Ethics in institutionalised social services

Ethics in institutionalised social services Introduction

Institutionalised social services have different missions, goals, and forms. They fulfil two basic functions: “they provide help, shelter, treatment to the citizen, or family, and protect society from dangerous individuals or groups” (Labáth, 2004, p. 15). They are predominantly helping in nature. We divide them according to the type of clientele, function, and legal norm. According to clientele, these are institutions that correspond to the typology of social work clients; they are specialised in a particular area and provide care for the same group of clients. We can speak about different functions in organisations; one organisation may have several functions such as: stimulative (its task is the development and stimulation of the client’s potential and the maintenance of their abilities), therapeutic (these are all institutions that work on therapeutic principles), substitute (all facilities replacing the natural environment). Among the organisations that fulfil a stimulative and substitute function, whose task is the development and stimulation of the client’s potential and the maintenance of their abilities, are facilities for seniors (retirement homes). The aim of the provided social service is to provide quality social services in accordance with its mission and development plan. It is important to align all the goals of the social service, the result of which is that: the client receives a social service corresponding in quantity and quality to their needs, and at the same time this service is economically efficient; the client determines their own individual goals; the social worker cooperates in the creation of plans with the client and their family.

When considering the inclusion of a client in institutionalised social care, four factors are always present that can answer the question of whether the placement of the client is justified:

• indication - it is necessary to consider placement in a residence, whether less invasive interventions have been used. Every stay is in a certain way threatening to the client and may affect the relationship network and the intensity of relationships.
• contraindication of the client’s stay in an institution - inappropriate placement of the client. Contraindication has two levels: socio-psychological and diagnostic. A stay in a day-care facility may be undesirable.
• secondary negative effects - of residential stay arise when the stay itself is indicated, but other threats appear. In seniors, hostile behaviour occurs.
• counterproductivity - causes reinforcement of the client’s problem and worsening of their condition. In this category we can include two phenomena - the so-called labelling effect (Siegel, Senna, 1998) and goal displacement (In Labáth, 2004).

In long-term institutional care, adaptive failure may occur - geriatric maladaptation syndrome. Therefore, when admitting clients to social service facilities, certain preventive measures may be taken: the facility for seniors to which the client will be admitted should not be too far from their home, family, and friends. Applicants admitted due to deteriorated health have greater adaptation problems. Every facility should have informational material about its facility, staff, and activities. The regime of a social facility suppresses individuality, leads to passivity, reduces psychological well-being, and worsens adaptation problems (Hegyi, 2001).

2 Professional Practice of Social Work Students

A focal topic of academic discussions among social work educators is also ensuring the theoretical and practical preparation of social work students. In recent times, it has become a separate topic of professional events - FSVaZ UKF in Nitra (2003), FZSP TU in Trnava (2006), PF KU in Ružomberok (2006, 2007, 2008), UK Bratislava (2009). These professional conferences and seminars are important for students and the practice facilities of the respective universities.

Practice facilities (institutions and organisations of social administration) are selected by universities on the basis of cooperation and the quality of the services provided. Practical preparation belongs to the compulsory subjects of the bachelor’s and master’s study programmes.

The aim of the contribution is to point out the ethical problems encountered by students during professional practice (1) in practice facilities with various target groups. These problems are identified, but their further resolution is problematic, since the reflection of students’ practical experience is addressed in post-practice seminars and supervision of professional practice at the school, not always in cooperation with the practice facility. Entering working relationships in other organisations is not possible. We hope that with the amendment of the law on social services this situation will change, since the provider of a social service is obliged, for the purpose of increasing the professional level and quality of the provided social service, to prepare and implement a supervision programme. (§ 9, para. 10, Act No. 448/2008 Coll.).

If we want to point out the ethical problems of students during professional practice, we are aware that the basic ethical principles arise from the universal human principles of the relationship person - person, group, society, declared in the Universal Declaration of Human Rights (1948), from which the Constitution of the Slovak Republic also derives. The international code of ethics and numerous national codes show a certain unity, which can be considered part of the theory of social work, forming the so-called philosophy of social work, which is the same regardless of different socio-cultural and political situations. (Levická, 2004).

The code of ethics of the social worker (2) is a systematically arranged set of norms, a collection of prescribed social norms that the social worker knows and observes. Students are familiar with the basic ethical principles in the first year of the bachelor’s study programme. It permeates several theoretical and practical disciplines, therefore we will try to point out individual problems through the ethical responsibilities of social workers in practice.

3 Ethical Problems During Professional Practice

Ethical problems of students during professional practice arise when observing social workers in practice or in their own direct work with clients. A problem is the awareness of difficulty; by formulating, expressing the problem or part of it. According to Democritus, Aristotle, and Plato, a problem is knowledge of ignorance (Plato, 1990 In: Nemčeková, 2008).

The given problem evokes our own behaviour and character traits. The subject of the problem is the subject of knowledge, by further examination of which the problem situation is overcome and the problem is solved.

The basic ethical problems that a social worker encounters and decides on are: when to intervene in the situation of a client, group, or community; which social problems to prioritise and address; how much help and care to provide in order to stimulate the client towards a change in attitudes and responsible behaviour; when to end social intervention, therapy, provision of services, contributions...? To avoid ethical problems in practice, the social worker applies the following procedures: apply knowledge and skills, as well as other relevant knowledge, in practice; maintain long-term relationships when working with individuals, families, or groups; choose appropriate methods of assessment, planning, and determining the goal of assistance; help, provide care, advise, guide, and protect individuals and families in a problematic situation; provide counselling, facilitate; lead groups in their community; work as a team member; understand and eliminate the consequences of discrimination; work with ethnically sensitive procedures.

Ethical awareness is a basic part of the professional practice of social workers. Their ability and determination to act ethically is a basic aspect of service quality. Social work promotes social change and the resolution of problems in human relationships. Through knowledge of theories of behaviour and social systems, social work intervenes in places where people interact with the environment. Respect for human rights and social justice are fundamental to social work. Social work is based on respect for the inherent worth and dignity of all people, and the rights arising from that principle should be promoted and defended by social workers (Nemčeková, 2008).

Next, we will point to the basic ethical principles in social work, such as norms of conduct and individual ethical responsibilities.

3.1 Basic Ethical Principles in Social Work

Norms for the conduct and behaviour of the social worker

• Conduct - the social worker continuously maintains their personal and professional behaviour and conduct at a high standard level.
• Abilities and professional growth - the social worker makes every effort to achieve and maintain a high level of professionalism in performing their work.
• Service - the social worker considers the primary commitment in their work to be service.
• Integrity - the social worker acts in accordance with the highest requirements of professional honour.
• Study and scientific research - the social worker engaged in study or scientific research follows the conventions of scientific work.

The social worker develops and regularly updates the individual norms of conduct through their own codes of ethics and ethical principles. They develop and maintain skills and abilities, act honestly, do not abuse relationships of trust with people, using their services, while recognising the boundary between personal and professional life.

Within the pre-practice meetings on setting the goals of professional practice, second-year students of the bachelor’s study programme in social work at PF KU in Ružomberok had one of the cognitive goals of practice: to assess, according to the code of ethics, the work of a social worker in a specific practice facility with a focus on extra-personal ethical problems. Within supervisory meetings at post-practice seminars, we found that students most often encounter the following problems:

3.1.1. Ethical responsibility of the social worker towards clients

Social workers are responsible for promoting social justice in relation to the client, i.e. in their work they draw from the client’s individual needs and ensure the distribution of resources fairly, according to need.

a) Priority of clients’ interests – the social worker has responsibility towards their clients. Students encounter compliance with ethical responsibility towards clients, but on the other hand also with:

• imposing their own procedures and decisions on clients, ( “I am the one here .....);
• transferring responsibility for the client’s situation onto other family members (the child);
• long waiting for intervention from workers;

c) Client’s rights - the social worker supports the client’s efforts to decide independently about their future.****

Students encounter respect for the client’s rights and protected interests, but on the other hand also with:

• imposing their own ideas about the client’s future,
• individual activities are carried out stereotypically,
• differences between individual clients in the group,
• the decision to report - not to report non-compliance with the client’s autonomy, the right to self-determination

b) Confidentiality and secrecy – the social worker respects the client’s privacy and maintains the confidentiality of information obtained in their work. Students encounter compliance with confidentiality and secrecy of information in the process of preparing a case study and case reports. But on the other hand also with:

• providing information in front of another client,

• the client being assessed as a diagnosis, ethnicity, problem... 3.1.2. Ethical responsibility of the social worker towards colleagues a) Decency and courtesy – the social worker respects their colleagues and approaches them with respect and trust.

Students encounter ethical responsibility between individual social workers, compliance with decency, courtesy, respect, and mutual regard, but on the other hand also with:

• negative evaluation of the individual procedures of their colleagues,
• refusal of tutored supervision,

b) Work with colleagues’ clients – the duty of the social worker is to devote themselves to the clients of their colleagues with the greatest professional effort and sensitivity.

Students encounter professionalism when working with a colleague’s clients - a social worker, but on the other hand with:

• refusal of intervention,
• questioning procedures, stages, and methods of working with the client.

3.1.3 Ethical responsibility of the social worker towards employers and employer organisations

Commitments towards employer organisations - the social worker approaches employer organisations with seriousness. Social workers should be willing to cooperate with universities and thus participate in the practical preparation of students. Support and engage in ethical discussions with their colleagues and employers and accept responsibility for creating ethically informed decisions.

3.1.4. Ethical responsibility of the social worker towards their profession a) Maintaining the honour of the profession – the social worker maintains and emphasises the ethical values, professional knowledge, and mission of their profession. But on the other hand with:

• pointing out the inestimable value of social work,
• emphasising financial remuneration.

b) Service to the community – the social worker supports the efforts of the professional community to make its services accessible to the widest public possible. But on the other hand with:

• perceiving social work not as a service but as .....

c) Development of knowledge – the social worker strives to acquire and develop professional knowledge and apply it in professional practice. But on the other hand with:

• not always striving to expand knowledge, skills..

Conclusion

In our contribution we wanted to point out the ethical problems encountered by students during professional practice in practice facilities with various target groups. During practice, the student enters into specific social relationships. Based on acquiring and later applying their qualification, they build their own professional career, while also building a relationship to their own profession. Practice is significant in professions whose professional status is gained through professional experience, the concretisation of theoretical knowledge, and the development of professional as well as human abilities and skills; later, in the performance of the profession, these develop to a certain level of mastery. Therefore, we point out the non-observance of some ethical principles in practice and at the same time stimulate professional discussion on the given problem.

Finally, we pose several questions for discussion:

• What procedure should be followed when educational workers fail to observe ethical principles in the given institutions and organisations?
• What procedure should be followed when workers in direct contact with the client fail to observe the code of ethics?
• Which selection criteria should be applied when choosing guides in practice?
• Which legislative norms should we work with?

Author: Doc. PhDr. Irena Kamanová, PhD. Catholic University, Faculty of Education, Department of Social Work

List of bibliographic references

[1] FAGGIONI, M. P. 2007. Life in Our Hands. Spišská Kapitula – Spišské Podhradie : 2007. 331 p. ISBN 978-80-89170-25-8. [2] HAŠKOVCOVÁ, H. Medical Ethics. 1st ed. Prague : Galén, 1994. 230 p. ISBN 80-85824-03-5. [3] HEGYI, L. 2004. Geriatrics for the General Practitioner. 1st ed. Bratislava: Herba, 2004. 298 p. ISBN 80-89171-06-0. [4] LABÁTH, V. 2004. Residential Care. Bratislava : OZ SP, 2004. 144 p. ISBN 80-89185-03-7. [5] LEVICKÁ, J. 2002. Methods of Social Work. Bratislava, 2002. 119 p. ISBN 80-89074-38-3. [6] NEMČEKOVÁ, M. 2008. Ethics in Nursing. Prešov : FF PU, 2008. 141 p. ISBN 978-80-8068-812-7. [7] NOVOTNÁ, V. – SCHIMMERLINGOVÁ, V. 1992. Social Work, Its Development and Methodological Procedures. Prague, 1992. [8] PLATÓN. 1990. Dialogues II. 1st ed. Bratislava: Tatran, 1990. 698 p. [9] ŽILOVÁ, A. 2005. Introduction to the Theory of Social Work. Badín : Mentor, 2005. 130 p. ISBN 80-968932-1-1.

(1) From Gk. praxis (Lat. practicus, Eng. practice, Ger. Praxis, Fr. practigue) = repeated performance or systematic training for the purpose of acquiring abilities, skills, or dexterity; it is the acquisition of certain skills, habits, and knowledge needed for the performance of a future profession, familiarisation with the environment of the future profession (Žilová, 2009).

(2) Social problems (negative social situations) are developmental tendencies that are considered burdensome in human interactions and in society, and they are addressed through specific compensatory measures (In Novotná, Schimmerlingová, 1992). When assessing whether it is a social problem or not, the value system of the given society is applied. This value system (depending on how integrated and uniform the society is) indicates the dividing line between a normal phenomenon and a social problem. Social norms codified in legal regulations or fixed in the public consciousness establish the boundaries between normality and abnormality. In human behaviour, these are situations of conformity or nonconformity.

The lecture was delivered at the international scientific conference Applied Ethics in Social Work and Other Helping Professions, which took place on 20 - 21 October 2010 in Piešťany and was published in the proceedings from this conference: MÁTEL, A. – SCHAVEL, M. – MÜHLPACHR, P. – ROMAN, T. 2010. Applied Ethics in Social Work and Other Helping Professions. Proceedings of the international scientific conference. Bratislava : VŠZaSP sv. Alžbety. 413 p. ISBN 978-80-89271-89-4.