The Ethics of Assisted Suicide

By Callahan, Jay | Health and Social Work, November 1994 | Go to article overview

The Ethics of Assisted Suicide

Callahan, Jay, Health and Social Work

In recent years, a great deal of publicity has been generated about "assisted suicide," especially physician-assisted suicide. In Michigan, Dr. Jack Kevorkian has assisted a number of people in killing themselves; his actions have precipitated much legal maneuvering and intense discussions of medical ethics (Kevorkian, 1991b). The book Final Exit, written and published by Derek Humphry (1991) of the National Hemlock Society, includes specific instructions on how to commit suicide. In the state of Washington, Initiative 119, which would have legalized physician-assisted suicide for terminally ill people, was narrowly defeated by voters in November 1991. A similar measure was defeated in California in November 1992. People with acquired immune deficiency syndrome (AIDS) and their friends and families are openly discussing suicide and assisted suicide. Clearly, this is an issue that has captured the interest and energy of a large number of people.

As a profession, social work must come to grips with the ethical issues and controversies involved in this topic. In a variety of settings, social workers may encounter clients struggling with issues of life and death and perhaps considering suicide or assisted suicide. Social workers in direct service in medical-surgical hospitals, nursing homes and convalescent centers, hospices, and outpatient clinics will inevitably encounter these situations. In addition, social workers on hospital ethics committees may play pivotal roles with regard to assisted suicide in the years to come. This article explores various aspects of the issue of assisted suicide, especially in relationship to social policy.


One of the central ethical positions of social work is self-determination. Loyalty to this conviction has led many social workers to support assisted suicide (Levy, 1992). After all, it is argued, if an adult chooses to end his or her life, is that decision not the ultimate manifestation of the individual's right of self-determination? The NASW Code of Ethics (National Association of Social Workers [NASW], 1994) states that "The social worker should make every effort to foster maximum self-determination on the part of clients".

However, another central social work value has always been the well-being of the client. Sometimes a client's self-determined wishes and his or her well-being are in conflict with each other, and this conflict makes it difficult for an ethical social worker to know how to proceed (Freedberg, 1989; Loewenberg & Dolgoff, 1992).

A small body of literature has grown up over the past several decades focusing on the possible conflict between a client's wishes and the social worker's conviction about what is best for the client. A brief review of this literature may shed some light on the issue of assisted suicide as a contemporary example of this dilemma.

Environmental Limitations to Self-Determination

Almost 30 years ago, Perlman (1965) wrote that self-determination was "nine-tenths illusion, one-tenth reality". She was referring to the numerous limitations to true self-determination that all of us face, and especially clients with limited resources. Everyone, she said, was limited by both inner constraints such as lack of ego strength and outer constraints such as limited alternatives. Nonetheless, she argued that self-determination was a goal that was an end in itself, not a means to some other end. To give up the elusive goal of self-determination meant to give in to a dehumanized view of people as animals or machines.

Perlman's (1965) external and internal limitations did not mean that clients might choose poorly, and thus place a social worker in a professional dilemma, but rather that modern psychology and modern science seemed to indicate that people are the products of numerous powerful forces they are relatively helpless to resist. Thus, genetics, environment, circumstances, and past experiences make up a social "determinism" that dictates our desires, needs, and preferences. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Cite this article

Cited article

Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25,

Note: primary sources have slightly different requirements for citation. Please see these guidelines for more information.

Cited article

The Ethics of Assisted Suicide


Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25,

    New feature

    It is estimated that 1 in 10 people have dyslexia, and in an effort to make Questia easier to use for those people, we have added a new choice of font to the Reader. That font is called OpenDyslexic, and has been designed to help with some of the symptoms of dyslexia. For more information on this font, please visit

    To use OpenDyslexic, choose it from the Typeface list in Font settings.

    OK, got it!

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Author Advanced search


    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.