Ethics and Harm Reduction

Here are a couple of thoughts on ethics and harm reduction in the midst of new and evolving definitions of harm reduction during the Covid-19 pandemic.

The very nature of an ethical dilemma is to be in the grey zone, to be in the middle, to have two or more choices on how to proceed and each/all of them have the likelihood of causing harm.

What to do? Most of us are trained to do a couple of things here.

First, ask what is the standard of care? This can call for some research into applicable laws, rules, regulations, codes of ethics, agency policy and procedure and so forth. Sometimes, this will be enough to resolve the ethical dilemma. When it isn't, we must next ask, "what is the standard of care where there is no standard of care?" This will then compel us to consult, consult and consult. The repetition is intentional here. Consult with three trusted colleagues of similar background, training and experience. and Document, document, document that consultation. If there is consensus on the action(s) to take, you are likely on solid ground as there is precedent in proceeding this way. It asks and answers the question of what would another professional, of similar background, training and experience do in this circumstance? That becomes the standard of care where one does not exist. This helps the practitioner should there be an adverse action regarding their license and /or if they were involved in a civil lawsuit.

So, as it relates to harm reduction, what would a consensus opinion be on the subject of bringing alcohol and/or marijuana to someone enrolled for ACT services be? I think it is likely that 3 colleagues would all agree that more harm could be caused by the enrolled consumer going out to get alcohol and/or marijuana, He/she and others encountered along the way would be potentially exposed. Many consumers that we serve have a variety of health concerns. The greater good may be served by limiting them in their travels into the community. They benefit. the community benefits. If Covid-19 were not in the picture, they would likely be out and about procuring alcohol and/or marijuana, anyway.

The grey matter of this type of dilemma centers on making the choice, neither of them swell, that causes the least harm to the least number of people.

There are a number of other considerations here, but this is the short version. Should our online community desire it, I'd be happy to expand on the above or provide ethics consultations to interested parties. I have presented ethics trainings for many years and have served on the Ethics Committee for the National Association of Social Workers.

Bottom line here is to talk with one another. Early and often. And if it is a sticky situation, document the conversations, decisions made, actions taken and resulting outcomes.

Be well.