Review Policy Advocacy Challenge 13.5, “Ethical Dilemmas in Policy Implementation.”
Policy Advocacy Challenge 13.5
Ethical Dilemmas in Policy Implementation
Gretchen Heidemann, Ph.D., Suzanne Dworak-Peck School of Social Work at USC
The Code of Ethics of the NASW outlines the ethical principles—ideals to which all social workers should
aspire—and the ethical standards that are relevant to the professional activities of all social workers. Yet,
despite these clearly articulated guidelines, ethical dilemmas frequently arise in practice. When it comes to
implementing policy at the organizational, community, and even higher levels, social workers might face
dilemmas in honoring client self-determination and honoring privacy and confidentiality. Let us consider a
couple examples.
Imagine you are a medical social worker at a private hospital. The hospital hires a new chief executive officer
(CEO) who, for religious reasons, opposes abortions and institutes a hospital policy against performing
abortions, providing abortion counseling, or even referring patients out to family planning clinics. Regardless of
your own personal beliefs about abortion, as a social worker you are committed to honoring your patients’ selfdetermination. A young woman who has been raped comes to see you seeking a referral to get an abortion.
Imagine you work at a homeless shelter. The well-intentioned director, who is not a social worker, implements a
new policy barring any staff from reporting clients to children’s services without first consulting with her. She
does this because she believes these families need to be protected against society’s stereotype of them as
bad parents. One evening at the shelter, you witness a husband degrading and physically assaulting his wife in
front of their two young children. The next day, you tell the director about the incident, and remind her that you
are mandated (i.e., required by state law) to report abuse. She thanks you for bringing the attention to her
concern, but the only action she takes is to have a conversation with the couple and ask them to keep their
personal matters private. Over the next few days, you continue to witness abuse.
Consider your options in both of these situations. What would you do? If you quietly make an exception for the
patient in the first example, will you continue to do so—and risk getting dismissed—if you are confronted by
other clients in similar circumstances? Would you resign? Would you form a team to confront the CEO and try
to get the policy overturned? In the second example, knowing that the mandatory reporting laws are very clear
and you could risk losing your license, do you report the family despite the agency policy? Do you try again to
talk to the director and change her mind? Do you take the issue to the media and expose her, risking your own
job? How far would you go to sabotage a policy you felt was unjust?
Consider your options in both of the situations. What would you do? If you quietly make an exception for the
patient in the first example, will you continue to do so—and risk getting dismissed—if you are confronted by
other clients in similar circumstances? Would you resign? Would you form a team to confront the CEO and try
to get the policy over- turned?
In the second example, knowing that the mandatory reporting laws are very clear and you could risk losing
your license, do you report the family despite the agency policy? Do you try again to talk to the director and
change her mind? Do you take the issue to the media and expose her, risking your own job? How far would
you go to sabotage a policy you felt was unjust?
Next, think of an ethical dilemma you have experienced with in a field placement or another organization with
which you are familiar, how did you handled the situation. If you had to do it over again, what, if anything, would
you do differently?