recovery. Third, post-disaster service delivery problems, gaps, and barriers .... provision of service best translates to the outcome ..... Data continues to emerge.
Elec tronic Jo urna l of So cial W ork ISSN: 1537-422X © College of Social Work, University of South Carolina
Vol.1 No.1, Issue of February 15, 2002 Invited Review Paper
Re view Article Hussein H. Soliman Mary E. Rogge
Ethical Considerations in Disaster Services: A Social Work Perspective Hussein H. Soliman , Ph.D. Dept. of Social
Ethical Considerations in Disaster Services:
W ork. Un ited Arab Em irates Un iversity. P.O. Bo x
A Social Work Perspective
177 71 A l-ain UAE. solimanh@ hotmail.com and Mary E. Rogge, Ph.D. College of Social W ork, University of Tennessee. 225 H enson H all.
Introduction Natural and technological disasters often
Knoxville, TN 379 96-3 333 . mrogge@ utk.edu
strike com m unities with little or no warning. Abstract
Individuals, families, and comm unities suffer
Natural and techno logical disasters often strike
trauma and debilitation in every dimension of their
comm unities with little or no warning. This paper
daily lives from the loss of life and health,
examines ethical considerations that influence disaster response and recovery efforts and that
com m unity infrastructu re, property, jobs, personal
may go unrec ogn ized within the overwhelming,
belongings, and so cial ties (Dukfa , 1988; Zak our,
complex situations created by disasters. First, background information is provided on similarities and differences between natural and technological disasters
and
on
the
phases
of
disaster
m ana gem ent. Second, a conce ptual frame work is
1996). Many groups and organizations, which ope rate under various auspices, assumptions, and values, are inv olved in the delivery of an array of
described that integrates values and ethical
post-disaster
services.
Despite
the
best
of
principles that govern social work practice into the
intentions, organizational variations in modes of
con text of disaster managem ent, with a focus on post-disaster res ponse and rec overy. Th ird, pos t-
comm unication,
disaster servic e delivery problems, gaps, and
scheduling, and eligibility standards increase the
barriers that often emerge are discussed. Fourth, roles that social workers have to play in the planning, preparation, and implem entation of eth ically
grou nde d,
culturally-sen sitive,
po st-
disaster social service de livery is reviewed.
application
requ irem ents ,
chance for inconsistency, conflict, and poor coordination in post-disaster service delivery (Gillespie, Colignon, Banerjee, Murty, & Rogge,
Em phasis is placed on ways to improve the
1993; Seaman, 1999). Em ergency managem ent
capacity, opportunity, and rapidity with which
and social service agencies may fail to address the
i n d iv i du a l s ,
f a m i li e s ,
comm unities can recover
o r g a niza t io n s ,
a nd
from the devastation
that accom panies disaster. Key Words Natural and technological disasters; Disaster managem ent; ethical principles; post-disaster service
needs of special populations such as children, individuals who are elderly, imm igrants, and individuals who are hom eless (Cherry & Ch erry, 1997; Ch erry, Cherry, & Bowie, 1995; Kilijanek & Drabek, 1979; Saylor, 1993). For survivors, such
Ethical Considerations in Disaster Services organizational limitation s ca n ad d frustration and
already vulnerable, including people who are po or,
anger to a chaotic situation, cause potentially life-
children, elderly individuals, imm igrants, and
threatening gap s in im m ediately and desperately
people who are homeless. Fourth, the important
needed assistance, and impede a comm unity's
roles that social workers have to play in the
movem ent toward longer-term social, economic,
planning, preparation, and implem entation of
and environmental recovery and development
eth ically
(Gillespie, 1991, Leitko, Rudy, & Peterson, 1980).
disaster social service delivery is reviewed.
T his
pap er
ex am ines
grou nde d,
culturally-sen sitive,
po st-
eth i c al
Em phasis is placed on strategies and tactics that
considerations that influence disaster response
can improve the capacity, opp ortun ity, and rapidity
and recovery efforts and that may go unrecognized
with which individuals, families, organizations, and
with in the overwhelming, complex situations
com m unities can recover from the devastation that
created by disasters. The authors draw upon an
acc om pan ies disaste r.
extensive review of social work, social sciences,
The Phenom ena of Disaster and Disaster Man agement Phases
and emergency managem ent research and their research regarding social services in the context of
Natural an d T ech nologica l Disas ters Disasters are bro adly defined in this article
natu ral and techno logica l disasters. First, background information is provided
as
events
that
disable
comm un ity
social
on similarities and differences between natural and
functioning. Earthquakes, tornadoes, and other
technological disasters and on the phases of
natural disasters, are often treated separately from
disaster managem ent. Second, a conceptual
technological disasters such as chemical spills and
fram ework is described that integrates the values
acts of terror, civil unrest, and war, despite th eir
and ethical principles that govern social work
potential to amplify synergistically the threat of
practice into the context of disas ter m ana gem ent,
harm to human populations and their built and
with a focus on post-disaster response and
natural environments. As illustrated in Chart 1, for
recovery. Third, post-disaster service delivery
example, natural hazards compound the threat of
problems, gaps, and barriers (e .g., administrative,
tox ic exposure when, for example, earthquakes
interpersonal, circumstantial) that often emerge
damage industrial facilities housing hazardous
are identified and critiqued using the frame work
m ate rials or w ate r reservo irs
(Soliman & Poulin, 1997). Emphasis is placed on
structural failure or an act of terrorism (Gillespie,
how social service providers may fail to address
Rogge,
the post-disaster needs of populations who are
suggested that the mas sive level of devastation
2
&
Robards,
collapse from
1996). Scientists
have
Ethical Considerations in Disaster Services from Hurricane Mitch in 1998 and other natural
organizations, and personnel to be accounta ble
disasters are outcomes of human-activity induced
and to act eth ically.
global warming and climate change (International
Disaster Manag ement Phases
Institute of Sustainable Development, 1999). Risks
The focus in this paper, and in social work
from natural and technologica l disasters are
practice
increasing, in part because the human population
comm unities during the respons e and reco very
continues to grow and concentrate in urban areas.
phases of disasters (Sanderson, 2000; Swatzyna,
Chart
provides
been
on
helping
similarities and differences in people’s perceptions
services, however, cannot be brought to bear
of and responses to natural and technological
without
disasters.
the
activities to assess, reduce or mitigate, and
perceived cause of the disaster as an act of fate or
prepare for disaster events, as shown in Ch art 2
nature, such as an earthquake, or an intentional
(Gillespie, Rogge, & R obards, 199 6). Disasters
act of humankind, such as the attack on the
occur in a social, economic, and political con text,
Pentagon and W orld Trade Center. Perceived
so that emergency responders, social service
cause has im portant implications for survivors and
organizations, and others involved in disaster
broader
of
managem ent must account for this context in all its
victimization, and how and whe re people turn for
phases. For social workers, the focal point of
solace, justice , and reco very (R ogg e, 1995;
disaster m ana gem ent involvem ent shou ld be to
Saylor, 1993). Despite differences, a num ber of
m inim ize
strategies for reducing the harmful consequences
streamline adm inistrative processes for vulnerable
of these two types of disaster are similar. Natural
populations (Karanci & Ak sit, 2000; Zak our, 2000).
and technological disasters both require external
Ethical Fram ew ork
comm unity
overview
has
2000). Ethical, efficient, and effective post-disaster
im portant
an
general,
of
One
1
in
distin ctio n
m e m b e rs ’
is
s e nse
assistance for response and recove ry, have
attending
risks,
to
important
maximize
pre-disaster
resources,
and
Disasters a nd E thical Unc ertainty
emotional and psychological effects, require
The com plex dynamics of disasters and
reconstruction of shattered lives and shattered
disaster
bu ilt
natural
grounds for ethical uncertain ty and dilemm a.
environm ent. Com m unication of risk and resources
Studies have found evidence of dissatisfaction, on
with survivors is critical in disasters (Jaswal, 2000;
the part of survivors and responders, with the type,
Streeter & Mu rty, 1996; Zak our, 2000). Disasters
exte nt, and consistency of disaster relief (Leitko,
of all types require disaster managem ent systems,
Rudy, & Peterson, 198 0; Soliman & Poulin, 1997).
3
environment,
and
repair
of
managem ent
are
natural
breeding
Ethical Considerations in Disaster Services Lack of p reparation and training of s ocial service
and com plexity of e vents . Outs ide assistan ce is
providers
desperate ly needed, including shelter, food,
and
em ergency
responders
can
influence the quality of services to survivors
evacuation,
(Gillespie
1993).
Survivors frequently need loans, grants, and other
Representatives of disaster relief agencies have
form s of compensation to replace e quipm ent,
felt unable to respond adequately to survivors’
rebuild hou sing, and clean up. C omm unities
needs, and, in some cases, felt compelled to act
require pub lic reso urces to restore roads, bridges
contrary to survivors’ interests because of certain
and highways; repair telephone and electrical
regulations and policies adopted by participating
lines; and re claim other infras tructu re.
agencies
et
al,
1993;
(Kurzman,
Newburn,
1983).
Policies
transportation ,
and
information.
and
Outside assistan ce is delivered by a range
regulations by national governmental entities
of governm ental, non-for-profit, and profit entities,
responsible for disaste r managem ent have been
each of which operates under its own philosophical
assessed as “unclear, poorly explained, too rigid,
stance, assumptions, and values. These variations
and required a high level of middle-class financial
may increase the chance fo r inc onsisten cy,
managem ent skills to com ply with eligibility
con flict, and lack of coordination in service delivery
requirements” (Cherry & Cherry, 1997, p. 71).
(Robards, Gillespie,
Such conditions may cause the denial or delay of
methods of interacting with survivors can be
services to survivors at crucial times at which the
harmful or produce frustration, anger, desperation
provision of service bes t trans lates to the outcome
and disappointm ent am ong survivo rs (Cherry &
of successful coping (Soliman & Poulin, 1997).
Cherry, 1997). Survivors m ay face a bewildering
Notwithstanding the best efforts and intentions of
array of agencies and organizations that use
organizations and individuals, the standards
different forms of comm unication, application
imposed by som e disaster relief and response
requirements, time fram ewo rks , and eligibility
policies and procedures, or the implem entation of
standards. Survivors ’ expe ctations, p articu larly in
such regulations, are not adequately resp ons ive to
the imm ediate aftermath of disaster, may exceed
survivors’ nee ds a nd m ay not b e built on clear
the capacity of an y org anizational system to
ethica l and m oral stand ards .
respond comprehensively. These problems and
Survivors of disaster experience abnorm al
other
&
a d m i n i s tr a ti v e,
Murty, 2000).
i n te r p e r s o n a l,
Som e
a nd
conditions in which their resources are more often
circumstantial barriers can unde rm ine the delivery
than not insufficient. Individuals’ ability to cope
of services to survivors (Soliman & Poulin; 1997)
may be temporarily crippled by the sudden change 4
Ethical Considerations in Disaster Services Ethical Vantage Points under Conditions of Disaster Ethical theories, the concepts of caring relationships and moral citizenship, and social work ethica l code s co ntribute to the construction of
( 19 89 ) of
n ote d
p articu lar
public
“ T he policy
responses to disasters will depend upon the specific criteria or principles or s tan dards one fee ls
philosophy offers several prim ary alternative ethical vantage points to guide planners and policymakers in the m itigation of disasters” (p. 7). In the las t twenty years, there has been a surge of work
professional
activity
regarding
disasters and disaster intervention strategies; howeve r, ethical and moral dimensions of social work intervention in this disaster activity generally have not been well defined. A general presentation of ethics in social work practice should be integrated more fully into disaster relief and
abnormal
disaster
grounding social work pra ctic e in m oral theory,
successful interventions. In times of catastrophic or persona l disaster, social workers are obligated to adopt a caring outlook toward survivors to be respon sive to their ne eds . Manning (1997) defines m oral citizen ship as “the re spo nsibility to determine rights and good behavior as part of the rights and privileges social worke rs have as m em ber of a comm unity that includes
clients,
colleagues,
agencies,
and
society” (p. 224). M anning clarified that moral citizenship is concerne d with “how social worke rs use awareness, thinking, feeling, and ac tion to enact social work purpose” (p. 224). Under conditions of disaster, then, social workers’ moral respon sibility towards survivors is enacted through connecting with survivors and through negotiating organizational and societal resources to protect
response. Ream er
(1999)
noted
the
particular
survivors ’ rights and p rivileges . Utilitarian theorists deem an action to be
relevance of normative ethics to social work practice, “Normative ethics consists of attem pts to apply ethical theories and practice to actual ethical dilemm as.
to
conditions. Imre (1989), in her discussion of
soc iety ought to acknowledge and embrace. Moral
social
applicable
relationships as the context for carrying out
Ethical Perspectives
appropriateness
ironically,
emphasized the cen trality of caring, interpersonal
the ethical framew ork use d in this paper.
B e a t le y
Norm ative eth ical theory and daily practice is,
Such guidance is especially useful
when social workers face conflicts among duties they are ordinarily inclined to perform ” (p. 65).
right if the action, under conditions of conflicting duties, prod uce s the grea test good and if the choice of action is predicated on the estimation of the future good to be p roduced (Ream er, 1999). Linzer
(19 99)
no tes
that
utilita rian
ethic al
standards have been m et if the benefits of disaster 5
Ethical Considerations in Disaster Services mitigation exceed costs . Se tting ethical prio rities is
ethics into the three principal theories of virtue,
often difficult for people in need and soc ial workers
duty, and the comm on good. “The theory of virtue
alike in daily living. This difficulty is amplified under
refers to such traits as honesty, probity, and
conditions of d isaster in which multiple, urgent
respect for others- -a theory of duties therefore
needs are generated and time constraints force
s u g g e s ts
imm ediate choices with little time to assess the full
contractual permissions and obligations- - the
range of potential costs or goods. Critics of
theory of comm on good addresses the issue of
utilitarianism focus on the difficulty of deciding
social justice (p. 106). Applications of these three
between two competing options where benefits of
theoretical perspectives indicate that individuals,
one option may be unfeasible considering the
families, and comm unities that face the afterm ath
cos ts and rewards of each ch oice. Social workers
of disasters should be treated with respect and
should help s urvivors of disas ter na vigate choices
dignity. Chodoff (1991) viewed ethics in practice as
and calculate their actions under the existing
behaving accountably and competently, and
conditions of disaster.
engaging in advocacy. Further, policies, programs,
prescriptions
and
p r o h ib i ti o n s,
A con struc tivist approach emphasizes
and services to help survivors should be based on
mutual problem definition, priority setting, and the
the rights of the individual to be protected against
potential for change among actors. In social work
physical and ps ychologica l harm .
practice, this approach translates to ethical
Taking these perspectives into acc oun t,
practice grounded in “mindfulness, respect, and
then, in times of disas ter, social workers have joint
em pow erm ent" (Allen, 1993, p. 35). Again, belief
obligations
systems shape rules of conduct which influences
individuals and to engage in m oral citizen ship that
behavior and ou tcom es. A llen arg ues that a
acc oun ts for the pressing needs of populations
con structivist approach in clinical practice places
and that maintains a social justice focus. These
greater emphasis on social context and social
obligations must be m et in part by individual and
justice than clinical social work “largely grounded
organizational pre-disaster action to m axim ize
in individualism and rationalism… often treated as
post-disaster prote ction o f rights and to m inim ize
u n i ve r s a l
physical and psychological harm .
t ru t h s
without
re spe ct
to
culture…neglecting the social contexts which may define
the
lives,
needs,
and
problems
of
individuals” (p .42). Kurzman (1983) summ arized the study of 6
to
create
a
caring
context
for
Social Wo rk Principles Professional social workers, regardless of the ir field of practice, comm it themselves to abide by a code of ethics such as the National
Ethical Considerations in Disaster Services Association of Social W orkers (1999), in the United
generally relied on their own resources. Many
States, and the International Federation of Social
survivors of n atu ral and technological disaster may
W orkers
find
(1994),
which
guides
conduct
in
it
difficult
to
seek
help
from
service
interaction with multiple systemic levels. Social
organizations because of the social stigma often
worke rs and other social servic e providers should
attached to these agenc ies and for fear of losing
be aware as well of governmental and international
respec t, independence, and control over their lives
humanitarian relief ethical guidelines such as the
(Rogge, 1995). Social workers must assess how
Code of Conduct of the International Federation of
intervention approaches best facilitate m utu al,
Red Cross and Re d Cresc ent Societies (2001a).
respectful relationships
An examination of how professional social work
families in the context of post disaster intervention.
guidelines apply in the contex t of disaster is
Allen (1993) states, "In postmodern dialogical
imperative. Richman (1997) states, for example,
therapies, a kind of respectful curiosity replaces
"W e always need to be aware of the ethical
neutrality. Curiosity focuses on the multiplicity of
implications of our work, but whe n de aling w ith
possible patterns…generates respect and respect
people in extreme situations we a re ob ligated to
generates curiosity within the client system…
give special thought to ethical issues " (p. 374).
invites collaboration" (p. 48).
Disasters
multiply
exponentially,
and
individual
amplify, crises.
at
times
Ind ividua ls,
with
individuals
and
The grea t m edia interes t in the survivors of disasters
rais es
issues about c onfidentiality,
families, and com m unities in crisis are particularly
privacy, and dignity. In m onitoring co m m unity
vulnerable to exploitation and misunderstanding.
reactions to a disaster and reporting on its effects,
Under the stigma of victimization, for example,
the use of media’s technological resources can
survivors’ reactions to extreme distress under
often contribute to com m unicating survivors’ needs
extreme conditions may be misinterpreted as
to the broader comm unity while simultaneously
m enta l
the
infringing on survivors’ most private experiences
foundational values to atte nd to under conditions
(Richman, 1997; Robinson, 2000). By focusing on
of
dram atic
illness
disaster
(Fulford,
are
respec t
1991).
and
Among
dignity,
self-
determ ination , jus tice , and advocacy.
news about disaster-related death,
injuries, damages, and loss, the media may
Respect and D ignity. Stud ies indicate
perp etua te suffering rather than address survivors’
that survivors of disaste rs are, in m ost cases,
needs. W hether publicized information about the
individuals and families who have little experience
performance of disaster response org anizations is
with social service organizations and who ha ve
correct or inaccurate, the pressure of operating
7
Ethical Considerations in Disaster Services under the media’s watchdog function may res ult in
resources (Tierney, Petak, & Hahn, 1988). For
widespread efforts to correct system ic failures to
example, an emergency housing shelter in which
anticipate and re act effectively and efficiently to
all family mem bers, regardless of gender, shared
the disaster. Alternatively, such trem endous
the same space would be contrary to traditional
pressure
Muslim
m ay
exacerbate
intraorganizational
practices; hence
the
services
may
chaos, create interorganizational conflict, and
compou nd post disaster stress by intensified
heighten survivors’ anxiety and distrust in service
feelings of frus tration, a nge r, and disrespe ct.
organizations. Social workers have obligations
Most
disaster
studies
indicate
that
following disasters to engage mem bers of the
com m unity m em bers ’ participa tion is critical to
m edia judiciously in ways that protect the rights of
effective and spe edy recovery (Soliman, 199 6).
survivors
broader
Jago (1991) described the impo rtant role of a
com m unity’s right to know with organizational
comm ittee com prised of disaster survivors along
auto nom y to func tion.
with local and state government officials. The
and
that
balance
the
Self-Determination. As disasters unfold,
comm ittee, in response to a local flood, monitored
so do situations that threaten self-determination as
recovery
progress,
identified
loc al
n eeds,
they generate uncertainty, confusion, and con flict.
advanced reco m m end ations to loca l and s tate
Survivors must m ake crucial decisions as they
governmental and other organizations, negotiated
seek imm ediate resolution to intense, trauma tic,
for, an d ca rried out rec overy activities.
emotional situatio ns. Often, however, individual
Social workers must take care in the
autonomy is curtailed as emergency response and
afterm ath of disaster to use approaches that
service organizations implem ent their post disaster
enhance
operations. Survivor input is m inim al in m atters
addressing material or emotional upheaval and
such as evacuation, shelter, and food distribution.
loss. Researchers have documented over time the
The unique characteristics, strengths, and needs
m ultiple financial effects of disasters (Visno, 1977;
of ind ividuals and families can be lost as
Dodds & Nuehring, 1996) Data regarding the long-
organizations strive to regain control in post
term effects of disaster on small and impoverished
disaster confusion. Survivors should have the
comm unities are still limited, however. Econom ic
opp ortun ity to ma ke k nown their unique life
effects on hous eholds, including loss of hom es,
situa tions, special needs (e.g., a child’s medical
decline in household values, loss of financial
condition or mobility limitations of a frail elderly
assets, and a drastic decline in family income,
fam ily mem ber), values, beliefs, culture, and
correspond with a greater dependency, at least
8
survivor
self-determination
whether
Ethical Considerations in Disaster Services tem pora rily, on others for sup port. As she argued
disaster relie f to individuals in these gro ups is
for the use of constructivist models, Allen (1993)
often delayed or diminished, and that special
cautioned,
"
needs,
possesses
superior
…the
ide a
that
the
knowledge
therapist
about
such
as
individuals
with
physical
what
challenges, are often not well accounted for in
constitutes problems and desired solutions…does
com m unity disaster m anagem ent effo rts (Cherry &
not hon or the client's a gency and experience in
Cherry, 1997; Fothergill, Maestas, & Darlington,
determining the problem or the outcomes so vital
1999; Streeter, 1991; Tierney, Petak, & Hahn,
to her or his life. A client can end up feeling
198 8).
grateful for the expert effort and help but feel disem powered at the sam e time" (p. 44). Ju stic e .
of
distributive,
procedural,
and
participatory justice under conditions of disaster
subsistence are essential for all individuals ,
(Hoff & Rogge, 1996; Sanderson, 2000). Allen
fam ilies, and com m unities to recu pera te from the
(1993) cited O'Conn or’s view that social work
effects of disasters (Sunde t & Merm elstein, 1996).
should adopt a justice framework based on
In
satisfying hum an n eed s rath er than
response
and
s e c u rity
principles and
disaster
Ph ysic al
Social workers should be able to apply
recovery,
social
wants.
networks, volunteers, and informal organizations
Otherwise, social workers are in danger of
address som e of these bas ic needs wh ile others
supporting a status quo in which m any individuals
require the coordinated intervention of local, state,
and fam ilies are disadvanta ged. U nfortun ate ly,
and federal governm ent (Gillespie et al., 1993).
suppo rt of the status quo can and has been
Intentional efforts on the part of governmental
justified by a focus on psychological symptoms
agencies,
and
and therapeutic interventions, w hich can res ult in
concerned citizens are required to guarantee
"un wittingly adjusting people to poverty and other
social justice to survivors of a disaster. In keeping
form s of injustice" (p. 50). On the other hand,
with our tradition and history, social workers
therapy can be a vehicle for addressing some of
should pay particular attention under conditions of
the injustice that occurs in society. “Just” therapies
disaster
and
account for “the gender, cultural, social, and
disenfranchised populations, including children
econom ic contexts of any person or family seeking
and elderly individuals; people who a re physically
help… require that political work be conducted in
and m entally challenged; ethn ic, racial, cultu ral,
association with the psychological" (p. 50). The
and religious m inority populations; and people who
use of just therapies is perhaps even mor e
are poor. A num ber of studies indicate that
essential under the enhanced conditions of stress
9
not-for-profit
to
the
needs
organizations,
of
vulnerable
Ethical Considerations in Disaster Services and turbulence of natural and technological
identity, social service personnel may be obligated
disaster.
to act on the joint principles of justice and class
Advo cacy. Advocacy is one of the most
advocacy. Social workers who practic e prim arily in
controversial issues in disaster response and
clinical m oda lities m ust assess their role as
recovery
cl ear
advocates under conditions of disaster. Advocacy
understanding of survivors’ interests and because
includes, as Richman (1997) stated, “ promoting
of the potential conflict with other core principles
ethical codes of conduct in clinical work and
such as self-determ ination (Manning, 1997).
research, informing others about the ethical issues
Advocacy in disasters engages social service
involved, and enc ouraging adequate and equita ble
providers in moving beyond attention to survivors’
services ” (p. 378).
beca u s e
it
d e ma n d s
a
imm ediate physical, subsistence, and emotional
Organizational challenges may underm ine
needs to fights for survivors’ rights as both case
the use of advocacy in disasters. Formal and
and class advocates (Murthy, 2000). Disasters,
informal organizations struggle to respond to so
howeve r, create such sheer volume of need that
many needs, yet they face m ultiple adm inistrative
basic subsistence needs may be unrecognized
and policy challenges. In other words, agencies
and unmet and advocacy becom es a sec ondary
during disaster are also vulnerable and m ay well
priority. This situation can be seen in individual
be stretched beyon d their own cap acity to respond
situations in which survivors have special needs
adequate ly
that may not be accounted for in the basic set of
organizational reactions to advocacy may be
disaster services that organizations are prepared
hostile. Enacting the principle of advocacy in
to provide (e.g., a child who is mentally retarded or
regard to disasters illuminates the obligation on the
an adult who has Alzheimer’s disease). In such
part
situations, social service personal are obligated to
organizations to become involved in pre-disaster
assess individual and families’ special service
a s s e s s m ent,
m itiga ti o n ,
needs to m aintain sub sistence level functioning
preparedness
processes
and to engage in case advocacy to address th eir
prob ability that services for special needs will be
needs sufficiently.
available if and when disaster strikes.
of
to
social
comm uni ty
workers
needs.
and
social
Thus ,
service
p l a n ni n g , to
increase
and the
W hen it becomes apparent that the needs
Case and class advocacy in disaster work
of a group of su rvivors (e.g. residents of low
can be vital to address survivors' unique and
income neighborhoods, indigenous comm unities)
unmet needs (Jago, 1991). This may require
are unattended to because of their group status or
emergency
10
res po ns e
a nd
so cia l
service
Ethical Considerations in Disaster Services organizations to recognize the vitality of advocacy as a tactic to improve services to survivors. Organizations
in
which
disaster
preparation
promotes an open m inded, flexible outlo ok will m ore easily adapt th eir strate gies to address new needs with minimal defensiveness. Considering the multiple, demanding roles in which social worke rs must engage in during disaster response
Agency Response to Hurricane Andrew W hen Hu rricane Andrew hit sou th Florida in 199 2, 75,000 hom es were d estroyed, over a m illion peo ple lost withou t shelter, electricity, telephone services and water, and costs reached $30 billion. Cherry & Cherry (1997) found critical limitations in the response of the U.S. Federal Em ergency M anagem ent Agenc y (FEMA ):
and recovery, case and class ad vocacy are Inadequate, unclear information from FEMA to ess ential parts o f the re perto ire.
the public about services;
Ethical Applications in Disaster Services
•
Disaster response and recovery programs have bec om e increas ingly sop histicated, efficient,
Lack of emergency m oney to support families following the hurricane;
•
Len gth of time for responding to
and organized in developing and im plementing
survivors’ requests for services and
plans for reducing the harmful consequences of
sup port;
disasters for survivors (Dufka, 1988; Soliman,
•
Raymond, & Lingle, 1996). One comm on factor among
successful
•
Unexplained policies and procedures;
objectives that have bee n tran slated directly to
•
Rigid requirem ents for documentation;
services
to
programs
help
is
that could be bought by families;
clear
con crete
more
Restriction on materials and goods
survivors
and
cope.
Notwithstanding the many advances in disaster preparation, how ever, there are m any as pec ts of disaster man agement, from local to international levels, which need im provem ent (Akas hi, 1998). As noted earlier, ex plicit attention to ethical guidelines and dilemm as is one important area that requires greater emphasis, training, and
•
Lack of sensitivity to the needs of special populations. Natural disasters
create
tremendous
pressure on em ergency response and social service organizations, from local to national and international
levels.
Congressional
hearings
following Hurricane Andrew, however, found that FE MA’s failure to learn from previous disasters
implementation. Two experiences of disaster contributed to th e problem s experienced in services illustrate service problems that arose as An drew ’s afterm ath (Cherry & Ch erry, 1997). a result of limited ethical guidelines in disaster Notwithstanding the com plicatio ns inherent in response and recovery training and practice. 11
Ethical Considerations in Disaster Services large-scale disaster, the failure of a federal organization, created to ensure survivors’ safety
services, •
Identification of the phase of emotional
and prote ction, is uns ettling. Beca use of ethical and
m oral
c o n s i d er a t io n s ,
emergency
respons es to disaster, •
Myths
managem ent age ncies at all levels are requ ired to
and
realities
of
disaster
response,
stu dy, prepare, and develop strategies and
•
Identification of groups at highest risk,
procedures that are adequate to help survivors
•
Special population groups such as frail
receive effective services. Such services in turn
elderly, children, disadvantaged, and
enhance survivors’ ability to cop e with disaster and
ethnic/ culturally specific, and
reduce the poss ibilities for long-term psychological
•
reac tions.
Provision of inform atio n and referral The training program was perceived as
The Great Flood of 1993
helpful to the o utrea ch c oun selors, yet it did not
The Mississippi Flood of 1993 devastated
exp licate ethical or moral standards for service
parts of five M idwestern states. As a res ult of the
delivery in disaster (Soliman, 1996). Review of the
m assive damage that affected 39 (40%) of Illinois’
outreach project’s materials and observation of
102 cou nties, the Illinois Department of Mental
meetings provided evidence of the consequences
Health and Developmental Disabilities received a
of not integrating ethical content in the training. For
grant from
example, outreach co unselors rais ed question s in
the
FEMA
to
provide
outreach
counseling servic es to flood victim s. Over a
follow-up
hundred cou nse lors w ere recruited a nd tra ined to
survivors, comm unication with representatives of
provide: 1) information and referral, 2) individual
different agencies, conflict between counselors
and group counseling, 3) education to the general
and supervis ors, c onfidentiality, administrative and
public on the mental health aspects of the disaster,
organizational barriers, term ination of s ervices with
and 4) consultation with other organizations that
survivors, and interaction with survivors after the
participated in disaster relief (Soliman, Raymond
termination of services. Counselors and survivors
& Lingle, 1996). Preparation for the outreach
may have benefited had ethical principles and
included a training program developed and
guidelines related to m any of their questions, as
administered to the counselors by two experts in
we ll as underlying logical processes used to
the area of disaster and mental health. The
assess ethical choices and outcomes, been
training program included:
addressed clearly and syste m atic ally in their training.
•
12
The concept of disaster response
meetings
about
interaction
with
Ethical Considerations in Disaster Services Post-Disaster Response, Reco very, and Social Intervention
evacuation processes that account for evacuees’
Response and Evacuation. Interventions
information about the area designated for the
by emergency response and social service
evacuation and the process of a dju stm ent sh ould
organizations during the early response stage of
be discussed with evacuees as soon as possible.
post disaster focus on triaging survivor needs,
Moreo ver, a proper reception of the evacuees and
estimating the effects of the disaster, and
adequate care m ay reduce anx iety and prevent
informing the public about the its nature and
exploitation (Res sles, 1993).
emotional and psychological status. For example,
magnitude. Interventions during this stage may
Rec overy. Jago (19 91) no ted , "Financial,
include the evacuation of residents from affected
material and personal support offe red im m ediate ly
areas. Voluntary and forced evacuation from
and sensitively, and then on an continuing basis
homes
has been noted as critical to recovery" (p. 43).
and
comm unity
are
highly stressful and
Gordon & W raith (1988) estimated that "The need
comm unities. Th ere a re un ans wered q ues tions,
for the greatest level of personal support tends to
uncertainty, and anxiety about what will happen to
occur between four and eight months after the
pets, livestock , belongings, and structures left
disaster event" and that "W ith ong oing com m unity
behind as well as what the future holds in terms of
sup port, approximately 80 percent of individuals
reestablishing
can be expe cted to recover from their 'normal
experiences
for
individuals,
comm unity.
fam ilies,
Many
individuals,
therefore, may resist leaving home regardless of
reac tions to abn orm al stress'“ (p . 10). Leitko,
what inform ation a bou t imm inent risk is provided to
Rudy,
and
Peterson
(1980)
analyzed the social response to dependence
them (Saylor, 1993). Disaster reco very the ory indicates that,
produced by disasters. Their research compared
during the early stages of disaste r, peo ple ten d to
public expectations for relief giving in natural
cling together in a cohesive group, while others
disasters to those in economic disasters. Based on
engage in heroic efforts to serve the group.
the ir observations, direct relief is co ntributed to
Richman (1997) noted that people in threatening
survivors of severe economic d isaster only for a
circumstances might feel secure if they can stay in
brief period until indirect work relief programs can
familiar places close to, and know the status of,
be devised. Disasters have somewhat different
relatives and friends. Loss and separation from
effects
one’s
an
Generally, natural disasters affect people across
individual’s thinking process and generate a sense
socio-econom ic strata more equally than do
of fatalism. Ressles (1993) advocated for effective
ec on om ic
13
familiar
environment
may
block
on
public
dire ct relief
di saste rs ,
contributions.
ho we ve r,
im por tant
Ethical Considerations in Disaster Services differences exist. For examp le, people who ha ve
variety of private agencies compete to provide
lower income are somewhat more likely to be
disaster relief, and local agencies within the
exposed to certain disas ters s uch as floods (i.e.,
national org anizations often have a considerable
living on flood plains), wh ile people with m iddle
amount of control over their own activities"
and upper-m iddle incom e levels are m ore lik ely to
(Gillespie, Murty, Rogge, Roba rds, & Shen , 1995).
be insured a gainst loss . Data continues to emerge
Jago (1991) argued "because of the unique
about the m assive extent and multiplier effects of
situation in every disaster, decision making on
direct relie f giving following the W orld Trade
recovery struc tures and proc ess es n eed s to
Center and Pen tago n attacks (Independent Sector,
rem ain invested in th e loca l com m unity, with
2001). People regardless of social status are
assistance from external resources" (p. 43).
vulnerable to severe financial loss, physical
Depending upon the country, location, and type of
deprivation, and psychological trauma.
disaster, disaster response and recovery services
Mem bers
of
different
s ocioeconom ic
may
be
decentralized,
nonprofessional,
and
status groups m ay perceive disaster differently as
supported through voluntary giving (Anonymous,
we ll as experience some dynamics of disaster
1999). His torically, in m any countries, th e public
differently. Leitko, Rudy, and Peterson (1980)
has expressed dissatisfaction with disaster relief
noted, "middle class victims resented the 'need not
provided by national governm ents (Dufk a, 1988).
loss' basis on which relief was distributed" (p. 732).
In the U.S., the quasi-governmental American Red
Em ergency
service
Cross was traditionally the primary source of
organization persona l may have to address ethical
disaster relief for individuals and fam ilies until
issues that stem from survivors’ perceptions of
responsibility for much of the m ore extensive and
app ropriate recompense. The authors found, for
long-term financial relief was assumed by the
exam ple ,
that
FEMA. The Am erican Red C ross' current efforts
offended
bec aus e
responders
middle
and
class
they
social
survivors
expecte d
we re
relief
to
are aimed
toward restoring individuals' and
correspond to their status in the commun ity and
families' independent functioning in the early
the ir losses, regardless of their ability to support
stages of post-disaster response, largely through
themselves, while this was not a comm on
the provision of food, clothing, emergency shelter,
complaint am ong working and low income status
short term mental health services, small loans and
individuals.
referral of victim s to other governmental and other
The status of inter-organizational disaster relief servic es rem ains sim ilar to Leitk o, R udy & Peterson (1980) desc ription two deca des ago : "a
14
non-governmental source of aid (Cosgrove, 2000). Characteristics of Effective Services Certain characteristics of service are
Ethical Considerations in Disaster Services crucial for survivors of disaster and are important
recent years (International Federation of Red
for
Cross and Red Crescent Societies, 2001b; U.S.
survivor
satisfaction.
For social service
organizations and professionals, attention to these
FEM A, 2001).
service characteristics is recomm ended as an
It is difficult to overestimate the barriers
optim al, ethical strategy for meeting survivors’
that
needs.
empirical
information
under
research in which disaster survivors shared their
Em ergency
response
views regarding how services could be valuable for
organizations must coordinate pre- and pos t-
them
These
disaster to prioritize reliable mechanisms for
characteristics reflect values and m orals that a
comm unication throughout the comm unity. Once
service program should integrate to address
comm unication networks are up and ru nning,
survivors ’ conc erns and nee ds.
organizations
Information
throughout the recovery phase to disseminate not
The
discussion
(So lima n
&
builds
P oulin,
on
1997).
Sufficient, valid inform ation is vital in disaster
and
exchange
conditions and
of
disaster.
social
co ntinue
to
of
servic e
coordinate
only data about th e natu re of the disaster and
information about the location, type, and eligibility
also about norm al disaster recovery processes,
requ irem ents for post disaster assistance helps
and how individuals, families, and comm unities
survivors mak e inform ed decisions that are
tend to react emotionally, psychologically, and
intrinsically related to their life arrangemen ts and
behaviorally to the stress of disaster (Gillespie,
future well being. Ac curate inform atio n of this
1991).
nature is crucial for social workers and other
information
services providers, as is valid information about
(Robinson, 2000). Jago (1991), for example,
the range of reactions and behaviors that survivors
described how newspaper supplements were used
will likely experience. Jago (1991) reported on the
over time for this purpose.
utility of information workshops following a disaster
Appropriateness and Clarity of Procedures
w ork sho ps,
presented
Media
can
carry
distribution
out
role
in
an
important
this
regard
by
Negotiating the processes for services
recovery experts on su rvivors’ reactions, were
may be daunting to survivors. Unfamiliar, detailed,
arranged for members of government and non-
bureauc ratic processes can often be confusing;
government organizations. Pre-disaster training,
the demand for doc um enta tion – in the afte rm ath
such as offered by the FEMA and the International
of widespread destruction of hom es, property, and
Federation of Red Cross and Red Crescent
legal documents - to sub stan tiate pro of of eligibility
Societies has become increasingly available in
can be m add ening to survivors and organizational
15
The
re covery.
sho uld
flow
information about how and where to get help, but
Aus tralia.
a nd
the
Ac curate
in
respon se
challenge
Ethical Considerations in Disaster Services personnel alike. As one survivor of the Great Flood
the need for imm ediate services to satisfy urgent
of 1993 noted in the presence of one of the co-
needs, including shelter, food and water, clothing,
authors, “I’m sorry, a ll m y docum ents w ere in the
transportation and information. If access to services
house and the house was gone”. Survivors’
is
tribulations may not be over once applications for
consequences as does the com m unity at large.
service have been completed. Survivors m ay leave
Service Coordination
delayed,
individual
survivors
suffer
the
a disaster relie f center with only an applicatio n
The efforts of the many organizations that
processing num ber a nd a teleph one num ber to call
may converge on a com m unity, region, state, or
for follow up. Applicants have reported feedback
nation in disaster must be coordinated. Poorly
on
and
harmonized activity among the m ix of local, state,
inconsistent; survivors have received different
federal, and international organizations can create
answe rs on the status of their application from the
wasteful redundancy, complicate access to services,
sam e office (S olim an, 1996 ).
or cause som e groups to receive delayed or no
their applications
Clear, services
are
procedures
to
be inaccurate
sim ple
pro cedures
critical
for
obtain
survivors.
These
educational level, life experience, nature of the
services have improved over time, m any survivors
disaster, type of loss, and survivors' experience
experience services as complicated, incon sistent,
with social service organizations. Jago (1991) and
and inadequate. Services may be formalized and
Soliman (19 96) found that rigid, unclear eligibility
categorized to the e xten t that they m ay fail to
requ irem ents
consider
needed
prevent funds
and
the
Implications Studies suggest that although disaster
could
consider
service (Gillespie, et al., 1995).
survivors’
receiving
should
to
survivors support.
from
the
principles
that
guid e
service
The
provisions. Furthermore, these services may
consequences of n ot acquiring post-disaster
continue to fall short of addressing adequately the
resources can be more serious for members of
needs of individuals who are elderly, children,
vulnerable populations such as children and
people of co lor, peo ple with low income, and other
elderly individuals. Trust betwe en survivors and
vulnerable populations. This article has illustrated
organizational rep resenta tives are essen tial for a
areas of pre- and post disaster planning and
positive working relationship; good comm unication
service interventions in which ethical issues are
between survivors and helpers are critical for
like ly to arise and in which clarification of ethical
effective re covery.
and value principles could foster resolution. Pre-
Appropriately Timed Service Delivery
disaster training that takes ethical considerations
Disasters are large scale crises that create
16
into
account
can improve
the
post-disaster
Ethical Considerations in Disaster Services cap acity of staff and volunteers to function
interpersonal and environmental coping
appropriately
resources, and the particular needs of
during intensified demands for
service, stren gthe n org anizational strateg ies to h a n dle
massive
d is a s te r ,
and
b r o a d en
vulnerable populations. •
opportunities for organizations to coordinate.
Provide personal support and case and class advocacy to survivors throughout
In this context, the roles of social workers in conducting ethical pra ctic e with survivors of
disaster response and recovery periods; •
disasters include:
Intervene through
sensitive
team
a nd
b uildin g,
planning,
co m m un ity
coordination -- pre- and post-disaster -•
Participate
in comm unity pre-disaster
managem ent
c o m m i tt e es
through the full spectrum of social work
and
approaches
encouragement of other social service
For
managem ent
to
include
an
ethical
fram ework for participation in disaster response and recovery activities; •
policies to maximize coherence between requirem ents
and
interests
of
orga nizations an d su rvivors ; •
activity that increases the capacity of p r iv a t e ,
o r g a n iz a ti o n s
to
and
v o lu n t e e r
c o o rd i n a te
and
collab orate ethically when disasters occu r. •
Engage in pre-disaste r, interdisciplinary, public, and professional training that a d dre s s e s
e th ic a l
a p pro ac h e s
to
survivors’ reactions to disaster, the use of
17
social
workers
op erating
under
conditions of disaster, Allen’s (1993) description of ethical res ponsibility applies. Ac countab ility "lies in the responsibility to advocate and to open space
that they can define themselves, their problems, the ir preferred solutions" (p. 40). Social service organizations and professionals at local, state, nation al, and international levels m ust c ontinu e to
Initiate and participate in pre-disaster
p u b l ic ,
direct
for client voices in the developing conversation so
Review organizational regulations and
the
and
and organizational administration.
involved; Structure social service organizational
clinical
practice through advocacy, organizing,
organizations and citizens to become
•
from
learn from past successes and failures to improve disaster managem ent frameworks, strategies, procedures, and collaboration s. W ith th e certain knowledge that new natural and technological disasters will emerge, our o bligation is to think and act, befo re disaste rs arrive, to m inimize potential harm
and
to
intervene ,
post-disaster,
w ith
m axim ally efficient, effective, and ethical service.
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Chart 1 Disasters: Events that disable community social functioning Natural Earthquake
Syn ergistic Flood
Technological Hazardous materials releases
Volcanic eruption
Landslide
Nu clear acc idents
Avalanche
Drought
Structura l and tra nsp ortation acc idents
Hurricane, typhoon, cyclone
Desertification
Forced migrations
Tornado
Deforestation
Terrorism
Snow/ice
Fam ine
W ar
Fire
Disease Epidemics
Civil unrest, riots
Insect swarm s
Global W arming
Genetic engineering Com puter-technology failure
Differences and Similarities between Natural and Tec hnolog ical Disa sters Differences
Cause: nature, fate, supernatural
Similarities Increasing vulnerability: greater population density in hazard zones Cause: human error, intent, neglect
External assistance required
Controllable, preventa ble
Long-term effects for victims
Unjust risk and victimization
Loc alized to large regional effects
Clear beginning, ending
Clear beginning, ambiguous ending
Em otional/psychological consequences
Reluctance to evacuate, readiness to return
Sponta neo us e vacuation , reluctanc e to return
Structural and non-structural mitigation
Uncontrollable, m itigatab le Random victimization
Mandated mitigation vs. loss of autonomy/control Visible event, consequences, recovery
Invisible event, consequences, recovery
Known destructive effects and remedial actions
Am biguous destructive effects and remedial actions
Em ergence of therapeutic com m unity
Com munity conflict and dissention
Risk perception and comm unication are critical Cost/benefit comparison of risk vs. mitigation Accountability for success of human disaster managem ent systems Threat detection, evaluation and information dissemination required
(adapted from Gillespie, Rogge, & Robards, 1996)
Chart 2 Disaster Manag ement Phases Evaluations of disaster potential
Actions th at m inimize destruction and disruption
Actions to reduce immediate loss, improve respond and recover
A S S E S S M E N T
M I T I G A T I O N
P R EPAREDNESS
Hazard (location, severity, probability of occurrence)
Legislating building codes
Planning response roles
Search and rescue Debris removal
Land use zoning
Training and exercising response roles
Reconstruction and sustainable development of:
Structural (building and construction standards)
Inventory community capabilities
Lifeline service reestablishment
*Built and natural environment, land use
Non-Structural (furniture, light fixtures, windows, gas lines)
Stockpiling, distributing resources
Medical, psychological, emotional care
*Economic opportunity and structure
Mass shelter and sustenance
*Emotional and psychological well-being
Differential outreach and response with vulnerable groups
Recovery-generated disruption, enhancement
Vulnerability (estimated loss & damage to persons, property, community functions, natural environment) Risk (estimated probability of vulnerability for a given hazard) Community capability (to manage disaster) Sustainable community development planning (hazard/development integration)
Insurance incentives Sustainable community development planning: involvement of vulnerable groups
Imm ediate and short term mobilization of resources to protect life, property RESPONSE
Disaster Event
Monitoring, warning, evacuation Planning for and involvement of vulnerable groups
Intermediate and longterm efforts to restore and stabilize community functioning RECOVERY
Differential recovery among vulnerable groups
organizationcom mun ity................localglobal------------------------------------> (adapted from Gillespie, Rogge, & Robards, 1996)
