End-of-Life Decisions

Ellen L. Csikai

in Social Work

ISBN: 9780195389678
Published online April 2013 | | DOI:
End-of-Life Decisions


End-of-life decisions occur throughout the lifespan and involve many aspects of the dying process. As medical technology continues to advance and produce the ability to prolong life almost indefinitely, individuals and families are asked to make increasingly complex choices about what treatments best correspond to their conceptions of how they wish to die. Discussions may occur around issues of advance care planning (including living wills), use of life-sustaining medical treatments, hospice and palliative care, organ donation, and physician-assisted death. Such discussions may be held with family and health professionals and decisions made about how to handle care at the end of life in advance of a serious, life-limiting illness, and, at the other end of the continuum, when treatment aimed at a curing a serious illness is no longer effective. These discussions take place in a variety of health settings and social workers are often asked to facilitate the process particularly at critical decision points in serious illness. End-of-life decisions create a need for attention to medical aspects as well as to psychosocial consequences. In addition, decisions may be complicated by policy considerations, particularly about including health insurance and federal and state policies governing coverage. Social workers play pivotal roles in ensuring that informed consent has taken place and individuals and families have access to needed resources to improve quality of life at the end of life. They also have a duty to safeguard individuals’ rights to confidentiality and self-determination in end-of-life decisions. Regardless of the setting or immediacy of planning need, working with individuals and families who face end-of-life decisions a high degree of commitment and competency given the profound implications of decisions that affect life and death.

Article.  7045 words. 

Subjects: Social Work

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