness to learn and to ponder these issues, the decision to accept our codes as an important part of decisions, the ability to self-reflect on our own motivations and biases, our honesty, and our propensity to know when we need assistance all involve the type of person we are.  

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