The Use of Modern Technology in Social Work: Ethical Dilemmas

The practice of social work has changed with pride to their respect for clients' cameras in residential facilities, and dramatically since its formal inception privacy. Concern over the years about microphones to monitor clients' behavior nearly a century ago. Methods of interthe confidentiality of information shared or to supervise staff raises a variety of vention, theories of human behavior and by clients has been based on a deepethical issues. To what extent should cli the social environment, research agendas, seated belief that, in all but the most ents be informed about such surveillance? funding and reimbursement procedures, extreme circumstances (for example, when How much detail should clients be pro and training programs have evolved over a client is suicidal or threatens to harm vided? This author recently intervened in the years to keep pace with an evera third party), clients have the right to behalf of a social work colleague whose expanding number of social and personal decide for themselves whether personal supervisor asked her to observe behind a problems with which social workers deal, information should be shared with othone-way mirror an intake interview con Although some of the profession's coners. Traditionally, social service agencies ducted with a client being admitted to a temporary concerns are comparable to have placed a premium on protecting psychiatric facility. The social worker asked those faced by the earliest social workers— records from scrutiny, on release of inforher supervisor whether the client had poverty, child welfare, housing, and health mation procedures, and on informed conbeen told about the one-way observation, care, for example—others were unknown sent, to ensure that clients' privacy is not She was informed that the agency did not, to social work's first practitioners. Present compromised.1 as a rule, tell clients about the use of the concern in the profession about genetic However, with the emergence of commirror. This unfortunate incident is illus counseling, use of psychotropic medication, puter technology in the human services, trative of ways in which the privacy of and victims of acquired immune deficiency there are new concerns about the protecclients may be compromised in clinical syndrome (AIDS) reflects the changing tion of privacy. The widespread use of settings that use covert observation or nature of the modern world—changes that computerized records in both public and detection devices.5 hardly could have been imagined by earlier private agencies certainly simplifies and Social workers in industrial, military, workers in the field, such as Mary Ellen makes more efficient the management of and law enforcement settings are faced Richmond, Graham Tkylor, Jame Addams, large volumes of information concerning with another set of privacy issues, which and Sophonisba Preston Breckenridge. clients. Yet this technology also creates relate to the use of technology to detect Along with the emergence of previously new opportunities to compromise the pridrug or alcohol use and, most recently, to unknown social and personal problems is vacy of records. Easy access to data files screen employees for AIDS. A large number the development of new technology deand to computerized account information of corporations and public and private agen signed to respond to these problems and (such as computer passwords) can provide cies operate such procedures for screening to other perennial issues The introduction unauthorized personnel with confidential job applicants and employees. Social work of computers, neuroleptic medication, and data.2 For instance, a number of states ers employed in personnel divisions and dialysis machines has contributed impreshave developed computer programs to dein employee assistance programs are be sively to the amelioration of a wide range tect welfare fraud and overpayments to ginning to face difficult choices that involve of human suffering. Yet the invention of public assistance clients. These programs honoring their clients' right to confidenti modern technology for therapeutic puruse "computer-aided wage-matching sysality and meeting the expectations of their poses has strings attached: The very availterns" designed to verify individuals' earnemployer—both of which are mandated by ability of technology has introduced a ings by comparing employer payroll records the National Association of Social Workers series of complex ethical dilemmas that with client-reported earnings.3 ComputerCode of Ethics.® The U. S. Defense Depart social workers are just beginning to exaided wage matching has been required ment, for example, recently announced a plore, primarily concerning the allocation for clients receiving Aid to Families with plan to test the 2.1 million people em and possible misuse of this technology. Dependent Children since 1979 and for cliployed by the U.S. military system for the These ethical concerns pertain principally ents of the food stamp program since 1983. HTLV-III virus associated with AIDS.7 In to issues of privacy, behavior control, and As a result, the requirement that informaa recent editorial in the Journal of the health care. tion be shared between state departments American Medical Association, a spokes of employment security and public welfare person for the San Francisco Department departments has led to clashes with reof Health advocated that "all AIDS patients gard to clients' right to privacy.4 be interviewed to obtain their heterosexual From the inauguration of the profession Concern about client privacy also arises contacts," and that these contacts be asked near the turn of the century to the prein clinical settings. The use of one-way to undergo a blood test to determine wheth sent time, social workers have pointed mirrors in treatment programs, concealed er they have been infected with the virus®