Social Workers' Perspectives in the Identification and Resolution of Ethical Dilemmas: Four Case Studies

Abstract

This qualitative, case study approach examined the experiences of medical social workers in the identification and resolution of a compelling ethical dilemma in the hospital setting. Social workers receive little or no formal ethics training and education in their graduate studies and professional career. The study sought to uncover the experiences of social workers and how they resolved a compelling ethical dilemma through the trajectory and integration of four theoretical approaches; virtue theory, Dreyfus model of skill acquisition, the bioethical principles and the five core virtues. The research revealed what their perception was of their level of ethical expertise from novice to expert according to the Dreyfus model and how they demonstrated the application of bioethical principles and the five core virtues. This study was based on in-depth semi-structured interviews as the primary data collection method with licensed social workers who are working and have worked in the hospital setting. The data was analyzed utilizing the Data Analysis Spiral procedure as outlined by Cresswell (1998). The procedure included data collection, data managing, reading/memoing, describing/classifying/interpreting and representing.;The study centers on the experiences of four medical social workers and how they approached, experienced and resolved the ethical dilemmas that emerged. "Michelle" and the ventilator dependent paralyzed newborn, "Paul" with Marie's life and death decision, "Olivia" and the adolescent who was violated and sexually abused and "Georgia" with a young adult veteran who did not want his terminal illness disclosed to his family.;This study discovered that the participants of this research experienced critical and compelling ethical dilemmas in the course of their practice in the hospital setting with minimal theoretical foundation and knowledge base to inform their practice and guide their decision making. It was further evident that the participants as a whole had minimal training and exposure to ethics. The importance of human relationships central to the values of the social work profession and virtue theory served as a meaningful foundation in the experience and outcome of the dilemma. It was evident that the participants demonstrated how they upheld their ethical responsibility to their patient; the promotion of their well-being; respecting and fostering the patient's right to self-determination as indicated. The core values of the social work profession are fundamental principles that social workers should strive to aspire to.