Ethical Decision Making in Social Work
Course Outline
- Cases and theories
- How to use this book
- Structure of the book
- Acknowledgements
Many cases social workers face present an ethical issue. How such a case is handled will either benefit or harm the persons involved, and so, for that reason alone, what a social worker decides to do in response to a case is an ethical decision.
The question is how best to help social workers and students to wrestle with the ethical aspects of social work practice. They need to make the best ethical decisions they can. There are two ways to proceed. We can study ethical theory and apply it to practice, or we can examine the practice to tease out the ethical issues involved. Each method has its advantages and its disadvantages.
In either case, we ought to resist the temptation to light upon one ethical theory as 'the best' and use it to answer all ethical problems that arise in practice. Such a method prescribes a clarity where often clarity cannot be achieved. The Code of Ethics of the National Association of Social Workers says that it does not specify which values, principles, and standards are most important and ought to outweigh others in instances when they conflict. Reasonable differences of opinion can and do exist among social workers with respect to the ways in which values, ethical principles, and ethical standards should be rank ordered when they conflict (Codes of Ethics, Purpose).
Appealing to one ethical theory as 'the best' will guarantee a rank ordering of ethical values and principles, but in doing so, we will lose the ethical ambiguities inherent in social work practice and obtain clear answers at the cost of misunderstanding the complexities that some ethical problems present to us. The Code of Ethics is clear again when it says that There are many instances in social work where simple answers are not available to resolve complex ethical issues (Code of Ethics, Purpose).
We have chosen to examine social work practice and tease out the ethical issues involved by using a method we call 'Tracking harms.' Among its other virtues, this option confronts the reader with real cases, gleaned from hours of interviews with social work practitioners. In each case, we put in what information the practitioner had. So one virtue, we found, is that the cases resonate with the experiences of practitioners.
Another virtue is that when used in a group or a class, the cases engender lively discussions about what ought to be done, and participants discover that what they think obvious others think wrong and that they will need to provide reasons for their views if they are to have a hearing.
It is helpful to have someone leading such a discussion, but the role should be primarily an organizer of others’ thoughts, writing on the board or for an overhead what is being discussed -- for instance, who is affected by the case. One can always intervene in the discussion when it seems to be going astray and say something like, ‘O.K. I’ve lost track of where we are here. I’m trying to write all this up on the board, but we were talking about such-and-such and now I’m not sure what we are talking about.’
Patience and a persistence in ensuring that the method is followed will almost always produce an answer from the participants -- whether they are experienced practitioners or students in social work. So the most difficult part for the discussion leader is to learn the right touch of deftness in figuring out when to say anything and then what to say.
One permanent feature of discussions about ethical issues is the underlying assumption, perhaps too often voiced, that ethics is just a matter of personal belief. 'No one has the right to tell me what to do, and I have no right to tell anyone else what to do.' That assumption is especially likely to be voiced when disagreement arises about what ought to be done.
But living by the creed of that assumption would undermine professional ethics. In becoming professionals, we agree to abide by the code of ethics of our profession. The codes do not assume that ethics is a matter of choice. They assume that sometimes there is a right and sometimes a wrong. For instance, we start Chapter I with someone telling you about a confidential case while both of you are standing in a line at a restaurant where others can overhear. The code of ethics prohibits such discussions, and they are wrong -- no ifs, ands, or buts.
Discussion of a case leads either to an answer or to the discovery of a conflict of values within the profession, a deep tension between, say, limiting a client's confidentiality and demonstrating a commitment to the client's well-being. We then have a case in which either of several responses is acceptable, with a recognition that we are in deep water. But even in such a case, participants come to see that ethics is not just a matter of personal belief. In such a situation, we are not free to believe what we wish. We must have reasons for our choice, reasons founded in the nature of the profession and in our commitment to its mission and goals. So if we must break confidentiality to protect a client, and we fear the loss of trust in the relationship in which we had confidentiality, we need to think through the full implications of taking the alternatives and make a decision based on our best judgment about what a social work practitioner ought to do in such a situation. That is what ethics requires -- that those whom we affect by our judgment can trust that we did what we thought was best in accordance with the goals and values of the social work profession.
So the discussion of a case which is interesting enough to generate lots of discussion may not lead to any clear resolution. Just as life sometimes does not provide us with all the facts we need to make a thoroughly informed decision, social work life sometimes provides us with competing values. But the model we propose does help us come to grips with cases that can seem incredibly messy and overwhelming upon our first encountering them.
We should mention another feature of our exposition which also mirrors life. We have made use of first person, second person, and third person pronouns, carefully switching between the three as the occasion requires. We may use 'we' when we think a value is fully shared or are speaking for an identifiable group. We use the third person when, for instance, we are trying to remind the reader of the kind of objectivity ethical decision-making requires. We may use the second person when we are trying to cajole the reader into adopting the point of view of a participant so as to more fully understand why the participant might have done what he or she did. Ethical decision-making is a peculiarly personal process. You must decide what to do, and if you decide not to do anything, you will have to live with what happens from your not deciding. In our use of pronouns, we are trying to engage each and every reader in that peculiarly personal way ethics requires.
We layout the method of tracking harms in Chapter 1, and Chapter 2 is devoted to detailing the crucial assumptions of our method -- the need for providing reasons in making a decision about what to do, the requirement that the reasons be of a specific kind, and so on.

About the Authors
Wade L. Robison, PhD
Wade L. Robison is the Ezra A. Hale Professor of Applied Ethics at the Rochester Institute of Technology. He received his Ph.D. in philosophy from the University of Wisconsin at Madison, with a minor in law. He directed a National Endowment for the Humanities Institute on David Hume at Dartmouth in 1990, has received several National Endowment for the Humanities fellowships, including a year-long fellowship in Political Science at the University of California at Santa Barbara. He was President of the International Hume Society for sixteen years and is active in Ethics Across the Curriculum at RIT and elsewhere. He has published extensively in philosophy of law, David Hume, and practical and professional ethics. His book Decisions in Doubt: The Environment and Public Policy (University Press of New England, 1994) won the Nelson A. Rockefeller Prize in Social Science and Public Policy. He has co-edited anthologies in medical ethics, business and professional ethics, and Hume, and his most recent book, with L. Reeser, is on Ethical Decision Making in Social Work (Allyn & Bacon, 2000).
Linda Reeser, B.A., M.S.W., PhD.
Education Ph.D., Bryn Mawr College
M.S.W., Temple University
B.A., Temple University
Dr. Reeser joined the School of Social Work faculty in 1981. She teaches courses in social policy, social welfare institutions, field education, and social change. She has published in the areas of professionalism, social activism, and social work ethics. Her interests include membership in professional and human service boards and community service. Her research interests are social work ethics, professionalism, activism, field education, and women's issues.
Learning Objectives
After completing this course you’ll be able to:
- Distinguish between ethical and legal dilemmas.
- Devise a method for determining ethically what we ought to do if we have an ethical dilemma.
- Provide examples of prudent and imprudent acts.
- Explain why appealing to a code of ethics does not resolve an ethical dilemma.
- Give an example of a valid argument.
- Explain why it is a mistake to rely solely on ethical principles to resolve ethical problems.
- Outline three steps in the method of tracking harms.
- Identify conditions that must be satisfied if someone is to be autonomous.
- Apply the Code of Ethics to a client’s right to self-determination.
- Identify professional and personal relationships which may pose conflicts of interest.
- Explain a professional’s obligation to serve a client competently.
- Distinguish among the issues of self-determination, confidentiality, and harm to others in any situation.
- Describe the inherent dangers of dual relationships.
- Deal with issues of diversity among clients.
Course Contents
- Ethics in Social Work: Tracking Harms
- Reasons for Acting
- Clients
- Relations Between Social Workers
- Agencies
- Justice
- Cases
- Additional Case Studies