L34-35 Ethics in clinical practice

Question 1

What are 3 characteristics of spcial worker practice in a variety of setting?

Answer 1

1. Health, disability, child protection, legal areas, immigration/refugee, community development;
2. Government and Not for Profit Sector;
3. Private practice (though not as widely known)

Question 2

What is a charcteristics of crisis intervention in emergency department for social work?

Answer 2

Crisis Intervention – Psychological first aid; post trauma support; bereavement/sudden loss – grief and loss; domestic/family violence; child safety; drug and alcohol; disability; homelessness.

Question 3

What are 3 characteristics of private practice for social work?

Question 4

What are 2 characteristics of social work?

Answer 4

1. Attorney General’s Department
   
   • Social Policy
2. Advanced Social Work Team Leader
   
   • Medical/Surgical/Specialty

Question 5

What ethical framework do you use?

Answer 5

1. Is it derived from your personal beliefs?
2. Is it derived from your profession?
3. Is it from your organisation?

Question 6

What are 3 characteristics of organisational ethics?

Answer 6

1. Queensland Health – Code of Conduct for the Qld Public Service 2011
2. Principles and values – integrity and impartiality; commitment to the system of government; accountability and transparency;
3. ‘promoting the public good’ – what does this mean??

Question 7

What are 3 characteristics of professional ethics?

Answer 7

1. Australian Association of Social Workers:
2. Social Work Values – respect for persons; social justice; professional integrity
3. Ethical Responsibilities - respect for human dignity and worth; culturally competent, safe and sensitive practice; commitment to social justice and human rights; social work service and propriety; commitment to practice competence; professional boundaries and dual relationships; conflicts of interest.

Question 8

What are 2 characteristics of personal ethics?

Answer 8

1. aware of your own worldview, moral, cultural, historical, political, religious, spiritual and societal values and biases and the possible influence of these on professional judgements;
2. Childhood, experiences, family, history

Question 9

What is an ethical dilemma?

Answer 9

“The social work profession acknowledges that ethical dilemmas may arise when a social worker must make a choice between alternative courses of action, each of which is supported by moral considerations and each of which may result in an outcome that is, in some way, undesirable. Ethical decision making is the systematic, reflective process by which such dilemmas can be resolved”

Question 10

What are 3 characteristics of ethics in practice?

Answer 10

1. Important to note that we can all be faced with difficult social situations during our professional careers;
2. How do we cope with these?
3. What is important?

Question 11

What are the issues? What do you do?

Answer 11

1. Domestic and family violence
2. Child protection

Question 12

What is domestic and family violence & child protection?

Answer 12

1. (Domestic) Intimate partner violence is a fundamental violation of human rights and involves an exploitation of power imbalances;
2. It is predominately perpetrated by men against women and their children;
3. Is where one person uses a pattern of abusive and/or coercive behaviour and/or pursuit in order to control or dominate the other both in a relationship and after separation.
4. This behaviour often repeats, may escalate and can result in death;
5. It often follows a cycle;
6. The most commonly acknowledged forms of domestic violence are physical and sexual violence, threats and intimidation, emotional and social abuse and economic deprivation;
7. The consequence of this behaviour instils fear for personal safety and/or well-being and traumatizes women and children.

Question 13

Why are issues this important?

Answer 13

1. Duty of Care;
2. Ethical principals;
3. Safety considerations;
4. Legal implications/considerations.
5. Domestic Violence does not discriminate;
6. Important to be aware and mindful.

Question 14

What is child protection- who is a child?

Answer 14

1. Under the law, and as stated in the Child Protection Act 1999, a child is “an individual under the age of 18 years”
2. What is harm – “Harm, to a child, is any detrimental effect of a significant nature on the child’s physical, psychological or emotional wellbeing” (Child Protection Act 1999)
3. Age = vulnerability, care needs, protective requirements.

Question 15

What are 2 reporting requirements?

Answer 15

1. Obligation arises from legislation (Public Health Act 2005; Child Protection Act 1999);
2. Common Law: Requires reporting as a result of the principal of duty of care.
3. Duty of Care Principal:
   
   1. “all health professionals have an obligation to report a reasonable suspicion of child abuse and neglect”;
   2. Exercise professional care;
   3. Take all reasonable steps to prevent harm
   4. If you have any concerns –> duty of care

Question 16

What are 2 reporting responsibilities?

Answer 16

1. Mandatory Reporting (Public Health Act 2005; Child Protection Act 1999)- Doctors and nurses
2. Non-Mandatory Reporting- Social workers
   
   1. Reporting under section 1590 of the Child Protection Act 1999;
   2. Responsibilities under the common law – duty of care

Question 17

What are 2 characteristics of a child in need of protection?

Answer 17

1. (a) has suffered significant harm, is suffering significant harm, or is at unacceptable risk of suffering significant harm;
2. (b) does not have a parent able and willing to protect the child from the harm.

Question 18

What are 4 characteristics of how to report?

Answer 18

1. Talk to the social worker if you have concerns;
2. Contact the regional intake service centre/After Hours Service to submit a verbal report;
3. Written report;
4. CPU (Child protection unit)

Can always ask for advice for what steps should be taken

Question 19

Why is this important (6)?

Answer 19

1. Adult Hospital vs. Children’s Hospital vs. Private Sector;
2. Child Abuse does not discriminate;
3. People are presenting with issues (DV, Alcohol and Drug Abuse, Mental Health) that impact on their ability to protect.
4. Legal/professional/ethical responsibilities;
5. Integrated responses to DFV
6. Duty of care

Question 20

What are 4 possible issues?

Answer 20

1. Capacity for decision-making; ( Do they understand the decisions they are making)
2. Right to personal decisions;
3. ACAT (Aged Care Assessment) referrals;
4. Squalor; (Understand the different level)
5. Self-neglect? (Make poor decisions)
6. CALD background – older=interpreter?;
7. Use of self;
8. Referral pathways;

Social isolation, no power of attorney

• Can take up to 3 months for a decision maker to be appointed

Question 22

What are 5 considerations?

Answer 22

1. Guardianship
   
   • How does this work;
2. Capacity for decision-making
   
   • Who assesses capacity;
3. Enduring Power of Attorney;
4. Rights of older person – rights to selfdischarge;
5. Medical situation – UTI;
   
   • What can a UTI cause? Confxusion (capacity?)

Question 23

What is capacity?

Answer 23

Capacity’ is a person’s ability to:

1. understand the nature and effect of decisions
2. freely and voluntarily make decisions
3. communicate those decisions in some way

Question 24

What are 6 characteristics of capacity considerations?

Answer 24

1. You should always assume that a person has capacity.
2. Capacity is not a ‘global’ concept;
3. Capacity is specific to the matter or the decision to be made;
4. Capacity can fluctuate;
5. Capacity can improve;
6. Decisions about capacity should therefore never be made in a vacuum – Courts are guided by clinical assessment.

Question 25

What is the enduring power of attorney?

Answer 25

Legal document;

• Allows you to appoint someone to make personal/health care and/or financial decisions on your behalf when you are unable to make your own decisions;

Question 26

What are financial decisions as ethical considerations?

Answer 26

can nominate whether you want the attorney to begin making financial decisions for you straight away or at some other date or occasion, such as once you’ve lost capacity;

Question 27

What are personal decisions as ethical considerations?

Answer 27

your attorney’s power to make personal decisions only commences when you lose capacity to make these decisions.

Question 28

What are short form and long form as ethical considerations?

Answer 28

1. Short form – same attorney
2. Long form – different attorney’s.

Question 29

What is an ACAT?

Answer 29

1. Over the age of 65 years;
2. Residential Care or Respite;
3. Home Care approval;
4. Consent.

Question 30

What is ACAT vs NDIS?

Answer 30

Age restrictions

1. ACAT: Over 65 years old
2. NDIS: Under 65yrs old

Pathways

Question 31

What are 4 (3) characteristics of the National Disability Insurance Scheme?

Answer 31

1. you have an impairment or condition that is likely to be permanent (i.e. it is likely to be life long) and
2. your impairment substantially reduces your ability to participate effectively in activities, or perform tasks or actions unless you have:
   
   1. assistance from other people or
   2. you have assistive technology or equipment (other than common items such as glasses) or
   3. you can’t participate effectively even with assistance or aides and equipment and
3. your impairment affects your capacity for social and economic participation and
4. you are likely to require support under the NDIS for your lifetime.

Question 32

What are 4 considerations?

Answer 32

1. Mental Health - concerns?;
2. Child Safety?;
3. Duty of Care;
4. Confidentiality;

• What is your role?;
• Who assesses?;
• Self care

Question 33

What are 4 characteristics of awareness?

Answer 33

1. Legal principles – duty of care;
2. Legislation governing practice – Guardianship Act, Mental Health Act (Same human Rights; person’s views to be considered; provision of support and information; achievement of maximum potential)
3. The role of important documents – EPOA’s, Advanced Health Directives;
4. Professional responsibilities via your own code of practice/ethics

Question 34

What are 5 challenges?

Answer 34

1. Confidentiality;
2. Duty of care;
3. Challenge to my own values – respect, dignity, human worth;
4. Impact on others;
5. Long term future consequences.

Question 35

What are 9 characteristics of the ethical dilemma (private practice environment)?

Answer 35

1. Referral from funding body;
2. Asylum Seeker;
3. Traumatic Brain Injury;
4. NESB
5. Very limited family/social support;
6. Cognitive, physical and visual difficulties;
7. Full team involved;
8. Claims Officer changes;
9. Funding ceased – current issues/outcome.

Question 36

What are critical incidences?

Answer 36

1. Dying and death
2. People’s personal choices around death and dying
3. Self care

Question 37

What is death and dying as a critical incidient?

Answer 37

1. For example – a cystic fibrosis patient that you have worked with for many years;
2. For example – a young ICU patient who you have been providing chest physio too – you have come to know their family, situation

Question 38

What is people’s personal choirce around death and dying as a critical incidient?

Answer 38

For example – declining blood products, declining future treatment.

Question 39

What are 3 ethical topics with critical incidences?

Answer 39

1. Organ Donation;
2. People in detention;
3. Self harm;

Question 40

What are 3 characteristics of private practice?

Answer 40

1. May have less access to other allied health, mental health, medical professionals when faced with ethical dilemmas;
2. System – clinical perspective vs the bottom line;
3. Documentation, report writing, confidentiality, access to information

Question 41

What is the importance of teamwork in ethical situations and social work?

Answer 41

Physios have regular and sometimes extended contact with clients/patients during therapy sessions

1. good source of client’s perceptions eg “I feel scared of going home. I’m afraid of falling again”
2. Hear other concerns of pt eg “my son won’t let me see my friends”
3. Barometer for physical capability

Question 42

How to work with Social workers?

Answer 42

1. Discharge planning with allied health – regular communication is essential
2. Sharing information
3. Ability to articulate the psycho-social aspects of the consumer – role of Social Worker
4. E.G. Skills in grief and loss counselling,
   
   1. Domestic Violence and family protection: Child protection, elder abuse, sexual assault
   2. Guardianship,
   3. Rights,
   4. Social Inclusion eg service providers for people who are homeless and in financial need.