The field of social work ethics is changing. While more established positions, such as utilitarianism and deontology, continue to influence social work thinking and practice, emergent approaches are taking hold, leading to a radical examination of social work as an ethical discipline. To contribute to this unfolding debate, this article examines Isaiah Berlin’s notion of value pluralism and its contribution to social work. The argument proceeds by summarising and categorising some of the traditional and emergent theories shaping social work according to metaphors of the ‘head’ (the justice-oriented, rational approaches) and the ‘heart’ (the grounded, particularistic and care-focused approaches). Berlin’s value pluralism is then adopted to contend that social work needs to hold both ‘head’ and ‘heart’ ethics in a vital equilibrium to generate the ethics of the ‘hand’ (i.e. the practical response to contested areas of need) and the ‘feet’ (the commitment to change and well-being). These metaphors are then mapped on to a decision-making process and applied to the fraught area of adoption without parental consent.