Bakgrund: Vid genomgång av lagar och etiska riktlinjer som beskriver ramarna för en god vård uppstår betänkligheter kring att till papperslösa tillämpa en begränsad sådan. Personalen som arbetar inom primärvården i Region Skåne ska arbeta enligt stadgade lagar samt förhålla sig till de riktlinjer som tillhandahålls. Enhetscheferna är de som har en övergripande blick över verksamheten och ska leda utvecklingsarbete på vårdcentralen. Det tycks vara en stor utmaning och det saknas en bild av hur detta går till, specifikt avseende en god vård av papperslösa. Syfte: Syftet med denna studie var att undersöka tillvägagångssätt på enhetsnivå inom primärvården för att erbjuda papperslösa en vård i enlighet med svenska lagar och etiska riktlinjer. Metod: Intervjustudie med sex enhetschefer. Datamaterialet analyserades med innehållsanalys. Resultat: De kategorier som framträdde relaterat till hur enhetscheferna uppfattar att Region Skånes riktlinjer och begreppet vård som inte kan anstå omsätts i praktiken var: kontaktväg, definition av patientgrupp, bedömning av vårdbehov och tolkning av vård som inte kan anstå. De utmaningar som enhetscheferna upplevde att de stod inför avseende implementering av riktlinjerna var: försvårande faktorer vid upprättande av kontaktväg, svårigheter att definiera patientgrupp, patientsäkerhet och praktiska problem vid administrering, svårighet att tolka vård som inte kan anstå, samsyn genom vårdkedjan, vårdpersonals värderingar, resurser versus människovärde, vårdpersonalens behov av kunskap och bristande information till patienten. Slutsats: Genomgående i resultatet sågs inkonsekvens genomsyra vården. Således kan en god vård till denna patientgrupp enligt nuvarande lagstiftning inte säkerställas. / Background: A review of the laws and guidelines describing the scope of quality of care create a disinclination towards limiting the care for undocumented immigrants. The staff within primary care in Region Skåne should work in accordance with laws and the proffered guidelines. The nurse managers have an overriding view of the unit and should lead the development work at the health centre. This appears to be a challenge and a depiction of how this is done is lacking, specifically revolving the care of undocumented immigrants. Aim: The aim of this study was to examine how to offer undocumented immigrants a care in accordance to swedish laws and ethical codes on a unit level within primary care. Method: An interview study was conducted with six informants. The data were analyzed with content analysis. Results: The question of how nurse managers perceive the guidelines of Region Skåne and how a care that cannot be deferred is turned into practice resulted in these categories: connection to health care, definition of patient community, assessment of health needs and interpretation of care that cannot be deferred. The challenges that the nurse managers perceived they are facing regarding the implementation of guidelines were: problematic factors in establishing a connection to health care, difficulties to define the patient community, patient safety and practical problems of administration, difficulties to interpret care that cannot be deferred, consensus through the care chain, values among the heath care staff, resources versus human dignity, required knowledge among health care staff and lacking information to the patient. Conclusion: Throughout the result was an inconsistency found to permeate the care. Hence, the quality of care for these patients can not be ensured.

<p>The aim of this study was to examine how the social services could investigate and support children of irregular immigrants within the boundaries of the law. More specifically it aimed to examine the legal possibilities and obstacles for the social services to support irregular immigrants, how the officials at the social services act considering the legal aspects, and how they reason morally and ethically when dealing with irregular immigrants. To answer the aim of the study the theory of positive law was used combined with qualitative interviews with two officials at the social services. Moreover a small quantitative telephone study with officials in the social services and with voluntary organizations was made. The study has used theories of sociology of law, law and ethics, and professional (civil) disobedience. The conclusions were that children of irregular immigrants are included by the Swedish law for social services, but are hindered from getting support by the legal obligation to inform the police authorities when the social services are dealing with foreigners who did not apply for a residence permit. There is a need for the officials to be extra committed in such cases and they break the obligation to inform to be able to support the children.</p>

The aim of this study was to examine how the social services could investigate and support children of irregular immigrants within the boundaries of the law. More specifically it aimed to examine the legal possibilities and obstacles for the social services to support irregular immigrants, how the officials at the social services act considering the legal aspects, and how they reason morally and ethically when dealing with irregular immigrants. To answer the aim of the study the theory of positive law was used combined with qualitative interviews with two officials at the social services. Moreover a small quantitative telephone study with officials in the social services and with voluntary organizations was made. The study has used theories of sociology of law, law and ethics, and professional (civil) disobedience. The conclusions were that children of irregular immigrants are included by the Swedish law for social services, but are hindered from getting support by the legal obligation to inform the police authorities when the social services are dealing with foreigners who did not apply for a residence permit. There is a need for the officials to be extra committed in such cases and they break the obligation to inform to be able to support the children.

This study focuses on the proposed legislative amendment regarding mandatory reporting. The purpose of the study is to investigate how social workers within social services perceive the legislative proposal on mandatory reporting, identify ethical dilemmas that social workers associate with the mandatory reporting law, and explore how they reason about handling these dilemmas. Consequently, three research questions have been formulated and answered using a qualitative interview method. We interviewed six social workers and within social services from different areas. Lipsky's theory of Street-level bureaucrats (1980) and previous research in this area were used as theoretical frameworks.  Our results indicate that social workers attitudes toward the legislative proposal vary; some remain critical, while others consider it similar to any other legislative proposal that regulates their work. Regarding the question of ethical dilemmas, they agree that such dilemmas can arise, but it does not necessarily affect all social workers. Concerning the management of role conflict and ethical dilemmas arising from mandatory reporting, there are different responses answers range from adapting the law to social workers' varied choices in handling this situation. Some argue that they want to align with the client's side, finding support in the organization's guidelines. On the other hand, there are those who believe it is best to follow the law to avoid potential consequences that may arise and conflict with the organization's mission and requirements. Some even choose to leave the workplace if they cannot align with the client within the organization's framework.