‘Shades of Grey’: The Ethics of Social Work Practice in Relation to Un-prescribed Anabolic Androgenic Steroid Use

Abstract

This paper reflects on some of the ethical dilemmas that social workers face when assessing risk in relation to those using substances. It explores how legislation and societal factors can impact not just on people's choices and decisions but also on their 'vulnerability' and access to services. Vulnerability, a contested term, is linked, in this paper, to assessment of risk. There are ethical issues that arise when assessing risk with people who use Anabolic Androgenic Steroid (AAS) from both service user and professional perspectives. These ethical issues concern a person's right to choose and make potentially harmful decisions. The paper argues that using a substance such as AAS in and of itself does not suffice to make a person vulnerable but that this does not mean that people using AAS are not in need of support. It suggests that there may be some groups of people who are more at risk to starting AAS use and that social workers should be aware of these. It also recommends the need for further qualitative research to understand the reasons for starting use and support to help people stop using AAS.

Generating evidence on the use of Image and performance enhancing drugs in the UK: results from a scoping review and expert consultation by the Anabolic Steroid UK network

“…Practitioners must have an appreciation of the complex relationship between AAS use and body image [ 96 ] and an understanding that there is a perceived normalisation of IPED use within some social groups, with concepts around masculinity and muscularity being highly influential on decisions to use IPEDs [ 91 ]. While the majority of the literature referred to practitioners in general, the potential for an increased role for both social workers [ 115 ] and endocrinologists [ 116 ] was highlighted.…”

“…Motives for commencement, continuation, and potential cessation of IPED use should also receive continued research attention [ 92 , 98 , 120 ]. Key examples identified for further attention include body image [ 96 , 97 , 129 ], muscle dysmorphia [ 94 ], muscularity [ 82 ], masculinity [ 87 , 130 ], and hypogonadism [ 99 , 113 , 115 ]. Research findings indicate a combination of routinely available data, survey data and other novel data collection methods should be employed [ 95 ], including online methodologies to gain a better understanding of the prevalence of use and associated behaviours [ 15 , 45 , 64 , 74 , 116 , 127 ].…”

Development of a scale to measure moral disengagement for occupational gains to enhance our understanding of the use of Performance and Image Enhancing Drugs (PIEDs) in the workplaceDevelopment of a scale to measure moral disengagement for occupational gains to enhance our understanding of the use of Performance and Image Enhancing Drugs (PIEDs) in the workplace

“…The link between moral disengagement and workplace behaviours in different occupations highlights the need to develop a measure of moral disengagement that is indexed to the use of PIEDs in specific occupations. Within these occupations each employee has the right to choose and make potentially harmful decisions; that using these drugs does not make one 'vulnerable' (Harvey, 2018). Employees also rationalise…”

Nonprescribed androgen use among women and trans men

“…One metaanalysis estimates the global lifetime prevalence rate among women to be 1.6% and 6.5% among men [9]. Women's comparatively lower use, secrecy and stigma around use [10][11][12], and illegality in some countries [13,14] may further explain the relative dearth of attention to women's use.…”