social work subject- Ethical decision making with case study.
You are a specialised social worker at a large tertiary public hospital and you work with women who experience unplanned pregnancies and are considering their options: continuing the pregnancy, terminating the pregnancy or adoption. You provide intake, assessment, counselling, advocacy and support services to women.
You are called by the hospital staff to see a woman, Debbie, lives in regional Victoria, and who is fifteen weeks pregnant and who has been admitted to a hospital ward overnight after she was admitted to hospital after excessive drug and alcohol consumption that has caused her to become very unwell. The hospital staff tells you they have concerns for the health and viability of the foetus due to the drug and alcohol use during pregnancy. They tell you that they have previously worked with Debbie (these notes are in her hospital file) who has a long history of poly-drug and alcohol use, and a complex history of her own childhood abuse as well as having been the victim of domestic violence from multiple partners as an adult. Debbie has four children, none of whom are in her care, and has mentioned the idea of having an abortion but is also stating she will not do this as it is against her belief systems to have an abortion and that every child should have a right to be born, and also because she believes that Child Protection services are pressuring her to have an abortion. The hospital staff are concerned that if Debbie continues the pregnancy the child will suffer severe medical issues including brain damage from foetal alcohol syndrome and have discussed this with the relevant specialists. The staff ask you for your assessment of what Debbie wants as well as discussing the need for urgent ante-natal care for Debbie, and of the need for available abortion services for Debbie as a back-up. They also tell you that Debbie has a history of absconding from the hospital, and failing to turn up to booked appointments.
When you sit with Debbie and being discussing the issues with her as she sees them, she tells you of her history of violence from multiple partners, including the father of this pregnancy. Debbie tells you she has just come out of refuge due to the violence experienced from this partner, however that she would like to have this baby and give it to her partner because hes had a hard life and might be a good father. Debbie discusses in detail her experience of having a previous abortion into which she was forced by a partner, and how this was traumatic for her and that she couldnt do it again. She tells you that she has had a long relationship with Child Protection and that she hates them as they have always punished her for the family violence she has experienced from partners. She tells you she is very angry at the pressure from Child Protection for her to have an abortion and that she might as well have another child in this context. Debbie then mentions that she might actually need to have the abortion sooner than later as is not sure if her partner, who has a new girlfriend now, will take the baby and if he doesnt, then (I) will probably abort.
Debbie asks you to hold her abortion appointment for another week so she can consider what to do.
You are aware that the only available public (free) abortion services that exist in the state must see Debbie before another week passes or she would be too late to access an abortion there. You are aware that there are many other women who are also hoping to access the same limited appointments that Debbie wants. They also experience similarly difficult situations to Debbie, including being victim/survivors of violence, homelessness, and mental health issues and that they wont be all able to get a service.
Use this scenario to demonstrate understanding of Chenoweth and McAuliffes (2015) inclusive model of ethical decision making, detailing each step.
What are the ethical considerations here (for example, duty of care for the children? who needs and rights are you protecting? do you hold the appointment for Debbie, but other women on the waiting list may miss out? )
What process might you use to make ethical decisions here? (Consider legal, ethical, and organisational)?
What ethical frameworks or theories might you use in considering your decision? What ethical frameworks might your client be using?
-appropriate referencing and citation, no plagiarism
Required readings and references:
McAuliffe, D., AND; Chenoweth, L. Ethics and social welfare, Leave No Stone Unturned: The Inclusive Model of Ethical Decision Making
Banks, S. (2006 ) Ethical problems and dilemmas in practice, Ch. 7, pp. 154-185, in Ethics and Values in Social Work (3 ed.). Hampshire, UK: Palgrave Macmillan
Banks, S. (2006 ) Ethical issues in social work, Ch. 1, pp. 11-26, in Ethics and Values in Social Work (3 ed.). Hampshire, UK: Palgrave Macmillan
Hugman, R ( 2013): Culture, value and ethics, Routledge: Chapter 5 Cultural differences in values and ethics
Ife, J. (2008), Achieving Human Rights through Social Work Practice, Ch. 10, pp. 159-187, in Human Rights and Social Work (2 ed.). Port Melbourne: Cambridge.
Chenoweth, L., & McAuliffe, D. (2015) The Road to Social Work & Human Service Practice (3rd). South Melbourne: Cengage Learning
McAuliffe, D, (2014) Ethical activism : exploring human rights and social justice in the interprofessional space, Chapter 3, in Interprofessional ethics : collaboration in the social, health and human Services, Cambridge University Press, Cambridge, pp. 46-65
Australian Association of Social Workers. (2003). Practice Standards for Social Workers: Achieving Outcomes. Canberra
Australian Association of Social Workers. (2010). Code of Ethics. Canberra: www.aasw.asn.au/document/item/740
United Nations Universal Declaration of Human Rights