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Kevin Bruch

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  • in reply to: Connections and Conflicts of Interest #395
    Kevin Bruch

    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.

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