Ethical Dilemmas in Home Health Care: A Social Work Perspective

Abstract

The survey in this article examined several factors related to the frequency and difficulty of resolving four ethical conflicts in a national sample of 364 home health care social workers. Ethical conflicts regarding the assessment of mental competence, self-determination, and access to services were moderately frequent and difficult to resolve, whereas conflicts over implementing advance directives were infrequent and not difficult to resolve. Each ethical conflict involved multiple stakeholders. Multiple regression analyses revealed significant predictors of the frequency and difficulty of resolving the ethical conflicts. Implications for practice and administration in home health care and social work education are discussed.

Etikk i sykehjem og hjemmetjenester

“…Likeledes mente relativt få at veiledning fra jurister ville løse deres etiske problemer. At etiske utfordringer ikke kan løses med lovregulering eller avviksmeldinger har også blitt understreket i andre studier (24,29,40).…”

Linking unlearning with quality of health services through knowledge corridors

“…Many researchers indicate that health care professionals are likely to feel the burden of outdated knowledge (Gideon et al, 1999;Kadushin, 2004;Kadushin & Egan, 2001;Madigan & Tullai-McGuinness, 2004;Rushmer & Davies, 2004;Wilson, 1988). Inappropriate knowledge influences knowledge corridors open to HHU members and may lead members to share inappropriate assumptions about inappropriate routines.…”

An Application of the Hospital-in-the-Home Unlearning Context

“…They fail because people (e.g., practitioners and social workers) cannot "manage" the tensions between exploring new practices and exploiting old certainties, and they are unable to see the threats they face or appropriately respond to the imperative to change. For example, ethical tensions often arise in homecare between the ethical commitment to the patient's autonomy and self-determination and to the need to ensure the patient's well-being (Kadushin & Egan, 2001).…”