Few studies have explored the moral and ethical dimensions of how, in practice, social workers talk about and handle cases as part of their daily work. At the same time, identifying and examining the ethical dimensions of actual social work practice can be challenging because ethics is often hidden within the complex particularities of daily work. This article applies and develops Sarah Banks’ conceptualisation of “ethics work” to examine how care managers in Sweden are “doing ethics”, while seeking and providing collegial support and guidance on how to deal with the wishes of adult (potential) service users who are reluctant to accept support – or whose wishes in the matter are difficult to determine. The study is based on an analysis of 14 audio-recorded case conferences. With the help of Banks’ conceptualisation, the analysis makes visible how the case discussions in question encompass a complex “doing of ethics”, by means of which the welfare of individuals is balanced against care managers’ legal duty to adhere, without exception, to the principle of self-determination. The findings suggest that further research that applies and develops Banks’ conceptualisation of ethics work by examining “actual” social work practice in situ, while recognising the particularities of the social and societal context in which this work is taking place, could provide new knowledge and understanding about both the specific and common challenges that social workers face in different parts of the world. It could also make the ethical dimensions of social work practice more widely recognised and valued.