The two faces of social exclusion: ethics, evidence-base and practice in responding to health and social care concerns within policy-led social theory and its emancipatory alternatives.

International social policy treats social inclusion as the remedy to health and social care concerns, thereby promising to promote international social work values of social justice and empowerment. However, social theory encompasses different perspectives, carrying radically different ethical, research and practice implications. Current social inclusion policy emphasises as paramount to the problems and their solution, the individual’s capacity for social participation and responsibility, further viewing this in learning theory terms. These understandings support natural science evidence-bases, individual functioning ethics, and behaviourist practice approaches. In response to these approaches, however, service users and practitioners experience ‘ethical distress’, but as indicated by user-led New Social Movements, new understandings inspiring user-centred practice and research are led by such ethical distress, arising from users’ experiences of concerns excluded from dominant perspectives. The paper will therefore seek to recognise these excluded concerns, exploring social theories in which service users are authors of their lives, but also face damage and limitation through many forms of social adversity over which they have little control. It will then trace the ethical, research and practice implications of these perspectives. The paper will focus upon UK policies within the wider international policy context. It will use gender prepositions interchangeably.