Workshop Description:

The NASW policy, Client Self-Determination in End-of-Life Decisions, states “Social workers have an important role in helping individuals identify the end-of-life options available to them. A key value for social workers is client self-determination” (NASW, 2003).

This workshop will introduce two end-of-life options available in Washington state: Medical Aid in Dying (MAID) and Voluntary Stopping Eating & Drinking (VSED) and discuss these options in the context of The NASW Code of Ethics. MAID was made legal in Washington over 12 years ago through the Death with Dignity (DwD) Act and is available to individuals in Washington with 6 months or less life expectancy due to terminal illnesses. VSED is an end-of-life option for individuals facing imminent decline and suffering who may not qualify for MAID/DwD.

We all have different cultural, spiritual, and philosophical beliefs about life and death that might conflict with those of a client who is seeking to access MAID or VSED. This conflict may cause ethical uncertainties to arise for social workers supporting terminally ill patients. To navigate these uncertainties, they can turn to the NASW Code of Ethics, which “is designed to help social workers identify relevant considerations when professional obligations conflict or ethical uncertainties arise.”

Workshop participants will explore MAID and VSED through the lens of the Ethical Principles outlined in the NASW Code of Ethics and practice applying these principles to end-of-life scenarios where conflict may occur.

Workshop participants will also work through case studies and small group discussion to build skills in end-of-life support scenarios utilizing “NASW Standards for End of Life Care”. End-of-life decision making includes ethical, religious, cultural, emotional, legal and policy concerns and concerns individual’s deepest fears, values and beliefs. Social workers have training and expertise in working with complicated intersections of individual, family, community, and culture and have important role as clinicians, educators, researchers, advocates, and community leaders. This workshop will help advance these skills relating to MAID and VSED to improve care and support for those facing terminal illness and unacceptable suffering.

Learning Objectives

1. Understand the basic qualifications for Washington’s Death with Dignity Act/Medical Aid in Dying (MAID).

2. Understand the option for Voluntary Stopping Eating & Drinking (VSED) and the best practices for support and planning.

3. Identify personal biases and cultural, spiritual, and philosophical beliefs about life and death and reflect on how they might conflict with a client’s choice to access MAID or VSED.

4. Apply the Ethical Principles outlined in the NASW Code of Ethics to end-of-life scenarios in which ethical uncertainties may arise for the social worker.

5. Discuss how culture and values can complicate end-of-life decision making. 

6. Utilize End of Life Washington resources to ethically support the self-determination of individuals facing terminal illness and unacceptable suffering.

About the Presenters: 

Cindy Nover, PhD, LICSW is an Associate Professor in the School of Social Work at Eastern WA University. In addition to her work at EWU, she works as a licensed independent clinical social worker in Washington and has a private practice providing clinical supervision to LICSW and LMHC candidates working in the fields of mental health, domestic violence, hospice, developmental disabilities, and Native mental health/domestic violence. Cindy is also the founder and owner of Sagebrush Crossing in Spokane County, a non-profit organization that offers a safe place where people with a terminal illness can pursue choice in death.

Beda Herbison, MSW, LICSW came to social work later in life, after volunteering with a program called Shanti that provided emotional support for people living with AIDS and their partners and/or family.

She graduated in 2001 with a MSW from the University of Washington and worked for the VA Medical Center in Seattle in the Spinal Cord Unit, the MS Clinic, the Geriatric Clinic, and other areas of the hospital.

After retiring and caring for her father-in-law, who was dying of cancer, she began providing clinical supervision for social workers who wanted to become licensed and for Multicare Hospice until she fully retired in early 2021, during the pandemic.  She continues to volunteer with other organizations such as the Hardy Plant Society of Washington, the Northwest Perennial Association, Shanti's Inmate Support Project, and End of Life Washington.