March/April 2015 Issue

Eye on Ethics: Cultural Diversity in Social Work Ethics
By Frederic G. Reamer, PhD
Social Work Today
Vol. 15 No. 2 P. 10

I recently returned from a trip to India, where I had been invited to consult with a remarkable group of social work educators and practitioners about ethical issues facing the profession in that nation. We spent several days exploring compelling ethical challenges confronting India and discussing social work values, ethical norms, ethics education, and social work regulation.

Much of our time focused on the particular ways in which Indian social workers understand and think about ethical issues given that culture's unique and complex history, and ethnic and religious diversity. During our work together we compared and contrasted the ethical issues and dilemmas faced by social workers in India and social workers elsewhere around the world. During the process I was reminded yet again of how important it is for social workers to consider ethical issues in the context of the cultures in which they work. The international variation is staggering. And India, the second most populous nation in the world, offers a truly unique opportunity to learn more about cultural diversity in social work ethics.

Social Work Ethics in India: A Case Study
In contrast to many other nations, the social work profession in India has not developed formal, indigenous ethical standards or a rich body of scholarship on professional ethics, although there are a few nascent and noteworthy efforts, particularly by the Tata Institute of Social Sciences, Bombay Association of Trained Social Workers, and several individual scholars and practitioners (notably Gracy Fernandes, Indrajit Goswami, and Josantony Joseph). That said, Indian culture is rooted in ethics and values that influence social work practice. Core ethics concepts are embedded in Ṛgveda, one of the oldest texts not only of India but also of the entire world. In Ṛgveda, one finds discussion of the idea of a cosmic order, ṛta, which represents harmony and balance in nature and in human society.

In Indian tradition, the concept of ṛta underpins the idea of dharma, which entails the core ethical concepts of duty, obligation, and righteousness. Dharma represents a way of life in which ethical values are considered supreme and everyone is expected to perform their duty according to their social position and station in life. There is a keen link between dharma and longstanding social work ethics concepts related to practitioner morality, virtuous conduct, and social justice.

Social work in India has also been influenced directly by the culture's embrace of core values related to the Bhakti movement's value of humanism and individual worth and dignity; Sarvodaya, which emphasizes the values of equity, justice, and empowerment of the community as a whole; and the spirit of Swaraj, which promotes self-governance. These too are values that resonate with traditional social work values. Indian social work values are replete with influences from the Vedic period, Hinduism, Buddhism, and Jainism.

Historically, Indian social workers have relied heavily on ethical standards developed in the United States. For example, the social work field education manual published by the prominent Tata Institute of Social Sciences features the NASW Code of Ethics.

The Importance of Cultural Context
During my work in India I participated in many discussions about traditional social work values and ethical principles related to confidentiality, boundaries, dual relationships, self-determination, paternalism, informed consent, distributive justice, whistleblowing, and compliance with laws and regulations. During one conversation, I spoke with an Indian social worker about how, in a nation with a population of more than 1.2 billion, it can be extraordinarily difficult to protect clients' privacy; services are often provided in stunningly crowded and chaotic settings.

Another Indian colleague explained to me how difficult it is to maintain clear boundaries when delivering services in India's remote and rural villages. Many service recipients expect social workers to attend important family and other rite-of-passage events. Responding to gifts from clients also requires considerable skill, as it can be difficult to maintain clear boundaries consistent with cultural norms.

One Indian social worker told me about a case involving a man who struggled with alcoholism. The man resisted help, but his large family was convinced he needed treatment. The social worker told me about the pressure she felt to collaborate with family members who wanted to arrange to get the man drunk so that the treatment program "would be willing to admit him." We had a rich conversation about the ways in which social workers in different cultures interpret and apply traditional social work concepts related to client self-determination, professional paternalism, informed consent, and coercion. We also talked about the challenges of obtaining clients' consent for services if they are illiterate and cannot read documents or sign their name; this is especially relevant in India, where, according to reputable estimates, more than 280 million adults are illiterate—accounting for more than one-third of the world's illiterate adults.

One of the most enduring themes in my discussions concerned Indian social workers' principal focus on clients' most basic needs: food, clothing, shelter, and hygiene. Some estimates indicate 30% of the Indian population lives in poverty; this is nearly double the poverty rate in the United States. In further contrast to the United States, where a significant percentage of social workers pursue clinical careers to provide counseling and psychotherapy, social workers in India focus particularly on issues of human survival and basic sustenance.

Consequently, social work ethics in India focuses to a great extent on issues of social and distributive justice. The social workers I met were certainly cognizant of and sensitive to ethical issues related to clinical social work, yet for many practitioners their priorities center on the ethical dimensions of macro social work and social justice issues.

Also, India is a much more collectivist culture than is the United States, which is much more individualistic; one practical consequence, I was told by many Indian social workers, is that their ethical decisions are often driven by what is considered best for the family or community. I heard story after story about how social workers in India filter many ethical decisions (e.g., about whether to treat clients paternalistically or share sensitive information about a client with his or her family members) through a cultural lens, which often places family and community interests above individual interests.

I also learned that social work in India is unregulated. There are no licensing or regulatory bodies that govern social work practice or enforce ethical standards, although many of the social workers I met yearn for reasonable regulation and the development of indigenous ethical standards that are sensitive to Indian values and culture.

What my international travels have taught me repeatedly is that social workers' understanding and application of professional values and ethical standards vary enormously. One size does not fit all.

— Frederic G. Reamer, PhD, is a professor in the graduate program of the School of Social Work at Rhode Island College. He's the author of many books and articles, and his research has addressed mental health, health care, criminal justice, and professional ethics.