05-02-2005
Ethics: To Tell or Not to Tell—A Case Study
By: Lee J. Zook, Ph.D.
http://www.socialworker.com/home/Feature_Articles/Ethics/Ethics%3A_To_Tell_or_Not_to_Tell%97A_Case_Study/
I’m telling! This article is called Ethics: To Tell or Not to Tell—A Case Study. Its by Lee J. Zook. This article was published in the winter of 2001. This article is about Lee J. Zook and a person she calls “Mary Jones”. Some of the topics that was discussed are some years ago, prior to teaching in undergraduate social work, I was working with families and children in an outpatient psychiatric setting, Children’s Agency. In the previous year, I had completed my MSW, having practiced social work several years with an undergraduate degree. The Director of Social Services at the Children’s Agency was my supervisor. We used a team model in our work, with any particular team consisting of at least a social worker, a psychologist, and a psychiatrist. Sometimes other professionals, such as educational specialists, early childhood development specialists, and social group workers were also on the teams.
While I was at Children’s Agency, Mary Jones (a fictitious name) applied for a job as a social worker. Four years earlier, I had seen Mary as a client while working for an emergency service at Adult Hospital, a psychiatric facility for adults. She came to be admitted to the hospital as her psychiatric condition was deteriorating. Mary told me she was a social worker with an MSW and had been in and out of psychiatric hospitals for many years. I located her chart, noted that she was previously diagnosed with schizophrenia, undifferentiated type, did the basic paperwork that social workers did on admission, consulted with the admitting psychiatrist, and took her to the hospital ward. It was a rather simple, routine admission; there were no police or court documents, and she was a voluntary client. However, the situation was a bit unsettling.
My feelings had to do with the fact that I was leaving my position in the near future to pursue an MSW, and here I was, a young, rather inexperienced, “untrained” social worker, admitting an older, more experienced social worker with an MSW to a psychiatric hospital. So now, three years later, I had my MSW, and Mary came for a job interview at Children’s Agency where I was employed. I had no responsibility for employment decisions. My supervisor, who was the Director of Social Services, and the psychiatrist, who was also the Executive Director, made these decisions. On one hand, I was concerned about whether Mary would function as a competent professional colleague. Was her illness in remission? If so, would it remain in remission? If not, what would the impact be on clients? Would she be able to function adequately to work with clients who came to the agency? If she would not, would harm come to clients?
On the other hand, my knowledge of her illness was unquestionably confidential. There was also the possibility that I could speak to Mary and verbalize my concerns to her. In summary, there seemed to be no ideal course of action in this situation. I did not know how to predict what would happen if I talked with Mary. It is conceivable that I would have a colleague who was less than happy with my reminding her of her illness. If I did intervene by reporting to persons responsible for hiring, confidential information would be divulged. I could be identified as practicing discrimination toward persons with a mental illness. If I did not intervene, and she was hired, harm could come to clients. There seemed to be no ideal answer and no way to avoid the situation. There may have been other options, but none seemed apparent to me at the time.
Zook wrote this article because there are times in social work practice when professionals are placed in situations, through no wrongdoing on anybody’s part, in which dilemmas occur because of a conflict in values or ethical principles within the situation itself. In those situations, it is not a matter of choosing good versus evil, or choosing right versus wrong. It is a matter of choosing between the better of two goods or, possibly more often, the lesser of two evils. Making those decisions is often not pleasant. In fact, it can be quite anxiety provoking. But it is also impossible to side step the issue when doing nothing will predictably yield a certain outcome. When I read this article I was amazed about the dilemma the author had to face.
By: Lee J. Zook, Ph.D.
http://www.socialworker.com/home/Feature_Articles/Ethics/Ethics%3A_To_Tell_or_Not_to_Tell%97A_Case_Study/
I’m telling! This article is called Ethics: To Tell or Not to Tell—A Case Study. Its by Lee J. Zook. This article was published in the winter of 2001. This article is about Lee J. Zook and a person she calls “Mary Jones”. Some of the topics that was discussed are some years ago, prior to teaching in undergraduate social work, I was working with families and children in an outpatient psychiatric setting, Children’s Agency. In the previous year, I had completed my MSW, having practiced social work several years with an undergraduate degree. The Director of Social Services at the Children’s Agency was my supervisor. We used a team model in our work, with any particular team consisting of at least a social worker, a psychologist, and a psychiatrist. Sometimes other professionals, such as educational specialists, early childhood development specialists, and social group workers were also on the teams.
While I was at Children’s Agency, Mary Jones (a fictitious name) applied for a job as a social worker. Four years earlier, I had seen Mary as a client while working for an emergency service at Adult Hospital, a psychiatric facility for adults. She came to be admitted to the hospital as her psychiatric condition was deteriorating. Mary told me she was a social worker with an MSW and had been in and out of psychiatric hospitals for many years. I located her chart, noted that she was previously diagnosed with schizophrenia, undifferentiated type, did the basic paperwork that social workers did on admission, consulted with the admitting psychiatrist, and took her to the hospital ward. It was a rather simple, routine admission; there were no police or court documents, and she was a voluntary client. However, the situation was a bit unsettling.
My feelings had to do with the fact that I was leaving my position in the near future to pursue an MSW, and here I was, a young, rather inexperienced, “untrained” social worker, admitting an older, more experienced social worker with an MSW to a psychiatric hospital. So now, three years later, I had my MSW, and Mary came for a job interview at Children’s Agency where I was employed. I had no responsibility for employment decisions. My supervisor, who was the Director of Social Services, and the psychiatrist, who was also the Executive Director, made these decisions. On one hand, I was concerned about whether Mary would function as a competent professional colleague. Was her illness in remission? If so, would it remain in remission? If not, what would the impact be on clients? Would she be able to function adequately to work with clients who came to the agency? If she would not, would harm come to clients?
On the other hand, my knowledge of her illness was unquestionably confidential. There was also the possibility that I could speak to Mary and verbalize my concerns to her. In summary, there seemed to be no ideal course of action in this situation. I did not know how to predict what would happen if I talked with Mary. It is conceivable that I would have a colleague who was less than happy with my reminding her of her illness. If I did intervene by reporting to persons responsible for hiring, confidential information would be divulged. I could be identified as practicing discrimination toward persons with a mental illness. If I did not intervene, and she was hired, harm could come to clients. There seemed to be no ideal answer and no way to avoid the situation. There may have been other options, but none seemed apparent to me at the time.
Zook wrote this article because there are times in social work practice when professionals are placed in situations, through no wrongdoing on anybody’s part, in which dilemmas occur because of a conflict in values or ethical principles within the situation itself. In those situations, it is not a matter of choosing good versus evil, or choosing right versus wrong. It is a matter of choosing between the better of two goods or, possibly more often, the lesser of two evils. Making those decisions is often not pleasant. In fact, it can be quite anxiety provoking. But it is also impossible to side step the issue when doing nothing will predictably yield a certain outcome. When I read this article I was amazed about the dilemma the author had to face.
posted by wannita at 6:34 PM
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