Eye on Ethics

Revisioning Ethics Education in Social Work
By Frederic G. Reamer, PhD
Social Work Today
September/October 2006

Ethics education in social work has come of age. In recent years, undergraduate and graduate social work education programs and diverse continuing education programs have begun to offer increasingly ambitious, intensive ethics education. Prior to this development, during most of social work’s history, practitioners did not receive comprehensive ethics education. Most contemporary social workers concluded their formal education at a time when ethics education included relatively brief introductions to the profession’s core values and code of ethics.

Social workers in every practice setting have come to recognize the prevalence of complex ethical issues. Social workers in hospice programs are involved in clients’ and families’ difficult ethical judgments about terminating life support. Social workers in schools struggle with decisions about how much confidential information to share with teachers, administrators, and parents. Social workers in the military and correctional settings must make difficult judgments about whether to blow the whistle on colleagues engaged in ethical misconduct. Social workers in independent practice must decide whether to accept invitations to life cycle events they receive from clients and whether to terminate services to clients whose managed care benefits are exhausted. Social work administrators must make difficult ethical decisions about allocating limited resources when faced with severe budget cuts.

To meet the increasing demand for ethics education, undergraduate and graduate social work education programs have added content to existing courses (social work practice, social policy, human behavior, research, field education seminars); sponsored training for field instructors to enhance their ability to address ethical issues that arise during field placements; and offered semester-long required and elective courses on ethical issues. In addition, social work continuing education programs—sponsored by the National Association of Social Workers (NASW) and its chapters, colleges and universities, and private continuing education firms—now offer a wide array of ethics seminars and workshops. These ethics courses are available to social workers in increasingly diverse formats, including traditional seminar and workshop instruction and various forms of distance education, such as Internet courses, audio recordings, satellite broadcasts, and journal articles accompanied by continuing education examinations and credits.

Despite this proliferation of ethics education, the profession continues to search for a clear conceptual framework that practitioners and educators can use to design and teach their courses, workshops, and seminars. Ideally, comprehensive ethics education should address several key topics: professional and personal values, ethical dilemmas and ethical decision making, and ethics risk management.

Professional and Personal Values
Social work is arguably the most values-based helping profession. The NASW Code of Ethics includes an explicit statement of the profession’s core values that is unparalleled in other professions, such as psychology, counseling, marriage and family therapy, and psychiatry.

Clearly, one principal aim of ethics education is to convey social work’s core values to new and seasoned practitioners. Social workers must understand and commit themselves to the profession’s values of service, social justice, dignity and worth of the person, importance of human relationships, integrity, and competence (see the NASW Code of Ethics). Beyond instruction on social work’s core values, ethics education should focus especially on conflicts that may arise among social workers’ personal values, clients’ values, employers’ values, and the profession’s values.

Several issues warrant special attention. With regard to clients, social workers sometimes encounter clients whose values and behaviors seem immoral or abhorrent. Social workers may have strong reactions to clients’ moral judgments and behavior related to infidelity, parenting, sexual orientation, domestic violence, drug use, and compliance with the law. How social workers respond in these situations—whether they share their opinions with clients, attempt to influence clients, or withhold their judgments—depends in part on practitioners’ views about the role of their personal values.

Similarly, social workers may find that their personal values clash with the profession’s traditional values. A prominent example involves social workers who, for religious or other reasons, oppose abortion and cannot accept the NASW’s pro-choice position. In such instances, ethics education must be directed toward helping these practitioners resolve this conflict in a way that does not compromise clients’ interests or violate the NASW Code of Ethics.

Ethical Dilemmas and Decision making
Many ethical issues in social work involve conflicting professional duties and obligations—ethical dilemmas. In these instances, social workers must decide which duties and obligations take precedence. Typical ethical dilemmas involve tension and conflicts among social workers’ simultaneous yet incompatible duties; for example, protecting clients’ right to confidentiality and disclosing confidential information to protect third parties from harm; respecting clients’ rights to self-determination and protecting clients from injuries likely to result from self-harming, high-risk behaviors; treating clients equally and giving certain clients preferential treatment because of their dire circumstances or past discrimination; telling the truth and obtaining needed services for vulnerable clients by embellishing or falsifying reports to managed care organizations; obeying the law and breaking the law to meet clients’ needs; and protecting colleagues’ privacy and exposing their ethical misconduct. Another principal aim of ethics education should be to acquaint social workers with patterns of ethical dilemmas in the profession.

Ethics education should focus on several key aspects of ethical decision making: the role of ethical theory, ethical standards, and the process of ethical decision making. In recent years, ethicists in nearly all professions have developed decision-making frameworks and guidelines to assist practitioners who face ethical dilemmas. Since reasonable, thoughtful, and principled social workers can disagree about the ethical principles and criteria that ought to guide ethical decisions in any given case, no precise formula could exist for resolving ethical dilemmas unequivocally. However, ethicists generally agree that it is important to approach ethical decision making systematically and to follow a series of steps to ensure that all aspects of the ethical dilemma are addressed.

By following a series of clearly formulated steps, social workers can enhance the quality of the ethical decisions they make. Typical decision-making frameworks focus on the relevance of professional and personal values, cultural and social diversity, ethical theories, ethical standards, codes of ethics, and relevant statutes, regulations, and policies.

Ethics Risk Management
In addition to making sound ethical decisions to protect clients, social workers must also learn about ethics risk management—that is, how sound ethical decisions can prevent litigation and ethics complaints filed with licensing boards, the NASW, and other professional associations. Well-informed social workers should be familiar with key concepts related to professional negligence, malpractice prevention, standards of care, and their relevance to ethical decision making related to such phenomena as the management of confidential and privileged information, informed consent, conflicts of interest, dual relationships, and the termination of services.

Enduring Issues
There is no question that in recent years social workers have developed a more keen understanding of ethical issues and a richer grasp of the importance of ethics education. Ethics instruction in social work education programs, agencies, and continuing education venues has increased exponentially. Unfortunately, the conceptual development of ethics education curricula in social work has not kept pace with the proliferation of ethics instruction.

As a group, social workers have moved far beyond superficial instruction on social work ethics. No longer is the profession satisfied with education limited to cursory overviews of social work’s values and codes of ethics. There is every reason to believe ethics education in social work will continue to mature. The immediate task is to draw on social workers’ increasingly sophisticated grasp of ethical issues and current knowledge about effective pedagogy, and ensure that the profession’s practitioners have the benefit of rich, ambitious, and creative ethics education throughout their careers.

— Frederic G. Reamer, PhD, is a professor in the graduate program of the School of Social Work, Rhode Island College. He is the author of many books and articles, and his research has addressed mental health, healthcare, criminal justice, and professional ethics.