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What An Ethical Dilemma Is

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For this assignment I will explain what an ethical dilemma is, before outlining a possible social work scenario. To navigate this dilemma, I will apply and evaluate three common ethical theories to a young family and drug use highlighting the complications that arise. A justification of the final decision to the ethical dilemma will conclude this assignment whilst acknowledging the difficulty of making the ‘right decision’.

Ethical dilemmas in social work are common considering the issues confronting this profession is often convoluted with conflicting interests, rights and needs of individuals involved (Gray and Webb, 2010). Banks (2012) defines an ethical dilemma as an occurrence of when two unequal and unwelcome choices are presented, often involving a conflict of ethical values and it is unclear which is the right choice. Congress (1999) cited in Gray and Webb (2010:20) defines values as the “relatively enduring beliefs about what is right and correct”. Rhodes explains that any choice results in an undesirable action and regardless of the choice made it will not be the ‘right’ one as ethical dilemmas are rarely satisfactorily resolved (Rhodes, 1991).

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The hypothetical dilemma I will be referring to is based on being a social worker working with a young family. The mother (“Sarah”) is a drug addict which lead to her three children (10, 8 and 5) being separated and placed in to foster care due to negligence. Sarah completes a drug treatment programme for the first time and claims to be drug free. Sarah is reunited with her family but informed if she uses any drugs the children will be removed. Sarah has fled with her children previously after being made aware social services would be getting involved so has been informed she will regularly be visited. Shortly after being reunited, I notice drug paraphernalia poorly concealed in the living room during a visit. Upon confronting Sarah, she admits to smoking Marijuana sporadically to help with stress and pleads to not remove her children. She acknowledges it was wrong and a mistake. The dilemma I am left with is as to whether I accept she has realised her behaviour is unacceptable and believe she will not repeat it or I report the disclosure and the children be removed due to concerns of repeated behaviour.

The ethical foundations of social work provide principles and clear lines of guidance in the form of codes of practice (GSCC, 2015; BASW 2014; HCPC,2012a) including international forms of codes of practice such as IFSW to provide a unified professional value position. A value position around promotion of human rights and social justice. These codes and expanding literature on social work values and ethics provide a starting point from which competing values can be analysed (Gray and Webb, 2010; Bell and Hafford Letchfield, 2015). Although there are several resources echoing the ethical codes and principles these will not provide you with the correct decision. The broad guidelines must be tailored to and reasoned with to make a decision.

Values conflicting in this ethical dilemma would be: self-determination; the right to safety; confidentiality; importance of human relationships and professional integrity (BASW, 2014).

There are several ethical theories (broadly categorised as deontological or teleological) that are often discussed in social work literature to aid the systematic process of resolving the dilemma using different approaches.

There are three prominent ethical theories that may be used to inform practice. These include Kantian ethics, utilitarianism/consequentialism and virtue ethics. These ethical perspectives applied to dilemmas may help individuals identify what drives them towards making ethical decisions and make sense of the situation.

The most influential deontologist in the history of Western moral philosophy was Immanuel Kant (1724–1804). He was the leading figure on displacing the moral authority of religion and heralded the ‘Age of Reason’.

(Misselbrook, 2013) Kant expressed that morals must come only from reason and not from authority, religion or traditions. He explained that each person possessed absolute moral worth or value and the ability to reason. Kant believed the ultimate and necessary motive for morality was duty. Applying this to the case of Sarah I would have to identify my duties and determine to whom I feel more duty bound. I cannot empower and uphold all of Sarah’s rights as well as the children’s. Furthermore, reporting information is also my duty according to social work policies, values and principles (BASW, 2018). Also, not reporting may be considered a form of lying which Kant states is always wrong. This means I would have to report it otherwise I may find myself facing disciplinary action should the children be harmed. However, Kant would not support the consideration of the outcome of lying and would disagree with the motivation of the action. I should report it according to him because we should never lie.

The difficulty I have so far with this is Kant’s belief that consequences of actions or situations should not motivate or influence you. I find it hard to believe that anyone, including professionals, would be able to act simply out of duty without any consideration to the consequences of their action. As a social worker, I cannot simply act without thinking of the consequences because my decision will impact the lives of others; in this case, Sarah and her children’s. Kant’s theory also fails to detail what should be done when duties and maxims clash and which should be given precedence. I have a duty to protect as well as maintain relationships and to report. Which duty is given priority?

As previously mentioned, Kant argues some duties are absolute. Absolute meaning, we are obliged to do certain types of actions. Kant calls this type of obligation a categorical imperative. There are two commonly referred to formulations of his categorical imperative: to only act in ways that can be universalised, and no one ought to be used as a means of satisfying other people’s purposes or ends (White, 2014).

If we were to apply the universalisation aspect to the case here, we would have to be content with the idea of having information we disclose in confidence to an individual, being shared with someone else without our consent. This is because if I was to inform the relevant people about Sarah I would be doing this without her consent as she may flee with the children if she was aware. I know this would not be something that would be accepted universally and would hinder human relationships and trust throughout society. Also, if we apply the second formulation of the categorical imperative, Kant would argue I am using Sarah as a means and not an end. The main reason for why I would not inform Sarah if I was going to report her behaviour would be because she may flee with the children. Therefore, in order to make sure the children remain where they are, I would not gain Sarah’s consent thus using her to fulfil one of my duties which is to protect the children from harm.

Kant’s theory brings forth many difficulties when presented with a complex situation. There are aspects to this theory that are difficult to harmonize when applying to cases such as the one being discussed. If I report Sarah to prevent lying, I have to do so by gaining her consent otherwise it would be going against both formulations of the categorical imperative. However, if I do this Sarah may leave with the children who could then be at further risk. If I do not report her, I ignore my duty to report and risk the children being neglected or harmed. The fact that Kant does not believe consequences should influence decisions and moral actions is why I think this theory does not lend itself to complex situations. Disregard of the consequences diminishes the acknowledgment of natural human emotions which are inevitable especially in social work when you are making crucial decisions impacting on others. This, combined with making decisions simply based on duty and absolutes is very difficult and this approach does not provide much flexibility to deal with challenging situations.

A contrasting perspective would be that of a consequentialist. This is a teleological theory and the dominant theory in this school of thought is utilitarianism. Utilitarianism was founded by Jeremy Bentham (1748-1832) and further developed by John Stuart Mill (1806-1873). Consequentialism is based on two principles: an act can only be defined as right or wrong depending only on the results of that act and the greater the good consequences an act produces, the better or more right the act (Akhtar, 2013). The key motivators outlined by Bentham in utilitarianism, were pleasure and pain. Focussing on increasing one and avoiding the latter. This lead to the development of the utility principle which was the idea that rightness and wrongness of an action was determined by how useful it was in providing the greatest happiness for the greatest number of people (Bentham, 2000).

Adopting the utilitarian/ consequentialist approach, I would be encouraged to think about the consequences of reporting what Sarah has disclosed as well as the potential outcome of not disclosing. By being able to consider the positive and negative outcomes of the choices, I believe a much more informed decision would be made. The choice that a utilitarianist would support however would be the one that produces the greatest happiness for the greatest number of people.

If I report the information, it will cause distress and upset to the family due to the possibility of separation from their siblings and mother and will also affect Sarah’s trust. The alternative would be to not report the situation and the possibility of separation will be significantly reduced and Sarah’s trust will increase. Comparing both choices, it is clear that the second choice would produce less pain and suffering for the greater number. Although I may feel distressed and unhappy with the choice, a utilitarian would focus on the decision producing the most positive consequences. Taking only the present situation into consideration, this approach would lead me to the decision of not reporting, as it leads to a greater number of people being happy as opposed to the alternative.

On the other hand, if I consider the possible outcomes of my action in the long term, the proposed decision could be argued. For instance, if I do not report the drug use Sarah could go back to using drugs excessively over time and previous history gives us reason to believe this. If this was to occur, the children may face neglect and danger for a prolonged period, essentially my decision would cause pain. Alongside this it would put my professional integrity into question due to withholding information as well as reflecting badly on the social work sector damaging the reputation. So overall if I was to overlook this due to Sarah’s pleas it could lead to a greater number of negative consequences and no happiness would be gained.

Nonetheless if I took the decision to share the information although it may cause distress initially; it may lead to a greater number being happier in their lives. In which case reporting the decision would then be the right choice for a utilitarian.

The biggest difficulty in this approach for me personally, lies in deciding what is the right course of action when the outcomes of your decision are not definitive. I am making a judgement on the knowledge I have. I cannot definitively say if the children were removed they would be happier in the long term or that if they were not removed Sarah would stop drug using.

Unlike its Kantian and utilitarian competitors which rely on the application of right claims, moral rules and following of duties or on the comparison of possible outcomes, Aristotle’s (384-322 BCE) virtue ethics has its emphasis on developing one’s character (Gray and Webb, 2010). According to Aristotle, “virtues are character dispositions or personality traits” (Dimmock, Fisher, 2017:52). Focusing on our dispositions and character, rather than singular actions, is what makes this moral theory an agent-centred one as opposed to act-centred (Dimmock and Fisher, 2017). The virtues identified expanded over time and twelve key moral virtues were highlighted by Akhtar (2013). A select few include courage, friendliness, sincerity, patience and faith. Each of these virtues are considered the ‘Golden mean’ and we should act to meet this optimal balance. The ‘Golden mean’ is equilibrium between a vice of deficiency and a vice of excess. To put this in to context, the golden mean would be courage and the vice of excess would be rashness whilst the vice of deficiency would be cowardice. Aristotle would argue, we are not born virtuous but have to strive to be virtuous.

Virtue ethicists would define an act as good if it is from a good character as they will act in line with one or more virtues. Thus, the goodness of the act is not due to the outcome of the act or adherence to duties but due to being a virtuous act by a virtuous person. To conclude, the goodness of an action depends on the person and their motivations and intentions of their actions (Gray and Webb, 2010).

This approach mirrors social work’s view of itself as a profession supporting people to reach their full potential. It differs from the others in that it focuses more on what is required to be a good social worker who naturally ‘does the right thing, in the right place at the right time’ (Gray,Webb, 2010:13)- essentially a virtuous social worker (Gray and Webb, 2010). Nonetheless it does not provide you with a methodical approach on resolving ethical conflicts. It is not clear how a virtuous disposition determines the right course of action. The right course of action, an ethicist would believe to be one that is done by a virtuous person. If I chose not to report Sarah’s marijuana use it should be because of the virtues I have such as liberality, sensitivity, compassion, understanding and faith. All of these would mean I am not reporting Sarah because I have confidence that Sarah will not do this again and have a sympathetic awareness of her situation. The above traits are all virtues of character and if I am a social worker that consistently acts according to these virtues and does again in this instance, no matter the outcome of my decision, it would be the ‘right’ action. This would mean that even if the children did come to harm because of Sarah relapsing and using drugs again; my moral character would not come into question because I had the right intentions when acting. Adams (2009) in his article says that if we are unsure as to how we should act in a certain situation and we want to act with integrity, we should seek someone we respect who has the necessary virtue. A virtue ethicist would concentrate less on the specific action, in any specific instance, and concentrate more on what the choice of action would say about the individuals character and moral outlook (Darwall, 2003).

After considering these ethical perspectives I have come to the decision that I would report the Marijuana use by Sarah. I would not inform Sarah of this decision before discussing this with the relevant people. Different opinions and experiences are crucial and can prove to be very useful in such decisions. However, I would inform Sarah about what would happen going forward, so she was included in the process and communications. As her social worker, I would explore other avenues and negotiate alternatives to removing the children upon the disclosure and make Sarah aware of what I was doing. I would also explain to her why I made the decision to report the information as I should be able to justify my actions and be accountable. My reason for deciding to report the Marijuana use is due to the evidence and case history available to me. Previous relapses and poor care of the children combined with the fact she has returned to using drugs after feeling the pain of absence of her children and an intensive drug recovery programme gives me reason to be prepared for a repeat relapse leading to neglect. She had also been informed of the consequences of using drugs again and made an informed choice to use drugs soon after having her family reunited. In the best interest of the children, it would be safer for them to be put into foster care without having to live around drug use that could exacerbate or face severe neglect. Faced with this situation as a social worker, I believe I would have to make sound judgement based on the facts available to me from previous case notes and my professional judgement as well as make use of the codes of ethics. Here we can appreciate that I have took more of a consequentialist approach by calculating the likelihood of something occurring should I take a specific course of action. Essentially my decision was based on what could happen if I discounted Sarah’s Marijuana use given her history and my overriding concern for the children. I do believe I am more likely to take a consequentialist approach in the future as making decisions about other people’s lives is not something I can do without fully considering the consequences and I know this would influence my decision.

Although the ethical theories may not provide a formulaic algorithm that tells us what to do with ethical decisions and which decision should take priority; the reality is, even with the ability to reason as rational human beings there will be different opinions on the “right” course of action (Reamer, 2014). As professional social workers we need to have a grasp on our own personal values and beliefs and be aware of how these may influence our decisions. Professional judgement, knowledge and an awareness of guiding principles are necessary to manage common complex ethical dilemmas in the profession of social work.

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