Ethical and Risk-Management Issues in Social Work: Essential Knowledge   West Lake Park Drive, Milwaukee, WI Phone:  Fax: A publication of the Alliance for Children and Families Frederic G. Reamer, Ph.D. Professor, School of Social Work Rhode Island College The Journal of Contemporary Social Services

Core Knowledge Ethical dilemmas Ethical decision-making Ethics risk management November 1, 2006 ● Alliance for Children and Families ● 2

Potential Ethics Risks Ethical mistakes Deliberate ethical decisions Ethical misconduct November 1, 2006 ● Alliance for Children and Families ● 3

Key Risk Areas Client rights Confidentiality & Privacy Informed consent Service delivery Boundary issues & Conflicts of interest Documentation Defamation of character Client records Supervision Staff development & training Consultation Client referral Fraud Termination of services & Client abandonment Practitioner impairment Evaluation & Research November 1, 2006 ● Alliance for Children and Families ● 4

Standard of Care “What an ordinary, reasonable, and prudent professional, with the same or similar training, would have done under the same or similar circumstances.” November 1, 2006 ● Alliance for Children and Families ● 5

Standards of Care Substantive standard of care Procedural standard of care Consult colleagues and supervisors Consult colleagues and supervisors Review relevant ethical standards Review relevant ethical standards Review relevant laws, policies, and regulations Review relevant laws, policies, and regulations Review relevant literature Review relevant literature Obtain legal consultation, when necessary Obtain legal consultation, when necessary Consult ethics committee, if available Consult ethics committee, if available Document decision-making steps Document decision-making steps November 1, 2006 ● Alliance for Children and Families ● 6

Professional Negligence A duty exists Dereliction or breach of the duty Damage or injury Causal connection between the breach of the duty and the damage or injury (proximate cause or “cause in fact.”) November 1, 2006 ● Alliance for Children and Families ● 7

Forms of Negligence Misfeasance: Commission of a proper act in a wrongful or injurious manner or the improper performance of an act that might have been performed lawfully. Malfeasance: Commission of a wrongful or unlawful act. Nonfeasance: The failure to perform an act that is part of one’s responsibility. November 1, 2006 ● Alliance for Children and Families ● 8

Boundary Issues Boundary crossings v. boundary violations Types of dual or multiple relationships Intimate relationships Intimate relationships Personal benefit Personal benefit Emotional & dependency needs Emotional & dependency needs Altruism Altruism Unavoidable & unanticipated circumstances Unavoidable & unanticipated circumstances November 1, 2006 ● Alliance for Children and Families ● 9

Ethics Committees Advisory v. Deliberative Functions Case Consultation Case ConsultationRetrospectiveConcurrentProspective Policy review and formulation Policy review and formulation Education & training Education & training November 1, 2006 ● Alliance for Children and Families ● 10

Ethical Decision-making Identify ethical issues: Conflicting values & duties. Identify individuals, groups, organizations likely to be affected by decision. Tentatively identify all possible courses of action & participants involved in each, along with possible benefits & risks. (cont’d) November 1, 2006 ● Alliance for Children and Families ● 11

Ethical Decision-making (cont’d) Examine reasons for & against each possible course of action, considering: Ethical theories, principles, guidelines Ethical theories, principles, guidelines Codes of ethics Codes of ethics Legal principles Legal principles Social work practice theory & principle Social work practice theory & principle Personal values (religious, cultural, ethnic, political) Personal values (religious, cultural, ethnic, political) Agency policies, regulations Agency policies, regulations November 1, 2006 ● Alliance for Children and Families ● 12

Ethical Decision-making (cont’d) Consult with colleagues & appropriate experts (e.g., agency staff, supervisors, administrators, attorneys, ethics experts) Make decision & document decision-making process Monitor, evaluate & document decisions November 1, 2006 ● Alliance for Children and Families ● 13

Metaethics Exploration of: The meaning of ethical terms (e.g., What do we mean by terms such as “right,” “wrong,” “good,” “bad”) The meaning of ethical terms (e.g., What do we mean by terms such as “right,” “wrong,” “good,” “bad”) Criteria to determine what is ethically right & wrong Criteria to determine what is ethically right & wrong Ethical theories & principles Ethical theories & principles November 1, 2006 ● Alliance for Children and Families ● 14

Normative Ethics Deontological Theory: (from the Greek deontos, “of the obligatory.”) Certain actions are inherently right or wrong, good or bad, without regard for their consequences. Teleological Theory: (from the Greek teleios, “brought to its end or purpose”) The rightness of an action is determined by the goodness of its consequences (also known as “Consequentialism.”) November 1, 2006 ● Alliance for Children and Families ● 15

Utilitarianism Act Utilitarianism: The rightness of an act is determined by the goodness of the consequences in this individual set of circumstances. Rule Utilitarianism: The rightness of an act is determined by the goodness of the consequences that would occur if this one action is generalized to all similar circumstances (e.g., this case sets a precedent.) November 1, 2006 ● Alliance for Children and Families ● 16

 Nontraditional and Unorthodox Interventions in Social Work: Ethical and Legal Implications Families in Society, 2006, v. 87, no. 2, page  Ethical and Legal Standards in Social Work: Consistency and Conflict Families in Society, 2005, v. 86, no. 2, page   West Lake Park Drive, Milwaukee, WI Phone:  Fax: A publication of the Alliance for Children and Families Frederic G. Reamer, Ph.D. Professor, School of Social Work Rhode Island College The Journal of Contemporary Social Services Additional Resources by Dr. Reamer:  Social Work Values and Ethics (3 rd ed.). New York: Columbia University Press, 2006  Social Work Malpractice and Liability: Strategies for Prevention (2 nd ed.). NY: Columbia University Press, 2003  Tangled Relationships: Managing Boundary Issues in the Human Services. NY: Columbia University Press, 2001  Ethical Standards in Social Work: A Review of the NASW Code of Ethics (2 nd ed.). Washington, DC: NASW Press, 2006  The Social Work Ethics Audit: A Risk-management Tool. Washington, DC: NASW Press, 2001