U.K. social workers’ attitudes toward assisted death, policies guiding practice, and transformational collaboration: Holding fast to medico-ethical principles of beneficence, non-malfeasance and social justice

Social workers play a key, but unacknowledged role regarding end-of-life decisions. The dearth of research on social workers’ attitudes toward assisted death is in stark contrast to the abundance of research on assisted death involving health care practitioners. Through analysis of data collected on members of the British Association of Social Workers (BASW) in 1998, this research examines attitudes of social workers toward assisted death (AD) including both voluntary euthanasia (VE) and assisted suicide (AS). Several hypotheses are developed from the available literature on assisted death involving social work and medical practice. The quantitative data are supplemented with written responses by BASW members. There is variation between social workers’ support of AD by country. English social workers are the most supportive, followed by Scottish, Welsh and Northern Ireland social workers. As a group, social workers support legalizing VE (72%) and AS (72.5%). A majority of social workers (69%) endorsed the Dutch model of legalized euthanasia. A minority of social workers (25%) indicated that they would report a colleague they suspected was involved in an assisted death. Catholics were less supportive of legalizing assisted death and the Dutch model of euthanasia but, regardless of religion, most social workers respect their clients’ wishes regarding end-of-life choices. Although less than 50% of social workers want to be involved in the decision-making making process with clients, over 65% indicated a willingness to engage in policy development regarding assisted death. Given their position, policy development is essential for social workers to be effective in end-of-life care. The theoretical perspective guiding the research shows that social workers support medico-ethical principles of autonomy, beneficence, non-malfeasance and social justice in assisted death. This finding places social workers in an important position regarding care of the dying. Future research should include the development and test of a collaborative model of training for all practitioners working with those facing end-of-life decisions. As a profession, social work must prepare itself for the challenges posed by growing populations of persons facing end-of-life decisions.