Ethical Dilemmas in Social Work - Coursework Example

Ethical dilemmas in Social work Title: Discuss an ethical dilemma that is relevant in social work practice and show its importance, its effect on people and systems, and how it can be contained Introduction In their direct service to individuals, social workers are faced by a myriad of ethical dilemmas which impact upon their lives and the people who are close to them. Such people may include family members and work colleagues. The ethical dilemmas are brought about due to the very nature and practice of social work. According to the NASW code of ethics (2008), the core mission of social workers is to facilitate the well-being of people and help them meet their most basic needs. Social workers all over the world have continued to have a special interest in trying to empower the vulnerable people across societies. With the advent of HIV and Aids, social workers, particularly in developing countries have had to rearrange themselves to deal with the needs of an ever increasing population of people with Aids. Social workers have attended to needs of oppressed people, people with extreme mental retardations, and those living in abject poverty. Social workers uphold social change and social justice on behalf of individuals, groups, families, and communities. The practice of social work is sensitive to ethnic and cultural diversity as it seeks to strive to end society’s vices such as oppression, discrimination, poverty and other forms of social injustices. Their intervention may be in the form of community organization, direct practice, consultation, supervision, advocacy, administration, social and political action, education, policy development and implementation, and research and evaluation (NASW code of ethics, 2008). The down-syndrome disease In trying to enhance the people’s capacity to address their own needs, social workers are faced with a variety of ethical dilemmas. Let’s consider a situation where a couple has the down-syndrome disease but still want to have a sexual relationship that will lead to marriage. Such a scenario may be of particular interest to the practice of social work as it entails some multiplier effects which beg for serious ethical answers. The serious ethical dilemma that any social worker may experience in such a scenario is whether to let the couple go on with their plans to get married and have their own children. As I have already discussed, it is the duty of a social worker to facilitate the capability of people to address their own problems. But such a relationship will definitely lead to more problems for the couple as the children born out of the relationship will very likely have the Down-Syndrome disease as well as other complicated health problems which will negatively impact on their developmental abilities (Should retarded people marry, 2006). This therefore means that the chances of the children leading a normal and fruitful life will be seriously compromised. This explains the relevance of such a dilemma to social work. In social work, ethical decision making involves a process. In such an instance where a couple with Down-Syndrome disease wants to have children, simple answers may not be available to resolve the complex ethical issues that such a decision may entail. That is where the National Association of Social Workers code comes into play. The ethical dilemma here is if it is right to allow the couple to go ahead and reproduce children when in fact they know that these children will be severely handicapped and will be a burden to society. Importance of the ethical dilemma to a social worker. The ethical dilemma is of particular importance since it will directly affect the social worker’s area of operation. In such a scenario, it is the role of the social worker to be an educator, mediator, negotiator, and facilitator for the couple to enlighten them and empower them with proper information so that they can make proper conclusions about their state and shelf any plans to bear children (Hick, 1998). One of the ethical principles of the Social worker is to help individuals who are in need to address their social problems. This is the value of service by social workers to society members (NASW code of ethics, 2008). This ethical dilemma should be of particular importance to the social worker as this couple must be helped out of the problems they face. It should be the function of the social worker to respect the inherent worth and dignity of this couple. This can only be attained by coming up with proper mechanisms to solve the ethical issues raised by the couple wanting to have children. As such, the social worker must always treat the couple with care and respect, and be mindful of their condition. Such an ethical dilemma will be important as it will help the social worker to promote the couple’s knowledge about the issues in question, and help them make mature and responsible decisions. The dilemma will help the social worker to facilitate the couple’s capability and opportunity to change their thoughts on having children and start addressing their own needs (NASW code of ethics, 2008). Such an ethical dilemma would also help the social worker in recognizing the core importance of individual relationships in evaluating the relationship of the couple and their desire to have children. One of the most core tenets of social work is to understand the importance of relationships between people as an effective medium for change. By understanding the ethical dilemma involved, social workers must always engage the couple as partners in the helping process (NASW code of ethics, 2008). How the people and systems will be affected by this dilemma. Such an ethical dilemma will affect very many people and systems. The parents themselves will be the first casualties of the decision to bring forth children. This is because the children will be retarded and will suffer many developmental defects. As such, the children will be wholly dependent on their parents for survival and upkeep. The parents will of course be affected emotionally as well as financially. The biggest impact will be on their emotions after realizing that they cannot bring forth healthy children. They may harbor feelings of shame, self-defeat and self worthlessness and may particularly want to avoid associating with members of the immediate community due to shame that generally comes with giving birth to genetically imperfect children. This can weigh down on them quite heavily considering that there are victims of the same disease- the Down-Syndrome (Should retarded people marry, 2006). The parents will also suffer financial distress since the children will be fully dependent on them for survival. Majority of the children born from parents with Down-Syndrome complications never develop to their full potential and thus will be an extra financial burden to the parents who may lack the necessary instruments and resources of children upbringing. (Should retarded people marry, 2006). Another casualty of the couple’s action will be the government because it has to support the children financially and medically. People with Down-Syndrome and other critical mental retardations are dependent on public funds to survive. As such, their children will certainly depend on public monies. To a larger extent, all the tax payers will suffer because they contribute collectively to the state funds and schemes that have been set to cater for people with the Down-Syndrome disease (Should retarded people marry, 2006). The children that will be born from such a relationship will be affected by this ethical dilemma for life. Available research seems to point to the fact that children born from parents with Down-Syndrome will certainly have the disease themselves, apart from experiencing other major developmental handicaps. The worst thing is that it is a condition that can never be reversed and thus the children will be bound to live with the condition permanently. Such children will therefore have to put up with short and brute lifestyles that arose out of an ethical dilemma. They are bound to be withdrawn, easy to irritate, and likely to suffer emotional breakdowns due to the stark realization that they will never be able to live productive lives. Many studies that have been undertaken over time reveals that people with Down-Syndrome disease often ended up committing suicide due to perceived or actual fear of rejection by society (Should retarded people marry, 2006). The ethical dilemma of deciding whether the couple with Down-Syndrome illness should go ahead and procreate will also make the surrounding community to suffer. Many members may at least suffer empathetically and emotionally. Other community members may suffer in their association with the children born out of such a relationship as they may find themselves rejecting them unconsciously. The social worker in such a case may have his hands all filled up when trying to advocate for the community’s acceptance of such children (Jackson, 2005). Finally, the social worker will be affected by the dilemma to a large extent. He or she must come up with effective ways of solving the ethical dilemma if the worker is to play his rightful role of facilitating the well-being of people and helping them meet some of their basic necessities. The social worker must come up with rigorous ways of ensuring that the couple chooses the right decision without necessarily stepping on their rights and privileges (NASW code of ethics, 2008). Cause of action and rationale As a social worker, I was particularly empathetic and sensitive to the couple’s condition. I knew their desire to get married and have children was born out of a valid and objective will to have children. I was more saddened by the fact that the Down-Syndrome disease could not allow them to bring forth normal children and thus it was of no use trying. The first action was to acknowledge and explain to the couple the depth and the dangers of the disease and to comfort them on the realization that they could not in any way bring forth healthy children. My rationale was based on the premise that such a realization could bring untold suffering and feelings of lack of self worth on the couple (Jackson, 2005). It was my duty as a social worker to instill that sense of worth in the couple and make them realize that there were many possible alternatives they could use to enjoy parenthood. For example, they could adopt a healthy baby to fulfill their desires. The next course of action was to endow them with the necessary skills required to understand the nature and the complications of the disease. They couldn’t understand how Down-Syndrome could be a life-long burden. It is one of the functions of social workers to provide skill and expertise in direct services to individuals and the family members (Bailey, 2004). The knowledge I had about the disease could influence the choice that the couple had earlier made. It empowered them to talk about their own condition with knowledge and assertiveness. They grasped the sense that I was trying to let them see after I provided them with knowledge about the disease and its effects on the children. To this extent, they shelved the idea. It was also my duty as a social worker to analyze, develop, and influence policies that help people living with Down-Syndrome disease live a more fulfilling life. These policies, whether done at a local or national level, goes a long way in making important improvements on the care given to patients with life-limiting diseases such as Down-Syndrome. These policies have gone a long way in ensuring that previously overlooked areas of the disease are generally taken care of (Bailey, 2004). I saw it as my duty to advocate for the couple’s decision, needs, and rights in the status that they were in. It was my duty to engage in political and social actions that sought to ensure that people affected by the Down-Syndrome disease have equal access to bio-psychosocial resources needed in the management of the disease. I also effectively addressed issues of self-denial that kept cropping up during my various interviews with the couple. To help the couple deal with the condition and accept it the way it was, I had to open up their hearts so that they could subscribe to the plain truth – that it was hard for them to bring forth healthy children. According to social work practice, self-denial is counterproductive and thus it is the duty of every social worker to make their clients perceive issues in the right frame of mind. According to various scholars, people are forced to use denial tactics in an attempt of controlling a situation that is otherwise uncontrollable. The couple could not control the outcomes of the Down-Syndrome disease and thus preferred to live in self denial (Burgess, 1994). My job as a social worker was to help the couple perceive their very own strengths in the whole scenario and make their own informed choices. True to practice, the couple’s self denial was replaced by more practical managing mechanisms after they regained some control over their lives. Another course of action I undertook was to commence counseling sessions for the couple affected by Down-Syndrome disease as well as close family members. The counseling was done hand in hand with psychotherapy, which aimed at addressing the cognitive behavioral interventions of the couple (Bailey, 2004). My rationale for undertaking counseling on the couple was the realization that it is a very effective therapeutic experience. After the counseling sessions, untruthful statements and beliefs that were previously held by the couple together with their parents had been done away with. Counseling gave them a new meaning to life. Conclusion It has been proved beyond reasonable doubt that social workers continue to be faced by conflict of values and ethical dilemmas in their attempt to make the life of sufferers better. Regardless of the areas of practice, all social workers will inevitably find themselves working with individuals who face long-term or acute situations that involve life-limiting diseases such as the Down-Syndrome condition I have just discussed above. It is under this backdrop that the social workers come face to face with far-reaching ethical dilemmas that the worker must overcome to be able to help the client. The worker must thus be in possession of adequate skills and knowledge to be able to facilitate and intervene appropriately in needs such as illnesses, trauma, death, or suicide (Burgess, 1994). References Bailey, G. (2004). NASW Standards for social work practice in palliative and end life care. NASW. Retrieved October 8 2008, from: http://www.socialworkers.org/practice/bereavement/standards/default.asp Burgess, D. (1994). “Denial and terminal illness.” American journal of hospice and palliative medicine, vol. 11, no. 2 pp 46-48. Retrieved October 8 2008, from: http://ajh.sagepub.com/cgi/content/abstract/11/2/46 Code of ethics of the National Association of Social workers. (2008). NASW. Retrieved October 8 2008, from: http://www.socialworkers.org/pubs/Code/code.asp Hick, S. (1998). The role of the social worker. Retrieved October 8 2008, from: http://www.socialpolicy.ca/cush/m5/m5-t16.stm Jackson, K. (2005). Helping clients through crisis of infertility. Retrieved October 8 2008, from: http://www.socialworktoday.com/archive/swt_0905p24.htm Should retarded people marry? (2006). JoeUser.com. Retrieved October 8 2008, from: http://little-whip.joeuser.com/article/124768/Should_Retarded_People_Marry . Read More