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Ethical Conflict in Adolescent Substance Abuse: Analyzing Self-Determination vs. Best Interest using the ETHIC Mode

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The document is an academic paper titled "Ethical Dilemma in Social Work" that analyzes a scenario involving a minor seeking help for substance abuse, focusing on the conflict between the ethical principles of self-determination and best interest/informed consent. The paper examines the ethical dilemma faced by a social worker regarding a 15-year-old client named Ken, who is coping with clinical depression and substance abuse (ecstasy and crystal meth). Ken consents to enrolling in a state-funded program but insists the social worker must not inform his parents about his drug problem. Core Conflict and Value Conflicts: The primary conflict is Self-determination vs. Best Interest. Self-determination: Respecting Ken's wish for confidentiality and autonomy in seeking treatment. Best Interest: Recognizing that Ken is a minor (underage) and may not be cognitively competent to give full informed consent, making the parents the custodians of his "best interest". Sub-conflicts: Confidentiality (social worker's duty) versus morality of disclosure (risk of adverse outcomes or lawsuits for not involving parents). Ethical Principles and Theories: The paper reviews several principles and theories relevant to the case: Principles: Confidentiality (can be breached if disclosure is needed to prevent serious, foreseeable, imminent harm to the client or others ), Informed Consent, Autonomy, Beneficence (do good), Nonmaleficence (do no harm), and Dignity and Worth of the Person. Theories: Virtue Ethics (not informing parents is morally wrong), Consequentialism (judging based on outcomes; informing parents may produce best outcomes for Ken), Utilitarianism (choosing the action that produces the best outcomes for the greatest number of parties), and Deontology (judging based on rules and duty; acting without parental consent is morally wrong if rules require it)

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Uploaded on
November 14, 2025
Number of pages
10
Written in
2025/2026
Type
Essay
Professor(s)
Unknown
Grade
A+

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Ethical Dilemma in Social Work




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Ethical Dilemma in Social Work

History of the Practice Context for Ethical Dilemma

Self-determination is the context of ethics refers to the concept of respecting a
person’s wishes and considering his/her views in decision-making processes in which the
person is a party of interest. The concept mainly applies for persons with predefined
preferences, which they would like to be fulfilled in their absence or incapacity to realize
these wishes themselves. Therefore, as Wehmeyer and Shogren (2016) observe, the preserve
of ‘self-determination’ would then apply for a minimally conscious person and would involve
provide care according to the person’s wishes or desires.

The origin of the idea of self-determination (rights to choose) traces back to the
eighteenth century, during the course of French and American revolutions, following the end
of World War II. The term coined its meaning during the battle for nationalism, which sought
progression towards liberty, justice, and freedom against authoritarian rule. In practice, the
notion of self-determination provided the impetus for de-colonization, and as of today, has
been conflated with independence, in the sense of promoting self-actualization and liberty to
exercise freedom, autonomy, non-discrimination and sovereignty (Danspeckgruber &
Gardner, 2024). According to Quaye et al. (2021), self-determination rights extends to
children, and follows the principle of non-discrimination on the basis of age. This
nonetheless, invites the principle of best interest, which somewhat in contexts argues that
children in their juvenile cognitive capacities may fall vulnerable to adversities, occasioning
the application of the principle of ‘best interest’. Quaye et al. (2021) consider ‘best interest’
in the context of decision-making as that which entails doing or acting within desires of a
patient, to ensure best outcomes as s/he may have wished. In a child’s case, the custodian to
his/her best interests is manly the parent, family or legal guardian.

Case Study Scenario

A social worker working with adolescents has a 15-year-old boy coping with clinical
depression. The boy (Ken-pseudonym) reports to experience troubles, characterized by
strained relationships with parents, struggling with school and staying out past curfew hours.
The turn of events is disturbing to parents who express worries that they were losing their
son. They are worried about the new friends that Ken is making, which comprise of school
drop-out teenagers (Reamer, 2009).
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