Any behavior that a group of people deems unpleasant is a social problem. In terms of social issues, human service workers must make wise decisions. The scenario's unique societal issue is the non-consensual disclosure of an individual's HIV status to her peers. Human care providers must therefore decide whether to disclose a client's HIV status or not, based on the particular context, as handling a patient's health information should be done with caution because doing so may have detrimental effects on the victim. In any situation where the HIV status of a patient affects a particular group of people, the care provider is required to disclose the information to the population at risk (Doel, 2016). Disclosure should only be done to people who are at risk of contracting HIV from the victim. However, it becomes hard to decide whether to reveal the health status of a person since it may lead to stigmatization or other related consequences. Disclosing one's HIV status is not a must and thus, should only be done when the situation dictates that it has to be done. Ethical considerations also have to be put in place to ensure that the human care providers do not breach their expected moral standards.
In the case provided, Jasmine is infected with HIV and does not disclose it to other clients who attend the same group sessions with her. She uses her glucometer to check her glucose level. During the session breaks, Jasmine pricks herself to get blood for testing her blood glucose level. As a result, she puts every individual in her group session at risk of contracting HIV. It is, therefore, necessary for Jasmine to disclose her HIV status to her group members so that they take safety precautions. However, she decides to keep this critical information about her health status from them. However, Jasmine's case is justifiable since disclosing her status to others would put her at risk of stigmatization, discrimination or even rejection. Disclosure of her status becomes a social problem since it does not only affect her but other clients as well who are at risk of contracting the disease.
Ethics and Ethical Dilemma
Ethics refers to a set of principles used by a group of people in determining what is right and what is wrong (Reamer, 2013). It refers to the beliefs, values, and rules that are observed and governs a specific group of people. It enhances the way people in a given society interact with each other and respects each other's opinions and decisions bringing about mutual understanding. In the social service profession, there are various ethical codes of conduct that govern care providers. The codes of conducts have to be followed in during provision of care. However, there are times when following the ethical considerations bring conflicts.
Ethical dilemma occurs when a human service professional has to make a decision and whichever decision is made brings adverse consequences to the situation (Reamer, 2013). For a case to be referred to as an ethical dilemma, some conditions must be met. First, the situation has to involve two or more decisions to be made. If the situation does not require making a choice, then it is not an ethical dilemma (Doel, 2016). Second, whichever the chosen course of action for the situation, ethical considerations would be breached. Therefore, in an ethical dilemma, there is no perfect decision or solution to a case.
Ethical Concerns in the Case
In the case study, there is a situation of an ethical dilemma. Jasmine is HIV positive and does not disclose it to other group members who attend the session with her. Ann is a licensed social worker and the professional who takes Jasmine and other clients through their meetings. She also knows that Jasmine is infected with HIV but does not inform anyone about it. Ann does this since it is ethical to respect the privacy and confidentiality of her clients. Eventually, Mary, the executive director, learns about Jasmine's HIV status but she gets the information from someone else who is not Ann. Mary demands that as the counselor, Ann should talk to Jasmine so that she discloses the information to other clients in her group. If Jasmine does not do so, then Ann must let the clients know about the social problem they are facing. Ann is directly involved in the social dilemma. She has to choose whether to disclose Jasmine's condition or not. If Ann discloses her situation, then she would have breached the confidentiality code of conduct. Likewise, if she does not reveal the same to her group members, she would violate the code of ethics of not harm. The ‘Do not harm' law requires that she informs her clients of the potential risk of contracting HIV from Jasmine. Either way, she would have to go against ethical standards of social work.
Human Service Profession Theories and Competencies
Human service profession has applied some of theories and competencies in guiding the social work practice. They include system theory which is concerned with the way people behave, needs, rewards, expectations, and attributes in a complex society. According to this approach, an individual's problem is solved by the whole group (Neukrug, 2016). In this case, Jasmine's condition is not her issue but also concerns her fellows. It also explains the competent skill of consistent behavior in choosing interventions which are matching with the values of one's self. Moreover, rational choice theory is applied. It is based on how decision making has risks and benefits according to the action of the character. For Ann to decide not to disclose Jasmine’s HIV status to other staff in the group session has advantages to Jasmine since she will not feel stigmatized of her current situation. On the other hand, disclosing Jasmine’s condition is risky because the other group members in the session will be at risk of getting infected with the HIV. Conflict theory explains how people are concerned expresses inequality with their interest through manipulation and use of power to control others instead of consensus (Neukrug, 2016). Ann has the authority to decide on whether she should disclose Jasmine's HIV status or not. She does not need Jasmine opinion on doing so. Also, the executive director does not consider how Jasmine feels when she will disclose her condition since she asks Ann to persuade Jasmine to reveal her status to her fellow staff in the group.
Decision-Making Process
The case of Jasmine involves some ethical considerations. It is therefore essential that a credible model is used in the decision-making process since it is a complex ethical dilemma situation (American Counselling Association, 2014). The model by Barret, Kitchener, and Burris (2001) can be used make decisions involving ethical dilemmas such as Anne and Jasmine’s case. The model analyzes Jasmine's case step by step. Although there would be no perfect solution, the decision made would be better than the initial decisions. The model has eight steps to be followed in the decision-making process
i) Personal response to the issue or case is reviewed.
ii) The response is compared to the existing facts.
iii) An initial plan is conceptualize based on the review of facts and personal response.
iv) The foundational principles and code of ethics are consulted.
v) The legal consequences of the initial decision is examined.
vi) Identification and evaluation of available options in order to refine the initial plan
vii) Choosing the best course of action
viii) Implementing the chosen choice of action and examining its effects.
Research Topic for the Social Problem
The specific research topic to address the social problem in Jasmine’s case is; disclosure an individual’s HIV status without informed consent. Most researchers cover various aspects of HIV, but for the matter of disclosing one's status under such situation, there seems to be a gap. Therefore, people need to be educated on the importance of revealing their status to people who are at risk of contracting the disease. By doing this, the social problem of disclosing one's HIV status would be addressed. The research topic would also cover the ethical issues to be considered when a person wants to disclose the health status of another person or their own. Social service professionals would also gain an understanding of the importance of following specific codes of conduct when handling their client issues.
References
American Counselling Association. (2014). ACA code of Ethics. Alexandra, VA: Author.
Cree, V. E. (2013). Becoming a Social Worker: Global Narratives (2, evised Ed.). Abingdon-on-Thames: Routledge.
Doel, M. (2016). Rights and Wrongs in Social Work: Ethical and Practice Dilemmas. London: Palgrave Macmillan.
Neukrug, E. S. (2016). Theory, Practice, and Trends in Human Services: An Introduction (6, illustrated ed.). Boston, MA: Cengage Learning.
Reamer, F. G. (2013). Social Work Values and Ethics (revised ed.). New York: Columbia University Press.
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