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5.7 References for Extract 4

Barn, R. (1999) Working with Black Children and Adolescents in Need, London, BAAF.

Butler-Sloss, E. (1988) Report of the Inquiry into Child Abuse in Cleveland, London, HMSO.

Department of Health (2000) Framework for the Assessment of Children in Need and their Families, London, Department of Health.

Gardner, R. (2003) Supporting Families: Child Protection in the Community, Chichester, John Wiley.

James, A. and Prout, A. (1997) Constructin
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5.6 Final words

While social work knowledge, skill and experience can make a difference to a family, the contexts in which we practise create the processes which, more than anything else, determine the life chances of us all. Whether social work always contributes to the solution of problems or sometimes actually adds to the problems that some families face is a debate which has existed as long as social work itself. On a more optimistic note, in the end, the vast majority of parents will want to do their be
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5.4 Involving children

The other key person to be consulted is the child herself. Although Jade's ability or willingness to communicate may vary in different contexts, her understanding will remain and for most children this understanding is well in advance of what they are able to communicate verbally. This has important implications and Jade should therefore be included in conversations, even if she does not appear to be participating.

A greater understanding of ways in which to communicate effectively, eve
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5.1 Children's rights

Initial information about the Palmer family

The story of the Palmer family is presented in the audio below, and it provides material about working with families. The case study is a dramatic presentation of a reconstituted family consisting of three generations living in the same household. During th
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4.3 What about communities?

The last activity looked at the key roles from the perspective of Lynne and Arthur as individuals, but in fact it also says that working with ‘families, carers, groups and communities’ is necessary. Do you think that Dev should also be taking account of the Durrants as a family, as carers and as members of a community? Dev's role in assessing Arthur's needs means that he should also take account of his family circumstances, in other words, Lynne and perhaps her sister. Lynne also has a ca
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4.1 Introduction: the social context of social work

Extract 1 discussed the four components of good practice: Knowledge, Skills, Values and Process. From Extract 2 you will now have an understanding of ‘individual people’ in soci
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2.4.2 What are social work values?

Traditionally, one of the things that distinguishes a profession is that it has a set of principles to which its members have to be committed and must put into practice. Sarah Banks defines social work values as:

a set of fundamental moral/ethical principles to which social workers are/should be committed.

(Banks, 2001, p. 6)

The British Association of Social Workers issued a revised C
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1.1.3 Time

The recommended duration of an aerobic exercise session is dependent on several factors, such as the participant’s goals and fitness levels, and the intensity of exercise. Obviously, the higher the intensity of the exercise, the shorter will be its duration. As a general guide the ACSM recommends between twenty and sixty minutes of aerobic exercise, which can be undertaken either continuously – i.e. all at once – or intermittently – i.e. in shorter bouts accumulated during the day (AC
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3.21 Conclusion

This extract has shown that CAM practice raises a variety of ethical issues. Although ethical considerations have different dimensions when applied to CAM, this extract demonstrated that ethical issues – such as consent, competence, boundaries and effective communication – remain central to good practice. CAM practitioners, like all other responsible health care workers, must be taught and encouraged to recognise the ethical dimensions of their work. All practitioners must be accountable
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3.4.5 What can be agreed about ethics?

Even though every person has an idea about what acting ethically means, when faced with an ethically contentious problem, or when it is not clear what will bring about the best outcome, ‘good’ people will act in diverse, and often opposing, ways, while maintaining they are ‘doing the right thing’. While ordinary individuals also have ethical responsibilities to one another (for example, to tell the truth), the duties owed by professionals to their users go beyond everyday ethical resp
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3.4.4 Law imposes more stringent requirements than ethics

All health care practitioners, including those in CAM, must work within the laws of the country where they practise. Although the law does not always reflect what is considered ethical – indeed, ethical duties may be thought of as higher than legal duties – in most jurisdictions it ensures that practitioners are subject, at the very least, to minimal requirements vis-à-vis respect for users' dignity, user information, confidentiality, and maintaining professional boundaries.

Howeve
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3.4.3 Respecting autonomy is the foremost ethical principle in health care

Some commentators believe the pendulum has swung so far in favour of respecting autonomy that it leaves little scope for users to be passive recipients of healing. The desire to make each user an active participant in their own healing process can make it hard, or even impossible, for a user to refuse to engage in active decision making, and leave the decision to the benevolent practitioner. In this case, the user may waive his or her rights, by choosing not to be kept informed about changes
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3.4.2 CAM practitioners are more ethical than conventional doctors

Proponents of CAM argue that because it is safer and has fewer side effects than conventional medicine, CAM practitioners must be inherently more ethical than doctors. This is a false argument in several respects. While CAM is generally very safe compared with some powerful conventional remedies (a point acknowledged in para. 4.21 of the House of Lords Report, 2000), all therapies can cause harm in unskilled hands. Some side effects of CAM are potentially serious, particularly if there is a c
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3.4.1 Practitioners know intuitively what it means to act ethically

Many health practitioners claim they have never encountered an ethical dilemma during their practice. Is this credible, or does it suggest that some practitioners have an insufficiently developed awareness about what constitutes an ethical issue? How many people justify a hard decision simply by saying, ‘I did what felt right'? Gut instinct may currently guide practitioners through some of the complexities of therapeutic relationships, but this is not an adequate substitute for rigorous, re
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3.4 Myths about ethics

The media portray most ethical issues in highly charged terms, so it can be hard to understand what professional ethics is about, and what the full scope of ethical behaviour amounts to. In short, the media rarely explore the ‘grey’ areas of many ethical decisions. For example, the issue of abortion is viewed as either ‘pro choice’ or ‘pro life’. In this way the following myths about ethics are perpetrated.


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3.3 Why ethical behaviour is central to the health care relationship

The health care relationship is basically a relationship of trust. This implies that practitioners are motivated by the users' best interests; will not exploit the therapeutic relationship to satisfy their own ends; will behave in an appropriate manner that is conducive to the healing process; and will refrain from behaviour that could harm users, including being physically or psychologically unfit to treat them. The examples in Author(s): The Open University

3.2 Ethics and health care relationships

Activity 9: Acting ethically

0 hours 30 minutes

Write down a few sentences about what you think ‘acting ethically’ means.


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2.14 Extract 2 References

Armstrong, D. (1987) ‘Silence and truth in death and dying’, Social Science and Medicine, Vol. 24, No. 8, pp. 651–7.

Armstrong, D. (1993) ‘Public health spaces and the fabrication of identity’, Sociology, Vol. 27, No. 3, pp. 393–410.

Budd, S. and Sharma, U. (1994) The Healing Bond: The Patient-Practitioner Relationship and Therapeutic Responsibility, London, Routledge.

Busby, H. (1996) Alternative medicines/alternative knowledges: putting fle
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2.13 Conclusion

All therapeutic relationships can harm as well as heal. In orthodox medicine, the bulk of the responsibility is placed on the doctor, because healing is attributed to specific effects brought about through the doctor's diagnostic and technical expertise. In CAM relationships, where users are expected to exercise self-responsibility, it may be inappropriate to focus solely on the shortcomings of the therapist (even though the law is unlikely to recognise mutual responsibilities when therapy go
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2.12.3 Scientific advances

Advances in science may have dramatic effects on future therapeutic relationships. As specific funding becomes available for testing CAM, and as CAM practitioners start accepting the idea that their future sustainability may depend on them citing scientific research to establish their claims, more information will become available about which aspects of the therapeutic relationship are more, or less, beneficial. This may include research testing the hypothesis that elements of the CAM therape
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