Ethical decision making frameworks and applications

Ethically, the social worker did everything in the correct manner. The NASW Code of Ethics states that "when social workers provide counseling services to families, couples or groups, social workers should seek agreement among the parties involved concerning each individual's right to confidentiality" (Code of Ethics, 2014). In this case, the social worker accomplished that by requesting confidentiality agreements before the group sessions began. Actions to be taken now include the fact that the social worker should speak with the party that leaked the information as well as the injured party. Legally speaking, the court system would not likely take kindly to a case such as this nature. Ethically speaking however, the case is a good example of just how careful the social worker has to be. Excluding the patient that leaked the information from participation in the group setting would be a good first step. The rationale for these actions are that if the social worker cannot trust the patients to keep the information to themselves, then it would behoove that worker to exclude the talkative patient from group sessions.

4. There are a number of areas that the social worker should be concerned with in this situation. First of all, the NASW guidelines state that "social workers should refer clients to other professionals when the other professionals specialized knowledge or expertise is needed to serve clients fully or when social workers believe that they are not being effective" (NASW 2014). In this specific situation, the social worker would more than likely not be effective at all, because the social worker is not a physician, but is more concerned with the social aspects of the family, not the physical renderings of the family.

Additionally, there may be some legal issues with this family's situation as well. Those issues may include the fact that the daughter could be developing a life-threatening tumor. The social worker is likely to not have expertise in that area, so it is very likely that the social worker would have to refer the family to someone who does specialize in that area. The social worker (according to the NASW guidelines) should also "facilitate an orderly transfer of responsibility" and by doing so provides the family and the patient with the opportunity to be addressed in a medical fashion. By accomplishing this task, the social worker also adheres to additional guidelines that state "social workers should work toward the maintenance and promotion of high standards of practice." Actions that should be taken are to refer the child to a specialist, talk to the parents about getting medical attention and determining whether the child needs medical attention or not. The rationale behind this specific case is that the girl could be touting a tumor that is malignant, and to let that malignancy spread throughout her body would be a travesty.

5. The actions that are legally necessary in this particular case include informing authorities that the woman has hoarded medicine that she intends to use to take her own life. Are those the actions that this researcher would take? Probably not. At some point in time, patients should be allowed to suffer with dignity, or do away with that suffering in a manner that is most conducive to their own personal goals and objectives. The individual in this case has suffered through intense pain the last several months and is most assuredly going to pass on, no matter what actions are taken.

Additionally, this individual would continue to suffer pain and agony throughout the remaining portion of her life. The question that could be asked then, might be…does she really have to suffer, or what about the quality of her life? Is it worth it to her to continue to struggle, to continue to endure that pain and suffering? That is something that only she can choose. The social worker has a legal obligation to inform the authorities, but in this specific case, that obligation could be set aside for a short while, at the very least providing the opportunity for this patient to make her own choice.

6. This situation is one that would surely test the knowledge and expertise of the social worker. On the one hand, the social worker must keep the privacy concept of the one party totally in mind, yet the other party deserves consideration as well. The legal duties that are needed to address this issue are not as relevant as the ethical issues. In point of fact, there don't really seem to be any legal issues involved with this case per se. However, in this particular case the social worker would like consult with colleagues to determine what steps to take next. The NASW guidelines state that "social workers should seek the advice and counsel of colleagues whenever such consultation is in the best interests of clients" and this is a perfect example of needing a colleague's advice and words of wisdom. What this social worker would likely do, after consulting with colleagues, is keep the provided information on the QT and not mention it to the spouse. This might not be the best route to follow, but perhaps the social worker could manipulate the discussions to bring out what has been told in confidence.

The rationale behind the social worker's actions are that while there is no actual legal precedence, the situation does present an ethical scenario that needs to be addressed. The social worker should adhere to the NASW standards that state "social workers should protect the confidentiality of all information obtained in the course of professional service, except for compelling professional reasons." In this case, the social worker's rationale would be that the information was definitely confidential, and therefore the information cannot be disclosed, no matter how much the social worker might wish to do so.