Review the following case. As you read, think about how these issues are related to the social science disciplines we have studied.
Marilyn Abbott is a 44-year old married mother of three children, ages 17, 19, and 21. Marilyn received her undergraduate degree in nursing in 1975, worked for two years in a large general hospital, then retired to raise her family. When her oldest child was in her in early teens, Marilyn returned to nursing on a part-time basis and completed work for her master’s degree, partly out of interest in her profession and partly for financial reasons (e.g., the Abbotts planned to send all their children to college).
Marilyn is supported in her professional interests by her mother, also a nurse who, at age 64, is still in private practice. Marilyn often refers to her mother as a woman whose chief goal in life was to "raise her only daughter to be a good nurse." Marilyn has worked as a public health nurse for the past three years.
In addition to liking her work, Marilyn appreciated the opportunity to maintain a reasonable work schedule because it is very important to her to maintain an even balance between work life and family life. Lately, however, that balance has begun to shift. Marilyn’s husband, Andrew, is a middle manager in a manufacturing firm. Recently, his firm merged with another company, and the new organizational structure appears chaotic. The organization is undergoing a reengineering plan, and there are rumors that this will be followed by a significant downsizing effort. A rising number of organizations in the Abbotts’ geographical area have downsized and let go many of their middle managers. Andrew is beginning to feel more closed out with respect to his career aspirations and has become moody and depressed in the last few months.
The Abbott children are in fairly good health and are actively pursuing their educational careers with the exception of the youngest, who, in the last six months, has become more reclusive, sullen, and secretive about his behavior.
Marilyn and her husband received a call this evening from the police department. Their youngest son had double-parked his car next to a busy bar and entertainment area. The police had searched the car, discovered small amounts of marijuana and cocaine, and arrested him.
Health Care
The Abbott family has always been very health-conscious and has realized the value of carrying comprehensive health insurance, thought the escalating cost of such insurance has increasingly become a financial burden to them. Health-consciousness has always been a strong value for Marilyn’s mother. On the other hand, Marilyn’s father, age 72, has always distrusted health care systems and health care workers. He prides himself on his independence and believes that he has maintained his health primarily because he avoids doctors. He recently transferred his health insurance to a health maintenance organization. This organization has been criticized in the press for inadequately screening its chronic care patients for appropriate medical care interventions.
Marilyn’s father has just suffered a stroke and is hospitalized. His physicians have indicated that the rehabilitation process will be long and arduous. Marilyn’s mother, who is usually competent to deal with most situations, has fallen apart and has become overly reliant on Marilyn.
Work Environment
Marilyn is a member of the Adult Health Team in Region Three, a culturally diverse team, and participates in nursing, health education, and community program coordination activities. She enjoys the variety of her job responsibilities and is generally well organized, but lately has begun to feel overloaded with work requests. Federal, state, and local regulations seem to be changing at such a rapid rate that she cannot keep up. Marilyn is so involved with paperwork that she is beginning to feel more like a corporation lawyer than a nurse. The entire agency has become hypersensitive to liability issues. In addition, changes in social policy have caused extensive cutbacks in the interorganizational system Marilyn relies on for case management activities in the community.
The morale in Marilyn’s office is generally good, although signs of tension are increasing. She has worked diligently to achieve a promotion to supervisor and feels involved in an unhealthy competition with two of her closest friends for the same position. Another of her co-workers, Sheila, has begun to show major signs of deterioration and burnout, and Marilyn thinks that Sheila may be impaired by chemical dependency problems. Marilyn worries about her own increasing stress management technique of using Valium whenever she is under stress.
Yesterday, Marilyn’s supervisor "came down on her" in an exceedingly harsh way because of some confusion about Marilyn’s interpretation of the new state and local regulations concerning service to refugee populations who are moving in to the area. Marilyn does not feel adequately trained to work with refugee populations. She does not understand Asian cultures and has received no training in diversity management. Marilyn’s supervisor is generally supportive but tends to monitor her work so closely that Marilyn feels constantly under observation.
Ethical scenarios