Moral and Ethical Framework Appraisal

The Role of Ethical Theories in Decision Making by Social Workers Rujla Osmo & Ruth Landau

This study analyses the arguments provided by a convenience sample of 62 Israeli social

workers for their preferred ethical principles in terms of ethical theories. Content analysis

of arguments given in four different contexts shows that the large majority of social

workers in the study based their arguments on either deontological or utilitarian ethical

concepts, less frequently using concepts from virtue theory, rights theory and care theory

of ethics. However, the analysis reveals a discrepancy: when social workers were requested

to justify their rank ordering of ethical principles without reference to a specific practice

situation, they most frequently preferred concepts reflecting deontological theory of ethics,

such as right intention, universalism, and duty. In contrast, when confronted with a

specific practice situation, the social workers’ most frequently chosen concepts were

relating to results, consequences, and utility, concepts identified with the utilitarian

theory of ethics. In view of the findings, the need for more thorough knowledge of a

variety of ethical theories and their potential role in ethical decision making in social

work practice and education are discussed.

Keywords: Ethical Theories; Ethical Dilemmas; Ethical Argumentation; Ethical

Decision-making; Ethical Principles

Introduction

Social work deals with individual and social problems and situations that are, by

definition, difficult and complex. Many situations in which social workers intervene

become ethically complicated, as they involve aspects of social control and change

vis-à-vis less powerful clients. These complications increase when we consider the

general societal context and that of the agency, as well as social workers’ professional

and personal values.

Even though social workers’ professional values may be partly compatible with

societal values, there may be important differences in emphasis, priorities or

Correspondence to: Rujla Osmo, Senior Teacher, Paul Baerwald School of Social Work, The Hebrew University of

Jerusalem, Mount Scopus, Jerusalem 91905, Israel. Email: [email protected]

Social Work Education Vol. 25, No. 8, December 2006, pp. 863–876

ISSN 0261-5479 print/1470-1227 online # 2006 The Board of Social Work Education DOI: 10.1080/02615470600915910

interpretation (Loewenberg et al., 2000). Moreover, a social worker’s professional

values are not always consistent with one another, and even a consistent set of values

may not always be uniformly implemented under the everyday rules by which we live.

In a pluralistic society, we must make a conscious effort to continuously evaluate our

professional values and rebuild them into the structures of our concrete daily

existence (Cooper, 1993). That is, in each situation, social workers must decide anew

which professional ethical principle has priority and with respect to whom (Hugman

& Smith, 1995).

The perspective with which social workers view the world reflects their personal

philosophy and value systems that derive from both their personal and their cultural

history (see Abramson, 1996). Indeed, recent research evidence indicates that there is

no difference between social workers’ professional and personal ethical hierarchies,

even though they do not hold a universally accepted hierarchy of ethical principles

and they tend to apply different ethical hierarchies in different situations (Landau &

Osmo, 2003). Landau and Osmo’s results indicate that, while social workers appear

to attach great importance to the professional ethical principles, their personal values

may play a great role in their ethical decision-making processes. The preponderance

of social workers’ personal values on their decision-making processes needs further

analysis.

It has been suggested that social workers need to ‘identify their own personal

values’ (Loewenberg et al., 2000, p. 133), to know themselves ethically (Abramson,

1996), to engage in explicit argumentation that can make a significant contribution

to the quality of decision making (Osmo & Landau, 2001), and to take a more critical

stance towards their professional work (Gambrill, 1997; Mattison, 2000). Explicit

scrutiny of the issues and explicit justification of the decision-making process in

cases of ethical dilemma are important facets of social work practice and lead to

crucial professional debate and critique. Personal accountability (Goldstein, 1998)

demands that social workers offer articulated arguments for their preferred ethical

principles when dealing with different ethical dilemmas. This articulation is

particularly important since social workers are increasingly subject to scrutiny for

purposes of quality assurance and payment authorization and they are increasingly

asked to provide evidence as the basis for further treatment decisions (Proctor,

2002).

Articulating their arguments in decision making exposes social workers to critical

thinking and public scrutiny, as well as allowing examination of the implicit

deliberations guiding practitioners. Argumentation is an act of forming a rationale,

drawing conclusions and applying them in discussions and decisions (Toulmin et al.,

1984; Imbrognio, 1997). An argument must involve at least two statements—one

putting forward a particular view and at least one specifying reasons for that view.

When we argue, we do not merely say what we think, we also say why we think it.

This allows others to make critical judgments as to whether they should agree or not.

Argumentation is an important element in ethical decision making. Yet, despite the

importance of social workers’ ethical decision-making processes, there has been little

empirical research by social workers in the field of ethics (see Jansson & Dodd, 1998),

864 R. Osmo & R. Landau

particularly on argumentation in ethical decision making (see Osmo & Landau,

2001).

Although there are a number of models of ethical decision making in social work

(Reamer, 1990; Rhodes, 1986; Loewenberg et al., 2000; Congress, 1999; Mattison,

2000), we still know very little about the actual process of social workers’

argumentation when they are confronted by ethical dilemmas in practice. How do

social workers justify their decisions and choices? How do they formulate their

arguments? What are the terms they use? Are these terms drawn from one or more

theoretical frameworks of ethics and are these frameworks similar or different?

Rhodes (1998) argues that social workers must ask what sort of perspectives or

guidelines help them to evaluate and justify decisions concerning ethical dilemmas

and what constitutes an adequate ethical framework. Cooper (1993) observes that

justification refers to the belief system or theory that is being used to give meaning to

our way of life. Examining arguments for ethical decision making in terms of major

ethical theories may shed more light on social workers’ preferences in ethical

approach within a given cultural and situational scene.

Ethical theories in the social work literature can be divided into two major groups

in order to help social workers recognize and understand the principles on which

their ethical decisions are based (e.g. Mattison, 2000; Reamer, 2001). (1)

Deontological theories claiming that certain kinds of action are inherently right or

good, as a matter of principle. This group of theories focuses on fulfilling one’s

duties; respecting the rights and autonomy of others and treating others with equal

justice. (2) Teleological theories arguing that certain actions are to be performed

because they are good by virtue of their consequences. One teleological orientation

that has influenced social work is the utilitarian one (Reamer, 2001).

Banks (2001) broadly identifies two kinds of ethical theories: (1) those that focus

on principles of action, such as deontological (e.g. respect for the individual person

and recognition of users’ rights to freedom in making their own decisions and

choices) and utilitarian orientations (e.g. utility and justice); (2) those that focus on

the character of the moral agents and their relationships with each other, such as

virtue ethics and the ethics of care. Further, Hinman (1994) introduces the rights

theory of ethics as one of the contemporary theories of ethics.

In this study we adopt Banks’ broader perspective based on a more contemporary

classification of ethical theories in the philosophical ethical literature (Beauchamp &

Childress, 1994; Hinman, 1994; Brannigan & Boss, 2001). This includes a number of

ethical theories relevant for social work, in addition to those more cited ethical

theories in social work literature: virtue, care and rights ethical theories.

Each of these theories, at least in their strong version, claims to be exclusively

correct. According to Hinman, the utilitarian theory claims that ‘morality is solely a

matter of consequences’; the deontological theory alleges that ‘morality is a matter of

having the correct intention, one that can be willed universally for all human beings’;

the rights theory sees the ‘only moral issues as being issues of rights and correlative

duties to respect the rights of others’, and the virtue theory maintains that ‘morality is

primarily about character’ (Hinman, 1994, p. 54), that is, having the moral virtues of

Social Work Education 865

someone who acts from proper motives such as acting with respect, beneficently and

with fairness (Beauchamp & Childress, 1994). The ethics of care theory, related to

virtue ethics in some respects, focuses on a set of character traits that are valued in

close personal relationships: compassion, sympathy, fidelity, and the like

(Beauchamp & Childress, 1994).

This study examines social workers’ arguments for their preferences of ethical

principles in general and specifically in the context of different situations containing

ethical dilemmas (professional and personal). The social workers’ arguments are

examined in terms of the five ethical theories presented above. We aim to answer the

following questions.

1. Do social workers’ arguments reflect one or more ethical theories in their choice of

ethical principles?

2. Do social workers’ arguments reflect different ethical theories in different practice

situations?

3. Is the content of the social workers’ arguments congruent with the content of the

ethical principles in terms of ethical theories?

Methodology

Procedure

The present study is part of a larger study of ethical decision making by social

workers (Landau & Osmo, 2003; Osmo & Landau, 2003).

As a first stage we compiled a list of 12 ethical principles in social work, based on

ethical principles as reflected in relevant social work literature (Bloom, 1990;

Loewenberg et al., 2000; Reamer, 2001) and in the codes of ethics of social workers

(IASW Code of Ethics, 1994; NASW Code of Ethics, 1996). Respondents were

requested to rank these 12 ethical principles in order of importance and then to

present arguments for their rankings of the first three and the last ethical principles.

Our aim was to examine social workers’ arguments concerning ethical principles with

respect to practice situations both as professionals and as individuals. Consequently,

in the pre-test, participants were requested to rank the ethical principles and their

arguments for two practice situations twice: once as professionals and once as

individuals. However, due to the time required to complete the tasks involved in the

study and respondents’ comments, following pre-test, the respondents were

randomly divided into two groups. One group was requested to rank the same 12

ethical principles in order of importance with respect to two specific practice

situations containing an ethical dilemma (vignettes). The second group was asked to

rank the 12 ethical principles in order of importance with respect to one specific

practice situation but to do it twice: first from a professional point of view and then

from a personal point of view (i.e. they were asked to assume that the described

situation occurred in their own personal life). Next they were requested to offer

arguments for their rankings of the first two ethical principles concerning each

vignette.

866 R. Osmo & R. Landau

Instrument

The instrument used in this study was a structured questionnaire, specifically

constructed for the larger study. Here we present the parts of the instrument relevant

for this analysis.

(1) The list of 12 ethical principles: (a) equality and inequality (equal persons have

the right to be treated equally and non-equal persons have the right to be treated

differently if the inequality is relevant to the issue); (b) basic justice (in the allocation

of resources, before the courts, etc.); (c) privacy and confidentiality; (d) protection of

life; (e) the good or the interest of the individual; (f) truthfulness and full disclosure;

(g) autonomy and personal freedom; (h) quality of life; (i) provision of basic human

needs; (j) the good or interest of the public; (k) least harm; and (l) the obligation to

obey the law and regulations.

(2) Participants were requested to rank the list of 12 ethical principles generally

and in two specific situations. In this study we used a ‘critical incident’ approach, a

common strategy for studying decision-making and discretionary processes (e.g.

Drury-Hudson, 1999). The first vignette described a practice situation where a

pregnant 14-year-old adolescent does not want her parents to know about her

condition [a modified version of a case described in Loewenberg & Dolgoff (1992,

p. 40)]. The second vignette described a three generational family, in which the 70-

year-old mother lives with her child’s family. She becomes the center of conflict

between the couple. The only old age home in the town that the social worker finds

suitable is far less desirable to her than the family’s home (Loewenberg & Dolgoff,

1992, p. 192). The vignette with the pregnant teenager was used for both groups of

respondents. These vignettes were selected because the dilemmas intrinsic in their

content seemed adequate to be discussed from different ethical perspectives.

(3) Open-ended qualitative information on arguments for the three most important

and the last (twelfth) choice was recorded for the general ranking of the ethical

principles—‘Please give your arguments why the three ethical principles you placed in

the three first places are the most important and in the last place the least important in

your opinion’. Respondents were similarly requested to give their arguments for the

two most important choices of the ethical principles for each of the vignettes.

The initial draft of the questionnaire, which included the rankings of all four

situations (the general ranking of the 12 ethical principles, the ranking of the two

specific vignettes and ranking of the pregnant teenage vignette from a personal point

of view), was pre-tested by 12 senior social workers. This showed that it was necessary

to divide the questionnaire and create the two groups because of the questionnaire’s

length and difficulty. The administration of the final form of the questionnaire and

the qualitative information required about 30–40 minutes.

Sample

The social workers in this convenience sample were recruited from community and

hospital social services in Jerusalem and the metropolitan area of Tel Aviv in Israel.

Social Work Education 867

The social workers were all professionally trained and certified with at least a BSW

(comparable in training to the MSW in the United States). Questionnaires were

distributed to social work practitioners by the directors of social services. Response

rate reached about 50%. This response rate is due to the lower response by

participants requested to return the questionnaires to the researchers by mail. Of the

66 questionnaires returned to the researchers, 62 were useable (gave arguments

justifying their preferred principles).

The sample distribution was: 92% were females, 73% were married, 33% had a

BSW degree, 18% had a MSW, 3% had PhDs, and 46% were students in a MSW

program. The mean age of the respondents was 36 years (SD59.29; range 23–58);

they had been at their current workplace for a mean of 9.38 years (SD58.2; range 1–

29); 63% of the sample worked in the areas of health and mental health, 10% in child

and youth care, and 37% in other areas of social work care; 87% of the sample were

Jewish, 5% Muslim, 2% Christian and 6% did not give a religion; 50% of the sample

claimed to be secular, 18% traditional, 23% religious, 3% very religious and 6% did

not answer the question.

Content Analysis of Arguments

The following coding instructions were specially constructed to analyze the

arguments.

1. Indicate whether the respondent included reasons for the ranking of a given ethical

principle in her argument.

2. Indicate whether the content of the arguments for the ranking of a given ethical

principle relates to one or more of five identified ethical theories: (a) utilitarian; (b)

deontological; (c) rights; (d) virtue; (e) care.

Each statement in the response was coded separately, allowing each respondent to

apply more than one argument and, consequently, to rely upon more than one

ethical theory.

The operational coding instructions were as follows.

1. The argument was coded as utilitarian if it or part of it included ideas or words

dealing with utility and consequentialism, such as maximizing the good and

minimizing harm, or words such as gain, loss, and results.

2. The argument was coded as deontological if it or part of it included ideas or words

dealing with duty, intention, or categorical imperative.

3. The argument was coded as rights based if it or a part of it included ideas or words

dealing with rights, eligibilities, and the respective obligations.

4. The argument was coded as virtue based if it or part of it focused on the social

worker or included ideas or words dealing with his or her traits.

5. The argument was coded as ‘ethics of care’ if it or part of it focused on the client or

included ideas or words dealing with the professional relationship and the process of

care.

868 R. Osmo & R. Landau

The reliability of the coding instructions was determined by reaching agreement of

85% among three judges: the authors and a third coder (a doctoral student in social

work). The data characteristics allow only basic statistical analyses, such as

percentages.

Results

The majority of respondents provided arguments only for their first two rankings of

ethical principles, so only these are analyzed.

Seventy percent of the sample of social workers (N562) gave arguments justifying

their two first preferred principles in the general rank ordering of ethical principles

and in the context of the first vignette (pregnant adolescent). Sixty-two percent of the

participants gave arguments justifying their rank ordering of the two preferred ethical

principles for the second vignette (three-generational family) and for the first vignette

from a personal point of view. A total of 329 arguments were offered; many of the 62

respondents offered more than one argument for each of their rankings.

The arguments of the two most important ethical principles in each of the four

contexts were analyzed for content. They were analyzed without differentiating

between the first and second preferred principle, since the respondents were asked

only to give arguments for the importance of the principles they ranked in the first

two (three) places without specifically differentiating between them.

Research question 1—Do social workers’ arguments reflect one or more ethical theories in their choice of ethical principles?

Table 1 shows the frequency of the arguments, in terms of ethical theories, in the

four contexts: A—general ranking; B—pregnant adolescent (professional dilemma);

C—three-generational family (professional dilemma); D—pregnant adolescent

(personal dilemma).

The most salient ethical theory emerging from the total number of arguments is

the utilitarian ethical theory (35%), followed by the deontological theory (27%). The

Table 1 Frequency of the Arguments in Terms of Ethical Theories in Four Different

Contexts (%)

Contexts Ethical theories A B C D Total

Utilitarian 28 36 48 37 35 (115) Deontological 33 23 22 24 27 (88) Rights 11 15 12 10 12 (41) Virtues 21 11 10 10 15 (48) Care 7 15 8 19 11 (37) Total 100% (123) 100% (114) 100% (50) 100% (42) 100% (329)

Notes: A5general ranking; B5pregnant adolescent (professional dilemma); C5three-generational family (professional dilemma); D5pregnant adolescent (personal dilemma). Number of participants562.

Social Work Education 869

remaining 38% of the arguments were divided among three ethical theories: virtues

(15%); rights (12%); and care (11%).

Research question 2—Do social workers’ arguments reflect different ethical theories in different practice situations?

Table 1 shows that deontological ethical theory is the dominant theory used to

justify the preferred ethical principles in the context of general ranking of ethical

principles (A533%), but it appears less frequently in the arguments justifying

preferred ethical principles related to specific situations (B523%, C522%, D524%,

respectively). However, the utilitarian theory was used more frequently to justify

preferred ethical principles in specific situations—36% of the arguments in the case

of the pregnant adolescent (B), in 48% of the arguments concerning the three-

generational family situation (C) and in 37% of the arguments concerning the

situation of the pregnant adolescent from a personal point of view (D). In contrast,

only 28% of the arguments related to the preferred ethical principles in the general

context were utilitarian (A). The arguments referring to virtue theory, like those

relating to deontological theory, are used more frequently in the context of general

ranking of ethical principles than in the context of specific situations (A521% vs.

B511%, C510% and D510%). Care theory is minimally reflected in the arguments

in the general ranking of ethical principles (A57%). Yet, this theory is more frequent

in the pregnant adolescent situation in both professional and personal contexts (B

and D). No differences were found for arguments reflecting rights theory among the

different contexts.

No notable differences in the classification of ethical theories were found by

comparing the arguments between the professional and personal evaluation of the

pregnant adolescent vignette (B and D). We found that utilitarian theory was more

frequently used in the content of the three-generational family vignette (C) than in

the pregnant adolescent vignette (B and D). We also found that care theory was used

twice as frequently in the pregnant adolescent vignette (B and D) than in the three-

generational family vignette (C).

In summary, the results show that the content of social workers’ arguments, in

terms of ethical theories, changes with the context of practice situations. There is a

marked difference in the content of arguments used in the general rank ordering of

ethical principles and in different specific practice situations. No such difference was

found in the content of the arguments from a professional and a personal point of

view.

Research question 3—Is the content of the social workers’ arguments congruent with the content of the ethical principles in terms of ethical theories?

Examination of the relationships between the content of the arguments of ethical

theories and the ethical principles for each of the four contexts revealed the following.

1. Of the 123 arguments given in the general ranking of ethical principles, the ethical

principle of sanctity of life was found to be the salient principle justified (25%); 52%

of these justifications were in terms of deontological ethical theory. The following

870 R. Osmo & R. Landau

arguments in the sample exemplify the relationships between the ethical principle

and ethical theory: ‘The principle of sanctity of life is an ultimate value. When

sanctity of life is jeopardized, we lose our human image’ or ‘Life for me is sacred,

and everything possible has to be done in order to secure it’.

2. Some 114 arguments were given in the context of the pregnant adolescent vignette

from a professional view. The good of the individual was found to be the most

important ethical principle justified (19%). Forty-five percent of the arguments for

this choice were identified as utilitarian (e.g. ‘My intention is [to secure] the welfare

of the adolescent and of the child. That is, can the adolescent fulfil the parental role?

Will the child born to this mother have adequate life conditions?’) and 36% as care

theory (e.g. ‘As a professional, I must present [the adolescent with] all the possible

alternatives, such as to abort, not to abort, without parents’ knowledge, or with their

cooperation, etc. If she still struggles [to make a decision], I will refer her to receive

mental and physical help, support and guidance during the pregnancy’). Another

important ethical principle in this context was confidentiality and privacy, justified

by 19% of the arguments. Twenty-seven percent of their content was identified as

deontological (e.g. ‘The principle of confidentiality and privacy is important because

it guards/defends human dignity, autonomy and personal freedom’) and 23% as

care theory (e.g. ‘The adolescent who trusts me must receive maximum help and

support from me, which cannot be provided without my keeping the confidentiality

that she trusts me to’).

3. Fifty arguments related to the three-generational family vignette. Twenty-four

percent of the sample chose to justify the ethical principle of public good. All of the

arguments for this principle were identified with the ethical theory of utilitarianism

(e.g. ‘In this instance I have chosen to ‘‘sacrifice’’ the personal welfare of the

grandmother for the welfare of other members of the family; because of the number

of people involved whose condition can improve, and considering their future’).

4. Forty-two arguments related to the context of the pregnant adolescent vignette from a

personal point of view. The social workers’ arguments in this context are similar to the

arguments from a professional point of view in their preferences for utilitarian and

deontological theories (see Table 1). As in the context of the professional point of

view, the principle of individual’s good was the most important ethical principle

justified (29%) (e.g. ‘Personal freedom is important because it’s a basic human need’,

reflecting deontological theory or ‘As a young adolescent, can she understand her own

good?’ reflecting utilitarian and care theories of ethics. Unlike in the professional

context, the results regarding the other ethical principles were insignificant.

The results indicate that, in general, the content of the social workers’ arguments is

congruent with the content of the ethical principles in terms of ethical theories. The

content of arguments in relation to ethical theories was distributed among all of

them, except for the ethical theory of rights. This result contributes to the inner

reliability of the study.

Discussion and Implications for Practice and Education

This study focuses on the arguments provided by social workers for their preferred

ethical principles in terms of ethical theories when confronted with ethical dilemmas.

Social Work Education 871

Our results illuminate a rather unknown area in the process of social workers’ ethical

decision making in practice.

Content analysis of arguments, given by the participants in different contexts,

shows that the large majority of social workers in the study based their arguments on

either deontological or utilitarian ethical concepts. The most salient ethical theory

emerging from the aggregate arguments for the four different contexts examined was

utilitarian, followed by deontological theory. Utilitarian principles have traditionally

been the most popular guides to social workers’ ethical decisions, at least in part

because they appear to foster generalized benevolence; a principle that requires one to

perform acts resulting in the greatest good appeals to professionals whose primary

mission is to provide aid to those in need (Reamer, 1990).

When social workers are requested to justify their rank ordering of ethical

principles without reference to a specific practice situation, they most frequently use

deontological theory of ethics, justifying their choices with concepts such as right

intention, universalism and duty. This result confirms previous findings in our

overall study (Landau & Osmo, 2003; Osmo & Landau, 2003) where most of the

social workers considered the 12 ethical principles to be important or very important,

emphasizing a deontological approach. The general reliance on deontological

concepts implies that social workers deeply value universal ethical principles based on

duty and good will. It is important to mention that we adopted a design that presents

to the respondents a standardized base of ethical principles for rank ordering them

and justify their ranking based on ethical principles as reflected in relevant social

work literature (Bloom, 1990; Loewenberg et al., 2000; Reamer, 2001) and in the

codes of ethics of social workers (IASW Code of Ethics, 1994; NASW Code of Ethics,

1996). Although this design allows better comparisons among the social workers than

asking for individualized lists of ethical principles, presenting the social workers with

a list of the 12 ethical principles to rank could have oriented them towards ethical

theories that lend themselves towards presentation in terms of universal principles

and therefore favor deontological theories.

However, the picture becomes more complex when practice situations are

examined. When social workers were confronted with a specific practice situation,

the content of their argument changed. While justification based on concepts from

deontological and utilitarian theories of ethics is still more frequent than those based

on concepts from the remaining three ethical theories, concepts arising from

utilitarian ethical theory became a more frequent choice than those from

deontological theory of ethics.

Utilitarian theory concepts were used to a differing extent in the two practice

situations (36% and 37% of the arguments concerning the pregnant adolescent from

a professional and personal point of view, respectively, and 48% of the arguments

concerning the three-generational family). In these specific contexts, the social

workers most frequently chose concepts relating to results, consequences, utility, etc.

and there was less use of concepts of intention, duty and universalism.

Our results provide additional support to Loewenberg et al.’s (2000) contention

that social workers are deontological in principle but adopt a utilitarian approach in

872 R. Osmo & R. Landau

practice. Carr (1999) argues that it is natural to ask where and when it is appropriate

to reason from a utilitarian or deontological point of view. The only general answer

to this question is that this must be contextually determined. Banks (2001) also

contends that neither deontological nor utilitarian theories of ethics ‘can furnish us

with one ultimate principle for determining the rightness or wrongness of actions’

(p. 34) while Beauchamp & Childress (1994) write that there is a ‘common morality

theory’ which is pluralistic and combines various ethical theories. Indeed, the current

trend in professional ethics is to broaden the perspective of ethical theories from a

dichotomous stand (deontological and teleological) to a more pluralistic and

differential approach, namely theories that emphasize different aspects of ethical

dilemmas (Brannigan & Boss, 2001). Yet, in our results, rights theory, virtue theory

and care theory were used less frequently than expected. The highest percentage

associated with concepts from rights theory appeared in the context of the pregnant

adolescent as a professional dilemma (15%), dealing with the adolescent’s right to

manage her life as a basic right that the practitioner must respect. The concepts of

virtue theory formed 21% in the general ranking of ethical principles and those of

care theory 19% in the ranking of ethical principles concerning the pregnant

adolescent from a personal point of view. These results suggest that the social

worker’s image of her/himself matters in general (virtue theory), but is less central in

specific practice situations. Particularly when a situation is examined from a personal

point of view, the respondent’s argument focuses on the person to be helped

revealing the relative importance of concepts from care theory. These results thus

raise the question of the social workers’ internalization of the importance of values

identified with theories of virtues, care and rights.

Although participants in this study were not asked to justify their preferences for

their ethical principles in terms of ethical theories, our content analysis of their

arguments shows that concepts of ethical theories were identifiable and congruent

with the ethical principles preferred.

While no one ethical theory offers the complete truth to a moral dilemma, a

diversity of ethical theories can give us a more comprehensive tool for effectively

analyzing ethical dilemmas. Boss (1998) suggests adopting a multidimensional

approach that draws from the strengths of each theory: ‘All theories have the same

ultimate goal to provide a rational basis for making better moral decisions’ (p. 40).

Because ethical theories can aid ethical decision making, we support recommenda-

tions in the social work literature that ethical theories be taught in social work

education (e.g., Rhodes, 1998; Mattison, 2000). Furthermore, as we found far less

justification for ethical decision making in terms of concepts from the ethical theories

of virtue, care and rights, we suggest that these theories specifically be included in

social work education emphasizing the following issues: social work students should

ask themselves what kind of individuals or social workers they want to be. In virtue

ethics, it is having certain feelings, as well as acting in certain ways, that makes an

action ethically right. Virtuous practitioners care because they sympathize with the

client’s suffering and pain (Brannigan & Boss, 2001, p. 38). Social work students

should reflect what care they want to provide to their clients. Care ethics, primarily

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connected with the feminist approach and developed from Gilligan’s study of moral

reasoning, claims that we are at our moral best when we are caring and being cared

for (Brannigan & Boss, 2001, p. 38). Care, not rational calculations nor an abstract

sense of duty, creates moral obligation. In terms of this theory, to take care of a client

is to be attentive to his or her needs. Thus, an ethics of care requires that we improve

our communication skills and moral sensitivity (Brannigan & Boss, 2001, p. 38).

Social work students should consider whether the various rights of those involved in

the situation are fulfilled. Since rights occupy a rather central place in our lives, it

seems appropriate that, when confronted with ethical dilemmas, social workers ask

questions such as: What are the client’s rights to non-interference? What are the

client’s positive rights and consequently society’s obligations? However, rights are

only one element to be examined when facing an ethical dilemma. As Hinman (1994,

p. 250) argues, close relationships, such as social worker–client relationships, cannot

be based solely on rights. These theories emphasize concepts central for practice such

as respect for and fulfillment of clients’ rights, care for clients, compassion, sympathy

and solidarity, and make the social worker aware of what kind of practitioner he/she

wants to be.

We also suggest that critical thinking be taught together with ethical theories. This

would not only enable students to apply ethical theories while considering possible

interventions but also teach them the limitations of each theory in explaining and

resolving ethical dilemmas. For example, as the arguments of most of the

respondents’ related to utilitarian ethical theories, students should be made aware

that it is not easy to decide the worth of an action when it is not clear how much

utility is enough and how utility is to be measured in terms of consequences, given

the limits of prediction (Hinman, 1994, pp. 163–178). Nor does utility necessarily

consider the dignity and rights of each individual (Brannigan & Boss, 2001, p. 27).

Indeed, classic utilitarianism, when taken to the extreme, can justify trampling on the

rights of a vulnerable minority in order to benefit the majority (Reamer, 2001, p. 28).

Applying such ethical theories to real-life professional decisions may provide valuable

guidance, and thus enhance a more reflective practice.

Students, and particularly practitioners, must be able to critically discuss the

reasoning behind their discretionary choices and be able to stand the scrutiny and

examination of professional colleagues and legal instances, justifying their

discretionary choices in terms of professional standards and values. That is, their

ethical justifications must be tied to normative professional justifications and be in

congruence with what can be called the ‘reasonable’ social worker. This requires

special attention in view of the research evidence indicating that personal values may

play a great role in their ethical decision-making processes (Landau & Osmo, 2003).

The prospect that social workers may be influenced in some situations by competing

codes of rules, such as the degree of religiosity of social workers, which may be in

conflict with the professional code of ethics, emphasizes the need of social workers’

awareness of their own belief system (Osmo & Landau, 2003).

The need to develop self-awareness and the ability to articulate explicitly their

thoughts may prove important in eliminating instances of arbitrary and

874 R. Osmo & R. Landau

discriminatory decisions which may disregard clients’ values and preferences. The

analyses of case studies may be useful in this respect. Specifically, they may help

students to recognize the possible contribution of each ethical theory when reflecting

on particular cases. The application of ethical theories, usually connoted with

philosophical content, in case studies may assist students in the translation of

theoretical concepts to specific practice situations.

Seventy percent of the social workers in the study provided arguments for their

preferred ethical principles, allowing us to assume that they are competent in

justifying their ethical decisions. However, disturbingly, 30% of the participants did

not justify their choices at all and their rankings appeared indistinct and unreflected.

Moreover, we found that when the respondents were asked to give a total of more

than six arguments, there was a decline in the number of arguments they gave. This

may be due to the difficulty that participants reported in giving arguments for their

preferred ethical principles. This difficulty may arise because social workers are not

used to engaging in an explicit process of justifying their actions and decisions in real

situations.

The results should be seen in the light of the limitations of the study, namely that it

was carried out with a relatively small convenience sample size. Yet, our findings

suggest that ethical theories may provide a meaningful tool in comprehending and

assessing ethical dilemmas. The findings justify further research, with larger samples

of social workers in various practice areas of social work also considering cultural,

social, ideological and gender differences on the application of ethical principles in

ethical decision making in social work.

Authors’ Note

The responsibilities and contributions in this paper were distributed equally between the authors.

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Accepted January 2005

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