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Transcript of Ethical Dilemma
Mayra Suarez Commitment to Clients
Termination of Services Ethical Dilemma 1.5 Self Determination
Obligation to Prevent Harm Ethical Issue Parties Involved:
18 yr old
Undiagnosed mentally disabled
Victim of sexual & physical abuse
Social Worker •It would be in Luisa’s best interested to accept serviced offered to her that would protect her from further rape and violence, however, Luisa refused services offered by agency. The social worker respects Luisa’s right of self-determination which is what is causing the ethical dilemma.
•Luisa’s communication problems, homeless lifestyle and undiagnosed mental limitations cause dilemma whether to intervene or honor her right to self-determination Person Responsible for Solving Ethical Dilemma: Social Worker Option #2 Social worker can honor Luisa’s self-determination which return to her to a high risk lifestyle which include homelessness, rape and violence. Courses of Action Option #1 Participants involved:
Social Worker and Luisa Social worker could encourage Luisa accept services and resources being offered to her. Participants involved:
Social Worker and Luisa Parties Involved Courses of Action Jane (made up name)
Resident of Rehabilitation Unit at Bethany Terrace
65 year old
Social Worker & Agency’s Administration at Bethany Terrace Bethany Terrace has a commitment to clients (Sec. 1.01) and due to that they would like to offer services that promote the well-being of their clients. Jane is a resident at Bethany Terrace who needs extensive medical care, however, Jane’s Medicare will soon be reach its 60 day limit and she has no other form of income to pay for the services at Bethany Terrace. Therefore, Bethany Terrace must decide if the Terminate Service (Sec. 1.16) after 60 days or if they should put their commitment to clients first and keep this patient in agency as a pro-bono because they do not take public assistance. Ethical Dilemma Responsible for Solving Ethical Dilemma Social worker and administrative staff at Bethany Terrace. Terminate Services & Removal of Property Continue Services Without Payment (Pro-Bono) Assist patient with public assistance application and refer her to agency that accept public assistance while application is still pending Gain: Agency does not use funds
Lose: Resident loses medical care and housing. Resident
Short and Long Term Benefits: Resident does not accumulate debt.
Short and long term consequences: Homelessness and lack of follow up medical care.
Short term consequences for agency: Possibility of resident tasking civil action
Long term consequences for agency: Loss of valued client and agencies medial facility rating could be affected. Agency
Short & Long Tern Benefits: Agency does not loose funds
Short & Long Term Consequences:
Short and Long Term Benefits: Does not accumulate debt and receives continuation of services at an agency that accepts public assistance
Short & Long Term Consequences: Resident's health condition could worsen without the proper medical care. Gain: Agency does not lose funds. Resident does not accumulate debt.
Lose: Resident loses elite follow up medical care. Decision that would cause the least harm is continuation of services. Assist resident with public assistance application and refer her to agency that accept public assistance while application is pending New Ethical Dilemma Undesirable Precedent: Terminating services due to lack of payment will set an undesirable precedent to possibly deny admission to potential residents with low or no sources of income and no Medicare. Other ethical dilemmas could arise surrounding transfer of resident to a difference agency. Resolution Consult anyone: At this time we do not feel we need to consult outside sources Monitoring: A one-time follow up of residents public assistance application
Evaluating outcome with agencies’ staff to discuss what could have been done differently. Monitoring & Evaluating Outcome Thank you for you attention! Agency
Long and short term consequences: Agency will use their own funds.
Short and long term benefits: Continuation of services at Bethany Terrace.
Resident will continue to receive elite medical care at no charge
Agency loses funds. Luisa
Short and Long Term Consequences: Luisa continues to live a high risk lifestyle and will continue to struggle for her safety unable care for herself
There are no benefits for Luisa in this situation unless Luisa accepts services. Luisa
Gain: Right to self-determination.
Lose: Protection from harm.
Lose: Loses the opportunity to service a member of the community in need. Luisa
Short and Long Term Benefits: Temporary and permanent housing, stability,security, and safety which would improve and maximize the quality of her lifestyle.
Short and Long Term Consequences: There are no consequences for Luisa because if Luisa accepts services the outcomes would only benefit her.
Short and Long Term Benefits: Luisa cooperates and accepts services offered and social worker gains the opportunity to work with Luisa.
Short and Long Term Consequences: There are no consequences for the social worker. Gain:
Luisa gains services that improve and maximize the quality of her lifestyle while also promoting her right to self-determination.
Neither one of the parties loses with this decision. When harm cannot be avoided the social worker would honor Luisa’s right to self-determination without encouragement or intervention. Resolution Monitoring
The social worker recognizes that the obligation to prevent harm must be primary, and thus encourages Luisa to accept services being offered to her, being careful to maximize opportunities for self -determination within these. Home visits (monthly)
Follow-up Calls (weekly) If good decision making is not encouraged we are setting undesirable precedent where Luisa will continue to make irresponsible choices without measuring the consequences. Seeking Exterior Advice NASW Code of Ethics. The obligation to protect life, an obligation that can be interpreted as protecting her safety, security, or as not obstructing her right to make life choices despite her mental limitations. We would seek consultation on the legal perspective; Social worker can refer Luisa to specialized resources for people with mental limitations (retardation) to ensure that her rights are protected or to initiate guardianship so she can have someone making decisions for her best interest. More ethical dilemmas could arise regarding Luisa’s personal choices and decisions pursing her own good because as a social service provider we are enabling dependency. Code of ethics also supports the social worker’s responsibility for promoting the general welfare of society (Sec. 6.01), which may be interpreted as the obligation to support the welfare of each of the members of the society as well.