Euthanasia: Israeli social workers' experiences, attitudes and meanings

Sixteen social workers in Israel were interviewed about their experiences with and attitudes towards various forms of euthanasia, as well as the meanings they ascribe to them. Using phenomenological analysis, seven themes were identified, emphasizing individual, interpersonal, organizational, social and therapeutic considerations, and suggesting a holistic and integrative structure of the phenomenon. The themes were arrived at by identifying distinctions and similarities between different forms of euthanasia. Two themes suggesting similarities were revealed: 'diminishing the value of life' and 'a call for help'. Three themes were found to distinguish between passive euthanasia (withholding and withdrawing life-sustaining treatment) and active forms (active euthanasia and assisted suicide): 'legality', 'social acceptance' and 'concern for the sick and dying'. The last two themes distinguished between withholding treatment and assisted suicide, on the one hand, and withdrawing treatment and active euthanasia, on the other: 'the involvement of others as executor' and 'the publicity of the act'. Further research and training is required to better inform social workers in this ethical area. Given their unique position, social workers should actively participate in legal, social and therapeutic discussions concerning end-of-life decisions, for the benefit of clients, their families and health-care providers.