Ethical dilemma(s) facing a social worker

Ethical Practice: For each of the ethical dilemmas outlined in Box 2.10, consider whether you would consult with colleagues. If so, what questions would you ask?

Case #1. A social worker employed in a county social services department as an eligibility worker has learned that local welfare reforms direct that she report any new children born to current welfare recipients. She fears that the new reporting requirement could prevent children born into welfare families from receiving income supports later in their lives. The worker is aware of the requirement that social workers should comply with the law. However, she is convinced that reporting newborns might preclude future essential services. The social worker also believes that the new regulations will create a new class of citizens (children born to welfare mothers) that might be discriminated against in various ways. She feels caught between complying with the law and ignoring the law to prevent what she views as likely injustice.
What is/are the ethical dilemma(s) facing the social worker?
Are these legitimate concerns? Why or why not?
As the social worker in this county agency, how would you respond in this situation? What A are your possible courses of action?
Case #2. A clinical social worker in a remote community trains paraprofessionals to do mental health counseling with members of their Asian, Pacific Islander, and Central American communities. She believes that well-trained paraprofessionals familiar with community members’ cultures and languages could broaden mental health services by bringing cultural depth in service to those communities. Months after those she trained began providing services, the state department that licenses her agency adopted new policies prohibiting unlicensed social workers from providing mental health counseling services. A regional department representative reports that he is considering filing a complaint against the social worker for facilitating the unauthorized practice of social work.
What do you see as the ethical dilemma here for the social worker? For the state department representative?
Which action would provide the best services to the clients? Why do you think so?
As the social worker at the agency, what would you do to protect your paraprofessionals and the services they provide to your clients?
As a state department representative (which may well be social worker too), on what ethical grounds can you feel justified in enforcing the law?
Is there a win-win solution to this dilemma? What do you think it might be?
Case #3. When a nonprofit hospital downsized, all social work positions were eliminated. The social workers were transferred to an affiliated home health care agency. The hospital then offered to contract with the home health social workers for the same work they had done previously for the hospital. At times, the social workers who do both hospital and home-based work experience conflicts of interest when faced with the need to refer hospital patients to home-based services. The social workers understand that they should not exclusively refer to the hospital’s home health care agency and that self-determination requires that patients have information about a range of available, appropriate services. But from the patient’s perspective, they also see that it would often be more desirable to be able to continue to work with the social worker who had been assigned during the hospitalization period. The hospital’s risk management officer has argued, however, that when patients choose their home health care agency, the same social worker should not continue to work with the patient because of the appearance of conflict of interest—that is, the social worker would receive compensation for services because of a referral he or she made.

If a patient chooses to continue with her hospital social worker as her home health social worker, is there really a conflict of interest for the social worker? If so, what do you believe the conflict to be?
What underlying social work values may be jeopardized in the above working arrangement?
Are there any standards of practice being violated in this working arrangement as set forth by the NASW Code of Ethics? Which one(s)

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