醫療體系中的社會工作是臨床取向，直接面對就診病患和家屬，但隨著醫療權益觀念的倡導、新興法案的制訂、病患問題與需求更為多元複雜的情形下，本文以急診社會工作為主軸，指出在「案主為中心」的觀念下，從專業責任的三項實務服務取向：支持性取向（support oriented）、主動性取向（proactive oriented）與協調性取向（coordinate oriented），和法定責任中的責任通報服務與陪同偵訊服務，來檢視社會工作者其專業權能、角色地位和服務內涵。並就社會正義論點，以優勢觀點（strengths perspective）、種族敏感實務觀（ethnic-sensitive practice）、正義取向實務觀（justice-oriented practice）與充權實務觀（empowerment practice）來檢視急診社會工作的服務過程。文末並提出臨床社會工作專業服務建構上的限制和後援服務系統的困境，和可能的因應策略。

In a medical system, clinical intervention is the major approach for social workers, which allows them to provide face-to-face services to patients and their families. Along with the advocacy of patient’s medical right and new bill enactment, patient’s problems and needs have become diverse and complex. This article aims at ER social work intervention, with the principle of “client-centered”, examining social worker’s roles, connotation of services and professional skills according to the following approaches: supportive, proactive and coordinative approach. Meanwhile, based on social justice point of view, it examines the delivery process of ER social work intervention from the perspectives of the following: strengths perspective, ethnic-sensitive practice, justice-oriented practice and empowerment practice. At the end of this article, it brings up the issues regarding limits of clinical social work services、short of back-up system and future possible strategies.