Ethical Dilemmas in General Hospitals

Abstract

Thirty-two hospital social workers, fourteen of them directors of social work services and eighteen direct practitioners, were interviewed about their perception of the factors influencing social workers' contribution to the resolution of ethical dilemmas in general hospitals in Israel. Findings revealed that while ethical decision-making in hospitals is an interdisciplinary process, social workers' contribution to the process is affected by rivalry between social workers and other members of the health team, personality differences, type of ward and the nature of the ethical dilemma. Participants of the study had quite a clear perception of their role and of the unique knowledge-base social work can offer, including knowledge of the individual and family life course, understanding and skills in coping with diseases, and systems thinking. In order to increase their influence in ethical decision-making, the hospital social workers felt they must put more effort into developing their relationships with the other professionals involved in ethical decision-making both by making themselves more indispensable and by making their contribution explicit through greater documentation of their activities. The findings also implied that in order to gain more power and be accepted as equal partners in multidisciplinary teams, hospital social workers should improve their communication skills when interacting with representatives of other heath care professions.

Interprofessional clinical decision‐making process in health: A scoping review

“…Communication within the team should be clear and well‐meaning, with room (and time) for the verbalization of emotions and of experiences in a shared climate of trust and safety, leading to express and accept uncertainty (Berg et al, 2020; Coombs, 2014; Ervin et al, 2018; Fox & Comeau‐Vallée, 2020) and to a collective emotional intelligence (Sinskey et al, 2019). Some studies suggested that the communication skills of doctors, particularly in end‐of‐life situations and of nurses towards healthcare aids could be improved (Brooks et al, 2017; Cranley et al, 2022; Landau, 2000). The tools used for communication and for sharing knowledge have been reported to contribute to the commitment of team members to the decision‐making process (Lee et al, 2021; Simon, 2016), sometimes as simple as using inclusive pronouns (Fox & Comeau‐Vallée, 2020).…”

“…Interprofessional decision‐making is a field of application of this collaboration (Nijhuis et al, 2007). This review presents communication as one of the principal elements of the process and identifies a deficiency of communication skills in interprofessional work in health (Baggs, 1994; Bokhour, 2006; Botes, 2000; Husson, 2011; Landau, 2000). A systematic review of the literature performed in 2017 suggested that nurse–doctor communication remained ineffective (Tan et al, 2017).…”

Türkiye’de Farklı Alanlarda Çalışan Sosyal Hizmet Uzmanlarının Etik İkilem ve Etik Karar Verme Durumları Üzerine Nitel Bir Değerlendirme

“…Furman'ın yapmış olduğu bir başka çalışmada zihinsel sağlık alanında çalışan sosyal hizmet uzmanlarının etik ikilem yaşadıkları sonucuna ulaşılmıştır (Furman, 2003). Landau'nun yapmış olduğu çalışmada hastanelerde sosyal hizmet uzmanlarının etik ikilemlerle karşılaştığı tespit edilmiştir (Landau, 2000). Wilkins'in yapmış olduğu çalışmada ise engelli gençlerle çalışan sosyal hizmet uzmanlarının etik ikilem yaşadıkları tespit edilmiştir (Wilkins, 2012) (Aldoğan, 2018;Acar vd., 2017;Reçber, 2020;Arıkan, 2017;Doyle vd., 2018).…”