Ethical behavior is crucial to helping professions, as it allows avoiding unwanted consequences and enhances the quality of care or support provided. As noted by Reamer (2006), “Ethical standards are created to help professionals identify ethical issues in practice and provide guidelines to determine what is ethically acceptable” (p. 1). Corey, Corey, Corey, and Callanan (2014), on the other hand, state that ethical codes and standards generally emphasize the principles of competence, privacy, confidentiality, as well as responsibility. Making ethical decisions also helps avoid discrimination, harm, and exploitation, thus promoting a genuine approach to client welfare and professional integrity (Corey et al., 2014). This paper will review the two cases provided and establish a preferable ethical course of action.
Case 1
The first case highlights the importance of promoting the client’s welfare and maintaining professional integrity. Joan’s decision to continue seeing Ms. Smith is controversial, as family therapy is out of her scope of practice. Ensuring that the social worker acts within his scope of competence are among the vital ethical principles supported by various ethical standards, including the American Psychological Association’s Code of Ethics and the NASW Code of Ethics (Corey et al., 2014). However, to judge whether or not Joan’s decision can be considered ethical, it is crucial to evaluate the context of her work. As noted in the case, there are no family therapists in the area where Joan works, which makes it impossible for her to refer Ms. Smith to a person who is more qualified and experienced in family conflicts. If Joan refused to see Ms. Smith, this would negatively impact the client’s family conflict, as she would have been unable to receive help.
By offering to treat Ms. Smith for anxiety, Joan can help her to lower the levels of stress, which could have a positive effect on the situation in her family. Lowering levels of stress and anxiety, as well as developing healthy stress-coping mechanisms, could help the client in preventing and mediating conflicts at home, or at least reducing their effect on her mental health and well-being. As noted by Corey et al. (2014), ethical standards and codes are no written laws. Thus there may be situations where the practitioner would have to review the situation independently of the set rules and codes to determine the best course of action for the client. In this case, Joan’s decision was ethical, as it ensured that Ms. Smith would receive care that would positively contribute to her well-being. Moreover, the decision promoted the best possible outcome for the client, which also complies with consequentialist and utilitarian ethical doctrines (Reamer, 2006).
However, it is important to understand that a small change in circumstances could affect the ethics behind Joan’s decision. For instance, if there were any qualified family therapists living in the area, Joan’s decision would be entirely unethical, as the client would not have received the best care for her situation. One possible alternative to Joan’s decision would be to encourage the client to seek online counseling from a qualified family therapist living in a different area. There are various communication technologies, such as Skype, that could help Ms. Smith obtain care from an appropriate professional living in another city. However, although this would allow the client to receive specialized care for her situation, it is a common view that online sessions are less effective than conventional face-to-face therapy. Thus, it would also be crucial for Joan to ensure that the chosen family therapist has a successful history of working with clients online and that Ms. Smith can use the required technology well and has a stable and quick internet connection. Alternatively, Joan could try to enhance her competency in the field of family therapy by completing courses or consulting with other professionals.
Case 2
Working with patients who are HIV-positive is challenging and difficult, as people with this diagnosis can harm others, either intentionally or unintentionally. Thus, it is crucial for social workers who support HIV-positive people to encourage them to comply with precautionary measures and treatment schemes. In the proposed scenario, Bill’s actions pose a direct threat to the health and well-being of his wife by not telling her about his status and continuing to have unprotected sex with her. To determine the preferred course of action, in this case, it would be vital to address the Tarasoff ruling, which exempts social workers and therapists from maintaining privacy and confidentiality if the client could harm self or other people (Corey et al.) due to the result of the Tarasoff case, therapists are required by law to warn the potential victim, client’s family members, or authorities if the client poses a danger to self or others. Although the transmission rate of HIV during unprotected sex is not 100%, an HIV-positive status is considered to be a potential threat, which is why some of the states have specific laws that establish the duty to warn of the client’s HIV-positive status.
Therefore, the decision on whether or not to disclose the information about Bill’s status to his wife would be determined by two factors. First of all, I would seek to inform Bill of the risks and encourage him to disclose his wife’s status. However, if Bill refuses or reports not having talked to his wife in the next meeting, I would determine what the states’ legal requirements are in relation to HIV status disclosure. Although there is no specific law that requires social workers and therapists to disclose a client’s HIV status to potential victims, it is illegal for Bill to have unprotected sex with his wife as long as she is unaware of his status. Moreover, health and social workers in Virginia are allowed to disclose a client’s test results to his or her spouse. Finally, it could also be argued that Bill’s decision not to tell his wife about his status creates a direct threat to her life and health, and thus the disclosure of this information would help to protect her. In this case, I would no longer be liable to maintain the client’s privacy and confidentiality. All in all, if Bill is reluctant to share his status with his wife and continues to have unprotected sex, I would follow the state law and disclose the information to his wife.
Conclusion
Both cases provide a useful opportunity to apply ethical codes and standards to a scenario that might occur in practice. The assignment shows that ethical decisions should be based not just on the set rules but also on the context of the situation and applicable legislation. Thus, it is important for therapists and social workers to obtain a full picture of the factors affecting the decision and its consequences before choosing an optimal action.
References
Corey, G., Corey, M. S., Corey, C., & Callanan, P. (2014). Issues and ethics in the helping professions with 2014 ACA codes. Scarborough, Canada: Nelson Education.
Reamer, F. G. (2006). Ethical standards in social work: A review of the NASW Code of Ethics (2nd ed.). Washington, DC: NASW Press.