State of Oregon’s Hospice Social Workers Agency, Research Paper Example

Abstract

This research investigates a social issue relatingto the State of Oregon’s Hospice Social Workers agencyPolicies and the social worker’s role. Precisely, discussion pertaining tothe theoretical foundations of the issue will be embraced. An analysis of the ethical conditions surrounding them would be explored and conclusions’ drawn.

Introduction

This document discussed Oregon’s Hospice Social worker’s issues. The motive of Oregon health care system is to offer residents improved access to services at every level primary, secondary and tertiary. Hospice care from a social work perspective has many challenges and regulations in Oregon. While social workers do not render care they are involved in the capacity of offering support to families of person placed into hospice.

An article presented by Norton and Miller (2012) asks, ‘what their terms of living and dying might be: hospice social workers discuss Oregon’s Death with Dignity Act.’ From their discussions thee themes evolved. They embraced values related to physician-assisted death. Secondly, was discussed agency policies regarding options social worker scan take during counseling families of patients in hospice. The third condition discussed was hospice social workers’ function alongside physician assisted suicide deaths (Norton & Miller, 2012).

Currently, three states in the United States of America have allowed terminally ill people access to lethal drugs that could aid in ending their lives. There are two other states now considering the measure. Hospice social work practitioners are committed tosupporting families during the decision making process and after the decision has been made (Norton& Miller, 2012).

Oregon’s Death with Dignity Act was legislated in October of 1997. This Act provided persons living in Oregon with terminally ill diseases to facilitate their death through voluntarily taking their life. This must, however, be conducted by administration of a lethal injection prescribed by a doctor. This Act also places the health author under scrutiny in that they are held accountable for producing and publishing data on how many persons were prescribed lethal injections for suicide purposes. This data periodically must be made available to the public (Death with Dignity Act, 2014)

Theoretical Framework

Identification and discussion of competing models

Some competing models exiting in physician assisted suicide encompasses patient autonomy, alleviating pain and suffering, clientconfidence in knowing if the treatment will be available when needed and the  patient/ physician decision. While social work practitioners’ intervention is vital the theoretical framework surrounding physician assisted suicide center on these main theories. The two competing theories that will be discussed are patient autonomy and relief of pain and suffering.

It has been argued that patient autonomy is the most ethical consideration in favor of physician assisted suicide. The assumption advanced pertains to the beneficence of the process Safranek (1998) however, contends that many theorists could err in their conclusions that when patient autonomy is apparent the right to die is maintained.Patients domake this decision for themselves accompanied by a physician and social worker(Safranek, 2008).

Further, the researcher argues that profound theories of patient autonomy are not validated in proving that autonomy has been realized   during the decision making process. Consequently, the autonomy concept as described by theorist could not substantiate that it was achieved prior to the decision makingprocess. In essence the author contention is that in no way theoretically can acts deemed morally acceptable be distinguished when applying current autonomy concepts.  Ultimately, noautonomy concept can accurately describe violations to the sanctity of life after the act has been performed (Safranek, 2008).

Salem (2009) criticized autonomy in physician assisted suicide to say that promoting autonomy is medicalizing suicide.  The argument lies in retaliating to the concept that autonomy creates an evidence of the process being voluntary. From his perspective the voluntary actions are construed. Descriptive and ascriptive properties of autonomy, the author argues, are morally limited. The freedom to rile one’s self free from external influences cannot be proven in the autonomy theory practiced in physician assisted suicide. Therefore once it is a suggestion offered as an option there is no autonomy ascribed to the process(Salem, 2009).

RichardDoerflinger and Carlos F. Gomez (2014) advocated a moral resolution pain and suffering challenge to physician assistedsuicide.In their view pilling the pain and not the patient was more morally sound. Advocates of physician assisted suicide always argue that relieving the person of pain and suffering is more dignified than allowing them the agony of pain. These experts advance that palliative measures could be employed since medication exists for pain resolution(Doerflinger& Gomez, 2014).

The counter argument of this theoretical premise relates to whether medication can no longer alleviate pain. It would be immoral as well to keep a person suffering when their pain can be relived in death.Doerflingerand Gomez(2014) continue to advance that physician suicide is immoral because health care is so expensive the better option today is limiting health care cost through earlier death. More so arguments have been that this theory is merely political in origin, underlying the issue of insensitivity of life itself (Doerflinger& Gomez, 2014).

Agencies, polices, by laws regulating physician assisted suicide

Departments of health are responsible for responsible for assisted physician suicide laws and regulations. For example the Oregon Death with Dignity Act allows Oregons to choose physician assisted suicide as an option for ending life prematurely. The health authority collects data on the use of this legislation and it is usually made public after a specified period. The legislation is known asDeath with Dignity Act (ORS 127.800-995) Oregon Death with dignity Act measure 16. The law allows a competent individual to consult with his/her physician during the final stages of a terminal illness to end his/her life. The law excludes mentally ill persons who are  incompetent. Family members cannot make this decision for the patient. It must be autonomous.

(Death with Dignity Act, 2014).

Personal views

Social workers take a social justice approach towards physicianassisted suicide in their role as counsellors in the industry alongside physiciansand their clients. Four forms of social justice is being practice during the decision making process and counselling of clients. They encompass commutative, contributive, distributive and restorative justice. Communicative justice requires an individual’s participation in h processes of his/he life. However, when communicative justice is executed by offering clear survival/alternative or options.

From experinces with the assistedphysician suicide process, in the same way that arguments regarding autonomy of the process are raised, similarly for me justice is not served in making these decisionsregarding ending one’s life due to terminal diseases. The moral and ethical implications are numerous. For example, physicians are expected to treat patients with the goal of recovering. With physician assisted suicide their roles have been changed to assisting people to die. A serious conflict of interest exist here, which is baffling social workers in their practice when they are called to intervene in the process.

Analysis of ethical issues, dilemma, malpractice and liability

Identification and discussion of competing models

Competing models were autonomy of decision-making process along with deliverance from pain and suffering.Major theoretical conflicts facing application of physician assisted suicide emerged. Social workers have been guided into taking appropriate action when facedwith these dilemmas.  Examples of ethical issues related to autonomy can be explained in executing assertive and descriptive autonomy.  In assertive autonomy patients must make these decisions without being influenced by outside forces. Ethical arguments have been that medical technology has complicated the autonomy of physician assisted suicide decision making process.

In cases where patients are supported by machines to sustain life, how does assertive autonomy apply regarding ending life? Oregon dying with dignity law allows death by lethal substance.  However, there are many other legislated forms of physician assisted. They are perceived immoral when applied to the other theory, removing pain and suffering. Patients who have been considered in a vegetated state are offered physician assisted suicide when the machines are turned off or treatment is discontinued because they may not be responding accordingly to medical science expectations.

Further, the pain and suffering assisted suicide dilemma becomes more pronounced when   nurses offer patients  large prescribed doses of injection morphine that depresses the heart eventually killing patients earlier than when death would have occurred. Autonomy has been undermined and the guise of relieving pain and suffering with morphine administration, is mercy killing within the patient’s consent.

Decision making models

Currently,applying appropriate decision makingmodels for a resolution is an ambitious process from a social worker’s position. However, as a patient advocate in the capacity of hospice social work practitioner collaborating with health care professions and patients advocates could be beneficial towards beginning the process. Patient advocates must come from outside of the social work and health care disciplines. These should include church leaders and ethical organizations.

Stake holders who ought to be targeted are politicians and healthcare administration. It would appear that that these mercy killings and physician assisted suicide in the healthcare industry maybe another managed care strategy in cutting cost. In the process the sanctity of life is lost. Autonomy is construed by alternatives and the pain and suffering theory is a mere deception ofmedicated suicide.

Alternative to

Alternatives

Clear alternatives encompass abolishing all these deceptive pain relieving medications from the health care arena since. It would appear that health care in America seems morally corrupt. When patients are placed in hospice they are given medications that end their live quickly, It is another dying with dignity concept. Th lethal drug is administered by the health care practitioner prescribed by the physician. Consequently, health care has emerged into a health scare whereby people are offered killing options rather than cures. Some  mercykikkings are tendered in disguise.

Conclusion and recommendations

The foregoing discussion outlined a theoretical frame work exploring hospice social worker’s role in physicianassisted suicide. While the process is highly medically mediated social workers have a solemn responsibility of standing on the ground between useless immoral loss of life and restoration towards living with dignity rather than dying with dignity.

References

Death with Dignity Act (2014). Oregon Health. Retrieved on November, 19^th, 2014 from http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/index.aspx

Doerflinger, R. &. Gomez, C. (2014). Killing the pain not the patient. Palliative care versus assisted suicide. Retrieved on November 18^th, 2014 fromhttp://www.usccb.org/issues-and-action/human-life-and-dignity/assisted-suicide/killing-the-pain.cfm

Norton, E., & Miller, P. (2012).What their terms of living and dying might be: hospice social workers discuss Oregon’s Death with Dignity Act.J Soc Work End Life Palliat Care.8(3):249-64

Safranek J. (2008).Autonomy and assisted suicide. The execution of freedom.Hastings Cent Rep.; 28(4):32-6

Salem, T. (2009).Physician-Assisted Suicide: Promoting Autonomy or Medicalizing Suicide The Hastings Center Report 29(3) 30-36