2. Karen Harper-Dorton
Doug Horner
Bill Dahlheim
Kelley Skinner
John David Smith
Holly Whitlock
The WV Social Work Education Consortium-SWEC

3. To review the major sections of the Social Work Code of
Ethics
To understand some of the legal precedents that
supercede the ethical standards and the tension
between the two
To learn a general decision-making model and an
ethical screen as a guideline for ethical decision-making
To apply ethical decision-making to a variety of practice
situations
To appreciate that in ethical decision-making there are
often unclear parameters surrounding the decision

4. Introductions and Overview for the Day


Review legal issues, ethical responsibilities to
clients, colleagues, practice settings, social work
profession, and broader society
Process of ethical decision-making
BREAK!


Dual relationships and NASW position on rural
social work
Film: Subtle Boundary Issues (Hazeldan)
LUNCH!

5. Ethics at Work






Decision-making model and value screen
Privacy and confidentiality
Conflict of interest, dual relationships, sexual
behavior
Informed consent and client self-determination
Impairment, incompetence, and unethical conduct
of colleagues
Best practices: De-escalation and termination
BREAK!

6. Case Examples
Case exercises
Post-test and feedback

8. Review legal issues,
ethical responsibilities to
clients, colleagues,
practice settings, social
work profession, and
broader society

9. Legal Precedents
DUTY TO WARN
CONFIDENTIALITY
MANDATED REPORTERS
MALPRACTICE

10. Legal Precedents
DEFAMATION
SOCIAL WORKER
PRIVILEGE
ENDING TREATMENT
RECORD KEEPING

11. Legal Issues
Disciplinary proceedings
What are some circumstances that call for
disciplinary proceedings by the SW
Board?

12. Legal Issues
What is the complaint process at your
organization?
What are the legal issues that you are
most concerned about in your practice?
What protections/safeguards do you have
in place or what preventative measures do
you employ?

13. Legal Issues

14. Legal Issues

15. When Do Clients Tend to Sue?
Disappointed with outcome of the
intervention
Believe they have been exploited or used
financially, emotionally, or sexually
Had a negative outcome and attributed it
to the social worker’s incompetence or
negligence
Presented with a bill larger or much later
than expected

16. What Constitutes Negligence,
Malpractice, and Liability?
Issues of “standard of care” – how would a
competent social worker behave in a
specific practice situation with children and
families?
Practice standards - predetermined best
practice standards - see NASW lists

17. Negligence
Defined as, “Performance outside of what
a reasonable professional in a similar
situation would do”. The four elements
that would be considered by the courts:

18. Negligence
Was there a legal duty to the client?
Was there a breach of duty through
action/inaction?
Was harm or damage incurred by the
client?
Was there causal connection between the
breach of duty and the resultant harm?

19. Types of Negligence
Acts of Commission or
Malfeasance-did; should not
have
Acts of Omission or
Nonfeasance-should have
done; did not

20. AVOIDING
MALPRACTICE SUITS
Purpose: to minimize the
possibility of being named in a
lawsuit alleging professional
negligence or misconduct.

21. Categories of Malpractice
Civil Lawsuits-potential monetary
damages
Criminal Complaints-potential criminal
sanctions such as probation and jail
Licensing Board Complaints-potential loss
of license to practice for varying periods of
time

22. In general, the plaintiff in a
successful malpractice suit must
prove four points.
The defendant (e.g., the social worker) was
obligated to provide the plaintiff with a
particular standard of care or professional
conduct.
The worker was derelict because he or she
breached that obligation (or duty) by some
act or omission that had a foreseeable
consequence.

23. Four points continued
The client suffered some injury or harm
(physical, financial, emotional, etc.)
The worker’s conduct was a direct or proximate
cause of the client’s injury or harm.

24. Risk Management
Licenses
Registrations in Order
Protocols for Emergency Situation
Insurance Coverage Paid
Maintenance and Safeguarding Client
Records
Specialist Consultants
Diagnosis and Treatment
Frederick G. Reamer. 2001. The Social Work Ethics Audit: A Risk Management Tool. NASW Press.
Tool.

25. Risk Management-cont.
Consultation with legal counsel
Second-Opinion Referrals
Ruling out Pathology
Psychological Testing
Appropriateness of Psychotropic
Medication
Continuing Education

26. Ethical Decision-making
The Social Work Code of
Ethics

27. Ethical responsibilities to:
Clients
Colleagues
Practice Settings
As Professionals
The Profession
The Broader Society

28. Values and Ethics
 What is the difference?

29. Values and Ethics
Values are concerned with what is good and
desirable
Ethics deal with what is right and correct
Ethics are rules of conduct to direct social
workers in a manner consistent with the
values of the profession

30. Values and Ethics
Social Work Values
1.
2.
3.
4.
All human beings deserve access to the resources they
need to deal with life’s problems and to develop their
potentialities
All human beings have intrinsic worth and dignity
The uniqueness and individuality of each person is of
value.
Given appropriate resources, human beings are capable
of growth and change and should be supported in
increasing their choices in solving their problems and
directing their lives

31. Primary goal is to help people in need & address social
problems
Challenge social injustice
Respect dignity & worth of the person
Importance of human relationships
Behave in a trustworthy manner
Practice in the area of competence and continue
professional development

32. Dual relationships
and NASW
position on Rural
Social Work

33. Dual Relationships
What are dual relationships?
The practice of assuming a second role with
a client
Examples?

34. Dual Relationships
The Code says…
“Social workers should not engage in a dual
or multiple relationships with clients or
former clients in which there is a risk of
exploitation or potential harm to the client”

35. Dual Relationships
When is a client not a client anymore?

36. Dual Relationships
and Rural Areas
Rural Policy Statement
Ethical practice in rural areas requires special
attention to the issue of dual relationships
They are unavoidable and need to be
managed

37. Dual Relationships
and Rural Areas
How do you keep professional and social
relationships separate or distinct?
What is the risk of working with someone
that you know through community
involvement?
How do you handle confidentiality and
conflict of interest?

38. Dual Relationships
and Rural Areas
What do you do when you see a client at
the store?
What if a client wants to give you a gift or
wants to barter for services?

39. Engaging in a
“Dual Relationship”
Entering a business relationship with a
current or former client
Participating in a romantic or a sexual
relationship with a current or former client
Establishing dual relationships with
instructor/students…in the field and in the
classroom

40. Next…LUNCH!

41. Decision-Making
Model and Value
Screen

42. Ethical Rules Screen (ERS)
Examine the Code of Ethics to determine if any of
the Code rules are applicable. These rules take
precedence over the worker’s personal value system.
One or more of the
Code rules apply:
Follow the Code rules.
The Code does not address
the specific problem, or
several Code rules provide
conflicting guidance:
Use the ethical principles screen.
Lowenberg, et al. 2005. Ethical Decisions for Social Work Practice, 7th Edition, F. E. Peacock

43. Ethical Principles Screen (EPS)
1.
Protection
of life
2. Equality and
inequality
3. Autonomy and freedom
4. Least harm
5. Quality of life
6. Privacy and confidentiality
7. Truthfulness and full disclosure
Lowenberg, et al. 2005. Ethical Decisions for Social Work Practice, 7th Edition, F.E. Peacock.

45. Values and Ethics

Managing Ethical Dilemmas
Right to life, health and well-being
Right of confidentiality
Right to life, health and well-being
Right to privacy or self-determination

46. Values and Ethics
Right of self-determination
Right to basic well-being
Right to basic well-being
Laws, policies, arrangements of organizations

47. Privacy and confidentiality
Conflict of interest, dual
relationships, sexual behavior
Informed consent and client selfdetermination
Impairment, incompetence, and
unethical conduct of colleagues

48. Confidentiality


Safeguarding confidentiality involves respecting
client privacy, gathering information only for the
purpose of providing effective services, and
disclosing information only with client consent
The Tarasoff case represents an example of the limits on
confidentiality.

49. Confidentiality
Limits-Supervision and consultation
Client waivers of confidentiality
Danger to self or others
Suspicion of child or elder abuse
Subpoenas and privileged communication

50. Failure to Maintain
“Confidentiality”
Often unintentional
Confidential nature of relationship and of the
information obtained in the relationship
Exception found in the “Duty to Warn”
*Threats of violence
*Threat is imminent
*Likelihood that threat will be carried out in
foreseeable future
*Victim(s) identified
Method? Motive? Opportunity?

51. Failing to Maintain “Accurate
and Complete Records”
Developing accurate assessments
Free of judgmental language and hear
say
Confidentiality guarded
Records document the service and
quality of care

52. 
Informed Consent
Informed consent:
requires Social Workers to clearly communicate
to a client(s) the purpose of the services, possible
risks related to the service, limitations of the
service, costs, alternatives to the service, clients’
right to refuse or withdraw consent, and the time
frame covered by the consent

53. Legal Responsibility to Obtain
“Informed Consent”
Clients right to expect the same degree of
competence as that provided by other
practitioners
Intended to guarantee clients’ freedom,
privacy, and safety
Including the use of audio or video taped
client sessions for course requirements

54. Self Determination
What is this again?

55. Self Determination
Self determination is the right of individuals to
exercise freedom of choice in decision-making

56. Conduct of Colleagues
What should you do if you suspect that a
colleague is in violation of an ethical principle?
Always get the facts (evidence, harm)
Options for next steps…See Code of Ethics-Section
2.11

57. Conduct of Colleagues
“Whistle-Blowing”
Reporting an ethical violation to outside authorities
When should this step be taken?

58. From: Gambrill (2002)

59. From: Gambrill (2002)

60. De-escalation and
Termination

61. De-escalation (handout)
What is it?
Decrease in intensity, magnitude or amount
What might it mean when engaging a
potentially violent child or parent?
What methods/techniques do you employ?

62. Termination of
Services (handout)
When is it necessary to terminate
services?
Examples?