The Ethics of MAID and Voluntary Stopping Eating & Drinking (VSED): A Workshop for Social Workers Webinar (2 CE's)

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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 15 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. The original law was amended in 2023 to decrease barriers to access. 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 discussions 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 individuals’ 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 roles 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. Describe the basic qualifications for Washington’s Death with Dignity Act/Medical Aid in Dying (MAID).
2. Describe 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:

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 was hired by the VA Medical Center in Seattle after being an intern there during the last year of her MSW program. She stayed at the VA, working in the Spinal Cord Unit, the MS Clinic, the Geriatric Clinic, and other areas of the hospital as an hourly employee until a permanent part-time position opened and she moved into Community Programs.
 
In Community Programs, she covered Benson Heights Rehab, a contracted facility with the VA for veterans who lived with severe mental health issues. After 7 years, she moved into the Homemaker Home Health Program, coordinating services for veterans who qualified for in-home support. And, shortly after this, she also coordinated Adult Day Health Programs through several local organizations that provided this service. She retired from this position in 2011.
 
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.

Daniela Miranda is the Community Outreach Manager at End of Life Washington (EOLWA). She holds a PhD in English Literature from Washington State University (WSU) and a Masters in Teaching English as a Second or Foreign Language from the University of Costa Rica. Prior to joining EOLWA, she worked as an advocate for a domestic violence prevention organization and as an instructor at WSU. Daniela is passionate about educating individuals, communities, and organizations about end-of-life choices. She currently lives in Pullman, WA with her dog Sadie.