Professional Ethics, Scope, and Referral
Scope of practice
Know that a CHW's role is to educate, support, navigate, and refer - not to diagnose, prescribe, or provide clinical treatment. Stay within training and role boundaries. A frequent trap is choosing an answer where the CHW gives clinical advice or interprets test results. The correct answer usually involves referral to the appropriate professional.
Ethical principles
Understand autonomy (respect client choice), beneficence (do good), nonmaleficence (do no harm), justice (fairness), and confidentiality. Know informed consent, mandatory reporting duties, and the limits of confidentiality when safety is at risk. A trap is assuming confidentiality is absolute or that the CHW's personal values should guide the client's decisions.
Boundaries and dual roles
Recognize professional boundaries and the risks of dual relationships, especially in small communities. Know how to handle gifts, personal disclosures, and conflicts of interest. Documentation must be accurate and objective.
Worked rule of thumb
When a client asks the CHW, "What dose should I take?" or "Do I have diabetes?" the best answer is to acknowledge the question, explain the CHW's role, and connect the client to the clinician who can answer. Never guess or interpret.
Traps to watch
Confusing advocacy with advice-giving; assuming that good intentions override scope; overlooking mandatory reporting.