END-OF-LIFE DECISIONS

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End-of-Life Decisions
Why I Chose This Topic

I want to do trauma work in my future career. Trauma work appeals to me because it is

an area that touches every person in some way or another. Trauma can encompass a great deal of
situations and scenarios so I can be constantly challenged and grow throughout my career. One
of the areas I expect trauma work to take me is right-to-die or end-of-life decisions. More often
than not, this population has suffered some sort of trauma (diagnosis of a terminal illness,
prolonged mental illness, etc.) and they are turning to counseling to walk them through their endof-life decisions. This topic appeals to my sense of justice and autonomy. Throughout my career
as a student and a professional, I have always valued the ideas of self-determination and client
well-being. However, upon further inspection, some argue those two ideals could be in conflict
with each other with regards to end-of-life decisions (Callahan, 1994), (Cohen, 2000). My
personal interest and importance to my future career have influenced me to take a deeper look
into the ethical concerns surrounding end-of-life decisions.
How End-Of-Life Decisions Relate to my Professional Development
From a young age I have always had a personal opinion regarding assisted suicide issues.
As I have progressed through my ethics course, I have come to realize that personal opinions
have no place when it comes to ethical decisions. Therefore, I have chosen to learn more about
ethical concerns associated with end-of-life decisions because I believe it will allow me to
navigate successfully with this population without relying on a moral/value laden personal
opinion. By analyzing the ethical concerns surrounding end-of-life decisions I will be able to
support my opinion (and in the future, ethical decisions) with the ACA Code of Ethics,
consultation, supervision, and competence in this field. To truly become an ethical professional, I

END-OF-LIFE DECISIONS

will need to be able to look at ethical dilemmas with a detached eye and not let personal values
stand in the way. End-of-life decisions are the perfect place to start for me because I do have
such a strong emotional reaction to the debate.
Why are End-of-Life Decisions Important to the Counseling Field
Some research has argued that counseling is the pivotal component of end-of-life
decisions. For a long time the debate surrounding end-of-life decisions has revolved around the
medical field and physician assisted suicide (Peruzzi, Canapary, & Bongar, 1996). Additionally,
depression is one of the most commonly encountered psychiatric illnesses in primary care
settings (Peruzzi, Canapary, & Bongar, 1996, p. 353). However, depression is also one of the
most consistently undiagnosed and overlooked symptoms by medical physicians (Peruzzi,
Canapary, & Bongar, 1996). Therefore, the argument can be made to advocate for higher
involvement of mental health professionals; like counselors. If more physicians referred to
counselors when their patient began expressing interest in assisted suicide, the counselor could
potentially be able to work with the client to the point where suicide is no longer their goal
(Peruzzi, Canapary, & Bongar, 1996). Peruzzi, et.al. argue that by utilizing counseling and
mental health services, the terminally ill patient can learn coping skills for their mental health
issues rather than resort to assisted suicide (1996). They go on to argue that even if the
counseling does not result in the client foregoing suicide, the counselor can rest assured that they
did everything they could ethically to foster the clients self-determination (Peruzzi, Canapary, &
Bongar, 1996).

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References

American Counseling Association (2014). ACA Code of Ethics. Alexandria, VA: Author.
Callahan, J. (1994). The ethics of assisted suicide. Health & Social Work, 19(4), 237-44.
Retrieved from http://search.proquest.com/docview/210547240?accountid=34899
Cohen, E. D. (2000). Permitting suicide of competent clients in counseling: Legal and moral
considerations. The International Journal of Applied Philosophy, 14(2), 259-273.
Retrieved from http://search.proquest.com/docview/70523253?accountid=34899
Peruzzi, N., Canapary, A., & Bongar, B. (1996). Physician-assisted suicide: The role of mental
health professionals. Ethics & Behavior, 6(4), 353-366. Retrieved from
http://search.proquest.com/docview/77891535?accountid=34899