ethics

By Ms Lim Puay Li, Senior Manager, Child Protection Service, Ministry of Social and Family Development

 

As the CPO assigned to this case, here are some questions that I could consider in relation to the ethical scenario above :

• How should I use the information shared with me in confidence by the FTSC?

• Should I reveal that the information came from Serene in the course of a counselling session?

• What are the consequences and risks of this disclosure for Serene? Would it affect her ability to trust professionals in the future? Should 9-year-old Serene be placed in this position?

• Should I report Mr Tan’s suspected drug use to the relevant authority for further investigation? Do I have an obligation to protect Mdm Tan given that she is the mother of my clients? How will reporting this affect the counsellor-client relationship with Mdm Tan and the children? 

• Given that there is no imminent harm or history of harm to the children, shouldn’t Mdm Tan be entitled to her right to self-determination and be trusted to ensure that she would not compromise their safety and welfare despite her poor choices of staying on with Mr Lim?

• Could the disruption caused by foster placement possibly be greater than the consequences of them remaining with Mdm Tan and being exposed to her father’s drug use and to the domestic violence, given that the children did not cope well with it the previous time?

 

Child protection cases, such as that of “Serene”, can arouse strong emotions and controversies and create ethical tensions for CPO, who has to decide on what is the “right thing” to do taking into consideration the best interest of the children concerned.

 

Finding a Solution

Ethical dilemmas can occur when a social worker is faced with having to choose between two equally unwelcome alternatives which may involve a conflict of ethical values, and it is not clear which choice will be the right one.

 

So, what are the “right” answers and “solutions” to this ethical dilemma for this case? Resolving the dilemma would require me to have a firm understanding of the standards of practice that constitute sound practice behaviour, have a working familiarity and understanding of the principles in the SASW Code of Ethics, make use of peer/supervisory consultation, understand applicable agency policies and legal mandates, and be open to examining the ways in which one' own values/preferences influence the ultimate choice of action.

 

One begins to address the ethical dilemma by identifying those professional values or obligations that conflict with each other and clarifying the issues of conflict at hand. One of the tensions in Serene’s case involves the protection of confidential information shared by Serene (see SASW Code of Ethics, Part A, No. 2e & f) as opposed to the disclosure of confidential information contrary to Serene’s wishes. Secondly, can I justify setting limits on Mdm Tan’s right to self-determine based on the belief that her relationship with Mr Lim is harmful to her children’s well-being, given that there have been no observable impact thus far? Is there an obligation to limit Mdm Tan’s right to self-determine in order to protect third parties from harm (see SASW Code of Ethics, Part A, No.6)?

 

The Right Decision?

The goal of sound ethical reasoning is thus not so much to find a “right” solution but rather to rationally and systematically consider the ethical aspects of a case and to be clear about the basis on which the decision was made. This involves a process whereby we consciously articulate the reasoning behind our choice of action. Social Workers must be able to explain and justify that the decision they reached would protect the client' rights and serve the client' best interests as well as uphold the values and standards of the Social Work profession.

 

As social workers, we are in close agreement about upholding standards related to client confidentiality, fostering self-determination, promoting the dignity and worth of the client, and acting in a trustworthy manner with clients. However, there is less agreement about how to translate these into practice, particularly when one of these commitments can be served only at the expense of another. 

 

In making decisions surrounding child protection cases, safety of children are of paramount importance.  However, this is also to be balanced by consideration to children’s wishes to be with their attachment figures [1]. For the case of Serene, the children were assessed to share good attachment with Mdm Tan. In addition, information gathered thus far did not suggest imminent risk to the children. However, the children’s safety needs remain a concern given Mdm Tan’s history of exposing them to her suicide attempts and her thoughts of killing the children when she was stressed out by her marital issues. The ongoing exposure of the children to spousal violence is also likely to impact on their emotional and psychological well-being.

In view of the above, there is no immediate need for the children to be removed from Mdm Tan’s care. However, intensive work needs to be done to help Mdm Tan gain insight into where my concern is stemming from and to empower and increase her ability to act in the best interest of her children.  This care arrangement would need to be closely monitored and ongoing assessment be conducted to determine if Serene and her siblings’ safety and other care needs are being adequately met by Mdm Tan. A removal might need to be considered should there be an escalation of risk or concerns surrounding their well-being.

 

 

 

[1] Bowlby’s Theory of Attachment states that an infant needs to develop a relationship with at least one primary caregiver for the child’s successful emotional development.