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The COVID-19 pandemic has been particularly overwhelming for communities of color in the United States. In addition to the higher levels of underlying health conditions, circumstances related to a history of oppression and unequal access to opportunities and services are apparent. Social service programs will need to be re-developed to accommodate a new reality, both in terms of how people connect with services and how social work professionals provide them. Professional social work organizations' codes of ethics are analyzed, along with the theoretical framework of structural competency. It is an ethical imperative that social welfare policy and practice advance as culturally competent, racial equity, and empowerment-based programs. Child welfare is portrayed as an example where the pandemic could provide an opportunity to learn from the past to construct a more compassionate, competent, and ethical future.

Walking outdoors supports health and well-being, but some people living with dementia are at increased risk of getting lost and of harm while missing. Electronic monitoring can potentially play an important preventative role by enabling the person's location to be continuously monitored by caregivers. However, there are considerable ethical concerns arising from electronic monitoring. This paper explores these thematically, drawing attention to its implications for autonomy and liberty; privacy; dignity; the rights and needs of caregivers and families; beneficence and nonmaleficence. Following from this, key questions for consideration in social work assessment are identified. The ethical issues necessitate assessment of the person's unique circumstances and preferences and that of their caregivers, and careful ethical deliberation in decision-making. Social work can play an important role in facilitating inclusive assessment and decision-making, leading to consensus on intervening with electronic monitoring. The need for the ongoing review following implementation is discussed to track whether decisions need modification in light of the experience of usage. In conclusion, while legislative instruments and professional codes of ethics frame social work practice responses, there is need for a nuanced debate about ethical use of electronic monitoring and specific guidance to inform assessment, decision-making, and review.

This exploratory, qualitative research explored the ethical problems faced by hospital social workers in South Korea and Australia, and what and who influenced their decision making using a focus group design. Although dilemmas of boundaries, confidentiality, self-determination, and other complex scenarios found in practice were identified, moral distress, a consequence of the unresolvable conflicts, dominated participants' narratives. This was particularly the case for the Korean social workers in this sample. A thematic analysis of the data yielded three main themes: 'Under pressure-"It's very uncomfortable"'; 'Failing our patients'; and 'Coping and codes'.

Social service professionals can face challenges in the course of providing family planning information to their clients. This article reports findings from a study that developed an original 27-item measure, the Reproductive Counseling Obstacle Scale (RCOS) designed to measure such obstacles based conceptually on Bandura's social cognitive theory (1986). We examine the reliability and factor structure of the RCOS using a sample of licensed social workers (N = 197). A 20-item revised version of the RCOS was derived using principal component factor analysis. Results indicate that barriers to discussing family planning, as measured by the RCOS, appear to be best represented by a two-factor solution, reflecting self-efficacy/interest and perceived professional obligation/moral concerns. Implications for practice and future research are discussed.

Although each state in the United States legally authorizes involuntary civil commitment on the grounds of severe mental illness, a considerable number do not have comparable laws to mandate drug addiction treatment. This discrepancy is due, in part, to differing ethical positions regarding whether a substance use disorder diagnosis provides sufficient justification to suspend individual liberty rights. This article chronicles some of the legal and ethical thinking on the subject and applies them to a social work-specific context.

In 2016 almost 39,000 Muslim refugees entered the United States, representing a record of admissions during a time of elevated anti-Muslim political rhetoric and public sentiment. Anti-Muslim attitudes and policies can affect refugees' ability to successfully resettle and contribute to decreased health status. Given the current social and political moment there is an ethical imperative for social workers to engage in resistance to anti-Muslim sentiment and the encoding of Islamophobia in resettlement policy. In this article, the authors explore constraints on resettlement social workers' engagement with advocacy and make suggestions for ethical practice that promotes social and emotional well-being.

This qualitative study sought to explore and understand eating disorder (ED) therapists' perceptions of whether and how their personal ED histories had professional ethical relevance. Analysis of multiple interviews with 11 therapist-participants indicated that they perceived their personal ED histories as having substantial ethical relevance in their day-to-day practice with ED clients. The major categories of ethics experiences that emerged were: boundaries, therapist wellness, helpfulness of personal ED history, and openness regarding therapists' personal ED histories. The findings have practical utility for the education, training, and continuing education of ED-historied practitioners.

Access to family planning has been identified as critical to public health. Improving the linkage between medical and social services could result in improved access to care for those most at risk of unintended pregnancy. This study used a survey based on Alfred Bandura's social cognitive theory (1986) to increase the understanding of the barriers social workers confront in the provision of family planning information to clients. Although moral disagreement with family planning presented a barrier for some, workplace policy, participation in family planning trainings, and working in an urban setting were of greater value in understanding barriers.

Accompanying the multiple benefits and innovations of social media are the complex ethical and pedagogical issues that challenge social work educators. Without a clear understanding of the blurred boundaries between public and private, the potentially limitless and unintended audiences, as well as the permanency of the information shared online, social work students who use social media can find themselves in difficult situations in their personal and professional lives. In this article, we present three scenarios that illustrate issues and complexities involving social media use by social work students, followed by a discussion and recommendations for social work educators.

The world that social work exists in is no longer defined by traditional physical settings and boundaries, such as schools, agencies, or even offices. With the advent of the Internet and digital communications, social work now exists in a far more complex reality, with clients and social workers engaging across multiple platforms, and sometimes even unintentionally and without one another's awareness. The implications of this can be ethical, practical, regulatory, and personal. This article explores these areas of concern and suggests strategies professionals can use to navigate these complex issues related to technology and clinical practice.

Information and communication technologies (ICTs) are becoming essential to social work practice by providing increased treatment possibilities and reducing barriers to service. While recognizing the importance of ICTs in practice, social work practitioners have had concerns about ethical use. In response, NASW compiled the Standards for Technology and Social Work Practice. While the guidelines set the groundwork, they were not embedded in a process that would allow them to adapt to the swift pace of ICT changes. This article reviews the current Standards, evaluates how these have been implemented by practitioners, and offers suggestions for updates.

Ethical decision making is critically important in hospice social work. Through in-depth interviews, researchers explored ethical dilemmas faced by 14 hospice social workers and the processes they used to move toward resolution. The dilemmas were integrated into a framework focused on the sources of ethical conflict: the client system, the agency, and the profession. Processes involved in resolving ethical dilemmas included consulting with other professionals, weighing the pros and cons of options, and bringing about desired outcomes. Findings suggest that hospice teams should be provided with opportunities to meaningfully discuss ethical decision making. Further, the involvement of social workers in administrative leadership is recommended to increase the likelihood that discipline-specific perspectives are incorporated into formal policies and procedures that shape practice in ethically complex situations.

Medical social workers have needs for training in ethics that is specific to dilemmas that arise while providing service to patients who are very ill, mentally compromised, or in a terminal condition. A social work department developed a continuing education training to educate social workers in bioethics related to determining decisional capacity and understanding standards of ethical decision making. Case studies are used to illustrate ethical conflicts and the role of social workers in resolving them. The benefits of case study training are discussed.

The Recovery Approach has been adopted by mental health services worldwide and peer support constitutes one of the main elements of recovery-based services. This article discusses the relevancy of recovery and peer support to mental health social work practice through an exploration of social work ethics and values. Furthermore, it provides an exploration of how peer support can be maximized in groupwork to assist the social work clinician to promote recovery and well-being. More specifically, this article discusses how the narrative therapy concepts of "retelling" and "witnessing" can be used in the context of peer support to promote recovery, and also how social constructionist, dialogical, and systemic therapy approaches can assist the social work practitioner to enhance peer support in recovery oriented groupwork., (Copyright © Taylor & Francis Group, LLC)

Hospice social workers and members of the interdisciplinary team develop close therapeutic relationships with patients and families as they journey toward death. During this process, situations can develop that challenge professional boundaries and blur the line between a professional and personal relationship. This article will examine professional boundaries within the context of hospice care through case studies identifying challenges that hospice social workers and members of the interdisciplinary team may encounter with recommendations for how to manage boundary concerns.

This article reports diagnosis disclosure decision comments arising serendipitously in five focus group discussions with 34 HIV-infected New Yorkers over age 50. Three overarching disclosure themes demonstrate the complexity of diagnosis disclosure decision-making: (a) hiding or selectively disclosing, or stigma management; (b) partial disclosure because of the perception of partial control of the information; and (c) widespread or complete voluntary diagnosis disclosure, representing stigma resistance. Social workers and other human services practitioners should remember the diversity in the HIV population, the aging population, and the HIV-positive aging population. Experiences of HIV stigma and choices about diagnosis disclosure and stigma management or resistance are individual, reciprocal, and dynamic.

We review selected aspects of current ethical guidelines pertaining to the design and conduct of social work evaluation and research studies. We contend that there are significant differences between social science research and evaluation studies, and that the uncritical application of ethical guidelines suitable for regulating social science research may hinder social workers undertaking clinical and program evaluations. What is needed are ethical guidelines that distinguish between retrospective and prospectively designed studies, which enumerate when voluntary and informed consent may not be necessary in order to use data obtained from clients, and clearer standards pertaining to exempting evaluation studies from oversight by Institutional Review Boards.

The National Association of Social Workers (NASW) Code of Ethics identifies numerous ethical standards that describe the responsibilities for the social work profession to the broader society. Mentioned among these ethical standards is the responsibility for social workers to provide appropriate professional services in response to public emergencies. However, few empirical studies describing effective interventions for public emergencies are available. This article reviews empirical evidence that can be used to guide social work practice in response to public emergencies, the methodological issues that present challenges for evidence-based research during public emergencies, and provides suggestions for the delivery of professional social work services in response to public emergencies considering the limited empirical evidence.

The purpose of this research is to evaluate the compliance of e-therapy websites to the NASW Code of Ethics. The E-therapy Site Compliance Evaluation Form (ESCEF) was used to retrieve data from 66 e-therapy websites with social workers. This study utilized a mixed method using both qualitative and quantitative approaches. A high level of compliance was found with the duty to inform and a low level of compliance was found with the duty to maintain professional boundaries. The duty to maintain confidentiality and procedures to be used in an emergency yielded mixed results, raising some concerns. Although a large percentage (59%) presented the procedures to be used in an emergency, only a third (32%) required giving information on local backups. Implications are discussed for social work practice, policy guidelines, research, and education.

This study examined two matters pertinent to social work practice: professional ethics and age bias among practicing social workers. Because social work ethics demand competent practice within one's area of proficiency, and because bias toward any segment of social work clientele impedes competent practice, prejudicial attitudes toward older people are problematic. This study found that age bias exists among practicing social workers (N = 367), with no discernible association between knowledge of professional ethical standards and age bias. The findings suggest a subtle and pervasive bias associated with work with older people. Positive bias was more prevalent than negative bias.

Within health-care settings, culturally competent practice presupposes an understanding of the socio-cultural meanings attached to illness and disability and the people who are likely to be consulted with respect to providing health care and restoring well-being. Large numbers of South Africans are known to consult with traditional healers in preference to or in conjunction with western, allopathic health-care professionals. The present study represents a secondary analysis of data from various studies conducted on Black African, Muslim, Hindu and Chinese traditional healing systems in South Africa. Common themes that emerged from the analysis included the attribution of illnesses and disorders to spiritual factors, punishment and superstitious beliefs. Treatment approaches included the use of natural substances, prayer and rituals, and procedures that were designed to restore equilibrium. The participants also articulated their views on medical pluralism, collaboration between western and traditional health-care practitioners, and reasons why people consulted with traditional healers. The findings are discussed in terms of their ethical implications for social work.

Many healthcare organizations and government agencies are making detailed preparations for the possibility of a pandemic of highly virulent influenza. All plans to date have recognized that there will undoubtedly be a greater need for medical resources than will be available. Thus, we will be faced with a situation in which not all will be offered curative care, even if they could benefit from it. Even if there were sufficient amounts of vaccines, hospital beds, ventilators, and antibiotics, there are still expected to be large numbers of deaths as well as stress due to the overwhelming nature of the pandemic. The challenges of caring for the incurable, the uncured, healthcare workers, and the survivors and their families will place almost unprecedented demands on mental health workers. In this article, I discuss these ethical and medical challenges and the role that social workers will be called on to play.

Value conflicts can be a source of ethical stress for social workers in health care settings. That stress, unless mediated by the availability of ethical resource services, can lead to social workers' dissatisfaction with their positions and careers, and possibly result in needed professionals leaving the field. This study explored social workers' experiences in dealing with ethical issues in health care settings. Findings showed the inter-relationship between selected individual and organizational factors and overall ethical stress, the ability to take moral actions, the impact of ethical stress on job satisfaction, and the intent to leave position.

The importance of cultural competence in social work practice is becoming increasingly more evident as the dividing lines between countries and cultures continue to fade away. Successful practice in today's global environment hinges on the ability to accept differences and to work towards a shared future. The necessity of cultural competence is painfully obvious when considering HIV prevention and care. From the start, HIV has been a global epidemic that has devastated many regions of world. The current paper examines the issue of HIV care and prevention from the perspective of Indonesia and the United States. Juxtaposition of these two countries reveals that they have approached HIV care and prevention differently because of their different histories. However, it is advanced that the two countries are likely to have a shared future given the highest infection rates are locating in similar populations, i.e., sex trade workers, intravenous drug users, street children-generally the poor, the oppressed, and their partners. Culturally competent social workers can play an important role in the fight against HIV by understanding and adapting to cultural differences and by merging best practices.

UK government policies over the last decade or more have focussed on giving older people more voice in the design, delivery and assessment of services. Mirroring these trends, there has been a shift towards increased involvement of older people in the research process. Drawing on three research studies, this paper examines the contribution of social work to an inter-disciplinary research agenda designed to promote increased involvement of older people in issues of service quality in primarily health settings. Challenges and opportunities are discussed. Each of the studies illustrates the importance of promoting research practice congruent with social work's commitment to partnership and empowering forms of practice. This, it is argued, requires the challenging of ageist assumptions, the use of a range of research methods and the valuing of different forms of knowledge.

Social workers in health care and mental health benefit from interventions that integrate principles of contextual social work practice with standards for clinical practice. The authors articulate a conceptual framework for the ethical practice of social work that complements the social justice purpose. The sixteen ethical preferences in this framework are the ethics of care, autonomy, power, change, respect, critical thinking, praxis, discourse, critique, justice, contextual practice, inclusion, anti-oppression, advocacy, collaboration, and politicized practice.

This study addresses the fit between social work education and practice in health care. A random sample of NASW members identifying with health care (N = 179) responded to a mail survey about the utility of core knowledge and roles that we had identified by reviewing seven commonly used health care social work texts. Quantitative data revealed knowledge and roles most frequently used in health care settings as well as differences in roles used dependent upon department name; and different professionals supervising social workers. Qualitative data from four open-ended questions provided suggestions for what knowledge and skills should be taught in social work programs, the best forums/methods for teaching this content, and topics for continuing education. Findings are discussed in relation to six key areas of the peer-reviewed literature: vulnerable populations/diversity, ethical dilemmas, interdisciplinary collaboration, mental health, managed care/accountability, and advocacy. Implications for social work practice, education, and research are discussed.

The HIV/AIDS epidemic has impacted all levels of society from the individual to the macro-economic. The continuing spread of infection around the world means that traditional methods of care and support are put under extreme pressure and many families lose their capacity to cope. Social workers are involved in providing care, counseling and support to those affected, and in developing programmes and other interventions to prevent the spread of the disease. Prevention and behaviour change are vital, but access to treatment is an ethical imperative, particularly in developing countries where the epidemic is most prevalent. Social work is a profession uniquely situated to demonstrate leadership in multi-sectoral collaboration in responding to this pandemic. Consequently this paper briefly reviews the scale and current nature of the epidemic and then considers how social workers can help build more compassionate policies at an international level. Social workers can help to create awareness of the negative effects of poverty, tackle gender inequity, help build more effective coalitions and partnerships, and work with other concerned groups and organisations to end stigma and discrimination. Using case examples the paper considers how social workers can help develop caring strategies that improve the lives of those living with HIV and AIDS.

Graduate and undergraduate social work students (N = 172) were surveyed to investigate their perceptions concerning memory impairment in elders. Approximately 70% of those surveyed did not strongly disagree with the perception that all elders are memory impaired. In further analysis, significant correlations were found to exist between this variable and several other variables, including perceptions of elders' behaviors (r = .602, p = .000) and perceptions of communicating with elders (r = .630, p = .000). In a standard multiple regression, three significant predictor variables accounted for 53.4% of the model's adjusted variance. These predictor variables included: (a) perceptions of elders' behaviors, (b) perceptions of communicating with elders, and (c) having taken courses in gerontology.

Intervention regarding older adult mistreatment raises many questions for practitioners. They have to interact with the victim, the abuser, and, in many cases, with both of them at the same time. In such cases, five themes emerge from the literature review on psycho-social and ethical issues in practice: practitioners' pre-construction and axiological frameworks, victims' capacity, confidentiality versus collaboration between practitioners or between agencies, social and family responsibilities and the balance between competing values in practice. Practitioners are well placed to offer a critical reflection on their practice and on ways of improving it. The goal of our qualitative study is to identify issues and ethical dilemmas in elderly mistreatment situations as represented in the discourses of practitioners in reference to interventions in their psychosocial practice. Sixteen practitioners from the public and community (non-profit organization) sectors were interviewed using a practice history approach. This paper presents the main ethical and psychosocial issues raised by practitioners and some ideas to improve the practice. It is motivated by the crucial question haunting the practitioners' minds: "How far should we go?"

During the last decade, the prevalence of cancer pain and the reality of undertreatment have been well documented in both adults and children. There has been a proliferation of educational and regulatory activity setting an expectation that management of pain is a priority. At the same time, pain has come to the attention of the media, advocacy groups, industry, legislators, regulators and litigators creating an environment where this rich and multidimensional aspect of oncology care has moved beyond a clinical focus and opening up a range of opportunities for oncology professionals to participate as experts and leaders. The ethical underpinnings of the mandate to treat pain and attend to suffering compels psychosocial clinicians to advocate for the care of patients and consider participating in an informed way in the policy, legislative and political issues that flourish around the treatment of pain.

This random national survey anonymously explored 299 gerontological social workers' attitudes about spirituality and the use of spiritual interventions in practice. Respondents support the inclusion of religion and spirituality in education and practice as a diversity component, as part of holistic assessment, and as a fundamental aspect of human life. Nearly 70% of respondents report little or no preparation on spiritual issues during their schooling and only 24.5% report satisfaction with their educational preparation on this topic. While respondents' personal spirituality correlates positively and weakly with the use of spiritual interventions, it is ethical attitudes toward spiritual interventions that predict the use of spiritual interventions by gerontological social workers.

In all aspects of health and mental health care-the emergency room, the outpatient clinic, inpatient facilities, rehab centers, nursing homes, and hospices-social workers interact with patients from many different cultures. This paper will introduce an assessment tool for health care professionals to advance understanding of culturally diverse patients and their families.

Research over the last 12 years has repeatedly shown that African-American ESRD patients are less likely than white patients to be referred for a transplant evaluation. This article takes an exploratory look at issues surrounding this racial disparity. Among the issues focused on are: (a) the multiple ramifications from this racial disparity; (b) neglected factors which may be militating against the equitable referral of African-American patients; and (c) the vulnerabilities of this patient population. The final focus is on intervention strategies for nephrology social workers and how they might help to facilitate a greater equity in this area of health care with African-American patients.

To have a significant impact in the arena of pain management, social workers must be able to articulate social work values and concepts clearly, productively, and compellingly as assets in overcoming identified barriers to pain relief. A literature review concerning vulnerable populations, identified barriers, and related social policies explores alternative perspectives that social workers can bring to a multi-disciplinary team's efforts to improve the delivery of pain management technology. The article offers a beginning framework for discussions about the profession's potential contributions. The goal of these discussions is to contribute to encouraging a more pronounced involvement of social workers in pain management issues.

This study examines attitudes and experiences concerning voluntary euthanasia (VE) and assisted suicide (AS) among 862 professional social workers from Washington State, USA. Although AS has been portrayed as more acceptable than VE, social workers make only a minor distinction in their support for the legalization of such acts (VE 72.4%; AS 77.6%). Only 26.6% agreed with the US Supreme Court's ruling that assisted suicide is not a constitutional right. More than 75% believe that social workers should be involved in the decision-making process with clients who are considering VE/AS. About 20% of social workers report being consulted about VE/AS issues either by clients or in their personal lives. Social workers employed in medical settings are more than twice as likely to be consulted about VE/AS than those employed in non-medical settings. Religious commitment explains some opposition to VE/AS for Protestants and Catholics, but not for other faiths. A small number of social workers (19) admitted to assisting the death of a patient by VE and 5 admitted to AS.

Little empirical research examines the extent medical social workers try to change attitudes, norms, expectations, and protocols to create a hospital environment that encourages their participation in ethical deliberations. The researchers developed an ethical activism scale that measured the extent medical social workers engaged in such ethical activism, confirming its reliability from data obtained from a sample of 162 medical social workers in 37 hospitals in the Los Angeles basin. They tested seven hypotheses that probed the extent specific ethics-training, organizational, and demographic variables influence the extent social workers engage in ethical activism. Data strongly suggest the need to expand ethics training to include tactics of ethical activism, since many social workers do not engage in ethical activism. Data also suggest the need to target such training to social workers in hospitals that are relatively unreceptive to social workers' participation in ethical deliberations, since social workers are least likely to engage in ethical activism in such settings.

A survey of home health social workers (N = 51) explored the effects on patients of ethical conflicts over access to services. The findings suggest that patients were as likely to be discharged or not receive services as they were to receive the services without paying a fee. Social workers rated themselves as moderately influential in the resolution of the conflict. Their influence was significantly correlated with patients more often receiving services and less often being discharged. Social work influence was enhanced by recognition of professional expertise and/or through informal networking within the agency. Implications for practice and education are discussed.

Ethical dilemmas are an integral part of the practitioner's reality and impact upon the quality of care provided to the resident. The establishment of ethical principles aims to guide the worker through difficult scenarios involving morals, values and beliefs. Often, these precepts contradict one another and are strongly bound to the practitioner's and the resident's standpoints. The ethical principles of beneficence and respect for autonomy pose a conflict in judgment regarding an elderly woman's care in an 816-bed long term care facility. The contributing parties to the conflict are the medical staff, social worker and the resident. The ethical dilemma will be analyzed according to the utilitarian and deontological theories. Resolution to the conflict is offered at the conclusion.

There are several important issues influencing the holding of confidences in family therapy, among them are privacy, family secrets, confidentiality, and privileged communication. Clinicians need to be aware that breach of confidentiality is considered a high-risk area in clinical practice, which could be brought within a "low profile" malpractice configuration by adopting certain risk management techniques. Family therapists have an obligation to maintain their practice under the guidance of professional ethics, agency policies/procedures, and within emerging judicial parameters. The questions of confidentiality that confront family therapists have no clear and easy answers and the legal dilemma is ever present.