Recognising or Minimising Ethical Trespass? An Exploration of Professionals’ Moral Agency in Prioritising Cases

Abstract

Deciding about priority cases in waiting lists is a controversial activity. However, it is a well-known challenge for many social workers. This article addresses two questions related to this problem: how do social workers, as moral agents, experience the policy context in which they must prioritise cases, and what stance do they take towards it? Building on a previous study where a practice of case prioritisation was observed, semi-structured interviews were conducted (n = 11) to explore these questions. The data were analysed through an inductive process of deepening interpretation. The findings paint a picture of ambivalence: the professionals adhere to the policy guidelines of neutrality, priority for the worst-off and equal application of criteria, which are at the same time contradicted by their lived experience. The decision-making process appears to be much more contextual, particularistic and interpretative than the policy guidelines suggest. Questions are raised as to why this reality remains hidden after a discourse of simple rule-following.