Ethical decision-making in child protection work by health visitors and social workers

This thesis is a qualitative enquiry of the role that interprofessional ethics plays in the decision-making between social workers and health visitors in child protection work. Through two in-depth discursive studies, the way that participants negotiate the complex ethical issues that run through practice is explored. The dynamics of interprofessional working and ways in which professionals construct identities within child protection work are examined. Focusing on language as a medium that both reflects and constructs social realities, the thesis provides an analysis of the professional positions that are adopted firstly in response to a case study and secondly within interviews. The first study, a preliminary investigation, considered the responses of five health visitors and nine social workers to an online case study. Building from this, the second study analysed talk within four semi-structured joint professional interviews with pairs of experienced professionals. The findings indicate that the fixed differences in perspective between the health visitors and the social workers within the study are minimal. As in previous studies, the influence of formal ethical frameworks is also difficult to detect, although there are some implicit frameworks for ethical decision-making that fit with those provided by moral philosophy. The contradictions and tensions within the professional accounts mirror tensions present within policy and guidance. The tendency for social workers and health visitors to emphasise their alignment during the interviews indicates that the performed identities of both groups might be more fluid and context sensitive than is often assumed within the literature about interprofessional practice. Instead professional identities are in flux, coalescing in relation to cases (at the individual level) and in relation to communities of practice (Wenger, 1998). The boundary work that delineates professional roles and identities can be seen as determined within less fixed and more situationally nuanced frameworks