Berusting

Toen ik klein was hadden we tijdens onze kampeervakanties in Drenthe een vast lied dat vaak van pas kwam

Social workers in a modernising welfare state: professionals or street-level bureaucrats?

Social workers are often depicted as street-level bureaucrats (SLBs) or professionals interchangeably. However, to find out how social workers relate to new policy measures, a clear distinction between SLBs and professionals is helpful. Ideal–typical SLBs subscribe to new policies although they may diverge from them in practice, to accommodate clients. Ideal–typical professionals weigh new policies against their ethical code. If the new policy goes against their professional principles, they protest on behalf of their clients. In this article, we study Dutch social workers who have to implement a new policy that (i) obliges their clients to actively participate in society and (ii) obliges them to rely on family and friends when they need help. The data for this article are derived from two projects: interviews with twenty-nine experienced social workers and interviews with social workers in neighbourhood teams and observations of their interactions with clients in six municipalities. We found that Dutch social workers think as professionals: they weigh the new policy against their ethical code and have serious doubts about the second part of the new policy. Hence, they find ways to avoid implementation. However, they behave as SLBs, bending the rules in practice. They rarely confront policymakers or higher management

The dignity circle: how to promote dignity in social work practice and policy?

According to the International Federation of Social Workers, social work has always been a human rights profession. However, the legalistic language of human rights is often found to be of limited use in the everyday practice of social workers. This article offers a practical and relatable translation of human rights language by operationalising the central human rights value ‘human dignity’. In the city of Utrecht, The Netherlands, empirical qualitative research was conducted in order to investigate what dignity might entail for social workers and service-users. The study reveals four different ways in which service-users experience their dignity to be violated: being seen or treated as an object, an empty space, a child or a monster. Conversely, social workers and service-users also try to maintain dignity in four ways: by treating people as a unique person, a participant, an adult or a (professional) friend. Together, these modes of dignity violation and dignity promotion form a typology termed ‘the dignity circle’. The dignity circle enables practitioners and policymakers to promote dignity in social work whilst helping them to consider the dilemmas and complexities involved. In this way, the dignity circle provides a practical tool for social work as a human rights profession

The involvement of family in the Dutch practice of euthanasia and physician assisted suicide: a systematic mixed studies review

Background Family members do not have an official position in the practice of euthanasia and physician assisted suicide (EAS) in the Netherlands according to statutory regulations and related guidelines. However, recent empirical findings on the influence of family members on EAS decision-making raise practical and ethical questions. Therefore, the aim of this review is to explore how family members are involved in the Dutch practice of EAS according to empirical research, and to map out themes that could serve as a starting point for further empirical and ethical inquiry. Methods A systematic mixed studies review was performed. The databases Pubmed, Embase, PsycInfo, and Emcare were searched to identify empirical studies describing any aspect of the involvement of family members before, during and after EAS in the Netherlands from 1980 till 2018. Thematic analysis was chosen as method to synthesize the quantitative and qualitative studies. Results Sixty-six studies were identified. Only 14 studies had family members themselves as study participants. Four themes emerged from the thematic analysis. 1) Family-related reasons (not) to request EAS. 2) Roles and responsibilities of family members during EAS decision-making and performance. 3) Families’ experiences and grief after EAS. 4) Family and ‘the good euthanasia death’ according to Dutch physicians. Conclusion Family members seem to be active participants in EAS decision-making, which goes hand in hand with ambivalent feelings and experiences. Considerations about family members and the social context appear to be very important for patients and physicians when they request or grant a request for EAS. Although further empirical research is needed to assess the depth and generalizability of the results, this review provides a new perspective on EAS decision-making and challenges the Dutch ethical-legal framework of EAS. Euthanasia decision-making is typically framed in the patient-physician dyad, while a patient-physician-family triad seems more appropriate to describe what happens in clinical practice. This perspective raises questions about the interpretation of autonomy, the origins of suffering underlying requests for EAS, and the responsibilities of physicians during EAS decision-making