Chair’s Blog | Social Work, End of Life and Assisted Dying
We must never forget that death is personal.
The current debate on the Assisted Dying Bill is leading to many questions about the nature of life and death for us all. Some of us will understandably want to step aside from this debate, some will have had or are anticipating distressing and difficult personal circumstances. Others will have more joyful or serene expectations as we or those close to us move towards end of life.
I have experienced a great deal of death, both personally and professionally. I know that does not necessarily make it any easier. I also know that there are always many questions to ask, some of them unanswerable, but it is important that we keep asking these questions while we deliberate on how we support people better at end of life from care, treatment and legal perspectives. We must never forget that death is personal.
End-of-life care for many people involves a number of professionals, often including medical, clinical, nursing, religious, pharmacy and, of course, social work colleagues. For the good of all concerned, especially those at the end of their life, it is essential that these professionals work well together. This may be whilst the person is at home, in a hospice or in hospital. As a profession, social workers are rightly asking questions about the crucial nature of the role we can and should continue to play in the end-of-life care and now more specifically if assisted dying becomes a legal option.
This excellent BASW production - The role of social workers in palliative, end of life and bereavement care - was co-produced by social workers and people with lived experience of end of life care or bereavement. The Association of Palliative Care Social Workers took a lead on it. It is very helpful on the social work contribution to death and dying, although it will probably now need to be updated as the public and political debate about Assisted Dying has moved on.
The resource starts with an overview of the context and an explanation of what palliative care social work is. It then sets out the particular capabilities (skills, knowledge and values) that palliative care social workers have, and the general capabilities that all social workers bring to supporting people through end of life, loss and bereavement. It explains what palliative care social work offers: in palliative care and end of life settings, in the last few days and hours of life and in the wider social care support for individuals, families and friends. It explains what all social workers can offer for people who are dying and bereaved and those who are close to them. The resource finishes with actions to further promote and develop palliative care social work at end of life and in bereavement.
It seems in some circles that the role of social work in end-of-life care is well understood and respected, including by people who are dying or at the end of their life. However, it would also seem it is not as yet fully appreciated by those in the current debate on Assisted Dying, judging by the proposed legislation and the ensuing public debates.
Questions worth asking include.
- Where is the crucial role of safeguarding in Assisted Dying and why is this not seen as the domain of the experts, social workers, as an integral part of the process?
- Where is the crucial role of emotional support in protecting those who need and are looking for it at the end of their life or those considering ending it?
- Where is the full consideration of mental capacity and best interests in this debate and the expert role of social workers in these fields?
There will be many more questions that BASW will want to continue to explore with our members, politicians and others. We must raise questions at this crucial juncture as the Assisted Dying Bill goes through Parliament, and ensure the protective and enabling role of social workers is made clear in the debates in the hope of creating a better death for all.