60 ● Kate van Heugten and Anita Gibbs
ethical choices that could be made, and then, ultimately, the making of an
ethically informed decision. O’Connor et al. (2008) noted that all ethical
decisions are connected to our own values, life experiences, and beliefs and
that we must critically reflect on these in our practice.
Resolving Ethical Dilemmas in Aleena’s Situation
Having highlighted a range of ethical dilemmas, values, and skills, we now
turn to Aleena’s situation (chapter 2) and explore some of the ethical dilemmas
that a human service professional might encounter when working with this
family and how those might be resolved.
Aleena and her family are having a tough time. There are concerns about
the potential neglect of her children and about Aleena’s own well-being.
Here is an example of an ethical dilemma that could arise: Aleena lives on
welfare benefit payments, but she cannot make ends meet, so she engages
in occasional shoplifting sprees. A human service worker becomes aware of
this and experiences dilemmas around the following questions: “Should I
confront Aleena about her illegal behavior?” “Should I report Aleena to the
police?” “Should I overlook this behavior, because I know she has to feed her
children?” Another ethical dilemma might occur if a worker discovers that
Aleena is consuming large amounts of alcohol to help relieve her feelings
of depression. Again, the worker might ask a series of questions: “Is Aleena
‘wrong’ to self-medicate by drinking alcohol?” “Is Aleena harming herself or
her children when she drinks?” “Should I breach client confidentiality and
talk to my agency manager or someone else about Aleena’s situation?”
Drawing on ethical principles and decision-making models and applying
social work skills, a human service worker might begin to help Aleena by
initiating a meeting with her at her home or in an alternative place where
Aleena feels comfortable meeting the worker. If the worker has not already
established a supportive, helping relationship with Aleena, then the first task
for the human service worker will be to use his or her skills of communication,
respect, and engagement to effect such a relationship. If a meeting is agreed
on, the worker will need to clearly articulate the focus of the meeting while, in
a spirit of partnership and collaboration, asking Aleena what her wishes and
needs are for the meeting. If the relationship is legally mandated, the building
of trust may take a long time or may never be achieved. The worker will need
to make a judgment on how urgent the ethical dilemmas are and whether
there are more pressing matters with which Aleena and her family need to be
assisted. The issues of Aleena’s shoplifting and her excessive drinking cause
conflict between confidentiality and privacy, between self-determination and
paternalism, and between the professional and personal values of the worker.