Ethics Alive! Religious Freedom and Social Work: Ethics of Referring Clients

by Allan Barsky, Ph.D., JD, MSW

     Freedom of religion is a central tenet within the American psyche. It is enshrined in American law through the First Amendment of the United States Constitution. Religious freedom is also a cornerstone of American immigration history. Dating back to the earliest European settlers, many immigrants and refugees have come to America to escape religious persecution and enjoy freedom to practice any religion—or no religion at all.

    In recent years, some politicians, businesses, and professionals have used religious freedom arguments to advocate for the right to refuse to provide services to people from certain diversity groups on the basis of religious objections. This article explores religious freedom in the context of social work practice, specifically whether it is ethical for social workers to cite religious differences with clients as the basis for referring clients to other workers, rather than providing services themselves.

    Consider the following dialogue between two social workers in a family counseling agency.  

Roger: I’ve just conducted an intake interview with Mr. Perez. I’d like to refer him to you. I think it would be a better fit. [Note: Ella identifies as a lesbian.]

Ella: Thank you, Roger. I’m wondering why you think it would be better for Mr. Perez to work with me.

Roger: Mr. Perez says he is gay, which fits more with your area of expertise.

Ella: I certainly welcome working with clients of all sexual orientations. However, I would also hope that you could work with gay clients.

Roger: As you know, I am Christian, and homosexuality is viewed as an abomination in my religion. It’s partly an issue of who can serve this client better, but also, a question of religious freedom. I don’t think I should be forced to support a homosexual lifestyle. This would violate my core beliefs. [Note: Roger identifies as an evangelist Christian.]

Ella: As a social worker, isn’t respect for the dignity and worth of all people one of our core beliefs? Don’t we have an obligation to provide service to all people, regardless of their sexual orientation?

Roger: Yes, respect for all is important, including respect for the religious beliefs of social workers. And yes, I do believe clients have a right to access to services, which is why I am referring Mr. Perez to you.

    This abbreviated interaction highlights issues that may arise when the principles of religious freedom conflict with social workers’ obligations to clients, including the ethical obligations to provide service and to treat all people with respect. What are your thoughts on Ella’s and Roger’s perspectives? What are the key differences in their narratives and ethical perspectives? How could they engage one another in a collaborative problem-solving discussion of these issues, despite their differences?

    One of Roger’s key points is that he should enjoy freedom of religion, just as any other person. The principle of religious freedom suggests that people should be able to have their own religious beliefs and conduct their life in accordance with these beliefs, without interference or coercion from the state or other actors (Carlson-Thies, 2017). The NASW Code of Ethics (2018) does not explicitly mention religious freedom. Standard 2.01 of the Code does suggest that social workers should show respect to their colleagues and not demean their religion. Standard 4.02 further suggests that social workers should not discriminate on the basis of religion. Remember, however, that the Code focuses on social workers’ ethical obligations to clients, employers, society, colleagues, and the profession. It does not identify social workers’ rights or freedoms.

    Standard 1.01 says that social workers’ primary commitment is to their clients. This is one of Ella’s key points. Standard 1.01 implies that social workers should give precedence to their clients’ needs for service, even over their religious beliefs. Further, Standard 4.02 suggests that social workers should not discriminate on the basis of sexual orientation. So, does Roger’s decision to refer Mr. Perez to Ella amount to discrimination? Isn’t he refusing to provide service on the basis of the client’s sexual orientation?

    Roger argues that he is acting ethically because he is staying within his area of competence (Standard 1.04) and referring the client to a social worker who has the knowledge and skills to serve Mr. Perez in a culturally competent manner (Standard 1.05). In this instance, Mr. Perez may be better served by working with Ella rather than with Roger. Still, Roger should consider the potential harm to Mr. Perez from refusing to serve him. By refusing service on the basis of sexual orientation, the client may feel rejected, insulted, or abandoned (Kaplan, 2014). Further, Roger should be developing his competence to work with people from diverse populations, including gay clients (Standard 1.05). Yes, social workers may refer clients to other social workers who are more competent to serve the unique needs of those clients; however, workers should also develop competence to work with people from diverse backgrounds. If it is ethically justifiable for Roger to refuse to develop competence to work with gay clients, then does this mean that it is ethically justifiable for other social workers to refuse to develop competence to work with African Americans, Hindus, people with disabilities, or elderly clients?

    A number of states have adopted or considered adopting religious freedom laws that permit people to refuse services to others because of matters of conscience or religious belief. Unfortunately, laws portending to promote religious freedom provide people with legal authority to use religion to discriminate against certain groups (American Civil Liberties Union, n.d.). Courts have dealt with cases involving bakers and others refusing to provide services for LGBT clients (Masterpiece Cakeshop et al. v. Colorado, 2018). Consider, however, the broader impacts of religious freedom laws, particularly with regard to social worker-client relationships. Would religious freedom laws permit Hindu social workers to refuse service to Christians? Would they permit Catholic social workers to refuse services to clients who have divorced? Would they permit Muslim social workers to refuse services to clients who do not follow the dietary laws of Halal?

    Professional social work ethics do not restrict social workers from practicing their religion in their personal lives. Still, when social workers are acting in their professional roles, they should not impose their religious beliefs on clients, and they should not exploit clients to further their religious interests (Scales & Kelly, 2016; NASW, 2018, Standard 1.06).

    As Roger and Ella discuss their conflict, they should demonstrate empathy to each other’s views. For instance, Ella might say, “I understand how your religious beliefs are important and how you believe that you are acting in Mr. Perez’s best interests when you are referring him to me for services.” Roger might acknowledge, “And I understand how you want to ensure that I am not discriminating against Mr. Perez or shunning my responsibilities to gain competence in serving clients from diverse backgrounds.” Even if they do not agree about how to resolve their conflict, at least they are showing understanding and respect to one another.

    Ella might try to work within Roger’s religious frame as they discuss the issues further. “My understanding of Christian notions of charity and service is that they are to be offered to all people, whether or not they are good Christians [pause for response]. All people are created in God’s image. Building on the principle, ‘Love your neighbor,’ all people are deserving of help when they are in need. In this spirit, would you be open to discussing how you could provide services to gay clients without compromising your religious beliefs?” (Carlson-Thies, 2017).

    If Roger is open to this discussion, they could further discuss how serving gay clients in a compassionate and competent manner may be consistent with Roger’s religious beliefs. If Roger does not believe he can effectively serve Mr. Perez without compromising his religious beliefs, then Ella may agree to serve Mr. Perez. The discussions need not end there. As Ella and Roger continue to work together with other clients, they may resume discussions about better ways of managing the tensions between religious freedom and the obligation to serve gay clients in a respectful, competent manner. Some ethical issues are not going to be resolved in a single conversation.

    Social workers should be wary of referring clients on the basis of conflicting religious beliefs with clients. To demonstrate respect and to ensure clients have access to needed services in a timely manner, workers should consider what they can do to enhance their knowledge and skills to work with diverse populations, including gay clients. Referring clients on the basis of conflicting religious beliefs may be perceived by clients as rejection or abandonment. Although referrals may be justified on the basis of the worker’s skills, the client’s best interests, and the client’s wishes, social workers should avoid making referrals simply because they have religious differences with their clients (American Counseling Association, 2011; Kaplan, 2014).

References

American Civil Liberties Union. (n.d.). End the use of religion to discriminate. Retrieved from https://www.aclu.org/issues/religious-liberty/using-religion-discriminate/end-use-religion-discriminate?redirect=feature/end-use-religion-discriminate

American Counseling Association. (2011). Brief for the American Counseling Association as amicus curiae in support of defendants-appellees and affirmance in Ward v. Wilbanks. Retrieved from http://www.counseling.org/resources/pdfs/EMUamicusbrief.pdf

Carlson-Thies, S. (2017). Religious freedom is good for social work and social justice. Social Work & Christianity, 44 (1/2), 96-111.

Kaplan, D. M. (2014). Ethical implications of critical legal case for counseling profession: Ward v. Wilbanks. Journal of Counseling & Development, 92 (2), 142-146.

Masterpiece Cakeshop et al. v. Colorado. (2018). No. 16–111 (USSC). Retrieved from https://www.supremecourt.gov/opinions/17pdf/16-111_j4el.pdf

National Association of Social Workers (NASW). (2018). Code of ethics. Washington, DC: Author. Retrieved from https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English

Scales, T. L., & Kelly, M. (Eds.). (2016). Christianity and social work: Readings on the integration of Christian faith and social work practice (5th ed.). Botsford, CT: North American Association of Christians in Social Work.

Allan Barsky, Ph.D., J.D., MSW, is Professor of Social Work at Florida Atlantic University and author of  Social Work Values and Ethics (Oxford University Press).

The views expressed in this article do not necessarily represent the views of any of the organizations to which the author is affiliated, or the views of  The New Social Worker magazine or White Hat Communications.