It is regrettable that the author does not follow up this penetrating analysis and make more explicit the ethical dilemmas that inevitably ensue from this inequality of influence and the controlling base of social work practice. He merely cautions against abuse and even raises “the nagging possibility that some individuals might gravitate toward the practice of social work because of the power it promises” (p. 77). Levy states that technical competence in the practice of social work must be assumed before ethical issues can be raised. His emphasis is on values “right in themselves” rather than on the efficiency of performance. When conflicting issues require ethical judgments, he perceives a clear order of priorities based on the fact that rightness in ethical terms is the higher value. He illustrates this aspect by posing a situation in which a social worker grapples with the issue of confidentiality in her work with a group that engages in unethical behavior. The ultimate choice of action must be made on the side of ethical principles. The second part of the book outlines standards of expected conduct in relationships with the client, the employing agency, third parties, colleagues and unions. Levy exhausts the full spectrum of activities and articulates the basic values that govern all these relationships. He deals with the issues of accountability, confidentiality, objectivity and acceptance and with the importance of involving the client in decision making. He is highly prescriptive about what a worker should value and the whole book is heavily interspersed with “ought to’s” and “should’s”. He states that social work ethics “must be formulated in a manner that is empirically realistic” but some of his prescriptions sound more like articles of faith that have no resemblance to the actual reality in the field. For example, he describes the social worker’s service “as priceless and precious and one that cannot be exchanged for cash. Payment for it by fee or salary cannot be viewed as a reciprocal gesture but rather as a kind of practical arrangement not contingent upon the client’s means or financial capacity” (p. 57). This presumption of total altruism and beneficence is difficult to read, much less believe at a time when the politics of the service professions and their self-serving interests are increasingly being clarified. The notion of care as the sole basis for giving services, no longer has credibility. Similarly, he stresses the need to maintain objectivity while allowing that “it may be impossible to prevent unconscious intrusion of values”. The delusion of objectivity has long been abandoned and in the opinion of the reviewer this must be clearly affirmed before any discussion of the ethics of social work intervention can progress. Levy cautions against any negative feelings toward clients that might prevent full and unbiased attention. This espousal of the “non-judgmental attitude” is frequently encountered in social work literature, but does not rep resent the reality of practice. It ignores the normative base of the profession. Furthermore, it is unrealistic to expect a worker not to react to behavior that is alien or repugnant to her own system of values. To prevent these negative feelings from interfering with the treatment efforts, they must be recognized and acknowledged. Awareness of their existence, rather than denial of them, will do more to insure dfective service to such clients. The author devotes a chapter to the societal goals of the profession in which he refers to “the dictate of ethical responsibility beyond the boundaries of the social worker’s relationship to. is client”. However, the elaboration of this “dictate” is glo 1 al and superficial. He does not deal with the conflicting demands of societal and individual goals and their integration through values. This issue has been a source of tension along the entire route of the profession’s history and is central to any consideration of social work ethics. The basic weakness of the book jr the failure to look
at facts and realities in the field and integrate them with values. In the final analysis, it. is the unfolding of reality that provides the source and authority for an ethical system. The limitations notwithstanding, the book remains an important addition to social work literature as a compendium on ethics that has not been attempted before. It is recommended as an overview of the espoused ethics of our profession, the base against which practitioners as well as students can grapple and come to terms with their own particular values and beliefs. Simmons College School OJ Social Work Boston, MA, U.S.A.
ANNE S. GERBER
Social Research in Conlliit with Law and Ethics, edited by PAUL NEJELSKI.Cambridge, MA., Ballinger. 1976. 197 pp. s15.00
Within the fields of social science and medicine, the last ten years could arguably be called the Decade of the Research Subject. in this period, in the United States at least, expressions of concern for the rights and welfare of subjects of medical or social research have become as common in professional parlance-if not always in professional conduct-as references to the current literature or levels of statistical significance. Assurances of informed consent are cropping up in the methodology sections of published research; hospitals and universities are rushing to establish procedures for certifying the ethics of research proposals according to guidelines of National Commissions and Federal granting agencies. Seminars, symposia, workshops, documentaries and books are tumbling into view, vying for the chance to extol human rights to privacy, confidentiality, informed consent, and the loyalty of physicians that is uncontaminated by non-therapeutic, investigative motives. Such has been the shape of society’s appropriation of the truths and horrors of Nuremberg. To a great extent, it has been the investigators themselves who have eloquently and persistently advanced this trend. Henry Beecher, Louis Lasagna and Margaret Mead come immediately to mind. At the same time, there is the nagging suspicion that many social and medical scientists are becoming increasingly tense and embattled. They perceive the advocacy of subject and patient rights as, at best, irresponsible meddling by a well-intentioned but unsophisticated public; or, at worst, as a threat to the vital center of the scientific enterprise. Certainly (these scientists declare) subjects’ rights are important, but what about researcher’s rights? This question is the major focus of Social Research in Conjlict with Law and Ethics. This book appears to represent a renewed militancy on the part of researchers who see themselves as hampered not so much by cumbersome ethics procedures and bureaucracies (although that view is expressed), as by two other developments: governmental agencies’ dedication to secrecy and self-protection, and the use of the subpoena power to require journalists and scholars to reveal confidential sources. The two issues of access to government information and testimonial privilege for researchers provide the primary framework for the ten articles collected in this volume. With considerable repetition, these articles make the following basic points: (1) Governmental agencies’ use of secrecy and the invocation of executive privilege tend to be self-serving and to obstruct the free flow of information on which an enlightened citizenry and an effective democracy depend. (Articles by Gideon Sjoberg Carol Barker, G. 0. W. Mueller, and Jack G. Day.)
Book reviews (2) The evaluation of soctal policy and the reform of existing institutions require vigorous. free and independent research that is answerable to the public good rather than to particular vested interests, (Article by Paul Nejelski. in addition to those already mentioned.) (3) Use of the subpoena power to require identification of researchers’ confidential sources strikes at the heart of the trusting relationships often necessary for effective research, and makes certain types of research, especially into deviant or illegal behavior, virtually impossible. (Articles by Marvin Wolfgang, Eliot Freidson and Vincent Blasi.) (4) While the Freedom of Information Act is reasonably effective for breaking down bureaucratic barriers to official documents, Federal legtslation establishing researchers’ testimonial privilege is the best way to protect the research community from official harassment and compromised commitments to confidentiality. (Articles by Nejelski and Howard Peyser. Freidson, Barker and Blasi.) These are potentially significant issues, They involve very basic questions of social conscience. professional identity and ultimate loyalty. to say nothing of the actual careers of people who have challenged the authority of government prosecutors to intrude into the relations between researchers and their subjects. It is therefore disappointing that this book seems more concerned with selling the virtues of researchers’ privilege and with vilifying secretive bureaucrats (especially in the Nixon years) than with exploring in depth any of the dilemmas and conflicts it so tantalizingly raises. The most thorough discussions in the book are essentially tactical. Eliot Freidson raises serious and delicate questions as to the definition of a researcher that would be included in protective legislation, pointing out the potential for elitism in definitions tied to academic credentials or particular methodologies. (Interestingly, Freidson’s carefully reasoned recommendations are ignored in the model statute appended to the volume.) Robert Boruch, in the book’s longest chapter, presents a highly technical survey of current computer strategies for merging data banks while protecting the identities of individuals, an article that will probably be accessible only to specialists. By contrast, two prior and critical substantive questions are barely mentioned. Little attention is paid to the complicated values and arguments on both sides of the fundamental tension between the state’s police power and the autonomy and integrity of the research community. And there is the difficult issue of professionals’ internal controls: what is there to justify the public’s confidence that researchers, academic, medical or otherwise, really do understand the public good, and are always capable of distinguishing self-serving from socially responsible motives and actions, whether in governments or in themselves? Let us have deeper analysis of this type of problem and then return to Nejelski’s book for the useful perspectives it contains. Program in Religion and Societ) Harcurd Unirersit) Cambridge, MA, U.S.A.
STUMPHAUZER, Charles 358 pp. $16.95
edited by JEROME S. Springfield. ILL. 1977.
It is rather unique, perhaps, for an analytically oriented psychiatrist to review a book on the behavioral therapy of delinquents. Despite my analytic bias, and perhaps because of it, I found Behaoior Therapy with Delinquents an interesting and educational reading experience. Behaoior Therapy with Delinquents, edited by Dr. Jerome S. StumphaGer, is a collection of 22 papers on the subject, some with rather elaborate bibliographies. The book is divided into four parts: delinquency and behavior therapy, basic research in behavior therapy, modification of delinquent behavior in institutions, and modification of delinquent behavior in the community. In addition to a general introduction by the editor, each section is preceded by an introduction addressing briefly the themes of the cor,
Judge Baker Child Guidance Center Boston, MA, U.S.A.