Ethical Dilemmas in Social Work Practice Preliminary Results of a Comparative Study Prof. Dr. Stefan Borrmann University of Applied Sciences Landshut (Germany)

Ethical Dilemmas in Social Work Practice

Preliminary Results of a Comparative Study

Prof. Dr. Stefan Borrmann

University of Applied Sciences Landshut (Germany)

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»Ethical Dilemmas in Social Work Practice«

General Overview

Conceptualization of the study and data collection during

a stay as a visiting scholar at the UC Berkeley

Financially supported by the Hans-Böckler-Stiftung;

logistically supported by the University of California at

Berkeley, School of Social Welfare

Data collection from November 2004 to January 2005



Leading Research Questions

Can the value base of social workers in the same field of

action in the USA and Germany be compared with each

other?

Are there similarities in the perceived ethical

issues/dilemmas of social worker who work in the same

field of action?

Are there differences in the way social workers deal with

these ethical dilemmas?



Outline of the Study and Methodological Scheme

Pilot study with the main aim to develop future research

questions

Anonymous online-questionnaire focusing mainly on the

value base and perceived ethical issues of social workers

in the chosen field of practice

Face-to face interviews with social workers about ways

and methods to deal with ethical issues



Chosen Field of Practice

Social workers currently working in agencies of the field of

HIV/Aids in San Francisco and Berlin A field of action where ethical dilemmas are most likely examined

The evolution and development of the social problems concerning

HIV/Aids in these two cities can be compared with each other

Access to the field (in Berlin) was secured in advanced



Sample

Sample in the USA: 126 agencies in the database of the

CDC National Center for HIV, STD and TB Prevention

Sample in Germany: 43 agencies listed by the Ministry for

Integration, Labor and Social Issues of the City of Berlin

(and additional resources)

The agencies were ask to forward my request to their

employees and volunteers

Random sample: 105 people participated in total, 70 in

Germany and 35 in the USA



(Academic) Degrees of the Participants (in %)

Erzieherin 4,29 Foreign Academic Degree 5,88

Krankenpfleger/ -schwester 1,43 BSW 17,65

anderer Ausbildungsberuf 12,86 other Bacherlor Degree 20,59

Dipl.-SozialarbeiterIn (FH) 32,86 MSW 35,29

anderer FH-Abschluss 4,29 other Master Degree 23,53

Dipl.-PädagogIn 15,71 PhD 8,82

anderer Uni-Abschluss 25,71 No post-high school 2,94

Dr. phil. 4,29 other 11,76

kein Berufsabschluss 4,29

anderer 4,29N (Germany) = 77, multiple answers were possible, 70 of 70 participants responded

N (USA) = 43; multiple answers were possible, 34 of 35 participants responded

Germany USA

Dipl.-SozialarbeiterIn (FH): 32,6%

BSW: 17,65%

Dipl.-PädagogIn (Uni): 15,7%

MSW: 35,2%

Dr. phil.: 4,3%

PhD: 8,8%



Personal Opinions about Selected Ethical Issues (in %) 1

Strongly agree2

Agree3

Neutral4

Disagree5

Strongly DisagreeN

All prisoners should be screened for HIV

GER 10 15,71 4,29 12,86 57,14 70

USA 34,29 8,57 14,29 25,71 17,15 35

AIDS-patients should have the obligation to participate in clinical trials

GER 0 1,43 0 18,57 80 70

USA 20 8,57 0 20 51,53 35

Pregnant women (HIV-positive/with AIDS) should be allowed to take drugs that are known to present a serious risk (e.g., stillbirth, malformation, handicap) for the unborn

GER 1,43 8,57 32,86 21,43 35,71 70

USA 8,57 25,71 17,14 2,86 45,71 35

34,3%

57,1%




Strongly agree2

Agree3

Neutral4

Disagree5

Strongly DisagreeN


GER 10 15,71 4,29 12,86 57,14 70

USA 34,29 8,57 14,29 25,71 17,15 35


GER 0 1,43 0 18,57 80 70

USA 20 8,57 0 20 51,53 35


GER 1,43 8,57 32,86 21,43 35,71 70

USA 8,57 25,71 17,14 2,86 45,71 35

0%

20%




Strongly agree2

Agree3

Neutral4

Disagree5

Strongly DisagreeN


GER 10 15,71 4,29 12,86 57,14 70

USA 34,29 8,57 14,29 25,71 17,15 35


GER 0 1,43 0 18,57 80 70

USA 20 8,57 0 20 51,53 35


GER 1,43 8,57 32,86 21,43 35,71 70

USA 8,57 25,71 17,14 2,86 45,71 35

8,6%

25,7%




Strongly agree2

Agree3

Neutral4

Disagree5

Strongly DisagreeN

Physicians should inform the spouses or partners of HIV-positive tested patients when the patients refuse to do so

GER 0 5,71 22,86 32,86 38,57 70

USA 11,43 20 8,57 17,14 42,86 35

Physicians should inform the spouses or partners of HIV-positive tested patients when the patients refuse to do so AND when there are valid indicators that the patient will practice unsafe sexual practices in the future

GER 14,29 31,43 24,29 17,14 12,86 70

USA 22,86 25,71 28,57 0 22,86

35

0% 5,7%

14,3% 31,4%




Strongly agree2

Agree3

Neutral4

Disagree5

Strongly DisagreeN

Physicians should inform the spouses or partners of HIV-positive tested patients when the patients refuse to do so

GER 0 5,71 22,86 32,86 38,57 70

USA 11,43 20 8,57 17,14 42,86 35

Physicians should inform the spouses or partners of HIV-positive tested patients when the patients refuse to do so AND when there are valid indicators that the patient will practice unsafe sexual practices in the future

GER 14,29 31,43 24,29 17,14 12,86 70

USA 22,86 25,71 28,57 0 22,86

35

11,4% 20%

22,9% 25,7%



Perceived Ethical Dilemmas (in %)GER USA

Informed consent 15 16

Cultural competence of you or one of your colleagues 66 40

Competence of you or one of your colleagues 40 40

Conflict of interest between you and your client 25 20

Conflict of interest between you and the agency you are working for 32 36

Conflict of interest between you and persons from other professions 34 56

Privacy and confidentiality 25 68

Access to records 2 20

Sexual relationships to clients 8 0

Sexual relationships to colleagues over whom you exercised prof. authority 3 0

Clients who lack decision-making capacity 47 64

Billing 27 32

Unethical conduct of colleagues 47 64

N (Germany) = 194; multiple answers were possible, 59 of 70 participants responded


34% 56%

25% 68%

2% 20%

Conflict of interest between you and persons from other professions

Privacy and confidentiality

Access to records



Ways to Deal with Ethical Issues (in %) GER USA

Discussion with colleagues 94,12 88,57

Discussion with own family and friends 36,76 25,71

Discussion with supervisors 54,41 71,43

Using policies and procedures provided by the employer 27,94 54,29

Using the Code of Ethics of the DBSH / NASW 10,29 40

Consulting professional publications (i.e. handbooks, journal articles, or manuals) 30,88 37,14

Legal counsel 23,53 31,43

In-service training 63,24 31,43

Other 10,29 2,86



Discussion with own family and friends 36,7% 25,7%












Other 10,29 2,86



Using the Code of Ethics of the DBSH / NASW 10,3% 40%












Other 10,29 2,86



In-service training 63,2% 31,4%



Policies and Procedures of the Agency (in %)

Yes No I am not sure

N

Does the agency you are working for have appropriate policies and procedures in place concerning employees' handling of boundary issues and conflicts of interest?

GER 52,94 26,47 17,65 68

USA 82,86 0 17,14 35



First Results There were only minor differences in the personal opinions

about selected ethical dilemmas of the social workers in

Germany and the USA

There were similarities in the perceived ethical

issues/dilemmas of social worker who work in the same

field of action but mayor differences in the area of

confidentiality occurred

The way professionals deal with ethical dilemmas however

are raising questions about differences in social work

education and the organization of the agencies themselves

Documents

Ethical Dilemmas in Social Work Practice Preliminary Results of a Comparative Study Prof. Dr. Stefan Borrmann University of Applied Sciences Landshut (Germany)