Whither the Social Workers? Why the Silence?
Skirtz, Alice, Social Work
"Act to expand choice and opportunity for all people, with special regard for vulnerable, disadvantaged, oppressed, and exploited people and groups" [NASW, 2000, p. 27, Sect. 6.04(b)].
The words above are particularly striking as related to two current national conversations on social and ethical issues that affect those who are vulnerable and disadvantaged. One concerns the battle about children's health insurance, the other the wars in Iraq and Afghanistan. As the congressional debate concerning passage of the State Children's Health Insurance Program (SCHIP) raged with an obdurate president steadfastly vowing the veto, I wondered where were the voices and actions of social workers. Nationally, we have heard the big voices of the likes of the American Medical Association, AARP, health insurance plans (the insurers' lobby), governors from both political parties, even the parties themselves openly endorsing passage of SCHIP to cover 10 million poor children. In local communities, we have heard the voices of peace and justice activists along with poignant testimony of desperate parents whose children are sick and uninsured. At the same time, we have heard the voices of those who, like the president, argue that SCHIP will bring us to the brink of socialized medicine as if that were an affront to the democracy. Throughout these conversations, what can we make of the silence of social workers? I don't mean our professional organizations and lobbyists, because they usually lobby for our professional interests, or even voices from our specialty practice sections like Children, Adolescents, and Young Adults and Health. I mean social workers like you and me, those of us who know poor children and their families, and know children by name, not just as some aggregate adding 6.6 million children to the program, bringing the number of children covered to just more than 10 million.
We social workers are uniquely positioned by our work and interventions with families and their children to inform, to make an especially powerful contribution to the SCHIP narrative, but first we must join the conversation. Unlike medical practitioners and providers, social workers generally do not sell or provide health goods and services; hence, we have no conflict of interest as most of us will make no financial gain if more of our children are insured. Yet those other practitioners and providers who do are heard. Poor uninsured children--those who are vulnerable and disadvantaged--are truly our children, for we know them and the realities of the struggles their families have trying to find ways to pay for acute and emergency health care at times of illness or injury. These same families cannot even imagine the luxury of preventive health care or coverage for all family members. Where are social workers' voices in this disgraceful episode in our national life? The real disgrace is that there are any children without health insurance. It is a matter of urgency that we join the conversation "with special regard for vulnerable, disadvantaged, oppressed, and exploited people and groups" [NASW, 2000, p. 27, Sect. 6.04(b)].
Another conversation requiring our participation in the national narrative, to be true to our ethical responsibilities for our clients and communities, concerns continuing war in Iraq and Afghanistan instigated and perpetuated by the United States. The voices of social workers heard during previous wars, remembered as we hear daily news reports of killing and bombing and violent acts of mercenaries and militias, haunt us like specters from our shared social work history. Upon her return from the Woman's International Congress at The Hague in 1915, Jane Addams, along with fellow social worker pacifists, lectured and wrote of engaging moral forces to bear against continuing The War. Yes, it was thought to be "the" war. She spoke of the great difficulty in getting media attention as "the press throughout the country systematically undertook to misrepresent and malign pacifists as a recognized part of propaganda, and as a patriotic duty" (pp. …