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Medical social workers’ values, views and practice regarding euthanasia Marshall, Carolyn Louise

Abstract

Medical social workers from health care institutions in the urban lower mainland of British Columbia were asked about their views, values and practice regarding passive and active euthanasia. This qualitative, exploratory study focused on the attitudes, values and structures that influence professional social work practice with clients requesting euthanasia. During the months of August to November, 1994, seventeen medical social workers, who were experienced in this area, were interviewed. An interview guide format was used that was previously tested in a pilot study of this project. Within the pre-selected categories; views, values and practice, responses were described and emerging themes were identified through content analysis. The study results confirm medical social workers are playing an active professional role with terminally-ill patients, families and staff when requests are made for euthanasia in the health care system. In this study population, in most cases, the social worker's views, whether for or against euthanasia, did not determine his/her practice with patients. Instead, it was the social worker's willingness to give up his/her control in the patient/professional relationship in an effort to support the patient's decision to die with dignity. This practice was based on the value of patient self-determination being paramount against all other interests. Self-determination was ranked as the most influential factor in determining practice by most of the participants. Responses revealed there was a lack of understanding by health care professionals at all levels regarding the process of separating personal values from the professional obligation to respect patient self-determination. Feminist medical ethics suggests that all health care professionals need to engage in self-evaluation to address any need they may have for power and control in the professional/patient relationship. Furthermore, medical social workers should recognize their own such needs, particularly when their personal views and values come into conflict with a patient's decision regarding euthanasia. This study not only presents the issues of power and control that social workers and other health care professsionals experience in the medical system, it also explores and describes the contributions social workers have made in their practice with patients who request the right to die with dignity.

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