Unozawa C, Tsuruwaka M
Bioethics/Nursing Ethics, Graduate School of Nursing Sciences, St. Luke's International University, 10-1, Akashi-cho, Chouo-ku, Tokyo, 104-0044, Japan.
J Bioeth Inq. 2025 Jun;22(2):441-456. doi: 10.1007/s11673-025-10421-y. Epub 2025 Jun 12.
Background Social workers (SWs) who support older people encounter ethical dilemmas and experience value conflicts when working with other professionals while fulfilling their responsibilities. We explored these experiences by interviewing SWs engaged in care for older people in Japan. Methods We conducted a qualitative interview survey with a targeted sample, employing a narrative analysis method. The participants included twenty-one SWs (four male, seventeen female) employed across acute-care hospitals, convalescent rehabilitation hospitals, home healthcare, and nursing homes. Results SWs described experiences of ethical dilemmas in supporting older people due to conflicting obligations and value priorities. They highly prioritize understanding the life backgrounds and values of patients to be able to discharge their duty to advocate patient autonomy and promote the best interest of the patients. However, SWs faced ethical dilemmas due to their responsibility to the organization, conflicting obligations toward the patient's family versus the patient's wishes, and differing prioritized values compared with medical professionals who prioritize the patient's physical function. Additionally, the relationship between SWs and medical professionals poses challenges in addressing these ethical dilemmas. Conclusion It is crucial to appreciate the significance of individuals from diverse professions by comprehending their respective roles and specialties, fostering equitable relationships, and capitalizing on their distinct expertise through collaboration.
背景 支持老年人的社会工作者（SWs）在履行职责时，与其他专业人员合作时会遇到伦理困境并经历价值冲突。我们通过采访日本从事老年人护理工作的社会工作者来探索这些经历。方法 我们对目标样本进行了定性访谈调查，采用叙事分析方法。参与者包括21名社会工作者（4名男性，17名女性），他们受雇于急症医院、康复疗养医院、家庭医疗保健机构和养老院。结果 社会工作者描述了由于义务冲突和价值优先级不同，在支持老年人过程中遇到伦理困境的经历。他们高度重视了解患者的生活背景和价值观，以便能够履行倡导患者自主权和促进患者最大利益的职责。然而，社会工作者面临伦理困境，原因包括他们对组织的责任、对患者家属的义务与患者意愿之间的冲突，以及与优先考虑患者身体功能的医疗专业人员相比不同的优先价值观。此外，社会工作者与医疗专业人员之间的关系在解决这些伦理困境方面带来了挑战。结论 通过理解各自的角色和专业特长、建立公平的关系以及通过合作利用他们独特的专业知识，认识到不同职业人员的重要性至关重要。
