Social Work Ethics Audits in Health Care Settings: A Case Study‪.‬

In recent years social workers in health care settings have paid increased attention to ethical issues and decision making. Along with members of allied health professions, social workers have enhanced their understanding of ethical challenges related to organ transplantation, the use of artificial organs, end-of-life decisions, genetic engineering, aggressive treatment of seriously impaired infants and frail elders, abortion, managed care, and the protection of participants in research protocols (Congress, 1998; Foster, 1995; Loewenberg & Dolgoff, 1996; Reamer, 1985, 2006). Most recently, various health care professions have begun to recognize the relevance of ethics "risk management" (Cohen-Almagor, 2000; Reamer, 2001a). Risk management is a concept that emerged in the 1960s; originally, the concept referred to efforts to minimize business-related losses resulting from accidents, theft, and negligence (Vaughan & Vaughan, 2000). Over time, risk management has broadened in scope to include many other settings and contexts, including various health professions. A broad range of health agencies now pay considerable attention to steps they can take to minimize the likelihood of harm to clients and staff, prevent ethics complaints (filed with professional associations and state licensing and regulatory boards), and prevent lawsuits alleging some form of ethics-related negligence (for example, conflicts of interest, inappropriate dual relationships or boundary violations, unethical delivery of services, mishandling of confidential information, and unethical termination of services (Barker & Branson, 2000; Houston-Vega & Nuehring, 1997; Reamer, 1998, 2003; Strom-Gottfried, 1999).