cAN THIS BE DONE IN 10 HOURS tODAY!!!

1

Kiara Bonds

SWK5007

Capella University

Dr. Robyn

5/18/2024

Ethical Dilemma in the Case of Marie

The ethical dilemma in the case of Marie involves balancing her autonomy with her need for care and managing the conflicting desires of her daughters, Lisa and Toni. Autonomy is central to the dilemma, as Marie is a woman who wishes to stay independent despite the troubles of her age and a recent knee replacement surgery. Toni would love to have her mother live in a nursing home as she thinks Marie is just becoming less and less able to be independent, and Toni can't be there regularly enough to help her out. Meanwhile, Lisa was trying to keep her mother active with her grandkids and taking her medicine for pain, which Marie feared would make her as dependent as Lisa. Marie further believed that Lisa was stealing her prescription medication for pain relief, and this added another layer of difficulty to the ethical issues at hand. This case further emphasizes the ambiguity of the lines between autonomy of Marie, ensuring her best interest, and safety versus the dynamics within the family and any issues of substance abuse that may be ongoing(Marie, 2023).

NASW Essential Steps for Ethical Problem-Solving

The NASW Code of Ethics lays out core steps for ethical problem-solving relevant to resolving the dilemmas in Marie's case. It is essential to distinctly identify the ethical issues; for example, the conflict is between the autonomy and safety of Marie and the potential substance abuse by Lisa. The second step would be to consider the core values and principles, which include respect for the dignity and worth of Marie as a human being and respect for the importance of relationships among people (Hadler et al., 2023). The third is considering relevant laws and policies, including laws on elder care and substance abuse treatment (Wogen & Restrepo, 2020). The fourth step is to identify possible actions that may be taken, for example, providing more in-home support to Marie or moving her to an assisted living facility. The fifth step is consultation with colleagues and experts. The healthcare providers and social workers need a diversity of perspectives and insights. The sixth step is to make decisions and clearly document the accountability process. The seventh and final step is monitoring and evaluating the outcomes, assessing Marie's situation with time to adjust the care plan if necessary. Such potential consequences at every stage run the gamut from the possibility of Marie becoming even less healthy if her independence is preserved at all costs without the proper support to negatively affecting her emotions by removing her from her home and placing her in assisted living.

Personal Values and Biases Impacting Decision-Making

Personal values and biases can have immense influence on the decision-making process in Marie's case. For instance, the autonomy value of a social worker may cause them to dwell on the fact that Marie is independent and thus overlook that she requires care with a more guided approach. One's biases toward Lisa could easily cause one to judge or even not attend to the right issues amicably. Further, cultural and personal beliefs on family obligations might inform suggestions on involving Marie regarding her grandchildren. To counter such values and biases, self-reflection process needs to be applied to always assess and challenge one's values and biases (Biidabinikwe & Cram, 2021). One should also be encouraged to seek supervision and consultation from peers to get other opinions and offset his or her own biases. Following the NASW Code of Ethics as a guide for actions and decisions is probably a key to objectivity and fairness that would ensure ethical decisions for all parties involved (Kesen et al., 2021).

Data Collection Methods for Ethical Decision-Making

Data collection underpins the effective, responsible, and ethical decision-making process in the case of Marie. Comprehensive client interviews with Marie, Lisa, and Toni are important in understanding worldviews and concerns related to each of them. Information gathered by Marie's healthcare providers about her physical and cognitive health forms a factual basis for evaluating her needs and risks. Home visits will establish firsthand observation of the safety and well-being of Marie and the family dynamics about living conditions. Checking with the preschool for any information about Lisa's children's behaviors would help assess the broader impacts of the family dynamic on the children. They ensure a thorough understanding of the situation, balancing risks with benefits. It also provide fact-based support for all recommendations and interventions, ensuring relevant support for ethical and effective decision-making.

Strengths, Needs, and Challenges in the Family System

In relation to the above-mentioned ethical issue, there are different strengths, needs, and challenges that can be identified within Marie's family. One of the strengths is that her family is closely knit; her children stay within the same vicinity and therefore represent an opportunity for an additional support network that could work well in her favor if utilized for her care. Another strength is that the family is tied closely through the involvement and emotional care for Marie by Toni. But there are also big demands, including Marie's need for structured support since her physical and mental health may deteriorate. Another necessity for change is the need for Lisa to improve her parenting difficulties and over-reliance on the taking of painkillers, in order to bring better dynamics within the family.

All the challenges are to ensure Marie's safety and balance with her freedom, to manage the different perspectives of Toni and Lisa in Marie's care, and to balance Marie's own autonomy with her care needs. The children added another new layer of complexity to the impact of parenting issues on Lisa. Some recommendations on reducing some of the struggles include hiring in-home support services to help keep Marie independent and safe, involving the family in counseling to overcome communication issues, and to unify them toward a single goal of care for Marie, and engaging Lisa in breaking free from the medication and faulty strategies for parenting. All the above steps are taken in order to capitalize on the family's strengths, meet their needs, work through the challenges, and strive forward to create a supporting and ethical atmosphere for Marie and her family.

Conclusion

Marie's case is rife with moral dilemmas between family issues and personal biases. Applying the NASW Code of Ethics creates principled resolutions to the concerns, ensuring that all decisions are made in the best interests. There are key practices to keep ethical standards in practice and uphold a supportive atmosphere for Marie and her family: continuous reflection of self, professional consultation, and thorough data collection. By balancing the exercise of autonomy with that of care for the person of Marie and further addressing family dynamics and possible substance abuse issues, the social worker promotes ethical and effective decision-making toward the well-being and dignity of all involved.

References

Biidabinikwe, E. T. ‐, & Cram, A. (2021). Who puts the value in Evaluation? There is a need for self‐reflection and transparency in advocacy and policy change evaluation. New Directions for Evaluation, 2021(171), 83–94. https://doi.org/10.1002/ev.20475

Hadler, R. A., Weeks, S., Rosa, W. E., Choate, S., Goldshore, M., Julião, M., Mergler, B., Nelson, J., Soodalter, J., Zhuang, C., & Harvey Max Chochinov. (2023). Top Ten Tips Palliative Care Clinicians Should Know About Dignity-Conserving Practice. Journal of Palliative Medicine. https://doi.org/10.1089/jpm.2023.0544

Kesen, N. F., Başer, D., Daşbaş, S., & Dziegielewski, S. F. (2021). Ethical Difficulties among Turkish Social Workers. Journal of Social Service Research, 1–13. https://doi.org/10.1080/01488376.2021.1889736

Marie, G., Stacy. (2023). Parents’ Perspectives of the Effectiveness of Family Treatment Court - ProQuest. Www.proquest.com. https://www.proquest.com/openview/53f685b00d69169564264ee86d518048/1?pq-origsite=gscholar&cbl=18750&diss=y

Wogen, J., & Restrepo, M. T. (2020). Human Rights, Stigma, and Substance Use. Health and Human Rights, 22(1), 51–60. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7348456/