For Ethics Week, we are featuring a different TBRHSC department daily to see what sorts of ethics questions they encounter.
What do you/does your department do?
Social Work at TBRHSC is diverse. We provide service throughout most departments, as well as in the community and larger Northwest Region through outpatient services and programs. When supporting patients and families we consider the psychological, social, physical, spiritual, emotional and financial elements that influence physical and mental health. We strive to provide a safe and inclusive environment that promotes client centred care. As regulated health care professionals, we adhere to the Code of Ethics and Standards of Practice set out by the Ontario College of Social Workers and Social Service Workers.
What kind of ethical issues come up in your area?
Prioritizing ethical practice is inherent in the field of Social Work. While performing the duties and responsibilities of our roles we often encounter a variety of situations with competing priorities or values, and with multiple possible outcomes. These ethical issues may be brought forward by staff, families, patients or other service recipients/providers. Some topics most often faced are: Advanced Care Planning and Goals of Care; capacity and consent; autonomy and decision making; moral/religious/spiritual dilemmas, and confidentiality.
Case Example:
A social worker is working with a patient who has a terminal illness and is in the hospital for end-of-life care. The patient has expressed a desire to be discharged from the hospital and spend their remaining days at home. However, the patient’s family disagrees with this plan and wants the patient to remain in the hospital, receiving the highest level of medical care possible.
The social worker must navigate this situation while balancing the patient’s wishes with the family’s concerns. They must consider the patient’s right to autonomy and self-determination, while also ensuring that the patient is not being coerced or influenced by outside parties. The social worker must also consider the ethical obligation to provide the highest quality of care possible, while also respecting the patient’s wishes for end-of-life care.
In this scenario, the social worker may need to facilitate a family meeting to discuss the patient’s wishes and goals of care, and work collaboratively with the healthcare team to ensure that the patient’s physical and emotional needs are being met. The social worker may also need to explore community resources and support services to help the patient and family navigate this difficult time.
