Eye on Ethics: Moral Disengagement in Social Work Unfortunately, during my career I have been summoned to serve as an expert witness in many litigation and licensing board cases in which social workers allegedly engaged in misconduct. Examples include the following: • A social worker employed in a hospital-based program serving clients with trauma histories pled guilty to engaging in sexual relationships with multiple clients. The social worker was sentenced to serve up to 10 years in prison. • A social worker was sentenced to 18 months in federal prison and ordered to pay $147,925 in restitution for a scheme that bilked insurance carriers for counseling services that the social worker never provided. • A clinical social worker exchanged thousands of sexualized text messages with a client. After several months, the social worker and client began a sexual relationship. The client eventually filed a lawsuit and licensing board complaint against the social worker alleging boundary violations. Having been consulted on many such cases, I have struggled to understand what leads some social workers—fortunately, a small minority—to engage in such egregious conduct. The irony, of course, is that social work is known for its longstanding commitment to altruism and attracts students and practitioners who are deeply committed to helping vulnerable people. In my role as an ethics consultant and expert witness in many legal proceedings, I have learned that there are complex reasons that some social workers cross the proverbial line and violate well-known ethical standards. Some of the social workers I have met are impaired. Their mental health and other personal struggles have led them down a dark path that resulted in heinous boundary violations. I also have interviewed otherwise capable and talented social workers who were in deep financial trouble, which led them to submit fraudulent invoices to insurance companies and government agencies. In other instances, the social workers were neither impaired nor desperate financially; rather, they were greedy and determined to generate revenue fraudulently or exploit clients to support a lavish lifestyle. Moral Disengagement in Social Work Moral justification. Social workers who engage in professional misconduct may view their behavior as having a moral purpose in order to make it appear socially acceptable. For example, a social worker who owns a group private practice and bills insurers fraudulently may try to rationalize this misconduct by claiming that insurance companies’ reimbursement rates are unconscionably low and that the social worker’s billing practices are necessary to keep their practice afloat and meet the needs of clients. Euphemistic labeling. Social workers who violate ethical standards may use euphemistic language to camouflage their actions’ true purposes. Thus, “fraudulent billing” may become “revenue enhancement.” “Sexual misconduct” may become “emotional support.” Advantageous comparison. Social workers who engage in misconduct may compare their behavior with other examples of immoral behavior to trivialize their wrongdoing. For example, a social worker who enters into an inappropriate business relationship with a client—a conflict of interest and an inappropriate dual relationship—may claim that this is not nearly as bad as engaging in a sexual relationship with a client. Displacing or diffusing responsibility. Unethical social workers may try to shift blame and responsibility onto people under whom they serve. For example, a social worker employed in a substance use disorders treatment program who submits fraudulent invoices to government agencies that fund behavioral health services may try to argue that they were “simply following orders” issued by the agency director. Disregarding or misrepresenting injurious consequences. Unprofessional social workers may try to minimize the impact of their misconduct. For example, a social worker may admit that they became sexually involved with a client—in clear violation of ethical and legal standards—yet argue that the client consented to the relationship and was not harmed by it emotionally. Dehumanizing the victim. Social workers who mistreat others may view their victims as subhuman. For example, a social worker who is accused of discriminating against clients of color and undocumented individuals by refusing services to them may view these individuals as less deserving or undeserving. Social Work Ethics Standards Social workers should not allow their own personal problems, psychosocial distress, legal problems, substance abuse, or mental health difficulties to interfere with their professional judgment and performance or to jeopardize the best interests of people for whom they have a professional responsibility (standard 4.05[a]). Social workers whose personal problems, psychosocial distress, legal problems, substance abuse, or mental health difficulties interfere with their professional judgment and performance should immediately seek consultation and take appropriate remedial action by seeking professional help, making adjustments in workload, terminating practice, or taking any other steps necessary to protect clients and others (standard 4.05[b]). Furthermore, according to the NASW Code of Ethics, social workers have a duty to intervene when they believe colleagues are impaired, incompetent, or engaging in unethical conduct. Regarding colleagues who appear to be impaired, the code states the following: Social workers who have direct knowledge of a social work colleague’s impairment that is due to personal problems, psychosocial distress, substance abuse, or mental health difficulties and that interferes with practice effectiveness should consult with that colleague when feasible and assist the colleague in taking remedial action (standard 2.08[a]). Social workers who believe that a social work colleague’s impairment interferes with practice effectiveness and that the colleague has not taken adequate steps to address the impairment should take action through appropriate channels established by employers, agencies, NASW, licensing and regulatory bodies, and other professional organizations (standard 2.08[b]). Regarding colleagues who appear to be incompetent, the code states the following: Social workers who have direct knowledge of a social work colleague’s incompetence should consult with that colleague when feasible and assist the colleague in taking remedial action (standard 2.09[a]). Social workers who believe that a social work colleague is incompetent and has not taken adequate steps to address the incompetence should take action through appropriate channels established by employers, agencies, NASW, licensing and regulatory bodies, and other professional organizations (standard 2.09[b]). And, finally, regarding colleagues who appear to have engaged in unethical conduct, the code states the following: Social workers who believe that a colleague has acted unethically should seek resolution by discussing their concerns with the colleague when feasible and when such discussion is likely to be productive (standard 2.10[c]). When necessary, social workers who believe that a colleague has acted unethically should take action through appropriate formal channels (such as contacting a state licensing board or regulatory body, the NASW National Ethics Committee, or other professional ethics committees) (standard 2.10[d]). Most social workers are deeply concerned about clients’ well-being and would never knowingly behave in ways that harm them. Social workers generally abide by the prominent principle in the NASW Code of Ethics to “treat each person in a caring and respectful fashion.” In this regard, it is incumbent upon all social workers to do what they can to prevent moral disengagement in their own lives and to address any instances of moral disengagement displayed by colleagues. As the social work lodestar Jane Addams said in her book Democracy and Social Ethics, published in 1902, shortly after the inauguration of the social work profession, “action indeed is the sole medium of expression for ethics.” — Frederic G. Reamer, PhD, is a professor in the graduate program of the School of Social Work at Rhode Island College. He is the author of many books and articles, and his research has addressed mental health, health care, criminal justice, and professional ethics. |