“Ethical Dilemmas in Policy Implementation.”

    Review Policy Advocacy Challenge 13.5, “Ethical Dilemmas in Policy Implementation.” Policy Advocacy Challenge 13.5 Ethical Dilemmas in Policy Implementation Gretchen Heidemann, Ph.D., Suzanne Dworak-Peck School of Social Work at USC The Code of Ethics of the NASW outlines the ethical principles—ideals to which all social workers should aspire—and the ethical standards that are relevant to the professional activities of all social workers. Yet, despite these clearly articulated guidelines, ethical dilemmas frequently arise in practice. When it comes to implementing policy at the organizational, community, and even higher levels, social workers might face dilemmas in honoring client self-determination and honoring privacy and confidentiality. Let us consider a couple examples. Imagine you are a medical social worker at a private hospital. The hospital hires a new chief executive officer (CEO) who, for religious reasons, opposes abortions and institutes a hospital policy against performing abortions, providing abortion counseling, or even referring patients out to family planning clinics. Regardless of your own personal beliefs about abortion, as a social worker you are committed to honoring your patients’ selfdetermination. A young woman who has been raped comes to see you seeking a referral to get an abortion. Imagine you work at a homeless shelter. The well-intentioned director, who is not a social worker, implements a new policy barring any staff from reporting clients to children’s services without first consulting with her. She does this because she believes these families need to be protected against society’s stereotype of them as bad parents. One evening at the shelter, you witness a husband degrading and physically assaulting his wife in front of their two young children. The next day, you tell the director about the incident, and remind her that you are mandated (i.e., required by state law) to report abuse. She thanks you for bringing the attention to her concern, but the only action she takes is to have a conversation with the couple and ask them to keep their personal matters private. Over the next few days, you continue to witness abuse. Consider your options in both of these situations. What would you do? If you quietly make an exception for the patient in the first example, will you continue to do so—and risk getting dismissed—if you are confronted by other clients in similar circumstances? Would you resign? Would you form a team to confront the CEO and try to get the policy overturned? In the second example, knowing that the mandatory reporting laws are very clear and you could risk losing your license, do you report the family despite the agency policy? Do you try again to talk to the director and change her mind? Do you take the issue to the media and expose her, risking your own job? How far would you go to sabotage a policy you felt was unjust? Consider your options in both of the situations. What would you do? If you quietly make an exception for the patient in the first example, will you continue to do so—and risk getting dismissed—if you are confronted by other clients in similar circumstances? Would you resign? Would you form a team to confront the CEO and try to get the policy over- turned? In the second example, knowing that the mandatory reporting laws are very clear and you could risk losing your license, do you report the family despite the agency policy? Do you try again to talk to the director and change her mind? Do you take the issue to the media and expose her, risking your own job? How far would you go to sabotage a policy you felt was unjust? Next, think of an ethical dilemma you have experienced with in a field placement or another organization with which you are familiar, how did you handled the situation. If you had to do it over again, what, if anything, would you do differently?