Ep. 85 Social Work & Voluntary Assisted Dying: We have all the tools we need
J S
0:02
Welcome to Social Work Stories, a podcast exploring social work practice through stories and critical reflection. This podcast is recorded on Aboriginal country lands which were never ceded. We acknowledge the traditional custodians and cultural knowledge holders of these lands, and pay our respects to Aboriginal elders past, present and emerging. We offer a warm welcome to any indigenous listeners who are part of our podcast community around the world. If you have thoughts or feedback for our team, or just want to find our whole back catalogue of episodes, check out our website Social Work stories.com. But for now, on with the episode.
Lis Murphy
0:49
And hello, welcome to the Social Work stories podcast. My name is Lis Murphy. And over there in Gadigal country I think is Dr. Mim Fox.
MF
Mim Fox
1:03
That's right. Hi, Lis. Hi, everyone. Hope everyone's well out there.
LM
Lis Murphy
1:06
I'm in Wiradgeri Country today Mim, and I feel very blessed to be here in this beautiful sunny day. And I want to actually look Mim, I think we've got a bit of catching up to do with our listeners. Because last October, we didn't drop an episode..
MF
Mim Fox
1:23
No well, we kind of Yeah. Didn't drop an episode dropped the ball.
LM
Lis Murphy
1:29
Got COVID Yeah, I got COVID for the first time ever, and every symptom that I have heard people describe but pretty well got that and you know what, Mim, happy to because it was my turn. It was the least I could do is to get it on this, I don't know what round we're up to in Australia at the moment. But
MF
Mim Fox
1:52
You were a bit late, late to the party on that one Lis like you're about three years too late, my friend.
LM
Lis Murphy
1:58
I know. But but but I feel like I've taken my for the team now. And I feel like I'm part of I'm not in the NOVID group as I believe they get called. I've moved from no COVID to the COVID group. So that's why I couldn't record in October.
MF
Mim Fox
2:14
Welcome to my people Lis, I'm very definitely in the COVID group, and have been for a good couple of years now. Well, that's your excuse. My excuse is that I have just come back from the Gold Coast. In Queensland because I was there for the ANZSWER Symposium this year, the Australian New Zealand Social Work Education and Research Symposium and our regular listeners will know that we have been there the last few years podcasting. And this year, I didn't do a lot of podcasting. But I did do a lot of hearing amazing work that people are doing all over the place and had some excellent discussions about social work education, about social work research about changes in practice and how we translate that into the classroom. Just absolutely inspiring stuff. So yeah, I always come out of that so blown away Lis by the incredible stuff that people are working on out there.
LM
Lis Murphy
3:12
And I'd imagine that we might hear a little bits and pieces of of the ANZSWER conference, maybe over the next few months. Who knows, but I know you and I will certainly chat about it. Mim but this is our last episode for 2023 in terms of a story with our reflections, and I am beside myself with excitement about this one because this is one that I've been wanting to record for months, and it is on voluntary assisted dying. And why I feel passionate about this is it's just about to be rolled out in New South Wales where we both live on the 28th of November.
MF
Mim Fox
3:54
So this is a change of legislation that's being rolled out Lis right? So effectively decriminalizing ...
LM
Lis Murphy
3:59
The change of legislation happened in 2019. So it's taken a while to get a wide rollout. Yeah, I need Yeah, I think again, COVID had some kind of, you know, again, a pause a pause in it, but the rollout in terms of in health and in the community, voluntary assisted dying were the last state in Australia, Mim that is actually rolling out voluntary assisted dying. So there's a there's a history that we have that's taken place over the last few years across our country. And I know that in some countries elsewhere, they've had voluntary assisted dying for decades. For Australia, and for us in New South Wales this is big and also in terms of our social work practice. So I'm really excited we can listen to this wonderful story today. And the story is from a Victorian social worker who has been working in the voluntary assisted dying space for four years. So she he'd be one of the first Australian social workers to be actively working in this area. And I feel so privileged that she has shared a story with us because there's lots of learning, especially for us in New South Wales from from this story that she shares.
MF
Mim Fox
5:15
Yeah, I think it's fantastic that she was able to share this story with us, Lis, because we've got so many social workers in health at the moment, who are really wondering what this is going to mean for them, right? Who are really sitting with well, is this a change? Is this Is it still my skills just in a different space, a different scope of practice? Or is it a completely new way of working. And I think the beauty of this story is that we get a bit of insight into what that actually looks like.
LM
Lis Murphy
5:43
And I love that this is a story that has a very much a de identified person. But it is a is a sweet story of a an older man, who has a big say in the death that he actually is able to have with the support of daughter and this social worker. So let's listen to it Mim with our listening friends. And then let's come back because I know you and I are chomping at the bit to kind of reflect on various elements of this story and beyond. Absolutely
MF
Mim Fox
6:21
Absoultely, sounds good.
SW
Social Worker
6:24
Today, I'm sharing the story of a man named Bob, who I supported through his process of accessing voluntary assisted dying. Bob was an elderly man who lived in the outer suburbs of Melbourne. And he contacted our service here in Victoria. And he asked for help to access voluntary assisted dying. During the time that I supported Bob, I drove to his house about three or three times in fact, Bob had an advanced cancer. And he satisfied all of the eligibility criteria in Victoria, for voluntary assisted dying. So this means that he had a prognosis of less than six months due to his advanced illness. It also means that he had decision making capacity, and that he was an Australian resident or sorry, an Australian citizen, and a Victorian resident.
SW
Social worker
7:27
So Bob lived in his family home, he was living alone, when I met him, he had two adult children. And he had been widowed, the home that he lived in was their family home. And certainly, when I visited him, it had the air of a place that had been lived in over a long time, you know, decades and people had had grown up there and moved out. It wasn't messy or cluttered or anything it was, but it was his family home. And there was lots of signs of that around the house photos and bits and pieces from his life and his children's lives and his wife as well. Bob lived in the community where he worked, and where he had worked. He was retired, long retired, but, but he was well respected. And he knew a lot of people. He knew a lot of people in his community. And he talked really fondly about his work life. And and I think he felt quite proud of the the contribution he'd made throughout his life.
So as is the case with most of the voluntary assisted dying laws in Australia, there there was and still is not an insignificant amount of paperwork involved. So there's, there's quite a lot of forms and things that need to be done exactly right, in order for, for the process to proceed. So I had at this stage, I had met Bob in his home and was, he had asked me to continue and support him to start the voluntary assisted dying assessment process. During the time that we were arranging those appointments. He had an admission to hospital. And in order for his assessments to continue, he needed to locate some of his identification documents. So this was a very practical thing that needed to be arranged. And this is what resulted in the first time that I had contact or an interaction with his daughter. So he had already told me that he had two children, and one of them lived in Melbourne and was available and willing to support him.
But it wasn't until this time that I actually had direct contact with his daughter. And I guess that's an interesting that was an interesting experience for me. Prior to this having mostly worked in hospital settings. I was unaccustomed to meeting people in their own home, and I was also much more much more used to meeting people When they're in hospital, they're obviously not in their own environment. They've been unwell in some way. And so they're their family are usually much more accessible. They're often the ones that you talk with as much as the patient, sometimes more. So it was a different experience for me to meet and get to know Bob, relatively well, before any of his before I had met or was introduced to any of his family. As a social worker, it was quite a welcome change in the dynamic of of that relationship, Bob seemed really at ease during our conversations. And I guess what it made me realize was that that dynamic of having met and established a relationship with Him first where he was in control, and he had initiated, asking us asking me for support it, it really, it really allowed Bob to be the person who was in control of the process and what was going on.
And indeed, that is a really strong tenant of the voluntary assisted dying laws, I'm sure elsewhere as well, but but in Victoria, the you know, the idea really is that it's the patient, the person who wants to access this is the one who is continuing to push the process or, or say, Yes, I want to continue. So it's not, it shouldn't be, and in my experience, it isn't something that a patient asks for. And then, and then the process just carries on, they actually have to actively engage with it and actively choose to continue on at each stage of, of the assessments.
So Bob proceeded with his three voluntary assisted dying assessments. And he became eligible to access an oral medication. After this, there was a period of probably a few weeks where we had limited contact. And again, that's very deliberate. So the nature of the support that we provide for people accessing voluntary assisted dying, is that we are always available and we try to make make that clear that the person or their family are welcome to contact us at any time. But once they've become eligible, it's really important that there is no real or perceived pressure to use the medication. So for a lot of people, there is great comfort in knowing that it's there if they need it. But for many people, and in Victoria, that number is about a third, a third of all people who become eligible don't actually use it. So again, the that theme of control. And I guess autonomy comes in, where it's quite important that we have done what we can to support the person in their wishes. Once they have that option, we really try to step back and empower the person to come to us if they need, but not to continue that involvement where it may not be needed any longer.
After that period of time, Bob had one further hospital admission. And I understand that it was during that time, he said to his daughter that when he got home from hospital, he was ready to use his medication. And so this set us on a path where his daughter contacted myself and the coordinating voluntary assisted dying doctor to talk about how how to make these arrangements. The outcome in this case was that both myself and the doctor attended Bob's house on the day that he used his medication. As I mentioned, we had been there three times by then and the voluntary assisted dying doctor had been twice. And Bob felt that we were the people who had supported him in this wish. That varies from person to person. But in this case, it was not very long after the law had come into effect. So there wasn't a lot of experience out there in the general health community of, of people who had supported patients through this process. So I do believe that that was part of the reason that Bob asked for, for the two of us to be there with you.
For many people, they, if they're going to use their assisted dying medication, they do it in the comfort of their home with only family. And that's absolutely fine, too. Again, it's it's whatever is the person feels comfortable with and what feels right for them. And equally, we need to be clear that as professionals, we have to think about our own boundaries. I had had thought about that well ahead of time, and myself and my colleague had had really frank conversations about the fact that it's not, it shouldn't be a given it shouldn't be an automatic thing that you would be present but that if a person raised that and and asked you, you, you need to go through a process of thinking why are they asking you to be there, do you feel comfortable? And if those things line up, then then the answer would be yes.
So for me as a social worker and a health care worker when a person was was waiting for an answer. So on the day that Bob used his medication he was he was at home with his daughter for the day. As far as I could tell, there wasn't anything particularly extraordinary about the day, aside from the fact that as father and daughter, they spent the day together, and Bob's daughter looked after him throughout the day,the doctor and I arrived in the mid afternoon, and by then Bob was already in his recliner chair in the living room. And that was where we had met him. On the other occasions as well. The afternoon proceeded, relatively straightforward. And Bob told us a few more stories and did a few more reflections. He actually said something which I didn't register as being overly significant at the time, it was really important to his daughter. And what he said was that she'd done alright, and she'd done a good job. And it was a very, I would say, it was a compliment that was pretty representative of the generation that Bob belonged to. I think he, it was heartfelt for him. And it meant a lot to his daughter, but listening to it from the outside, you wouldn't have necessarily recognized that. But we it's something that his daughter talked about afterwards, that to her that was that was really high praise from her dad.
So Bob used his oral medication. And he died in his home. It was a home as I said he'd lived in for for many decades, and a community that he'd lived in, and worked in for that long as well. I think in considering both mine and the doctor's role, but in considering my role as a social worker, this process was about accompanying Bob for something that was important to him. He, as we know he was going to die from his cancer, and had voluntary assisted dying not being available, I feel quite confident that Bob would have had a comfortable death. He had wonderful healthcare team around him, including oncology and palliative care services. He had a supportive daughter. And he also had the ability to communicate his his wants and needs. So this was not something that was the be all and end all if he hadn't used voluntary assisted dying, I think he would have likely had a very comfortable death either way. But it was a process that he decided to do. And once I'd met his daughter, she, she explained to me after a period of time that this didn't surprise her at all, that her father had always been a man who made his own decisions and liked to be in control of things. He was very, he was very polite and very cordial all throughout. But she said if he's decided on something, then then that's what's going to happen.
For me, one of the lessons from this, this case in in supporting Bob is about the fact that for me, because it was early, early in the time that voluntary assisted dying was available. The there was still a lot of commentary about the ethics of it. And there was still some political concern about the implementation going smoothly. And that was certainly felt by people who were, who were working in that area to the want for it to be as as smooth and as non controversial as possible. However, this experience was, for me, a very pure one of a man at the end of his life, you know, being supported by his daughter and dying in the family home in a way that he had chosen and at a time that he had chosen. I think a big part of that is, is the experience of meeting the person where they are. For Bob, this wasn't a huge deal. It wasn't something that he grappled with, when he knew that voluntary assisted dying was available. He felt like that was the right thing for him. And as I said, he's you know, his daughter really reflected that, that that accorded with his personality and the way he lived his life. He didn't grapple with it over time. He just thought, yep, this is this is right for me.
Following Bob's death, it was important that we were available to support his daughter. Again, I wouldn't say that there was a huge amount of complexity in terms of her bereavement. However, it was the newness so there weren't a lot of people in the community who would exereinced this. And again, the role that we had was to make sure that she had someone who knew what she had gone through and who she could just bounce things off and, and express how she was coping. There wasn't any red flags that she wasn't going to cope in the long term or that she was going to have prolonged grief from from my assessment. But again, my the best word I would use for this is that it was an accompanying process. This was something really new. And it was important that for Bob, and especially his daughter, after the fact that there was someone there, who understood partially what she'd been through and who just their role was to, to listen and allow her space to reflect. So, as with all deaths, it's important that we consider the bereaved person's needs and their support needs in in their time of grief.
So, in this case, as with with all of ours, I followed up with Bob's daughter, she certainly initially wanted to talk a little bit about what had happened on the day. And that was a quite important process of her, confirming the narrative and, and reflecting with someone who had been there and been a small part of part of that day. But subsequently, when I saw her for the second time, she reflected more on her dad's life as a whole. So she talked about his roles as a father, as a professional, a member of the community, certainly as a husband and his role in their family. And to me, that represented a, a quite normal and expected grief trajectory, she certainly was, was grieving for her father, and was appreciative of the bereavement care. But in this case, I certainly didn't identify anything that was a red flag that indicated possible complicated grief. For some people, there are factors relating to the mode of death. So for some people, that can be a real struggle, the fact that a person chose voluntary assisted dying, but in this case, it was something that that we were able to sit with his daughter and support her as she, as she provided some reflection on that. And then, you know, relatively quickly moved through to grieving for her father and thinking about him in the setting of his life as a whole. So that, to me, was an indicator of grief progressing and a normal grief reaction.
So I think one of the key things that comes up for me from this story and from this experience, is that, although voluntary assisted dying, presents a very new process, and it's certainly a highly legislated process. The things that patients and families go through when they're accessing voluntary assisted dying are things that social workers have the skill set to deal with. It's, it's within what we know already, of course, it's new. And some of us are better at sitting with uncertainty than others. But I think getting used to the fact that that we've got a new process available is one of the big tasks in the early in the early times of implementation. But by and large, what I have found is that the skills needed to work in this space are skills that are possessed by social workers and and the tasks are related to spending time reflecting, making sure that that we know our own personal values and how we sit with things and there's no doubt in my mind that that doing those things will allow social workers to work really positively and and really productively with with people and families who are going through the voluntary assisted dying process.
MF
Mim Fox
23:55
Lis firstly, I want to say how much I love this story. And then I've been waiting to hear a voluntary assisted dying story actually coming out of one of the other states that has already come around to this change in practice of legislation. So, so I'm very thankful for this story. But I was thinking as I was listening to what I was thinking about how I have just come back from the ANZSWER Symposium at that symposium, one of the professors from Griffith University, Donna McAuliffe, she gave her closing address and she said to the room, that social work is a profession that is compelled to ask at all times, what is the compassionate response? And I've been sitting with that Lis since that I heard it right. It's just been going around and around in my head and you know, when something just sits with you and your it starts to, you know, create a life in your mind mind starts going down little pathways, and what could it mean here? And what could it mean there? And, and it wasn't until I heard this story, where I actually it made sense to me how all encompassing that statement is, what is the compassionate response? Because in this story, the compassionate response is clearly on so many different levels, right? Like, it's not just about Bob, it is about so much more than Bob. That's what I was sitting with hearing this.
LM
Lis Murphy
25:31
And God rest Bob's soul ashe'll never know this Mim, but I agree with you. But I'm going to I'm going to start with Bob, just before I get into that space, yes, I think I have a belief that we can die as we live, you know, that often there are elements of our death, if we if we can actually have a death. It can be really, really valuable if it reflects elements of who we are in the living. Yeah. And I, for me, this death that Bob co created in some regard with within the legislation, he fitted a criteria that actually allowed him to have true agency around a death that represented how he lived in the world. He was a man, we heard who, who was very decisive, once he made up his mind, he stuck to it. He got to decide on the where he wanted to die in the community and the home that he'd lived in for many years. And with the people around him, and back to your point, Mim, back to the social work practice within that, yes, I see what you're saying. Because that's what I see to like the compassion that was threaded throughout Bob's death in terms of the social work practice. Yeah, it was breathtaking,
MF
Mim Fox
27:02
breathtaking. And what you've just described, Li is so reminiscent to me of the discussions we were having 15-20 years ago in palliative care around what is a good death? Right, you know, like that. I feel like those discussions aren't as present as they were at that point. We were grappling with it and how does how there was like, but it was almost like there was a definitive good death notion that sat out there somewhere, that people might have to be able to subscribe to. And what I love about this story, is that it actually a good death for Bob is what Bob determines a good death to be. And that's the compassionate response for Bob is actually being able to stand there. And I think the social worker talks about companioning. Bob, through that process, right, and companioning, the daughter, and I think that's right. It's about being there as the companion as the witness as the support through the process.
LM
Lis Murphy
28:02
Yes, there was the there was a companioning, there was the bearing witness for both Bob. But there was also the post death support that I thought was really interesting, where she said so much that resonated for me around that death, the quality of that death allowed the daughter to grieve in, you know, although we avoid the word normal grief, as she says, right, because, because so much of her grief was impacted by what had happened by the fact that her dad had chosen the death to be in the way that he wanted. And she also got to reflect on his death with someone who was also there present with her and, and I think there's a lot to be said about that, that he was a social worker who bore witness and was then able to talk about it with the daughter. And remember that point about this was very new in Victoria at the time of Bob's death. So it would have been a hard conversation to have found someone who could understand what a voluntary assisted dying process can look like. Right and have a language around it. Yeah, but the social worker obviously did. So there was that that that connection with daughter that was also really powerful, and, you know, bouncing around Mim I think that that will be that must be a very big part of the social work practice in the voluntary assisted dying. It's not just about the work done with the person who is voluntarily you know, has been has been approved in the voluntary assisted dying process, but the family, and fortunately in this situation, father and daughter, were on board with it. I imagine it gets pretty interesting with when they're not when that doesn't happen.
MF
Mim Fox
29:58
Yeah,I would agree with that. I think also, like us, like you said, the social worker was onboard with the language and with the kind of context in which this was occurring, but the social worker did say that that was a learning process for her as well that she come from being an inpatient hospital social worker, suddenly into this community space. And I thought that was really interesting as well, because, you know, in a hospital, someone can die, whether they die, a beautiful peaceful death in a ward, or whether they die in a horrendously traumatic scenario in the emergency department or on a ward or in an intensive care unit, wherever it might be. There's a limit to what the social worker then can do in terms of follow up for those family members, right. Whereas part of this service that is she's providing here is that follow up. And I do actually think that's how the compassionate response actually then gets extended. Because it's not just in terms of working with the family, after the event. It's also about that community education, that she was saying that actually, that daughter now has to go and talk to people about how her father died, and deal with the fact that not everybody is actually going to be an agreement with voluntary assisted dying. And so it's a community education and outreach, as well, social worker is fulfilling here, which is about spreading awareness and understanding, and then being able to advocate on behalf of the rollout, as well. So that people, not just family members, not just individuals themselves, but these practitioners that they are safe doing this work, that they are not constantly coming up against people like they are in other spaces like abortion, for example, where it's a constant value push. There's a there's an element here of trying to bring that down as well of trying to mediate that value clash in that work. You know what I mean? This work?
LM
Lis Murphy
32:02
Yeah, I'm like, I'm, I'm, I'm kind of processing it, as I'm listening to you. And perhaps some of the listeners are like that, you know, your brain moves a little bit faster than mine, I see what you're actually saying. And I'm getting it. And I guess what comes up for me as a result of of that commentary is reflecting on where some of our social workers might be at, at the moment in in this state, in thinking about what is this going to look like for me and my practice? What is this going to look like in terms of where I sit ethically around, voluntary, assisted dying. And Mim I wanted to spend a little bit of time reflecting on on that with you, because I learned a lot from this particular social worker, who was able to reflect with me off mic around what it looked like when it first came out. So Bob's death was very reflective of where that social worker was at. And remember, this is a social worker who had elected to work in a voluntary assisted dying project program, right. But we also know that there are going to be social workers that are impacted, because they work in a less, you know, maybe in a hospital, maybe they're working in community, maybe they're having conversations with their clients working in a different capacity. But I know that some of my colleagues who are in that group are questioning now like, what What will my practice look like? Where do I sit with this practice? And we've set up a community of practice around voluntary assisted dying in the hospital I work at just so that we can tease out these ideas, right, just so that we can actually be looking at what are our social work values, because we know in the New South Wales legislation, as in some of the other states, there is the ability to be a conscientious objector. And so that's a really interesting thing to be thinking about as a social worker, right? So where do I sit personally in relation to voluntary assisted dying? Where does that sit with my social work values? Is my scope of practice going to be impacted by voluntary assisted dying? Am I going to be able to think about this thing in a proactive way like this social worker said to us, I thought through some of the ethical issues, even before I found myself in a situation where I've got a person saying to me, can you be present as I take the medication? Now, this is someone who's been proactive and so this is what I'm getting back to the people I am. Now is a perfect opportunity to be thinking through what are some of the things being pre emptive around this in terms of my practice, and where I sit with it?
LM
Lis Murphy
33:01
Yeah,I Think I think the onus is on all social workers to inhealth to be doing that now. And I think that that's what happens when new practice, met fields come into play, right? We need to actually do that really important critical reflection. And it needs to be proactive. Because what you don't want is to find yourself in a situation with someone saying, Will you be there, in that moment when I take the medication, and you haven't already thought about where your positionality sits, right, where you are positioned in this space. And so I really want to stress that that's the space for supervision in a proactive way, that often, we end up in supervision, having these debriefing discussions and, you know, teasing apart what happened. But this is actually a proactive critical reflection now.
LM
Lis Murphy
35:49
So I've been thinking about this lots Mim and I'm just so on board with what you're saying. So what I would say now, now, so we've got our social workers has been proactive. What I would say to is to our social work supervisors, you do the work now? Yeah, you do the work now about how you create a safe space in your supervisory practice, for your supervisee to come in and to have this discussion, not a debrief, we're actually doing a proactive discussion. Yeah. And how do you make them feel safe in that? How do you make them feel non judged? This isn't about what you think in that space, you do that in your own supervision. This is about how you create that space for your supervisee to to absolutely think this one through as much as they can.
MF
Mim Fox
36:37
I really love that, actually.
LM
Lis Murphy
36:39
Because I think also about the corridor conversations that we'll have, how to think about what what can that sound like for myself or my colleagues, I don't want to be having this in the corridor, I want to be having this in like a Yeah, Community of Practice, I want to be having this, as this particular social worker said to me, she's discovered that the teams that do really well in health are the one so you can safely have a conversation and not be judged. So that within any one team, let's imagine you've got a ward, because we know that some people will be coming into hospital to take their voluntary assisted medication, right? Yeah, die medication, they'll need the support of a hospital ward to do this. Now, you don't want to be that ward that hasn't actually had this conversation already. Right? You don't want that patient to be feeling like, "Oh boy, what's going on here? I've got you know, I've got this real tension in the room," because maybe they've got someone who hasn't actually had the opportunity to be talking through"How am I going to be if I'm asked to support someone in this?", they need to be having those conversations now. And in a way this social worker said to me, in a way that people can absolutely process, how they feel about it. And the other thing is Mim, you and I know, this is not static, our ethical practice or what we but what we see as ethical practice in ourselves. It's not static. So how I feel today about supporting someone, let's say in the voluntary, assisted dying space, wont always look the same. This won't look the same this time next year. That's right. And that might be because of conversations I've had with patients that might be conversations that I've had with myself, with my supervisor. It's not static in that's what you and I keep on saying, we need to constantly be reflecting on scope of practice, ethics, how it butts up against our faith, how it butts up against our person, the ways in which we live personally, all of those things, constantly, we need to be working on. Right,
MF
Mim Fox
38:53
I just listening to you. Listen, I just had this awful vision of somebody ending up on a ward that hasn't had these conversations. And the treating trading team saying, "no, you don't meet the eligibility criteria," only because they haven't discussed it as a ward and as a team. And then the person saying "well, I want a second opinion." Right. Okay, so I see that debate happening.
LM
Lis Murphy
39:23
So just Well, yeah, look, I don't think it's going to look like that one Mim, because there are some really strict criteria that goes on before they even get to that stage. Right. Right. Right. What what will happen was like in terms of that assessment, and you heard about, so this particular social worker was doing was doing assessment every step of the way. And so Bob met that criteria. He had six months prognosis, he was a resident of Australia. He was a no citizen of Australia resident of Victoria and the issue of capacity is very important. So, so back to your point, though, I I will pick up though you do not want someone who's made or that criteria, for whatever reason, can't be dying at home, because maybe they don't have a daughter who's going to be like that and, and that maybe they're isolated and or because of health reasons, can't actually be administering their medication without the assistance of a hospital setting. Another person, for instance, yeah. But back to your point, yeah, be kind of hoping that that team is doing those conversations now, before that Bob, comes into their ward. That's exactly. Because ultimately, we want to be able to support Bob, whether he chooses to do it at home, or whether he chooses to have voluntary assisted dying in the hospital setting. And that and you're right, we actually need our New South Wales Health teams to be having these conversations now. And in a safe, non judgmental way, not in the space of the patient. Right. I agree. Like back to your point, that would be a nightmare,
MF
Mim Fox
41:05
it will be a nightmare, right? I am. Yeah. And I, I want to go back Lis to what you were describing with this beautiful community of practice happening in the local health district that you're working in. And I am, I think that's a very, it's a very special thing. When social workers get to sit together in a space and discuss their practice, in a way that is safe, and where people can be vulnerable and can air those concerns, and air those internal conflicts that they're wrestling with all the time. And I'm I want to say like, a large part of that is down to you listen, the the strength that you bring as an educator into that space. But I also am listening to this, and I'm thinking about those social workers who will not have that, who will be on their own, or will be working in a department that doesn't have that culture already. And I think supervision is one way for them to do it. But I am, I'm also conscious, that's not always the best way for everyone, depending on the supervisory relationship. So I guess what I'm trying to say is that I hope that this discussion that we're having now, although we have been slightly convoluted at times, I do hope that those listening who are in more isolated positions, will take some inspiration for this discussion and reach out. And so either reach out to colleagues that you know, we're in other hospitals dealing with this issue, or reach out through your professional network, reach out to us via the podcast via our website, like, reach out. Because actually, I think when you're in this moment of changing practice, it's really important that you are connected to your virtual community. That's where we get our strength from, I think, as social workers,
LM
Lis Murphy
42:56
I agree, Mim and you know, in getting ready to for us to close up, I just wanted to say that there are many social workers in this in around Australia, who, like this social worker have been practicing in this space. And I know that this particular social worker has generously not only offered her story, but she's she is connecting with, with our community of practice. And I know that there are other social workers who are offering their practice wisdom. And I think this beautiful social worker says a lot in her closing comments. And that is that as social workers, we have a wonderful skill set to meet the challenge of working in voluntary assisted dying. And that's reassuring, because we know that our practice changes. Well, it feels like monthly at times, I'm sure. But we do we have this skill set. And we had the skill set in supporting each other in the learning of changing in practice scope. And, and I feel absolutely privileged to say that, that's a big feature of our profession. And I just, I actually just wanted to say, a big heartfelt farewell to that particular community of practice, because I'm actually stepping away from health. Next week, I'm retiring from health. Sorry, podcast listeners, you guys are stuck with me. My health colleagues, however, will not have the thrill of me bursting in on them and actually saying this is wonderful, this community of practice that you have developed. I love it. I love you guys. But I do and I just want to say that this particular story we have co created especially for you. So from me, I want to say a fond farewell. Are you ready to say goodbye to Mim? But not quite yet? Episode not from the production?
MF
Mim Fox
44:53
Yeah, not quite yet. Before I do, I just want to say that let's As you know, Lis as the voice on this podcast, but there are countless social workers who have known Lis in a totally different capacity, have known her up close and personal. And they have been affected throughout their careers by the incredibleness of Lis Murphy. And I'm gonna say more much more formally at her farewell next week, in person. But I do want to let you all know how incredibly missed Lis will be from the health space. And we are so lucky, so incredibly lucky to have her with us on this podcast. And continuing on in all the podcasts that we make. Lis I think it's time for us to say goodbye. Take care, everyone. We hope you're well please get in touch with us if you need all the best. Bye for now.