As you consider entering the profession of human services, it is important to think about the role you will play as well as the responsibilities that come with that role. One of the joys and challenges of working with human beings is that unique interactions occur every day. Whether you are a director, a supervisor, a receptionist, an assistant, or a case manager, you will encounter situations that you have not seen before. The field of human services was developed in response to human needs and human problems. It is a profession dedicated to helping diverse individuals solve the challenges that they face while valuing each person’s community, culture, and self-determination. While doing so, the professional must act with integrity and compassion with social justice in mind.

There is not a set of directions to follow when you work with individuals. When putting together a piece of furniture or preparing a tray of enchiladas, for instance, you might follow instructions or recipes. You might even deviate a little bit or add your own flair to the project. Working with individuals and families, however, requires a stronger internal set of values and principles. That foundation is one that you build inside yourself using the tools of education, experience, and understanding of ethics, which are the moral principles of the profession.

Figure 3.1. Ethics and values are intertwined with human, regional, national, and world cultures. Figure 3.1 Image Description

Any code of ethics is also embedded within the cultural norms of the local community, the country, and the ethos of the world (figure 3.1). As we examine ethics, we must also look at values and culture. It is important to note that different countries and cultures have differing values and that subcultures within the United States may conflict with, complement, and/or mirror the country’s overall norms.

It is critical to pay attention to the cultures and values of the families that you work with, as well as being mindful of your own ethics and values. Looking at all of these elements together is complicated, and that is why it is being highlighted right as you start learning about this profession. It takes time, experience, education, and reflection to develop your foundation. This chapter will support that building process.

3.3.2 Structure of NOHS Code of Ethics: Two Sections

The National Organization for Human Services (NOHS) is the professional organization that serves both students and working professionals. As a member of this organization, workers network, follow research, and support one another. The NOHS Code of Ethics consists of two sections:

• Preamble: a short narrative introduction
• Ethical Standards: 44 standards that are grouped in seven areas including responsibility to clients, colleagues, profession, public and society, employers, self, and students

The set of ethical standards, adopted by NOHS in 2015, begins with a preamble that outlines the importance of each professional’s behavior and the fundamental values of the human services profession.

3.3.2.1 Preamble

The preamble focuses on characteristics of the profession such as helping others and paying attention to the context of individuals and families. It emphasizes the role of education and professional growth.

A key part of the preamble is the acknowledgment of the conflict that may exist between the code and other policies and expectations such as employer policies, credentialing boards, laws, and personal beliefs. Each entity has some shared but some differing priorities, and this can lead to inconsistencies in what is best in any given situation. We will look at ethical dilemmas later on to help us understand this section of the preamble better.

The fundamental values of human services are described as follows:

• Respect the dignity and welfare of all people.
• Promote self-determination.
• Honor cultural diversity.
• Advocate for social justice.
• Act with integrity, honesty, genuineness and objectivity.

The preamble reminds us that professionals as well as students and educators are bound by these standards.

3.3.2.2 Ethical Standards

These next part of the NOHS Code of Ethics include a brief introduction and then summarize the 44 standards into a bulleted list form, which we’ll introduce in the next section.

3.3.3 Professional Responsibilities

The NOHS Code of Ethics describes standards of responsibility to seven groups: clients, public and society, colleagues, employers, the profession, self and students.

3.3.3.1 Responsibility to Clients

Clients are the first and most obvious group to highlight. The very first standard describes the responsibility of recognizing and building on individual and community strengths. The prominence of this statement emphasizes its importance. Overall, these standards focus on the professional: client relationship and how to maintain standards within your interactions with the client. There are nine total standards which include the following:

• Be strengths-based.
• Obtain informed consent.
• Privacy and confidentiality.
• Protect from danger or harm.
• Avoid dual or multiple relationships.
• Prohibition of sexual or romantic relationships.
• Ensure that personal values or biases are not imposed.
• Protection of client records.
• Utilize technology in legal and confidential ways.

This set of standards contains both concrete actions such as preserving privacy and confidentiality of clients, as well as more abstract concepts such as maintaining a strengths-based approach. Which of these standards might be most challenging to implement?

3.3.3.2 Responsibility to the Public and Society

Human services professionals are not always focused on a singular client, or discrete clients and families. Listed second in the Code of Ethical Standards, the responsibility to see how greater society affects individual problems is a requirement of the profession.

Understanding social problems, which are any condition or behavior that has negative consequences for large numbers of people and are generally recognized as a condition that needs to be addressed by society, helps the professional to avoid blaming the client for their personal troubles. Multiple factors contribute to the complexity of social problems. Typically the solution to the problem needs to be systemic in nature; in other words it cannot be solved by any one individual. For example, both homelessness and racism are considered social problems, and human services professionals need to recognize the effects of the social problems on individuals, as well as to work toward solving those social problems.

These nine standards remind us of the social justice mission of the profession:

• Provide services without discrimination or preference related to social characteristics.
• Be knowledgeable and respectful of diverse cultures and communities.
• Be aware of laws and advocate for needed change.
• Stay informed about current social problems.
• Be aware of social and political issues that differentially affect people.
• Provide ways to identify client needs and assets and advocate for needs.
• Advocate for social justice and to eliminate oppression.
• Accurately represent their credentials to the public.
• Describe treatment programs accurately.

Whether you work on the macro, mezzo, or micro level in human services, you must keep the macro–or societal–level in mind and work to decrease discrimination, disparities, and social problems.

3.3.3.3 Responsibility to Colleagues

Being ethical in behavior toward colleagues is crucial to the healthy functioning of any agency, as well as across organizations. It’s especially important to work together so that funding is used effectively and services are coordinated but not duplicated by multiple agencies. These four standards speak to the value of having integrity with everyone you work with:

• Coordinate, collaborate but do not duplicate services.
• Deal with conflict by approaching the person directly; follow up with supervisor if needed
• Respond to unethical behavior of colleagues.
• Keep consultations between colleagues private.

You might not have thought about having ethical responsibilities to colleagues, but you do! In the same way that self-care is important, it is also critical to treat those working side by side with you ethically.

3.3.3.4 Responsibility to Employers

The responsibility to your employer supports your commitment to clients and to the public. These three standards emphasize this with a particular focus on seeking resolution if you experience a conflict of interest at work:

• Stick with commitments made to employers.
• Create and maintain high quality services.
• In conflicts between responsibility to employer and responsibility to clients seek resolution with all involved.

3.3.3.5 Responsibility to the Profession

Being responsible to the profession includes the commitment to lifelong learning and growth, acknowledging that both workers and the profession itself need to be nurtured in order to continue to develop.

• Gain education and experience to work effectively with culturally diverse individuals based on age, ethnicity, culture, race, ability, gender, language preference, religion, sexual orientation, socioeconomic status, nationality, or other historically oppressive groups.
• Know your own limits; serve others within those limits.
• Seek help when you need it.
• Promote cooperation amongst related disciplines.
• Promote continuing development of the profession itself.
• Continue to learn and practice new techniques; inform clients appropriately.
• Conduct research ethically.
• Be thoughtful about self-disclosure including on social media.

Being responsible toward your profession makes it more likely that everyone involved–agencies, professionals, and clients–will be successful.

3.3.3.6 Responsibility to Self

Being responsible to yourself is the core of the ethical standards. The following three standards show that being self-aware of your feelings and health, as well as your own beliefs and biases will make you a more effective and ethical human services worker:

• Develop awareness of your own culture, beliefs, biases, and values.
• Develop and maintain your own health.
• Commit to lifelong learning.

As a student, you are well-aware of the challenges of balancing multiple responsibilities, including care for yourself. While work life can be more focused than student life, taking care of yourself is still a challenge to prioritize.

3.3.3.7 Responsibility to Students

This is the only section of the code that calls out a particular subset of human services professionals: the educators. Educators model the standards at the same time that they are teaching across the breadth of the profession. In particular the structure, quality, and adherence to the code of the class setting, including field experiences, are the responsibility of the educator. The final eight standards emphasize the special duty that educators have to students who are in a relationship where power and status are unequal:

• Develop and implement culturally sensitive knowledge, awareness and teaching methodologies.
• Commit to the principles of access and inclusion.
• Demonstrate high standards of scholarship.
• Recognize the contributions of students to the work of educators.
• Monitor field experience sites; ensure quality and safety.
• Establish guidelines for self-disclosure and opting out.
• Awareness of power and status differential.
• Ensure students are aware of ethical standards.

Take a look at this last set of standards from your unique position of being the recipient of college faculty and internship supervisors good faith efforts to meet these standards. Can you see the value and importance of educators adhering to a code of ethics?

3.3.4 Complexities of Ethical Behavior

Let’s dig a little deeper into some of the ethical standards and how they might lead to questions and dilemmas for practitioners. In this section, we will do the following:

• Focus on the ways that individual standards may support or conflict with one another.
• Contrast and compare common standards with national culture, policies and practices.
• Focus on social justice.
• Draw attention to the importance of examining your own values more deeply and how those connect to the Ethical Standards for Human Services Professionals.

It is worthwhile to view the ethical standards in these multiple contexts. Using and interpreting the ethical standards are a career-long process.

3.3.4.1 Privacy, Confidentiality, and Safety

Let’s start with something you may already be familiar with: privacy, confidentiality and safety. While these may seem straightforward, there are other factors at play. Here are the full standards that describe these behaviors:

STANDARD 3 Human service professionals protect the client’s right to privacy and confidentiality except when such confidentiality would cause serious harm to the client or others, when agency guidelines state otherwise, or under other stated conditions (e.g., local, state, or federal laws). Human service professionals inform clients of the limits of confidentiality prior to the onset of the helping relationship.

STANDARD 4 If it is suspected that danger or harm may occur to the client or to others as a result of a client’s behavior, the human service professional acts in an appropriate and professional manner to protect the safety of those individuals. This may involve, but is not limited to, seeking consultation, supervision, and/or breaking the confidentiality of the relationship. (NOHS, 2015)

These two standards helpfully highlight the conflict between them in the last sentence of Standard 4, which states that it might include “breaking the confidentiality of the relationship.” Similar conflicting ethical standards appear in most codes for helping professions. Facing the dilemma of whether to break confidentiality in order to preserve someone’s safety is one that many human services professionals will confront during their careers. In those circumstances, the worker should take into consideration:

• The applicable laws and regulations of the region (e.g. when and to whom are reports made)
• The workplace policies
• The worker’s role (e.g. counselor, manager, student, receptionist)
• The Ethical Standards
• Any other resources and expectations

Notice that the professional’s own personal beliefs and values are not on this list. Nor are local or religious beliefs and values considered relevant to putting someone in danger. This relates to Standard 34 and the self-awareness that each professional is bound to keep of their own cultural backgrounds, values, and biases. What dilemmas might this pose for the professional?

3.3.4.2 Social Justice

Understanding the systems of oppression and privilege have long standing traumatic effects, as well as impacting clients’ health, well-being, and socioeconomic status contributes to your ability to be an effective professional. These standards articulate the responsibility of human services professionals to be aware and to advocate.

STANDARD 14 Human service professionals are aware of social and political issues that differentially affect clients from diverse backgrounds.

 STANDARD 16 Human service professionals advocate for social justice and seek to eliminate oppression. They raise awareness of the underserved population in their communities and with the legislative system. (NOHS, 2015)

Let’s look at a social issue, or social problem, currently affecting the United States but disproportionately affecting people who are in ethnic groups that have been traditionally underrepresented. A social problem is typically defined as one that affects many people, affects the health and well-being of society, includes multiple causes and effects, and needs a systemic solution. Social problems are discussed in depth in Chapter 4.

The COVID-19 pandemic is acknowledged to fit this definition. As a correlation, the disproportionate COVID-19 illness and death rate of people in ethnic minority groups could also be described as a social problem. In the United States (with data reported from 14 states) 33% of COVID-19 hospitalizations are among African Americans, although they make up 18% of the population in those states. With data from 51 states and territories, the reported death rates for Black, American Indian, and Alaska Natives is 1.4 times the death rates of White people. Latino/a/x people have a death rate that is 1.25 that of White people. Asians have the lowest death rate who are less likely than White people to die from Covid-19 (The covid racial data tracker, 2021).

While we have the data to know that this is a social problem, how does this relate to the ethical standards? The next questions to ask are related. What contributes to underrepresented groups being more likely to get sick and also more likely to die if they are hospitalized for the illness?

The answers are complex, but here are some conclusions drawn from the Centers for Disease Control and Prevention (CDC) and other data. People from underrepresented groups are more likely to experience the following conditions:

• Live in densely populated areas and housing with fewer services such as medical clinics.
• Use public transportation more.
• Work in jobs that are essential and/or require exposure to the public such as transportation workers, store clerks, and factories supplying food or other essential products.
• Work in jobs that have few or no benefits such as sick leave or health insurance, meaning that they may be more likely to go work even if they or family members are sick.

Although we have not discussed COVID-19 and age here, this chart is provided for contextual reasons (figures 3.2 and 3.3).

Figure 3.2. The CDC collects data related to cases, hospitalization and deaths by race and ethnicity.

Figure 3.3. The CDC collects data related to disease, race, age, and ethnicity.

Access to health care services and health care insurance is inequitable in the United States. In particular, states that have not expanded Medicaid funding as allowed under the Affordable Care Act have higher populations of ethnically underserved groups.

Whether this information is brand new to you, or you are familiar with this data, it seems obvious that there are multiple social problems to be unraveled and examined. Poverty and low socioeconomic status intersect with the racial and ethnic inequities examined here. All of us have been affected by the pandemic. Some of us have personal experiences with illness and death related to the pandemic.

The question is, how does the human services professional adhere to ethical standards 14 and 16? Standard 14 talks about awareness. Just by reading this section of the text, your awareness has increased. What other steps could you take next to increase awareness? Standard 16 moves to another level, requiring the human services professional to advocate for justice.

Advocacy takes many forms. Here are a few ideas:

• Educate yourself about information literacy. What are reliable sources of information? Read and view those.
• Talk with people close to you. Share accurate information.
• Listen closely to people from underrepresented groups. Believe their experience. Stand by them.
• If you are from an underrepresented group and you feel comfortable doing so, speak up and share your experiences. Your perspective is valid.
• Write a letter or a postcard to your political representative.
• VOTE.
• Take part in the Census and the American Community Survey.
• Help amplify the voices of people of color (POC). Feature them on your social media.

In the field of human services there is an ethical responsibility to work toward a better society. The role a person plays in the workplace will define specific responsibilities and time allotment but each professional will also have a commitment to the ethical standards and to working toward social justice.

3.3.4.3 Immersed in Values

Being aware of your own values is important self-knowledge, but it is even more critical to your work with clients. If you are not aware of your own values and beliefs, you may inadvertently make assumptions about others, or project your own values on clients.

STANDARD 34 Human service professionals are aware of their own cultural backgrounds, beliefs, values, and biases. They recognize the potential impact of their backgrounds on their relationships with others and work diligently to provide culturally competent service to all of their clients (NOHS, 205).

Our personal values and beliefs come from multiple influences: our families, geography, the time we live in and one or more cultures that may include religion. They also come from the broadly held values, policies, and culture of the United States, and we will focus on that here for a moment.

Figure 3.4. David Foster Wallace was an acclaimed American author.

David Foster Wallace, in a 2005 commencement speech, described this metaphor for the ways in which we can be unaware of the social constructs that we live within (figure 3.4).

“There are these two young fish swimming along and they happen to meet an older fish swimming the other way, who nods at them and says “Morning, boys. How’s the water?” And the two young fish swim on for a bit, and then eventually one of them looks over at the other and goes “What the hell is water?” (Wallace, 2009).

When we are immersed in something, we may not know exactly what it is. In the example above, the fish may not know to contrast water with other environments like the earth, or air. Living in the United States we are grounded in ideas such as “freedom”, “equality” and “patriotism.” But what do those words mean to you? And what do they mean in the context of the United States?

For example, the Declaration of Independence is commonly quoted to demonstrate that the United States is founded on equality: “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.”

But as we know, this declaration did not apply to all men in the United States, but only to men who were White, and in some cases was limited to land-owners (early in the history of the United States individual states regulated the right to vote, so there was variability about which White men had access to equality, including voting). Not to mention women, at a time when the White culture defined sex and gender in a binary system.

Figure 3.5 shows another concept of equality that also incorporates the idea of equity. As you view the image, which definition do you find yourself the most aligned with? In this drawing, “equality” is represented by each person having the same size box; “equity” shows each person having a box or boxes that help that person see over the fence; and in “equity for all” the solid fence is removed and everyone can see the game.

Figure 3.5. Equality, Equity, Equity for All.

One lesson is that each professional needs to spend time thinking deeply about what their own values are, and how they define those values. Examine the source of those values. If they come from “the water” that you are immersed in, it may be time to poke your head out, reexamine and redefine your perspectives and values (figure 3.6).

Figure 3.6. When you are immersed in an environment’s conditions, it is important to periodically assess how it affects you.

Standard 34 is about awareness: deep knowledge about yourself and about how your culture, beliefs, biases and values potentially interact with those of your clients and of society. This level of understanding does not come quickly or easily. While some of a person’s core beliefs and behaviors may be stable over time, most people grow, change, and deepen in their thinking and beliefs. Age, experience, education and action all contribute to greater self-awareness. Action can come in the form of reflective thinking and writing, interaction with other thinkers and practitioners, and via thoughtful listening and discussion. As a student in the field of human services, you are engaged in this process simply by reading, reflecting and discussing the ethical standards. You are not expected to have all of the answers, but you are expected to be engaged in the process.

3.3.5 Ethical Decision Making

Human services workers must make difficult decisions, sometimes quickly, and sometimes without support or resources. It is helpful to have a model of decision making that you practice many times so that you can feel more confident about making decisions on your own.

The ETHICs decision-making model includes the following steps:

E: Evaluate and define the problem. Examine relevant personal, societal, agency, client, and professional values. Gather information from all possible sources.

T: Think about which ethical standard applies, as well as relevant laws and agency rules. Brainstorm possible actions and decisions.

H: Hypothesize about the possible consequences of different actions.

I: Identify who will benefit and who will be harmed.

C: Consult with supervisor and colleagues about the most ethical choice.

S: Select an action. Implement the action. (Ling & Hauck, 2016)

After the action has been implemented, an important final step is to evaluate the action. Who has been harmed? Who has benefitted? Is there any additional information that you have gained, that you wish you had known earlier? All of these questions will help you to evaluate the decision and inform your practice for the next time that you face a dilemma.

3.3.7 References

Centers for Disease Control and Prevention. (2020, April 30). Communities, schools, workplaces, & events. https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/race-ethnicity.html

Declaration of independence: A transcription. (2015, November 1). National Archives. https://www.archives.gov/founding-docs/declaration-transcript

Dolgoff, R., Harrington, D., & Loewenberg, F. M. (2009). Ethical decisions for social work practice (9th ed.). Cengage.

Kirby, T. (2020). Evidence mounts on the disproportionate effect of COVID-19 on ethnic minorities. The Lancet Respiratory Medicine, 8(6), 547–548. https://doi.org/10.1016/S2213-2600(20)30228-9

Ling, T., & Hauck, J. (2016). The ETHICS model: Comprehensive, ethical decision making. American Counseling Association. https://www.counseling.org/docs/default-source/vistas/the-ethics-model.pdf

National Organization for Human Services. (2015). Ethical standards for human services professionals. https://www.nationalhumanservices.org/ethical-standards-for-hs-professionals

The covid racial data tracker. (2021). The COVID Tracking Project. https://covidtracking.com/race

Wallace, D. F. & Kenyon College. (2009). This is water: Some thoughts, delivered on a significant occasion, about living a compassionate life. Little, Brown & Co. https://search.ebscohost.com/login.aspx?direct=true&scope=site&db=nlebk&db=nlabk&AN=763281

Wood, D. (2020, September 23). As pandemic deaths add up, racial disparities persist—And in some cases worsen. NPR. https://www.npr.org/sections/health-shots/2020/09/23/914427907/as-pandemic-deaths-add-up-racial-disparities-persist-and-in-some-cases-worsen

Image Description for Figure 3.1:
Five concentric circles. The inner circle says Ethical Standards. The next ring, moving outward, is labeled Local, followed by Regional, National, and Global. Radiating out beyond the concentric circles from Ethical Standards are four rays, labeled Cultural Beliefs, Values, Laws, and Employer Practices. These are the same eye-catching yellow as the central circle labeled Ethical Standards.
[Return to Figure 3.1]