Advanced human services professional practitioners are bound by laws (e.g., Title VII of the Civil Rights Act of 1964), by the NOHS code of ethics, and by organizational policies and procedures that promote ethical behavior and cultural sensitivity. Practitioners may encounter challenges when the laws, code of ethics, and organizational policies and procedures conflict. For example, suppose a service user asks the practitioner to pray with them at an intake assessment because they are experiencing stress. The practitioner reluctantly agrees to pray to avoid exacerbating the service user’s stress, even though the organization’s policy prohibits discussing religion. Leaders created the policy to prevent practitioners from trying to convert service users to their religion. The practitioner’s supervisor ultimately decides to terminate the practitioner for violating the policy. Did the supervisor make the right decision? How might these and other violations be better addressed?
For this Discussion, you will explore a human services organization’s policies and procedures to determine how ethics training is addressed in relation to maintaining appropriate boundaries and cultural sensitivity. You will also use the NOHS code of ethics to evaluate the organization’s response to violations of policies and procedures.
• Identify a local human services organization with which you are familiar. This could be an organization in which you currently work or have previously worked, an organization in which a friend or family member works, or an organization that is well-known in your community.
• Go to the organization’s website and find the policies and procedures. Read the policies and procedures, paying particular attention to how the organization addresses ethics training in relation to maintaining appropriate boundaries and cultural sensitivity. In addition, consider the following questions:
o Are there professionals who come from the same cultural groups served?
o Are professionals given training on self-reflection in order to be aware of potential bias or imposing their own values?
o Are alternative healing practices needed and implemented?
o How do the cultures in this community view mental health?
o Are assessments biased in terms of worldview or linguistic accessibility?
o Are interpreters available for all language groups?
o Are there cultural differences in symptoms or disorders?
o Are microaggressions evident?
o Are services restricted based on religious principles?
Sample Answer
The situation presented involves a direct conflict between an organizational policy, ethical considerations (client well-being), and the potential for a culturally sensitive response.
Analysis of the Supervisor's Decision
The supervisor's decision to immediately terminate the practitioner for violating the organization's policy on discussing religion is likely too harsh and arguably not the "right" decision from a comprehensive ethical and corrective standpoint.
Ethical and Policy Conflict
Organizational Policy: The practitioner violated a clear policy prohibiting religious discussion. This policy's intent is sound (preventing conversion/imposition of values). Policy violations typically warrant disciplinary action.
Ethical Justification (Client Welfare): The practitioner's intent was rooted in the core human services principle of client welfare and avoiding harm (Nonmaleficence). The practitioner made an immediate, high-stress judgment call to alleviate the client's current distress.
NOHS Code of Ethics:
Standard 7 (Confidentiality): Not directly violated, but the standard emphasizes the primary responsibility to the client.
Standard 9 (Client Self-Determination): The client initiated the request, honoring their cultural/spiritual need for coping, supporting self-determination.
Standard 11 (Client Welfare): The practitioner acted to prevent exacerbating the client's stress.
Standard 12 (Imposing Values): While the action risks imposing values, the context suggests the client initiated the action and the practitioner reluctantly agreed to avoid harm.
Standard 27 (Organizational Policies): Practitioners must be knowledgeable about and adhere to policies, but must also "work toward the modification of any that limit the rights of clients or the ability of the practitioner to provide appropriate services." This suggests a mechanism for dealing with policy limitations in practice.
Rationale Against Termination
Intent vs. Impact: The practitioner's intent was ethical (to help the client), while the impact was a policy violation. Termination should be reserved for egregious or repeated violations, or actions taken with malicious or self-serving intent (like actual proselytizing).
Proportionality of Discipline: Termination is the most severe penalty. A more proportionate response would be a written warning, mandatory remedial ethics/cultural competency training, and guided supervision on navigating such conflicts.
Lost Opportunity: Termination loses a practitioner who, though imperfect, demonstrated a commitment to client well-being and a nuanced understanding of cultural coping mechanisms.
Addressing Policy and Ethical Violations Better
Instead of immediate termination, human services organizations should adopt a restorative and corrective approach that emphasizes training and procedural clarity.