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Learning about Ethical Decision Making

An e-Learning Module for Social Work Practitioners

What is this e-Learning Module about and what is it's purpose?

This module will explore ethical decision making from a theoretical perspective and present a case scenario for you to work through an Ethical Decision Making model.

The purpose of this module is to enhance your capacity for ethical decision making in practice as a part of your professional development.

How To

The sequence of this module has already been planned. All you need to do to work through this module is to press the right arrow key or space bar when you are ready to move onto each slide.

There will be prompts for moments of thought and reflection, we encourage you to take these.

Hello, Social Worker!

Welcome to Social Services!

There are a few things on today's schedule so grab a coffee and prepare for a busy day of reseach and case work.

First up on the agenda...

Your supervisor has asked you to read up on Ethical Decision Making Theory and a few specific Ethical Theories.

Time to get to work!

Ethical Decision Making Theory

Ethical Decision Making Theory

You start your reading this morning on Ethical Decision Making Theory...

Ethical decision making theory tells us that an ethical decision making model or framework will fall into two categories: rationalist and non-rationalist.

Markič, O. (2009). Rationality and emotions in decision making. Interdisciplinary Description Of Complex Systems, 7(2), 54-64.

Rationalist Models

Rationalist models will assume, explicitly or implicitly, that a reason-based process takes place to result in a moral judgement. A rationalist approach would see the decision maker attempt to resolve conflict through a logical, rational and deliberative cognitive process.

To do this, the decision maker would consider and weigh up various moral standards that may be in conflict with each other. Rationalist decision makers will acknowledge that intuition and emotion can play a role in ethical decision making, but would not let these factors determine the moral judgement.

Schwartz, M. (2016). Ethical decision-making theory: An integrated approach. Journal Of Business Ethics, 139(4), 755-776.

Non-Rationalist Models

A non-rationalist approach involves personal intuition, emotion and sentiment. A non-rationalist approach has been considered the sovereign approach when it comes to moral judgements. This intuitive process of moral reasoning is retroactive and can be described in layman's terms as a 'gut feeling'.

Intuitive moral reasoning has been said to be critically important to understanding people's behaviour. Philosophers suggest that individuals have an in-built sense of right and wrong, which is expressed through intuition in decision making processes. Non-rationalist models have been criticised for the involvement of emotions that are detached from rationality. It is important to note that not all intuitive judgements are charged with emotion, therefore some intuitive processes can be considered as rational.

Schwartz, M. (2016). Ethical decision-making theory: An integrated approach.

Journal Of Business Ethics, 139(4), 755-776.

Ethical Theories

Next, it's time for a little reading about Ethical Theories...

Ethical Decision Making models are also influenced by ethical theories.

Some more notable examples of ethical theories are deontology and utilitarianism.

Elements of these theories can be found within the Ethical Decision Making model that we will explore later in this module.

Deontology

Deontology

Deontology focuses on the correctness or wrongfulness of one's conduct when making a decision, rather than the outcome itself. This concept is most often considered when one acts from a set of guidelines or rules. The Hippocratic Oath (“First, do no harm”) is the most notable form of deontological ethics.

Filip, I., Saheba, N., Wick, B., & Radfar, A. (2016). Morality and ethical theories in the context of human behaviour. Ethics & Medicine: An International Journal Of Bioethics, 32(2), 83-87.

Utilitarianism

Utilitarianism

Utilitarianism is a form of consequentialism, where the decision maker will choose their course of action based on the greatest outcome for the most amount of people involved. The main concern with this concept is that the greatest outcome for all does not necessarily equate to the most moral action, for example the Holocaust. A result in happiness for most people is not decidedly a moral course of action either.

Filip, I., Saheba, N., Wick, B., & Radfar, A. (2016). Morality and ethical theories in the context of human behaviour. Ethics & Medicine: An International Journal Of Bioethics, 32(2), 83-87.

A quick note on moral philosophy

Moral philosophers have debated for centuries about virtues and values, rights and wrongs, justice and freedom. It is important to note that moral philosophy is influenced by cultural and world views.

'Moral realists' will often combine deontology and utilitarianism.

“Moral philosophy is dominated by the distinction between deontology, or the justification of actions that conform to a particular set of duties, and consequentialism, or the justification of actions that advance a desirable set of outcomes”.

Chenoweth, L., & McAuliffe, D. (2008). Locating the lighthouse: Values and ethics in practice In L. Chenoweth & D. McAuliffe (Eds.), The road to social work and human service practice (pp. 48-75). South Melbourne: Victoria.

Thomas, A. (2015). Deontology, consequentialism and moral realism.

An Open Access Journal of Philosophy, (19)1, 1-24.

Next on the agenda...

You have a brief discussion with your supervisor about what you've learnt so far about Ethical Decision Making.

They suggest you have a look at a Rational/Cognitive Ethical Decison Making Model...

Time to have a look for a model...

Rational/Cognitive Model

Rational/Cognitive Model

This e-Learning Module will explore a case scenario using Forester-Miller and Davis's 7 Step Model (1996), which is a Rational/Cognitive Model.

This seven-step rational model incorporates the work of Van Hoose and Paradise (1979), Kitchener (1984), Stadler (1986), Haas and Malouf (1989), Forester-Miller and Rubenstein (1992), and Sileo and Kopala (1993) to incorporate a practical and consecutive Ethical Decision Making model.

Forester-Miller, H. & Davis, T.E. (1996). A practitioner’s guide to ethical decision

making. Alexandria, Virginia: American Counseling Association.

1. Identify the Problem

In order to do this there needs to be as much information as possible that is both specific and objective. This information needs to outline the essential facts whilst eliminating judgement and assumptions. It is important to question whether the problem is ethical, legal, professional, or a clinical problem. Ethical problems are usually complex which means that it is important to explore the problem from numerous perspectives to avoid a one-dimensional solution.

2. Refer to relevant code of ethics and professional guidelines

2. Refer to relevant code of ethics and profession...

The reason this step is completed next is to clarify whether the AASW Code of Ethics (2010) addresses the ethical dilemma. In some cases, there will be an appropriate standard that addresses the dilemma and can resolve it. However, there will be cases in which the code of ethics does not have a standard to address the dilemma. In this instance, further steps in the ethical decision making process will need to be undertaken.

3. Determine the type and various dimensions of the dilemma

In this step, there are various factors that need to be explored so that the dilemma is examined in every aspect. To help guide this process, Forester-Miller and Davis have identified five main principles that should be considered.

Autonomy, which addresses the client's independence;

Nonmaleficence, the concept of not inflicting harm;

Beneficence, practitioner responsiblity to contribute to the welfare of the client;

Justice, being able to express the reasons why some are treated differently to others in relation to their own differences;

Fidelity, being loyal, trustworthy and advocating for your client;

In some instances, principles will conflict with others. In these cases, it is important to seek the guidance and perspective of other professionals.

4. Produce potential courses of action

Once the dilemma has been identified and examined, a variety of alternate actions need to be collated. In this step, it is useful to write these down and, if possible, ask for assistance to generate ideas.

5. Consider the potential consequences of all options and then choose a course of action

5. Consider the potential consequences of all options a...

After gathering alternate courses of action, the potential consequences of all options need to be considered and assessed. It is vital to think about the implications for each course of action for yourself as a practitioner, the client, and other individuals that will be impacted. As a result, it will be possible to eliminate some options that do not provide the anticipated outcomes or cause problematic results. Finally, review the remaining options to determine which option, or combination of options, best suits the situation and addresses the priorities that were previously identified.

6. Evaluate the course of action

This evaluation can be carried out by applying three simple tests to the chosen course of action to ensure that it is suitable. Firstly, the test of justice can be done by assessing whether you would treat others the same way in this situation. Secondly, the test of publicity which involves questioning whether this behaviour is something you would want reported in the media. Thirdly, the test of universality challenges you to question whether you would recommend that same course of action to another practitioner in a similar situation (Stadler, 1986). Throughout these three tests, if the course of action presents new ethical issues then the seven-step model will need to start again to assess the options and where the problem is stemming from. If each test is answered positively then it is time to implement the course of action.

7. Implement the course of action

The final step of this model focuses on strengthening the practitioner to allow successful implementation. It is important to follow up the situation to examine whether the course of action had the expected results and consequences.

How does the 7 Step Model relate to theory?

The 7 Step Model is a rationalist model as per Ethical Decision Making Theory.

This model can be considered predominantly Utilitarian in it’s quest to weigh up the consequences of courses of action.

However, it is important to note that elements of deontology can also be found in this model, particularly in Step 2, where the practitioner will refer to their Code of Ethics or Code of Conduct.

Broadly, we could consider that the model expresses a moral realist perspective by combining successful elements of each of the two notable ethical theories.

Now stop and take a moment to think...

You've had a big morning so far reading about theory, so you should take some time to have a think about what you've learnt.

What do you think about this Ethical Decision Making Model?

Do you think this would be helpful in your own practice to make decisions on ethical dilemmas?

Are there any gaps or issues that you can see within this model?

A critique of the 7 Step Model

A critique of the 7 Step Model

It is important to consider that no model or approach is 'perfect' and it is helpful to think about what gaps may exist.

The first critique of this model involves the incorporation of the code of ethics. This critique suggests that when practice is influenced by prescriptive and explicit codes the more generalised it becomes. Consequently, there is minimal involvement of personal values and philosophies. Therefore, the seven-step model raises concern due to the normalisation of using a code to advise practitioners of what to do in relation to ethical dilemmas (Bowles, Collingridge, Curry and Valentine, 2006). Furthermore, practitioners are working in an ethical way if they uphold personal and professional honesty alongside the best interests of the client (Van Hoose and Paradise, 1979).

However, by incorporating professional codes there is a risk of working in a normative relativism framework where a practitioner’s professional honesty is not considered (Bowles, Collingridge, Curry and Valentine, 2006). On the contrary, the seven-step model outlines that not all ethical dilemmas will relate to a standard within the AASW code of ethics in which case, the model will need to be continued to identify alternate options and select an alternate course of action (Forester-Miller and Davis, 1996).

In addition to the above, the second critique examines the fact that there are no cultural variables involved in this model (Garcia, Cartwright, Winston & Borzuchowska, 2003). This is contentious because the model has included the AASW Code of Ethics which states that a core social work value involves engaging in culturally sensitive practice by acknowledging the importance of culture (AASW, 2010). Therefore, by not including a cultural component in the model this reinforces the gap between the goal of educating culturally competent social workers and the ways in which culturally competent practice is measured (Soydan, 2010).

Australian Association of Social Workers. (2010). Code of Ethics. Retrieved from https://www.aasw.asn.au/document/item/1201

Bowles, W., Collingridge, M., Curry, S., & Valentine, B. (2006) Ethical practice in social work: An applied approach. Crows Nest: Allen & Unwin.

Garcia, J. G., Cartwright, B., Winston, S. M., & Borzuchowska, B. (2003). A transcultural integrative model for ethical decision making in counseling. Journal Of Counseling & Development, 81(3), 268.

Soydan, H. (2010). Anti-racist practice. In M. Gray & S.A. Webb (Eds.), Ethics and value perspectives in social work (pp. 135-148). Great Britain: Palgrave Macmillan.

Van Hoose, W.H. & Paradise, L.V. (1979). Ethics in counseling and psychotherapy: Perspectives in issues and decision-making. Cranston, RI: Carroll Press.

Next on the agenda...

Your supervisor has asked for your assistance with one of her current cases.

She is having some difficulty in making a decision in this particular case and thought it might be helpful to apply the 7 Step Model to gain a new perspective.

You have agreed to help her with the case and take the file back to your desk to work through the 7 steps.

Case Scenario...

Your supervisor is currently engaged with a family consisting of three self-placed children and a mother who is currently pregnant. Based on previous case management history a decision has to be made whether the child will be removed after birth or not, dependant on whether the mother is able to make significant changes in relation to drug and alcohol abuse, domestic violence, and the capacity to provide sufficient care and safety to the children in her care – particularly the new baby.

Some concerns...

The mother has been previously told of the required changes. She has not made these changes, but has expressed she still wants to maintain custody of her baby. The caseworker must decide whether to remove the child or not.

There is concern that removing the baby will have negative impacts on physical and psychological wellbeing for the three self-placed children and the baby due to domestic violence, drug and alcohol abuse, and parental capacity.

Practice Context

Practice Context

In an Australian context, the process of Child Protection and Child Removal would operate within Family and Community Services (FACS).

Section 25 of the Children and Young Persons Care and Protection Act, 1998 allows for prenatal reports to be made to FACS if there are concerns that an unborn child may be at risk of significant harm when born.

The purpose of allowing FACS intervention in this act is to allow the agency to provide assistance and support to the parent/s to reduce the likelihood of removal at birth.

New South Wales Government. (1998). Child and Young Persons Care Act. Retrieved from http://www.legislation.nsw.gov.au/#/view/act/1998/157/whole

In response to a pre-natal report, FACS caseworkers must al...

In response to a pre-natal report, FACS caseworkers must also consider if the reported concerns are relevant for existing children within the household.

In our case scenario, there are three self-placed children in the home. Based on the case history, what concerns might you have for their wellbeing?

Family and Community Services. (2011). Responding to Prenatal Reports Policy. Retrieved from http://docsonline.dcs.gov.au/__data/assets/pdf_file/0012/286779/responding_prenatal_reports_policy.pdf

If the Child Protection Helpline receives a pre-natal repo...

If the Child Protection Helpline receives a pre-natal report with any of the following high risk concerns, it must be forwarded to FACS for a response within 72 hours:

  • A child or young person under the parental responsibility of the minister is pregnant;
  • One or more sibling of the unborn baby has died (reviewable by the ombudsman) or has been taken in to care;
  • Ongoing substance abuse by the expectant mother;
  • The expectant mother is not, or refuses to seek help for a mental illness;
  • The expectant mother has attempted or threatened suicide;
  • Domestic violence is present within the household, where a serious injury has been inflicted, hospitalisation was needed or a weapon has been involved

Family and Community Services. (2011). Responding to Prenatal Reports Policy. Retrieved from http://docsonline.dcs.gov.au/__data/assets/pdf_file/0012/286779/responding_prenatal_reports_policy.pdf

Responding to Prenatal Reports Policy

Responding to Prenatal Reports Policy

The FACS Responding to Prenatal Reports policy provides guidelines to staff around early intervention practices to reduce the likelihood of a child being taken into care when they are born. The policy also provides guidance to prepare protective interventions where it is evident that the child will need protection after their birth.

Family and Community Services. (2011). Responding to Prenatal Reports Policy. Retrieved from http://docsonline.dcs.gov.au/__data/assets/pdf_file/0012/286779/responding_prenatal_reports_policy.pdf

Step 1: Identify the Problem

In order to identify the problem, Forester-Miller and Davis (1996) advise that you need to gather as much information as possible to inform the situation.

Think about, or go back to, the practice scenario...

Are there gaps in the information you have been given?

What would you like more information about?

What are you curious about?

Where could you go to find more information?

Questions we might ask...

  • What is the mother's relationship with the father?
  • What is the nature of the identified domestic violence?
  • What do we know/can we find out about the three self-placed children?
  • What are the health, wellbeing and resilience factors of the three self-placed children?
  • Are there concerns for mental health and wellbeing for the mother?
  • Are there cultural or spiritual factors that should be consider?

Ethical, legal or professional...

Forester-Miller and Davis (1996) advise that at this first stage, you will need to decide whether this dilemma is ethical, legal or professional.

The case scenario can be determined as an ethical dilemma, as it is complex and requires exploration for numerous perspectives to determine a course of action.

Step 2: Refer to relevant code of ethics and professional guidelines

Step 2: Refer to relevant code of ethics and profession...

“Social workers are encouraged to critically reflect on ethical dilemmas and make decisions about them whilst observing the values outlined in the code of ethics” (AASW, 2010, p 14).

In this context, it is important to consider the following relevant codes and guidelines for this case scenario:

AASW Code of Ethics

FACS Code of Ethical Conduct

FACS Care and Protection Practice Standards

Children and Young Persons Care and Protection Act 1998

Australian Association of Social Workers. (2010). Code of Ethics.

Retrieved from http://www.aasw.asn.au/document/item/1201

You should consider the Child and Young Person Care and Protection Act 1998, FACS Code of Conduct and FACS Care and Protection Practice Standards

Critical reflection is a vital element for ethical decision maki...

Critical reflection is a vital element for ethical decision making by social workers (AASW, 2010).

Reflective decision making requires:

  • Full and relevant information
  • Identify values or ethical concerns
  • Identify the range of decisions that could be made with consideration to theories, code of ethics, legalities, organisational policies and best practices
  • Identify risks and benefits for all parties involved in the decision

Australian Association of Social Workers. (2010). Code of Ethics.

Retrieved from http://www.aasw.asn.au/document/item/1201

Here, consider FACS practice standard 7 -Culturally responsive practice with diverse communities

Reflective decision making also requires...

  • Being transparent in practice
  • Cultural diversity considerations
  • Documenting the issues considered in the decision making process and outcomes
  • Critically reflect on personal and professional values

Reflective decision making also requires...

  • Being transparent in practice
  • Cultural diversity considerations
  • Documenting the issues considered in the decision making process and outcomes
  • Critically reflect on personal and professional values

Consider FACS practice standard 5 - Critical Reflection

Here, refer to FACS practice standard 10 - Documentation in casework

To review these relevant documents, follow the...

To review these relevant documents, follow these links...

AASW Code of Ethics

https://www.aasw.asn.au/document/item/1201

FACS Code of Ethical Conduct

www.facs.nsw.gov.au/coec (follow link for downloadable version)

FACS Care and Protection Practice Standards

https://www.facs.nsw.gov.au/__data/assets/file/0018/332244/practice_standards.pdf

Children and Young Persons Care and Protection Act 1998

http://www.legislation.nsw.gov.au/#/view/act/1998/157/whole

Step 3: Determine the type and

various dimensions of the dilemma

Step 3: Determine the type and

various dimensions of t...

In this practice scenario, the caseworker must make a difficult choice between two alternatives, both of which may have undesirable consequences. The first choice is to remove the baby from the mother immediately after birth, thereby reducing the risk of immediate harm but potentially damaging the child’s connection to their family. The second choice is to leave the baby in the care of the mother, which places the baby at increased risk of immediate harm but affords the family an opportunity to maintain a connection and reduces the risk of psychological or emotional upset associated with child removal.

When considering each of these options in accordance with the Forester-Miller and Davis Model (1996), applicable principles should be explored so that the dilemma is examined in detail. It is important to remember that individual views towards moral principles can often be subjective and conflicting. Practitioners should therefore consider the ethical and value frameworks of specific agencies and contexts, advice from experienced colleagues or supervisors, and relevant professional literature.

What to consider if you remove the child...

In this instance, the decision to remove the baby from the mother’s care can be viewed as morally correct as it upholds the moral principle of nonmaleficence by reducing the risk of immediate harm. This choice could also be viewed as upholding the moral principles of beneficence and justice as the motivation behind the decision is to improve the welfare of the child and upholds the child’s right to safety. As the child does not yet have independence or the capacity to make decisions, the principles of autonomy and fidelity are not applicable to the client. However, they should still be considered when determining the impacts of the decision on stakeholders, particularly the mother. In this instance, this choice could be viewed as a failure to uphold these principles as the mother has not been able to self-determine, and her decisions have not been advocated for during the child-removal process.

What to consider if you leave the child in parent's care...

In the second instance, the decision to leave the baby in the care of the mother could be viewed as a nonmaleficent and beneficent decision if the motivation is to avoid the psychological and emotional upset that can occur as a result of child-removal for all stakeholders, and to afford the child an opportunity to establish and maintain a connection with their family. If the mother’s wishes to keep the child are upheld in combination with intensive family support services, this decision could also be seen as upholding the moral principles of autonomy and fidelity as they recognise the stakeholders right to self-determination and advocate for their decision. However, it is important to note that while this decision may be made with the best of intentions, it is likely that the child would remain at risk of immediate and on-going harm and disadvantage. This could therefore be seen as a violation of the child’s right to safety and consequently a violation of the moral principles of nonmaleficence, beneficence and justice.

Step 4: Produce potential courses of action

In an Australian FACS context, there would only be two main courses of action that we could take:

A) Remove the child

B) Leave the child in parent's care

It is important to note that option A does have potential for restoration of the family if the parent wishes to partake in services provided by the organisation and is successful in their appeal.

Furthermore, if option B is taken, intensive family support will continue to be provided by the agency to ensure safety for all children in the mothers care.

Step 5: Consider the potential consequences of all options and then choose a course of action

Step 5: Consider the potential consequences of all options a...

Take a moment to think about the scenario and the two options you would have...

A) Removing the child

B) Leaving the child in parent's care

What would the risks and benefits of each option be?

The following slides will consider the risks and benefits of these options as suggested in academic literature...

Potential Consequences:

Option A) Removing the child

Potential Consequences:

Option A) Removing t...

Benefits:

  • Reduce risk of immediate harm - removing the infant from an abusive environment to avoid further exposure of physical abuse and neglect (Richards, 2011)
  • Provide appropriate safety and care - reducing the risk of significant harm. Removing the infant to provide a safe and nurturing environment (De Jong, 2016)
  • Evidence suggests that removal of the child will often outweigh the benefits of family preservation - higher levels of re-reports, multiple substations, multiple reunification attempts and instability in care for children result in higher levels of intergenerational dysfunction for children who get caught in the 'system' (Thomas, 2017)

De Jong, A. R. (2016). Domestic violence, children and toxic stress. Widener Law Review, 22(2), 201-213.

Richards, K. (2011). Children’s exposure to domestic violence in Australia, Trends & Issues in Crime and Criminal Justice,419, 1-7. Retrieved from http://www.aic.gov.au/media_library/publications/tandi_pdf/tandi419.pdf

Thomas, K. (2017). The Lost Children. Policy, 33(1), 16-21.

Potential Consequences:

Option A) Removing the child

Potential Consequences:

Option A) Removing t...

Risks:

  • Risk of harm in out-of-home care - this can effect the increase of adverse behavioural activities (Malvaso, & Delfabbro, 2015)
  • Loss of identity - the formation of identity is a crucial role in human development. Removal of children from their homes and family can further the potential risk of behavioural problems in the future (Nutton & Fast, 2015)
  • Trauma including associated attachment and behavioural conditions (Redd et al., 2017)
  • Bereavement - removal of the child can cause long-term impacts including depression and post-traumatic stress which can affect the whole family (Wickham, 2009)

Malvaso, C., & Delfabbro, P. (2015). Offending behaviour among young people with complex needs in the Australian out-of-home care system. Journal Of Child And Family Studies, 24(12), 3561-3569. http://dx.doi.org/10.1007/s10826-015-0157-z

Nutton, J., & Fast, E. (2015). Historical trauma, substance use, and Indigenous Peoples: Seven generations of harm from a 'big event'. Substance Use & Misuse, 50(7), 839-847.

Redd, Z., Malm, K., Moore, K., Murphy, K., & Beltz, M. (2017). KVC's bridging the way home: An innovative approach to the application of trauma systems therapy in child welfare. Children And Youth Services Review, 76, 170-180. doi:10.1016/j.childyouth.2017.02.013

Wickham, M. (2009). Who's left holding the woman?. Children Australia, 34(4), 29.

Potential Consequences:

Option A) Removing the child

Potential Consequences:

Option A) Removing t...

Broadhurst, K., Shaw, M., Kershaw, S., Harwin, J., Alrouh, B., Mason, C., & Pilling, M. (2015). Vulnerable birth mothers and repeat losses of infants to public care: is targeted reproductive health care ethically defensible?. Journal Of Social Welfare And Family Law, 37(1), 84-98. http://dx.doi.org/10.1080/09649069.2015.998007

Malvaso, C., & Delfabbro, P. (2015). Offending behaviour among youngpPeople with complex needs in the Australian out-of-home care system. Journal Of Child And Family Studies, 24(12), 3561-3569. http://dx.doi.org/10.1007/s10826-015-0157-z

O'Donnell, M., Scott, D., & Stanley, F. (2009). Child abuse and neglect: is it time for a public health approach?. Child: Care, Health And Development, 35(3), 434-435. http://dx.doi.org/10.1111/j.1365-2214.2009.00971_8.x

Risks, continued:

  • Increased risk factor for poor mental health in the removal of a child has serious consequences in an increase with drug and alcohol use and other serious health issues (Broadhurst et al., 2015)
  • Risk of systems abuse - defined here as the maltreament or injury to a child's social, physical, emotional or developmental welgare, in relation to the policies or program which are intended to provide care and protection (Malvaso & Delfabbro, 2015)
  • Research shows children being removed from their parents and positioned in multiple placements have a higher potential risk of damage (O’Donnell, Scott & Stanley, 2009).

Potential Consequences:

Option B) Leaving the child in parent's care

Potential Consequences:

Option B) Leaving the child ...

Fear, R. M. (2016). Attachment Theory. London: Karnac Books.

Grant, T., Huggins, J., Graham, J., Ernst, C., Whitney, N., & Wilson, D. (2011). Maternal substance abuse and disrupted parenting: Distinguishing mothers who keep their children from those who do not. Children And Youth Services Review, 33(11), 2176-2185. http://dx.doi.org/10.1016/j.childyouth.2011.07.001

Nutton, J., & Fast, E. (2015). Historical trauma, substance use, and Indigenous Peoples: Seven generations of harm from a 'big event'. Substance Use & Misuse, 50(7), 839-847.

Benefits:

  • Children keep identity - the formation of identity is a crucial role in human development. Removal of children from their homes and family can further the potential risk of behavioural problems in the future (Nutton & Fast, 2015)
  • Families remaining together encourages positive well-being for the baby/mother. This is demonstrated through the mothers/fathers wanting to achieve and maintain their recovery and benefiting from the ongoing relationship with the child; success is often shown when parent's work alongside social service providers who can encourage and help the families stay together (Grant et al., 2011)
  • Maintaining continuity of attachment - the strong emotional and physical attachment to at least one primary caregiver is crucial (Fear, 2016)

Potential Consequences:

Option B) Leaving the child in parent's care

Potential Consequences:

Option B) Leaving the child ...

Australian Institute of Family Studies. (2014). Effects of child abuse and neglect for children and adolescents. Child Family Community Australia. Retrieved from https://aifs.gov.au/cfca/publications/effects-child-abuse-and-neglect-children-and-adolescents

Richards, K. (2011). Children’s exposure to domestic violence in Australia, Trends & Issues in Crime and Criminal Justice,419, 1-7. Retrieved from http://www.aic.gov.au/media_library/publications/tandi_pdf/tandi419.pdf

Risks:

  • Increased risk of immediate harm - continuous exposure to domestic violence and alcohol abuse. Research suggests children exposed to abuse or neglect are often likely to be exposed to more than one type of abuse. Children who are exposed to multi-type abuse are more likely to experience high levels of trauma symptoms (AIFS, 2017)
  • May be subject to mental, physical, emotional harm - consider the potential psychological and behavioural consequences of a child being exposed to domestic and family violence such as depression, anxiety, trauma symptoms, increased aggression, antisocial behaviour, low self-esteem, impaired cognitive functioning, increased risk of substance abuse, eating disorders, suicide attempts and violence (Richards, 2011)

Potential Consequences:

Option B) Leaving the child in parent's care

Potential Consequences:

Option B) Leaving the child ...

Risks, continued:

  • Feeling or being told they are responsible for domestic violence behaviour (Richards, 2011)
  • Visual and physical exposure to violence - children may be used as a weapon, be subject to watch or partake in assaults, deal and cope with their own injuries (Richards, 2011)
  • Mothers experience grief and loss emotions from the impact of child removal - most mothers experience grief, trauma and depression; grief and loss emotions can be influenced from losses such as losing a bond with the baby, losing the status of mother or claims to motherhood and physically losing the presence of the baby in their life (Nixon, Radtke, & Tutty, 2013)

Nixon, K., Radtke, H., & Tutty, L. (2013). Every day it takes a piece of you away: Experiences of grief and loss among abused mothers involved with child protective services. Journal Of Public Child Welfare, 7(2), 172-193. http://dx.doi.org/10.1080/15548732.2012.715268

Richards, K. (2011). Children’s exposure to domestic violence in Australia, Trends & Issues in Crime and Criminal Justice,419, 1-7. Retrieved from http://www.aic.gov.au/media_library/publications/tandi_pdf/tandi419.pdf

Step 6: Evaluate the course of action

Forester-Miller and Davis advise that three tests should be applied to the ethical dilemma to determine whether the course of action is appropriate. We will apply these three tests to our potential courses of action - option A) removing the child or option B) leaving the child in parent's care.

Test 1: the test of justice. This is done by assessing whether you would treat others the same way in this situation.

Test 2: the test of publicity. This involves questioning whether this behaviour is something you would want reported in the media.

Test 3: the test of universality. This challenges you to question whether you would recommend that same

course of action to another practitioner in

a similar situation (Stadler, 1986).

Stadler, H. A. (1986). Making hard choices: Clarifying controversial

ethical issues. Counseling & Human Development,19, 1-10.

What would you answer to these three tests?

Take a moment now to stop and think about the practice scenario and what Forester-Miller and Davis (1996) have advised are the best three tests to decide on your ethical dilemma...

What would you answer to these three tests?

Do you think this is a fair, just and logical way to make a decision?

Option A) Removing the child

Option A) Removing the child

Test of justice: Yes. As a social worker, we would treat others the same in this situation because we have assessed that there is greater risk if the child remains in care. By removing the child in this situation we are advocating the child’s basic human right to a standard of living that is capable of meeting their physical and mental needs (UNICEF, 1996). Furthermore, we are upholding the AASW Code of Ethics, values and standards (2010), and the FACS Guidelines.

Test of publicity: Yes. This behaviour is something you would want reported in the media due to the role media has in practice, policy change, and the ways in which it influences public perception of child protection, all of which are powerful sources of change. The media influences further discussions amongst the public sphere and policymakers about public health issues. Consequently, the media can potentially influence policymakers on child protection issues and therefore the removal of the child is something you would want reported in the media (Weatherred, 2015).

Test of universality: Yes. This course of action would be recommended to another practitioner in a similar situation, given the social worker

is working with FACS, as child protection is mandated and

this decision is supported within FACS Guidelines.

Australian Association of Social Workers. (2010). Code of Ethics. Retrieved from http://www.aasw.asn.au/document/item/1201

UNICEF (1996). A simplified version of the United Nations convention on the rights of the child. Retrieved from https://www.unicef.org.au/Upload/UNICEF/Media/Our%20work/childfriendlycrc.pdf

Weatherred, J.L. (2015). Child sexual abuse and the media: A literature review. Journal of Child Sexual Abuse, 24(1), 16–34, DOI: 10.1080/10538712.2015.976302.

Option B) Leaving the child in parent's care

Test of justice: Would you treat others the same in this situation? It needs to be acknowledged that each situation varies depending on the child’s environment. However, it is not fair on the child to leave them in care that indicates risk and violates their rights to safety. The answer is no.

Test of publicity: Would you want this reported in the media? "A social worker has decided to not remove a child who is in a problematic environment where there is risk of physical and psychological harm". The answer is most likely no. Society would find this unacceptable as social work is a profession grounded in social justice and respect for persons which should work towards what is best for each child (AASW, 2010; UNICEF, 1996).

Test of universality: Would you recommend this to another practitioner? No, the risk is greater than benefit, restoration can occur after removal but harm to the child cannot be undone. In this situation, all decisions have been made in alignment with AASW Code of Ethics (2010), FACS Guidelines and

United Nations Convention on the Rights of the

Child (1996), which all social workers within

FACS use to inform their practice.

Australian Association of Social Workers. (2010). Code of Ethics. Retrieved from http://www.aasw.asn.au/document/item/1201

UNICEF (1996). A simplified version of the United Nations convention on the rights of the child. Retrieved from https://www.unicef.org.au/Upload/UNICEF/Media/Our%20work/childfriendlycrc.pdf

Weatherred, J.L. (2015). Child sexual abuse and the media: A literature review. Journal of Child Sexual Abuse, 24(1), 16–34, DOI: 10.1080/10538712.2015.976302.

Step 7: Implement the course of action

Following Forester-Miller and Davis's model (1996), you would have decided on your course of action at this stage and implement this in practice. As per Step 6, the three tests resulted in the best possible course of action to be removing the child.

This would be actioned as per the policies and procedures of the agency you are working within.

It is important to note that following up on the course of action is crucial in practice. Measures should be taken to ensure that the chosen course of action has the expected outcomes and consequences.

What are your thoughts...?

Now that you've worked through the 7 Step Model, what do you think of it?

Do you think that a rational/cognitive approach is appropriate for this scenario?

Do you think that this rational/cognitive approach would be appropriate in every situation?

Do you agree with the decision that was made by working through the model?

Thank you

The Ethical Decision Making component of this module is now complete.

The final component of the module will consider group work and making decisions as a team.

Group work in Ethical Decision Making and Social Work Practice

When in practice, you will undoubtedly work with and make decisions as a group. This group may be comprised of practitioners from the same field, or it could be an interdisciplinary team. However, in every group experience, it is likely that individuals will have very different personal values.

Think about a time when you have had to collaborate or make decisions as a group? What do you think worked well? What do you think made this difficult?

For example...

This module has been developed by a group of nine Social Work students all working towards a common goal.

Working as a team, we have been able to identify successful factors of our group work and where conflict has risen.

Existing strengths and skills of individual group members can encourage successful group work; conflict based on personal values and personalities can stall progress. Conflict does not neccessarily mean failure as a group, it can be a helpful learning experience for future practice.

What worked well?

Positive interdependence. Our group worked effectively by acknowledging the important of everyone's role within the team. This positive interdependence allowed our group members to discuss their concerns freely, particularly when we were each personally challenged with the case scenario (Johnson & Johnson, 2009).

Successful groups are formed naturally, respectfully and thoughtfully (Pullen-Sansfacon & Ward, 2014; Blumenfeld, Marx, Soloway & Krajcik, 1996). This group had all worked together on projects previously, meaning rapport and trust had already been built amongst members. This was expressed particularly well when personal challenges had impacted some group members. The group made conscious choices to value the group members who were impacted in their personal lives and respected the time needed.

Blumenfeld, P. C., Marx, R. W., Soloway, E., & Krajcik, J. (1996). Learning with peers: from small group cooperation

to collaborative communities. Educational Researcher, 25(8), 37–40.

Retrieved from http://www.jstor.org/stable/1176492

Johnson, D.W. & Johnson, F.P. (2009). Joining together: Group theory and group skills.

Upper Saddle River, N.J.: Pearson Education.

Pullen-Sansfacon, A. & Ward, D. (2014). Making interprofessional working work:

introducing a groupwork perspective.

British Journal of Social Work, 10, 1284-1300. doi:10.1093/bjsw/bcs194

What else worked well?

Effective communication. As Social Work students, we all value the use of effective communication (Parris, 2012). Particularly in a group on nine individuals, being respectful when having conversations, waiting for people to finish talking, not interrupting someone speaking and valuing all opinions are some forms of successful communication that have been identified as being beneficial to our group process (Seden, 2005).

There was particular emphasis on active listening when making decisions as a group. Considering multiple points of view is integral to group decision making, as we each bring personal values to the case (Trevithick, 2012b).

Parris, M. (2012). An introduction to Social Work Practice. Maidenhead: Open University Press.

Seden, J. (2005). Counselling Skills in Social Work Practice. Maidenhead: Open University Press

Trevithick, P. (2012b). Social Work Skills and Knowledge: A Practice Handbook.

Berkshire: Open University Press

What caused conflict?

The main cause of conflict that arose during the development of this Ethical Decision Making Module was the clarification of what the ethical dilemma actually was. The case scenario was inspired by real practice experiences, but has been adapted for the sake of the learning module. Attempting to clarify exactly what the dilemma was did cause some challenges within the group and stalled progress considerably as we struggled to make a decision as a group. One example of risk associated with this conflict is 'group think' (Day & Leggat, 2015). 'Group think' occurs when a group cannot make a decision and some are pressured into agreeing with the others. The concern with this phenomena is that the individuals pressured to agree will start to believe the decision that has been made is the right one while letting go of their own perspectives and opinions on the matter (Day & Leggat, 2015).

Leggat, S. G & Jepsen, D. M. (2015). Evidence-based practice In Day, G. A. & Leggat, S. G. (Eds.), Leading and Managing Health Services: An Australasian Perspective. (pp. 265-273). Port Melbourne, Victoria: Australian Cambridge University Press.

How to manage this conflict...

There are two methods we used to settle this particular conflict.

Silence and 'doing nothing' can be helpful when settling conflict and can mitigate any rushed or ill-informed decisions (Lindsay & Orton, 2008). In several instances of our group process, we had to agree to put our concerns and conflict 'on the shelf' and come back to it at another time, or another day. This strategy helped settle anxieties and stress that could have initially hindered the result of the project.

Secondly, we were able to resolve this issue using a direct whole-group approach in which we carefully examined and discussed written documents to clearly identify what the roles and responsibilities of each group member would be moving forward (Hadad & Reed, 2007). A direct whole-group approach is a preferred method as this style of mitigation does not split the group, nor locate the problem within any one person or persons (Lindsay & Orton, 2008).

Hadad, M. & Reed, M. J. (2007). The Post-Secondary Learning Experience. Canada, North

America: Nelson College Indigenous.

Lindsay, T. M. & Orton, S. (2008). Groupwork Practice in Social Work. Exeter,

United Kingdom: Sage Publications.

How else might you manage conflict?

Should conflict arise in a group situation, it is important to remember there are effective ways to manage them – and that this is not necessarily a sign that the group cannot function (Hadad & Reed, 2007). In fact, if the conflict is handled well it can improve group cohesion (Borg, Kembro, Notander, Petersson & Ohlsson, 2011). Moreover, if conflicts are able to be recognised as evidence that people are involved and excited about their work, and that they are showing a passionate commitment to what they are doing, groups may be able to view what has been a negative situation as an opportunity for developments and positive outcomes (Hadad & Reed, 2007).

Hadad, M. & Reed, M. J. (2007). The Post-Secondary Learning Experience. Canada, North

America: Nelson College Indigenous.

Borg, M., Kembro, J., Notander., Petersson, C., & Ohlsson, L. (2011) Conflict management in student

groups – a teacher’s perspective in higher education. Högre Utbildning, 1(2), 111-124.

Conflict management - Prevention

Conflict management - Prevention

Recognise skills and strengths; delegate work equally. When working in larger groups, identify and value the strengths of other members and delegate tasks from there. This tactic can minimise the domineering personalities from taking a controlling role and utilise the skills of those who may be more reserved (Trevithick, 2012a).

Prevent conflict by contructing a group agreement. Group agreements can prepare all members on the expectations of the group process and provide agreed upon mitigations for when conflict arises or expectations are not met (Borg et al., 2011).

Borg, M., Kembro, J., Notander., Petersson, C., & Ohlsson, L. (2011) Conflict management in student groups – a teacher’s perspective in higher education. Högre Utbildning, 1(2), 111-124.

Trevithick, P. (2012a). Groupwork Theory and Practice. In P. Stepney & D. Ford (Eds.), Social Work Models, Methods and Theories. (pp. 236-254). Lyme Regis, Dorset: Russell House Publishing.

Conflict management - Intervention

Reducing differences. Rather than succumbing to 'group think', it is advised that the more successful strategies for overcoming conflict is to meet in the middle (Carton & Tewfik, 2016). Consider your personal ideologies for why you are in favour of one choice over another; these underpinnings can help you to articulate your perspective and move towards a negotiated decision that works for all parties. Similarly, consider the unique relationship and similarities that all group members share (i.e. all Social Work students). Focus on a common bond can minimise perceived differences (Carton & Tewfik, 2016).

Tolerate differences. The strategy can involve tactics that encourage group members to value the strengths and skills of the individuals involved (Carton & Tewfik, 2016). Active listening, respect, empathy are all tactics that can promote tolerance and acceptence within a group. These tactics may start within a group agreement, but should be consistently acted on within the group process and in order to intervene in conflict management.

Carton, A. M., & Tewfik, B. A. (2016). Perspective-A New Look at Conflict Management in Work Groups.

Organization Science, 27(5), 1125-1141.

That brings us to the end of this learning module...

You have completed all components of this learning module.

We hope this experience has highlighted some key theoretical underpinnings of ethical decision making and enhanced your capacity for decision making, particularly in a group environment.

Credits

The module has been developed by the following Social Work students:

Amie Purcell, Tammie Ison, Sarah Quinlan, Kim Gallegos, Lauren Shoebridge, Mikayela Hill, Grace Sim, Karina Walker, Campbell Rodden

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