Connections and Conflicts of Interest

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This topic contains 4 replies, has 5 voices, and was last updated by  B00538573 3 months, 3 weeks ago.

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  • #382

    Hannah.Cameron
    Participant

    Sarah is an intake worker in Child Protection. A referral has come in to another worker alleging abuse and neglect of an 8-year-old child, George. George has autism and is shy and reserved, refusing to speak to people with whom he is not comfortable. The social workers have not been able to obtain any information from George, which makes it difficult to complete an assessment of risk. As Sarah listens to them discuss the case, she realizes that she knows the child through family friends. She is certain that George would be comfortable talking to her, and she might be able to discuss his home life with him. This is a clear conflict of interest, as she knows the child and family from previous connections. Interacting with her in this context might be uncomfortable for the family. However, it may be the only way that George will talk about his situation. Sarah’s supervisor is supportive of her offer to talk to George, as he feels George would not be able to understand the conflict of interest and therefore would not be uncomfortable. Sarah’s supervisor feels that George’s comfort is more important than the family’s comfort in this situation. Other team members feel that making an exception to a rule puts social workers in a precarious position, as it opens the door for other exceptions to be made. One team member worries that if George is brought into care, the situation will become more complicated, as Sarah will have to decide again whether to become more involved with the family.

    1) What would you do in this situation?
    2) Who would you consult in this situation?
    3) Which is more important in this case – the family’s privacy, or possible risks towards George?
    4) In small or niche communities, where dual relationships are likely, how can social workers maintain professional boundaries without secluding themselves?
    5) Would this situation change if the reason for George’s communication difficulties was a language barrier? For clients who belong to linguistic minorities, often the only people able to translate are those who are already friends or family of the client. How might this affect the intake process?

    #393

    Emma Kearney
    Participant

    1. What would you do in this situation?
    If I were a social worker in Sarah’s position I would try to meet with George’s familiar prior to meeting with George. I hope this would allow me to assess how they felt about the situation with George and the conflict of interest. I would explain my thoughts to the family, letting them know I believed George may be more comfortable talking with someone he is comfortable with. If they were strongly against me speaking with George I would want to inquire why this is. My goal would be to find a solution that would make all participants comfortable while still finding the information needed to help George.

    2. Who would you consult in this situation?
    I would consult with my supervisor and the social workers already working on George’s file to form a plan of action. I would also want to consult with Georges family whom I had connections with, before I took any steps to talk with George. I would also want to consult with George to see if he really would feel comfortable speaking with me.

    3. Which is more important in this case – the family’s privacy, or possible risks towards George?
    I believe both the families privacy and the risks towards George are very important, and intersecting issues. As a social worker in a child welfare setting I believe it is our responsibility to ensure the possible risks towards George are the main focus.

    4. In small or niche communities, where dual relationships are likely, how can social workers maintain professional boundaries without secluding themselves?
    I think the best way to maintain professional boundaries with clients in this setting is to ensure social workers are setting very clear guidelines for interactions very early on. It is important to ensure clients are familiar with the boundaries that are being set and have a good understanding of why the boundaries need to be in place. I also think these boundaries need to be very consistent across the board.

    5. Would this situation change if the reason for George’s communication difficulties was a language barrier? For clients who belong to linguistic minorities, often the only people able to translate are those who are already friends or family of the client. How might this affect the intake process?
    I think the situation would be similar if George’s communication difficulties were due to a language barrier. It is a very tricky situation as it can lead to bias as the social worker will have prior thoughts and views on the situation. I believe, if at all possible, it is best to avoid any conflicts of interest and try to find an outside party to translate or conduct the interview. In a situation where there is no way around it I believe there must be clear guidelines for the intake process and all parties involved must be consulted with to ensure they are comfortable with the arrangement.

    #395

    Kevin Bruch
    Participant

    I agree with Emma, I would meet with the family first, however I would not attempt to gain their consent to talk to George. I would try to form as complete a picture as possible of the risk from the other tools available to me, without reference to George’s account. Unless there was strong corroborating evidence that George was being abused, I would be very hesitant to place myself in the conflict of interest. The statement that Sarah “feels certain George would be comfortable talking to her” is highly speculative. There is no certainty, and if Sarah does take this step, not only would she be violating her ethical obligation to the family, but she would also be taking advantage of her pre-existing relationship with George. If there are other workers available, they should use recognized practice methods to work with George, rather than exploit his trust in Sarah. Much of this turns on how important it is to have George speak. What if Sarah ends up pressuring him into saying what she wants to hear? It would be difficult for her to ask him questions without leading him to the conclusion she is seeking, either way. This raises a more general question for me about the extent to which a child’s testimony is considered in apprehension.

    I would request a consult with a clinical ethicist if one were available – most provincial health agencies have them. As Sarah did, I would consult with my colleagues and supervisor as well. I would also contact any mentors I may have, while maintaining anonymity for George and his family. I would also talk to the legal advisors for my agency. There are apparently legal issues surrounding the reliability of a child’s testimony in court, and if the information George could provide would not be considered, there would be no point in creating the conflict of interest.

    George’s safety is paramount, however it would need to be clear that he is at risk in order for any breach of professional ethics to be justified. If the wider investigation does not turn up any other indications of risk, it may not be necessary to make that decision at all.

    In small communities many of these arguments would not apply, and a different approach is necessary. I agree with Emma when she said that setting clear boundaries and having clients understand the need for them is very important. Since the conflict of interest cannot be avoided, it may be possible to speak with George if his family consents. I would still argue that it is necessary to guard against excessive intervention however; despite the fact the conflict of interest is inherent to the situation, it is still necessary for the social worker to mitigate it as much as possible.

    The language barrier is an interesting twist. Many government agencies employ a phone-based real-time translation service that could help with communication, however it would not solve the problem of George being uncomfortable with strangers. Ultimately, the same principles would apply as in a small community. The social worker must recognize the power dynamics at play and try to identify her own attitudes, biases and hopes for the client.

    From a theoretical perspective, this brings two theories into conflict. Sarah has a duty not to exploit her relationship with George, and to respect his family’s wishes. She is also obligated to ensure that no harm comes to George, that is, she is concerned about the consequences of taking no action. The former is an example of a deontological principle; Sarah is duty bound to maintain her professional integrity and that of her relationship with George and family. The latter is utilitarian, in that the ethical nature of the decision rests in what that consequences will be to George, i.e. if he will be at risk of harm.

    Finally, the point Hannah made about one of the social workers being concerned that making an exception would lead to more exceptions down the road is an example of a slippery slope argument. This sort of argument usually relies on a logical fallacy, and seems to in this case. There is no evidence or other reason to think that by making an exception in one case, more would inevitably follow. The ethical dilemma in this case is highly contextual and would be relatively rare, unless the setting were niche as in the rural twist on the case.

    #451

    Jenny Gage
    Participant

    1) What would you do in this situation?

    I personally like to avoid all conflicts of interest out of respect for the client. However, I know that may not always be an option. In this situation, it appears George’s case has already been assigned to another social worker within the agency. Although, the assigned social worker is having difficulty receiving any information from George it is their responsibility to follow through with the investigation. If the social worker is able to build a little rapport with George that may be helpful, but if there is a limited time (which there usually is) that may not be a possibility. The worker could also contact collaterals and speak with them about the family environment, of course, the family would provide consent to talk to collaterals and confidentiality would be respected when speaking to the contacts.

    The reality is that not all clients may have the ability to communicate due to age or level of functioning, or children may feel uncomfortable working with social workers. It is a learning experience for the social worker assigned to the file and may be difficult to work with these clients. However, if I were to talk to George I would be concerned that by knowing him previously I’d bring my own bias to the situation. Another concern I would have is if the allegations were deemed to be true I would worry that George would continue to only communicate to me and not corporate with other workers that may be assigned throughout his involvement with the agency.

    2) Who would you consult in this situation?
    In this situation, I would consult with my supervisor and would like to assume that my supervisor would agree this is a conflict of interest. However, if the supervisor believed that it was in Geroge’s best interest for me to speak with him I would respect their opinion and do so. If appropriate I would talk with the assigned worker and perhaps suggest some collateral contacts such as a teacher or doctor that they could ask the family to speak to.

    3. Which is more important in this case – the family’s privacy, or possible risks towards George?
    At this point, there are only allegations, and although they should be taken seriously so should the respect for the family’s privacy. I would not feel comfortable talking to George about the matter unless it was a very serious situation. It would be disrespectful to the family, I would bring in a bias, there is a chance George may not talk to me. In addition, I think it is important to have trust and believe the assigned social worker is competent and can find the means to complete the case without my involvement.

    4) In small or niche communities, where dual relationships are likely, how can social workers maintain professional boundaries without secluding themselves?

    In small communities, there is no doubt a challenge of being both professional and being part of a community. I believe that although we are professionals, we are also individuals outside of our careers with personal lives. I think in cases where there is likely going to be dual relationships it is important to establish boundaries immediately. This could include stating that I will not be able to talk about our professional interactions when I am not working. Or if I see you in the community I won’t say hi to you unless you acknowledge me.

    5) Would this situation change if the reason for George’s communication difficulties was a language barrier? For clients who belong to linguistic minorities, often the only people able to translate are those who are already friends or family of the client. How might this affect the intake process?

    I do not believe that my opinion would change if George had a language barrier and I could provide a translation. I do not believe the onus should be placed on the social worker to act as a translator especially if they know the family. I would have the expectation that the agency hires someone to translate or finds another social worker that may know the language and is not familiar with the family. I understand in smaller organizations hiring a translator may not be a possibility. However, it could also be a possibility to have a non-immediate family member or friend act as the translator to the assigned worker. If the family member was not part of the immediate family I would feel more comfortable, as the information shared has the potential to be less biased then an immediate family member involved in the investigation. Ultimately I think it is the assigned social worker’s task to explore all possibilities to communicate with George.

    #470

    B00538573
    Participant

    1) What would you do in this situation?

    As others have laid out any and all aspects of a conflict of interest should be avoided at any cost. With that being said I do understand the need to get Georges side of the story for a needs assessment to be completed. If I myself strongly and truly felt that my engagement with George would mean he would feel comfortable enough to talk, I would move forward with the consult of my supervisor. I would hope to speak with the family prior to let them know I would be speaking with George as that was a way for him to remain comfortable. The most important thing to outline here is the fact that I as the service provider needs to be 100% certain that I will be able to enter the situation with no biases towards George or his family. As Jenny as laid out it is important that this will not hinder Georges further involvement with social workers, should things be taken further. To help smooth this over it may be a good idea to be accompanied with the caseworker working the case so that I myself am able to articulate to George that this is someone who he can trust and will be assisting me.

    2) Who would you consult in this situation?

    In this situation I would consult with my supervisor and over all else would respect whether my supervisor felt this would a hinderers or a help to George. Sitting down and having a meeting with both my supervisor and the caseworker on the case is a way to get multiple opinions on the situation.

    3) Which is more important in this case – the family’s privacy, or possible risks towards George?

    In this case I believe that both things are equally important. With that being said I still believe it is important to take into account the possible risk towards George. As child welfare workers our main concern is always to the safety of the child.

    4) In small or niche communities, where dual relationships are likely, how can social workers maintain professional boundaries without secluding themselves?

    In this instance it is important to set clear boundaries right at the beginning of the relationship. Let these individuals know that even though you may know them outside of your working relationship the two things must remain separate. I think it is also important that you reiterate your confidentiality within your practice so they can feel comfortable working with you.

    5) Would this situation change if the reason for George’s communication difficulties was a language barrier? For clients who belong to linguistic minorities, often the only people able to translate are those who are already friends or family of the client. How might this affect the intake process?

    I think if the communication was due to a language barrier it would in the best interest of everyone involved to bring in a third party translator. You want to insure the voices of the people speaking are fairly being articulated without being misconstrued by any feelings involved.

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