In Medical Settings, Social Workers May Face Ethical Dilemma

In Medical Settings Social Workers May Face Ethical Dilemmas Around T

In medical settings, social workers may encounter ethical dilemmas involving testing, treatment decisions, disclosure of diagnoses, and cultural or religious considerations. When children are involved, these dilemmas often involve conflicts between the child's best interests, parental rights, and medical recommendations. Ethical dilemmas require social workers to adhere to the NASW Code of Ethics and apply ethical reasoning to navigate complex situations. This paper explores an ethical issue involving a pediatric patient with a chronic illness, analyzing the different perspectives and social workers' responsibilities within ethical standards.

Paper For Above instruction

The selected illness for this discussion is juvenile diabetes, specifically Type 1 diabetes mellitus, a chronic autoimmune condition characterized by the body's inability to produce insulin. This illness typically manifests during childhood or adolescence and requires ongoing management through insulin therapy, blood sugar monitoring, diet, and lifestyle adjustments. The implications of living with Type 1 diabetes extend beyond the physical health deficits to psychological, social, and developmental domains, creating a multifaceted challenge for the young patient and their family.

An ethical issue that can arise in the management of a child with Type 1 diabetes concerns the adolescent's autonomy in making health decisions versus parental authority. As adolescents seek greater independence, disagreements often occur between the minor and their parents or medical team over treatment adherence. For instance, an adolescent may refuse to administer insulin regularly, risking acute complications such as diabetic ketoacidosis, or may resist dietary restrictions, impacting long-term health outcomes. This scenario frames a conflict between respecting the adolescent's developing autonomy and ensuring that health interventions are in the child's best interest for survival and well-being.

On one side of the dilemma, respecting the adolescent's growing capacity for decision-making aligns with developmental and ethical principles of autonomy. According to the NASW Code of Ethics, social workers should promote clients' self-determination and respect their informed choices (National Association of Social Workers, 2017). This perspective emphasizes empowering adolescents to participate in their healthcare decisions and respecting their opinions, especially as they approach legal age for medical consent.

Conversely, parental authority and the healthcare team's responsibility to act in the child's best interests are also vital ethical considerations. Parents typically possess legal authority to make health decisions for minors, especially when adolescents are deemed unable to understand the full consequences of their choices or are at risk of significant harm. Protecting the health and safety of the child is paramount, and medical teams and social workers have a duty to intervene when refusal of treatment jeopardizes the child's life or long-term health (McCoyd & Kerson, 2016).

This ethical tension between autonomy and beneficence is compounded by cultural and religious beliefs that may influence decision-making. Some families may refuse specific treatments due to religious convictions or cultural practices, challenging clinicians and social workers to balance respect for cultural diversity with the imperative to prevent harm. Such complexities necessitate sensitive, culturally competent engagement and multidisciplinary collaboration to navigate conflicts effectively (Gehlert & Browne, 2019).

In adherence to the NASW Code of Ethics, social workers are mandated to advocate for clients' well-being, honour cultural differences, and promote ethical decision-making (National Association of Social Workers, 2017). Specifically, in this context, social workers must facilitate a process of open communication among the adolescent, parents, and healthcare team, ensuring that the adolescent's voice is heard and that their views are incorporated into the decision-making process. When the adolescent exhibits decision-making capacity, their preferences should be respected while ensuring they are fully informed about the consequences of their choices.

Furthermore, social workers should employ ethical reasoning frameworks like the principle-based approach, considering beneficence, non-maleficence, autonomy, and justice. Situations where treatment refusal endangers the child's life require careful assessment of capacity, understanding, and informed consent. When the adolescent demonstrates sufficient maturity and understanding, their autonomy may be prioritized, aligned with the ethical standards and legal statutes in many jurisdictions. In cases where capacity is limited or refusal presents imminent danger, social workers may need to advocate for protective interventions, such as hospital admission against the adolescent's wishes, while seeking alternative solutions that respect the adolescent's dignity and rights.

As part of their responsibilities, social workers must also document decision-making processes thoroughly, engage in ethical consultations when dilemmas become complex, and support families emotionally throughout the process. The goal is to balance respecting the adolescent's rights with safeguarding their health, utilizing ethical principles as a guide for equitable and compassionate practice (Beder, 2006). This balanced approach aligns with the mandates of professional standards and promotes trust and effective care.

In conclusion, managing ethical dilemmas in pediatric care involving chronic illnesses such as Type 1 diabetes requires social workers to employ a nuanced understanding of ethical principles, legal frameworks, and cultural contexts. Prioritizing the child's best interests, promoting autonomy where appropriate, and respecting family values are integral to ethical social work practice in healthcare settings. Upholding the NASW Code of Ethics ensures that social workers advocate effectively for vulnerable minors while supporting families in making informed, culturally sensitive decisions that promote their health and well-being.

References

• Beder, J. (2006). Hospital social work: The interface of medicine and caring. Routledge.
• Gehlert, S., & Browne, T. (2019). Handbook of health social work (3rd ed.). Wiley.
• McCoyd, J. L. M., & Kerson, T. S. (Eds.). (2016). Social work in health settings: Practice in context (4th ed.). Routledge.
• National Association of Social Workers. (2017). Code of ethics of the National Association of Social Workers. NASW Press.
• Congress, E. P. (2000). What social workers should know about ethics: Understanding and resolving ethical dilemmas. Advances in Social Work, 1(1), 1–26.