You are a medical social worker in a hospital. Mr John, age 75, is a divorcee
who lives alone in a small apartment. Three months ago, he was found unconscious at
home by a befriender who visits him regularly. Mr John was immediately sent to the
hospital. Medical investigations found that he had suffered a mild stroke and was
subsequently started on treatment. Mr John has responded well to treatment and now
needs to be transferred to step-down care at the Community Hospital, where he can
continue another 6 months of rehabilitation.
During the recent discussion with the medical team regarding his long term care plan,
Mr John was insistent on being discharged home. He does not wish to be transferred
to the Community Hospital. Mr John is very concerned about the medical bill, as he
does not have adequate savings, nor is he covered under insurance. As he has been
staying in the hospital for more than three months, he is also worried about the state of
You have noted that Mr John has three adult children and has been trying to contact
them to see if it is possible for them to use their savings to pay for Mr John’s
medical fee (including the fee that may be incurred at the Community Hospital).
Unfortunately, all the three children were uncooperative and claimed that ever since Mr John
had divorced their mother many years ago, they had severed relationship with
The medical team’s professional opinion is Mr John needs an extended period of
rehabilitation and would not be suitable to discharge home. They warned that if Mr John is to suffer another stroke, the consequence could be fatal.
(a) You are the medical social worker in-charge of this case and the multidisciplinary team comprising the doctor, nurses, and yourself has called for a case
conference to discuss the ethical problem posed in this case. Using the
Loewenberg and Dolgoff’s Ethical Principle Screen, analyse what is this model
about and how it can be used to resolve the ethical problem presented in Mr John’s case.
(b) With reference to the social workers’ code of
ethics from NASW (National Association of Social Workers), discuss how a social worker’s responsibility to clients is
relevant for you when managing this case.