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Ethical Decision Making

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Leslie Shafran

on 25 March 2013

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Transcript of Ethical Decision Making

Mattison's Model Ethical Decision Making Class Discussion Model of Ethical Decision Making Chosen: Resolution Alternatives Ethical Relevance of CAS/other Laws, Regulations Why is this model appropriate for our service sector? Rationale for choosing this Model Ethical Dilemma Resolution of Resolution: Resolution Alternative #1 Resolution Alternative #2 Background Information & Case Details Separating Practice Considerations and Ethical Components Identifying Value Tensions Identifying Principles in the code of Ethics which bear on the Case Identifying Possible Courses of Action Assessing which priority/obligation to meet foremost Practice Considerations: Ethical Components: Family trust with client rapport children's safety and security first duty to report confidentiality to provide resources, services and opportunities for the overall benefit of humanity Mattison's Model
• Given that the code of ethics does not provide adequate guidelines to resolve ethical dilemmas fellow scholars Corey et al. (1998) too constructed an ethical decision making model constituting of eight hierarchical steps similar to Mattison’s - both provide a concrete step-by-step model for resolving ethical dilemma's • Moves from personal and subjective to ensuring ethical decisions are tied to reasoning and are connected to intellectual resources
• Encourages social workers to see how their personal & professional values/principles have influence over their ethical decision making • Develops insight into how these value patterns have a constant influence in the social workers responses to value conflict
• Increases awareness into how the values that influence ethical decisions in the past continue to take precedence in current and future decision making

• Clearly defined ethical model with Step by step approaches to analyze ethical dilemmas • Remind the social workers to be consconcerncious of their value preferences when engaged in the ethical decision making

• Assessment of the ethical with attention to identifying the value conflicts

• Opportunity to recognize ethical components as separate from the practical considerations

• Use of the value guide to determine which of the value should outweigh the others in importance

• Based on the values given priority, social workers can be informed about their value patterning

• Comparison of these value preferences with the choices that the social worker has made in the past & those in the future Dilemma References Mattison, M. (2000). Ethical decision making: The person in the process. Social Work, 45(3), 201-212. doi: 10.1093/sw/45.3.201 Corey, G., Corey, M. S., & Callanan, P. (1998). Issues and ethics in the helping professions Introduction
Therefore, flexibility by welfare officials and practitioners can go a long way towards meeting basic needs for clients. In the desire to promote bureaucratic efficiency, society advocates that agency rules are to be adhered to for maintaining order and achieving efficiency. Neither society nor particular institutions can have longevity if their rules, regulations and laws are not followed. However, in the welfare framework, these rules regulate the behavior of millions of people who lack the power and resources to change them.
1) Adhere to rules and regulations that might result in denial of benefits, or
2) to bend or circumvent the rules in order to meet the desperate needs of clients. An inescapable dilemma facing administrators and practitioners in public welfare agencies is whether to: This dilemma can also be represented as adhering to a policy of “less eligibility’ versus recognizing that “the levels of benefits are below the poverty line” even for people eligible for welfare benefits. The case presents an ethical dilemma because it involves a conflict of values for the practitioner in relation to a specific client Value Tensions Bureaucratic Values which restrict un-reimbursable services as much as possible through eligibility For Social Workers, the value tensions can be characterized, on a macro level, as the classic conflict between… Professional Values for which the tension concerns respecting a client’s self-determination and confidentiality & Tension Therefore... (Linzer, 1999) Loewenberg, & Dolgoff, 1992) How can a practitioner respect and uphold client self-determination and confidentiality when working with a client whose conception of what is good for him or her differs from that of the bureaucracy for which the social worker is employed? The point of contention for the social worker is: Linzer, N. (1999). Resolving ethical dilemmas in social work practice Loewenberg, F. M., & Dolgoff, R. (1992). Ethical decisions for social work practice Flexibility by welfare officials and practitioners can go a long way towards meeting basic needs for clients. Thus, using Decision Making we will endeavor to resolve this ethical dilemma without preconception or bias. Mattison's Model of Ethical Mom: Kids: Linda (37) Jake (7) Alex (9) Lena (10) Case: Linda and her children first became clients after Lena's teacher noticed that Lena was frequently without nutritious lunches, often picked up late from school and lacked appropriate winter clothing. Linda's Job: Linda works cleaning houses for cash while the kids are in school. Initial Observation: Aside from her obvious financial troubles, Linda's kids seem well cared for and she seems to be working hard to ensure that she is able to better provide for her children in the future. "Decisions regarding ethical questions are not made by social workers in an arbitrary manner; they are grounded in the conditions and factors related to the decision maker, the situational circumstances, and the process itself." (Mattison, 2000) "Client self-determination and the primacy of client interests" A desire to avoid paternalism versus Best interests of the client in the short-term Best interests of the client in
the long-term? Obligation to all clients equally Standards of care Consequences for the family Help Linda secure work so she can get off OW
•She may incur extra costs for child care as she would not be able to be home with the children when needed
•Full time work is scarce and hard to secure
•Many jobs require higher education which she may not have •If she was able to secure a permanent full time position of employment she would have a regular paycheck
•If she secured a full time job she would receive health benefits that would help her and her children Advantages:
Disadvantages: Try to find alternative resources that are not financial so that she doesn’t can quit her cash job. Resources such as the food bank, breakfast clubs, and clothing donations may be able to cover some of their basic needs.
• Food banks do not always provide fresh produce or overly nutritious food
• Each food bank have their own sets of rules around eligibility and obtaining assistance which she may not meet Advantages: Disadvantages: • The money saved on these resources would leave more money for her and her children Implications:

The implications for both of the alternate resolutions are that they both address the financial situation of the family but provide no resolution for the care of the children. If alternative resources are provided that do not cost money there is still no guarantee that she will not continue to work cash paying jobs. Intersectionality: Duty to report Obligation to the agency Dominelli, Li. (2002). Anti-Oppressive Practice as a Legitimate Concern of Social Work: in Anti-Oppressive Social Work Theory and Practice. Baines, D.(ed.). (2011). Doing Anti-Oppressive Practice: Social Justice Social Work, 2nd edition. Halifax: Fernwood books, Ltd. Papadaki and Papadaki, in their study on ethical decision making in Greece, cite the following as strategies employed to deal with ethical problems and dilemmas: (1) the search for charity funds and personal resources; (2) the neediest receive available resources; (3) pointing out clients uncovered needs; and (4) violating organizational rules and regulations that were viewed as unjust in order to cover clients' needs. (Papadaki & Papadaki, 2008) Yan (Zoe) Lin Leslie Shafran Imogen Mercer Samantha Woolnough Shuguan Sathiyaseelan Ehab Hussein
Advocate for equal treatment and protection under the law and challenge injustice

Demonstrate and promote honesty, reliability, impartiality and diligence in their professional practice

Demonstrate adherence to the values and ethical principles

Social workers may break confidentiality and communicate client information without permission when required or permitted by relevant laws, court order or this Code. Not To Report To Report Uphold the rights of clients to have access to resources to meet basic human needs

Responsibility to protect vulnerable members of society, such as children Bringing their knowledge and skills to resolve conflict and ssist those affected by conflict Social workers respect the client’s right to confidentiality of information shared in a professional context. Uphold the right of clients to be offered the highest quality service possible Social workers demonstrate transparency with respect to limits to confidentiality that apply to their professional practice by clearly communicating these limitations to clients early in their relationship. To Report To Not Report



The working relationship with the mother becomes hostile. An investigation will be made into her Ontario Works case and her assistance will be removed or suspended. The progress she has made in providing necessary care for her children is undermined. She feels disempowered and is very anxious about being able to look for employment and providing consistent childcare.
1. Discuss dilemma with supervisor
2. Discuss implications of client’s behaviour and impending disclosure with client, seek consent to discuss the matter with their OW case worker
(if she does not give consent then)
3. Call the welfare fraud hotline
4. Document events in case notes Benefits Costs

Promoting the law (Ontario Works Act) and working within the Code of Ethics. Loss of trust and rapport with client, and detrimental financial costs for all clients (mother and children) Projected Outcome
1. Discuss dilemma with supervisor
2. Discuss the possible consequences of client’s actions, and suggest resources for her to seek employment alternatives that she will feel comfortable reporting to Ontario Works
3. Do not document any disclosure of client receiving income that she does not report to Ontario Works Benefits Costs Projected Outcomes Trust is maintained and potentially strengthened with client, and upholding the Code of Ethics and the Child and Family Services Act
Privileging this client above other clients that may be in similar situations, but who are reporting all of their sources of income, and turning a blind eye to ‘fraud’ The trust and rapport is maintained with the client, she feels more confident that you have her and her children’s interests as your top priority. The client is open to receiving referrals for employment services that will help her seek full time employment. In the meantime her
additional finances help her to provide the necessary items for her children’s well being while also allowing her to be home when they are out of school.
To what extent is adhering to agency policy important to me?: Very important Critical Self-Reflection Working from an anti-oppressive approach framework I believe that the feminization of poverty and welfare reporting are forms of oppression that result from a patriarchal, neoliberal society
Am I willing to act outside of legal obligations? : Yes (adapted from Mattison, 2000) What are my personal beliefs?:

the expectations of welfare-to-work do not take into account single mother’s childcare responsibilities (Gaszo, 2007) Client Factors single mother, low income, at risk of having her children removed Do Not Report Personal Working from an anti-oppressive framework CAS (Child and Family Services Act)
Primary obligation is to act in the best interest of the children
support the autonomy and integrity of the family unit CASW & OCSW Code of Ethics primary obligation is to act in the best interest of the client (Gaszo, 2007) Mattison's Model of Ethical Decision Making Ontario Works Act *(1997). Ontario, Canada: Ministry of Community andSocial Services. Retrieved March 18, 2013, from http://www.elaws.gov.on.ca/html/statutes/english/elaws_statutes_97o25a_e.htm

Code of Ethics *(2005). Ottawa, ON: Canadian Association of Social Wrkers. Retrieved March 18, 2013, from http://casw-acts.ca/sites/default/files/attachements/CASW_Code%20of%20Ethics.pdf
Ontario Works Policy Directives* (2012). Ontario, Canada: Ministry of Community and Social Services. Retrieved March 18, 2013, from Code of Ethics and Standards of Practice Handbook 2nd Ed. *(2008). Toronto, ON: Ontario College of Social Workers and Social Service Workers. Retrieved March 18, 2013, from http://www.ocswssw.org/docs/codeofethicsstandardsofpractice.pdf Child and Family Services Act* (1990). Ontario, Canada: Ministry of Children and Youth Services. Retrieved March 18, 2013, from http://www.elaws.gov.on.ca/html/statutes/english/elaws_statutes_90c11_e.htm Child Welfare Anti-Oppression Roundtable. (2009). Anti-oppression and child welfare. *Ontario Association of Children Aid’s Societies Journal*,53(1). http://www.mcss.gov.on.ca/en/mcss/programs/social/directives/ow_policy_directives.asp You are a member of the Ontario Association of Social Workers working for Children’s Aid Society (CAS) Toronto, and your job primarily involves case management. One of your clients is a single mother of three young children who is struggling to find employment and is currently supporting her family on a low income. Children’s Aid Society became involved with this client
after a Toronto District School Board teacher called CAS and reported that the children were repeatedly, insufficiently dressed for the weather and without nutritious lunches. The following situation is presented as an ethical dilemma. As a case worker for CAS Toronto you are required to adhere to the agency’s
guidelines and are subject to the Child and Family Services Act (1997). You
find out that your clients is receiving Ontario Works, but in order to
improve the provision of care for her children, as per your direction as
her CAS caseworker, she tells you she has started working a cash paying job
‘under the table.’ She feels she is now able to better support her children
and her hours are flexible so she is no longer away from the home looking
for employment when they are out of school. You know that reporting would
have a devastating impact on your client, who would most likely lose the
financial support she needs to support herself and her children in order
for them to remain together as a family. Situation Practice Canadian Association of Social Workers, 2005 Code of Ethics
Value 1: Respect for Inherent Dignity and Worth of Persons
•Social workers uphold each person’s right to self-determination, consistent with that person’s capacity and with the rights of others

Value 2: Pursuit of Social Justice
•Social workers uphold the right of people to have access to resources to meet basic human needs.

Value 3: Service to Humanity
•Social workers promote individual development and pursuit of individual goals, as well as the development of a just society.

Value 4: Integrity of Professional Practice
•Social workers demonstrate adherence to the values and ethical principles of the profession and promote respect for the profession’s values and principles in organizations where they work or with which they have a professional affiliation.

Value 5: Confidentiality in Professional Practice
•Social workers respect the client’s right to confidentiality of information shared in a professional context.

Value 6: Competence in Professional Practice
•Social workers uphold the right of clients to be offered the highest quality service possible. Ontario College of Social Workers and Social Service Workers,
2008 Code of Ethics
1) A social worker or social service worker shall maintain the best interest of the client as the primary professional obligation

6) A social worker or social service worker shall protect the confidentiality of all professionally acquired information. He or she shall disclose such information only when required or allowed by law to do so, or when clients have consented to disclosure

(2)The additional purposes of this Act, so long as they are consistent with the best interests, protection and well being of children, are:

1. To recognize that while parents may need help in caring for their children, that help should give support to the autonomy and integrity of the family unit and, wherever possible, be provided on the basis of mutual consent. Children’s Aid Policy, Child and Family Services Act, 1990
1.(1)The paramount purpose of this Act is to promote the best interests, protection and well being of children. Other purposes Paramount purpose
14. (1) If an applicant, recipient or dependant fails to comply with or meet a condition of eligibility in this Act or the regulations, the administrator shall, as prescribed:
1. Refuse to grant assistance.
2. Declare the person ineligible for assistance for the prescribed period.
3. Reduce or cancel assistance or that part of it provided for the benefit of the person who has failed to comply.
4. Suspend assistance or suspend that part of it provided for the benefit of the person who has failed to comply.

“Aid and Abet: To help someone else commit a crime. An aider and abettor is a helper who is present at a crime scene but in a passive role, such as acting as a lookout.” Ministry of Community and Social Services, Ontario Works Act, 1997 9.7 Controlling Fraud Legislative Authority Sections 57, 58 and 79 of the Act. Application of Policy No person should knowingly obtain or receive assistance, or aid or abet another person to obtain or receive assistance to which they are not entitled. Failure to comply (Cornell, 2010) Cornell University Law School. (2010). Nolo’s Plain English Law Dictionary, Aid and Abet. Retrieved March 18, 2013, from http://www.law.cornell.edu/wex/aid_and_abet (Dominelli, 2002; Child Welfare Anti-Oppression Roundtable, 2009; Baines, 2011) Case 2:
Mother: age 36
-has difficulty with English literacy
-says she feels depressed
-was fired from her previous job How would your opinion alter if you knew these facts?
Case 1:
Mother: age 26
-each child has a different biological father
-not her first involvement with CAS
-will not disclose what her cash paying job is Do Not Report Personal Agency & Professional Priorities protecting the best interests of the individual a. Not having her OW suspended & b. Retaining custody of her children Positionality Applying AOP Practice to Systemic Marginalization As we know from Mattison, the ethical decision making process is shaped by the decision maker and thus the self is always implicated in ethical decision making. The AOP social worker must strive to balance the demands of agency and client but must always be critical of positionality to ensure that they strive to work against systemic oppression and the status quo. Decision making will always be influenced by the person in the practice . Critical self reflexivity allows the social worker to understand the context of the decision making process which then can allow them to recognize and account for the context of the client and the uniqueness of every situation. maintain rapport and trust with client Which of these strategies do you think applies in this case and how would you use it to assist Linda and her family? Implications for social work practice, especially within anti-oppressive perspectives (AOP) The child welfare system is implicated in the oppression experienced by such marginalized groups as single mothers, so AOP social workers must acknowledge structural barriers and attempt to dismantle systematic inequalities that underlie social injustice. Wanting to make a positive impact is admirable, but social workers employed by agencies that are endowed with state legal authority must recognize the power imbalance that is inherent in their worker-to-client relationships. AOP social workers need to address these power divisions and strive to have “power with” rather than “power-over” relationships with their involuntary service users. Combatting a history of paternalism, social workers in the child welfare system and similar institutions must treat the service user as the expert on their own life and promote empowerment to undo the stigma of parental failure and the binary of good versus bad. Challenging the status quo of such bureaucratic, agency policies that enforce these structural inequalities is necessary at times for social workers to adhere to the profession’s code to promote social justice and ensure every individual has equal access to resources. Papaaki Intersectionality is an essential component of social work however, for the sake of focusing exclusively on
thehical dilemma a thand, we will not be going into detail about the cleitns intersecting identities.
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