Eye on EthicsPrima Facie and Actual Moral Duties in Social Work Many years ago I read a slim book by Scottish moral philosopher Sir William David Ross, usually cited as W. D. Ross, The Right and the Good. Ross published this book in 1930, during social work’s early years and long before the emergence of the professional ethics field in the 1970s. Before the 1970s, the term “ethics” referred primarily to the relatively abstruse perspectives associated with Socrates, Plato, Aristotle, John Stuart Mill, Jeremy Bentham, Immanuel Kant, and Ross himself, among others. For centuries, these and other moral philosophers speculated about the meaning of ethical terms such as “good,” “bad,” “right,” and “wrong” (known in philosophical circles as metaethics) and proffered various moral theories with complex names such as teleology, act utilitarianism, rule utilitarianism, deontology, and the categorical imperative (known in moral philosophy as theories of normative ethics). Ross was born in Thurso, a small industrial, fishing, and tourist community in the county of Caithness on the northern coast of Scotland. In 1900 he was offered a lectureship at Oriel College, Oxford, a constituent college of the University of Oxford. Ross remained at Oxford for nearly 50 years, serving on the faculty and in various administrative positions, including Provost of Oriel College (from 1929 to 1947) and Vice-Chancellor of the University (from 1941 to 1944). In The Right and the Good—which I think has remarkable relevance to social work ethics—Ross distinguished between so-called prima facie and actual duties. Ethical challenges surface, however, when prima facie duties conflict, as they sometimes do. In social work, we sometimes encounter conflicts between the prima facie duty to protect client confidentiality and the prima facie duty to protect people, including clients and third parties, from harm. At times social workers must consider disclosing clients’ confidential information, without their consent, in order to protect third parties from harm (for example, when an unstable and impulsive client makes comments in a confidential counseling session that lead his social worker to conclude that the client may seriously injure his estranged partner in the very near future). Or a social worker may feel caught between a client’s prima facie right to self-determination and the social worker’s prima facie duty to protect the client from engaging in self-harming behavior. Conflicts among prima facie duties constitute ethical dilemmas, that is, conflicts among one’s moral duties and obligations. Actual Duties • A social worker at a mental health center, Melanie L., provided counseling to a single parent, Emily M. Emily was required by a local judge to receive counseling services at a mental health center. Emily’s case was in court because of allegations by the county child welfare agency that she neglected her 2-year-old child. For years Emily has struggled with depression and cocaine abuse. During one counseling session at the mental health center Emily disclosed to Melanie that the day before she left her child in the car while Emily visited a friend. Emily shared her distress about her poor judgment, particularly since the friend she visited is someone with whom Emily once used cocaine on a regular basis. The social worker, Melanie, reminded Emily that as a social worker she was obligated to comply with the state’s mandatory reporting law, which requires social workers to contact the county child welfare agency whenever they suspect child abuse or neglect. Emily pleaded with Melanie to not call child welfare officials. “You know how well I’ve been doing,” Emily said. “This was just a slip. It won’t happen again.” Melanie was caught between her prima facie duty to protect her client, including her confidentiality, and her prima facie duty to obey the state’s mandatory reporting law. • Roberto C. was a social worker in a community outreach program sponsored by a large agency that serves homeless people in a prominent Midwestern city. His duties include contacting and offering social services to people who live on the streets and have no permanent residence. Late one snowy winter night, when the temperature had dropped far below freezing, Roberto drove his agency’s van through a neighborhood and saw a man huddled in an alleyway for protection. Roberto approached the man, who was holding a large bottle of whiskey, and engaged him in conversation. Roberto, who has extensive training in engagement skills appropriate for this kind of situation, explained to the man that he was affiliated with a program that could arrange shelter and food. The man shooed Roberto away and muttered, “I don’t need no one. I hate those shelters. Just leave me be.” Based on his extensive experience, Roberto was concerned that the man might succumb to bitter weather and be seriously injured or die. Roberto felt caught between his prima facie duty to respect the man’s right to self-determination and his prima facie duty to assist vulnerable people in need. Prima facie duties are those duties social workers ought to perform, other things being equal. A principal challenge in social work, however, is that “other things” often are not equal. Moral philosophers refer to this as the ceteris paribus problem; ceteris paribus is Latin for “other things being equal.” Ross’s prescient conceptual framework anticipated these kinds of difficult moral choices faced by today’s social workers. Using Ross’s language, among the most daunting challenges social workers face is choosing their actual duty from among competing prima facie duties. In some instances choosing the morally right course of action is not difficult. Often, however, it is. And while we might yearn for formulaic algorithms that tell us what to do when prima facie duties conflict, and which option should take precedence, the hard reality is that very often reasonable minds can and do differ about the “right” course of action. What I have learned over the years is that hard moral choices resist easy solutions. That’s the nature of the enterprise. Ross understood this well. — Frederic G. Reamer, PhD, is a professor in the graduate program of the School of Social Work at Rhode Island College. He’s the author of many books and articles, and his research has addressed mental health, health care, criminal justice, and professional ethics. |