Social workers play an important role in advocating for choice at end of life,, which includes assisting eligible clients with accessing medical aid in dying (MAiD), where legal, and advocating for safe and equitable access to MAiD services to uphold client self-determination. Mandatory reporting expectations for U.S. social workers may cause confusion with MAiD, so it is important to distinguish between harm to self and MAiD (which is legal in 12 states and the District of Columbia) for hastening death. This article fills a gap in the literature by discussing U.S. social work roles and MAiD through an ethical decision-making framework and suggests social work roles, ethics, and risks of MAiD. Relevant ethical expectations include self-determination, social justice, dignity and worth of a person, informed consent, and competence. Terms related to MAiD, including voluntary stopping of eating and drinking, and the current U.S. legal context for social work practice in this area are also described herein.
In this qualitative study conducted in Israel, the authors explored the experiences of family members (N = 19) who lost a loved one to COVID-19 following hospitalization in intensive care units (ICUs). In particular, the authors examined how bereaved individuals perceived their interactions with ICU staff, institutional policies, and power dynamics within healthcare settings. Semistructured interviews with the 19 participants revealed recurring themes of struggle, perceived injustice in medical decision making, enforced patient isolation, and a resulting erosion of trust in the healthcare system. These experiences shaped not only the bereavement process but also participants' perceptions of fairness, care, and institutional responsibility, often culminating in a sense of institutional betrayal. Alongside these challenges, some participants described moments of compassionate care and meaningful communication. The authors argue that these findings underscore the importance of transparent communication, psychosocial support, and trauma-informed care in ICU settings, particularly during times of crisis.
