1. Ethical Dilemmas in Social Work Practice Preliminary Results of a Comparative Study Prof. Dr. Stefan Borrmann University of Applied Sciences Landshut (Germany)

2. Back to the first page26.4.1999Prof. Dr. Stefan BorrmannPage 2 »Ethical Dilemmas in Social Work Practice« General Overview l Conceptualization of the study and data collection during a stay as a visiting scholar at the UC Berkeley l Financially supported by the Hans-Böckler-Stiftung; logistically supported by the University of California at Berkeley, School of Social Welfare l Data collection from November 2004 to January 2005

3. Back to the first page26.4.1999Prof. Dr. Stefan BorrmannPage 3 »Ethical Dilemmas in Social Work Practice« Leading Research Questions l Can the value base of social workers in the same field of action in the USA and Germany be compared with each other? l Are there similarities in the perceived ethical issues/dilemmas of social worker who work in the same field of action? l Are there differences in the way social workers deal with these ethical dilemmas?

4. Back to the first page26.4.1999Prof. Dr. Stefan BorrmannPage 4 »Ethical Dilemmas in Social Work Practice« Outline of the Study and Methodological Scheme l Pilot study with the main aim to develop future research questions l Anonymous online-questionnaire focusing mainly on the value base and perceived ethical issues of social workers in the chosen field of practice l Face-to face interviews with social workers about ways and methods to deal with ethical issues

5. Back to the first page26.4.1999Prof. Dr. Stefan BorrmannPage 5 »Ethical Dilemmas in Social Work Practice« Chosen Field of Practice l Social workers currently working in agencies of the field of HIV/Aids in San Francisco and Berlin l A field of action where ethical dilemmas are most likely examined l The evolution and development of the social problems concerning HIV/Aids in these two cities can be compared with each other l Access to the field (in Berlin) was secured in advanced

6. Back to the first page26.4.1999Prof. Dr. Stefan BorrmannPage 6 »Ethical Dilemmas in Social Work Practice« Sample l Sample in the USA: 126 agencies in the database of the CDC National Center for HIV, STD and TB Prevention l Sample in Germany: 43 agencies listed by the Ministry for Integration, Labor and Social Issues of the City of Berlin (and additional resources) l The agencies were ask to forward my request to their employees and volunteers l Random sample: 105 people participated in total, 70 in Germany and 35 in the USA

7. Back to the first page26.4.1999Prof. Dr. Stefan BorrmannPage 7 »Ethical Dilemmas in Social Work Practice« (Academic) Degrees of the Participants (in %) Erzieherin4,29Foreign Academic Degree5,88 Krankenpfleger/ -schwester1,43BSW17,65 anderer Ausbildungsberuf12,86other Bacherlor Degree20,59 Dipl.-SozialarbeiterIn (FH)32,86MSW35,29 anderer FH-Abschluss4,29other Master Degree23,53 Dipl.-PädagogIn15,71PhD8,82 anderer Uni-Abschluss25,71No post-high school2,94 Dr. phil.4,29other11,76 kein Berufsabschluss4,29 anderer4,29 N (Germany) = 77, multiple answers were possible, 70 of 70 participants responded N (USA) = 43; multiple answers were possible, 34 of 35 participants responded GermanyUSA Dipl.-SozialarbeiterIn (FH): 32,6% BSW: 17,65% Dipl.-PädagogIn (Uni): 15,7% MSW: 35,2% Dr. phil.: 4,3% PhD: 8,8%

8. Back to the first page26.4.1999Prof. Dr. Stefan BorrmannPage 8 »Ethical Dilemmas in Social Work Practice« Personal Opinions about Selected Ethical Issues (in %) 1 Strongly agree 2 Agree 3 Neutral 4 Disagree 5 Strongly Disagree N All prisoners should be screened for HIV GER1015,714,2912,8657,1470 USA34,298,5714,2925,7117,1535 AIDS-patients should have the obligation to participate in clinical trials GER01,43018,578070 USA208,5702051,5335 Pregnant women (HIV- positive/with AIDS) should be allowed to take drugs that are known to present a serious risk (e.g., stillbirth, malformation, handicap) for the unborn GER1,438,5732,8621,4335,7170 USA8,5725,7117,142,8645,7135 34,3% 57,1%

9. Back to the first page26.4.1999Prof. Dr. Stefan BorrmannPage 9 »Ethical Dilemmas in Social Work Practice« Personal Opinions about Selected Ethical Issues (in %) 1 Strongly agree 2 Agree 3 Neutral 4 Disagree 5 Strongly Disagree N All prisoners should be screened for HIV GER1015,714,2912,8657,1470 USA34,298,5714,2925,7117,1535 AIDS-patients should have the obligation to participate in clinical trials GER01,43018,578070 USA208,5702051,5335 Pregnant women (HIV- positive/with AIDS) should be allowed to take drugs that are known to present a serious risk (e.g., stillbirth, malformation, handicap) for the unborn GER1,438,5732,8621,4335,7170 USA8,5725,7117,142,8645,7135 0% 20%

10. Back to the first page26.4.1999Prof. Dr. Stefan BorrmannPage 10 »Ethical Dilemmas in Social Work Practice« Personal Opinions about Selected Ethical Issues (in %) 1 Strongly agree 2 Agree 3 Neutral 4 Disagree 5 Strongly Disagree N All prisoners should be screened for HIV GER1015,714,2912,8657,1470 USA34,298,5714,2925,7117,1535 AIDS-patients should have the obligation to participate in clinical trials GER01,43018,578070 USA208,5702051,5335 Pregnant women (HIV- positive/with AIDS) should be allowed to take drugs that are known to present a serious risk (e.g., stillbirth, malformation, handicap) for the unborn GER1,438,5732,8621,4335,7170 USA8,5725,7117,142,8645,7135 8,6% 25,7%

11. Back to the first page26.4.1999Prof. Dr. Stefan BorrmannPage 11 »Ethical Dilemmas in Social Work Practice« Personal Opinions about Selected Ethical Issues (in %) 1 Strongly agree 2 Agree 3 Neutral 4 Disagree 5 Strongly Disagree N Physicians should inform the spouses or partners of HIV- positive tested patients when the patients refuse to do so GER05,7122,8632,8638,5770 USA11,43208,5717,1442,8635 Physicians should inform the spouses or partners of HIV- positive tested patients when the patients refuse to do so AND when there are valid indicators that the patient will practice unsafe sexual practices in the future GER14,2931,4324,2917,1412,8670 USA22,8625,7128,57022,86 35 0% 5,7% 14,3% 31,4%

12. Back to the first page26.4.1999Prof. Dr. Stefan BorrmannPage 12 »Ethical Dilemmas in Social Work Practice« Personal Opinions about Selected Ethical Issues (in %) 1 Strongly agree 2 Agree 3 Neutral 4 Disagree 5 Strongly Disagree N Physicians should inform the spouses or partners of HIV- positive tested patients when the patients refuse to do so GER05,7122,8632,8638,5770 USA11,43208,5717,1442,8635 Physicians should inform the spouses or partners of HIV- positive tested patients when the patients refuse to do so AND when there are valid indicators that the patient will practice unsafe sexual practices in the future GER14,2931,4324,2917,1412,8670 USA22,8625,7128,57022,86 35 11,4% 20% 22,9% 25,7%

13. Back to the first page26.4.1999Prof. Dr. Stefan BorrmannPage 13 »Ethical Dilemmas in Social Work Practice« Perceived Ethical Dilemmas (in %) GERUSA Informed consent1516 Cultural competence of you or one of your colleagues6640 Competence of you or one of your colleagues40 Conflict of interest between you and your client2520 Conflict of interest between you and the agency you are working for3236 Conflict of interest between you and persons from other professions3456 Privacy and confidentiality2568 Access to records220 Sexual relationships to clients80 Sexual relationships to colleagues over whom you exercised prof. authority30 Clients who lack decision-making capacity4764 Billing2732 Unethical conduct of colleagues4764 N (Germany) = 194; multiple answers were possible, 59 of 70 participants responded N (USA) = 209; multiple answers were possible, 35 of 35 participants responded 34% 56% 25% 68% 2% 20% Conflict of interest between you and persons from other professions Privacy and confidentiality Access to records

14. Back to the first page26.4.1999Prof. Dr. Stefan BorrmannPage 14 »Ethical Dilemmas in Social Work Practice« Ways to Deal with Ethical Issues (in %) GERUSA Discussion with colleagues94,1288,57 Discussion with own family and friends36,7625,71 Discussion with supervisors54,4171,43 Using policies and procedures provided by the employer27,9454,29 Using the Code of Ethics of the DBSH / NASW10,2940 Consulting professional publications (i.e. handbooks, journal articles, or manuals)30,8837,14 Legal counsel23,5331,43 In-service training63,2431,43 Other10,292,86 N (Germany) = 239; multiple answers were possible, 68 of 70 participants responded N (USA) = 142; multiple answers were possible, 35 of 35 participants responded Discussion with own family and friends 36,7% 25,7%

15. Back to the first page26.4.1999Prof. Dr. Stefan BorrmannPage 15 »Ethical Dilemmas in Social Work Practice« Ways to Deal with Ethical Issues (in %) GERUSA Discussion with colleagues94,1288,57 Discussion with own family and friends36,7625,71 Discussion with supervisors54,4171,43 Using policies and procedures provided by the employer27,9454,29 Using the Code of Ethics of the DBSH / NASW10,2940 Consulting professional publications (i.e. handbooks, journal articles, or manuals)30,8837,14 Legal counsel23,5331,43 In-service training63,2431,43 Other10,292,86 N (Germany) = 239; multiple answers were possible, 68 of 70 participants responded N (USA) = 142; multiple answers were possible, 35 of 35 participants responded Using the Code of Ethics of the DBSH / NASW 10,3% 40%

16. Back to the first page26.4.1999Prof. Dr. Stefan BorrmannPage 16 »Ethical Dilemmas in Social Work Practice« Ways to Deal with Ethical Issues (in %) GERUSA Discussion with colleagues94,1288,57 Discussion with own family and friends36,7625,71 Discussion with supervisors54,4171,43 Using policies and procedures provided by the employer27,9454,29 Using the Code of Ethics of the DBSH / NASW10,2940 Consulting professional publications (i.e. handbooks, journal articles, or manuals)30,8837,14 Legal counsel23,5331,43 In-service training63,2431,43 Other10,292,86 N (Germany) = 239; multiple answers were possible, 68 of 70 participants responded N (USA) = 142; multiple answers were possible, 35 of 35 participants responded In-service training 63,2% 31,4%

17. Back to the first page26.4.1999Prof. Dr. Stefan BorrmannPage 17 »Ethical Dilemmas in Social Work Practice« Policies and Procedures of the Agency (in %) YesNoI am not sure N Does the agency you are working for have appropriate policies and procedures in place concerning employees' handling of boundary issues and conflicts of interest? GER52,9426,4717,6568 USA82,86017,1435

18. Back to the first page26.4.1999Prof. Dr. Stefan BorrmannPage 18 »Ethical Dilemmas in Social Work Practice« First Results l There were only minor differences in the personal opinions about selected ethical dilemmas of the social workers in Germany and the USA l There were similarities in the perceived ethical issues/dilemmas of social worker who work in the same field of action but mayor differences in the area of confidentiality occurred l The way professionals deal with ethical dilemmas however are raising questions about differences in social work education and the organization of the agencies themselves