ABSTRACT
End-of-life care decision making is perhaps the most difficult practice situation faced by health care social workers. Complex ethical issues arise from decisions regarding use of advancing medical technologies and/or other artificial treatments that may prolong life and/or compromise its quality. NASW has set forth a policy to help guide social workers dealing with end-of-life care decisions and the preservation of client self-determination in these situations. However, the present study (N = 63) revealed that a majority (57%) of social workers were not aware of the existence of, or were only somewhat familiar with the policy. Ethical dilemmas most often faced in end-of-life care situations related primarily to issues of communication between and among patients, families, and professionals. Practitioners indicated that more specific practice guidelines and increased education regarding bioethics and issues of end-of-life care are needed to be effective in assisting patients and families in end-of-life decision making.
Subject(s)
Attitude of Health Personnel , Ethics, Professional , Social Work/statistics & numerical data , Terminal Care/standards , Adult , Decision Making , Female , Humans , Male , Morals , Practice Guidelines as Topic , Professional-Family Relations , Professional-Patient Relations , Social Work/standards , Surveys and Questionnaires , United StatesABSTRACT
Euthanasia and assisted suicide are the subjects of increasing controversy in the health care setting. In this study of 122 hospital social workers' attitudes toward euthanasia and assisted suicide, many respondents reported agreement that both practices may be ethical, should be legal in some situations, and that they would be willing to participate in the practices. Almost one-fourth of the respondents have been asked by patients and families during their careers to discuss euthanasia and assisted suicide. The social workers also identified situations in which euthanasia and assisted suicide may be appropriate and safeguards that should apply if practices are legalized. Preparation for requests to discuss these practices, through awareness of their own beliefs and attitudes and becoming knowledgeable about current controversies, policies, and practices, is essential. By doing so, social workers will be ready to seize the opportunity to emerge as leaders of multidisciplinary discussion of complex ethical issues in health care.
Subject(s)
Attitude of Health Personnel , Euthanasia , Personnel, Hospital/psychology , Social Work Department, Hospital , Social Work , Suicide, Assisted , Adult , Ethics, Professional , Female , Humans , Male , Surveys and Questionnaires , WorkforceABSTRACT
This article reports results of a study examining the impact of personal and professional values and experience on 122 hospital social workers' attitudes toward euthanasia and assisted suicide. Respect for self-determination was rated as the most important consideration in end-of-life issues. Predictors of social workers' agreement that euthanasia should be legal were: self-determination, religious beliefs, educational level (BSW/MSW), and for assisted suicide were: religious beliefs, belief in the potential for abuse, educational level and participation in ethics training. The findings underscore the need for social workers' awareness of how an interplay of personal and professional factors in potentially explosive ethical issues may influence practice in health care settings.
