Transcript Ethical and Risk-Management Issues in the Human Services

The Journal of Contemporary Social Services
Ethical and Risk-Management
Issues in Social Work:
Essential Knowledge
Frederic G. Reamer, Ph.D.
Professor, School of Social Work
Rhode Island College
Email: [email protected]
[email protected]  www.familiesinsociety.org  11700 West Lake Park Drive, Milwaukee, WI 53224
Phone: 414-359-1040  Fax: 414-359-1074
A publication of the Alliance for Children and Families
Core Knowledge
Ethical dilemmas
Ethical decision-making
Ethics risk management
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Potential Ethics Risks
Ethical mistakes
Deliberate ethical decisions
Ethical misconduct
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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
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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.”
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Standards of Care
Substantive standard of care
Procedural standard of care
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Consult colleagues and supervisors
Review relevant ethical standards
Review relevant laws, policies, and regulations
Review relevant literature
Obtain legal consultation, when necessary
Consult ethics committee, if available
Document decision-making steps
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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.”)
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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.
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Boundary Issues
Boundary crossings v. boundary violations
Types of dual or multiple relationships
 Intimate relationships
 Personal benefit
 Emotional & dependency needs
 Altruism
 Unavoidable & unanticipated
circumstances
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Ethics Committees
Advisory v. Deliberative
Functions
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Case Consultation
Retrospective
Concurrent
Prospective
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Policy review and formulation
Education & training
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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)
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Ethical Decision-making (cont’d)
Examine reasons for & against each possible
course of action, considering:
 Ethical theories, principles, guidelines
 Codes of ethics
 Legal principles
 Social work practice theory & principle
 Personal values (religious, cultural, ethnic,
political)
 Agency policies, regulations
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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
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Metaethics
Exploration of:
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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
Ethical theories & principles
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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.”)
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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.)
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Frederic G. Reamer, Ph.D.
Professor, School of Social Work
Rhode Island College
Email: [email protected]
The Journal of Contemporary Social Services
Additional Resources by Dr. Reamer:
 Nontraditional and Unorthodox Interventions in Social Work: Ethical and Legal Implications
Families in Society, 2006, v. 87, no. 2, page 191-197
 Ethical and Legal Standards in Social Work: Consistency and Conflict
Families in Society, 2005, v. 86, no. 2, page 163-169
Social Work Values and Ethics (3rd ed.). New York: Columbia University Press, 2006
Social Work Malpractice and Liability: Strategies for Prevention (2nd 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 (2nd ed.).
Washington, DC: NASW Press, 2006
The Social Work Ethics Audit: A Risk-management Tool. Washington, DC: NASW Press, 2001
[email protected]  www.familiesinsociety.org  11700 West Lake Park Drive, Milwaukee, WI 53224
Phone: 414-359-1040  Fax: 414-359-1074
A publication of the Alliance for Children and Families