Ensuring Ethical Practice: An Examination of NASW Code Violations, 1986–97

The NASW Code of Ethics is intended to serve as a guide for practice and as a statement of professional standards that the public may use to hold social workers accountable for their actions. At times, however, the Code's proscriptions may seem overly general, difficult to apply, or unrealistic in light of the challenges workers face daily. How then is the Code interpreted? What actions by social workers may result in findings of ethics violations? This article reviews earlier research on violations of the NASW Code and reports on a recent study reviewing allegations made against NASW members from 1986 to 1997. The article describes the frequency and types of behaviors that resulted in findings of ethical misconduct and offers suggestions for enhancing practice and reducing exposure to ethics complaints. Key words: adjudication; ethics; ethics violations; social workers Ethical social work practice has received increased attention during the past 10 years because of concerns about managing malpractice risk, ensuring quality services delivery, and demonstrating professional competence to the satisfaction of funding agencies and regulatory bodies. Paralleling this sensitivity to ethical practice is the perception that vulnerability to ethics charges has increased-client cases are increasingly complex and multidimensional, there is high risk in bad decisions, and the available resources to address client needs are decreasing while pressures for efficiency are rising. Against this backdrop, the National Association of Social Workers adopted a revised Code of Ethics (NASW, 1997), which more thoroughly explicates the obligations of social workers to their clients, colleagues, and employing organizations. NASW offers the Code as a guide for practice, as a protection for the public, and as a tool for adjudicating complaints made against the organization's members. This increased attention to ethics is reflected in the literature of social work and related professions. Authors have described a range of ethics challenges, such as dual relationships (Kagle & Giebelhausen, 1994), threats to privacy (Corcoran & Winslade, 1994; Davidson & Davidson, 1996), client abandonment (Reamer, 1997), and the duty to warn (Abramson, 1990; Kopels & Kagle, 1993). Elsewhere in the literature, authors have focused on the strategies for managing ethical and malpractice risks (Houston-Vega & Nuehring, 1997; Kurzman, 1995), and still others have examined professional perspectives on ethical practice (Jayaratne, Croxton, & Mattison, 1997; Kugelman, 1992; Smith, McGuire, Abbott, & Blau, 1991). With regard to the incidence of unethical behavior by social workers, Reamer (1995a) reported on malpractice claims filed against NASW members for the years 1961 through 1990. Reamer noted that during that period, 634 claims were filed, and although not all were substantiated, the two most common categories, constituting almost 40 percent of the claims, involved incorrect treatment and sexual improprieties. The latter category, however, was the most costly, resulting in 41 percent of the total damages awarded. Although these are less common, claims regarding the suicide of a patient and failure to warn a third party to protect them from imminent harm also had a high cost, relative to other forms of malpractice. Three studies used NASW-adjudicated cases as a basis for examination. McCann and Cutler (1979) reviewed the ethics complaints (N= 154) filed with NASW between 1955 and 1977 and found that, most frequently, the central issues had to do with the firing of employees, personnel practice violations, and breaches of contracts. Because 25 percent of the complaints were held as having been in violation of the Code, the authors suggested the need for less abstract standards, so that behaviors and professional expectations could be more clearly linked. Berliner's study (1989) examined individual ethics cases filed between 1979 and 1985 and found that of the substantiated complaints (N = 96), the greatest number (n = 27 or 28 percent) were in the category of the social worker's ethical responsibility to organizations, the profession, and society, followed by the category of responsibility to colleagues (n = 26 or 27 percent of violations) and conduct as a social worker (n 24 or 25 percent of violations). …