Self-Determination and Confidentiality

ABSTRACT

This article seeks to further clarify the ambiguous nature of two of social work's most important values: self-determination and confidentiality. Previous research indicates that many ethical decisions in social work practice are difficult to make; and, many times decisions are made based on the worker's values and experiences rather than on written ethics, laws, and agency policy. To explore this concept further, an open-ended survey instrument was distributed to 82 social work students after completing the required practice classes. The participants were asked whether they would break confidentiality based on a specific vignette and describe what decision was made and why. Results indicated that degree level (MSW versus BSW) proved to be a significant factor related to whether and/or why the respondent would break confidentiality. In addition, students with more paid work experience were more likely to question the issue of confidentiality and were more likely to break it. Two issues reflected in the decision-making process involved ensuring client safety and self-determination. In conclusion, this article explores possible reasons for breaching confidentiality and pitfalls that can occur for all professionals in making these types of decisions. Furthermore, it explores the ambiguous nature of problem solving in this area, and suggests ways that social workers can improve their decision-making skills.

Key Words:

• Confidentiality and social work
• self-determination
• ethics and social work practice
• ethics and confidentiality