Walking the Tightrope Between Cultural Competence and Ethical Practice:
The Dilemma of the Rural Practitioner
Joanne Gumpert
School of Social Work
Marywood University
Scranton, PA 18509
570 348 6282
Gumpert@ac.marywood.edu
Phyllis N. Black
Lehigh Valley Program
School of Social Work
Marywood University
2640 Station Avenue
Center Valley, PA 18034
610 282 0479
black@ac.marywood.edu
Anne Hills
School of Social Work
Marywood University
2640 Station Avenue
Center Valley, PA 18034
annehills@ac.marywood.edu
Rural practice represents a unique mix of characteristics, which differentiates
it from urban practice. (Waltman, 1986; Buxton, 1978; Davenport & Davenport,
1984; Marmelstein & Sundet, 1995). To be accepted and trusted,
the rural practitioner must be an integral member of the community, connecting
personal and professional life through informal social networks (Gumpert,
Saltman & Sauer-Jones, 1999; Martinez-Brawley, 2000). Abiding by ethical
codes can pose challenges for the rural practitioner. Unavoidable
dual/multiple relationships, handling confidentiality where anonymity does
not exist, and worker competence related to the spectrum of problems faced
by isolated practitioners suggest ethical complexities. Few guidelines
are available to assist rural workers in balancing cultural competence
while attempting to adhere to ethical standards (Martinez-Brawley,
2000).
The authors completed a qualitative and quantitative study concerning
ethical perplexities in rural practice. Qualitatively, individual
interviews (N=6), and focus groups (N=2) provided a narrative of the ethical
conundrums inherent in rural practice and formed the basis of a self-administered,
anonymous inventory mailed to a convenience cohort of rural social service
practitioners (N=42 respondents). The inventory included a series of vignettes
reflecting ethical perplexities for respondent analysis.
Results revealed consensus on ethical issues unique to practice in
small communities: dual/multiple relationships, confidentiality and
professional competence. The majority of respondents declared that their
training failed to prepare them for the ethical exigencies of rural practice.
Aware of ethical tensions embedded in the vignettes, respondents’ management
strategies identify intuitive, innovative means to safeguard ethical mandates
and at the same time respect the cultural realities of rural life.
These findings suggest need for increased attention to management of ethical
issues in rural practice and inclusion of this content in the educational
curricula of schools of social work. Emphasis should be placed on promoting
a model that integrates sensitivity to rural culture and attention to ethical
mandates.
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