Mellan värderingar och direktiv: Etiska konflikter och moralisk stress inom ekonomiskt bistånd

Sammanfattning: Moral injury occurs when a social worker experiences the ethical dilemma of judging that there is a morally correct course of action but perceives that they are prevented from following it. Repeated moral injury can result in the compound phenomenon of moral distress. In Swedish welfare benefit processing, social workers make decisions based on laws, workplace directives and guidelines, as well as professional values. This study explores social workers' experiences of ethical dilemmas and moral distress in the context of welfare processing, and how the social workers handle these situations. Six semi-structured interviews were held with social workers working in Swedish welfare benefits processing in the Skåne region. The interviews were transcribed and analysed using the theory of uncertainty and the theory of accounts. The results show that social workers in Swedish welfare benefits processing experience ethical dilemmas and moral distress, and that these experiences stay with the social workers for a long time. We conclude that, as ethical dilemmas are a typical part of work within Swedish welfare benefits processing, social workers have experiences of moral distress. Social workers have a need of qualifying their decisions both to the client and to themselves. In this process, social workers use various forms of accounts. The participants cope with ethical dilemmas primarily through conversations with colleagues. All participants appear to handle the uncertainty of ethical dilemmas by constructing accounts around the appeals process as an assessment of right and wrong.