Social work is deeply rooted in a fundamental set of values that ultimately shapes the profession’s mission and its practitioners’ priorities. As the social worker one would be concerned about several key values, including a person’s right to self-determination; the obligation to protect from harm; the obligation to obey the law; and the right to self-protection. Ideally, the social worker would act in accord with all these values simultaneously. What social worker would not want to respect clients’ right to self-determination, protect clients from harm, obey the law, and protect her or himself?
The problem, however, is that situations sometimes arise in social work in which core values in the profession conflict, and this leads to political dilemmas. In order to explore fully the nature of contemporary values, political issues, conflicts and ethics in social work, it is important to understand the historical evolution of thinking in the field with respect to the profession’s value base, political dilemmas in practice, political decision making in social work, and practitioner malpractice and misconduct.
The social work profession’s grasp of key values and political issues has matured considerably in recent years. In fact, most of the profession’s scholarship on this subject has been published since the early 1980s. Nonetheless, the general topics of values and ethics have been central to social work since its formal inception. Historical accounts of the profession’s development routinely focus on the compelling importance of social work’s value base and principles. Over the years, beliefs about social work’s values and ethics have served as the foundation for the profession’s mission.
Social work is, after all, a normative profession, perhaps the most normative of the so-called helping professions. In contrast to professions such as psychiatry, psychology, and counseling, social work’s historical roots are firmly grounded in concepts such as justice and fairness. Throughout its history, social work’s mission has been anchored primarily, although not exclusively, by conceptions of what is just and unjust and by a collective belief about what individuals in a society have a right to and owe to one another.
Although the theme of values and ethics has endured in the profession, social workers’ conceptions of what these terms mean and of their influence on practice have changed over time. The evolution of social work values and ethics has had several key stages (Reamer, 1998). The first stage began in the late nineteenth century, when social work was formally inaugurated as a profession. During this period social work was much more concerned about the morality of the client than about the morality or ethics of the profession or its practitioners. Organizing relief and responding to the “curse of pauperism” were the profession’s principal missions.
This preoccupation often took the form of paternalistic attempts to strengthen the morality or rectitude of the poor whose “wayward” lives had gotten the best of them. The rise of the settlement house movement and Progressive era in the early twentieth century marked the beginning of a second key stage, in which the aims and value orientations of many social workers shifted from concern about the morality, or immorality, of the poor to the need for dramatic social reform designed to ameliorate a wide range of social problems, for example, those related to housing, health care, sanitation, employment, poverty, and education (Reamer 1992).
The third key stage began in the late 1940s and early 1950s, when concern about the moral dimensions of social work practice intensified, although in rather different form. Unlike the earlier preoccupation with the morality of the client, this mid twentieth-century concern focused much more on the morality or ethics of the profession and of its practitioners. This was a significant shift. Nearly half a century after its formal inauguration, the profession began to develop guidelines to enhance proper conduct among practitioners.
In 1947, after several years of debate and discussion, the Delegate Conference of the American Association of Social Workers adopted a code of ethics. The profession’s journals also began to publish articles on the subject with greater frequency. This is not to say, of course, that social workers neglected the subject until this period. Social workers have always espoused concern about a core group of central values that have served as the profession’s ballast, such as the dignity, uniqueness, and worth of the person, self-determination, autonomy, respect, justice, equality, and individuation (Joseph 1989).
In addition, there were several modest efforts earlier in the twentieth century to place ethics on social workers’ agenda. As early as 1919 there were attempts to draft professional codes of ethics. Not surprisingly, in the 1960s social workers shifted considerable attention toward the political constructs of social justice, rights, and reform. This was the beginning of the fourth key stage in the evolution of social work values and ethics.
The public and political mood of this turbulent period infused social work training and practice with a prominent set of values focused on social equality, welfare rights, human rights, discrimination, and oppression. Perhaps the most visible expression of emerging concern about social work values and ethics was the 1976 publication of Levy’s Social Work Ethics. Although the profession’s journals had, by then, published a number of articles on social work values and ethics, Levy’s book was the profession’s most ambitious conceptual discussion of the subject. This had great symbolic significance.
Until the late 1970s, the profession focused primarily on social work’s values and value base. At this point the profession underwent another significant transition in its concern about values and political issues—a transition to the current stage. The 1970s saw a dramatic surge of interest in the broad subject of applied and professional ethics. Professions as diverse as medicine, law, business, journalism, engineering, nursing, social work, and criminal justice began to devote sustained attention to the subject.
Large numbers of undergraduate and graduate training programs added courses on applied and professional ethics to their curricula, professional conferences witnessed a substantial increase in presentations on the subject, and the number of publications on professional ethics increased dramatically. The growth of interest was due to a variety of factors. Controversial technological developments in health care and other fields certainly helped to spark political debate involving such issues as termination of life support, organ transplantation, genetic engineering, and test-tube babies.
What criteria should be used to determine which medically needy patients should receive scarce organs, such as hearts and kidneys? When is it acceptable to terminate the life support that is keeping a comatose family member alive? To what extent is it appropriate to influence, through laboratory intervention, the sex of a fetus? Is it ethically justifiable to implant an animal’s heart into the body of an infant born with an impaired heart? Widespread publicity about scandals in government also triggered considerable interest in professional ethics.
Beginning especially with Watergate in the early 1970s, the public has become painfully aware of various professionals who have abused their clients and patients, emotionally, physically, or financially. The media have been filled with disturbing reports of physicians, psychologists, lawyers, clergy, social workers, and other professionals who have taken advantage of the people they are supposed to help. Consequently, most professions take more seriously their responsibility to educate practitioners about potential abuse and ways to prevent it.
In addition, the introduction, beginning especially in the 1960s, of such terminology as patients’ rights, welfare rights, and prisoners’ rights helped shape professionals’ thinking about the need to attend to concepts. Since the 1960s, members of many professions have been much more cognizant of the concept of rights, and this has led many training programs to broach questions about the nature of professionals’ political duties to their clients and patients. Contemporary professionals also have a much better appreciation of the limits of science and its ability to respond to the many complex questions professionals face.
Although for some time, particularly since the 1930s, science has been placed on a pedestal and widely regarded as the key to many of life’s mysteries, modern-day professionals acknowledge that science cannot answer a variety of questions that are, fundamentally, ethical in nature. Finally, the well-documented increase in litigation and malpractice, along with publicity about unethical professionals, has forced the professions to take a closer look at their ethics traditions and training.
All professions have experienced an increase in claims and lawsuits against practitioners and a substantial portion of these complaints allege some form of unethical conduct. As a result of this noteworthy and troubling trend, the professions, including social work, have enhanced their focus on ethics education. The net result of these developments was the emergence in the 1980s of a critical mass of literature on social work ethics. For the first time in the profession’s history, several books and many journal articles explored the intricate and complex relationship between political dilemmas in social work and political decision making.
Unlike the profession’s earlier literature, publications on social work ethics in the 1980s explored the relevance of moral philosophy and political theory to political dilemmas faced by social workers; similar developments occurred in nearly all the professions. Clearly, this was a watershed period, one that has dramatically changed social workers’ understanding of and approach to political issues.
Since its inception in 1935 the American welfare state has been composed of an amalgam of diverse programs. Unlike Britain’s influential Beveridge Report, American social planners never developed a vision of a comprehensive welfare state. Instead, Franklin D. Roosevelt patched together a welfare state in response to the conditions of the Depression and the need to maintain free market capitalism. Despite Roosevelt’s initial vision, tensions remained as to the appropriate level of benefits and coverage. This discomfort was reflected in low benefit levels, strict means tests, and occasional cutbacks in welfare spending.
Despite the American skepticism toward welfare, progressive change did occur, albeit in fits and spurts. One such period was marked by the Great Society and the War on Poverty programs of the 1960s, a period that came to represent the halcyon days of liberal social welfare policy (Karger & Stoesz, 1990). Important social welfare policies of the mid-1960s included the Food Stamp Act and the introduction of Medicare and Medicaid. At the same time, aggressive social plans were designed that promised a poverty-free America and a non-stigmatized, community-based and easily accessible system of social welfare.
To realize these objectives, the Johnson administration developed programs designed to help low-income children, families and communities. In one of the few instances where rhetoric was backed up by fiscal resources, the number of federal domestic aid programs rose from 200 to 1,100 from the early 1960s to 1975. America’s brief flirtation with bold social welfare initiatives ended by the early 1970s, and liberals had few successes to point out when pressed to justify the massive expenditures of the 1960s.
While Aid to Families with Dependent Children (AFDC) rolls tripled (from 3 to 9. million) from 1960 to 1970, social problems such as drug addiction, crime, teenage pregnancy, child abuse and mental illness continued to grow. By 1968 the Great Society programs had clearly become unpopular with the American public. The American welfare state entered a paradoxical period with the election of Richard Nixon in 1968. While most Great Society programs were terminated or reassigned to mainstream federal bureaucracies, the more established income maintenance programs–Social Security and AFDC-grew dramatically.
In addition, when Nixon was reelected in 1972, he attempted to streamline income maintenance programs by proposing a Family Assistance Plan (FAP), which called for a guaranteed annual income to replace AFDC, Old Age Assistance (OAA), Aid to the Blind (AB) and Aid to the Permanently and Totally Disabled (APTD). While the FAP was rejected by Congress, the OAA, AB and APTD programs were federalized under a new program called Supplemental Security Income (SSI). The Nixon administration’s ambivalence toward social welfare was followed by two low-key presidencies, and whatever lull existed in welfare thinking from 1975 to 1979 was abruptly shattered by the Reagan administration.
In most industrialized nations, welfare states grew steadily during the relatively stable economic climate of the 1950s to the early 1970s. By the middle 1970s, however, most industrial economies began to experience high inflation, high rates of unemployment, sluggish economic growth and unacceptably high levels of taxation.
During this difficult period Western governments were forced to reassess their overall economic strategies, including the resources allocated to welfare activities. Hence, beginning in the early 1970s most Western governments either cut welfare programs or arrested their growth. As such, much of the present retrenchment in welfare can be traced to the effects of the global economy. All Western nations are experiencing a crisis rooted in the need to compete in a new global economy. According to conservatives, national survival in the new economic order can only be achieved if government cuts costs and becomes more efficient.
In addition, conservatives argue for the creation of government policies that encourage the accumulation of the capital necessary for investment, industrial modernization and corporate growth. Conservatives maintain that this precondition for economic survival can only occur when government freezes or lowers personal and corporate tax rates. The subsequent loss of tax revenue, however, leads to heavy governmental debt, cuts in all governmental services (including social services), a deterioration of the public infrastructure and myriad social problems.