Introduction
This essay examines the ethical dilemmas presented in the case of Tina, a client with bipolar disorder under the care of Mary, a mental health agency case manager. Tina’s disclosure of an intimate relationship with a previous social worker raises significant ethical concerns that must be navigated with care. To address these issues, this essay will utilise Reamer’s ethical decision-making framework, a widely recognised model in social work for resolving complex ethical challenges. The discussion will first identify the specific ethical issues in the case, drawing on concepts from Chapter 4 of Daley’s text regarding professional boundaries. Subsequently, it will outline a structured resolution process using Reamer’s framework, demonstrating how Mary can balance competing ethical obligations while prioritising Tina’s well-being. This analysis aims to provide a clear and logical approach to handling the situation, with reference to relevant academic sources.
Identifying Ethical Issues
The primary ethical issue in Tina’s case centres on the breach of professional boundaries by her previous social worker, who engaged in an intimate relationship with her. As highlighted in Chapter 4 of Daley’s text, maintaining clear boundaries is fundamental to ethical social work practice, ensuring that power imbalances are not exploited and client vulnerability is safeguarded (Daley, 2018). Such relationships violate core principles of the profession, including integrity and client protection, as they can cause emotional harm and undermine trust in services. Additionally, Tina’s plea for Mary not to report the incident introduces a secondary dilemma: the tension between respecting client confidentiality and the duty to report unethical conduct to protect others from potential harm. This conflict underscores the complexity of ethical decision-making in social work, where competing values—such as autonomy and justice—must be carefully weighed. Furthermore, Tina’s fear of disbelief raises concerns about her emotional well-being and the potential for retraumatisation if the issue is mishandled. These intertwined issues necessitate a structured framework to ensure a responsible resolution.
Applying Reamer’s Framework
Reamer’s ethical decision-making framework offers a systematic approach to resolving such dilemmas, comprising several key steps: identifying the problem, considering relevant ethical principles, evaluating alternatives, and implementing a decision with ongoing monitoring (Reamer, 2013). Firstly, Mary must clearly define the ethical problem as a breach of professional conduct by the previous social worker, alongside the conflict between confidentiality and reporting obligations. Secondly, relevant ethical principles include respecting Tina’s autonomy by honouring her request for privacy, while also adhering to the duty to protect public welfare by addressing potential misconduct. The British Association of Social Workers (BASW) Code of Ethics emphasises accountability and safeguarding as central to practice (BASW, 2014), which supports the need for action despite confidentiality concerns.
Thirdly, Mary must evaluate possible courses of action. One option is to maintain strict confidentiality, prioritising Tina’s trust. However, this risks enabling further unethical behaviour by the social worker, potentially harming others. Alternatively, Mary could report the incident anonymously to the relevant regulatory body, minimising direct exposure for Tina while fulfilling her duty to report. Another possibility involves seeking Tina’s consent to disclose the information, ensuring her agency in the process. Reamer’s framework encourages weighing the potential consequences of each option, considering both short-term impacts (e.g., Tina’s emotional distress) and long-term implications (e.g., systemic accountability). Consulting a supervisor or ethics committee, as Reamer advocates, would also provide additional guidance and support.
Finally, Mary should implement the chosen action—arguably, reporting with Tina’s informed consent—and monitor the outcomes. This includes offering Tina ongoing emotional support to mitigate any distress and ensuring she feels heard throughout the process. This approach balances ethical obligations while minimising harm, aligning with the principle of beneficence discussed in Daley’s Chapter 4 (Daley, 2018).
Conclusion
In conclusion, Tina’s case presents significant ethical dilemmas involving professional boundary violations and confidentiality conflicts. By applying Reamer’s framework, Mary can systematically address these issues, ensuring a balance between client autonomy and professional accountability. The process highlights the importance of ethical principles, such as safeguarding and integrity, in guiding social work practice, as reinforced by concepts from Daley’s text. This resolution not only protects Tina’s well-being but also upholds the profession’s standards, preventing future harm. Indeed, the case underscores the necessity of structured ethical decision-making in navigating the complexities of social work. Future practice implications include the need for robust training on boundaries and enhanced support mechanisms for clients disclosing sensitive issues, ensuring that ethical challenges are met with clarity and compassion.
References
- British Association of Social Workers (BASW). (2014) The Code of Ethics for Social Work. BASW.
- Daley, M. (2018) Social Work Ethics and Professional Boundaries. 2nd ed. London: Sage Publications.
- Reamer, F. G. (2013) Social Work Values and Ethics. 4th ed. New York: Columbia University Press.
