Paternalism and Dual Relationships Notes

Paternalism and Dual Relationships

Overview

• Paternalism: An ethical principle where a professional restricts a client's freedom for their perceived best interest.

• Dual Relationships: Occur when a professional has additional roles with a client outside the primary professional relationship.

Key Concepts

• Paternalism Defined:

  • As per Reamer (1999), it restricts a subordinate's freedom in the "best interest" of that individual.

  • The client’s autonomy is sacrificed for their own good.

• Types of Dual Relationships:

  • Roles: Different capacities in which professionals interact with clients (e.g., neighbor, colleague).

  • Timing:

    • Prior to professional relationship

    • During professional relationship

    • After professional relationship ends

  • Behaviors: Examples include physical gestures (hugging, shaking hands), gift exchange, and other forms of personal interaction.

Ethical Considerations

• Dual Relationships:

  • Not all dual relationships are unethical but require careful evaluation by the professional.

  • Professionals are responsible for assessing risks of exploitation or harm.

  • Code of Ethics Highlights:

    • Maintain professional boundaries

    • Acknowledge and mitigate conflicts of interest

    • Avoid any relationships that exploit clients.

Moral Hazards in Paternalism

• Risks:

  • Acting paternalistically, even with good intentions, can lead to significant moral dilemmas.

  • Examples include deciding what information to disclose based on perceived harm.

• Common Morality Framework:

  • Gert et al. (1997) describe that paternalistic actions must be justified when ethical boundaries are crossed.

  • Such actions require the violation of at least one moral rule and must occur without the client’s consent.

Application of Concepts in Practice

• Identifying Ethical Dilemmas:

  • Social workers must recognize moral questions and ethical conflicts arising from dual roles.

  • Clients' empowerment is crucial, while professionals must navigate the inherent power imbalance.

• Case Application:

  • Use the common morality framework to assess whether paternalism is justifiable in specific client situations.

• Guiding Principle:

  • Actions must aim to do the least harm while considering the expressed autonomy of clients.

Learning Outcomes

• Define the different types of dual relationships and their implications.

• Discuss ethical frameworks relevant to dual relationships.

• Apply ethical principles to real-world scenarios involving paternalism and dual roles.

Conclusion

• Understanding paternalism and dual relationships is essential for ethical practice in social work.

• The balance between supporting client autonomy and ensuring their safety often presents complex challenges.

Future Topics

• Informed Decision Making: To be covered in the next class, focusing on informed consent and shared decision-making processes.