The first part of academic papers on social work
Social work ethics
Abstract: Social workers often face difficulties and ethical problems in practice. Through a case of AIDS patients, this paper analyzes the ethical problems and dilemmas involved, and makes possible ethical decisions based on social workers' professional ethical values and ethical decision-making screening methods.
Keywords: ethical dilemma of social work ethical decision
1, case introduction
Mr. Li is a married man in his late fifties. He is a well-educated, intelligent and eloquent businessman. He has a son with his wife of 25 years. To outsiders, he has a happy family and a happy life. Recently, he found himself suffering from AIDS, because he was often unwell and mentally ill, and went to the hospital for examination. Mr. Li admits that he is gay. He said that he was born in a conservative and rigorous intellectual family, and his homosexuality could not be accepted by his family. Society has no tolerance for homosexuality and is full of contempt and discrimination. For the sake of parents and integration into normal life, Mr. Li chose to marry his current wife at the age of trial marriage, and also concealed his sexual orientation from his wife and family. Married life is harmoniously decorated by Mr. Li, but Mr. Li still often feels helpless, lonely and miserable, and his sexual desire is not satisfied. So after my son went to junior high school, he began to have a one-night stand with unknown homosexuals online. Although not many times, Mr. Li was unfortunately infected with AIDS. After learning that he was infected with AIDS, Mr. Li panicked and developed a series of depressive symptoms, including insomnia, helplessness and suicidal thoughts. Mr. Li hopes that social workers can help him, but at the same time, he also declares that his homosexuality needs to be kept secret from anyone, including his wife and son.
2. Main ethical problems and dilemmas
2. 1 who is the party?
Traditionally, a customer refers to a person who has a working relationship with a worker and pays her. In other words, the client is an individual or a system in which professionals take intervention measures to change or correct their behavior. At the same time, social work intervention often includes changing other systems besides the client system. In this case, according to the traditional definition of the party, Mr. Li is of course a party. He is not only infected with AIDS, but also has a series of depressive symptoms and even suicidal thoughts. Social workers should first give psychological counseling to Mr. Li, calm his emotions and let him face his illness bravely. However, if social workers follow Mr. Li's instructions and hide the fact that they have AIDS from their wives and children, the possibility of their wives and children being infected with AIDS will greatly increase. Social workers also have the obligation to protect anyone's life. Is it Mr Li or Mr Li's wife and son? Whose interests should take precedence? Today's social work service model includes service applicants, parties, work objects, beneficiaries, employees, institutions, communities and so on. In the case, when Mr. Li, his wife and son play these roles, their expectations and goals are different and conflict with each other, which brings ethical problems to social workers. Whose expectations should be given priority?
2.2 The conflict between the right to privacy, the principle of confidentiality and the principle of minimum harm
The right to privacy of AIDS patients means that AIDS patients enjoy the same private life and peace as other citizens, and their private life information is protected according to law, without being disturbed, informed, used, disclosed or made public. Confidentiality means that social workers will not disclose the information obtained from the client to anyone without his informed consent. It is generally believed that the parties can trust social workers to keep secrets, which can enhance their trust in workers. If the parties realize that confidentiality is limited, it will hurt their relationship with social workers. At present, a large number of studies on the mental health of AIDS patients at home and abroad have found that AIDS patients generally have serious psychological problems, among which anxiety and depression are the most prominent, and sometimes their anxiety is more serious than neurasthenia patients and anxiety patients. The factors that affect their mental health are: the long-term torture of diseases; Social and family roles change, and the labor force decreases; Inferiority and help-seeking psychology are not satisfied; Interpersonal tension, etc. Considering the professional relationship established between social workers and Mr. Li and his unhealthy physical and psychological condition, they should not reveal Mr. Li's privacy. But from the perspective of Mr. Li's wife and children, they have the right to know the sexual orientation and physical condition of their husbands and fathers. At the same time, social workers must also realize that the later wives and children know the truth, the more likely they are to be infected with AIDS. Once the fact of homosexuality is exposed due to other factors, the wife and children will not only be hit hard, but also will inevitably vent their anger on social workers. If his wife and children are unfortunately infected with AIDS, should social workers bear the responsibility or be recognized as "accomplices"? When the difficulties faced by social workers are likely to cause harm, they should avoid or prevent such harm. But this will inevitably lead to violation of the principle of confidentiality.
2.3 Differences in values
There is a traditional expectation for professional social workers, that is, not to impose their own personal values on the clients, even if they are required to judge the behavior of the clients from their own values or social values, they should be put on hold for the time being. However, in actual social work practice, things are not always so simple. It is common that there are obvious differences between the values of social workers and clients. In this case, Mr. Li was gay and had a one-night stand with other homosexuals, which easily made social workers question Mr. Li's moral quality. On the question of whether to tell his wife and children that they are infected with AIDS, the values of social workers are to protect their own lives, while Mr. Li values his own interests more. In the process of intervention, the values of social workers are incompatible with those of Mr. Li, and they are likely to be biased against Mr. Li. But Mr. Li is now an AIDS patient, and he needs the understanding, tolerance, care and support of social workers. When making a decision, social workers may move towards professional values and ignore Mr. Li's feelings.
3. Possible moral decision-making and basis
3. 1 ethics determines the screening method.
When social work encounters similar ethical conflicts in the process of specific professional services, it will follow a set of values, principles and standards to guide decision-making and behavior. In view of the ethical dilemma in the case, I will use "ERS" and "EPS" to make ethical decisions respectively.
3. 1. 1 "ethics screening method" (ERS)
As the most important method of ethical decision-making in social work, social workers should refer to the American Association of Social Workers' code of ethics to see if there are one or more suitable standards that can be fully applied. China's "Code of Ethics for Social Work" does not indicate the information disclosure norms for AIDS patients or homosexuals. However, referring to the code of ethics of the American Association of Social Workers (1997), it is stipulated that "social workers should respect the privacy of all cases. Once private information is provided, the confidentiality standard will be used ",but at the same time, it is stipulated that" it is not necessary to prevent the owner of the case or an identifiable third party from suffering serious, foreseeable and immediate harm, or when the disclosure is required by laws or regulations. " Through the application of the Code of Ethics, we can understand that although Mr. Li's right to privacy is inviolable, social workers can disclose relevant information to Mr. Li's wife and children to the minimum only in some special circumstances that endanger others or legal requirements, that is, when his wife and children may be infected with AIDS. 3. 1.2 "ethical principle screening method" (EPS)
According to this method, social workers should first list a series of ethical principles, and arrange them in the following order: protect life; Equality and difference equality; Autonomy and freedom; Reduce harm; Quality of life; Privacy and confidentiality; Sincerely and unreservedly disclose information. Secondly, the different ethical demands in the ethical dilemma are classified into the guide of ethical principles. Thirdly, the order of ethical demands is determined according to the requirements of meeting the high-level principle first and then meeting the low-level principle. In the ethical dilemma of this case, we found that Mr. Li's right to privacy is not in the absolute first place. In order to protect the right to life of the parties or others, and promote the equal rights and differential rights of all people, information disclosure is conducive to promoting the autonomy or freedom of the parties, and information disclosure is more harmful to others than information disclosure. The principles of privacy and confidentiality can be appropriately compromised.
3.2 Possible moral decisions
3.2. 1 Clarify all parties and work objectives.
Mr Li, his wife and his son are all clients and clients of social workers. The main problem that social workers need to solve is (1) to relieve a series of depressive symptoms of Mr. Li and dispel his suicidal thoughts. (2) Mr. Li's AIDS needs professional treatment and nursing. (3) Ensure that Mr. Li's wife and children will not be infected with HIV from the medical and health point of view. (4) Persuade Mr. Li to have the courage to tell his wife and children about his homosexuality and AIDS. (5) Calm the emotions of Mr. Li's wife and children and promote communication between the two sides.
Informed authorization
According to the analysis of "ethical standard screening method" and "ethical principle screening method", social workers should tell his wife and children the truth against Mr. Li's wishes. However, informed authorization means that a social worker or another professional can't intervene in the life of the client, and can't disclose confidential information related to it unless the client allows it. Social workers must explain the medical knowledge about AIDS to Mr. Li, analyze the possible dangers of Mr. Li's wife and children, give him courage and strength, persuade him, win his written consent and disclose the scope and content with him in detail and clearly. As for whether Mr. Li's privacy is disclosed to people other than his wife and children, it depends on Mr. Li's wishes, and social workers don't have to force it.
provide services
After learning the truth, Mr. Li's wife, children and Mr. Li will bear great pressure, both physically and economically, and more importantly, psychologically and spiritually. This kind of psychological pressure is often caused by ignorance of basic medical knowledge. Therefore, it is necessary to provide them with all kinds of advice. (1) Social workers provide Mr. Li with: ① psychological counseling to relieve his psychological pressure. Social workers need to provide psychological counseling and consultation to help them reduce their psychological burden and treat diseases with a rational attitude. ② Timely behavioral intervention. It is necessary to provide him with knowledge about the spread of AIDS and urge Mr. Li to restrain his irresponsible behavior through direct intervention. (2) Social workers provide patients' families with: ① medical knowledge counseling to change the concept of discrimination and exclusion. Mr. Li's wife and children may have an irrational understanding of the facts of Mr. Li's homosexuality and AIDS, and try their best to exclude and discriminate against him, or even shut him out. Therefore, it is necessary to educate the families of his wife and children about basic medical knowledge, persuade them to put Mr. Li's life and health first, and give Mr. Li some family care. ② Strengthen the education of prevention knowledge. Social workers should also strengthen the comprehensive education and prevention knowledge consultation for Mr. Li's wife and children, so as to prevent problems before they happen.
Provide support.
In addition to providing services, social workers need to provide all kinds of support, including emotional and medical support. ① Provide emotional support and strengthen life confidence. Although there have always been differences in values between social workers and Mr. Li, social workers should face the problems together with Mr. Li on the principle of equal acceptance. Through in-depth communication and strengthening emotional counseling, Mr. Li can gradually release his nervous mental state, thus re-establishing his confidence and courage in life. ③ Provide its auxiliary support. For example, through regular investigation, research and evaluation of patients' condition, medical institutions can be assisted to adjust treatment or mitigation measures in time, so as to relieve patients' pain more pertinently.
refer to
Huang Yuhua. Anxiety analysis of AIDS patients and nursing countermeasures [J]. General Nursing, 2009,7 (29): 2688.
[2] Ralph? Dogov, Frank? m？ Donna, Lovenberg? Harrington. Social Work Ethics: A Guide to Practical Work (7th Edition) [M]. Beijing: China People's Fire Science Publishing House, 2005.
[3] militia. AIDS prevention: the perspective of social work [J]. chinese primary health care, 2006,20 (10):13.
Academic papers on social work II
Research on Social Work Spirituality
Due to the decomposition of social traditions, the separation of churches, and the proliferation of secularism and rationalism, people urgently need to appeal for the certainty of life, pursue the meaning of life, and establish contact with the "other". The development of spirituality provides the possibility for the development of social work value, and also opens up another road for social work practice.
Keywords: spirituality; Social work; meaning
China Library Classification. : C9 13 document identification number: A article number:1002-2589 (2015) 32-0041-02.
The focus of the new era is to expand the definition of spirituality, rebuild religious spirit, respect religious and non-religious expressions, enhance spiritual tension and make it more inclusive and pluralistic. How to understand spirituality? This requires us to change the way we look at problems every day and change the conventional automatic thinking. Spirituality should be given a higher goal, oppose oppression, improve social welfare and promote social justice.
First of all, the concept of spirituality
There is no universal definition of spirituality, and different scholars have different interpretations of spirituality. Some scholars believe that spirituality is a transcendental dimension of human experience and existing things, seeking a broader ontological context for self; Some scholars believe that spirituality is a response to God's grace and shows the relationship between man and God. Some scholars believe that it is related to human pursuit of value, purpose and meaning; Some scholars regard spirituality as the opposite of physical attributes, which belongs to transcendental category, rather than appeal to reason's logic. Spirituality is the pursuit of holiness, with transcendence as the core (the transcendence of disorder, irrationality and meaninglessness), emphasizing people's subjective experience and religious belief tendency. It not only represents people's concept system such as belief, emotion and morality, value structure, but also is a functional system of people's self-integration, self-interaction with others and environment.
Secondly, modernity and religion.
With the emergence and spread of capitalist monetary economy, people put almost all their energy into industrial production and commercial activities, threatening the ancient value of _ _ _. Industrial production makes us live in a world full of risks, full of words such as ecological crisis, total nuclear fission and accumulation of radioactive waste storage, market collapse and capital depreciation, war and terrorism, information threat and so on. The global problems of various harmful substances, such as cancer and toxins, swept through. People in business activities enthusiastically pursued material interests, the principle of eating, drinking and having fun, and the immediate pleasure, and developed narcissistic and selfish personality types. The prevalence of individualism runs counter to the traditional values of asceticism and thrift in general religions. Modern law and ethics require heteronomy and rational behavior, not individual self-discipline behavior. Human behavior is only bound by law, and "not breaking the law" is the bottom line of human behavior, not bound by moral beliefs. Law is added to the surface of people and things, but it does not go deep into people's consciousness and heart. People began to evade their obligations and responsibilities, resulting in mutual distrust and insecurity. The result of group collapse comes from the continuous "colonial division" of individuals living in various intimate group living spaces, as well as the gradual decline and fracture of strong life ties. Individualized lifestyle cuts off all kinds of connections between individuals and society. People in society have become individualized and atomized, resulting in alienation phenomena such as indifference, naturalness, no communication, no sense of belonging and no sense of belonging, and people's sense of alienation has been strengthened. Daniel? Bell said earnestly: "The real problem of modernism is the problem of faith." Value nihilism will inevitably lead to paralysis and shock of the subject's vitality and wisdom creation, and lead to spiritual and cultural poverty and moral collapse in the western world. Rich, a famous psychiatrist, described the modern city like this: "This is a decadent inner city, telling all kinds of gloomy stories of sadness and despair and showing a spiritual wasteland."
The modern lifestyle has undergone unprecedented changes, and the influence of religion in social life has gradually declined. The decline of religion and the erosion of the institutional basis within society have brought adverse consequences to individuals and society. With the decline of orthodox religious ideas and the gradual decline and collapse of social order, some value is urgently needed. Wittgenstein believes that people believe in religion in order to appeal for the certainty of life. However, spirituality and religion are linked, which seems to make people cautious.
Third, look for the meaning and certainty of life.
There is a saying in the Jerusalem Bible: People don't live just for food. The "I-it" relationship is only a tool to meet my needs, interests and desires, and it will only lead to the division of my body and mind. People pay too much attention to matter and ignore other things, and individual rationality is surrounded by materialization or simplification. Therefore, we urgently need to reconstruct the meaning of life, get rid of the shackles of physical attributes, and make individuals become "complete people".
Spirituality requires respecting human dignity and value, helping people find self-reliance and sense of belonging, re-examining the meaning of their lives, affirming the passive way of non-indoctrination, bravely facing the limitations of life beyond self, exploring and giving inspiration, and actively looking forward to the future, instead of focusing on the past and morbid life.
Religious belief is also a clear demand for life, which we can understand as an exploration of sacredness. People rely on the divine power of God to get rid of secular temptation and pursue a holy life, and regard faith as the energy source of vitality and the driving force of life. Faith contains the concepts of God, holiness, ultimate reality and transcendence.
Spiritual needs are not limited to people with religious beliefs, but also apply to redundant atheists. Although he/she will not adopt the concept of God, it does not mean that he/she has not explored and tried the status quo, development and laws, and the meaning and purpose of life. Sacredness is the same point between religion and spiritual life. Personal consciousness and subconscious psychology, human soul seek to transcend value, meaning, experience, development and ultimate reality, thus making the individual moral universe have a sense of belonging and sacredness of life.
Fourth, build the world of others.
"The other" belongs to the concept of anthropology, and caring for the other is undoubtedly the discipline tradition of anthropology. The "other" is the edge, and its existence implies some disadvantages of egoism, which inevitably permeates some defilement and prejudice. Bowman earnestly pointed out that only by integrating with society can individuals ensure the meaning and eternal value of life, and integration with society requires the cultivation of "consciousness of the other".
The existence of "consciousness of the other" can promote moral development, so that the parties can stand in the perspective of the other, think for others and experience feelings. Without "consciousness of the other", moral sympathy cannot be formed. Autonomous morality not only means self-discipline, but more importantly, it can put itself in others' shoes to restrain itself, a self-centered process. The "other" here is the person in the concept of equality, and the investment of "self" in "the other" can promote mutual understanding. In the face of others, you can clearly order yourself to fulfill moral obligations and responsibilities. He has no other power or wealth to force him to yield, but he has moral authority to make people respond with responsibility and justice. The "other" liberates people from the material place and space without spiritual level, and the realistic material order is abstracted from the inner life that advocates paying attention to the soul to some extent. This integrity of the individual is not only realized by himself, but also in the meaningful relationship with others, other things and the environment.
V. Spiritual and social work
Historically, social work is rooted in religious tradition, and religious sympathy is the main source of social work values. Spiritual social work is the highest level in the practice system of social work, which is universal. The provision of religious belief resources is extremely scarce in China today, which means that we may lack religious belief, but as human beings, we all need spiritual care and services of spiritual social work. Social work and spirituality are connected, and they are a natural alliance in the process of good service between individuals and society. Psychologists have found that more religions and spirituality have made unique contributions to the provision of health and well-being, and consciously combining personal positive will pursuit with spiritual strength has great health value. Spiritual development may produce some virtues, such as sympathy, forgiveness, humility and sense of justice, and spiritual development may also produce happy qualities, such as philosophy, calmness, satisfaction, joy and clear life goals. Belief in the sacredness of spirituality can help us transcend the limitations of problems and stop focusing on the past and suffering, but lead us to explore inspiration and find solutions to problems. Spirituality plays an important role in natural disasters, diseases, stress, loss of relatives, divorce and other major life events, as well as death and near-death fields. Believing in religious and spiritual experiences and maintaining a lifestyle can always find ways to cope with difficulties, such as spiritual support, spiritual meditation, forgiveness, prayer, confession and religious ceremonies. Social workers will also encourage clients to take relaxation training (conscious breathing, etc.). ), meditation, positive imagination, forgiveness and challenging irrational beliefs.
Buddhism says that "desire is the root of all evil" and _ _ _ advocates asceticism. "Abstinence" is the only way for us to get rid of the predicament of survival. Believing in religious spirit helps to avoid personal quality defects such as overeating, desire, jealousy and pride, and maintain a low level of alcoholism, drug abuse and sexual promiscuity at the family level. Yearning for religious spiritual life, not angry or greedy, selfish, want to have a higher level of life satisfaction and high self-esteem, and maintain a complete and coherent personality in the face of fragmented cultural and social forces. Spirituality adheres to the humanistic tradition. It actively pays attention to the marginal experience and different voices ignored by traditional theories, pays attention to people's perception, feelings, beliefs, intentions and even spirituality, and avoids using inherent and pre-existing concepts to test the so-called empirical materials to understand "dismembered human beings."
From a macro point of view, spirituality has opened up an all-inclusive new world experience order, absorbing not only Christian theology, but also oriental philosophy, psychoanalysis and medicine. Spirituality is of great significance to the social system, the driving force of individuals and families, cultural diversity, loss and communication in social work. If social workers want to know the spiritual needs of dying patients, they need to check their race, culture, religious and spiritual beliefs, traditions and rituals. At the micro level, mental nursing comprehensively considers the patients' physiology (pain and symptom control)-psychology (anxiety and depression)-socialization (isolation of family and friends, fatigue of participating in social affairs)-spirit.
Spirituality in social work explores the characteristics of the whole person and family, the whole process and the comprehensive care model, explores the case owner and the case owner system from a holistic perspective, investigates the significance and explanation behind the problems of the case owner and the case owner system, and responds to the moral framework and the personal specific level of the relationship with others. The happiness produced by the case owner is a kind of "super-personal" sense of wealth. As a "complete person", the case owner experienced the satisfaction of life, the harmony with others and the world, and the recognition with the ultimate world.
Religion and spirit are inseparable parts of life. Visits by church groups, priests or social workers made the case owner feel that he was not abandoned, and the "extremely negative self-evaluation or any destructive thinking mode" he experienced was dispelled by the power of kindness.
As a social ideology, the decline of religion is not a blessing. People gain strength from religious belief, and spiritual and social work tries to save the collapse of the religious world. But it deviates from or transcends religion, reinterprets consciousness and soul, and gradually extends to the advanced spiritual realm. In other words, only religious revival can restore intergenerational continuity and bring global order, humility and love.
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