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Eye on Ethics

Managing Complex Ethics — Social Work’s ‘Goat Rodeo’
By Frederic G. Reamer, PhD
September 2013

Last month, my wife and I attended a remarkably unusual concert at Tanglewood, the lovely music venue in the Massachusetts Berkshires. The concert was touted as the “Goat Rodeo Sessions” and featured famed cellist Yo-Yo Ma and several equally skilled musicians: Chris Thile, Edgar Meyer, and Stuart Duncan.

I had never heard the term “goat rodeo” and looked up its definition: a chaotic situation, often one that involves several people, each with a different agenda/vision/perception of what's going on; a situation that is very difficult, despite energy and efforts, to instill any sense or order into.

The image of a goat rodeo suggests chaos. But what Ma orchestrated with his colleagues from very different musical traditions (a mix of classical cello, bluegrass, and jazz) was anything but chaotic. Somehow these virtuosos managed to blend remarkably different musical genres. The product was stunningly beautiful music. On the surface, someone may have difficulty imagining how such different perspectives and musical languages could blend so seamlessly.

During the concert, it occurred to me that the metaphor of a goat rodeo aptly describes what I often experience when I try to manage challenging ethical dilemmas. Typically, an ethical dilemma invites differing perspectives in a common effort to reach a joint solution. The challenge, to push the goat rodeo metaphor, is to figure out how to blend these perspectives to produce a good outcome.

Bringing Order to Chaos
Imagine, for example, the diverse opinions social workers might bring to these ethical challenges:

• A social worker who has been employed full-time at a mental health center decided to take a leave of absence to parent her first child. The social worker was eager to continue her clinical work part-time and in a way that would accommodate her unpredictable schedule. The social worker explored developing a distance counseling practice where she would provide video and e-mail counseling to clients she never meets in person and who may live far away. The social worker was unsure about whether this is ethical.

• The director of a program within a family service agency that serves high-risk teenagers contacted a social work administrator at the agency. The program director explained to the administrator that one of the program’s clients, a 16-year-old girl, just disclosed to her clinician that she is struggling with substance abuse. The girl was eager to get help with her addiction issues. Despite the clinician’s efforts, the girl refused to authorize program staffers to disclose information about the girl’s substance abuse to her parents; she told her social worker she was “deathly afraid” of her parents’ reaction. The agency had a federal grant to provide services to adolescents with mental health and substance abuse challenges; thus, the agency did not need to bill the parents or their insurance companies. The clinician, program director, and administrator were unsure whether the agency could provide clinical services to the girl without notifying her parents or obtaining their consent.

• A social worker lived and worked in a relatively small town. She provided addiction counseling to people who live in the town and surrounding area. One of her clients was a 37-year-old man who struggled with clinical depression. One afternoon, the social worker, who is the parent of a nine-year-old boy, learned that her son had become quite friendly with the client’s son, a classmate. The social worker’s son, who was not aware of his mother’s professional relationship to the new friend’s father, asked his mother for permission to have his classmate spend a weekend night at the social worker’s home. The social worker was unsure how to manage the boundary and confidentiality challenge.

Of course, not all ethical issues are this challenging. Some ethical issues are relatively uncomplicated. No one debates whether it is appropriate for a clinical social worker to enter into a sexual relationship with a client, for a social work administrator to use agency funds for personal expenses, or for a program director to falsify data in a formal evaluation required by funding agencies. Clearly, these are unethical actions.

In recent years, social workers have paid considerable attention to ethical decision making, particularly in complex cases. Part of the challenge is that social workers often examine ethical dilemmas through different lenses, reflecting their diverse training, ideology, values, and professional experience. By way of analogy, social workers are like musicians from different genres who join forces to play a shared piece of music. In the end, it is essential for them to be on the same page.

Steps to Solutions
What steps must social workers take to coordinate their approach to ethical dilemmas? First, social workers must speak a shared vocabulary. Whether they are clinicians trained in different intervention models and methods, community organizers, programs managers or administrators, researchers, or policy professionals, social workers who put their heads together to address an ethical dilemma must grasp key ethics concepts and language. Ideally, all social workers would have a keen understanding of ethical theories, drawn from classic and contemporary moral philosophy, that can help them examine the strengths and limitations of ethics-related options.

Second, all social workers must be familiar with prevailing ethical standards, particularly those contained in prominent codes of ethics. Today’s codes of ethics are more detailed and comprehensive than those that were in effect when many current social workers completed their formal education. Contemporary ethics codes include explicit guidelines on a wide range of complex challenges related to, for example, confidentiality, informed consent, boundary issues and dual relationships, conflicts of interest, practitioner competence and impairment, unethical conduct, documentation, consultation and referral, supervision, termination of services, commitments to employers, resource allocation, labor-management disputes, evaluation and research, and social and political action.

Social workers also should be familiar with laws, regulations, and agency policies that are germane to some ethical decisions. Not all ethical dilemmas raise legal or policy questions; however, many do, particularly with respect to issues concerning privacy, confidentiality, and informed consent.

Perhaps the most important ingredient for social workers is their willingness and determination to consult with each other when they encounter challenging ethical dilemmas. Social workers who choose to perform solo in the face of ethics challenges often do so at their own peril. Consultation with colleagues increases the likelihood of a comprehensive assessment of all relevant issues. As the NASW Code of Ethics states, “Social workers should seek the advice and counsel of colleagues whenever such consultation is in the best interests of clients” (standard 2.05[a]).

Social work is a remarkably diverse profession. It is not unlike an orchestra that includes violinists, oboists, percussionists, bass players, harpists, cellists, bassoonists, and clarinetists. They are all musicians, but when they work together on a project, their remarkably diverse training and specialties require deliberate, purposeful collaboration and coordination. So, too, with social workers who face daunting ethical dilemmas.

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