How do you balance self-determination with duty of care?

1 What is self-determination?

Self-determination is the ability and right of individuals to make their own decisions and choices about their lives, without undue influence or coercion from others. It is a core value and principle of social work, as it recognizes the dignity, autonomy, and empowerment of clients. Self-determination also implies that clients have the capacity and responsibility to deal with the consequences of their actions.

2 What is duty of care?

Duty of care is the obligation and responsibility of social workers to act in the best interests of their clients, to protect them from harm, and to promote their welfare. It is based on the ethical principles of beneficence, non-maleficence, and justice. Duty of care also involves adhering to professional standards, codes of conduct, and legal requirements.

3 When do they conflict?

Self-determination and duty of care may conflict when your client's decisions or actions may harm themselves or others, or when they may violate the law or the rights of others. For example, your client may refuse to take medication, engage in substance abuse, neglect their children, or express suicidal thoughts. In these cases, you may have to intervene or limit your client's autonomy, which may compromise their self-determination.

4 How do you balance them?

Careful assessment, communication, and collaboration are necessary to balance self-determination and duty of care. To achieve this balance, you should assess your client's situation, needs, risks, and preferences. Communicate with them openly, honestly, and respectfully. Explain your role and responsibilities, as well as the possible outcomes and consequences of their choices. Collaborate with them to find solutions that respect their self-determination while also ensuring their duty of care. Involve them in the decision-making process and seek their consent whenever possible. Additionally, document your actions and rationale in accordance with policies and procedures. Record the details of your assessment, communication, and collaboration with your client to explain the reasons for any interventions or limitations on autonomy.

5 How do you cope with the stress?

Social workers often experience ethical dilemmas, moral distress, or legal challenges while trying to balance self-determination and duty of care. Additionally, they may suffer from compassion fatigue, burnout, or vicarious trauma. To cope with the stress, social workers must practice self-care and seek support. It is important to recognize and acknowledge feelings and reactions, be aware of values, beliefs, and biases, and reflect on ethical principles and professional standards. Additionally, workloads should be managed by prioritizing tasks and delegating when necessary. Reasonable goals and expectations should be set. Well-being should be nurtured by engaging in activities that relax and recharge the social worker. A healthy lifestyle should be maintained, as well as connections with family, friends, and community. Professional help should be sought when needed. By following these principles and strategies, social workers can uphold their ethical and professional obligations while also empowering and supporting their clients.

6 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?