Ethics in Adult Guardianships
Ethics in Adult
Guardianships
KATIE KRUKENBERG, LCSW
UNIVERSITY OF MARY
Agenda
Guardianship Responsibilities and Ethical Principles and overlap with
NASW and ND Social Work Codes of Ethics
Ethical Decision Making Models
Ethical Scenarios and Application of Decision Making Models
Guardianship Ethical Principles
NASW Code of Ethics
ND Social Work Code of Ethics
Purpose of a Code of Ethics
(Birkenmaier, et. Al.)
Affirms role as a legitimate profession
Provides guidance for practice circumstances
Sets standards by which public can hold professionals
accountable
“Hasn’t the public a right to know how the
ordinary social worker is likely to act under
ordinary circumstances?”
The Compass , April 1924
Definitions
(Barker, 2003)
Values
Ethics
Code of Ethics
Ethical Dilemma
Ethical Decision Making
National Guardianship Association
Ethical Principles
(National Guardianship Association)
1. A guardian treats the person with dignity.
2. A guardian involves the person to the greatest extent possible in all decision
making.
3. A guardian selects the option that places the least restrictions on the person’s
freedom and rights.
4. A guardian identifies and advocates for the person’s goals, needs, and
preferences.
5. A guardian maximizes the self-reliance and independence of the person.
6. A guardian keeps confidential the affairs of the person.
7. A guardian avoids conflicts of interest and self-dealing.
8. A guardian complies with all laws and court orders.
9. A guardian manages all financial matters carefully.
10. A guardian respects that the money and property being managed belong to
the person.
Core Values from NASW Code of Ethics
Service
Social Justice
Dignity and Worth of the Person
Importance of Human Relationships
Integrity
Competence
ND Social Work Code of Ethics
Not the same as NASW Code of Ethics
Located in ND Century Code
Social workers licensed in ND sign an agreement to
uphold the ND Code of Ethics
Guardianship and Social Work Ethical
Guideline Overlap
National Guardianship Association
Ethical Principles
1. A guardian treats the person with dignity.
2. A guardian involves the person to the greatest extent
possible in all decision making.
3. A guardian selects the option that places the least
restrictions on the person’s freedom and rights.
4. A guardian identifies and advocates for the person’s goals,
needs, and preferences.
5. A guardian maximizes the self-reliance and independence
of the person.
6. A guardian keeps confidential the affairs of the person.
7. A guardian avoids conflicts of interest and self-dealing.
8. A guardian complies with all laws and court orders.
9. A guardian manages all financial matters carefully.
10. A guardian respects that the money and property being
managed belong to the person.
NASW Code of Ethics
6 Core values
Client right to self determination
Informed consent
Competence
Conflict of Interest
Privacy and Confidentiality
Clients lacking decision making
capacity
Ethical Decision Making Models
Does the dilemma meet criteria of
a professional dilemma?
1)
The social worker must decide on a
course of action
2)
Multiple courses of action exist
3)
Regardless of the course of action,
one of the social work ethical
principles will be compromised
(Allen, 2012, p. 4)
Additional Considerations
Importance of training
Good supervision
Ongoing continuing education
Importance of interdisciplinary teams
Health care, behavioral health, community
resource agencies
Idea of “Ethical Humility”
Ethical Dilemmas
Good decisions are rational, not
rationalizations
(Hardy)
Rational Decisions
are the result of a careful
reasoning process evaluating the effectiveness and ethics of
options.
Rationalizations
are stated reasons developed to justify
decisions the decision maker wants to make or has already made.
Resolving Ethical Dilemmas
Codes of ethics provide guidelines, but don’t necessarily tell
us what to do.
There is typically no “right” answer, and often no easy answer.
Negotiating ethical dilemmas and decisions in general is a
life-long learning process.
Kohlberg’s Moral Development
Heinz’s wife was dying from a particular type of cancer.
Doctors said a new drug might save her. The drug had been
discovered by a local chemist and Heinz tried desperately to
buy some, but the chemist was charging ten times the money
it cost to make the drug and this was much more than Heinz
could afford.
Heinz could only raise half the money, even after help from
family and friends. He explained to the chemist that his wife
was dying and asked if he could have the drug cheaper or
pay the rest of the money later. The chemist refused saying
that he had discovered the drug and was going to make
money from it. The husband was desperate to save his wife, so
later that night he broke into the chemist’s and stole the drug.
Reamer’
s Steps in Ethical Decision-Making
(Birkenmaier, et. Al.)
Identify conflicting ethical issues, values, and duties
Identify those who are likely to be affected by the decision
Identify possible courses of action and their respective risks
and benefits
Examine reasons in favor of and opposed to each action
Consult with colleagues and experts
Document decision
Monitor and evaluate decision
Principles of Biomedical Ethics (2009)
Principle 1: Respect for Autonomy
Principle 2: Nonmaleficence
Principle 3: Beneficence
Principle 4: Justice
Ethical Principles Screen
(Dolgoff, et. Al.)
Right to Client Self Determination
“This principle means that the client is ultimately in charge
of making his own decisions and finding solutions to
problems, regardless of whether a social worker agrees
with his course of action. A social worker may provide
guidance and help clients explore their options, but she
may not allow her own opinions and personal biases to
influence the client. This is a difficult dilemma that is
created by the social worker's desire to act in the client's
best interest and the need to respect his right to act in a
way that he feels is best.”
http://work.chron.com/list-ethical-dilemmas-facing-social-work-21946.html
Best Interest
(National Guardianship Association)
to be used in decision-making when the
guardian cannot determine the
preference of the ward, or when the
ward’s preference will cause substantial
harm. Choices should reflect the least
intrusive, least restrictive options that
promote the ward’s wellbeing.
Substituted Judgement
(National Guardianship Association)
This decision-making tool promotes the
self-determination of the ward in
instances where the ward’s preference
is known or can be determined. This
option is ethically preferred and, when
possible, the guardian shall make
choices in conformity with the
preference of the ward.
Ethical Dilemmas
Factors to Consider
Applicable laws
Professional Codes of Ethics
Agency Policy
Evidence Based Practice
Best Practice Guidelines
NGA Standards of Practice
How do I handle a situation when
the ward’s values differ from my
own values, or those of their
involved family members?
Relevant Ethical Principles
Client Right to Self Determination
(NASW/ND Code of Ethics)
Self Determination comes from the core value of Dignity and Worth of the Person
Acting in Client’s Best Interest
(NASW Code of Ethics)
Our need to act in a client’s best interest comes from the core value of Service
(Bryan, et. Al.)
National Guardianship Ethical Principles:
A guardian involves the person to the greatest extent possible in all decision
making
4. A guardian identifies and advocates for the person’s goals, needs, and
preferences.
Autonomy and Freedom (Ethical Principles Screen)
Decision-making Checklist
Is this decision within the limits of the guardian's authority?
What are the alternatives or options and possible outcomes of
each action?
Is the action or treatment congruent with the values and beliefs of
the ward?
What are the ward's feelings and wishes about it?
What are the risks and benefits to the ward if the action is taken?
What are the risks and benefits to the ward if no action is taken?
Is it the least restrictive/intrusive action or treatment available?
If the ward’s preference is unknown, is this action in the best interest
of the ward?
NASW Directives for Clients Lacking
Decision Making Capacity
(Bonifas)
When social workers act on behalf of clients who lack the capacity to make
informed decisions, social workers should take reasonable steps to safeguard
the interests and rights of those clients.
In instances when clients lack the capacity to provide informed consent, social
workers should protect clients
’
interests by seeking permission from an
appropriate third party, informing clients consistent with the clients
’
level of
understanding. In such instances…seek to ensure that the third party acts in a
manner consistent with clients
’
wishes and interests…take reasonable steps to
enhance such clients
’
ability to give informed consent.
Substituted Judgement
Refers to the requirement that the guardian make decisions that
reflect what the ward would have decided if he or she were
capable of making the decision
If unable to determine what the ward would have decided,
required to make decisions based on the best interest of the ward.
You are always encouraged to discuss situations with the ward’s
caregivers, family, and friends unless doing so would violate the
ward’s privacy
When making decisions based on the best interest of the ward, you
must select the least intrusive, least restrictive course of action.
(New Guardian Guidelines, ND Courts Adult Guardianship)
What guidance is there for
decisions pertaining to
medication
permissions/administration?
Relevant Ethical Principles
NASW/ND Code of Ethics
Informed Consent
Client Right to Self Determination
Acting in Client’s Beset Interest
National Guardianship Association Ethical Principles
2. A guardian involves the person to the greatest extent possible in all decision
making.
4. A guardian identifies and advocates for the person’s goals, needs, and
preferences.
Factors to Consider
In deciding whether or not it is in the ward's best
interests, the guardian must consider:
The invasiveness of the medication or treatment.
The likely benefits of the medication or treatment.
The side effects of the medication or treatment
(Wisconsin DHS, 2014)
NGA Standards of Practice Checklist
NGA Standard 14 – Decision Making About Medical Treatment
___Yes ___No ___N/A Does person have duly executed living will, durable power of attorney or oral
declaration of intent?
___Yes ___No ___N/A Have person’s wishes been requested for consideration in decision process?
___Yes ___No ___N/A Does guardian have a clear understanding of the medical issues and discussed
the medical condition, proposed treatment options and preferences with the person placed under a
guardianship order?
___Yes ___No ___N/A Has guardian received an independent second medical opinion when
appropriate and discussed the person’s preference with the physician providing the consultation?
___Yes ___No ___N/A Have legal/ethical considerations been identified and discussed with hospital
ethics committee or legal counsel?
___Yes ___No ___N/A Has the guardian only denied medical treatment after doing a thorough review
of person’s history and determined what the person’s preference would be if he/she was still competent?
___Yes ___No ___N/A Has the guardian sought court authorization for extraordinary procedures?
___Yes ___No ___N/A Has the guardian done everything he/she could to inform the person and get
feedback from the person concerning medical treatment?
___Yes ___No ___N/A Has the guardian discussed palliative care with the person under guardianship
order to determine preferences and values and in keeping with those wishes, incorporate palliative care in
the health plan?
Ethical Principles Screen
(Dolgoff, et. Al.)
Ethical Principles Screen
(Dolgoff, et. Al.)
Rights of wards in long term
care centers pertaining to
mail and visitors
Any times where limitations
needed?
Rights in Long Term Care Facilities
From National Long Term Care Ombudsman Resource Center “Nursing
Home Resident Rights”
privacy in written communications, including the right to send and
receive unopened mail promptly;
A resident shall have the right to receive and send mail or any other
correspondence unopened and without interception or
interference.
to have private written and verbal communications or visits with
anyone of your choice, or to deny or end such communications or
visits.
Relevant Ethical Principles
Client Right to Self Determination
(NASW/ND Code of Ethics)
Self Determination comes from the core value of Dignity and Worth of the Person
Acting in Client’s Best Interest
(NASW Code of Ethics)
Our need to act in a client’s best interest comes from the core value of Service
(Bryan, et. Al.)
Privacy and Confidentiality
Duty to Protect
National Guardianship Ethical Principles:
A guardian involves the person to the greatest extent possible in all decision
making
4. A guardian identifies and advocates for the person’s goals, needs, and
preferences.
Ethical Principles Screen
(Dolgoff, et. Al.)
Ethical Principles Screen
(Dolgoff, et. Al.)
When communicating with client’s
with dementia, it is challenging to
know if it is best to continue to attempt
to relay information to them and solicit
their input, if this is creating confusion,
agitation, or distress due to features of
dementia.
Relevant Ethical Principles
Acting in Client’s Best Interest
(NASW Code of Ethics)
Our need to act in a client’s best interest comes from the core value of Service
(Bryan, et. Al.)
National Guardianship Ethical Principles:
1. A guardian treats the person with dignity.
4. A guardian identifies and advocates for the person’s goals, needs, and
preferences.
Ethical Principles Screen
(Dolgoff, et. Al.)
Ethical Principles Screen
(Dolgoff, et. Al.)
Additional ethical dilemmas
you’ve encountered?
Ethical Principles Screen
(Dolgoff, et. Al.)
Katie Krukenberg, MSW, LCSW
Asst. Professor of Social Work, Director of Field Education
University of Mary
701-355-8087
kbkrukenberg@umary.edu
References
Birkenmaier, J., Berg-Weger, M., &Dewees, M. (2014).
The Practice of
Generalist Social Work
. New York, NY: Routledge.
Bonifas, R. (n.d.). Ethical Issues in Discharge Planning. Retrieved March
1, 2016, from
www.cswe.org/File.aspx?id=37519
Bryan, V., Sanders, S., & Kaplan, L. (2016).
The Helping Professional's
Guide to Ethics: A New Perspective
. Chicago, IL: Lyceum.
Corey, G., Corey, M., & Callanan, P. (2003).
Issues and Ethics in the
Helping Professions, 6th edition
. Pacific Grove, CA: Brooks/Cole.
Hardy, M. (2013).
Ethics In-service
[PPT]. Beach, ND
.
Mattison, M. (2000). Ethical Decision-Making: The Person in the
Process.
Social Work, 45
(3), 201-212.
National Association of Social Workers (1996).
Code of Ethics.
Retrieved from
http://www.naswdc.org/pubs/code/code.asp
.
New Guardian Guidelines Packet.
https://www.ndcourts.gov/Media/Default/Legal%20Resources/Legal%20Self%20Help/A
dult%20Guardianship/New-Guardian-Guidelines-Packet.pdf
Long Term Care Ombudsman. “Nursing Home Residents’ Rights.”
https://ltcombudsman.org/uploads/files/support/Module-2.pdf
Guardian Consent For Psychotropic Medications For Developmentally Disabled Clients
https://www.dhs.wisconsin.gov/clientrights/psychotropic-meds.htm
Communication and Alzheimer's. Alzheimer's Association.
http://www.alz.org/care/dementia-communication-tips.asp. Accessed April 6, 2016.
Caregiver guide. National Institute on Aging.
http://www.nia.nih.gov/alzheimers/publication/caring-person-alzheimers-disease.
Accessed April 7, 2016.
Voyer P. Communicating with people with dementia: Avoiding mistakes. Canadian
Nurse. 2015;111:10.
This presentation delves into the ethical principles and responsibilities in adult guardianships, exploring decision-making models, scenarios, and application of ethical codes. It emphasizes the importance of ethical standards and the considerations needed when acting as a guardian for vulnerable adults.
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Ethics in Adult Guardianships KATIE KRUKENBERG, LCSW UNIVERSITY OF MARY
Agenda Guardianship Responsibilities and Ethical Principles and overlap with NASW and ND Social Work Codes of Ethics Ethical Decision Making Models Ethical Scenarios and Application of Decision Making Models
Guardianship Ethical Principles NASW Code of Ethics ND Social Work Code of Ethics
Purpose of a Code of Ethics (Birkenmaier, et. Al.) Affirms role as a legitimate profession Provides guidance for practice circumstances Sets standards by which public can hold professionals accountable Hasn t the public a right to know how the ordinary social worker is likely to act under ordinary circumstances? The Compass , April 1924
Definitions (Barker, 2003) Values Ethics Code of Ethics Ethical Dilemma Ethical Decision Making
National Guardianship Association Ethical Principles (National Guardianship Association) 1. A guardian treats the person with dignity. 2. A guardian involves the person to the greatest extent possible in all decision making. 3. A guardian selects the option that places the least restrictions on the person s freedom and rights. 4. A guardian identifies and advocates for the person s goals, needs, and preferences. 5. A guardian maximizes the self-reliance and independence of the person. 6. A guardian keeps confidential the affairs of the person. 7. A guardian avoids conflicts of interest and self-dealing. 8. A guardian complies with all laws and court orders. 9. A guardian manages all financial matters carefully. 10. A guardian respects that the money and property being managed belong to the person.
Core Values from NASW Code of Ethics Service Social Justice Dignity and Worth of the Person Importance of Human Relationships Integrity Competence
ND Social Work Code of Ethics Not the same as NASW Code of Ethics Located in ND Century Code Social workers licensed in ND sign an agreement to uphold the ND Code of Ethics
Guardianship and Social Work Ethical Guideline Overlap National Guardianship Association Ethical Principles NASW Code of Ethics 1. A guardian treats the person with dignity. 2. A guardian involves the person to the greatest extent possible in all decision making. 3. A guardian selects the option that places the least restrictions on the person s freedom and rights. 4. A guardian identifies and advocates for the person s goals, needs, and preferences. 5. A guardian maximizes the self-reliance and independence of the person. 6. A guardian keeps confidential the affairs of the person. 7. A guardian avoids conflicts of interest and self-dealing. 8. A guardian complies with all laws and court orders. 9. A guardian manages all financial matters carefully. 10. A guardian respects that the money and property being managed belong to the person. 6 Core values Client right to self determination Informed consent Competence Conflict of Interest Privacy and Confidentiality Clients lacking decision making capacity
Does the dilemma meet criteria of a professional dilemma? 1)The social worker must decide on a course of action 2)Multiple courses of action exist 3)Regardless of the course of action, one of the social work ethical principles will be compromised (Allen, 2012, p. 4)
Additional Considerations Importance of training Good supervision Ongoing continuing education Importance of interdisciplinary teams Health care, behavioral health, community resource agencies Idea of Ethical Humility
Ethical Dilemmas Self- determination Environmental and Policy limitations Privacy Health Care Decisions Responsibility for Safety
Good decisions are rational, not rationalizations (Hardy) Rational Decisions are the result of a careful reasoning process evaluating the effectiveness and ethics of options. Rationalizations are stated reasons developed to justify decisions the decision maker wants to make or has already made.
Resolving Ethical Dilemmas Codes of ethics provide guidelines, but don t necessarily tell us what to do. There is typically no right answer, and often no easy answer. Negotiating ethical dilemmas and decisions in general is a life-long learning process.
Kohlbergs Moral Development Heinz s wife was dying from a particular type of cancer. Doctors said a new drug might save her. The drug had been discovered by a local chemist and Heinz tried desperately to buy some, but the chemist was charging ten times the money it cost to make the drug and this was much more than Heinz could afford. Heinz could only raise half the money, even after help from family and friends. He explained to the chemist that his wife was dying and asked if he could have the drug cheaper or pay the rest of the money later. The chemist refused saying that he had discovered the drug and was going to make money from it. The husband was desperate to save his wife, so later that night he broke into the chemist s and stole the drug.
Reamers Steps in Ethical Decision-Making (Birkenmaier, et. Al.) Identify conflicting ethical issues, values, and duties Identify those who are likely to be affected by the decision Identify possible courses of action and their respective risks and benefits Examine reasons in favor of and opposed to each action Consult with colleagues and experts Document decision Monitor and evaluate decision
Principles of Biomedical Ethics (2009) Principle 1: Respect for Autonomy Principle 2: Nonmaleficence Principle 3: Beneficence Principle 4: Justice
Ethical Principles Screen (Dolgoff, et. Al.)
Right to Client Self Determination This principle means that the client is ultimately in charge of making his own decisions and finding solutions to problems, regardless of whether a social worker agrees with his course of action. A social worker may provide guidance and help clients explore their options, but she may not allow her own opinions and personal biases to influence the client. This is a difficult dilemma that is created by the social worker's desire to act in the client's best interest and the need to respect his right to act in a way that he feels is best. http://work.chron.com/list-ethical-dilemmas-facing-social-work-21946.html
Best Interest (National Guardianship Association) to be used in decision-making when the guardian cannot determine the preference of the ward, or when the ward s preference will cause substantial harm. Choices should reflect the least intrusive, least restrictive options that promote the ward s wellbeing.
Substituted Judgement (National Guardianship Association) This decision-making tool promotes the self-determination of the ward in instances where the ward s preference is known or can be determined. This option is ethically preferred and, when possible, the guardian shall make choices in conformity with the preference of the ward.
Factors to Consider Applicable laws Professional Codes of Ethics Agency Policy Evidence Based Practice Best Practice Guidelines NGA Standards of Practice
How do I handle a situation when the ward s values differ from my own values, or those of their involved family members?
Relevant Ethical Principles Client Right to Self Determination (NASW/ND Code of Ethics) Self Determination comes from the core value of Dignity and Worth of the Person Acting in Client s Best Interest (NASW Code of Ethics) Our need to act in a client s best interest comes from the core value of Service (Bryan, et. Al.) National Guardianship Ethical Principles: A guardian involves the person to the greatest extent possible in all decision making 4. A guardian identifies and advocates for the person s goals, needs, and preferences. Autonomy and Freedom (Ethical Principles Screen)
Decision-making Checklist Is this decision within the limits of the guardian's authority? What are the alternatives or options and possible outcomes of each action? Is the action or treatment congruent with the values and beliefs of the ward? What are the ward's feelings and wishes about it? What are the risks and benefits to the ward if the action is taken? What are the risks and benefits to the ward if no action is taken? Is it the least restrictive/intrusive action or treatment available? If the ward s preference is unknown, is this action in the best interest of the ward?
NASW Directives for Clients Lacking Decision Making Capacity (Bonifas) When social workers act on behalf of clients who lack the capacity to make informed decisions, social workers should take reasonable steps to safeguard the interests and rights of those clients. In instances when clients lack the capacity to provide informed consent, social workers should protect clients interests by seeking permission from an appropriate third party, informing clients consistent with the clients level of understanding. In such instances seek to ensure that the third party acts in a manner consistent with clients wishes and interests take reasonable steps to enhance such clients ability to give informed consent.
Substituted Judgement Refers to the requirement that the guardian make decisions that reflect what the ward would have decided if he or she were capable of making the decision If unable to determine what the ward would have decided, required to make decisions based on the best interest of the ward. You are always encouraged to discuss situations with the ward s caregivers, family, and friends unless doing so would violate the ward s privacy When making decisions based on the best interest of the ward, you must select the least intrusive, least restrictive course of action. (New Guardian Guidelines, ND Courts Adult Guardianship)
What guidance is there for decisions pertaining to medication permissions/administration?
Relevant Ethical Principles NASW/ND Code of Ethics Informed Consent Client Right to Self Determination Acting in Client s Beset Interest National Guardianship Association Ethical Principles 2. A guardian involves the person to the greatest extent possible in all decision making. 4. A guardian identifies and advocates for the person s goals, needs, and preferences.
Factors to Consider In deciding whether or not it is in the ward's best interests, the guardian must consider: The invasiveness of the medication or treatment. The likely benefits of the medication or treatment. The side effects of the medication or treatment (Wisconsin DHS, 2014)
NGA Standards of Practice Checklist NGA Standard 14 Decision Making About Medical Treatment ___Yes ___No ___N/A Does person have duly executed living will, durable power of attorney or oral declaration of intent? ___Yes ___No ___N/A Have person s wishes been requested for consideration in decision process? ___Yes ___No ___N/A Does guardian have a clear understanding of the medical issues and discussed the medical condition, proposed treatment options and preferences with the person placed under a guardianship order? ___Yes ___No ___N/A Has guardian received an independent second medical opinion when appropriate and discussed the person s preference with the physician providing the consultation? ___Yes ___No ___N/A Have legal/ethical considerations been identified and discussed with hospital ethics committee or legal counsel? ___Yes ___No ___N/A Has the guardian only denied medical treatment after doing a thorough review of person s history and determined what the person s preference would be if he/she was still competent? ___Yes ___No ___N/A Has the guardian sought court authorization for extraordinary procedures? ___Yes ___No ___N/A Has the guardian done everything he/she could to inform the person and get feedback from the person concerning medical treatment? ___Yes ___No ___N/A Has the guardian discussed palliative care with the person under guardianship order to determine preferences and values and in keeping with those wishes, incorporate palliative care in the health plan?
Ethical Principles Screen (Dolgoff, et. Al.)
Ethical Principles Screen (Dolgoff, et. Al.)
Rights of wards in long term care centers pertaining to mail and visitors Any times where limitations needed?
Rights in Long Term Care Facilities From National Long Term Care Ombudsman Resource Center Nursing Home Resident Rights privacy in written communications, including the right to send and receive unopened mail promptly; A resident shall have the right to receive and send mail or any other correspondence unopened and without interception or interference. to have private written and verbal communications or visits with anyone of your choice, or to deny or end such communications or visits.
Relevant Ethical Principles Client Right to Self Determination (NASW/ND Code of Ethics) Self Determination comes from the core value of Dignity and Worth of the Person Acting in Client s Best Interest (NASW Code of Ethics) Our need to act in a client s best interest comes from the core value of Service (Bryan, et. Al.) Privacy and Confidentiality Duty to Protect National Guardianship Ethical Principles: A guardian involves the person to the greatest extent possible in all decision making 4. A guardian identifies and advocates for the person s goals, needs, and preferences.
Ethical Principles Screen (Dolgoff, et. Al.)
Ethical Principles Screen (Dolgoff, et. Al.)
When communicating with clients with dementia, it is challenging to know if it is best to continue to attempt to relay information to them and solicit their input, if this is creating confusion, agitation, or distress due to features of dementia.
Relevant Ethical Principles Acting in Client s Best Interest (NASW Code of Ethics) Our need to act in a client s best interest comes from the core value of Service (Bryan, et. Al.) National Guardianship Ethical Principles: 1. A guardian treats the person with dignity. 4. A guardian identifies and advocates for the person s goals, needs, and preferences.
Ethical Principles Screen (Dolgoff, et. Al.)
Ethical Principles Screen (Dolgoff, et. Al.)
Additional ethical dilemmas you ve encountered?
Ethical Principles Screen (Dolgoff, et. Al.)
Katie Krukenberg, MSW, LCSW Asst. Professor of Social Work, Director of Field Education University of Mary 701-355-8087 kbkrukenberg@umary.edu
