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ETHICAL ISSUE ANALYSIS PAPER

Ethical Issue Analysis Paper

Ashlee Johnstone

Tom Dillinger works as a caseworker at a shelter for the homeless population. The shelter

houses individuals who have been homeless for 12 months or more. Being a resident of this

shelter gives access to different treatment groups that fit their needs such as alcoholics

anonymous. Every resident arrives in the community with an assessment of needs. These

resources are funded by the city budget and operated by city employees. Eligible individuals

must attend mandated meetings and take prescribed medications to continue as a resident.

Violating this policy results in a write-up. After receiving three write-ups, the resident will

undergo a review and possible expulsion from the community. As a result, the resident would no

longer be at the shelter.

Anna Dingleberry is a 63-year-old widow who suffers from schizophrenic episodes and

bipolar disorder. She became homeless when her husband passed away. Her retirement benefits

were insufficient to continue paying the mortgage bill she and her late husband shared. Anna

refused assistance from distant family and friends. She felt that taking care of herself was

sufficient. After being homeless for over a year, a woman’s shelter representative referred Anna

to a new city project, where individuals experiencing homelessness are given access to a stand-

alone pallet to call their own and are fed three times a day. She liked the idea, as she was still

able to live independently. While living in this community, Anna was assigned Tom Dillinger as

her caseworker. He was made aware of her recent loss, mental complications, and other issues

that may hinder her progression.

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While on her medication, Anna had been doing well acclimating to living within the

program, but her episodes pushed her to believe her therapy group leader was verbally attacking

her. In a frantic manner, Anna began insulting the group leader with derogatory and racial slurs.

When asked to calm down, she tossed a folding chair in his direction and accused everyone of

being devil worshipers. Tom was called to de-escalate the situation. Having worked with Mrs.

Dingleberry for a few months now, Tom knew of her antics and outlashes. She had reached her

maximum number of write-ups, and he knew a review board would certainly expel her from the

community, thus placing her back onto the streets. Tom can try to explain this sudden attack,

knowing it was caused by her refusal to take prescribed medications, and recommend she is

allowed another chance; or knowing the community’s policy on medication, report it as a blatant

refusal to take prescribed medicines, resulting in resident expulsion from the community. Tom

knows his decision will determine if Anna can stay in the community. She was attending weekly

support groups to help her grieve the loss of her husband, and therapy groups to assist her in her

battle with the negative effects of schizophrenia and bipolar disorder. Everything was going fine

until Anna began to skip days of using her medication.

The CWSE Competencies play a large role in this ethical dilemma. Competency #1 in the

CWSE Competency-Based Education Policy, states, “Social workers understand the value base

of the profession and its ethical standards, as well as relevant policies, laws, and regulations that

may affect practice with individuals, families, groups, organizations, and communities. Social

workers understand that ethics are informed by principles of human rights and apply them

toward realizing social, racial, economic, and environmental justice in their practice.” (CWSE 8)

This competency is based on the idea that social workers are expected to demonstrate ethical and

professional behavior. The Code of Ethics is what shaped what social workers should consider
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“ethical”. The Code of Ethics, states, “instances may arise when social workers’ ethical

obligations conflict with agency policies or relevant laws or regulations. When such conflicts

occur, social workers must make a responsible effort to resolve the conflict in a manner that is

consistent with the values, principles, and standards expressed in this Code.” (NASW) This

shows that the NASW code of ethics values the agency’s guidelines but also acknowledges you

to abide by the code of ethics. If the agency’s policy conflicts with the code of ethics, it is

recommended that you consult another person to make a logical decision. In relation to this

situation, Tom’s agency requires that if a client has 3 write-ups, then the review board will have

to expel the resident from the community. However, according to the code of ethics and our

NASW competencies, we are required to keep the best interest of the client in mind. This is a

conflict because it can place Tom, the caseworker, in the position of not knowing whether to

abide by the homeless community’s policy or to not report Anna and instead hope she starts to

consistently take her medication, maintain shelter, and attend group sessions.

General Decision-Making Model:

1 a. Identify the Short term:
problem.
WHO AND Does Tom report the refusal to take the prescribed
WHAT medication in the event Mrs. Dingleberry faces the
possible expulsion from the homeless community?
consider: what
decision needs to Long term:
be made?
Minimize or diminish Mrs. Dingleberry’s outbursts
and have her consistently take her medication daily.
b. Identify the Key player 1:
persons (key
Tom Dillinger is the caseworker.
players in the
dilemma) Key player 2:
Anna Dingleberry is the client.
Key player 3:
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ETHICAL ISSUE ANALYSIS PAPER

provide a brief
description of each
N/A
(i.e.,
demographics, Key player 4:
background, etc.)
N/A
c. Identify the Agency you work for:
institution(s)
Tom is a caseworker at a homeless community.
Agency/Agencies you work/partner/communicate
with:
The homeless community review board.
d. Identify the Specific client (if applicable)
client
Anna Dingleberry is the client.
(who are you
Client system (who does the agency serve?)
serving?)
Residents who have been homeless for 12+ months
are able to be housed in this community.
e. Identify Tom Dillinger
professional(s)
(what other
professionals are
involved?)
f. support systems - Narcotics Anonymous
- Alcoholics Anonymous
- Mindfulness
(what supports do - Mental Support
clients have? What - Financial Literacy
resources are - Shelter Security
available to clients - Food Security
or the
agency/agencies?)
g. others involved - Peers within the homeless community
- Homeless community review board
2 a. Who should be
involved in the
DECISION Tom Dillinger
decision making
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ETHICAL ISSUE ANALYSIS PAPER

MAKING out of the above?
b. Who can make
the decision?
Determine who Tom Dillinger
should be
involved in the
decision making c. Who has the
authority and scope
Tom Dillinger / Homeless Community Review Board
of power to make
the decision?
3 a. Values of key Worker’s values:
players
VALUES - Anna Dingleberry’s quality of life
- The resources that can help Anna with the
negative effects of schizophrenia and bipolar
Identify the disorder.
relevant values
held by those
identified in Client’s values:
step 1
- Living independently
- Shelter security
- Food security
- Her husband

b. Values of Your agency’s values:

institutions
- Proving shelter for residents
- Providing 3 meals a day for residents
- Providing resources to help residents with
therapy groups.
- Showing up to group therapy consistently

Other agencies’ values:

N/A
c. Values of client Providing resources for the homeless community.
system

d. Values of other - Tom wants to provide his client with shelter.

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ETHICAL ISSUE ANALYSIS PAPER

professionals - Tom also wants to make sure his client is healthy
and getting the help Anna needs.
e. Values of To provide those who are homeless for 12+ months
support systems with shelter, mental help, and a support system.
involved

4 a. Client goals - Live independently.

GOALS (What does the
client want to
accomplish?)
b. Worker goals - Help Anna minimize and diminish outbursts.
- Take medications daily.
(What must the
- Continue to live independently
SW accomplish?)
c. Others’ goals - Uphold company policy.
(What do others
want you to
accomplish?)
5 Solution A Description:
SOLUTIONS Tom would report Anna to the review board for not
taking her medication.
Solution A Pros: Solution A Cons:
Identify (3) Report Anna to the
alternate Review Board - Uphold homeless - Put Anna back on
intervention community the street.
strategies and policy. - She would not
assess the - Protect Tom’s job receive care for
effectiveness security. her schizophrenia.
and efficiency / - Clients will be - She would not
pros and cons of safer in group receive grief
each in terms of settings. support.
the identified - Increase the
goals overall
environment for
other clients.
Solution B Description:
Tom would not report Anna to the review board for
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ETHICAL ISSUE ANALYSIS PAPER

not taking medication.
Do not report Anna Solution B Pros: Solution B Cons:
to the Review
- Anna would have - Possibility of
Board
shelter and would Tom being caught
still be somewhat for not reporting
independent. Anna.
- Receive - Go against
medication for community
schizophrenia. policy.
- Continue to attend - Take the risk of
grief groups. Tom losing his
job.
Solution C Description:
Due to Anna’s emotional outbursts, Tom thinks this is
caused because she does not take her medication
Take Anna out of
daily. Therefore, Tom could decide not to report her
group settings until
but instead remove her from group settings to make
medication is
sure the emotional outburst minimize as the
consistent and do
medication is taken consistently.
not report Anna.
Solution C Pros: Solution C Cons:
- Anna would have - Possibility of
shelter and would Tom being caught
still be somewhat for not reporting
independent. Anna.
- Receive - Go against
medication for community
schizophrenia. policy.
- Have individual - Take the risk of
therapy settings. Tom losing his
job.
- Medication
consistency
doesn’t change,
and Anna
continues to have
emotional
outburst putting
other clients in
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ETHICAL ISSUE ANALYSIS PAPER

danger.
6 a. Which of the I chose solution A. I chose this because the
above possible community gives 3 write-ups before expulsion. This
DECIDE
interventions / means that Anna has already received 3 chances for
solutions did you change to happen. I would send Anna off with other
select and why homeless shelter resources and mental health help.
Select and
implement the b. Why is it better Tom can no longer risk other client’s safety and
appropriate than the other 2 overall quality of environment for one client.
strategy stating proposed
why it is the strategies?
BEST one and a
c. How does it best The clients are aware of policy when they become a
rationale for this
address the resident of the homeless community. Due to Anna
problems set forth? breaking policy 4 times, she leaves Tom no choice.

d. How does it It does not advance the client’s needs and goals
advance or not because it will ultimately put her back out onto the
advance the street.
clients’ needs and
goals?
e. How does it It advances the social worker’s need to uphold
advance or not company policy and his own job security. However, it
advance the social does not achieve his goal which would ultimately see
worker’s needs and Anna as a success story in the future.
goals?
f. Which takes The company policy takes precedence. A part of
precedence and being a social worker is not only helping the client
why? Based on but still abiding by the company that you are
which ethical employed by.
standards?
g. What theories The code of ethics requires us to be professionals in a
and research are social work setting.
informing your
selection?
7 a. How will you If the other residents in group settings are showing
know the chosen progress rather than seeing Anna have emotional
MONITOR
intervention / outbursts in therapy.
solution is
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ETHICAL ISSUE ANALYSIS PAPER

working?
Monitor the b. What will you I will pay attention to their individual progress.
implementation, pay attention to?
paying attention
c. What could you Possibly their moods by having clients record a mood
to unanticipated
possibly measure? log.
consequences;
evaluate results d. What are some The success would be the other residents would show
success and improvement. However, the residents could also be
unanticipated upset with the sudden loss of Anna to the group
consequences? depending on how much her presence mattered.
e. How will you Residents show up to the group every week and
evaluate or know participate.
when you reach
success?

Through this assignment, I have learned that a decision regarding the client is not always

a clear-cut decision. This assignment was meant to teach us that we will be in positions during

practice where our initial decision will not match our final one once we consult others and follow

the decision-making model. A decision is not going to be made in the best interest of a client by

making an on-the-spot decision. The pros and cons of a situation will need to be weighed out

before a person’s life is affected. This assignment taught me to slow down when the first thought

popped into my head. Instead, I will now take time to think about a decision before it is made. To

be a professional social worker does not mean making personal decisions that will affect others

without any input from outside resources. Being a professional social worker means

incorporating agency policy, CSWE competencies, NASW code of ethics, and collaborating with

a supervisor on possible solutions when it comes to the best interest of a client.

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ETHICAL ISSUE ANALYSIS PAPER

References

Educational Policy and Accreditation Standards for Baccalaureate and Master’s Social Work

Programs COUNCIL ON SOCIAL WORK EDUCATION Commission on Accreditation

Commission on Educational Policy 2022 EPAS. (n.d.).

https://www.cswe.org/getmedia/bb5d8afe-7680-42dc-a332-a6e6103f4998/2022-

EPAS.pdf&clen=539839&chunk=true&pdffilename=2022-EPAS.pdf

National Association of Social Workers. (2021). Code of Ethics. National Association of Social

Workers. https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-

English