Social Work for Sociologists: Theory and Practice

Key Values, Ethics, and Skills for Working with People ● 59

Another ethical dilemma for human service professionals can arise over the
clash between maintaining confidentiality in the best interests of the client and
breaching confidentiality in the name of public interest or to achieve the greater
good. Ethical dilemmas challenge the practitioner’s determination to uphold
ethical principles; it is not always possible to “do no harm,” allow full self-
determination, or maintain clear professional-private boundaries. For guidance
with resolving such ethical dilemmas, professionals might turn to their code
of professional practice or to their professional association. They might also
employ specific ethical decision-making models, such as those advocated by
Guttmann (2006), Reamer (2006), and O’Connor et al. (2008).
Guttmann (2006, 166) believed that ethical dilemmas mostly occur
around “matters of power, equity, and just distribution of scarce resources.”
He wrote that the main duty of social workers is caring for clients, treat-
ing them equally and respectfully. In his model, social workers must employ
three essential principles in ethical decision making: autonomy, beneficence,
and justice. While the principles may conflict with each other in particular
situations, they all need to be applied to an ethical dilemma. Guttmann also
argued, however, that autonomy, or client self-determination, is the decisive
principle.
Reamer (2006, 73–85) held that ethical decision making needs to be
systematic. He formulated a seven-step model, involving the sequential
identification of essential elements:

1. The ethical issues, including where social work values and duties
   conflict


2. The people likely to be impacted by an ethical decision


3. The potential actions arising from ethical decision making and the
   positive and negative impacts of these actions


4. The ethical theories, rules and principles, codes, legalities, practice, and
   personal values


5. The colleagues and experts who need to be consulted


6. The decision and the documenting of the decision-making process


7. The follow-up required and the evaluation needed

Reamer suggested that this systematic model be applied to ethical dilem-
mas involving clashes between personal and professional values, and when
there are conflicts of interests, or concerns about privacy, confidentiality, and
self-determination.
O’Connor et al. (2008) identified several models of ethical decision
making: process, reflective, and cultural models. They opted for a process
model based on clear definitions of the problem, a phase of gathering detailed
information through consulting with others, a phase of reflection on the