reflection 2

Ethical Dilemmas in Human Service Management: Identifying and Resolving the Challenges

Cheryl A. Hyde

Human service managers are called on to make a variety of difficult decisions that often involve fundamental conflicts in values. Such conflicts constitute ethical dilemmas. This qualitative exploratory study examines how human service managers (N �40), from the United States, identify and resolve ethical dilemmas. The dilemmas identified by the managers tended to result in the restriction of missions, programs, services and practice methods. The resolution of these ethical problems often rested on following the very rules that created the dilemmas. Additional strategies included consultations and reliance on abstract principles, specifically those of one’s spiritual faith. Missing, however, were systematic or evidence-based procedures for resolving challenges that often threatened the very goals of the human service agencies. The need for more careful training in the area of ethical problem solving that maintains the vision of human services is presented.

Keywords Ethical Dilemmas; Solutions; Human Service Managers; Qualitative Methods

Human service managers constantly are called upon to make difficult decisions

with regard to service provision, staff support, resource acquisition, and program

development. At the heart of many decisions are fundamental conflicts in values:

accessibility versus efficiency, social change versus security, or compassion

versus compliance. Such conflicts constitute ethical dilemmas, the resolution of

which often involves prioritizing and then selecting from a set of competing

values and attendant actions.

While the importance of ethical conduct is widely acknowledged in the human

services, how managers identify and resolve ethical issues has received relatively

ISSN 1749-6535 print/1749-6543 online/12/040351-17 # 2012 Taylor & Francis http://dx.doi.org/10.1080/17496535.2011.615753

Cheryl A. Hyde, PhD, MSW, is Associate Professor at the Temple University School of Social Work. She serves as Coordinator for the Community and Policy Practice Concentration and Coordinator for the Education, Training and Community Outreach Core of the Center for Intervention Practice and Research. Her primary areas of interest are organizational change, community capacity building, social movements and macro practice ethics. Correspondence to: Cheryl A. Hyde, School of Social Work, College of Health Professions and Social Work, Temple University, 1301 Cecil B. Moore Ave, 517 Ritter Annex Philadelphia, PA 19122, USA. Email: [email protected]

ETHICS AND SOCIAL WELFARE VOLUME 6 NUMBER 4 (DECEMBER 2012)

little attention (but see Levy 1982; Manning 2003). As a partial means of addressing

this gap in the scholarship, I examine how 40 managers, from US human service

agencies, name and then address ethical dilemmas in their organizational

practice. Based on this analysis, I discuss some of the implications for ethical

practice in, as well as maintaining the values of, human service organizations.

Overview of Human Service Management and Ethics Resources

Human services signify society’s commitment and ability to care for its

vulnerable, marginalized or challenged populations through the provision of

social benefits and services (Brodkin 2010). In the United States, the human

service sector is composed of nonprofit, public and for-profit organizations that

literally address human needs and concerns from birth to death. In recent

decades, the sector has been buffeted by broad social, political and economic

trends including increased privatized and contracted services, the rise of

consumer-driven groups and movements, and the dominance of a conservative

ideology in government. The environment within which human service organiza-

tions operate is challenging, at best, and more often chaotic and hostile. Managerial work in the human services is informed by a complex, and at times

contradictory, set of demands and functions. Human service agencies manifest a

number of unique characteristics including people as ‘raw material’ (the clients),

the primacy of client�worker relationships, considerable contingency planning with interventions, work that is emotionally and morally laden, and the gendered

composition of staff and client populations (Hasenfeld 2010). Human service

managers, then, need to be attuned to the altruistic, human relations, business

and service delivery aspects of their organizations.

Human service managers can draw from several ethical codes and guidelines

for principles that apply to their practice, as well as that of their staff. For

example, social work practitioners, a significant part of the human services

workforce, are steeped in that profession’s code of ethics, though these codes

vary by country. For US social workers, the NASW Code (NASW 1996) does include

a specific standard (3.07) that holds social work administrators responsible for

ensuring adequate resources, supervision, and a working environment that

upholds ethical practice; however, much of the code’s focus is on clinical

situations. In the United States, for example, the National Network for Social Work

Managers (NNSWM) (2004) has delineated 14 competency areas, one of which is

‘Ethics’ that includes:

. commitment to meeting the needs of clients within the purview of the

services offered by the organization;

. commitment to the work and the organization that transcends personal desires;

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. loyalty to the mission of the organization; and

. commitment to the social work values of social justice, equity and fairness.

The small body of social work literature on ethical managerial practice focuses

primarily on three related themes: supervision, risk management, and quality

assurance of staff and programs. In particular, Reamer (2000a, b, 2004, 2005a, b,

2008) has drawn attention to the critical import of organizational protocols and

standards as strategies to minimize risk and error (see also Kirkpatrick et al.

2006; Lynch & Versen 2003; McAuliffe 2005). There is not, however, an extensive

managerial code of ethics comparable to that of the Clinical [US] Social Work

Federation (see Loewenberg et al. 2000) within social work. There also is a body of literature within social work that identifies common

(usually clinical) ethical conflicts and their resolution (Loewenberg et al. 2000;

Manning 2003; Reamer 1990; Rhodes 1991). Among these approaches is the

strategy of ‘ethical screening’, in which values or principles are rank ordered and

a decision is reached when a given principle is met. For example, the current

version of the Loewenberg et al. ethical screen prioritizes these principles (from

most to least compelling): protection of life, equality and inequality, autonomy

and freedom, least harm, quality of life, privacy and confidentiality, and

truthfulness and full disclosure (2000, p. 69). The authors assert that this screen

is used only if the dilemma cannot be resolved by following the NASW Code of

Ethics. More recently, blended models of ethical decision making have been set

forth. Such frameworks offer a step-by-step resolution strategy that incorporates

the inclusion of professional values, views of key stakeholders, available

resources, peer consultation and thorough examination of the pros and cons of

all possible options (see Reamer 2004).

Human service managers of nonprofit agencies can access a number of model

ethical guidelines (for US examples, see websites of Maryland Association of

Nonprofit Organizations, Pennsylvania Association of Nonprofit Organizations,

Utah Nonprofits Association, and the Independent Sector). Emphasis tends to be

on legal compliance, fiscal obligations, public disclosure, conflicts of interest

and responsible fundraising (White 2010). These standards, however, do not

specifically address the unique challenges of human service organizations.

For public-sector managers, the American Public Human Services Association

and its affiliates (including the National Association of Public Child Welfare

Administrators, National Staff Development & Training Association, National

Association of State TANF Administrators and IT Solutions Management for Human

Services) offer education and training in ethical issues of concern to human

service leaders. The US federal and state governments have Ethics Commissions/

Offices that focus on promoting and (mostly) enforcing standards of conduct for

public officials and employees (most specifically on issues of lobbying and

financial disclosures), as well as investigating ethics violations. The National

Conference of State Legislatures has a Committee on Human Services that has

some information on leadership development and ethical (legal) challenges, but

ETHICAL DILEMMAS IN HUMAN SERVICE MANAGEMENT 353

mostly is concerned with issue information and research. Thus, public agency managers have resources at their disposal, though perhaps not in as focused a

manner as exists for nonprofit managers. Overall, the information on ethics and ethical conduct that is available to US

human service managers spans several professions and sectors. Yet these writings are mostly prescriptive; there is scant empirical evidence that the strategies and

recommendations are implemented with fidelity or effectiveness. Some small-

scale studies have examined aspects of ethical dilemmas such as barriers to services (Egan & Kadushin 2002; Walden et al. 1990); impact of privatization and

program contracting (Anderson 2004; Lonne et al. 2004); responding to policy mandate effects on agency functioning (Yang & Kombarakaran 2006); and

conflicts between management and direct line staff (Landau 2000; Millstein

2000). Other disciplines, particularly business, have begun to develop more analytical and empirical bodies of literature on ethics and mentoring, commu-

nication, supervisee behaviors, decision making, and peer consultation (Bowie

2005; Gottlieb 2006; McDaniel 2004; Moberg 2006, 2007; Moberg & Velasquez 2006; Reinsch 1996; Schwepker 2001; Worthington et al. 2002). Nonetheless,

there is a need to engage in more research regarding ethical problems and their resolution.

Methodology

This exploratory study addressed two broad questions: (1) what do human service

managers identify as ethical problems or dilemmas, and (2) how do these

managers address or resolve these ethical problems or dilemmas? The findings presented here are from a larger qualitative study on various facets of human

service management in the United States. The constant comparative method

(Charmaz 1983, 2006; Chenitz 1986; Locke 2001; Strauss & Corbin 1990) guided the gathering and analysis of the data. This is a qualitative approach in which the

researcher engages in the iterative process of ‘moving’ between collection and analysis, and between inductive and deductive stances with respect to the data.

Sample

Data are from in-depth interviews with 40 managers working in human service or

social change organizations in a large mid-Atlantic urban area in the United

States. The author constructed the sample from a list of 75 individuals who served as management, planning and/or community field or task instructors for

the area’s schools of social work. In addition to convenience, these individuals were chosen because they had familiarity with social work education, including

the importance of ethics. All of these individuals were in management positions,

broadly defined (e.g. executive director, program director, or coordinator),

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supervised staff, and had planning responsibilities. Initially, 20 individuals were

randomly selected from the sample. However, the total number of persons who

were interviewed expanded to 40 as an additional 20 individuals were randomly

selected from the remaining 55 original persons in order to achieve theme

saturation related to ethics and the resolution of ethical dilemmas.

Table 1. Selected characteristics of respondents (N�40)

Name Race Degree Position Practice area/issue

Allen White MSW Director Community development Andrew Af. Am. MPH Director Health/addictions Anna White MSW Aff. Action Off. City hospital/health Barbara White MSW Program Director Housing Beth Af. Am. MSW Unit Supervisor Child welfare Celeste Latina MSW Director Poverty Cynthia White MSW Director Community mediation Darnell Af. Am. Urb. Pl MA Executive Director Youth mentoring Deanna White MSW Coordinator Women’s issues Don White MSW Director Veterans’ services Emily White MSW Education Director Women’s issues Emma White MSW Outreach Coordinator Peace issues Evan White MPA Associate Director Environmental impact Evelyn Af. Am. MSW Assistant Manager Juvenile justice Frank White MSW Executive Director Community development Jay White MBA State Representative Politics Jessica White MSW Program Director Community center Joe White MSW Dir of Social Services Mental health Jose Latino MSW Program Director Mental health Julie Af. Am. RN Vice President Health Karen White M.Ed Principal Elementary education Linda White MSW Public Policy Director Homelessness Marcus White M.Div Director Anti-racism/social change Marian Latina MSW Program Director Workforce development Martin Af. Am. M.Div Assistant Director Civil rights Maureen White J.D. Community Specialist Homelessness Mike Af. Am. MSW Executive Director Juvenile justice Nancy White MSW Program Director Children recreation Paula White MSW Program Director Children & youth Richard White MSW President Foster care Rick Af. Am. Urb. Pl. MA President Community development Rosemary White MSW Executive Director Health/HIV-AIDS Ruth White MSW Director Employment Sandy Af. Am. MSW Supervisor Counseling center Sara White MSW Education Supervisor Violence against women Tamika Af. Am. MSW Transplant S.W. Health Ted White MSW Director Poverty Tom White MSW Program Director Mental health Tony Latino MSW Consultant Organizational dev. Valerie Af. Am. MSW Deputy Director City�neighborhood rel.

ETHICAL DILEMMAS IN HUMAN SERVICE MANAGEMENT 355

Table 1 summarizes select characteristics of the 40 respondents (pseudonyms

for individuals and organizations were used for confidentiality purposes). The

sample is comprised of 16 men and 24 women; 25 whites, 11 African Americans

and 4 Latinos/as; and 30 MSWs (field instructors) and 10 individuals with graduate

degrees in related fields (task instructors) such as public policy, divinity, nursing,

and education. The age range was from 37 to 66, though most were in their late

40s or early 50s. Their areas of practice reflect a wide array of interests including

child welfare, mental health, community development, homelessness, juvenile

justice, and the environment. Seven respondents (Anna, Beth, Evelyn, Jay, Mike,

Ruth, and Valerie) worked in the public sector, with the other 33 in nonprofit

organizations; seven individuals (Celeste, Jessica, Nancy, Richard, Sara, Ted, and

Tom) characterized their organizations as faith-based.

Data Gathering and Analysis

Unstructured schedule interviews (Denzin 1989), two or more hours in length,

were conducted. In this type of interview there is a list of questions or items to

be covered, but there is flexibility in terms of order, phrasing, follow-up, and the

pursuit of tangents or unanticipated ideas. Interviews covered: education and

career path; knowledge and skills needed for current job; overview of a ‘typical’

day in the agency; agency strengths and challenges; ethical problems and their

resolution; and the political environment of the organization. Because the

researcher engages in data coding while collecting the data, emergent themes or

coding categories inform subsequent interviews, primarily to clarify or verify

findings (Charmaz 2006). The author and graduate research assistants conducted

the interviews, which were taped and transcribed. Per the constant comparative method, initial descriptive data coding followed

the topics outlined in the interview protocol, though unexpected insights or ideas

also were coded. This initial coding began once the first three interviews were

completed so that emergent themes could be incorporated into the interview

protocol; this iterative process continued as interviews were completed. Through

this descriptive coding process, core themes were identified. As these core

themes became more robust, more in-depth categorical and theoretical coding

schemes were developed. These codes were grouped into substantive categories,

and these categories were compared across all interviews and with the literature

to determine areas of common focus and points of divergence within the sample

and between the sample and the literature, all of which were recorded in theme

memos. Further interviewing was guided by emergent themes and coding

conflicts. In this way, codes and categories were continuously examined against

newly collected information (Charmaz 2006; Chenitz & Swanson 1986). Analytical

categories and themes concerning various facets of ethical challenges and

resolutions were developed.

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Two persons*the interviewer and a research assistant*coded each interview. When disagreements arose, another research assistant coded the interview. For

each interview, the research team met to discuss coding and emergent themes,

identify and (if possible) resolve differences, and determine the need, as well as

parameters, for any additional interviewing. The author composed theme memos

that captured key points of the interview and linked the findings to those in other

interviews. Coding and analysis ended when theme saturation occurred. Theme

saturation means that any additional data for a given analytical category would

not contribute any new information. A coherent, systematic, and rigorous

condensation, as well as interpretation of the data, supported the integrity of

the research in that all possible explanations had been taken into account or

eliminated (Charmaz 2006; Chenitz & Swanson 1986; Strauss & Corbin 1990).

Theme saturation is a primary way in which internal validity is enhanced within

the constant comparative method. Also key to this study’s internal validity was

the use of triangulation (Denzin 1989), specifically through the convergence of

different interpreters (coders), and explanations (emergent analysis and existing

scholarship). External validity and reliability are more problematic given the

exploratory nature of this study. This research has limited generalizability since it

used a relatively small, non-random sample located in one geographic area. It

also has limited reliability (though ‘perfect’ replication is difficult given the

uniqueness of a qualitative study), (Cresswell 1994; Lee 1999).

Results

The respondents identified numerous concerns and problems that they deemed

to be ‘ethical dilemmas’. Common to most (if not all) of these challenges was an

infringement of the ability to deliver needed services because of several

interrelated problems: external rules and regulations, compromised missions,

or staff competencies.

External Rules and Regulations

The most frequently mentioned ethical problem was how rules and regulations,

imposed by funders, contractors and other external institutions, circumscribed

program offerings. One senses palpable frustration from these managers, as they

discussed how work of their agencies was hampered:

It seems as though we are always running up against wanting to promote or encourage client self-determination with the pressure to conform to the standards or rules of outside entities that monitor and fund us. (Julie)

ETHICAL DILEMMAS IN HUMAN SERVICE MANAGEMENT 357

We really believe in client empowerment. Unfortunately one of our contractors is really, really strict with its guidelines and we couldn’t pursue the level of client participation that we really had wanted to. (Linda)

The worse part of my job is having to enforce regulations, since that can get in the way of actually helping the residents either because it takes too much of my time or a particular rule is too rigid and doesn’t allow for empowerment. (Barbara)

What we’re dealing with requires long-term interventions, but I feel as though we mostly do short term fixes. You can’t solve poverty or other problems that immigrants face with a four-week program. But that’s all we can get funding for. So I guess we’ve decided its better to stay open to serve our clients than pursue more long term, deeper changes in the system. (Celeste)

A related situation concerns how broader system rules*in these examples the insurance industry and the city bureaucracy*prevent agencies from engaging in preferred comprehensive practice:

We have some older psychiatric patients, who have histories of homelessness and chronic mental illness, and the system out there really doesn’t, or isn’t able to meet their needs. At times we have to discharge people to shelters and we know that they just go right back out onto the street. The hospital and insurance companies will not support interventions that take time. We can’t do what we really know should be done. (Joe)

The politics of being part of a city system was one giant ethical headache, but you just have to deal with it. The city just makes it difficult to get anything done the way you want to do it. You just can’t serve your clients sufficiently. (Evelyn)

These examples underscore the difficulties of sufficiently and appropriately

working with clients because of the constraints imposed by various rules and

protocols that, in turn, alter the nature of the social work intervention.

Compromised Missions

A related theme is represented in a second cluster of ethical situations that

centered on compromised agency missions and orientations usually because of

financial mandates. Frank, who runs a community development agency, offered

this example:

We have a mission, which says that we are in the settlement house tradition and we’re about social justice and empowering people through advocacy and education and so forth. So I think ethically we need to look at where we’re going. There are times when a request for proposals has come out that we are going after because of the money, rather than because it is really meeting the mission, and so that’s a bit of a struggle.

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For other respondents, consistency with agency mission is challenged when

partnering with another organization that may not share some or all of its core

values. Sara, who oversees a domestic violence program, identified the issue of

providing educational trainings, as part of a lead agency’s program, in which

some principles were at odds with those of her organization:

Working with the [XYZ] agency definitely presented problems because it is a program that imparts some values that we don’t necessarily agree with. So it’s a question about*do we want to have sort of a purist stance and decide we are not going to associate ourselves at all with this work or are we going to say well, its better for us to at least be able to infuse some of our philosophy into the program, even if it means we can’t really have a purist stance. And I think there are issues that come up like this all the time that are tricky and they don’t have black or white answers and we have to talk them over and struggle. And some in our agency said that they wouldn’t participate because they were so uncomfor- table. That was okay; we still did the presentations but didn’t mandate staff involvement.

The difference between this theme and the prior one is that the focus is on

undermined agency values rather than specific client access. In most cases,

however, the result was the same: the kind of work that the respondents wanted

to do was compromised.

Staff Competencies

A third grouping of ethical concerns involved various aspects of staff competency

and performance, and underscored the challenges that human service managers

experience as supervisors. In the following example, the dilemma related to

compliance with regulations or mandates is expressed:

I have a model of empowerment and engagement with staff. Everyone has a say. But then there are things that we have no choice in, we have to do them. We can bitch and moan and debate about breaking the rules, and in the end we grit our teeth and do what is required of us. But it can be exhausting to have to keep reminding, and at times, nagging staff to do what they need to do. And these stupid reports just get in the way of us doing the work we do so well. So that makes me, and I think everyone, feel ethically challenged. (Ruth)

With respect to practice skills, cultural competency was the primary area of

concern for the respondents, with several noting how difficult it was to get staff

engaged in this aspect of professional development. In many respects, Beth

echoed the sentiments of others: ‘It’s hard to get staff to take diversity training

seriously or at least for them to take the time to learn. But I think it is unethical

for staff to be racially unaware.’ Some respondents reflected on their own competencies and how these related

to ethical practice. For example, Sandy noted:

ETHICAL DILEMMAS IN HUMAN SERVICE MANAGEMENT 359

I’m not sure that it’s really ethical for me to be doing community engagement work. I was trained as a clinician and when I got promoted [into current supervisor position] I was asked to do outreach and I just don’t know what I’m doing.

Resolution of Ethical Dilemmas

How do managers proceed when faced with the aforementioned challenges? Respondents relied primarily on one of three strategies*following the rules, consultation, or adhering to principle*in order to resolve ethical problems.

Regulatory compliance. Despite the concerns and complaints regarding the damage that various restrictions and regulations had on their agencies, most

respondents deferred to those external guidelines or to agency policies and protocols, rather than social work ethic rules:

I work at the pleasure of the mayor, so what he says to do, I do even if I might disagree. And since we’re regulated, you pretty much stay within regulations and policies. (Mike)

I do what my supervisor wants and my staff does what I want. (Nancy)

Funder restrictions [for client access to services] always seem to take precedent. We really want some of these people, who need our services, to get them but our funding source doesn’t allow them [active substance abusers] to attend the programs and get help. It’s frustrating, but we need the money. (Marian)

This approach to resolving ethical dilemmas moves the ethical decision-making process away from social work values and into the realm of the regulator’s principles. While practitioners expressed regret over decisions ‘having’ to be

made in this way, they did not indicate a willingness to engage in negotiations to alter these processes. And, some seemed relieved that another person or entity

had made the decision for them.

Case consultation. Another, often mentioned, strategy for resolving ethical dilemmas is that of consultation. Jessica offered the following rationale for seeking this type of assistance:

If I made a decision [about an ethical issue] in a vacuum without consultation from either other staff members or consumers or leaders of consumer groups, then I’m not serving my population the best that I can.

Often, the decision to engage in peer consultation is influenced by the particulars

of the moment. That is, respondents sought out assistance and guidance from various individuals or groups as determined by a given set of circumstances, for

example:

I think it [resolving ethical dilemmas] is different for different issues. I think for some issues our strategy is just sitting down and having a conversation and

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making an agreement as a group and I think, when possible, that’s what we try to do. I think that with other issues I think it does come down to what the director feels needs to happen. I think particularly when it is a more public issue in which our name is going to be out there, that it will be a decision made by somebody who is in management. (Sara)

In another case, the decision to engage in consultation was quite informal, for

example:

One thing I like about this agency is that you can talk to anyone about your concerns. And I do. Whoever is available, that’s who I bounce ideas around with. (Jose)

Each of these examples reflects an almost idiosyncratic approach to ethical

problem solving. While a case-by-case approach has some advantages in that

decisions can be tailored to the specifics of the situation, these respondents did

not suggest that a body of wisdom was being developed. Instead, there was an

ahistorical approach to the use of consultations. Emily provided an example of a more purposeful use of consultation for a

particular event. She worked for a feminist organization that had been given an

invitation by the Playboy Foundation to apply for program funds, which meant

having to weigh taking the money versus upholding feminist ideals. Emily and the

Executive Director (also an MSW) facilitated discussions with the other staff, the

board, and their political peers in the community before making a decision. They

chose not to apply for the money because it would be too much of a political

liability within feminist and progressive circles. Interestingly, however, it was

concern over credibility with allies and not the violation of feminist ideals, per

se, that resulted in this decision. Using a similar approach, Deanna noted that she

and other staff ‘engaged in continuous group dialogue and analysis that link

programs to social change goals, so we can monitor whether we are staying true

to our mission’. What Deanna, as her organization’s coordinator, has done is

instill a review and decision-making framework that is participatory and

reflective. In both of these examples, the practitioners sought comprehensive

review of the situations.

Adherence to personal principles. The final strategy used by the practitioners was the reliance on moral beliefs and practices that held personal meaning. For

some, this involved invoking the value of social justice, or more specifically anti-

racism or gender equality ideals, such as in this example:

I always keep in mind my goal of peace and justice and what will get us there. There are not a lot of moments when working for these things that you feel a great sense of satisfaction, and so you have to, for your mental health, you have to figure out how to stay the course. For me, what I’ve often said is, I do this because I can’t NOT do it. Physically I think that I probably just have to do it, and I remember what Gandhi said, ‘You may never see the fruits of your labor.’ I hold that in my head. (Emma)

ETHICAL DILEMMAS IN HUMAN SERVICE MANAGEMENT 361

The more common principle used by respondents, however, was spiritual. Respondents often cited religious values and practices as the touchstone for their decisions, and consequently relied on prayer for guidance. For example,

Ted, who was worried about the ‘displacement of poor folks through economic development’, spoke of his ‘faith commitment’ to serving the poor and often

‘prayed for guidance in dealing with the economic fall-out of development.’ Similarly, Tom tried to understand how to address concerns by invoking ‘the

mission spirit’ as noted in the following example:

I get in touch with the mission spirit*talking about seeking the guidance of God. This is part of the [agency’s] mission: seeking God’s guidance and believing we are responsible to each other as members of one family. That’s how I deal with problems. I see what God has to say about it, and encourage my staff to do the same.

What’s missing. While some of the practitioners seemed to follow some value ranking, as in ‘best interest of the client’, social change, or a principle of faith over other considerations, none indicated the use of a decision-making frame-

work (see, for example, Loewenberg et al. 2000; Reamer 1990; Rhodes 1991). Only one respondent, Marian, specifically referenced the NASW Code of Ethics as

a possible, though ultimately unhelpful, tool for resolving ethical concerns. Few practitioners referred to existing literature or evidence to assist in their

decision making, though some referenced prior efforts as rationales for the ways

in which decisions were made. Nor did they convey any confidence that the ‘right’ decision had been made or the preferred outcome achieved. Overall,

there was a general lack of systematic and evidence-based protocols for addressing concerns, as if good will and luck would suffice: ‘We are making

guesses when we work with the really difficult clients and if we make enough correctly, mathematically we end up in the right place’ (Don).

Discussion

Findings from this exploratory study, in which a sample of human service managers from the United States was asked to identify ethical challenges and

how they resolved them, have several implications. Few respondents identified ethical dilemmas in the truest sense of the definition*that of competing and equally compelling values within a situation that has no perfect resolution

(Reamer 1990; Rhodes 1991). Instead, more generic problems or challenges were identified as constituting an ethical dilemma. This may indicate a relatively

simple or basic approach to ethical practice. Given that most of this study’s respondents were social workers, their

decisions about organizational practice ought to reflect, and be guided by, the ethics of that profession. To some extent, key social work standards, such as

commitment to social justice and the best interests of the client, did inform

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the thinking of those who were interviewed in this research study. Yet it was

expressed in a general way rather than as a clear guidepost for ethical

resolution. Additionally, these were superseded by other considerations such as

regulations, funders, intra-organizational power dynamics, or principles de-

rived from other reference points (such as faith). Thus, decisions regarding

social work practice seem to be informed largely by non-social work values

and procedures. One gets the sense that attempts to enact social work values

were thwarted by external factors and barriers. This is significant as it

suggests a broader problem for social work as a whole*practitioners may either lack the needed analytical skills to effectively prioritize and promote

social work values and/or the external threats are substantial enough to erode

or suppress one’s commitment to social work values. Among the challenges identified, however, the impact of external factors

looms over practice in the human services. Respondents consistently men-

tioned rules, regulations, and mandates as constraints. The recognition of

outside threats is not new (Austin 2002; Hopkins & Hyde 2002; Lohmann &

Lohmann 2002), though identifying them as ethical dilemmas could be. With

increased privatization and contracted services, these concerns are likely to

deepen (Anderson 2004; Carey 2007; Healy & Pine 2007; Lonne et al. 2004;

Reamer 2000a, 2008). Such developments represent a considerable threat to

social work, since these external factors often supersede social work values or

principles when a decision has to be made. Lonne et al. (2004) have similarly

noted the erosion of social work values from these environmental threats.

Human service managers need to be particularly attuned to these develop-

ments, since they are often the agency personnel charged with compliance

tasks.

Perhaps most significant is the dearth of evidence provided by the respondents

that would indicate that their resolution strategies were grounded in research or

practice principles. Rather, a case-by-case approach seemed to be adopted in

those instances where a decision needed to be made, though in a number of

instances there was no ‘true choice’ because the respondents took their cues

from rules and regulations. The research findings presented here parallel those of

Holland and Kilpatrick (1991), who note in their qualitative study on resolving

ethical issues that their respondents (all social workers) did not use the code of

ethics or another framework to resolve ethical dilemmas and often deferred to

some form of authority. Moreover, Holland and Kilpatrick assert that the

‘profession suffers from a lack of systematic studies of ethics in practice’

(1991, p. 138), which suggests that there may not be much in the way of best

ethical practices from which social workers can draw. The findings from this study also might illuminate the conclusions reached

by the Ethics Resource Center in its 2008 report on ethics in nonprofit

organizations. While not specific to human service agencies, this report should

serve as a cautionary tale in that it notes that within the nonprofit sector

ethical violations are on the rise, boards are not fulfilling their obligations of

setting clear ethical standards for their organizations, and financial fraud is

ETHICAL DILEMMAS IN HUMAN SERVICE MANAGEMENT 363

higher than in profit or public-sector organizations. With respect to the public

sector, it seems that there is a daily stream of professional malfeasance,

particularly in the area of child welfare and protection. Because this group of managers did not use available prescriptive codes and

guidelines, it may be that a place to start is with a thorough review of this

material to determine its usefulness for managers. Steps then need to be taken

toward embracing a more critical and analytical process for the resolution of

ethical conflicts. Managers would do well to establish ethics committees and

other procedures that would move them toward systematic and consistent

decision-making practices (Healy 2003; Reamer 2000a, 2004, 2008). One useful

tool, which assists in identifying potential ethical problems that could place the

agency at risk, is the social work ethics audit (Reamer 2000b). By engaging in a

systematic assessment of the agency, managers would engage in a proactive

approach, and hopefully solutions, to possible ethical challenges rather than

adopting a reactive stance, as many of this study’s respondents did. Human service managers also need support in contending with the various

challenges, threats, and mandates of external actors. This has implications for

nonprofit boards of directors and other oversight bodies, in that they need to

determine how to uphold social work principles, particularly when confronted

by external demands. Boards that emphasize the acquisition of funds, the use

of corporate business practices, or other priorities that jeopardize social work

values place managers in potentially untenable situations. Finally, the

profession, through continuing education, curriculum development, accredita-

tion standards and lobbying activities needs to consider how it is promoting

ethical decision making at the managerial level. Does sufficient training,

focused on managerial and not clinical practice, exist? What is being done to

assist social work practitioners as they negotiate with potentially hostile

external demands? If the profession, through its educational and advocacy

venues, does not address these managerial challenges, then it will cede the

administration of human service organizations to other disciplines. Though the research findings reported here are limited in that they are

derived from a small sample located in a specific region in the United States,

they nonetheless suggest that work needs to be done to improve ethical

problem solving by human service managers. Otherwise, the essential purpose

of human services may be weakened and ultimately lost.

Acknowledgements

An earlier version of this paper was presented at the 2010 ARNOVA Annual

Meeting, Alexandria, VA, USA. Please do not quote without author’s permis-

sion. Direct all inquiries to Dr. Cheryl Hyde at the address given in the

footnote on the title page of this article.

364 HYDE

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