As Social Work and Human Services professionals, many times we are face with decisions that create ethical Dilemmas. Using the Hierarchy of Ethical Principles, Social Work Code of Ethics, and the Ethical Decision-Making Chart, determine the appropriate course of action for the scenario provided.
1. Identify the Ethical Issues, including the social work values and ethics that conflict.
2. Identify the individuals, groups, and organizations that are likely to be Affected by the ethical decision.
3. Tentatively identify all possible Courses of Action and the participants involved in each, along with possible benefits and risks for each.
4. Thoroughly examine the reasons in favor of and opposed to each possible Course of Action, considering relevant (a) ethical theories, principles, and guidelines; (b) NASW codes of ethics; (c) hierarchy of ethical principles; (d) the Ethical Decision Making Chart, and (e) personal values (including religious, cultural, and ethnic values and political ideology).
Scenario: Pats post-surgical team consists of a physical therapist, occupational therapist, nurse practitioner (who provides nutritional counseling) and a clinical social worker by way of home visits. A pharmacist offers medication management and consultation to Pat in the healthcare team. Pat’s treatment and medications are paid for by Arkansascare insurance. She’s collecting disability until she returns to work. While visiting with Pat she shares that she is not complying with her medication protocol or diet plan. She has not told this to her other providers and ask you to keep it confidential. “The others are not as understanding as you are,” she says. “I tell them what they want to hear so the leave me alone.” At the monthly phone huddle, the pharmacist voices concern that, with the exception of her pain medications, Pat does not seem to be refilling her prescriptions. In regard to the pain meds, the pharmacist also discloses that Pat has asked the pharmacy twice for an early pain med refill. The nurse practitioner states concerned that Pat is gaining rather than losing weight despite insistence that she staying on her diet plan. “I don’t think she’s really committed to her treatment” he says. “She’s playing Russian roulette with her health”.
