Military Social Work and the Ethical Dilemmas Associated
Katelyn Elizabeth Hutchins
Elizabethtown Community and Technical College
Ms. Jo Yates
Human Services 102
October 10, 2018
Military Social Work embarks many conflicts and complications, although it encompasses high rewards and offers a great opportunity for learning that Social Workers may not receive elsewhere. Civilian Social Work and Military Social Work are much alike but show great differences as well. There are ethical issues regarding confidentiality, conflicts between commanders and social workers, ethical dilemmas regarding relationships and boundaries, and complications regarding time pressing issues. Social Work in the United States Military imposes many complications, in which Civilian Social Workers would not have to consider. How do Social Workers in the military deal with troops, during wartime, who wish to go home? Do they impose greater risks to mental damage by sending their patients home, or forcing them to stay? Do Social Workers have a higher command than the commanders themselves? How do Social Workers in the United States Military deal with relationships and maintaining boundaries? This paper will explore the depths of each of these topics, mainly in relation to wartime issues, and how they have been resolved and utilized in real time.
Keywords: Confidentiality, Relationships and Boundaries, Ethical Dilemmas
We all realize the importance of confidentiality in the civilian setting of Social Work. Confidentiality helps to build and maintain trust with your clients. There are many ethical dilemmas in the civilian world regarding confidentiality. These ethical dilemmas include, but are not limited to, considering where to store client information and sharing important, or life-threatening, information with colleagues. How does this work in a military setting? Are Military Social Workers even able to guarantee confidentiality to their clients during a time of war? In the Journal Article, “Ethical Challenges of Military Social Workers Serving in a Combat Zone,” published by Catherine Simmons and Joan Rycraft, two military commanders commented on the topic of confidentiality. A Captain in the United States Air Forced reported that “There’s very little privacy. A patient’s issues are quickly known to his unit and to the base. It’s a fine line on protecting the client’s right to privacy and the ‘need to know’ for Commanders.” (Simmons & Rycraft, 2010). In addition, a Navy Commander similarly reported that “Privacy was concerning to me. Everybody seemed to know everybody else’s business. I dealt with it by sticking to my guns and got consent when needed” (Simmons & Rycraft, 2010) These two military commanders have painted a clear picture to show that there are great concerns when working in a Military setting during wartime regarding the position of Social Work. The Air Force Captain has specifically made it clear to us that confidentiality is not guaranteed by any means. Often time, during war, the units are kept very small and words spread like wildfire. However, the Navy commander made a great point that “getting consent when needed” was his way of coping with the ethical concerns with confidentiality and should be considered in the decision-making progress during critically stressful times.
Military Commanders vs. Military Social Workers
There are many huge decisions to make during wartime. Many types of decisions that people will often never have to consider making in their entire lifetime. When it comes to the military, they are extremely strict, as we all know. There are piles of documents that must be filled out and submitted before you are even granted the ability to enter any branch of the United States Armed Forces. Therefore, when making the personal choice to enter the military, people must realize what they are signing on the dotted line for, and they do. Often there are moms and dads that get deployed into war, and their children press their small faces into their bedroom window waiting for their parents to come back home. This takes a mentally draining toll on some people during their time away from home, and can affect their ability to remain logical, and imposes huge ethical issues for Social Workers themselves. Often, the central question is “Is this person well enough to continue to fight, or should they be sent home?” As stated in Ethical Dilemmas of Military Social Workers Serving in a Combat Zone, an Army Major commented that you should “First assess for dangerousness and prognosis, then look at motivation. Most soldiers want to complete their mission so when they “want” to go home as their presenting problem, it is suspect. First, they may be manipulative and second, they may want to go home in response to some problem at home and do more harm there. We must assess all aspects of the situation thoroughly. We have to do this without prejudice. In a true MH mental health emergency, no one gets held in theater without a plan or given special treatment because of rank. (Simmons ; Rycraft, 2010) Although Military Social Workers can assess a person’s mental state and determine if it is right for them to go home, they do not always get the final say. An Air Force Major stated that “We are merely advisers. The commander is the one who makes the final decision about the troop” (Simmons & Rycraft, 2010) and similarly, a United States Air Force Captain responded that “We have to request supervisors to do something when someone is suicidal” (Simmons & Rycraft, 2010) I believe that this can cause conflict, not only between commanders and Social Workers, but also between clients due to lack of power in the Social Workers hands. The Social Worker is someone that the client trusts to be on their side, but even when the most suicidal person walks through the doors, the Social Worker still has minimal ability to send them home during a time of combat. The general mindset seems to be that it is better to keep military personnel in the combat zone, rather than to send them back home to their families. It is stated by an Army Major that “We do operate with a different paradigm. Our job is to return soldiers to the fight and to conserve the fighting strength. In sending a traumatized person back to duty, we may be exposing them to future trauma. However, by evacuating them too soon, we may create evacuation syndromes or cause a soldier to commit suicide because they believe they failed their mission.” (Simmons & Rycraft, 2010) Similarly, an Air Force Major commented that “if we send them home, someone else has to take their place. The cost of sending them home is greater for both the individual and the unit than keeping them in place.” (Simmons & Rycraft, 2010) Both of these branches of the armed forces argued that it is much safer, and cost-effective, to convince members of the military to continue to fight for their mission than to return home. Not only are Social Workers combating with commanders to help to meet individual needs, but they are having to look at the greater whole of the units and their mission. This often results in using manipulation to convince patients that they are going to be okay and reassuring them that when they return home they will have the chance to get treatment and better themselves.
Relationships and Boundaries
In the civilian world, you would more than likely live a few miles away from your clients at least. In the military, during times of combat, this is not the case. In the United States Military, Social Workers are battling to find solutions to boundary complications. An Army Captain reported that “I remember one afternoon in Kuwait, while waiting to redeploy with my unit, I looked around the tent I was in and noticed I was surrounded by “patients.” The majority of the women I had counseled at one time or another in the past year. I chuckled to myself then, but it is quite a difficult thing to deal with sometimes. A military social worker on deployment eats, sleeps, showers with people they will see professionally as well. Again, boundary maintenance was critical. I had to learn when to say no to a soldier coming to my room in the middle of the night “to talk.” (Simmons & Rycraft, 2010) Your patients have become adopted as your battle buddies as well. How do you find a balancing medium? According to this Army Captain, sometimes you just have to say no. Although it is disheartening to see that many clients in the Military Social Work setting are struggling to maintain friendships and relying on one another for support, Social Workers also must also keep in mind that they have to maintain their professional relationships with their clients. “However, when normal boundaries are impossible because of the isolation and smallness of a unit, privacy and confidentiality become more difficult. As one Army major explained, if you’ll pardon the blunt report … it was entirely odd to work on a mental health issue with a client and then find yourself standing right next to the guy an hour later … with both of you naked and showering. (Simmons ; Rycraft, 2010) Chuckle, if you must, but this breaks into an entirely new realm of complications and raises other questions regarding ethics in the Social Work setting. In the journal Article “Military Social Workers at War: Their Experiences and the Educational Content That Helped Them,” written by Catherine Simmons and Vaugh, DeCoster, an Air Force Captain commented on the issue of loneliness during combat time. The Captain commented that “The aloneness in terms of the professionalism, in terms of being the only mental health provider, the physical environment, and the separation from my family were all difficult. The deployment forces you to deal with issues yourself while also trying to help others with their similar issues.” (Simmons ; DeCoster, 2007) She states that she was forced to learn how to work through her issues alone, which can cause huge issues when Military Social Workers have issues going on for themselves as well. In Non-Military work settings, there are often supervisors to consult during times of hardships, when complications are arising for themselves. However, this is not the case for Social Workers in a combat zone. Can you imagine how this may affect the success of their clients?
Time Pressing Decisions
Military work or not, we have all experienced the issue where we have had to make decisions at the last minute to save ourselves or others. The United States Military Social Workers deal with time-pressing decision making for their clients, as well as struggling to keep in mind the importance of safety for themselves and the unit. As stated in the Journal Article “Ethical Challenges of Military Social Workers Serving in a Combat Zone,” “When making decisions about actions that are considered right or wrong, both social workers and military members are required to carefully consider the ethical values and responsibilities to which their respective organizations subscribe. In the case of military social workers, both sets of values and responsibilities apply. During peacetime and in noncombat situations, these ethical challenges are frequently less pressing because there is usually more time to weigh options” (Simmons ; Rycraft, 2010) It is also stated that “However, during wartime, these challenges are often more complicated, and decisions need to be made under circumstances that are less familiar, less stable, time-sensitive, and tremendously more difficult than those experienced during peacetime or in noncombat situations” (Simmons ; Rycraft, 2010) There are many complications that follow the inability to make a rational decision in the limited time provided.
Although we have discussed several negative components of becoming a Social Worker in the United States Military, it includes a multitude of rewards and skills that are not offered elsewhere. An Air Force Captain expressed that “Everything was rewarding. The experience itself was rewarding. As a social worker, I never thought I would be out fighting a war or even a component of that. Being a social worker and being out with the flyers and warfighters and helping them with stressful things was one of the most amazing things I’ve ever done.” (Simmons ; DeCoster, 2007) Although Military Social Workers endure great hardships from their job, so do Non-Military Social Workers and both find their work extremely rewarding. It is important to note and explore the challenges and ethical issues that one may face in their future endeavors at any career that they may adopt. It is always the Social Workers duty to take care of others, while also remembering to care for themselves. It is critical to assess personal values, remain open-minded, learn how to accept the differences of others, remember the pressing complications of time, and to love each other unconditionally, especially during exceptionally stressful times. Although this job, like many others, is extremely stressful the rewards always seem to pay off. Are you Social Work strong?
Simmons, C. A., ; DeCoster, V. (2007). Military Social Workers at War: Their Experiences and the Educational Content That Helped Them. Journal of Social Work Education, 43(3), 497. Retrieved from Questia.
Simmons, C. A., ; Rycraft, J. R. (2010). Ethical Challenges of Military Social Workers Serving in a Combat Zone. Social Work, 55(1), 9. Retrieved from Questia.