Digest- V8, I3 Full Issue

7 TPC Digest 7 | I ndividuals with terminal illnesses face complex end-of-life decisions. As death is close in sight, some terminally-ill individuals may desire to hasten their deaths through physician-assisted death (PAD). PAD is currently legal in six U.S. states and Washington, DC. Terminally-ill individuals who seek to hasten their deaths (PAD clients) must be over the age of 18, permanent residents of one of the six states or Washington, DC, carry life expectancies under 6 months, and be deemed mentally competent to make end- of-life decisions in order to legally hasten their death. Many helping professionals, such as medical doctors, palliative care nurses, social workers, and psychologists, have different roles and responsibilities in assisting PAD clients. PAD clients may seek care from professional counselors to address the socioemotional challenges that accompany the process of dying via PAD. For counselors and clients alike, the topic of death presents complex questions about the meaning of life and one’s mortality. This can evoke reflections on one’s personal beliefs and values surrounding death and the dying process as well. Many social factors and environments influence the construction of personal beliefs and values. One’s family, community, and cultural expectations for a morally just or good death all influence PAD clients’ and counselors’ belief and value systems surrounding death and dying. If counselors’ beliefs and values conflict with PAD clients’ beliefs and values, or PAD itself, then counselors may face a values- based ethical dilemma. The American Counseling Association’s Code of Ethics requires counselors to be aware of, and avoid imposing, their own values, attitudes, beliefs, and behaviors onto clients. When counselors are at risk of imposing their values, they must engage in ethical decision-making processes to maintain ethical care that respects the diversity of clients and supports their goals for counseling. Considering the systemic nature of beliefs and values, counselors must work to resolve value conflicts related to PAD through an ethical-decision making process that explores systemic influences and impacts. The counselor values-based conflict model (CVCM) can be used to effectively resolve values-based conflicts with PAD. Within this model, ethical bracketing may be used as a strategy to intentionally set aside personal values from professional values and interventions. The authors discuss values and decision-making through an ecological systems lens to address the systemic nature of value formation. The authors also provide a case illustration to apply the CVCM and ethical bracketing through an ecological systems lens. Nancy E. Thacker, NCC, is a doctoral candidate at the University of Tennessee, Knoxville. Jillian M. Blueford, NCC, is a doctoral candidate at the University of Tennessee, Knoxville. Correspondence can be addressed to Nancy Thacker, 501 BEC, 1122 Volunteer Blvd, Knoxville, TN 37996-3452, nthacke2@vols.utk.edu. Nancy E. Thacker, Jillian M. Blueford Resolving Value Conflicts With Physician-Assisted Death A Systemic Application of the Counselor Values-Based Conflict Model