Confidentiality: An Ethical Dilemma

https://www.hpso.com/Resources/Legal-and-Ethical-Issues/Alleged-breach-of-confidentiality
Confidentiality is the obligation of social workers to not reveal the information provided by the

client to anyone without the client’s consent and agreement (Dolgoff, Harrington, &

Loewenberg, 2012, p.147) Breach of confidentiality is one of the possible bases of malpractice in

the line of social work issues (Dolgoff, Harrington, & Loewenberg, 2012, p.36), however, the

very action of social workers to value and respect the principle of confidentiality is becoming an

issue or problem in some cases because this very value and principle of confidentiality limits

their action and movements, as a matter of fact, Dolgoff, Harrington, and Loewenberg mentioned

that social workers, for different reasons, might not be able to keep all information provided by

the clients to be confidential at all times (p.74), which could prompt the ethical issues, in

addition to that, it was also mentioned that most social workers cannot give complete assurance

to clients regarding complete confidentiality of their information due to the limited control on

what others (e.g. team members, companies, courts, and others) will do with the provided

information (p.75), mainly speaking, the ethical issues of confidentiality appears when the social

worker have to make an ethical choice of protecting the client’s confidential information and the

right of other people and society to know these information (p.148).

While sharing confidential information of the clients need their informed consent and agreement,

there are some cases where social workers can reveal the provided information from the client

under certain conditions such as situations where court orders require the disclosure of

confidential information, prevention of serious, predicted, and immediate damage to the client

(Dolgoff, Harrington, & Loewenberg, 2012, p.148). For example, Dolgoff and others provided

an example where a student being bullied physically by his classmates was reported to a social

worker by the victim’s friend without the victim’s knowledge, and when he was approached by

the social worker, he refuse to join the mutual support group and told the worker that everything
is well and fine at his school, which brings to the issue on how the social worker will assess the

risk and whether she should reveal the confidential information to others to prevent further harm

or damage to the abused victim (p.4). To elaborate further, Dolgoff, Harrington, and Loewenberg

mentioned specific examples for the ethical dilemmas of confidentiality such as cases concerning

child maltreatment, applying that into the case of bullying, where there are many involved parties

such as the preparator, parents, siblings, relatives, teachers, school, and other parties that might

require conflicting demands for confidential information, which is important to consider on

making an ethical decision for sharing confidential details to these parties as their needs vary

from situation to situation and legal and ethical obligations (p.148-149).

Code of Ethics of the NASW guidelines about confidentiality

Concerning the Code of Ethics of the National Association of Social Workers (NASW), the

guidelines and principle they have provided to determine that confidentiality issue is an ethical

issue. First, in the Code of Ethics of the NASW (2017) under the section of Privacy and

Confidentiality, it was mentioned that once private information is shared to the social worker,

standard rules of confidentiality must be applied. It is important to consider that there are

exceptions to sharing confidential information such as prevention of harm or foreseeable damage

to an individual or groups (NASW,2017), although, this might not enough reason for the social

worker to share the confidential reason as the worker cannot assess the risk and evaluate the

situation because the bullied student does not intend to cooperate and provide information

regarding the situation, more importantly, the social worker’s source of information only came

from the student’s friend, which means that this particular friend does not have any legal

authorization to authorize the sharing of confidential information, which is in opposition to the

NASW (2017) guideline that stated that only the client and legally authorized representative can
consent to the sharing of confidential information, looking into the situation, the student and the

friend is neither a client nor a legally authorized representative. Evaluating this particular issue

based on the guideline of the NASW can be considered as an ethical issue because the social

worker will be forced to make an ethical decision of choosing between the victim’s right to

confidentiality and prevention of further harm and damage to the victim. Another application of

the NASW guidelines regarding the second example where involved parties might require

conflicting demands depending on the context and various legal and ethical requirement which

might rise to conflict on what should the social worker prioritize, the ethical obligation of

confidentiality or the demand of involve parties to know the information whether it is required

legally or not, is specifically shown in the section 1.07 Privacy and Confidentiality of NASW

(2017) where it stated that social workers should discussed to the clients the circumstance or

situations where their confidential information may be requested such as requirement on legal

proceedings, in addition, the social worker should also protect the confidentiality of the client

even under the legal requirement as long as it is under the extent permitted by the law. Most of

the NASW guidelines regarding this issue mainly focused on the client’s consent to share their

confidential information and the full capability of the social worker to protect the client’s

confidentiality, even under the pressure of legal requirement, third-parties, agencies, social

workers, and other involve parties to the case.

Using the general decision-making model to the confidentiality issues requires to evaluate the

ethical dilemma. For the first step of the general decision-making model, Dolgoff et al. (2012,

p.73) mentioned that a social worker should identify the problems and the people, client,

professionals, support groups, victims, and involved parties. Applying this step to the

confidentiality issue is a complicated step as described by Dolgoff, Harrington, and Loewenberg

because confidentiality covers every social cases, but, looking at one example given from

previous paragraphs, the case of bullying where there are a lot of parties involved such as the

preparators, victim, parents, siblings, relatives, child protective agencies, school and others,

however, in general, the involved parties varies from context to context of social cases, but, most

of the time, the issue of sharing confidentiality information only involves the client or legally

authorized representative and the social worker in the social case, although, it is also important to

consider or identify third parties that might be involve and demand confidential information.

Conclusion

Ethical dilemmas and issues concerning social work practice is not usually an uncommon

occurrence as unethical misconduct and behavior are almost present in the society, however, as

per Reamer (2012), social work is a noble pursuit that requires compassionate, earnest, and

principled workers, as to why unethical misconduct and behaviors in social work setting is only

minimal in number, but, it is a fact that these kinds of behavior exists and occur in social work

practices.

In conclusion, the discussion of the confidentiality breach in terms of legal dilemma covers a lot

of grounds, while it is important for the social worker to protect the right of confidentiality of the

client, there are some situations and conditions where the social workers might need to provide

this confidential information to other parties such as families, courts, and other institutions that

might be involve in the case. However, this decision must be heavily coordinated with the client

because it is their confidential information that would be at stake, while some client might

stubbornly pursue the right to confidentiality, there might be cases where social workers is in

need of violating this right due to immediate danger to the client, which might be unethical, but

for a good purpose. This particular issue always dangles in my mind as taking into consideration
the intention behind the breach of confidentiality might also be an important factor to designate

whether the action of sharing the information is unethical, even though, it is for the safety of the

client. My learning on this assignment mainly focus on how broad the ethical obligations of

social workers cover when they are dealing with situations that concerns with confidentiality,

more importantly, social workers does not only need to coordinate with the client itself, when

they are making a decision concerning the best interest of the client with regards to their

confidentiality, it is also important to coordinate with other people and parties that might be able

to help with the problem of the client, which means that social work is not an individual work or

cooperation between the worker and client alone, but, it is a coordination with a group of people

that aligns with the same objective for the best of the client. Lastly, my understanding of what it

means to be a professional social worker means that one must be reliable and equipped with the

ability to make an ethical and appropriate decision for the case of the client whether it concerns

confidentiality or other ethical issues, because the ethical decision concerning ethical issues

always fall on the responsibility of the social worker (Dolgoff et al., 2012, p.73), which means

that the burden of making the decision must always be on the shoulder of the social worker, as to

why, reliability and right decision-making skills is an important part of being a social worker for

evaluating situations and deciding what would be the appropriate course of actions that protects

the best interest of the client.

 References

Dolgoff, R., Harrington, D., & Loewenberg, F. (2012). Ethical decisions for social work

practice (9th ed.). Brooks Cole.

National Association of Social Workers. (2017). Code of Ethics of the National

Association of Social Workers.

Reamer, F. (2012). The Dark Side of Social Work: Ethical Misconduct.

Socialworktoday.com. Retrieved 24 October 2020, from

https://www.socialworktoday.com/news/eoe_051712.shtml.