Ethics of Self-Determination in Medical Settings (1.5HR)

Medical settings present service providers with diverse patient situations and circumstances which sometimes involve ethical dilemmas. This training will present an overview of key social work ethical principles and frameworks. Specific ethical dilemmas in medical settings will be presented through case studies, including decisional capacity, competence, cultural factors, and autonomy. Participants will be encouraged to use critical thinking skills, ethical principles, and ethical decision-making models to arrive at best practice decisions regarding medical self-determination cases.

Upon completion of this training, participants will be able to:

• Analyze self-determination ethical dilemmas in case studies.
• Identify key ethical concepts and considerations in medical self-determination.
• Review and summarize the social work code of ethics values, principles, and standards.

Syllabus:

Introduction to Self-Determination

• Define client self-determination and its application in healthcare
• Explore client rights to make or change decisions during illness
• Examine implications of decision-making when capacity is in question

Objective #1: Ethical Dilemmas in Medical Contexts

• Define ethical dilemmas as competing professional values
• Understand when ethical content is present in clinical scenarios
• Analyze case vignettes involving patient autonomy and provider authority

Objective #2: NASW Code of Ethics and Professional Standards

• Review Section 1.02: client self-determination
• Highlight core value: dignity and worth of the person
• Discuss when self-determination may be limited due to risk

Objective #3: Skills and Frameworks for Ethical Decision-Making

• Ethical assessment including laws, cultural values, and regulations
• Use of problem-solving models to navigate ethical conflicts
• Application of the 4-Box Method for analyzing cases

Objective #4: Key Ethical Principles in Practice

• Autonomy: supporting informed, intentional, and voluntary decisions
• Beneficence: promoting well-being and minimizing harm
• Justice: ensuring fair and equitable treatment
• Non-maleficence: avoiding unnecessary harm

Objective #5: Clinical Case Examples and Reflection

• Analyze real-world scenarios involving fall risk, DNR orders, and information sharing
• Reflect on competing values such as privacy, respect, and beneficence
• Use case-based questions to explore provider decision-making

Objective #6: Decision-Making Capacity vs. Competence

• Differentiate between specific decision capacity and global competence
• Explore assessment tools such as MSE, orientation, memory, and understanding
• Discuss temporary impairment and timing of consent in acute care

Objective #7: Cultural Considerations and Paternalism

• Acknowledge the limits of Western bioethics in diverse cultures
• Understand family-centered vs. individual-centered decision-making
• Analyze paternalism and its ethical risks in medical decisions

Objective #8: Special Considerations with Minors

• Introduce the Mature Minor Doctrine and exceptions to parental consent
• Discuss minor status categories and services eligible for minor consent
• Review ethical challenges in balancing protection and autonomy for minors

Objective #9: Integrating Ethical Practice in Client Work

• Start with open-ended questions to understand client values and preferences
• Clarify goals and assess for imminent risk or harm
• Consult with colleagues and remain flexible in approach
• Reflect on personal motivations and ensure client-driven direction

Social workers completing this course receive 1.5 Ethics asynchronous continuing education credits.

For other board approvals, this course qualifies for 1.5 Ethics continuing education training.

Instructor: Diane Bigler, LCSW, LSCSW

Recording Date: June 8, 2024

CEUS On-Demand, LLC, provider #2274, is approved as an ACE provider to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Regulatory boards are the final authority on courses accepted for continuing education credit. ACE provider approval period: 08/7/2025 - 08/6/2026. Social workers completing this course receive 1.5hrs Ethics continuing education credits.  

CEUs On-Demand, LLC has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 7091. Programs that do not qualify for NBCC credit are clearly identified. CEUs On-Demand, LLC is solely responsible for all aspects of the programs.

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Request for Special Accommodations: Learners can request special accommodations by contacting the administrative team at admin@ceus-ondemand.com