Ethical Dilemma of the Month
Response to Member re Unethical Behavior of a Client Who Is Also a Social Worker
An NASW member requested Office of Ethics and Professional Review (OEPR) comment on the following situation:
A female client who is also a social worker has revealed that she has engaged in dual relationships with her own clients. In one instance, the social worker client hired a former client as a secretary. In another, she invited a client to attend a professional social work seminar and gave the client a ride to the seminar. The social worker client also recently revealed to the caller that she had engaged in a romantic relationship with a former client as well. The caller wanted to know what his responsibilities are in relation to his social worker client’s apparently unethical behavior.
Before turning to the substance of this inquiry, please be reminded that there are no hard and fast ethical “rules” governing a professional social worker’s conduct in a professional setting. There are only guidelines. An excerpt from the Purpose section of the NASW Code of Ethics states:
“The Code offers a set of values, principles, and standards to guide decision making and conduct when ethical issues arise. It does not provide a set of rules that prescribe how social workers should act in all situations. Specific applications of the Code must take into account the context in which it is being considered and the possibility of conflicts among the Code's values, principles, and standards. Ethical responsibilities flow from all human relationships, from the personal and familial to the social and professional.”
Nevertheless, there are specific standards of the code that seem related to the situation as posed, that might inform the decision-making process in this instance. In addition, there are certain questions that might be asked to help determine what seems to be the wisest course of action. Please note that the questions included here are not exhaustive in nature. The may well be others that could and should be considered.
The ethical dilemma: The most obvious standard in the code pertains to dual relationships (1.06 c). However, before reviewing that standard, it is important to first identify what the ethical dilemma actually is in this instance. To be an ethical dilemma, there must at least be two conflicting or competing elements. These can be competing ethical standards, principles, values, a conflict between agency policy and an ethical standard, etc. At the outset the dilemma in this instance could be defined as consisting of a conflict between two ethical standards. These two standards from the NASW Code of Ethics are presented next:
“2.11 Unethical Conduct of Colleagues. (a) Social workers should take adequate measures to discourage, prevent, expose, and correct the unethical conduct of colleagues.”
“1.07 Privacy and Confidentiality. (a) Social workers should respect clients' right to privacy. Social workers should not solicit private information from clients unless it is essential to providing services or conducting social work evaluation or research. Once private information is shared, standards of confidentiality apply.”
- Does a social workers responsibility to address unethical conduct in a colleague also pertain to misconduct by a social worker that is revealed in the context of therapy?
- Is the responsibility to uphold the standards of the profession superceded by the social worker client’s right to confidentiality?
- What standard of the Code of Ethics is the social worker client’s conduct allegedly violating?
The last question relates to the standard in the Code mentioned earlier (1.06c). That section of the Code reads:
“1.06 Conflicts of Interest. (c) Social workers should not engage in dual or multiple relationships with clients or former clients in which there is a risk of exploitation or potential harm to the client. In instances when dual or multiple relationships are unavoidable, social workers should take steps to protect clients and are responsible for setting clear, appropriate, and culturally sensitive boundaries. (Dual or multiple relationships occur when social workers relate to clients in more than one relationship, whether professional, social, or business. Dual or multiple relationships can occur simultaneously or consecutively.)”
- Would there be any risk of exploitation or harm to the clients of this social worker (i.e., the clients of the client of the caller) in any or all of the three situations described?
- Were the dual relationships unavoidable in any or all of these three instances?
- What would constitute clear, appropriate and culturally sensitive boundaries?
- Does there appear to be a pattern of misconduct by the social worker client involving dual relationships and possibly sexual misconduct?
- Would this alleged misconduct, if true, place more than one person at risk?
- Does the placing of many people being seen by the social worker client at risk fall within the responsibility of the social worker clinician to the larger society?
This last question raises the issue of the social worker clinician’s responsibility to the broader society. Standard 6.01 of the Code of Ethics reads:
“6.01 Social Welfare. Social workers should promote the general welfare of society, from local to global levels, and the development of people, their communities, and their environments. Social workers should advocate for living conditions conducive to the fulfillment of basic human needs and should promote social, economic, political, and cultural values and institutions that are compatible with the realization of social justice.”
- In the situation the caller described, just what is the social worker’s responsibility to the broader society?
- Does the social worker’s responsibility to the larger society as well as his responsibility to prevent a colleague’s misconduct take precedence over his responsibility to protect his client’s confidentiality?
- If so, does this mean he has an obligation to report the alleged misconduct?
- To whom would the report be made?
This last question returns the discussion to standard 2.11 of the Code, Unethical Conduct of Colleagues, sections b, c and d. Those sections read:
2.11 Unethical Conduct of Colleagues.
(b) Social workers should be knowledgeable about established policies and procedures for handling concerns about colleagues' unethical behavior. Social workers should be familiar with national, state, and local procedures for handling ethics complaints. These include policies and procedures created by NASW, licensing and regulatory bodies, employers, agencies, and other professional organizations.
(c) Social workers who believe that a colleague has acted unethically should seek resolution by discussing their concerns with the colleague when feasible and when such discussion is likely to be productive.
(d) When necessary, social workers who believe that a colleague has acted unethically should take action through appropriate formal channels (such as contacting a state licensing board or regulatory body, an NASW committee on inquiry, or other professional ethics committees).
Comment: These sections seem quite clear as to the options for where the social worker would make a report concerning alleged unethical behavior. The dilemma was originally posited as a conflict between this obligation to act regarding a colleague’s unethical behavior and that same colleague’s right to confidentiality as a client.
There are many other questions and considerations, which might apply to this situation, depending on other factors that, may or may not be operative. Some of the questions included here may not apply in this instance or may have already been answered in the description of the problem. A useful format for problem-solving an ethical dilemma can be found on this web page as well.