Ethical implications of case management services organization: a comparison France–Quebec

Abstract

Introduction: Professional ethics is an important aspect of case managers’ under construction professional identity. We tried, from a comparison France-Quebec, to understand case managers’ main values and their link with case management services organizations. Methods: We realized a qualitative study based on Focus Groups (3 in Quebec, 4 in France). The questioning route included questions on case managers attitudes concerning respect for autonomy, cost control and information sharing, and general values of case management. Results: All case managers asserted the importance of respecting clients’ choices even in at risk situations, and despite clients’ frequent cognitive troubles. However, in practice, case managers try to convince clients to accept services in order to protect them, resting mainly on family and professional partners in Quebec, whereas French case managers engage themselves in a strong personal relationship to understand the clients ‘values and negotiate individualized services. Quebec case managers were attached to the idea of defending public interest and respecting procedures, whereas French case managers considered administrative work as time taken to serve the system instead of the clients. Conclusion: Most of these results can be explained by the differences between the two systems in cases selection and cost control process.