Danger and Ethics

Outline key issues utilizing the 4-Box Model of ethical analysis, as well as any further information you feel it would be helpful to obtain; 2) outline the steps you would take to reach your ethical decision, utilizing the decision-making template, incorporating the NASW Code of Ethics and keeping in mind the context in which health.

You are a social worker covering the NICU. Two of the parents you are working with are Roberta and Jasmine, whose infants are expected to be in the NICU for 6-8 weeks. Both Roberta and Jasmine are from out of the area, and Medicaid is paying for them to be staying in local housing while their infants are NICU patients. Roberta and Jasmine had begun a friendship, given they were staying in the same local hotel and frequently saw each other in the NICU. From your initial assessment, you know that Jasmine is a single parent, but the baby's father is present in her life, visiting on weekends when he is not working construction jobs. Jasmine has a history of gang involvement and some drug history, but states that she is "done with that now". Your assessment and interactions with Roberta revealed multiple concerns about her ability to parent, including a recent history of drug use, behaviors indicating intoxication while visiting her baby, a partner (not the father of the baby) who has "appeared threatening" to a nurse on the unit when she intervened in a loud argument between Roberta and her partner, and a CPS history, including removal of Roberta's other child one year ago.

Last week, Jasmine told you that Roberta had asked to buy Jasmine's urine, so that she could present that sample to the doctor requesting a urine analysis (a CPS requirement, given her drug history). Jasmine had refused.

Today Jasmine asks you to work with her Medicaid broker to find her another place to live. She states that she cannot go back to the hotel because Roberta thinks that Jasmine reported her to CPS, and both Roberta and her boyfriend have "threatened" her. You agree to work with the broker, who agrees to provide different housing, but she wants to know more about who made the threat. Because Roberta has a different broker, you tell her that Roberta is not a client with that broker, so it's not something you can disclose.

That afternoon, you get a call from the DSHS office, which oversees all of the agencies in the state who serve as Medicaid brokers. She states that because the situation required a change of housing, which also cost more, that she wants to know who the individual is who is making such threats: "We are not in the business of paying for housing for people who do such things."

You depend heavily on relationships with the brokers and the state in providing resources to your patient families. You also need to continue working with Roberta and Jasmine.