Ethics and Advocacy

In class recently, we had a long discussion about how many social work students (and, I would argue, practitioners) are relatively unfamiliar with the obligations of our Code of Ethics. We may know the Code well enough to stay out of trouble, but our incomplete understanding often fails us when we face those difficult, ‘gray’ areas that predominate in macro practice, where the Code is much less explicit and ethical dilemmas abound. Here are some of the questions, none of which have clear-cut answers, that I often ask my students as we grapple with these real-life challenges. Donna Hardina and other social work authors have done some excellent work exploring ethical decision-making models with relevance for advocacy practice. A research interest of mine relates to how social workers navigate the ethical differences in macro vs. direct micro practice, and also how social work advocates encounter ethical dilemmas differently than the non-social work advocates and organizers with whom they most often work. I have included some of the ethical dilemmas, all drawn from real practice, that I ask my students to consider. Tell me, what would you do in these cases? How do you make ethical decisions in advocacy practice? How would you revise the NASW Code of Ethics (if at all) to make it more helpful to macro practitioners?

The NASW Code of Ethics includes some specific mandates to engage in advocacy—‘challenge social injustice’, ‘advocate within and outside their agencies for adequate resources to meet clients’ needs (3.07a), ‘ 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’ (6.01), ‘engage in social and political action that seeks to ensure that all people have equal access to the resources, employment, services, and opportunities they require to meet their basic human needs and to develop fully’ (6.04a).
There are also implicit requirements to engage in advocacy, as it is necessary in order to ‘promote the well-being of their clients’ (1.01), and to fulfill the social work mission statement (given that the status quo creates and perpetuates social problems and human need).
What does it mean to fulfill our ethical obligation to fight oppression and discrimination, given that many of us, as privileged members of society with higher education and professional careers, have in some ways benefited from the status quo? How can we practice social work ethically without engaging in radical practice?
How do we fulfill these mandates (given limited time and resources) and our other social work obligations simultaneously (like commitment to clients, supervision, recording)?

A. Means vs. Ends
1. Does our ethical obligation to respect the dignity of all persons mean that adversarial tactics that could harm opponents must never be utilized by community/advocacy practitioners? What does this mean for promoting clients’ interests, if these are the best/surest way to win?
2. What does cultural competency mean in terms of adopting strategies that may be comfortable for one community but not for another?
3. Given that ethical dilemmas really only exist when there are legitimate, available alternative actions, and that macro practitioners are often highly limited in their options, should ‘unethical’ means be employed when they are the only ones available? Are there some actions which are inherently unethical, always, or are ethics in community/advocacy practice by definition situational ethics? If the latter, what guides us?

B. Informed consent, paternalism, self-determination
1. How does one obtain informed consent on behalf of a large class of potential beneficiaries?
2. How do social work advocates reconcile the pursuit of the most expedient/effective means with the obligation to ensure that ‘clients’ (question about exactly who this is in advocacy/community practice) self determine the course of action? Again, what about in the context of our ethical obligations to advocate and to advance client interests (especially when the Code allows for advocacy ‘on behalf of’ rather than ‘with’)?
3. If one gives testimony or media interviews or other public communication ‘on behalf of’ an affected community, is this indefensible paternalism?
4. What should social workers do if community members’ self-determined goals are contrary to social work values?
5. Given that so much of the advocacy process is impossible to predict, how can a participant ever really give truly informed consent? (we can never say what the effects or outcomes will be, either on individuals or in terms of results)

C. Competency
1. Given that few social work schools adequately prepare practitioners to engage in community/advocacy practice (because, indeed, it is difficult to do so in an academic context), is it unethical for macro practitioners to ‘learn on the job’ if doing so means that they are practicing before being completely competent?
2. How is competency to be judged, given that there is no uniform opinion about what makes good advocacy practice and that so much of the success of macro practice depends on external variables (and on context)? There’s no universal standard for competency, and the environment changes so rapidly that we’re trying to ‘stand on shifting sands’.

D. Tensions between clients’ needs and those of the employing agency (or general society)
1. Is it unethical to carve out one group of beneficiaries in order to increase the likelihood of legislative passage (if all need the solution)? If no, how are we ever to work on incremental policies when a complete overhaul is what’s needed (which is almost always the case)?
2. Is it unethical to represent, as an organizer, the needs of one community over another? If not, how do we build solidarity and group identity?
3. What should an ethical community practitioner do when the employing organization’s policies or interests are opposed to those of the client/community (given that social workers have an obligation to both)? Is this different when an organization is trying to develop?

E. Integrity (related to means and ends, but also somewhat distinct b/c social workers have a specific obligation to act with integrity that is not present in all professional codes of ethics)
1. Is it unethical to work in coalition with organizations that have behaved in ways contrary to the NASW Code of Ethics? How far back should we look? What about blemishes in our own organizational history?
2. Is it unethical to lead decision makers to believe that a problem is more severe than we can prove it is (even if we really believe it to be so)?
3. Is it unethical to lead policy makers to believe that a solution is surer than we can prove it is (even if we really believe it to be so)? This isn’t necessarily misrepresentation, but there are questions regarding the level of certainly required.

F. Privacy and Confidentiality
1. How can macro practitioners ‘put a human face’ on community/policy problems without compromising client confidentiality?
2. How can clients be spokespersons for the issues on which they’re working without (in addition to their voluntary disclosure about their situations) also disclosing that they are working with the social worker/agency?

Limitations of the NASW Code of Ethics for Advocacy/Community Practice
• Definition of ‘client’ as primarily individually focused
• Dual relationship prohibitions/cautions presume more ‘traditional’ clinician role rather than one of community practitioners—this does NOT mean no boundaries, but the boundaries and roles are different in community practice
• Nature of social work relationship different—mutual impact assumed, and more reciprocal relationship for community practitioners than clinicians
• Conflict of interest more fluid, given that many organizers come from the same communities where they are working
• Given that some macro practitioners engage in advocacy on their ‘own time’, unclear how NASW Code of Ethics applies to this volunteer practice

ethical-dilemmas

17 responses to “Ethics and Advocacy

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  4. I really like how you raise these questions for social work advocates. My foundation year it seemed as if ethical questions were mostly around direct practice issues. I especially like when you talk about privacy and confidentiality.

    F. Privacy and Confidentiality
    1. How can macro practitioners ‘put a human face’ on community/policy problems without compromising client confidentiality?

    This specifically comes to mind because last semester, I needed an advocacy practice way to enhance my professional development for my learning contract. I wrote a policy brief over legislation impacting human trafficking and presented it to my Congressman. The Modern Abolitionist Movement, or anti trafficking movement is somewhat against re-telling stories of clients outside of context because they feel like it is “re-exploiting” them again. So, I told the story of a particular client from a service provider perspective, offering more generic examples and “run of the mill” examples of problems that human trafficking survivors face, which one could easily find from doing a google search. Then I just talked about how the barriers could be eliminated with the specific legislation for which I was advocating for.

    I think one can put a face on an issue by asking for either generic examples, or asking a client to share their story anonymously through a story database. My practicum agency has a database of survivor stories which can be used in the public because the specific survivor has signed a release. A social worker could come up with something similar by asking a client at the end of services if they were interested in doing that and then sign a form.

    • Thanks for sharing that example, Adele! I am glad to hear that your organization has taken steps to overcome the tension between needing to protect clients’ confidentiality and yet humanizing the issues on which we’re working such that they have a greater chance of being resolved. I still think it can be difficult to have truly informed consent around confidentiality, because we just can’t control how narratives will be used in the advocacy process. And, even if clients’ names are removed, seeing our stories in print or in a policy debate can still feel like a breach, because those details are personal to us, with or without our identifying information. I don’t know how one overcomes that, though, other than forming really solid relationships with clients and sharing everything we do know about how the disclosure might unfold. I am so glad to see you already navigating these quandaries with such thoughtfulness!

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  6. C. Competency
    1. Given that few social work schools adequately prepare practitioners to engage in community/advocacy practice (because, indeed, it is difficult to do so in an academic context), is it unethical for macro practitioners to ‘learn on the job’ if doing so means that they are practicing before being completely competent?

    I have always wondered about this and I am glad that this is a discussion. I was taught all in my undergraduate to be “competent” before we start practicing. The question that this raises for me, are any of us really completely “competent”. I think a lot of social work practices thrive off of trial and error. How do we know if something works if we don’t try it?
    I think it is so facinating that the Code of Ethics requires us to learn before starting to the job. The problem is that social work isn’t learned just in the class room, but with real life experiences. I have always wanted to advocate in Topeka, and don’t really know how to go about this. But what is important and that social workers should know is the restrictions for the non-profits they work for. This is an area we should be confident and competent that we are not breaking any rules. Ethical conflicts are the WORST. I don’t like not having any definite answer. I guess I better get use to it with this profession.

    • This resonates with me so much, Morgan. What is ‘competency’, really, in the relatively unproven areas in which we work? With a presumption of competence comes some arrogance, I think, and I, for one, start to feel really uncomfortable with presenting myself as though I know all I might need to know. How do you define competence? How do you think our Code defines it? What do we do if those definitions don’t align?

  7. Since I began my studies as a masters level social work student I have been exposed to the macro-level experience of the profession; this is advantageous in many ways, but there are definitely some disadvantages that are clear when it comes to evaluating direct practice processes, etc. One advantage I’ve had is exploring the ethical dilemmas in a supervision course I took my first year studying at Case Western. We reviewed multiple scenarios and had to apply the ethical decision-making model at each step answering the following questions:
    • Define the ethical issues, including the social work values and duties that conflict
    • Identify the individuals, groups, and organizations who are likely to be affected by the ethical decision
    • Tentatively identify all possible courses of action and the participants involved in each, along with possible benefits and risks of each
    • Thoroughly examine the reasons in favor of and opposed to each possible course of action
    • Consult with colleagues and appropriate experts (such as agency staff, supervisors, agency, administrators, attorneys, ethics scholars)
    • Make the decision, monitor, evaluate, and document the decision-making process
    Answering these questions I was able to make a clear distinction between, as you put it, Melinda, “the ethical differences in macro vs. direct micro practice, and also how social work advocates encounter ethical dilemmas differently than the non-social work advocates and organizers with whom they most often work. “ It was interesting to explore the different thought processes that occur at each level of practice and then to realize how important it is for social workers to be able to examine ethical implications at all these levels regardless of their practice focus. In other words, I found that it was impossible to compartmentalize social work practice when it comes to ethics and thus found the NASW Code, as it is, to be useful. Of course there are some changes I would make to the Code but I’m unsure how I would edit the Code to fit macro practice.

  8. That’s the challenge, of course; even though there are areas where the Code may not optimally serve our needs as macro practitioners, opening it up for revisions raises the specter of all kinds of problems…and also runs the risk of inadvertently sending the message that we think the Code doesn’t apply to ‘our kind’ of social work. Still, the strictures around informed consent are tricky for me to wrap my head around, so those continue to plague me. I appreciate you sharing the decision-making approach that you have found useful, though.

  9. madelinegiesler

    I really relate to the “crises of conscience- when we know the right thing to do and we just need to muster the courage to do it”. It can be daunting to bear the weight making a decision in an ethical dilemma, and discussing with one’s supervisor can be so helpful just for reassurance. I have had a few instances when I asked for advice on an issue at the agency, and I already knew what would be the best course of action. However, I have also had experience where I receive feedback on an issue that is extremely helpful. I think that when in doubt, discussing the ethical issue with another person is the best choice a professional can make, because it at least means you spent additional time deliberating the different outcomes and how they would impact the client.

    Another interesting issue brought up in another post was “how far back should we look” to decide if an agency’s past history is ethical. I think that this is relevant and applicable in many different ways, such as how far back should we look at an individual’s past to make decisions about them (examples: client eligibility for services, past issues within the agency, or hiring new staff). I think that agencies can make poor choices or mistakes, and there is also room learning and evolving. As social workers and administrators, we should understand the capacity of individuals and of agencies to change and grow. I do not think that we can make overall judgments on an agency or a client based solely on something from their history. We must also take into consideration what they have done to change their actions or make up for ills in the past, and determine what would be the most ethical decision for moving forward.

    • Oh, yes, the ‘consultation’ as cover…or reassurance, when we already know what we need to do, but just don’t feel confident to make the decision ourselves. Kudos to you for recognizing that, and for bracing yourself for taking the next step, and leaping in the right direction alone next time!

  10. Brittany Brooks

    I really struggle with the means vs. ends problem this semester. While we were working on a bill at the Alzheimer’s Association we had to go against the nursing home lobbyist. As a lawyer she gets to play by different rules. Its hard to win when your opponent has no rules. I still do not know the answer, and I will be faced with this in my future career for sure. I also struggle with the competency aspect. To some extent one has to learn on the job, but often this feels inadequate. It is difficult to distinguish whether this is just a case of impostor syndrome or whether my feelings are related more closely to the competency ethic. I think these are things that I will have to battle with and think about for years to come, because there is no simple solution. I feel that the code of ethics assumes all social workers are micro workers who do advocacy in their free time. I wish there were more specific ethical guidelines for macro practice, but then again with as vast of field as macro work is, it would probably be an impossible task.

  11. What specific ethical guidelines do you feel are ‘missing’, Brittany, that you wish you had to guide your practice? And, when you say that the other lobbyist had ‘no rules’, what do you mean by that? Certainly she doesn’t have to abide by the NASW Code, but there are not only real strictures governing other professions, but also the reality that those who develop a reputation for acting without integrity will pay a price for those actions, in terms of their ability to get things done. Do you see that manifesting? Is that the type of behavior you’re referencing?

  12. E. Integrity
    2. Is it unethical to lead decision makers to believe that a problem is more severe than we can prove it is (even if we really believe it to be so)?
    I wanted to touch on our value of integrity, mainly because that is what I feel I deal with day-to-day while working on an interdisciplinary team. More so, the question seemed to present a tactic I see used in mental health settings a lot. Ultimately, leading people on would just be lying…essentially that is what it is, and it’s often used to get better results. Which, if we were honest, is a good tactic to use. We can twist words or use a different tone of voice to imply something without having to actually lie. I get it. However, and what I have to constantly remind myself, is that integrity goes right along with honesty; and in this profession we have to be different! We are mandated to be different in our actions, words, and deeds. We can get results without having to mislead people. Simply stating facts should be all that we have to say. We have to remember to not get to emotionally attached or invested in a situation that could cause us to question our integrity in the first place. Ethical dilemmas are simply that, dilemmas that cause us to pause and think about what to do. Thankfully, we have a code that can help guide us in the right direction.

    • Thank you for this–yes, we have to constantly remind ourselves that efficacy isn’t the standard; we care not if something ‘works’, but if it’s right (or, I guess, at least FIRST if it’s right, because if it isn’t, it doesn’t matter if it works). And, also, an important reminder that lies should be labeled as such…and if we don’t hold ourselves to that standard, how can we expect to hold anyone to it?

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