A conversation with social work researcher, Dr Sacha Kendall

Dr Sacha Kendall began her social work career in acute mental health. She is now a qualitative health researcher. Her research investigates the social, cultural and ethical aspects of health, with a focus on marginalised populations. She is passionate about promoting qualitative approaches to understanding health and addressing health inequity.

Sacha contributed a chapter to a book I reviewed last year- Rethinking Values and Ethics in Social Work. In her chapter, she wrote about postmodern ethics for practice, drawing on the work of Zygmunt Bauman.

In our conversation, we mulled over some big questions.

• What is the difference between morality and ethics?
• How can social workers honour commitments to social justice?
• Is professionalism grounded in ethics technical competence?
• Are social workers experts in managing uncertainty?
• How do we handle our moral responsibility for the Other, particularly in circumstances where the Other is a person with impaired competence as a result of severe mental illness?
• And in the sphere of health and social science research- has research ethics delivered on its promises?

By Lynne Harrold

The community aged care sector for older adults is growing exponentially and will continue to do so as our population ages. The facts are there and the projections are clear, but despite this knowledge it seems that private social workers are lagging somewhat behind other professions in moving into this sector.  The challenge has in part been to do with the reluctance of this current aged cohort to seek our services,  and the restrictions of Medicare funding for residents in high care facilities. However all that is changing.

The current ageing of the very psychologically minded baby boomers has begun to change the culture in this sector with the demand growing for any type of service that can assist their needs. Furthermore funding streams are opening up. Prior to the introduction of My AGED CARE and the NDIS, private work in this field has been primarily limited to accredited mental health social workers via Medicare and DVA.

Changing systems creates opportunities and this is the time to start embracing these changes and start claiming our space in the market. We are needed and if we do not take leadership as a profession to claim that space, social workers will miss out and so will our clients.

The sector is becoming increasingly competitive with corporate enterprises vying for their share, in what is expected to be an increasing consumer driven market. Large GP super clinics employing allied health teams are partnering with some of the larger retirement villages and residential aged care facilities, which in effect make it difficult for the sole practitioner to access clients. Psychologists are developing specialist gerontology courses and positioning themselves in Aged Care facilities.

So how does the lone social worker navigate this terraine? How do we position ourselves in the market? Do we go it alone or are there safer options?

I would like to share my experience of how I am attempting to navigate this changing system on the NSW Central Coast an area which has the highest proportion of people aged 65 and over in the country. After many years of working as a sole practitioner in Sydney I made the decision only 12 months ago to resettle.  I also wanted to work with a team of like- minded social workers. The professional isolation of the sole practitioner was no longer for me.  I wanted to build a service that included a team of social workers who could deliver an array of services to the community aged care sector. My vision was to create mobile services for older adults living at home, and educational support to the aged care workforce. Not quite 10 months later I now have three people on that team with huge potential to grow.

So how has this been achieved?

We have aligned ourselves with several other private allied health services to set up the Central Coast Allied Health network. This network provides an array of mobile services to give wrap -around assistance to older adults  at home. Being able to offer a more holistic service to our clients is something that is crucial in being able to work with this age group who often have complex physical, social and mental health needs.

The network includes occupational therapists, dieticians, speech therapists, exercise physiologists, physiotherapists, podiatrists, naturopaths and of course social workers. It is this alliance and the cross referrals from these services that has created the foundation from which we grew our business in the early months. We facilitated this by educating each business as to our role, when referrals would be appropriate to our service and how we could best work together.

Apart from the advantages of cross referral the network is an effective way to market our service as a team or as individual service which is another bonus. It is a much easier way to access clients than attempting to market directly to GP’s. We did attempt to see individual GP’s when commencing the service but there was little interest in us as social workers. As our service has grown we are now beginning to get referrals directly from the GP’s! A sign to us of emerging success.

As a large network of specialised allied health providers we are also more strongly positioned to apply to funding bodies like our local Primary Health Network, which is more interested in funding larger conglomerates than individual providers.

We are not aligned to a large medical conglomerate choosing to keep autonomy of our business and our work and not be restricted to a medical model. The strength in this is that we are not paying the exorbitant rent and commission fees that many allied health providers are forced to do if they work in a large medical practice, or are contracted by many of the emerging corporate allied health companies that are now emerging.

As private social workers we are guided in business by our strong social work values and ethics, which in fact lend themselves beautifully to growing an ethical business.

As the business develops new opportunities arise.

Recently we signed up with two major community care providers as the sole service to provide counselling & general social work services to their clients and carers. Our services are being funded through the new care packages and also through Medicare and DVA. We are extremely interested to see how these packages work for our clients and for us. By working closely with these organisations, educating them on the bio/psycho/social needs of their clients and how we can assist them with their clients we believe that we are facilitiating cultural change within these organisations to better care for the needs of this age group.

We are very much aware that if our service is to survive and grow into the future there are real challenges ahead. Our challenges are the challenges that we as a profession are needing to address now if we are to secure a space for social work .

The first is recruitment. It is difficult to find social workers who have mental health accreditation and experience in either working with older adults or knowledge of the aged care system. Both are needed as are social workers with palliative care experience.

Secondly we need to stand out from the crowd as offering specialist skills.

Community aged care organisations provide untrained support workers and pastoral care positions to largely service the emotional distress needs of their clients. We need to be able to market ourselves as offering specialist skills. Credentialing gerontology and palliative care social work is much needed as is the opportunity to develop evidence based individual and group programs.

We also need the infrastructure as a profession to be able to network each other not only for recruitment purposes but to be able to strongly advocate for our clients. We are dealing with some of the most marginalised people in our society and need to be united in our quest for social justice in this sector.

I can truly say that I have never felt more of an advocate for my clients or for my profession since moving into the private sector. I strongly encourage others to get involved. Yes it is challenging but extremely rewarding and there is more than enough work for all of us now and in the future.

Lynne Harrold BSW/MSW had over two decades of working in community mental health before moving into fulltime private practice in 2006.She has subsequently worked predominantly in the private Aged Care sector. She is  the convenor of the NSW self-employed practice group as well as an executive member of MHSWiPP.

It was a pleasure to host this article on my blog. It was originally slated to appear in the AASW magazine- In Focus- but was pulled as it was deemed to give unfair publicity to Lynne during the AASW election period!

Let me frame this piece by stating unequivocally that the NDIS is a genuine capacity building initiative and a great social good. Its current target is to improve the lives of 460,000 Australians with individual funding packages, to help them to participate more fully in their communities. It enshrines in legislation the assertion that,

people with disability have the right to determine their own best interests, including the right to exercise choice and control, and to engage as equal partners in decisions that will affect their lives (National Disability Insurance Scheme Act 2013, Section 4 (8))

and that people with disabilities should be supported so that,

in all their dealings with the NDIA..their capacity to exercise choice and control is maximised in a way that is appropriate to their circumstances and cultural needs (Section 4 (9))

 Our taxes (via the Medicare levy) have been increased to help cover the costs, and no sensible person would begrudge paying a bit more to help their fellow citizens to participate more fully in their communities.

The design of the scheme and the manner of implementation does however create risks which will inevitably continue to cause harm if not dealt with quickly.

Firstly a few words about outsourcing. This is the ‘go to’ methodology of governments captured by free market thinking. Outsourcing ensures that labor markets are fluid and flexible. But as we know the ‘flexibility’ is one way. Workers are paid less, career prospects diminish, 12 month contracts are standard, and professional development is less likely to be employer subsidised.

Governments are also striving to outsource risk and responsibility; not always successfully. And when things go wrong, the fallout can degenerate into enquiries, commissions, and a farrago of fingerpointing.

The NDIA has outsourced to varying degrees the assessment for eligibility, service planning and delivery of the scheme. In NSW for example, the NDIA has “commissioned” three “Partners in the Community”, for what is described as “local area co-ordination”. These partners are Uniting, the St Vincent de Paul Society, and Social Futures.

To use the word ‘partner’ in this context is to stretch the word completely outside its ordinary meaning of – a joint venture with shared risks. The NDIS has designed and funded the rollout to its smallest detail. In this context, comparing even the largest NGO to the NDIA is to compare a mosquito to a 160 kilo gorilla. It is a franchise, not a partnership; and the NDIS has done its best to outsource all risk to its franchisees.  Every NGO, every relevant NGO employee and every sole provider or small business must sign a Declaration of Suitability to be registered as a service provider with the NDIS. Providers declare that they are compliant with all employment and workplace health and safety laws, and that they have mechanisms in place to ensure that any contractors engaged also comply.

The Royal Commission into the Home Insulation Program (HIP) had some relevant points to make about the attempts of the Australian Government to outsource risk. Why, do you ask, am I bringing the ‘pink batts’ disaster into this discussion? We are all familiar with mess and chaos around outsourcing refugee processing and the operation of detention centres, but the example closest to the NDIS is probably the HIP rollout; A huge scaling up of existing services, a significant social good, and the apparent necessity that it be done in a hurry. In its wake, there were four tragic, avoidable deaths, as well as number of enquiries and a royal commission. Most readers will recall that the aim for the HIP was to install insulation into the ceilings of some 2.2 million Australian houses in a period of two and a half years. This was a stimulus package in response to the global financial crisis, that was also designed to bring significant environmental benefits.

In relation to outsourcing, there are some comments of the Royal Commissioner, Ian Hanger, that are worth quoting at length,

Government must recognise that as much as it might seek to do so, risk cannot be abrogated. The responsibility of Government is to care for its citizens and to exercise care and diligence to do everything reasonable to ensure citizens are not placed in danger by its actions…

It was said, by a number of federal public servants, that the Australian Government had no regulatory power in the field of workplace health and safety, and therefore that it was not a risk that the Australian Government could control. In my view, this attitude was deplorable. I discuss..the purported reliance of the Australian Government on the States and Territories and conclude that such reliance was both unjustified and unreasonable

Pretty blunt!

In my view, the most serious flaws in the NDIS occur at the very beginning of the assessment and planning process, and continue for those participants who need service coordination funded by the NDIS.

As things stand, at the beginning of the planning process, potential participants are asked a range of questions by “local area coordinators” to determine eligibility and formulate a plan. All the information needed to generate goals, support and a 12-month budget are gathered; usually in one meeting. Participants may have some verbal confirmation of the answers they give. This data is uploaded for a centralised desktop assessment and a plan is sent back to the participant as a fait accompli. The legislation makes it quite clear that as soon as a plan is approved, it comes into effect. But there is in fact no reason why a paper copy of the participant’s answers could not be left with them for a week, in order to double check completeness, accuracy, and to fully digest the implications for the participant; and further, that the plan be considered a draft, subject to discussion. Remember that the Act states,

people with disability have the right to determine their own best interests, including the right to exercise choice and control, and to engage as equal partners in decisions that will affect their lives. (my emphasis)

This a lopsided transaction; it is not a partnership. It is an insurance assessment that gives the most vulnerable participants no time to review or reflect. (Sixty percent of approved plans in the third quarter of 2016/17 were for participants with an intellectual disability or autism.) I have heard anecdotal evidence of 12 month reviews of plans that revealed unreasonable anomalies between what was needed and granted to assist participants in achieving their goals. But this is not just a question of efficiency and accuracy; it is one of fundamental dignity.

I don’t know what has been happening behind the scenes, but I find it puzzling that disability advocacy groups have not made more of a public fuss about this? I do know however, that governments of all persuasions have lately paid lip service to human rights, whilst simultaneously de-funding robust advocacy. Any consumer group funded by government has difficult choices to make, if it involves biting the hand that feeds it.

These ‘take it or leave it’ plans also present ethical dilemmas for local area coordinators. Some of these frontline workers might make an ethical choice to defy NDIA driven KPI’s and routinely give participants time to reflect in a genuine partnership. But this could be a hard choice for anyone to make, working on low paid 12 month contract.

Ironically, in the Royal Commission into the HIP, Commissioner Hanger had plenty to say about ethical pressures faced by public servants fearful of their tenure.

It has been a long-standing principle that public servants had security of tenure giving them both longstanding experience in the field of public administration, a great depth of knowledge about that art and the workings of various portfolios. Security of tenure has another important consequence: public servants could, if warranted, advise their Minister against certain courses of action, and in trenchant terms if necessary.

 I found the APS Values and Code of Conduct .. a valuable resource..(in particular) the concept of frank, honest, comprehensive, accurate and timely advice, referred to in ..the Public Service Act. After having read all of the documents provided to the Commission, and having heard all of the evidence given particularly by public servants, I have little doubt that had such advice been given at key junctures of the HIP, the tragedies that occurred would have been avoided..

Commissioner Hanger couldn’t however bring himself to recommending security of tenure. Instead he advised these senior civil servants to include a “devil’s advocate” section in their briefing templates! Astonishing advice to some of the smartest and most skilful people in the country.

This underlines just how unreasonable it is to expect individual workers, either in management or the frontline, to defy the powerful, when dignity and human rights ought to be built into the system. Only a concerted, combined effort by the relevant trade unions, disability advocacy groups, and the range of professional associations that cover these frontline workers, will ensure that justice prevails.

And, as can be seen from the pink batts disaster, should some scandal or tragedy occur, there is no guarantee that the senior public servants will be able to successfully argue that they washed their hands of all risk.

Turning our focus to ‘support coordination’, it is important to note that this is the only funded service that gets a mention in the Declaration of Suitability. It will soon become apparent why this is the case. (The role of support coordinators is to work creatively and resourcefully with NDIS scheme participants in how they utilise their support budgets to achieve their goals.)

Social workers (along with other Allied Health professionals) can register to provide specialist support coordination; their tertiary qualification and relevant experience being routinely accepted as sufficient credentialing. But few participants need specialist support, and the more generic ‘line item’ of support coordination is open to a broader range of workers. Obtaining credentialing to provide generic service coordination requires the provision of extensive evidence to state based credentialing agencies. It is time consuming, and may cost thousands of dollars. Workers who already have specialist support coordination credentials, are given no recognition, or advanced standing in applying for generic support coordination; an illogical anomaly that also has important consequences for participants.

NGO’s have put themselves in the business of providing support coordination in the marketised environment of the NDIA. Importantly some of them seek to provide a ‘one stop shop’ that offers both coordination, as well as the services themselves. (Sometimes as a hangover from how they used to do business pre the NDIS era.) The inherent conflict of interest is so great that the Declaration of Suitability document seeks to outsource this risk. Paragragh 12 requires that individuals and agencies to declare that

If you are seeking approval in relation to both the provision of supports and managing the funding for supports under plans- the provider has mechanisms in place for dealing with conflicts of interest when performing both of those roles in relation to the same participant.

Because of social work’s robust code of ethics, it is reasonable to say that social workers (along with other health and disability professionals) have been at the forefront of embracing the disaggregation of service coordination from service provision. Let me remind you again of Section 4 (8) of the Act,

people with disability have the right to determine their own best interests, including the right to exercise choice and control, and to engage as equal partners in decisions that will affect their lives 

Hypothetically, if a sole practitioner social worker were providing support coordination, and a participant wanted to stay with agency XYZ for occupational therapy based services, but wanted to change their speech therapy from agency XYZ to another provider, the social worker would do their best to honour this choice. If, however agency XYZ is providing support coordination and a range of services (as it might have before the NDIS), it is a nonsense to think that the agency will be as scrupulous in honouring the wishes of the participant, no matter what “mechanisms” it has “in place”. The proper intent of the Act could easily be implemented, by simply stating that agencies cannot provide both coordination and services to the same participant. Problem solved; end of story.

Let us hope that it does not take a scandal or a tragedy for this problem to be fixed. And again, we ought not rely on individual whistle blowers to bring it to the public’s attention. The combined efforts of trade unions, consumer groups and professional associations is a better way to get the changes we need. To continue to allow agencies to provide a ‘one stop shop’ simply facilitates patronising attitudes that no longer have a place in a society that respects the worth and dignity of every human being.

Want to continue the conversation on Facebook? I have created a page connected to my blog for just that purpose. fb.me/socialworkblogger

Lincoln may be able to claim that he did the ‘right thing’ at the ‘right time’, but it was not by any stretch the ‘right way’. What is now hailed as a piece of political genius could also have the seen the President impeached, and his Secretary of State imprisoned. Yet Lincoln is portrayed in the film as a man of strong moral conscience, the courage of his convictions, great personal virtue and an abiding respect for the dignity of all the people in his orbit. And we, the observers, are inclined to believe this deeper truth.

Social workers often find themselves in the frontline of the war between those would grant human rights to all, and those who would prefer to privilege some people over others. It is a messy and complicated war. Governments weigh in, slicing and dicing people into more or less privileged categories (asylum seekers, people on the dole, the disabled and so on). The battle is engaged all over the planet between rich and poor, north and south, big city dwellers and their rural cousins, communitarians and libertarians, as well as many permutations of racial divides. Tactics shift, and all sides claim a superior ideology and a higher moral ground.

Discussions of ethics in the context of this war often revolve around tactics. Is it enough to demand equality of opportunity, or should we insist on equality of outcomes? Do ends justify means? How much weight should we give to the looming ecological disasters? What about feminism? When do we compromise and take a minor victory, and when do we choose martyrdom?

These ethical decisions are in turn are underpinned by our moral conscience. By some accounts it has taken tens of thousands of years for humans to develop a conscience. Most of us now accept the premise that a moral persons are guided in their actions by giving careful consideration to the interests of each individual affected by their decisions. And many of us now (at least in principle) aspire to the ideal of universal human rights.

This provides some context to the recently published book edited by Richard Hugman and Jan Carter, Rethinking Values and Ethics in Social Work.

For readers who want to begin by exploring notions of moral conscience, I would suggest beginning at Chapter 13. In her piece on postmodern ethics for practice, Sacha Kendall relies heavily on the insights of Zygmunt Baumann. Kendall contends that

“moral responsibility consists of individuals choosing to take unconditional responsibility for the Other. Morality cannot be grounded in ethical principles, nor can it be a means to an end. The ‘self’ is therefore central to ethics. This self is a moral self that will take responsibility for and act to address the needs of others without reason or reward. The moral self is part of the human condition; it is our moral impulse or moral conscience. Accordingly, morality has no foundation, but is rather the ‘ultimate, non-determined presence..”

It follows that to slavishly follow any moral code reduces us to replaceable machines. Kendall believes that we should continually deconstruct our notions of professional expertise, and critically reflect on our relationship with the ‘other’. This is a theme echoed by many contributors to the book.

In Chapter 1, Carter and Hugman hark back to a time

“when conscience was social and moral, indivisible and unitary. But now a moral conscience has become understood as being confined to the private sphere of life, whilst a social conscience is seen as an appropriate responder to those injustices detected as public issues, particularly those involving vulnerability, suffering and victimization for human and other species and the environment. One of the tasks of this book is to see how the moral and social aspects of conscience might be brought together again.”(my emphasis)

Although impossible to measure, it certainly does seem that the modern world offers a more fertile ground for the growth of cynicism, corruption and self regard. The times seem to suit a Trump rather than a Lincoln. Like Donald Trump, we have all become more acutely aware of our own social standing, and many of us are adept at image polishing on broadcast and social media. And of course it is easy, with one click, to ‘like’ a social justice campaign or send a donation to Get Up. In a similar vein, Hugman and Carter approvingly quote Sennett,

“Flexibility, adaptability and agility are valued ahead of stability; teamwork practices favour people good at public relations and ‘spin’ and ignore developing the deep commitments and loyalties that are fundamental to the formation of character”

If, as it seems, courage combined with a critical commitment to ethics is in short supply, how can we nurture it within the ranks of social work? Sarah Banks, (Chapter 4) in her contribution to the book, recommends that we actively participate, and

“work through professional groups and networks. Integrity is often invoked in situations of adversity –when someone’s values are undermined or threatened. This means practitioners need courage to stand up for their beliefs and act in accordance with them. They may need to resist pressures to cover up or conform to corrupt agency norms (Preston-Shoot 2011) and to be prepared to ‘blow the whistle’ on bad practice. Solidarity with other work colleagues and through professional associations, political networks and trade unions is also important in such cases. Individual practitioners, no matter how resilient or courageous, risk victimization and disempowerment if they stand alone as isolated individuals.”

Building on Banks thoughts about the ‘right way’, Michael Reich (Chapter 3) helps us to consider the ‘right thing’, stating that a social justice framework might include:

“particular attention to the causes and consequences of inequality, oppression, marginalization and exclusion; increased recognition in practice settings of the significance of history, culture and context in the development of people’s problems and in creating ways to resolve them; an understanding of the interconnectedness between individual problems and their institutional origins and between domestic and international issues; integration of a critical perspective on the impact of race, gender, ethnicity, sexual orientation and ability status on people’s lives; an enhanced focus on the impact of the maldistribution of power, resources, rights, status, privilege and opportunities, and a critique of their ideological rationales; a view of society and social change that emphasizes the basic humanity and equality of all people; and a goal of not simply ameliorating people’s problems, but of transforming society through the creation of alternative values, institutions, laws and processes”

The foundation of social work in the liberal traditions of individual freedom have made it natural for the profession to gravitate towards identity politics as its main battleground, in standing up for human rights. But this kind of politics risks collapsing into culture wars that do not examine the roots causes of social injustice, or offer practical programs beyond slogans of resistance. We should not forget that the hundreds of thousands of One Nation voters in regional Queensland are by any measure, marginalised and oppressed. Their access to jobs, health, education and welfare has been seriously eroded by agribusiness, globalisation and the failures of all the political parties that claim to represent them.

Its suits the powerful to fan culture wars and promote the building of walls, either virtual, or made with concrete and steel. Social workers who would like to think about alternative futures would do well to read Paul Mason’s latest book, Post Capitalism: A Guide to our Future. He argues that the rise of robotics and the information technology revolution, with its refusal to fit with economic orthodoxies, and its privileging of networks over hierarchies offers a glimpse of real alternatives. (You can catch a recent interview with him on ABC Radio’s Late Night Live.)

To round of the book, Carter and Hugman, in the final chapter, (Chapter 14) remind us that the notion of a moral conscience applies beyond the character and actions of individuals.

“collectivities too can be understood in relation to values such as honesty, responsibility and integrity through the way in which structures, policies and procedures are formulated and create a social space for the actions of individuals.”

Many large corporations have developed sophisticated public relations strategies to promote themselves as good citizens, whilst simultaneously engaging in a range of immoral practices that adversely affect the communities within which they operate. In a similar vein trade unions and churches have betrayed the trust of their members, and worse still compounded the bad behaviours with sustained attempts to cover them up. The reflexive response of loyal individuals to hide and excuse wrongdoing is so pervasive, it must surely give us pause to consider the effect that group loyalty has on the otherwise sound moral conscience of individuals.

Our colleagues in psychology have done some significant and sobering and research in this area, particularly around the phenomenon of confirmation bias. There is sound evidence that the teaching of critical thinking skills, which is supposed to help us overcome the bias on a purely individual basis, does not seem to yield very good results. Individuals with a pre-existing opinion are likely to search for supportive arguments rather than dispassionate evaluation. The upside of course, is that people (either individually or in groups) are very good at assessing arguments and evidence in an unbiased way provided that they have no axe to grind. For a review of the research in this area, I encourage readers to look at the comprehensive review paper, Mercier, H., & Sperber, D. (2011). Why Do Humans Reason? Arguments for an Argumentative Theory. Behavioral and Brain Sciences, 34 (2), 57-74. This research has profound implications for social workers exercising power in organisations, both for themselves and the groups they work with.There is a clear imperative to seek independent counsel, rather than suppress divergent views.

There are many gems in this collection, some already mentioned, but I would like to highlight a few that resonated with me.

Dorothee Hölscher (Chapter 7) gives us fresh insight into the refrain, ‘the personal is political’, turning it on its head. She reminds us that social justice and injustice are experienced, felt and recreated by each and every person in their day-to-day relationships, interactions, practices and routines. A social worker, for example, who attends to her own experience of vicarious trauma opens up an important source of understanding, “and therefore reveal crucial ways in which structural processes and contextual factors work through relationships to impact people’s sense of self, agency and so on.”

“Acknowledging this may help to judge less and attend more to the need to create safe spaces for people to engage critically with themselves and one another so as to better meet their responsibilities in relation to the social injustices within which they are implicated. Knowing this, practitioners may feel encouraged to pursue social justice as a practice that is political and personal at once.”

Hilary Weaver (Chapter 9) outlines Indigenous and First Nations people’s experience of social work both as a product of colonization and as a potential ally in struggles for decolonization. If we accept that  human rights do no exist outside culture, there are crucial implications. Western culture privileges an individualist ethos legally, morally and ethically. Consequently the collectivist, holistic value systems and aspirations of Indigenous societies struggle to gain a proper footing within an individualist framework. This casts sharp relief on just how central Indigenous self- determination is within a human rights context, and why “settler” societies fight so hard against it.

Sarah Todd (chapter 11), specifically addresses ethics in community practice. She makes important points about the humility and level of tact required to work in the space of provisional uncertainty, invoking Levinasian ethics to acknowledge the impossibility of truly ‘knowing’ a community. Whilst it is possible to work in the space of culture and social inclusion, working to transform power relations or tackling injustice is rarely within the scope of the possible.

Mark Hughes (Chapter 12) in his piece on ethics in organizations gives us a timely reminder that there is plenty of room to move before a social worker needs to ‘blow the whistle’. Most organisations share many of the values that are found in the AASW Code of Ethics. This provides fertile ground for strategic collaboration; points well illustrated in Hughes practice vignettes.

There were also some contributions that left me disappointed.

Kam-shing Yip (Chapter 8) suggests that the ideas embodied in the international social work organizations’ ethical statements are culturally specific to ‘Western’ society. Using the example of Chinese cultural values, the author gives a couple of clinical examples that would seem to be within the bounds of good clinical practice in both Western and Chinese social work. Given the real and significant difference between these cultures, I was left wanting sharper illustrations.

Elisabeth Reichert (Chapter 2), notes (not unreasonably) that the use of human rights frameworks that are not legally enforceable seriously weakens the capacity of social workers to implement human rights. But her prescriptive exhortations are jarring and unhelpful within the critical, provisional and tentative tone of the rest of the book.

“There can be many reasons for a state’s non-adoption of a human rights document, some of which have no relevance to social work ethics. Certainly, though, if the ethical consideration violates local laws then the social worker may have to yield to those laws. Generally, though, the social worker should always follow ethical guidelines regardless of whether a state has adopted a human rights document.”

Fred Besthorn, Terry Koenig, Richard Spano and Sherry Warren (Chapter 10) champion the notion of ‘ecological justice’, repudiating the notion that ‘environmental justice’ can “effectively and collaboratively to mediate the extractive and exploitative contours of capitalist excess”.

The distinction appeared to me to be simply a matter of degree . With over seven billion people on the planet some extraction will continue to occur! Let us take a local example. The Coorong Wetlands are in danger of dying. Overuse of water along the Murray River is a principle cause. Whether the Coorong is saved by joined up movements of ‘environmental’ justice initiated by many communities along the Murray, or by ‘ecological’ justice imposed in a single stroke by an enlightened Federal Government, will be a product of campaign tactics informed by local circumstances.

For a better understanding of capitalism and its relationship to the ecological destruction of the planet, readers should have a look at Naomi Klein’s bestseller, This Changes Everything: Capitalism vs. the Climate. It documents the efforts of environmental activists around the world, who are fighting extractive industries that threaten to ruin their homelands.

As a whole, this collection will, I believe, become a very important text within its genre, and the profession will be thankful that Jan Carter and Richard Hugman took the time to both contribute and put it together.