This article was downloaded by: [Shanghai Jiaotong University on:23May2012,At:07:30 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House 37-41 Mortimer Street London W1T 3JH, UK Australian social work Publication details, including instructions for authors and AUSTRALIAN scription information: SOCIAL WORK http://www.tandfonline.com/loi/rasw20 There are no Answers, Only Choices: Teaching Ethical Decision Making it Social work Mel GrayE Jill Gibbons School of Social Sciences, University of Newcastle, Newcastle New South wales. Australia Available online: 01 Jun 2007 To cite this article: Mel gray &t Jill Gibbons(2007): There are no Answers, Only Choices: Teaching Ethical Decision Making in Social Work, Australian Social Work, 60: 2, 222-238 Tolinktothisarticlehttp://dx.doi.org/10.1080/03124070701323840 PLEASE SCROLL DOWN FOR ARTICLE Fulltermsandconditionsofusehttp://www.tandfonline.com/page/terms-and- conditions This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing systematic supply, or distribution in any form to anyone is expressly forbidden The publisher does not give any warranty express or implied or make any representation that the contents will be complete or accurate or up to date. The accuracy of any instructions, formulae, and drug doses should be independently verified with primary sources. The publisher shall not be liable for any loss, actions, claims proceeding demand,or costs or damages whatsoever or howsoever caused arising direct/yor indirectly in connection with or arising out of the use of this material
This article was downloaded by: [Shanghai Jiaotong University] On: 23 May 2012, At: 07:30 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK Australian Social Work Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/rasw20 There are no Answers, Only Choices: Teaching Ethical Decision Making in Social Work Mel Gray a & Jill Gibbons a a School of Social Sciences, University of Newcastle, Newcastle, New South Wales, Australia Available online: 01 Jun 2007 To cite this article: Mel Gray & Jill Gibbons (2007): There are no Answers, Only Choices: Teaching Ethical Decision Making in Social Work, Australian Social Work, 60:2, 222-238 To link to this article: http://dx.doi.org/10.1080/03124070701323840 PLEASE SCROLL DOWN FOR ARTICLE Full terms and conditions of use: http://www.tandfonline.com/page/terms-andconditions This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. The publisher does not give any warranty express or implied or make any representation that the contents will be complete or accurate or up to date. The accuracy of any instructions, formulae, and drug doses should be independently verified with primary sources. The publisher shall not be liable for any loss, actions, claims, proceedings, demand, or costs or damages whatsoever or howsoever caused arising directly or indirectly in connection with or arising out of the use of this material
Australian Social Work V.60,Na.2,June2007,pp222-238 R Routledge There are no answers only choices Teaching Ethical Decision Making in Social work Mel gray Jill Gibbons School of Social Sciences, University of Newcastle, Newcastle, New South Wales, australia Abstract In teaching students about ethical decision making in social work, it is essential that the students are able to recognise the moral implications of their work and develop a deep understanding about ethical issues and their personal responsibility for making ethical hoices. Thus, more than a how to do it"approach is needed and teaching students about values and ethics is an essential thread that runs through our experience-based social work education program. The present paper describes a learning unit that soug to teach students about ethical decision making as a critical thinking process and, in so doing, to integrate students'knowledge and experience of values, ethics, policy, and research in the final year of study. The relationship between values, ethics, policy, research, and social work practice provided an ideal context within which students could learn to integrate their knowledge and experience and apply it directly to their fieldwork practice. The paper ends with our critical reflection on this teaching experience and a critique of decisionism ethical frameworks Keywords: Ethical Decision Making Frameworks; Ethical Decision Making: Teaching Ethics Virtue ethics s not only the transformation of the public consciousness that we are interested in, but it's our own transformation as artists that's just as important. Perhaps a corollary is that community change can't take place unless it's transformative within us. That familiar line- I see the enemy and it is I"means that every prejudice, every misunderstanding that we perceive out in the real world is inside of us,and has to be challenged. (Allan Kaprow, cited in Lacy, 1995, P. 33) "This article was accepted under the editorship of Christine Bigby and Sharon McCallum. Correspondence to: Mel Gray, School of Social Sciences, University of Newcastle, Newcastle, New South Wales, Australia. E-mail: Mel Gray@newcastle.edu.au issN 0312-407X(print)/ISSN 1447-0748(online)@ 2007 Australian Association of Social Workers
There are no Answers, Only Choices: Teaching Ethical Decision Making in Social Work+ Mel Gray & Jill Gibbons School of Social Sciences, University of Newcastle, Newcastle, New South Wales, Australia Abstract In teaching students about ethical decision making in social work, it is essential that the students are able to recognise the moral implications of their work and develop a deep understanding about ethical issues and their personal responsibility for making ethical choices. Thus, more than a ‘‘how to do it’’ approach is needed and teaching students about values and ethics is an essential thread that runs through our experience-based social work education program. The present paper describes a learning unit that sought to teach students about ethical decision making as a critical thinking process and, in so doing, to integrate students’ knowledge and experience of values, ethics, policy, and research in the final year of study. The relationship between values, ethics, policy, research, and social work practice provided an ideal context within which students could learn to integrate their knowledge and experience and apply it directly to their fieldwork practice. The paper ends with our critical reflection on this teaching experience and a critique of decisionist ethical frameworks. Keywords: Ethical Decision Making Frameworks; Ethical Decision Making; Teaching Ethics; Virtue Ethics It’s not only the transformation of the public consciousness that we are interested in, but it’s our own transformation as artists that’s just as important. Perhaps a corollary is that community change can’t take place unless it’s transformative within us. That familiar line*‘‘I see the enemy and it is I’’ means that every prejudice, every misunderstanding that we perceive out in the real world is inside of us, and has to be challenged. (Allan Kaprow, cited in Lacy, 1995, p. 33). + This article was accepted under the editorship of Christine Bigby and Sharon McCallum. Correspondence to: Mel Gray, School of Social Sciences, University of Newcastle, Newcastle, New South Wales, Australia. E-mail: Mel.Gray@newcastle.edu.au ISSN 0312-407X (print)/ISSN 1447-0748 (online) # 2007 Australian Association of Social Workers DOI: 10.1080/03124070701323840 Australian Social Work Vol. 60, No. 2, June 2007, pp. 222238 Downloaded by [Shanghai Jiaotong University] at 07:30 23 May 2012
In the social work literature, ethical guidelines embodied in codes of ethics are said to provide the guidance needed when ethical dilemmas arise(Banks, 2001: Congress, 1999; Hugman Smith, 1995; Loewenberg, Dolgoff Harrington, 2000; Reamer, 1999; Rhodes, 1986; Rothman, 1998). However, this is only the tip of the iceberg, because ethical guidelines do not guarantee ethical social work practice (Gray, 1995; Rhodes, 1992). Social work education programs want to graduate students who take morality seriously, who take responsibility for moral action, who can demonstrate their commitment to ethical practice, and who have the awareness to recognise, and the expertise to work through, complex ethical problems. Field education placements provide rich and valuable experience on which to draw, as well as opportunities for direct application of new learning(Plath, 2004) A common purpose in social work is to teach students how to solve problems by c≥zom developing as full an understanding of the situation as possible through listening to the client's story, by helping clients to consider possible options for problem solving and anticipate the possible consequences of each option, and by enabling clients to choose a solution that best suits their needs and interests and those of others lved. However, we need to be careful not to overemphasise the rational aspects of ecision making to the detriment of other ways of knowing and gaining understanding. If we want to develop creative, imaginative practitioners, we need to avoid what Dreyfus and Dreyfus(1986)refer to as the Hamlet model of decision making: the detached, deliberate, and sometimes agonising selection among alternatives. This overemphasis on rational problem solving or decision making leads to the situation where students, and practitioners, want to be told how to do things wherein they are happy only when they are being given a well-defined structure within which to work. Although not overlooking the importance of the technological or skill dimensions of social work, we believe that an overemphasis on technical skills and models discourages students from thinking creatively By encouraging students to reflect on their values and commitments as well as their intuition and emotions, we lead them to exciting and perplexing discoveries about themselves and others Although rational decision making is important, ethical practice requires us to go beyond formulaic responses to become intuitive decision makers who know from experience that it is impossible to generate a complete list of options and to anticipate their consequences(Dreyfus Dreyfus, 1986). Essentially, problem solving is an interactional or dialogical process wherein discoveries are made. Thus, we also need to encourage students to respond intuitively and to reflect on the validity of their intuitions, as well as to draw on their experience and to incorporate situational and intuitive understanding into their reasoning processes More than this, we need to teach students to reflect on the way in which their reasoning, actions, and decisions are affected by their values, because without values the helping process becomes a rational-technical endeavor(Gray Askeland, 2002); without an understanding of the complexity and uncertainty of the helping situation, the"practical, problem solving perspectives of professional helpers may only prolong the false hope . that there is one rational solution to any problem"(Goldstein
In the social work literature, ethical guidelines embodied in codes of ethics are said to provide the guidance needed when ethical dilemmas arise (Banks, 2001; Congress, 1999; Hugman & Smith, 1995; Loewenberg, Dolgoff & Harrington, 2000; Reamer, 1999; Rhodes, 1986; Rothman, 1998). However, this is only the tip of the iceberg, because ethical guidelines do not guarantee ethical social work practice (Gray, 1995; Rhodes, 1992). Social work education programs want to graduate students who take morality seriously, who take responsibility for moral action, who can demonstrate their commitment to ethical practice, and who have the awareness to recognise, and the expertise to work through, complex ethical problems. Field education placements provide rich and valuable experience on which to draw, as well as opportunities for direct application of new learning (Plath, 2004). A common purpose in social work is to teach students how to solve problems by developing as full an understanding of the situation as possible through listening to the client’s story, by helping clients to consider possible options for problem solving and anticipate the possible consequences of each option, and by enabling clients to choose a solution that best suits their needs and interests, and those of others involved. However, we need to be careful not to overemphasise the rational aspects of ethical decision making to the detriment of other ways of knowing and gaining understanding. If we want to develop creative, imaginative practitioners, we need to avoid what Dreyfus and Dreyfus (1986) refer to as the Hamlet model of decision making: the detached, deliberate, and sometimes agonising selection among alternatives. This overemphasis on rational problem solving or decision making leads to the situation where students, and practitioners, want to be told how to do things wherein they are happy only when they are being given a well-defined structure within which to work. Although not overlooking the importance of the technological or skill dimensions of social work, we believe that an overemphasis on technical skills and models discourages students from thinking creatively. By encouraging students to reflect on their values and commitments, as well as their intuition and emotions, we lead them to exciting and perplexing discoveries about themselves and others. Although rational decision making is important, ethical practice requires us to go beyond formulaic responses to become intuitive decision makers who know from experience that it is impossible to generate a complete list of options and to anticipate their consequences (Dreyfus & Dreyfus, 1986). Essentially, problem solving is an interactional or dialogical process wherein discoveries are made. Thus, we also need to encourage students to respond intuitively and to reflect on the validity of their intuitions, as well as to draw on their experience and to incorporate situational and intuitive understanding into their reasoning processes. More than this, we need to teach students to reflect on the way in which their reasoning, actions, and decisions are affected by their values, because without values the helping process becomes a rationaltechnical endeavor (Gray & Askeland, 2002); without an understanding of the complexity and uncertainty of the helping situation, the ‘‘practical, problem solving perspectives of professional helpers may only prolong the false hope ... that there is one rational solution to any problem’’ (Goldstein, Australian Social Work 223 Downloaded by [Shanghai Jiaotong University] at 07:30 23 May 2012
224 M. Gray e J. Gibbons 1987, P. 184). When values are factored into the equation, a richness and complexity is added and students begin to understand that moral conflicts, by their very nature, defy"coherent explanations or plausible solutions"(Goldstein, 1987, p. 182) Combined with the ambiguity and uncertainty of human experience, helping mes centered on the critical choices that need to be made . [and our ation and responsibility to others"(Goldstein, 1987, P. 181; see also McBeath Web,2002) For students to appreciate the complexity of moral issues, it is necessary for them be able to accept and deal with uncertainty and ambiguity, and the absence of cookbook solutions, and to learn that when moral conflicts or ethical dilemmas arise, they can only be resolved through dialogue and a process of moral reasoning, where existing knowledge, theory, skills, values, and ethical guidelines are brought together to inform the decision making process. As Allen(1993)observed, moral decisions are made through active dialogue"(p. 46). She went so far as to say that it was the ethical responsibility of the clinician to behave in ways that maintain the dialogue and foster an atmosphere of respect for a multiplicity of views"(p. 38 ). To do this, students need to understand the role that their own values and beliefs play in this dialogue and the way in which they contribute to meaning-making around clients and their problems"(p. 39). They need to recognise too that judgments, assessments, or diagnoses are meanings and represent the values and cultural and gender biases of the dominant voices of the therapy world"(p. 40), as well as their own. They also need an understanding of the broader context in which the dilemmas arise and those affected by them. Thus, we have an ethical responsibility to extend our curiosity to the web of connectedness manifested in how clients perceive themselves, their lives, their problems, and their possibilities"(Allen, 1993, p. 47) This is why, when students are at the highest level of their learning in working with people, we also engage them in practising and reflecting on their ethical decision making, as well as their responsibilities to build knowledge and be accountable hrough social work research, and to participate in policy development and evaluation through policy practice Ethical Decision Making The Australian Association of Social Workers(AASW) Code of Ethics(AASw, 1999, Section 5.1) defines ethical decision making as a"process of critical reflection, evaluation and judgment through which a practitioner resolves ethical issues, problems and dilemmas"(p. 22). These can occur inter alia(a) when peoples interests conflict with one another, (b) when there is conflict between the workers professional values and those of the employing organisation and wider society, (c) when resources do not match client needs, and(d) when system demands for efficiency and outcome conflict with the workers' ethical responsibilities. There are many ethical decision making models in the social work literature, most of which follow a rational, problem solving framework, as mentioned previously (e.g
1987, p. 184). When values are factored into the equation, a richness and complexity is added and students begin to understand that moral conflicts, by their very nature, defy ‘‘coherent explanations or plausible solutions’’ (Goldstein, 1987, p. 182). Combined with the ambiguity and uncertainty of human experience, helping becomes centered on the ‘‘critical choices that need to be made ... [and our] obligation and responsibility to others’’ (Goldstein, 1987, p. 181; see also McBeath & Webb, 2002). For students to appreciate the complexity of moral issues, it is necessary for them to be able to accept and deal with uncertainty and ambiguity, and the absence of cookbook solutions, and to learn that when moral conflicts or ethical dilemmas arise, they can only be resolved through dialogue and a process of moral reasoning, where existing knowledge, theory, skills, values, and ethical guidelines are brought together to inform the decision making process. As Allen (1993) observed, ‘‘moral decisions are made through active dialogue’’ (p. 46). She went so far as to say that it was ‘‘the ethical responsibility of the clinician to behave in ways that maintain the dialogue and foster an atmosphere of respect for a multiplicity of views’’ (p. 38). To do this, students need to understand the role that their own values and beliefs play in this dialogue and the way in which they ‘‘contribute to meaning-making around clients and their problems’’ (p. 39). They need to recognise too that judgments, assessments, or ‘‘diagnoses are meanings and represent the values and cultural and gender biases of the dominant voices of the therapy world’’ (p. 40), as well as their own. They also need an understanding of the broader context in which the dilemmas arise and those affected by them. Thus, we have an ethical responsibility to extend our ‘‘curiosity to the web of connectedness manifested in how clients perceive themselves, their lives, their problems, and their possibilities’’ (Allen, 1993, p. 47). This is why, when students are at the highest level of their learning in working with people, we also engage them in practising and reflecting on their ethical decision making, as well as their responsibilities to build knowledge and be accountable through social work research, and to participate in policy development and evaluation through policy practice. Ethical Decision Making The Australian Association of Social Workers (AASW) Code of Ethics (AASW, 1999, Section 5.1) defines ethical decision making as a ‘‘process of critical reflection, evaluation and judgment through which a practitioner resolves ethical issues, problems and dilemmas’’ (p. 22). These can occur inter alia (a) when people’s interests conflict with one another, (b) when there is conflict between the worker’s professional values and those of the employing organisation and wider society, (c) when resources do not match client needs, and (d) when system demands for efficiency and outcome conflict with the workers’ ethical responsibilities. There are many ethical decision making models in the social work literature, most of which follow a rational, problem solving framework, as mentioned previously (e.g., 224 M. Gray & J. Gibbons Downloaded by [Shanghai Jiaotong University] at 07:30 23 May 2012
Congress, 1999; Hill, Glaser Harden, 1995; Loewenberg, Dolgoff Harrington 2000; Mattison, 2000; Robinson Reeser, 2000; Rothman, 1998 ). Within these models students, and practitioners, are(a) entreated to review the relevant code of ethics and know the applicable laws and regulations(Corey, Corey Callanan, 2003);(b) to reflect on their ethical preferences, isolate the ethical and technical aspects of the situation, and reflect on their choice of action(Mattison, 2000); (c)to Examine relevant personal, societal, agency, client and professional values, Think about what ethical standard of the relevant Code of Ethics applies to the situation, as well as about relevant laws and case decisions, Hypothesise about possible consequences of different decisions, Identify who will benefit and who will be harmed in view of social works commitment to the most vulnerable, and Consult with supervisor and colleagues about the most ethical choice( Congress's(1999) ETHIC Decision Making Model Chenoweth and McAuliffe(2005)observed that despite some merit in available ethical decision making frameworks, ethical dilemmas often masquerade as other things. In reality, problem solving is never a structured linear process of decision making: people are not always available for consultation and may not always give good advice; clients often do not understand the situation they are in; there is always the potential for unintended or unforeseen outcomes; and it may not always be possible to get all sides of the story. In reality, all we can do is work ith the incomplete information we have and do the best that we can. although we are expected to justify our actions drawing on available research(evidence), including agency policy and relevant ethical codes, ultimately ethical decisions are subjective and relational and depend very much on the situations in which they occur. They are complex. There are no right answers, only choices, and we are responsible for, and have to be able to live with, the decision or choices we make. Chenoweth and Mcauliffe(2005)believe that it is helpful to have a support network with whom to discuss ethical issues and reflection is critical. Every challenge creates opportunities for learning and for ones practice Learning Unit on Ethical Decision Making With this theoretical framework as a backdrop, the learning unit on ethical decision making will now be presented in the form that it is given to students However, before doing so, we want to draw attention to two important aspects of our pedagogical approach. First, we teach experientially through the medium of small groups, which Reisch and Lowe(2000)referred to as being especially useful for teaching material on ethics"(p. 27), and, second, students analyse an ethical dilemma drawn from their field experience, which, like Reisch and Lowe(2000) we have found to be a particularly useful teaching tool"(p. 28). The goals of the earning unit are to
Congress, 1999; Hill, Glaser & Harden, 1995; Loewenberg, Dolgoff & Harrington, 2000; Mattison, 2000; Robinson & Reeser, 2000; Rothman, 1998). Within these models students, and practitioners, are (a) entreated to review the relevant code of ethics and know the applicable laws and regulations (Corey, Corey & Callanan, 2003); (b) to reflect on their ethical preferences, isolate the ethical and technical aspects of the situation, and reflect on their choice of action (Mattison, 2000); (c) to Examine relevant personal, societal, agency, client and professional values, Think about what ethical standard of the relevant Code of Ethics applies to the situation, as well as about relevant laws and case decisions, Hypothesise about possible consequences of different decisions, Identify who will benefit and who will be harmed in view of social works commitment to the most vulnerable, and Consult with supervisor and colleagues about the most ethical choice (Congress’s (1999) ETHIC Decision Making Model). Chenoweth and McAuliffe (2005) observed that despite some merit in available ethical decision making frameworks, ethical dilemmas often masquerade as other things. In reality, problem solving is never a structured linear process of decision making; people are not always available for consultation and may not always give good advice; clients often do not understand the situation they are in; there is always the potential for unintended or unforeseen outcomes; and it may not always be possible to get all sides of the story. In reality, all we can do is work with the incomplete information we have and do the best that we can. Although we are expected to justify our actions drawing on available knowledge and research (evidence), including agency policy and relevant ethical codes, ultimately ethical decisions are subjective and relational and depend very much on the situations in which they occur. They are complex. There are no right answers, only choices, and we are responsible for, and have to be able to live with, the decision or choices we make. Chenoweth and McAuliffe (2005) believe that it is helpful to have a support network with whom to discuss ethical issues and reflection is critical. Every challenge creates opportunities for learning and for refining one’s practice. Learning Unit on Ethical Decision Making With this theoretical framework as a backdrop, the learning unit on ethical decision making will now be presented in the form that it is given to students. However, before doing so, we want to draw attention to two important aspects of our pedagogical approach. First, we teach experientially through the medium of small groups, which Reisch and Lowe (2000) referred to as being ‘‘especially useful for teaching material on ethics’’ (p. 27), and, second, students analyse an ethical dilemma drawn from their field experience, which, like Reisch and Lowe (2000), we have found to be ‘‘a particularly useful teaching tool’’ (p. 28). The goals of the learning unit are to: Australian Social Work 225 Downloaded by [Shanghai Jiaotong University] at 07:30 23 May 2012
226 M. Gray e /. Gibbons 1. Stimulate the moral imagination and to alert students to the ethical dimensions of social work theory and practice. 2. Apply critical thinking skills in identifying and dealing with ethical issues when they arise. 3. Develop a sense of moral obligation and personal responsibility for our value choices and the ethical decisions we make 4. Respond to ethical controversy and ambiguity and understand that, ultimately, ethical decisions result from the moral judgments we make The learning unit is taught over five 3-hour sessions. During these sessions, we locate values and ethics in social work practice, examine core social work values, the purpose and limitations of ethical codes, ethical dilemmas in social work, and ethical decision making. It must be emphasised that this learning unit is the culmination of teaching students about social work values in an integrated manner over the 4 years of the program, includes a course on ethics in second year taught by Session 1: Locating Values and Ethics in Social Work Practice In the first session, we encourage students to reflect on, and add to, their learning about social work theory on values through integrating ethics with social work practice (i. e, through connecting values and ethics to knowledge, theories, skills, practice, policy, and research). We want students to understand that intellectual knowledge alone cannot prepare them for the uncertainties and ambiguities of social work practice and will not be sufficient for the types of complex decisions they will have to make, especially when ethical dilemmas arise. Although often presented as a rational process, ethical decision making is a complex problem solving activity that requires the application of critical thinking, as well as the ar ability to make judgments on the basis of our knowledge, theories, practice experience, and values, not to mention those of the client involved. This requires a certain kind of understanding, not just rational-technical approaches( Schon, 983). We want students to learn to accept that things are not always black and white; there are many shades of gray( Gray Askeland, 2002), which is why a thorough understanding of the moral implications of what we do is needed, along with critical reflection on personal and professional values and the guidance of ethical codes. Through group discussion, we establish what the students already know about values and ethics, identify areas that they want to learn more about and conduct an exercise to help them articulate their values. In a sense, our values are our ideals, whereas our ethics guide us towards the achievement of these ideals. Codes of ethics are guides for practice. We examine the history of social work values and debate their universal nature and their applicability to diverse cultural contexts( Gray Fook, 2004; Gray, 2005). Finally, we link values to concepts of human rights and social justice, which, like codes of ethics, offer guidelines for
1. Stimulate the moral imagination and to alert students to the ethical dimensions of social work theory and practice. 2. Apply critical thinking skills in identifying and dealing with ethical issues when they arise. 3. Develop a sense of moral obligation and personal responsibility for our value choices and the ethical decisions we make. 4. Respond to ethical controversy and ambiguity and understand that, ultimately, ethical decisions result from the moral judgments we make. The learning unit is taught over five 3-hour sessions. During these sessions, we locate values and ethics in social work practice, examine core social work values, the purpose and limitations of ethical codes, ethical dilemmas in social work, and ethical decision making. It must be emphasised that this learning unit is the culmination of teaching students about social work values in an integrated manner over the 4 years of the program, which includes a course on ethics in second year taught by philosophers. Session I: Locating Values and Ethics in Social Work Practice In the first session, we encourage students to reflect on, and add to, their learning about social work theory on values through integrating ethics with social work practice (i.e., through connecting values and ethics to knowledge, theories, skills, practice, policy, and research). We want students to understand that intellectual knowledge alone cannot prepare them for the uncertainties and ambiguities of social work practice and will not be sufficient for the types of complex decisions they will have to make, especially when ethical dilemmas arise. Although often presented as a rational process, ethical decision making is a complex problem solving activity that requires the application of critical thinking, as well as the an ability to make judgments on the basis of our knowledge, theories, practice experience, and values, not to mention those of the client involved. This requires a certain kind of understanding, not just rationaltechnical approaches (Scho¨n, 1983). We want students to learn to accept that things are not always black and white; there are many shades of gray (Gray & Askeland, 2002), which is why a thorough understanding of the moral implications of what we do is needed, along with critical reflection on personal and professional values and the guidance of ethical codes. Through group discussion, we establish what the students already know about values and ethics, identify areas that they want to learn more about, and conduct an exercise to help them articulate their values. In a sense, our values are our ideals, whereas our ethics guide us towards the achievement of these ideals. Codes of ethics are guides for practice. We examine the history of social work values and debate their universal nature and their applicability to diverse cultural contexts (Gray & Fook, 2004; Gray, 2005). Finally, we link values to concepts of human rights and social justice, which, like codes of ethics, offer guidelines for 226 M. Gray & J. Gibbons Downloaded by [Shanghai Jiaotong University] at 07:30 23 May 2012
practice and are mainly enforceable to the extent that they are embodied in Session 2. Core Social Work values In the second session, we examine various value classification systems, such as those of Biestek(1961), Biestek and Gehrig(1978), Levy (1993), Pumphrey(1959),Reamer (1999)and Timms (1983). Students complete a values questionnaire on their own and then discuss the questions and their responses in small groups. The questions relate to (a)the values of social work and why they are important;(b) the difference between values and ethics; (c) ways in which we may encourage people to practice ethically; and(d)the he relationship between personal, professional, organisational, and social values. Working in their small groups, we ask students reflect back over the 3 years they have been studying social work and to consider the Have your values changed? If so, how? If not, what values have been confirmed? What do you see as the most important, pivotal, or even overarching values of ocial work? 3. What do you know about the history of social work values? 4. How have social work values changed or remained the same over the years? 5. What are the limitations of your knowledge about values? 6. Do you know how to apply your values in practice? Session 3: The Purpose and Limitations of Ethical Codes In the third session, we review different ethical codes(some different social work codes, and some codes from other disciplines)to identify the main tenets of the code, to establish how they embody the core values of social work, and to relate them to the ethical and legal duties of helping professionals, such as the duty of care, duty to respect privacy, duty to maintain confidentiality, duty to inform, duty to report, and duty to warn. Working in small groups, students review a different ethical code in social work, identify the main tenets of the code, establish how this differs from core values identified in the previous learning task, and connect the code to critical thinking. Thereafter, they work through a case example, usually a current australian story in the media with ethical overtones, using the codes, values, and critical thinking to reflect on the moral issues involved in this case situation. In reporting back, we draw their attention to the purpose of ethical codes as a means of ensuring that we are accountable for our actions and to protect client interests. We discuss the difficulties of using codes prescriptively, because they are only guides, and the importance of having an understanding of moral and ethical theory to help us identify the ethical aspects of the situations we encounter( Gray, 1995, 1996)
practice and are mainly enforceable to the extent that they are embodied in legislation and policy. Session 2: Core Social Work Values In the second session, we examine various value classification systems, such as those of Biestek (1961), Biestek and Gehrig (1978), Levy (1993), Pumphrey (1959), Reamer (1999) and Timms (1983). Students complete a values questionnaire on their own and then discuss the questions and their responses in small groups. The questions relate to (a) the values of social work and why they are important; (b) the difference between values and ethics; (c) ways in which we may encourage people to practice ethically; and (d) the relationship between personal, professional, organisational, and social values. Working in their small groups, we ask students to reflect back over the 3 years they have been studying social work and to consider the following: 1. Have your values changed? If so, how? If not, what values have been confirmed? 2. What do you see as the most important, pivotal, or even overarching values of social work? 3. What do you know about the history of social work values? 4. How have social work values changed or remained the same over the years? 5. What are the limitations of your knowledge about values? 6. Do you know how to apply your values in practice? Session 3: The Purpose and Limitations of Ethical Codes In the third session, we review different ethical codes (some different social work codes, and some codes from other disciplines) to identify the main tenets of the code, to establish how they embody the core values of social work, and to relate them to the ethical and legal duties of helping professionals, such as the duty of care, duty to respect privacy, duty to maintain confidentiality, duty to inform, duty to report, and duty to warn. Working in small groups, students review a different ethical code in social work, identify the main tenets of the code, establish how this differs from core values identified in the previous learning task, and connect the code to critical thinking. Thereafter, they work through a case example, usually a current Australian story in the media with ethical overtones, using the codes, values, and critical thinking to reflect on the moral issues involved in this case situation. In reporting back, we draw their attention to the purpose of ethical codes as a means of ensuring that we are accountable for our actions and to protect client interests. We discuss the difficulties of using codes prescriptively, because they are only guides, and the importance of having an understanding of moral and ethical theory to help us identify the ethical aspects of the situations we encounter (Gray, 1995, 1996). Australian Social Work 227 Downloaded by [Shanghai Jiaotong University] at 07:30 23 May 2012
228 M. Gray e /. Gibbons Session 4: Ethical dilemmas in Social work In the fourth session we learn about the nature of ethical dilemmas We review the most commonly encountered ethical dilemmas in social work practice and the extent to which the AASw Code of Ethics helps us to work through these dilemmas. Students identify ethical dilemmas they have encountered in their fieldwork practice. Drawing on their collective experience, they make a list of possible ethical dilemmas they have encountered grouped under the following headings 1. Confidentiality, privacy, and informed consent: Limits of confidentiality and privacy. 2. Self-determination and paternalism: Clients right to self-determination and deciding what is in the clients'best interest; that is, the appropriateness of paternalism, conflicts of interest and boundary issues, duty of care, and self- determination 3. Allocating resources: Ways to allocate limited resources and ethics inherent in eligibility for services 4. Laws, policies, and regulations: Conflicts between policy and professional values and bureaucracy and procedures that block access. 5. Research and evaluation: Issues of confidentiality, prevention of harm to research participants, respect for privacy, and protection of autonomy 6. Administrative practices: Ethics of whistle blowing and ethics in organisational practices. 7. Community practice: Conflicts between individual and collective interests, individual rights(entitlement), and the common good 8. Ethical dilemmas among colleagues: Dilemmas of reporting malpractice or unethical conduct We then discuss the way in which the AASw code provides guidance for practitioners faced with an ethical dilemma and compile a possible strategy for ethical decision making in social work. Finally, the groups present their strategies for ethical decision making to the class. Session 5: Ethical Decision Making In the fifth session, each group chooses a different strategy for ethical decision making. In this particular unit, the various ethical frameworks used included Congress(1999), Corey et al.(2003), Hill et al.(1995), Loewenberg et al.(2000) Mattison(2000), Robinson and Reeser(2000), and Rothman(1998). Thus, students gain an idea of the range of perspectives and emphases in the ever-increasing number of decision making frameworks that proliferate with each new text on ethics. For example, Loewenberg and dolgoff's model, which was first introduced in the early 1980s and is now into its sixth edition with Harrington, uses a priority ranking system with ethical rules and principles screens. Hill et al. (1995) provided a feminist
Session 4: Ethical Dilemmas in Social Work In the fourth session, we learn about the nature of ethical dilemmas. We review the most commonly encountered ethical dilemmas in social work practice and the extent to which the AASW Code of Ethics helps us to work through these dilemmas. Students identify ethical dilemmas they have encountered in their fieldwork practice. Drawing on their collective experience, they make a list of possible ethical dilemmas they have encountered grouped under the following headings: 1. Confidentiality, privacy, and informed consent: Limits of confidentiality and privacy. 2. Self-determination and paternalism: Clients right to self-determination and deciding what is in the clients’ best interest; that is, the appropriateness of paternalism, conflicts of interest and boundary issues, duty of care, and selfdetermination. 3. Allocating resources: Ways to allocate limited resources and ethics inherent in eligibility for services. 4. Laws, policies, and regulations: Conflicts between policy and professional values and bureaucracy and procedures that block access. 5. Research and evaluation: Issues of confidentiality, prevention of harm to research participants, respect for privacy, and protection of autonomy. 6. Administrative practices: Ethics of whistle blowing and ethics in organisational practices. 7. Community practice: Conflicts between individual and collective interests, individual rights (entitlement), and the common good. 8. Ethical dilemmas among colleagues: Dilemmas of reporting malpractice or unethical conduct. We then discuss the way in which the AASW code provides guidance for practitioners faced with an ethical dilemma and compile a possible strategy for ethical decision making in social work. Finally, the groups present their strategies for ethical decision making to the class. Session 5: Ethical Decision Making In the fifth session, each group chooses a different strategy for ethical decision making. In this particular unit, the various ethical frameworks used included Congress (1999), Corey et al. (2003), Hill et al. (1995), Loewenberg et al. (2000), Mattison (2000), Robinson and Reeser (2000), and Rothman (1998). Thus, students gain an idea of the range of perspectives and emphases in the ever-increasing number of decision making frameworks that proliferate with each new text on ethics. For example, Loewenberg and Dolgoff’s model, which was first introduced in the early 1980s and is now into its sixth edition with Harrington, uses a priority ranking system with ethical rules and principles screens. Hill et al. (1995) provided a feminist 228 M. Gray & J. Gibbons Downloaded by [Shanghai Jiaotong University] at 07:30 23 May 2012
perspective, although gendering an ethics of care and polarising male reason and feminine caring is discouraged" for it is not clear that caring qualities pertai properly only to women"(McBeath Webb, 2002, P. 1027). Robinson and Reeser (2000)advocate a least harms model, Mattison's(2000)"person in the process model emphasises the reflective cycle, and so on. We ask students to examine the differences and similarities between these models and their groups framework and others they have found themselves through their reading. a practitioner is invited to present students with information on setting work priorities, experiences of having a colleague practicing unethically, limits of confidentiality, conflicts between organisa- tional, professional and personal values, and case examples of situations where ethical dilemmas have arisen. Working in small groups, students apply theory to practice using a case example drawn from their field placement experience and consider the 1. Is this an ethical dilemma? 2. If so what is the ethical dilemma involved? 3. How do existing ethical frameworks help us deal with the dilemma? 4. What, if anything, does the code of ethics say about this dilemma? They then have to use all the knowledge they have learnt, including the ethical code, decision making frameworks, and their reading, to decide on an appropriate solution to a particular dilemma. They are asked to justify the analytical process they used to make this decision and to plan how they may act on the decision made. Finally, they are asked to reflect on the extent to which critical thinking, ethical codes, and ethical screens or decision making frameworks have helped them think through their dilemma. Usually the session ends with the lecturer analysing one of the dilemmas presented by the students to demonstrate how to integrate knowledge from various sources. There is always a relationship between the ethical material and policy whether agency policy or legislation relating to particular practice areas, such as child protection or aging The final assessment When we first began teaching this learning unit, the assignment(which constituted one of the assessment items for this course, the second being an essay on competing research models in social work) was conducted as an oral where students presented to two of their teachers who then engaged them in discussion about the case they had presented. More recently, we have made this into a written assignment in the belief that our students needed to be able to articulate their ideas in writing because our model of teaching provided ample opportunity for students to participate in small group discussions In their assignment, students are required to draw together their learning on values, ethics, models of ethical decision making, the social work code of ethics, and self-awareness about how their own values and experience influence their ethical
perspective, although gendering an ethics of care and polarising male reason and feminine caring is discouraged ‘‘for it is not clear that caring qualities pertain properly only to women’’ (McBeath & Webb, 2002, p. 1027). Robinson and Reeser (2000) advocate a least harms model, Mattison’s (2000) ‘‘person in the process’’ model emphasises the reflective cycle, and so on. We ask students to examine the differences and similarities between these models and their group’s framework and others they have found themselves through their reading. A practitioner is invited to present students with information on setting work priorities, experiences of having a colleague practicing unethically, limits of confidentiality, conflicts between organisational, professional and personal values, and case examples of situations where ethical dilemmas have arisen. Working in small groups, students apply theory to practice using a case example drawn from their field placement experience and consider the following questions: 1. Is this an ethical dilemma? 2. If so, what is the ethical dilemma involved? 3. How do existing ethical frameworks help us deal with the dilemma? 4. What, if anything, does the code of ethics say about this dilemma? They then have to use all the knowledge they have learnt, including the ethical code, decision making frameworks, and their reading, to decide on an appropriate solution to a particular dilemma. They are asked to justify the analytical process they used to make this decision and to plan how they may act on the decision made. Finally, they are asked to reflect on the extent to which critical thinking, ethical codes, and ethical screens or decision making frameworks have helped them think through their dilemma. Usually the session ends with the lecturer analysing one of the dilemmas presented by the students to demonstrate how to integrate knowledge from various sources. There is always a relationship between the ethical material and policy, whether agency policy or legislation relating to particular practice areas, such as child protection or aging. The Final Assessment When we first began teaching this learning unit, the assignment (which constituted one of the assessment items for this course, the second being an essay on competing research models in social work) was conducted as an oral where students presented to two of their teachers who then engaged them in discussion about the case they had presented. More recently, we have made this into a written assignment in the belief that our students needed to be able to articulate their ideas in writing because our model of teaching provided ample opportunity for students to participate in small group discussions. In their assignment, students are required to draw together their learning on values, ethics, models of ethical decision making, the social work code of ethics, and self-awareness about how their own values and experience influence their ethical Australian Social Work 229 Downloaded by [Shanghai Jiaotong University] at 07:30 23 May 2012
230 M. Gray e/. Gibbons decision making. By this time, students are expected to be aware of their lega responsibilities(they undertake a legal subject taught by the law faculty in their third year)and to have some experience of agency practice(they have completed two 50-day field placements by this stage; Plath, 2004). As an example of the way in which students fulfill this task, we now present a case example Case Presentation This case has been adapted from a lengthier assignment wherein the ethic arose while the student was on placement in a hospital setting. The client was Mrs Brown, an elderly woman hospitalised for a recent fall. The student was involved in to support her return home or to recommend a nursing hor ne c≥zom placement. The student identified the ethical dilemma as client safety versus client self-determination". In thinking critically about this ethical dilemma, the student turned to Rothmans(1998)and Mattison's(2000)ethical decision making frame- works, as well as her knowledge of (a) social work theory,(b) legal requirements, and (c) the AASw Code of Ethics, at the same time taking client, personal, social, and agency values into consideration. In so doing, the student recognised her need for knowledge pertaining to research on the impact of older people going home as against nursing home care, particularly information relating to (a) clients who remain at home in unpredictable conditions,(b) resources and services available in the home,(c)statistics on injuries to elderly people who live alone and on nursing home admissions,(d)adjustments of patients to nursing home settings, and(e)life satisfaction at home and in institutional settings(Rothman, 1998). In order to gain a deeper level of understanding, the student also thought it may be useful to explo the terms self-determination"and"client safety, to examine their meaning, the conditions in which they may be limited, and the values and laws that support them. Relevant social work the In applying structural social work theory to the case, the aim would be to support the client in taking control of her own social structures and promote an empowering outcome, such as supporting her to be self-determining and allowing her to come to the decision, agreement, or compromise about her situation rather than letting social constructions of her situation push her into a decision. The strengths perspective reminds us to focus on the client's strengths and to use her determination, (Saleebey, 1999). This may draw the worker into an advocacy role( Payne, 197? dependence, strong-spirited nature, and self-reliance as a source of empowermer There are many elements of grief and loss theory that are related to Mrs Browns experiences, including her loss of independence, autonomy, life style, experiences, social supports, freedom, and even loss associated with her mortality. It is important
decision making. By this time, students are expected to be aware of their legal responsibilities (they undertake a legal subject taught by the law faculty in their third year) and to have some experience of agency practice (they have completed two 50-day field placements by this stage; Plath, 2004). As an example of the way in which students fulfill this task, we now present a case example. Case Presentation This case has been adapted from a lengthier assignment wherein the ethical dilemma arose while the student was on placement in a hospital setting. The client was Mrs Brown, an elderly woman hospitalised for a recent fall. The student was involved in deciding whether to support her return home or to recommend a nursing home placement. The student identified the ethical dilemma as ‘‘client safety versus client self-determination’’. In thinking critically about this ethical dilemma, the student turned to Rothman’s (1998) and Mattison’s (2000) ethical decision making frameworks, as well as her knowledge of (a) social work theory, (b) legal requirements, and (c) the AASW Code of Ethics, at the same time taking client, personal, social, and agency values into consideration. In so doing, the student recognised her need for knowledge pertaining to research on the impact of older people going home as against nursing home care, particularly information relating to (a) clients who remain at home in unpredictable conditions, (b) resources and services available in the home, (c) statistics on injuries to elderly people who live alone and on nursing home admissions, (d) adjustments of patients to nursing home settings, and (e) life satisfaction at home and in institutional settings (Rothman, 1998). In order to gain a deeper level of understanding, the student also thought it may be useful to explore the terms ‘‘self-determination’’ and ‘‘client safety’’, to examine their meaning, the conditions in which they may be limited, and the values and laws that support them. Relevant Social Work Theory In applying structural social work theory to the case, the aim would be to support the client in taking control of her own social structures and promote an empowering outcome, such as supporting her to be self-determining and allowing her to come to the decision, agreement, or compromise about her situation rather than letting social constructions of her situation push her into a decision. The strengths perspective reminds us to focus on the client’s strengths and to use her determination, independence, strong-spirited nature, and self-reliance as a source of empowerment (Saleebey, 1999). This may draw the worker into an advocacy role (Payne, 1997). There are many elements of grief and loss theory that are related to Mrs Brown’s experiences, including her loss of independence, autonomy, life style, experiences, social supports, freedom, and even loss associated with her mortality. It is important 230 M. Gray & J. Gibbons Downloaded by [Shanghai Jiaotong University] at 07:30 23 May 2012
