What have I done?

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THE CASE
You are a social worker who has been working with Ruth, a 13 year old girl in the 8th grade at a local middle school. Ruth’s parents have brought her to see you because they are concerned that she is not “well”.
During your first few visits with Ruth completing a comprehensive assessment proved difficult. Finally, toward the end of the second session, you revisit the spiritual assessment. At this time Ruth shares with you that her family is part of the local Kingdom Hall. She further tells you that she is unsure about getting help from you because while the church elders neither encourage nor discourage seeking assistance from a professional, they do want one to seek Jehovah first. Ruth says that her parents told her that the elders have concerns about how this could result in Ruth revealing confidential information about members of the church. She says that she is afraid of doing or saying something that will get her disfellowshipped, which would be devastating to her family.
After several sessions, Ruth finally begins to open up to you and reveals to you that she is 14 weeks pregnant. Her family and church are aware. She tells you that the father is, Seth, the 15- year- old son of another Jehovah’s Witness family in their church. She further reveals that she has been before the church elders and found to be repentant but that she was publicly reproved during a church service. By this point, Ruth is crying and fearful. She shares with you that she has three older siblings who have been disfellowshipped from the church because they had turned “worldly”. She tells you that her family is not allowed to associate with them because the church does not approve of association with others who are not followers. She is extremely worried that this will happen to her and if it does, her family will have to shun her. She knows that because she is a minor that she will be able to remain in the home but her relationship with her family will never be the same.
Two months go by and Ruth’s overall well-being seems to be deteriorating. She is now visibly showing the pregnancy and tells you that she is being mocked at school, as is the young man who is the father. Ruth tells you that the other children, especially other Jehovah’s Witnesses, are shunning her at school and are saying things about her being immoral and they whisper when she is around making her feel like they are talking about her. Ruth tells you that she only had a few friends anyway and now she is completely alone. However, Ruth seems to be more concerned about Seth. She tells you that when he went before the church elders, he was not found to be repentant and had been disfellowshipped. She begins to weep as she tells you how devastated his family is about what has happened and how much it hurts her to see them like that. Ruth then begins to insist that his disfellowship is all her fault. At this point she is sobbing and inconsolable. You try to discuss this with her thinking that she is thinking irrationally and has internalized blame. Then suddenly she screams, “YOU DON’T UNDERSTAND. IT IS MY FAULT. HE DIDN’T DO ANYTHING WRONG. HE ISN’T EVEN THE FATHER. HE JUST TOLD ME TO TELL EVERYONE THAT HE WAS SO THAT HE COULD PROTECT ME AND THE CHURCH!” and suddenly covers her mouth. She then begin to rock back and forth saying, “Oh no! What have I done? What have I done?”
Following the outburst and Ruth’s reaction afterward you ask her to tell you what she means. Ruth immediately shuts down and says she doesn’t know that she is just scared and confused. You immediately suspect that this story is much deeper and more complicated than you had originally thought. You again ask Ruth to explore this outburst with you and she just keeps saying that she can’t because she can’t cause any more harm to her family and her church; she wants to but she can’t. You remind her that she is safe, free of judgement, and remind her of confidentiality and its limits. Ruth tells you that she doesn’t want her parents to know that the Seth really isn’t the father but she can’t tell you who the father is because she doesn’t want to break the rules established by the church because she fears disfellowship. She further insists that even if she did tell you there is nothing that can be done about it and shuts down.
The next session begins with Ruth telling you that she knows that she can trust you now because you didn’t tell her parents that she and Seth are lying. She opens up to you and tells her that the father of her baby is an adult male in the church who began having sex with her eight months ago. When Ruth told him that she was pregnant, he denied the paternity by pretending that he had no idea what she was talking about. Distressed, Ruth confided in Seth who was one of her few friends. They considered her options and determined that disclosing the truth would bring shame on the church and even if they did disclose the truth church rules would prevent any real action from taking place. Instead they decided that Seth would claim paternity. However, the two did not anticipate disfellowship and when it happened to Seth, Ruth has been overcome with guilt. She feels that she should confess to the elders but fears that it will result in her being disfellowshipped. Ruth tells you that she would rather die than be disfellowshipped.
THE TASK
Now that you are familiar with Ruth’s case, you must “work” this case from an ethical standpoint (i.e. only address ethical issues associated with this case; I don’t need a treatment plan). Incorporating what you have learned this semester, you need to do the following:
Clearly identify the ethical dilemma(s) associated with this case
Clearly identify how you will resolve the dilemma(s) using the concepts we have discussed in class to argue and justify your actions. Please note that there are other considerations you will need to address as you see fit (such as minor status, the law, church doctrine, etc.).
Remember: the whole paper is about justifying how you would tackle this case from an ethical perspective. This paper must be well-reasoned and impartial.
There is no page minimum or maximum for this assignment. You are expected to use citations, to adhere to APA publication guidelines, to follow general grammatical and compositional guidelines, and to write with clarity, supporting your ideas and assertions with sound, informed reasoning. The use of spell check, grammar check and proof reading work is expected prior to the submission of the assignment.
Some additional tips:
Remember to assume that your reader knows NOTHING about what you are discussing so you have to explain it to them in a manner that they can understand it and follow your thoughts. This means that you should explain the models and approaches that you reference in the paper.
This paper is about the decision you would make in this case, therefore, I am interested in your thought process. I need to know how this all makes sense to you and how you see the concepts applying to the case. Spell it out clearly for me.
This is not a case that you can wait until the night before to address. Give yourself plenty of time to think this through. Jot down your thoughts as you think them so that you don’t forget them when you sit down to type the paper.
Some of the ethical considerations in this case, will require you to seek information from other sources (for example, the law). Be sure to do so and CITE the source.
Don’t approach this paper trying to anticipate what you think I want you to do. Be true to yourself and submit what you would actually do and cite your arguments. This is an exercise in reality about what you would do based upon the correct application of the ethical concepts we have discussed and if your arguments would hold up.
An effective writing style, good grammar, and correct use of APA is absolutely essential for this paper and neglecting any one of those areas will negatively impact your grade. This is clearly outlined in the syllabus and is expected of graduate level academic writing.
Your paper will be assessed based on the following general rubric:
Common Morality – 2 step process – 30 points
Paternalism – 10
informed consent/competence – 15
confidentiality – 10
Status as a minor, KY law, church doctrine, & Other ethical issues – 15
Organization/Spelling/Grammar – 10
APA Style – 10

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