How does a social worker balance the values of self determination and the protection of vulnerable populations and engage in ethical practice?
This can be a difficult situation for a social worker because these two values can come into conflict at times. Social workers have a responsibility to allow their clients to have self-determination. That is, they must allow the clients to decide what they want to do rather than imposing actions on the clients. This can be a problem when there is a need to protect vulnerable populations. For example, a client might want to do something that could bring harm to themselves or to other members of their family. The social worker will want to prevent this, but in doing so, they could be infringing on the client’s right to self-determination. This makes ethical practice difficult for the social worker.
In resolving this sort of issue, the social worker should be guided by something like the following passage from the National Association of Social Workers’ code of ethics. The passage reads:
Social workers may limit clients’ right to self-determination when, in the social workers’ professional judgment, clients’ actions or potential actions pose a serious, foreseeable, and imminent risk to themselves or others.
By using this guidance, social workers can navigate this ethical conundrum. What social workers need to do is to think carefully about the possible impacts of the course of action that the client is proposing to undertake. They have to decide if the harm that could be caused by that action would be “serious.” They have to decide whether the harm would be “imminent,” which means that they have to decide if the harm would certainly occur as a relatively immediate and direct result of the client’s actions. To think about what this means, let us think of two examples.
In one example, a client might wish to stop taking medications designed to improve her mental health. If she stops taking the medications, she is likely to become suicidal and/or violent towards others. This would constitute a serious harm that would be likely to happen soon after the client takes her proposed course of action. Therefore, the social worker should not allow the client to stop taking the medications.
By contrast, imagine a client who wants to go to a casino to gamble even though she does not have enough money to pay off her credit card bills. If she fails to pay her bills, she will incur some interest charges. These might lead to serious financial trouble somewhere down the road, but they are not going to cause her serious financial difficulty in the near term. In this situation, the social worker should allow the client to act as she wishes.
Of course, there can be cases in which the answers are not clear. In such cases, social workers simply have to try their best to follow the guidance of the passage from the Code of Ethics.