Episode 87 - Dr. Pam Miller: Oregon's Death with Dignity Act: Hospice Social Work and End-of-Life Decision-Making

Monday, January 09, 2012, 9:12:51 AM

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In this episode, Dr. Pam Miller discusses her research on social worker attitudes, values, and practices since the enactment of Oregon's Death with Dignity Act.

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Average Rating: 5stars  in considering end-of-life, Tuesday, March 26, 2013

By Joanne Boyce :

Dr. Pam Miller gave a very thorough and insightful discussion about how this Act came to fruition, the myths surrounding the act, and the adjustments the medical as well as social work profession had to make to accommodate its eventual passage. Whether you agree with the Act or disagree, the very existence of such a law illustrates how very far we have come in the consideration of end-of-life issues. Death was always something that was taken for granted, that left the client and family little or no choices, but now there is Hospice and much better pain management techniques than were available decades ago. The Act has put the social work profession in a rather precarious spot, as there seems to be conflict with several core ethical principles, that of the protection of life, self-determination, least harm, and quality of life (Dolgoff, Loewenberg, & Harrington, 2005). We have long been advised that we should look out for our clients' well-being and that if they are considering harming themselves in any way that we are to intervene. However, patients have a right to self-determine, but at what cost? To end a life would be thought of as causing the ultimate harm, but would letting one endure pain and suffering cause even more harm? What does that say for the quality of life? As a social worker, there is now the possibility of being put in a position of helping a client with a personal choice that may go against our personal values and beliefs. Will we be able to have the strength to be there for him or her? The rhetoric in this discussion reminds us that we all have some very thoughtful self-reflection when we are faced with dilemmas of this nature and the reminder that this is about the client and not about ourselves; ultimately the choice is theirs.
Dolgoff, R., Loewenberg, F.M., & Harrington, D. (2005). Ethical Decisions for Social Work Practice (7th ed.)Belmont, CA: Brooks/Cole.

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Average Rating: 5stars  review, Tuesday, January 17, 2012

By Doug C :

This podcast is an in depth interview of a social worker heavily involvedin Oregons controversial Death with Dignity Act. Dr Pam Miller discusses the history of the act and some myths orworries expressed prior to the enactment of the act. What I found very interesting is Oregons voting process with this act, it narrowly passed in 1994 and was voted on again in 1997 to ensure complete accuracy. The state of Oregon has taken many steps to ensure that patients who choose to end their lives using this act are fully capable of decieding for themselves and are aware of all alternatives. Dr Miller discusses how many myths that were believed to come true have not involving the patients that choose to use this act, 44% of patients possessed bachelors degrees or higher and 98% were caucasian. Althouth the act has faced opposition from the federal government the state of Oregon has been very cooperativewith it. Oregon has successfully implemented a controversial act and taken every step possible to ensure that it is carried out properly. Although much controversy still exists regarding the act, the patients that choose this option are completely informed and aware of their decisions.

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Average Rating: 5stars  very informational, Tuesday, January 17, 2012

By Mercedes V. :

This was my first podcast listen and I have to say it was very interesting and informational. I am a student and have never heard of the ORegon's Death with Dignity Act and considering that I knew nothing about it the podcast was very informational in explaining the different aspects of it. I was very intrigued with the information disucssed and how the interview was set up. It lets me know that I am able to learn about this from a professional who is able to clearly explain its history and different context about the concept. I am very impressed with the podcast and hope to enjoy others!

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Average Rating: 5stars  an informative podcast on the social worker's role in end-of-life decisions, Monday, January 16, 2012

By David Lee :

The podcast starts with a quick history lesson on the Death with Dignity Act to give the listener a quick bit of knowledge on the subject to understand what decisions the clients have to face and how social workers must go about supporting them. In the podcast, Dr. Pam Miller explains how the social workers within a hospice must be knowledgeable about the patients' individual needs and what they must do to help support them throughout their time being there.

I appreciate how immersed that the social workers will get in the clients life, always there discussing with the client and each other about every step they take in helping the client with making sure that this is the choice they want to make and to display all of the alternatives available. I myself feel that people have the right to choose when they wish to die when it comes to having a terminable disease or having lived to the point of having little control of one's self. I like how the social workers don't force their religion or spirituality upon their client but rather simply discussing it with them as not to directly deter them from making their own choice. The social workers will bring the family in to have them discuss with each other their opinions and concerns about their family members potential choices. They keep into account the clients personal problems, such as grief, when they discuss the situation with them.

I felt the Dr. Miller got her message across and I am now planning to research the topic a bit more in my free time to get a better feel for this individual portion of social work.

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