Reply To: Motivational Interviewing (& Right to Die)

Home – NEW Forums Module 6 – Comorbidity & Relapse Fall 2023 Motivational Interviewing (& Right to Die) Reply To: Motivational Interviewing (& Right to Die)


I think you made great points when working with people who are not wanting to reduce their substance use. I enjoy the intentional alignment with the social work perspective especially considering self-determination and the right to live at risk. It can be tricky to reconcile the moral distress associated with knowing that our clients are making decisions that will cause them harm. It is important to support these decisions from a harm reduction point of view both from a safety standpoint, and also from a destigmatization perspective. Being reflexive enough not to let moral distress bleed into the interactions we have with clients about risk behaviour helps us create the safety that is necessary to plan with clients from a non-judgemental point of view.

In regards to the “right to die” conversation, I find this a fascinating example of the limits of our abilities as practitioners in the sense that what we’re expected to be able to do, and where our responsibilities end, in terms of dying. It seems like often there is this magnifying glass over healthcare in the court of public opinion about protecting people from dying, though, in contradiction, we do not invest adequately in supports that we know will keep a large portion of these folks from wanting to die: income, housing, food, community, etc. We place such a value on life itself, and once we establish that, it seems like we believe our job to be done. I think it speaks to our colonial cultural values in Canada where our supports can sometimes aim to reduce the moral distress associated with the oppressive systems we employ to maintain the status quo, wherein we think keeping people alive is virtuous in it of itself, rather than aiming to support people in maintaining a quality of life they deem as worth having. Definitely an interesting conversation to have, especially when it comes to our roles, and how much of a crossover there unfortunately is between psychosis and suicidality.