ETHICS IN ACTION

STRIVING FOR OUR BEST ETHICAL SELVES

Social work and ethical decision-making

BY MALLORY MACLEOD, MSW, RSW

As a social work student, I, along with colleague Kelly Isenor, had the opportunity to work with the NSCSW to develop an ethical decision-making tool. At the time, being a freshly minted Bachelor of Social Work graduate, the Code of Ethics and Standards of Practice seemed relatively straightforward and at a glance reflective of my own values. Given complexities of the environments social workers practice in, intersectional positionalities, and the influence of dominant discourses, the tool was meant to be a way to organize thought-processes when facing ethical dilemmas.

Having some years of social work experience, I find that my questions around what is most ethical have increased, and experience has not decreased the number of dilemmas I have faced.

Practicing in mental health in particular has illustrated the complexities of using the Code of Ethics in day to day life. As a social worker, I feel I am often cognizant of my values, but I sometimes struggle to place these values in action given structural complexities that impact micro, mezzo and macro levels. Given such, I have used the ethical decision-making tool in a several instances and have come to it when I felt conflicted as a social worker. This conflict has been further complicated by my own privilege, as well as the culture of neoliberalism in which many social workers practice. Given my own privileged positionality and work expectations it has become clearer to me how easy it is to maintain the status quo and play a part in wider oppressions.

Working in mental health has brought numerous ethical dilemmas in my practice within which I have attempted to follow the least wrong path. Having the privilege to have worked in adult mental health services, complex dilemmas juxtaposing a client’s rights to self-determination and privacy with the protection of life have frequently left me wondering what the path of least harm is. As a clinical social worker, dilemmas concerning the accessibility of mental health services coupled with my beliefs in cultural humility and the code of the respect of the inherent dignity of all persons have left me wondering how to provide mental health services in an ethical way given time and session constraints.

Given these constraints, taking time to analyze my own personal biases seemed sadly sometimes an afterthought. The Code of Ethics and Standards of Practice, which I once thought to be straightforward, are documents that I have frequently come back to when questioning my own decisions and the structure of the broader systems in which I have worked.

The importance of integrating theory into day-today practice to work towards goals of social justice has become clearer in navigating ethical dilemmas.

I often feel particularly ill at ease given the individualization of mental health problems that have arisen from and are intertwined with wider structural oppressions. Rethinking what the “pursuit of social justice” and “putting social work values into action” look like has challenged me to expand my practice. This includes linking macro systemic concerns into micro individual social work practice.

The use of the ethical decision-making tool has brought about questions such as:

• How can I work with those who have lived through trauma without recognizing the wider structural factors that have made these traumas possible?

• What is the role of considering income inequity when looking at the impacts of depression and anxiety?

As a result of ethical reflection, naming the oppressions we face and recognizing how these are intertwined in an individual’s mental health are tools I try to integrate into my daily practice.

I have been surprised that re-visiting questions from the ethical decision making tool such as “what is the client’s perspective?” and “what are alternative courses of action?” have not always come naturally. In day to day work, it is re-visiting these questions, as well as the Standards of Practice and Code of Ethics, that remind me of why I am passionate about social work and choose to be a lifelong learner. Confronting and acknowledging ethical dilemmas with the backing of theory, codes, and standards holds me accountable to my mistakes in endeavoring to find the least wrong path forward. The idea of the best ethical self involves confronting uncomfortable questions and challenging the biases that come from my own experiences, culture and positionality. Through reflection, consultation, and reflecting on ethics in strategic and organized ways I hope to continue to present my best ethical self to work towards solidarity with clients.

REFERENCES:

1. Code of Ethics. (2005). Canadian Association of Social Workers (CASW). https://www.casw-acts.ca/sites/default/ files/attachements/casw_code_of_ethics.pdf

2. Dolgoff, R., Loewenberg, F. M., & Harrington, D. (2009). Ethical issues for social work practice.

3. Mullaly, R. P. (2010). Challenging oppression and confronting privilege: A critical social work approach. Don Mills, Ont: Oxford University Press.

4. Spencer E; Massing, D & Gough, J (2017). Social Work Ethics; Progressive, Practical, and Relational Approaches; Oxford Press.

5. Standards of Practice. (2017). Nova Scotia College of Social Workers (NSCSW). http://nscsw.org/practice/ standards-of-practice

MALLORY MACLEOD (RSW) graduated from Dalhousie University with her MSW and currently practices in Halifax in the field of mental health and addictions. Mallory identifies as a lifelong learner working to understand processes of selfreflection and best practice in ethical decision making.

To access the ethical decision-making tool she helped develop, visit ethical.nscsw.org