Doing 'ethics work' together : negotiating service users’ independence in community mental health meetings.

Abstract

This article develops the concept of ‘ethics work’ (Banks [2016]. “Everyday Ethics in Professional Life: Social Work as Ethics Work.” Ethics and Social Welfare 10 (1): 35–52) from a focus on efforts made by professionals, to a domain co-constructed with service users and others. It takes an ethnomethodological approach to examining verbatim interactions in review (multi-party) meetings concerned with reviewing progress and making decisions about and with service users in community mental health settings in England and Finland. Drawing on the everyday, micro-level ethics of social welfare practice, this article demonstrates the ‘doing of ethics’ in real-life situations, thus widening the applicability of ‘ethics work’ as an analytical concept. Extracts from two meetings are discussed, focussing on the ethical challenges of supporting service users to live independent lives, while also protecting them from harm and respecting their own choices. While this is a classic ethical tension in social welfare work, it is also exacerbated in the current austerity regimes in many Western countries as service users and carers are ‘responsibilised’ and required to become more self-sufficient. Our analysis shows the significant ethical content in review meetings as professionals, service users and family members negotiate plans together.