Chapter 3:

Ethical Standards

Chapter Overview

One of the defining factors of a profession is that it contains a Code of Ethics. In this chapter we examine The Ethical Standards for Human Services Professionals.

Then the National Association of Social Workers (NASW) Code of Ethics is described for comparison and contrasting. Depending on where you work and what your role is you may use one of these codes, or another one entirely. In addition, there will be workplace standards and governmental laws that will regulate your work. Ethical Standard 28 refers to the responsibility that you have to consult and review when there is an ethical, legal or other dilemma that you face in your work.

Chapter Learning Objectives

1. Recognize the value of codes of ethical standards.
2. Describe the NOHS Code of Ethical Standards.
3. Relate the NOHS Code of Ethical Standards to laws, policies, personal values and the NASW Ethical Code.
4. Apply the Code of Ethical Standards to identified dilemmas.

Key Terms

Key Terms are important vocabulary for understanding the content of the chapters. They will be bolded and defined via an in-text glossary the first time that they appear in the chapter.

Key Terms for this chapter are: dilemma, ethics, National Association of Social Workers (NASW), National Organization of Human Services (NOHS), professionalism, social problem, standards

References

Barrett, S. (2019). Ethical Standards for HS Professionals.
Nationalhumanservices.org
; National Organization for Human Services.

https://www.nationalhumanservices.org/ethical-standards-for-hs-professionals

Open Content, Original

“Chapter Overview” by Elizabeth B. Pearce is licensed under

CC BY 4.0

Ethical Standards for Human Services Professionals

Ethics and Professionalism

As you consider entering the profession of human services, it is important to think about the role you will play as well as the responsibilities that come with that role. One of the joys and challenges of working with human beings is that unique interactions occur every day.  Whether a director, a supervisor, a receptionist, an assistant or a case manager, you will encounter situations that you have not seen before. The field of human services was developed in response to human needs and human problems. It is a profession dedicated to helping diverse individuals solve the challenges that they face while valuing each person’s community, culture and self-determination. While doing so, the professional must act with integrity and compassion with social justice in mind.

There is not a set of directions to follow when you work with individuals. When putting together a piece of furniture or preparing a tray of enchiladas you might follow instructions or recipes. You might even deviate a little bit or add your own flair to the project. Working with individuals and families, however, requires a stronger internal set of values and principles.
That foundation is one that you build inside yourself using the tools of education, experience, and understanding of ethics.

There is a code of ethics for the human services profession that will help you build that foundation. In fact you will be required to use that code as soon as you start working in this profession, including during your practicum and internship experiences.  All professions have a code of ethics and those codes have many similarities in terms of how they relate to being responsible toward clients, colleagues, and society. Psychologists, attorneys, medical professionals, and social workers all embed these obligations and duties within their ethical codes.
In this chapter we will focus on the Ethical Standards for Human Services Professionals; in the following chapter the National Association of Social Workers (NASW) Code of Ethics is analyzed.

Figure 3.1. Ethics and values are intertwined with human, regional, national, and world cultures.

Whatever the profession, the code of ethics is embedded within the cultural ethos of the world and here, the cultural norms of the United States. As we examine ethics, we must also look at values and culture. It is important to note that different countries and cultures have differing values. and that there are many sub-cultures within the United States that conflict, complement and/or mirror the overriding norms of the country.

It is critical to pay attention to the cultures and values of the families that you work with, as well as being mindful of  your own ethics and values. Looking at all of these elements together is complicated and that is why it is being highlighted right as you start learning about this profession. It takes time, experience, education and reflection to develop your foundation. This chapter will support that building process.

Structure of NOHS Code of Ethics: Two Sections

The NOHS Code of Ethics consists of four sections:

• Preamble
• Ethical Standards

The set of ethical standards, adopted by the National Organization for Human Services in 2015, begins with a preamble that outlines the importance of each professional’s behavior  and the fundamental values of the human services profession. It then goes on to describe 44 separate standards of responsibility to seven groups: clients, public and society, colleagues, employers, the profession, self and students.

Preamble

The preamble contains four introductory paragraphs.  The first two paragraphs focus on characteristics of the profession such as helping others and paying attention to the context of individuals and families. It emphasizes the role of education and professional growth.

A key part of the preamble is the acknowledgment of the conflict that may exist between the code and other policies and expectations such as employer policies, credentialing boards, laws and personal beliefs. Each entity has some shared but some differing priorities and this can lead to inconsistencies in what is best in any given situation.  We will look at ethical dilemmas later on to help us understand this section of the preamble better.

The fundamental values of human services are listed:

• respecting dignity and welfare of all people.
• promoting self-determination.
• honoring cultural diversity.
• advocating for social justice.
• acting with integrity, honesty, genuineness and objectivity.

The last part of the preamble reminds us that professionals as well as students and educators are bound by these standards.

Ethical Standards

These next seven sections include a brief introduction and then summarize the 44 standards into a bulleted list form.

Responsibility to Clients

Clients are the first and most obvious group to highlight. The very first standard describes the responsibility of recognizing and building on individual and community strengths. The prominence of this statement is key to the profession. There are nine total standards which include:

• Be strengths-based.
• Obtain informed consent.
• Privacy and confidentiality.
• Protect from danger or harm.
• Avoid dual or multiple relationships.
• Prohibit of sexual or romantic relationships.
• Ensure that personal values or biases are not imposed.
• Protect of client records.
• Utilize technology in legal and confidential ways.

Responsibility to the Public and Society

Human services professionals are not focused on a singular client, or discrete clients and families. There is a responsibility in this profession to visualize all of society, to pay attention to
social problems
 and to how laws and policies affect communities. This profession has a social justice mission as these nine standards remind us:

1. Provide services without discrimination or preference related to social characteristics.
2. Be knowledgeable and respectful of diverse cultures and communities.
3. Be aware of laws and advocate for needed change.
4. Stay informed about current social problems.
5. Be aware of social and political issues that differentially affect people.
6. Provide ways to identify client needs and assets and advocate for needs.
7. Advocate for social justice and to eliminate oppression.
8. Accurately represent their credentials to the public.
9. Describe treatment programs accurately.

Responsibility to Colleagues

Being ethical in behavior toward colleagues is crucial to the healthy functioning of any agency, as well as across organizations. It’s especially important to work together so that funding is used effectively and services are coordinated but not duplicated by multiple agencies. These four standards speak to the value of having integrity with everyone you work with:

1. Coordinate, collaborate but do not duplicate services.
2. Deal with conflict by approaching the person directly; follow up with supervisor if needed
3. Respond to unethical behavior of colleagues.
4. Keep consultations between colleagues private.

Responsibility to Employers

The responsibility to your employer also serves clients and the public. These three standards emphasize this with a particular focus on seeking resolution if you experience a conflict of interest:

1. Stick with commitments made to employers.
2. Create and maintain high quality services.
3. In conflicts between responsibility to employer and responsibility to clients seek resolution with all involved.

Responsibility to the Profession

1. Gain education and experience to work effectively with culturally diverse individuals based on age, ethnicity, culture, race, ability, gender, language preference, religion, sexual orientation, socioeconomic status, nationality, or other historically oppressive groups.
2. Know your own limits; serve others within those limits.
3. Seek help when you need it.
4. Promote cooperation amongst related disciplines.
5. Promote continuing development of the profession itself.
6. Continue to learn and practice new techniques; inform clients appropriately.
7. Conduct research ethically.
8. Be thoughtful about self-disclosure including on social media.

Responsibility to Self

Being responsible to yourself is the core of the ethical standards. Being self-aware of your feelings and health, as well as your own beliefs and biases will make you a more effective and ethical human services worker.

1. Develop awareness of your own culture, beliefs, biases, and values.
2. Develop and maintain your own health.
3. Commit to lifelong learning.

Responsibility to Students

This is the only section of the code that calls out a particular subset of human services professionals: the educators. The final seven standards emphasize the special duty that educators have to students who are in a relationship where power and status are unequal. Educators model the standards at the same time that they are teaching across the breadth of the profession. In particular the structure, quality, and adherence to the code of the class setting, including field experiences, are the responsibility of the educator.

1. Develop and implement culturally sensitive knowledge, awareness and teaching methodologies.
2. Commit to the principles of access and inclusion.
3. Demonstrate high standards of scholarship.
4. Recognize the contributions of students to the work of educators.
5. Monitor field experience sites; ensure quality and safety.
6. Establish guidelines for self-disclosure and opting out.
7. Awareness of power and status differential.
8. Ensure students are aware of ethical standards.

Complexities of Ethical Behavior

Let’s dig a little deeper into some of the ethical standards and how they might lead to questions and dilemmas for practitioners. In this section, we will

• Focus on the ways that individual standards may support or conflict with one another.
• Contrast and compare common standards with national culture, policies and practices.
• Focus on social justice.
• Draw attention to the importance of examining your own values more deeply and how those connect to the Ethical Standards for Human Services Professionals.

It is worthwhile to view the ethical standards in these multiple contexts. Using and interpreting the ethical standards are a career-long process.

Privacy, Confidentiality and Safety

Standards three and four appear in the second section of the Ethical Standards, for Human Services Professionals,  Responsibility to Clients:

STANDARD 3 Human service professionals protect the client’s right to privacy and confidentiality except when such confidentiality would cause serious harm to the client or others, when agency guidelines state otherwise, or under other stated conditions (e.g., local, state, or federal laws). Human service professionals inform clients of the limits of confidentiality prior to the onset of the helping relationship.

STANDARD 4 If it is suspected that danger or harm may occur to the client or to others as a result of a client’s behavior, the human service professional acts in an appropriate and professional manner to protect the safety of those individuals. This may involve, but is not limited to, seeking consultation, supervision, and/or breaking the confidentiality of the
relationship
.

These two standards helpfully highlight the conflict between them in the last sentence of Standard four, which states that it might include “breaking the confidentiality of the relationship.” Similar conflicting ethical standards appear in most codes for helping professions. Facing the dilemma of whether to break confidentiality in order to preserve someone’s safety is one that many human services professionals will confront during their careers.  In those circumstances, the worker should take into consideration:

• The applicable laws and regulations of the region (e.g. when and to whom are reports made)
• The workplace policies
• The worker’s role (e.g. counselor, manager, student, receptionist)
• The Ethical Standards
• Any other resources and expectations

Notice that the professional’s own personal beliefs and values are not on this list. Nor are local or religious beliefs and values considered relevant to putting someone in danger. This relates to Standard thirty-four and the self-awareness that each professional is bound to keep of their own cultural backgrounds, values, and biases. What dilemmas might this pose for the professional?

Social Justice

Standards 14 and 16 appear in the third section of the Ethical Standards, for Human Services Professionals, Responsibility to the Public and Society:

STANDARD 14 Human service professionals are aware of social and political issues that differentially affect clients from diverse backgrounds.

 STANDARD 16 Human service professionals advocate for social justice and seek to eliminate oppression. They raise awareness of the underserved population in their communities and with the legislative system
.

Let’s look at a social issue (aka social problem) that is currently affecting the United States, but disproportionately affecting people who are in ethnic groups that have been traditionally underrepresented. A social problem is typically defined as one that affects many people, affects the health and well-being of society, includes multiple causes and effects, and needs a systemic solution.
Social problems are discussed in depth in the What is a Social Problem? chapter.

The COVID-19 pandemic is acknowledged to fit this definition. As a correlation, the disproportionate COVID-19 illness and death rate of people in ethnic minority groups could also be described as a social problem. In the United States (with data reported from 14 states) 33% of COVID-19 hospitalizations are among African Americans, although they make up 18% of the population in those states. In New York City, death rates were higher for Black (92 per 100,00) and Latinx (74 per 100,00) people than for White (45 per 100,000) or Asian (34 per 100,000) people. So Black and Latinx people who get COVID-19 are about twice as likely to die as are White and Asian people.  Native American and Alaskan Native rates of death and sickness are also disproportionately greater.
All of these trends are continuing to worsen.

For the most up to date national and state data, click here.

While we have the data to know that this is a social problem, how does this relate to the ethical standards?  The next questions to ask are related.  What contributes to underrepresented groups being more likely to get sick and also more likely to die if they are hospitalized for the illness?

The answers are complex, but here are some conclusions drawn from the Centers for Disease Control and Prevention (CDC) and other data. People from underrepresented groups are more likely to:

• Live in densely populated areas and housing with fewer services such as medical clinics.
• Use public transportation more.
• Work in jobs that are essential and/or require exposure to the public such as transportation workers, store clerks, and factories supplying food or other essential products.
• Work in jobs that have few or no benefits such as sick leave or health insurance, meaning that they may be more likely to go work even if they or family members are sick.

Although we have not discussed COVID-19 and age here, this chart is provided for contextual reasons.

Figures 3.2 and 3.3: The CDC collects data related to disease, race, age, and ethnicity.

Access to health care services and health care insurance is inequitable in the United States. In particular, states that have not expanded Medicaid funding as allowed under the Affordable Care Act have higher populations of ethnically underserved groups.

Whether this information is brand new to you, or you are familiar with this data, it seems obvious that there are multiple social problems to be unraveled and examined. Poverty and low socioeconomic status intersect with the racial and ethnic inequities examined here. All of us have been affected by the pandemic. Some of us have personal experiences with illness and death related to the pandemic.

The question is, how does the human services professional adhere to ethical standards 14 and 16? Standard 14 talks about awareness. Just by reading this section of the text, your awareness has increased. What other steps could you take next to increase awareness?  Standard 16 moves to another level, requiring the human services professional to advocate for justice. Advocacy takes many forms.
Here are a few ideas:

• Educate yourself about information literacy.  What are reliable sources of information?  Read and view those.
• Talk with people close to you. Share accurate information.
• Listen closely to people from underrepresented groups. Believe their experience. Stand by them.
• Write a letter or a postcard to your political representative.
• VOTE.
• Take part in the Census and the American Community Survey.
• Help amplify the voices of people of color (POC). Feature them on your social media.

In the field of human services there is an ethical responsibility to work toward a better society.  The role a person plays in the workplace will define specific responsibilities and time, allotment but each professional will also have a commitment to the ethical standards and to working toward social justice.

Immersed in Values

Standard 34 appears in the seventh section of the Ethical Standards for Human Services Professionals, Responsibility to Self.

STANDARD 34 Human service professionals are aware of their own cultural backgrounds, beliefs, values, and biases. They recognize the potential impact of their backgrounds on their relationships with others and work diligently to provide culturally competent service to all of their
clients
.

Our personal values and beliefs come from multiple influences: our families, geography, the time we live in and one or more cultures that may include religion. They also come from the broadly held values, policies, and culture of the United States, and we will focus on that here for a moment.

Figure 3.4. David Foster Wallace was an acclaimed American author.

“There are these two young fish swimming along and they happen to meet an older fish swimming the other way, who nods at them and says “Morning, boys. How’s the water?” And the two young fish swim on for a bit, and then eventually one of them looks over at the other and goes “What the hell is water?” –David Foster Wallace

When we are immersed in something, we may not know exactly what it is. In the example above, the fish may not know to contrast water with  other environments like the earth, or air. Living in the United States we are grounded in ideas such as “freedom”, “equality” and “patriotism.” But what do those words mean to you? And what do they mean in the context of the United States?

For example, The Declaration of Independence is commonly quoted to demonstrate that the United States is founded on equality: “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.”

But as we know, this declaration did not apply to all men in the United States, but only to men who were White, and in some cases was limited to land-owners (early in the history of the United States individual states regulated the right to vote, so there was variability about which White men had access to equality, including voting).  Not to mention women, at a time when the White culture defined sex and gender in a binary system.

Here is another concept of equality that also incorporates the idea of equity.  As you view the image, which definition do you find yourself the most aligned with? In this drawing, “equality” is represented by each person having the same size box;  “equity” shows each person having a box or boxes that help that person see over the fence; and in “equity for all” the solid fence is removed and everyone can see the game.

Figure 3.5. Equality, Equity, Equity for All.

One lesson is that each professional needs to spend time thinking deeply about what their own values are, and how they define those values.  Examine the source of those values. If they come from “the water” that you are immersed in, it may be time to poke your head out, reexamine and redefine your perspectives and values.

Figure 3.6.  When you are immersed in an environment’s conditions, it is important to periodically assess how it affects you.

Standard thirty-four is about awareness: deep knowledge about yourself and about how your culture, beliefs, biases and values potentially interact with those of your clients and of society. This level of understanding does not come quickly or easily. While some of a person’s core beliefs and behaviors may be stable over time, most people grow, change, and deepen in their thinking and beliefs.  Age, experience, education and action all contribute to greater self-awareness.  Action can come in the form of reflective thinking and writing, interaction with other thinkers and practitioners, and via thoughtful listening and discussion. As a student in the field of human services, you are engaged in this process simply by reading, reflecting and discussing the ethical standards. You are not expected to have all of the answers, but you are expected to be engaged in the process.

Ethical Decision Making

Human services workers must make difficult decisions, sometimes quickly, and sometimes without support or resources. It is helpful to have a model of decision making that you practice many times so that you can feel more confident about making decisions on your own.

The ETHICs decision-making model includes the following steps:

E
:
Evaluate and define the problem. Examine relevant personal, societal, agency, client, and professional values. Gather information from all possible sources.

T:

Think about which ethical standard applies, as well as relevant laws and agency rules. Brainstorm possible actions and decisions.

H
:
Hypothesize about the possible consequences of different actions.

I
:
Identify who will benefit and who will be harmed.

C:

Consult with supervisor and colleagues about the most ethical choice.

S:

Select an action. Implement the action. (Ling & Hauck, 2016)

After the action has been implemented, an important final step is to evaluate the action. Who has been harmed? Who has benefitted? Is there any additional information that you have gained, that you wish you had known earlier? All of these questions will help you to evaluate the decision and inform your practice for the next time that you face a dilemma.

Activity: Ethical Dilemmas

As a human services worker you are likely to face a situation where there is not a clear answer right away or when you are forced to choose between two or more decisions.  Each choice might bring  undesirable outcomes for one or more persons (Dolgoff, Harrington, & Loewenberg, 2009). These are known as ethical dilemmas.

For each dilemma

1. Identify standards that you would consider using to solve this dilemma.
2. Select the primary standard(s) from that group that speak most directly to this dilemma.
3. Make a note of both groups–those you considered and those you end up selecting.
4. Follow as many of the steps of ETHICS and describe what you would do.

Dilemma One: Fundraising

You work for an agency that serves middle school and high school aged youth. About ⅓ of the youth identify somewhere in the LGBTQ+ community and the agency hosts a regular support group for these youth.

It’s time for the annual fundraiser, and your employer asks you to downplay any mention of the LGBTQ+ support because some of the big funders are opposed to supporting people with this social identity.

Dilemma Two: Pediatric Surgery

You are a medical social worker and a surgeon at a children’s hospital strongly recommends that a child have surgery. The parents of the child refuse to consent to the surgery due to the complications and risks. The surgeon asks you to convince the parents to agree to let him operate regardless of the parents’ concerns.

Dilemma Three: Work Expectations

You are a court advocate for clients. A regular client calls you for help at a scheduled court hearing that has been moved up an hour unexpectedly. You have promised your employer you would stay in the office to answer phones while the administrative assistant is at lunch.

Dilemma Four: Embezzling Funds

A client tells you that he intends to embezzle funds from his employer.

As you can see, ethics must be considered within the context of multiple systems. The most complicated are the overlapping cultures that affect us: the cultural context of the individuals and families that are served, the employers’ beliefs and priorities, the professional’s own culture, and the ways that societal values and policies affect everyone. These are not to be given equal weight, but they are all factors in the work and ethical life of the helping professional. Being ethical requires weighing multiple factors in order to make the best decision that you can in each unique circumstance.