Social Work Assessment at End of Life

Abstract

As social workers, we are educated about the values of client self-determination as well as the affirmation of uniqueness in how the client experiences life and death. In terms of choices at the end of life, assisted suicide has begun to come out of the closet, so to speak, and as a result, the National Association of Social Worker's adopted a policy in 1993 which addresses this end of life option. Oregon passed Ballot Measure 16 in November of 1994 which allows for a terminally ill person to request drugs to end life. As the legalities of assisted suicide are decided by judges and courts, some terminally ill people will think about and decide to take their own lives rather than wait for the disease process to come to its own ending. There are very few practice guidelines available to social workers who work with the suicidal terminally ill. A traditional mental health model for evaluation of lethality cannot be imposed onto this population. A three-part model for assessment and evaluation of a suicidal request from a terminally ill person is proposed in this article.

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“…It is essential for the social worker to explore the older adults' biological and biographical context and meaning of life as well as exploring all treatment options regarding end-of-life decisions. Older adults need to know that they are not only free in making their decisions, but that they are informed and understand the consequences of all treatment options (Miller, 1998).…”

La intervención de los trabajadores sociales en el marco de la Ley de Eutanasia

“…La atención sociosanitaria al final de la vida se asocia con los cuidados paliativos que se centran en la valoración integral de la persona y su familia donde la enfermedad terminal se considera como un proceso biológico y biográfico que no ve la muerte como fracaso. La intervención de los trabajadores sociales en la eutanasia voluntaria ha sido considerada como relevante para la práctica y los valores del trabajo social por diferentes autores (Csikai, 1999(Csikai, , 2000aCsikai & Bass, 2001;Miller, 2000;Miller et al 1998;Ogden & Young, 2003;Smokowski & Wodarski, 1996).…”