Some clients may be unable—temporarily or permanently—to make fully informed decisions. That doesn’t mean they lose their rights. Section 1.14 of the NASW Code of Ethics emphasizes that when decision-making capacity is limited, social workers must act with increased care to protect the client’s dignity, autonomy, and best interests.
Here’s the standard:
1.14 Clients Who Lack Decision-Making Capacity
When social workers act on behalf of clients who lack the capacity to make informed decisions, social workers should take reasonable steps to safeguard the interests and rights of those clients.
What It Means in Practice
This standard is about ethical substitute decision-making. Whether due to age, disability, illness, trauma, or temporary impairment, a client may not be able to fully understand or consent to services or decisions. In these situations, the social worker becomes an advocate, protector, and translator of the client’s values—not a substitute authority figure.
The goal: protect without overstepping.
Key Guidelines
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Act in the client’s best interest
Consider safety, well-being, and long-term dignity in every decision. -
Include the client whenever possible
Even if capacity is limited, clients should be involved in ways that match their understanding. -
Use the least intrusive means
Avoid unnecessarily limiting autonomy. Only restrict decision-making to the degree required. -
Collaborate with legally authorized decision-makers
Work with guardians, healthcare proxies, or court-appointed representatives—but still advocate for the client’s preferences and rights. -
Document your reasoning
Clearly record why the client is considered to lack capacity, what steps you’ve taken, and how you’ve prioritized the client’s interests. -
Reassess regularly
Capacity can change. Don’t assume a client’s limitations are permanent unless formally determined.
Practice Question
Here's how this section of the code might look in an ASWB exam question:
A social worker is working with an older adult client who has early-stage dementia. The client insists on returning home alone after a hospital discharge, but the care team believes this poses significant safety risks. What is the most ethical FIRST step for the social worker?
A. Respect the client’s wishes and assist in arranging transportation home
B. Seek a court order to place the client in supervised housing
C. Set aside the client’s preference and proceed with discharge to a nursing facility
D. Assess the client’s decision-making capacity and consult with appropriate parties
Even when clients express a clear preference, social workers must first evaluate whether the client has the capacity to make an informed decision. If capacity is in question, the social worker must involve others and take steps to protect the client’s well-being without jumping to conclusions. The correct answer is D.
How to narrow it down: A assumes capacity without assessment, risking client harm. B is premature and skips least-intrusive options. C is overly paternalistic without proper evaluation. You have your answer.
Want more practice navigating questions like these? Explore SWTP’s full-length practice tests to sharpen your instincts and build confidence.