Research into Practice

Neil Thompson looks at research into social workers’
attitudes towards euthanasia, which emphasises the need for
education on the issue.

The subject of euthanasia is one that generates considerable
debate, with strong feelings both for and against it. This research
study by Ronit Leichtentritt therefore makes for interesting
reading. The researcher, based in Israel, interviewed 16 social
workers concerning their experiences of, and attitudes towards,
euthanasia. She regards social workers as being in a unique
position in relation to end-of-life decision-making, but recognises
that the existing literature base does not address these
issues.

She distinguishes between three sub-categories of
euthanasia:

Active versus passive euthanasia – both are intentional acts,
but the former involves actively causing death, while the latter
involves avoiding the prolonging of life.

Voluntary versus non-voluntary euthanasia – that is, requested
versus not requested.

Assisted suicide – where someone takes their own life with the
aid of drugs or advice provided by another person.

These are subtle distinctions, but can be very significant in
particular circumstances.

From the research, the author was able to identify seven themes,
as follows:

Diminishing the value of life – moral questions relating to the
value of life.

A call for help – therapeutic issues relating to patients
wanting to be helped in extreme circumstances.

Legality – questions relating to what different legal systems
deem acceptable.

Social acceptance – different social mores and opinions.

Concern for the sick and dying – the implications and
consequences.

The involvement of others as executor – the role and
responsibilities of others.

The public nature of the act – hospital versus home.

The study revealed a wide variety of contrasting attitudes,
which highlight the dilemma faced by the social workers involved.
The workers had to wrestle with conflicting values (individual
autonomy versus the common good), dual considerations (patient
versus health care provider) and multiple roles (organisational
representative and patient advocate). These challenges, of course,
add to what is already a difficult area of practice – that of
dealing with end-of-life issues.

Of course, an exploratory study of such a complex area does not
offer anything resembling a definitive way forward. However, it
does give us considerable food for thought and emphasises the point
that social work education needs to address these issues: “Until
professional guidelines are available around the world, social
workers ought to at least examine their own meanings and attitudes
towards the universal phenomenon of euthanasia. The subject needs
to be included in professional training programmes and
socialisation processes. The social work profession cannot allow
itself to ignore this issue; ignorance and a lack of discourse are
the most dangerous forms of addressing and practising
euthanasia.”

In my view, Leichtentritt is correct to flag up the importance
of these issues, but I would want to locate them within a broader
context of the field of loss and grief, an area I regard as
crucially important as a fundamental part of the issues social
workers regularly face – but an area that tends to be neglected in
social work education as in day-to-day practice.¹ This
research can therefore play a part in the broader process of
raising awareness of the significance of loss and grief in social
work.

Ronit D Leichtentritt, “Euthanasia: Israeli Social Workers’
Experiences, Attitudes and Meanings”, British Journal of Social
Work, 32(4), June 2002

Neil Thompson is director, Avenue Consulting www.avenueconsulting.co.uk
and visiting professor at the Liverpool University. He is also an
author and a member of the International Work Group on Death, Dying
and Bereavement

Reference:

¹N Thompson (ed), Loss and Grief: A Guide for Human
Services Practitioners, Palgrave Macmillan, 2002