The following cases are relatively short snapshots of dilemmas involving responsibilities to clients, communities or society. Choose four of the seven narratives and create short (3 to 4 paragraphs) solutions to these questions using the values, ethical frameworks, and NOHSE guidelines we have explored so far in this course.
A woman studies on a laptop.Please indicate which cases you are writing about, either as a title line or an introductory sentence. Submit your responses, below.
Case One: A Financial Dilemma
Case #1 in Reamer (p. 145) – Ethics of Funding Cuts: Natalie K. is the executive director of the Camden Yards Drug Treatment Center. The center provides counseling and supportive services for individuals who have substance abuse problems. For years, the center has depended upon state contracts and fees paid by insurance companies and self-pay clients. Natalie K. was recently informed by the director of the state’s substance abuse division that state funding for the new fiscal year is to be cut by 25 percent. State revenues have been down because of a sluggish economy and, as a result funding for most state programs must be reduced. Natalie K. knows that it will be impossible for her staff to continue serving as many clients. During the past year the center’s staff served approximately 500 people most of whom were state subsidized. Ordinarily the agency has no waiting list or has a short one. Natalie K. estimates that with the funding cuts her staff will be able to serve only about 325 clients. Natalie K. has assembled her staff to give you the bad news. She has told you that together you will have to decide how to distribute the limited funds. She wants each of you to think about it for a week and present a proposal that explores the ethical issues and will be both feasible and equitable. You are to prepare a three to four paragraph summary of your recommendations and ethical rationale for your recommendations.
Case Two: Ethics and Social Controversy
Case #2 in Reamer (p.150) – Ethics and Social Controversy: Shelly G. is the executive director of the Metropolitan United Federation, the local organization responsible for soliciting donations and raising funds to be distributed to social service agencies. As part of her responsibilities, Shelly G. oversees the annual allocation of the organization’s funds to member agencies.Ordinarily the Metropolitan United Federation distributes money to a wide variety of social service agencies, including programs for the elderly, children, substance abusers, homeless, disabled, mentally ill and so on. Funding decisions are based on recommendations submitted to the organizations board of directors by several different allocations panels that review proposals prepared by agencies requesting funds.This year Shelly G. and the organization’s board of directors find themselves embroiled in a difficult controversy. An allocation panel approved funding for the local Planned Parenting agency. Planned Parenting offers a wide range of services including sex education throughout the community, contraception, abortion counseling, and abortion.Two members of the (11 member) board of directors were appalled by the decision. They argued that the United Federation should not be funding an organization that supports abortion-related services. These two members contacted anti-abortion groups, which subsequently threatened to mount negative publicity and to discourage potential donors from contributing to the United Federation campaign. Shelly G. has called a special meeting of her executive committee (of which you are a member). She worries that the Federation will be significantly harmed by the negative publicity, but wants to explore the agency’s ethical responsibilities in this matter. She wants each of you to think about it for a week and present a proposal that explores the ethical issues and will be both feasible and equitable. You are to each prepare a three to four paragraph summary of your recommendations and ethical rationale for your recommendations.
Case Three: Clients’ Rights v. Neighborhood Rights
Case #3 in Reamer, (p. 153) – Clients’ Needs v. Community Rights: Aaron K. is the assistant director for program services in the state Department of Mental Health. One of his primary duties is to establish, fund, and monitor community based facilities for mentally ill individuals. In light of the emphasis on deinstitutionalization in mental health care, Aaron K’s responsibilities have increased substantially over the years.Aaron K. is attempting to establish a new group home in a section of the state that has not had any community based facilities. The proposed home would accommodate seven residents who would otherwise be cared for in one of the state’s psychiatric hospitals. Following procedures used in his successful efforts to establish group homes elsewhere in the state, Aaron K. consulted with local community leaders and officials, architects, and community representatives. He and his staff identified an appropriate residence that had been foreclosed by the bank that held the property’s mortgage.Shortly after construction crews began appearing at the house, Aaron K. received a telephone call from a lawyer who told Aaron K. that she had been retained by “a group of concerned community residents” who are upset about the state’s plan to establish a group home in their neighborhood. The lawyer told Aaron K. that the group is not pleased with the way the state “decided to dump this residence in the community’s backyard.” and that her clients are planning to go to court to stop further work on the house. The lawyer has invited Aaron K. to discuss the possibility of locating the group home elsewhere.”Imagine you are Aaron K. What values, ethical frameworks, and human service ethical principles would apply in this situation? What are your responsibilities to the following: the clients who need a new home, the complaining neighbors, the broader community that has already approved construction, the contractors, your own ethical standards. What ethical approach do you think you would take and why?
Case Four: Human Services and Political Action
Case #4 in Reamer, (p. 157, Case 5.4 modified) – Human Services and Political Action: You are a member of the legislative committee of a large human service professional organization. Susan R. is director of the state Department of Social Services. She was appointed to the position shortly after the current governor was elected to office two years ago.The governor has informed Susan R. (and at a recent conference of human service professionals, she has informed you and your colleagues) that because of a recent financial crisis, each department will be expected to reduce its budget by 10 percent during the next fiscal year. … Susan R. explained that to comply with the governor’s mandate, her department will have to reduce the number of people eligible for emergency public assistance from 153,000 to 110,000. That is, approximately 43,000 people, primarily single people who are unable to work, and require emergency welfare assistance and health care, will not receive state aid. In her speech, Susan R. acknowledged that this is a bitter proposal, however, she claimed that this is the only way to meet the governor’s required budget cuts.”Immediately after Susan R’s speech the board of directors of the professional association held an emergency meeting to consider ethical strategies for approaching the budget cuts to emergency funds. Some people argued that the cuts were fair since they affected all state funded programs by an equal percentage. Others argued that they were not fair because many programs rely on other sources of funding, making state funds a rather small proportion of their budgets. Still others argued that the state funds many “nice, but not necessary” programs for the middle and upper classes that they could well afford to pay for, but that the loss of emergency assistance might well mean the difference between life and death for the 43,000 poor people affected. It is clear that there will be no increase in the total amount of funds allocated to human services, but many on the board of directors feel that it should be better allocated. You are charged with sorting through this dilemma and developing a policy statement that the association will use as a basis for lobbying the governor, the state Department of Human Services, and the state legislature for a change in policy. Develop a short policy statement and three or four paragraphs summarizing the ethical reasons for your recommendation.
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