The ethics of care – addressing moral dilemmas in social services

For social services working with vulnerable populations, ethical issues are often present in practice. The Covid-19 pandemic has only added to these uncertainties. During the panel ‘Ethics in Community-Based Social Services’, speakers at the 28th European Social Services Conference (ESSC) organised by the European Social Network (ESN) addressed many of the moral dilemmas that social services workers face both in their daily work and in emergency circumstances.

The value of care

The past few months have taught us all is to recognise the incalculable value of care. This was the main message of Francesc Torralba. A philosopher and theologian, Mr Torralba stressed that this recognition should be reflected in a new model of society in general and social services in particular. He emphasised that caring means responding to another person’s needs. Therefore, careful needs assessment should be at the heart of social services planning. This also means that care cannot be of a paternalistic nature but must respect the autonomy of the beneficiary. “To care for someone is to empower their capacities” Mr Torrabla concluded.

Recognising the value of care should entail acknowledging the value of the work done by caregivers, including social services professionals. Iris Kohlfürst, a professor at the University of Applied Sciences in Linz, Austria emphasised that the principle of cost-effectiveness, which dominates the financing of social services, impacts negatively the quality of services and their ethics. “Ethical competence does not come from nowhere”, Ms Kohlfurst stressed. “It is something you have to practice first. And social service workers should be offered a wealth of training in this area”.

Underfunding of social services means that frontline workers carry too heavy a burden. The resulting feelings of being unappreciated cause employees to not value the work they do. And  this is reflected in the way they approach the people who benefit from their support, Ms Kohlfürst added.

Ethical challenges posed by Covid-19

There is no doubt that the pandemic has prompted additional debate on moral questions around caring. Participants in the discussion highlighted a number of new ethical challenges brought about by the Covid-19 crisis. The first of these was the huge number of illnesses and high death rate among nursing home residents. Faced with these data, moving to a community care model is as much a matter of efficiency or economics as it is of ethics. Also, disproportionately high rates of infection among marginalised ethnic groups and poorer populations presents a challenge for care and social services. The data available should prompt decision-makers to plan for the delivery of social and health services in an equitable, accessible and just manner.

Phelim Quinn, Chief Executive Officer at the Irish Health Information and Quality Authority shared how national regulatory bodies in Ireland struggled with balancing the necessity to introduce rapid and effective measures to limit the spread of the virus with the need to protect meaningful relationships of people reaching the end of life. Mr Quinn stressed that a key rule to guide the resolution of such dilemmas is respect for fundamental human rights of people using social services.

Conclusion

The Covid-19 crisis hit our societies after years of austerity in social services in ways that could prove crucial to the post-pandemic recovery process. This has been made clear in ESN report “Covid-19 Impact on Europe’s Social Services. Protecting the Most Vulnerable in Times of Crisis”. But, as Mr Torralba pointed out, a crisis can also be an opportunity. By generating a break in the normal course of things, the pandemic enabled us to recognise the real value of care and made us think about how to plan care services better and more equitably. Panelists agreed that these findings should reach all decision makers in social services and ultimately translate into the delivery of community-based services that are responsive to the individual needs of beneficiaries.

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