Social work in health care
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Soc Work Health Care · Jan 2000
Health care social workers' views of ethical issues, practice, and policy in end-of-life care.
End-of-life care decision making is perhaps the most difficult practice situation faced by health care social workers. Complex ethical issues arise from decisions regarding use of advancing medical technologies and/or other artificial treatments that may prolong life and/or compromise its quality. ⋯ Ethical dilemmas most often faced in end-of-life care situations related primarily to issues of communication between and among patients, families, and professionals. Practitioners indicated that more specific practice guidelines and increased education regarding bioethics and issues of end-of-life care are needed to be effective in assisting patients and families in end-of-life decision making.
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Soc Work Health Care · Jan 2000
Ethical dilemmas in general hospitals: social workers' contribution to ethical decision-making.
Thirty-two hospital social workers, fourteen of them directors of social work services and eighteen direct practitioners, were interviewed about their perception of the factors influencing social workers' contribution to the resolution of ethical dilemmas in general hospitals in Israel. Findings revealed that while ethical decision-making in hospitals is an interdisciplinary process, social workers' contribution to the process is affected by rivalry between social workers and other members of the health team, personality differences, type of ward and the nature of the ethical dilemma. ⋯ In order to increase their influence in ethical decision-making, the hospital social workers felt they must put more effort into developing their relationships with the other professionals involved in ethical decision-making both by making themselves more indispensable and by making their contribution explicit through greater documentation of their activities. The findings also implied that in order to gain more power and be accepted as equal partners in multidisciplinary teams, hospital social workers should improve their communication skills when interacting with representatives of other heath care professions.
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Soc Work Health Care · Jan 1999
Hospital social workers' attitudes toward euthanasia and assisted suicide.
Euthanasia and assisted suicide are the subjects of increasing controversy in the health care setting. In this study of 122 hospital social workers' attitudes toward euthanasia and assisted suicide, many respondents reported agreement that both practices may be ethical, should be legal in some situations, and that they would be willing to participate in the practices. ⋯ Preparation for requests to discuss these practices, through awareness of their own beliefs and attitudes and becoming knowledgeable about current controversies, policies, and practices, is essential. By doing so, social workers will be ready to seize the opportunity to emerge as leaders of multidisciplinary discussion of complex ethical issues in health care.
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Do-not-resuscitate (DNR) orders have differing meanings for persons depending on their age, training, and personal beliefs. In this paper we explore these meanings as expressed in the attitudes about do-not-resuscitate orders of three groups: university students in a health-related discipline of social work, university students in a non-health related discipline, and persons over the age of sixty. Findings from analysis of the three groups suggest a strong interest in issues surrounding resuscitation. ⋯ Next to their spouse, respondents named their physician as the person they most wanted to talk with about withholding resuscitation. Yet, studies of physicians cited earlier indicate many physicians are hesitant to discuss end of life decisions with their patients. With the added help and support of the family, concerned friends, and social workers, individuals can make the best possible DNR decision and avoid unnecessary pain and suffering.
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The health care system is a complex and demanding environment requiring an acculturation process for all those who provide services under its aegis. Social workers new to a medical setting, are faced with difficulties relating to all aspects of their role: bureaucratic, professional and clinical. ⋯ A core group of 22 social workers participated in the program, and in the final session, the participants evaluated the course verbally and in an anonymous closed questionnaire. Feedback was mixed and included the participants dissatisfaction with the reduction of the experiential component of the sessions.