We, the board members of the Social Work Hospice and Palliative Care Network (SWHPN) recently made a statement in response to the demographic data released by the Association of the Social Work Boards (ASWB). We noted our concern about the inevitable inherent racial bias embedded in the exam. Representing an organization of social workers working to bring humanity to serious illness and end-of-life care, we continue to reflect on ways to challenge the systems that deny and defy the basic humanity in all of us. It is in this endeavor that we respond to the recent New York Times opinion piece written by John McWhorter. 

In his opinion piece, Mr. McWhorter takes issue with the protest against the ASWB exam as racist. He points to the petition on Change.org and derides it for not sufficiently explaining why the tests are racist. Whether or not you believe the assertion that the test is racist depends on whether or not you believe the educational system in the United States, from preschool to graduate school, is embedded in a racist system and is infused with racist practices. There has been sufficient research data that support the fact that there are “categorical inequalities between Black and white students” in disciplinary policies, access to advanced courses, assignment to gifted and talented and special needs programs, and in practices of racialized tracking. The truth is that 68 years since the US Supreme Court ruling in Brown v Board of Education, high levels of racial and economic segregation persist in most metropolitan areas and with it, disparities in education. 

Hello SWHPN Members! On behalf of the SWHPN Board and staff, we hope you are enjoying a relaxing and safe summer. At the 2022 Conference, we extended our commitment to enhanced communications and transparency with our members. We hope you have enjoyed the new monthly Membership newsletter which came out last week, as well as our first Advocacy and Policy newsletter.  It was developed in conjunction with several Board members, and is generously supported by Healthsperian, a Washington DC-based company that provides healthcare advocacy on behalf of non-profits across the country; they are providing this to SWHPN free of charge to help our members stay abreast of policy issues that may impact our field, and have been supporters of SWHPN conferences for a number of years.

Additionally, we are working to write more regular blog posts, to provide more opportunities to gather feedback from members, and to develop new member benefits, including leadership and professional development opportunities. We also want to make sure our members stay up-to-date on what is happening behind the scenes with the Board and staff as we take on our own development to transform the organization into an anti-racist, inclusive space. 

SWHPN Statement on SCOTUS Dobbs v. Jackson Ruling

The Social Work Hospice and Palliative Care Network (SWHPN) is outraged and profoundly disappointed at the decision released on Friday, June 24 by the Supreme Court of the United States in the Dobbs vs Jackson ruling. This decision not only becomes the first Supreme Court decision to take away recognized individual liberty by ignoring stare decisis, it also places many people’s, and in particular, women’s autonomy lives, and well-being in jeopardy.  It conflicts with the Social Work Code of Ethics by interfering with social workers’ commitment to the dignity and worth of every person, and people’s rights to self-determination, especially over their bodies. Bodily integrity and autonomy are cornerstones for liberty within our society. We anticipate that those who have been historically marginalized and excluded within our society will suffer greatly, and disproportionately, from this decision. We will remain vigilant and encourage our members to work for unfettered access to high-quality health care for every person in our country. Social workers will stand firm in our commitment to social justice, access to quality healthcare, including reproductive health, and the right of every person to self-determination and liberty. 

It’s hard to find the words and we are struggling with what to say. But how can we not say anything, not acknowledge the shootings, the grief, the tremendous loss, and suffering. 

In continuing our commitment to speak up against injustice, racism, and acts of violence committed against people of color, SWHPN is issuing this statement to acknowledge the grief, loss, and heaviness in the world right now. SWHPN condemns the recent racist attacks in Buffalo, NY, where 10 people were murdered by a white supremacist; the murders of Taiwanese-Americans in a church in Laguna Woods, California; the massacre of 19 schoolchildren and two teachers in Uvalde; the killings at a medical facility in Tulsa, Oklahoma. These are just the acts within communities that made national headlines in the past few weeks. Yet gun violence remains a public health crisis that disproportionately affects Black and Brown communities. As of June 7, 2022, there have been 8,415 gun deaths and 247 mass shootings this year in the United States (1). 

In March of 2021, the Improving Access to Mental Health Act of 2021 was introduced in the House. This bipartisan bill, co-sponsored by Senator Debbie Stabenow (D-MI), Senator John Barrasso (R-WY), and Representative Barbara Lee, MSW (D-CA), will address gaps in services that Clinical Social Workers are able to provide under current law. 

There are 42 cosponsors in the House and 5 in the Senate. Per the NASW advocacy alert, we need at least 175 cosponsors in the House and over 50 in the Senate to demonstrate broad support for this bill and elevate it to potential consideration. It is anticipated that this might be a topic of focus in the coming months due to a recent request from the Senate Finance Committeeabout concerns that every American should be able to access high-quality behavioral health care when needed. 

Finding time to keep updated on pending palliative care legislation can be a challenge for busy palliative care practitioners. However, political advocacy work is as important as direct care work, and in some instances, may have the potential to improve lives and decrease suffering on a much larger scale. There is an urgent need to improve equitable access for all people who could benefit from palliative care, especially those who have been unfairly impacted by systemic racism and other forms of oppression in health care. This type of change will require some changes in public policy and laws. The palliative care community can work together to influence these changes through increasing engagement in political palliative care practice. 

Political palliative care is not partisan. Policy advocates view frontline healthcare professionals as important potential contributors for political action and advocacy due to their unique knowledge, proximity, and insight into the lives of the patients they care for. For patients with complex long-term healthcare needs, such as those served in palliative care, this type of practitioner advocacy can help communicate the perspective of a population of patients who may not be as well-equipped to communicate their experiences barriers to care and unmet needs.

The Congressional Social Determinants of Health (SDOH) Caucus is a bipartisan effort of lawmakers started in July of 2021 to improve approaches for addressing health disparities experienced by persons disproportionately impacted by SDOH and improve well-being. In this effort, the Caucus is seeking comments and feedback from the public on challenges and opportunities related to SDOH by September 21, 2021.  

Beginning this week, SWHPN will begin posting weekly updates from our committees, to highlight the important work each is doing to help advance the organization’s mission. This series is being launched by our Strategic Engagement committee, and the following was written by Jennifer Hirsch, LMSW and PhD candidate.

In continuing with our work to speak up and challenge social injustice, SWHPN is issuing this statement condemning the hateful attacks against Asians, Asian-Americans, and Pacific Islanders. We have seen a rise in verbal and physical violence in cities across the United States because of anti-Asian racism following the COVID-19 pandemic (Ruiz, Horowitz, Tamir, 2020; Jeung, Yellow Horse, Popovic, Lin, 2021). In the murders of Korean-Americans on March 16th in Atlanta, we saw the twin biases of sexism and racism that Asian women, in particular, have been victims of in our societal structure of white patriarchy. Affirming our social work values, we explicitly reject all forms of racism, xenophobia, and nativism, and stand with our Asian-American victims of violence and hate. By doing so, we also acknowledge that the struggles of Asian-Americans are inextricably linked with other BIPOC communities in a common endeavor for the humanity of this country. We uphold the inherent dignity and worth of each person and challenge others to join us in working against anti-Asian violence.

We recognize that our statement must be followed with action. Understanding our positionality and respecting the vanguard role of the Asian-American community, we want to use this opportunity to highlight the work being done by our Asian American Social Workers, and advocacy groups like Asian Americans Advancing Justice and Stop AAPI Hate (@stopAAPIHate on Twitter). The Atlanta branch of the Asian Americans Advancing Justice released a very powerful statement earlier today that we encourage you to read, and amplify and donate if possible. The Chicago branch is holding a series of bystander intervention trainings during April that SWHPN staff will be participating in, and we encourage you to sign up (also available here, through ihollaback.org).

SWHPN is thrilled to announce that three social workers have been announced as part of the seventh cohort of the Cambia Health Foundation’s Sojourns® Scholar Leadership Program. 

Cara L. Wallace, PhD, LMSW, APHSW-C of Saint Louis University; Rachel Rusch, LCSW, MSW, MA of Children’s Hospital Los Angeles; and SWHPN Board Member Stephanie P. Wladkowski, PhD, LMSW, APHSW-C of Eastern Michigan University were each carefully chosen through a rigorous selection process from a highly competitive pool. SWHPN is proud of their commitment to improving the experience of people facing serious illness and their caregivers. 

Watching the events from yesterday unfold, and then reading many responses on social media and in major news and journalistic outlets, we at SWHPN feel the need to reflect and respond. As an organization, we obviously strongly condemn the insurrectionist riot that occurred at the Capitol Building in Washington, D.C. and at statehouses around the country.

While social justice and self-determination are pillars of social work, what happened yesterday was an attempt by a group of nearly all-white people to compel their desired election result over the expressed wishes of millions of Americans who voted differently. Freedom of speech and freedom of assembly are guaranteed rights, but breaking windows and doors to enter Congress for the sole purpose to cause havoc and delay a procedural process to certify the President is not.

On Monday, October 12, the Texas State Board of Social Work Examiners changed the section of its code of conduct that establishes when a social worker may or may not deny services, to remove previous language specifying that discrimination based on disability, sexual orientation, or gender identity constitutes a violation of the code of conduct for Social Workers in Texas. The removal of these specifications puts the Texas code of conduct in contrast with existing social work principles, ethical guidelines for practice, and federal anti-discrimination mandates by allowing for discrimination based on disability, sexual orientation, or gender identity. 

The Social Work Hospice and Palliative Care Network (SWHPN) is horrified and dismayed by these changes, and condemns them in the strongest terms possible. This action explicitly violates the National Association of Social Workers’ Code of Ethics Section 4.02:

“The world has been abnormal for so long that we've forgotten what it's like to live in a peaceful and reasonable climate. If there is to be any peace or reason, we have to create it in our own hearts and homes.” ― Madeleine L'Engle, A Swiftly Tilting Planet

As of this writing, there are less than thirty days until the 2020 Election. This has been a year of tremendous uncertainty on so many fronts, and unlike in past years, it seems the uncertainty will continue through Election Night and possibly beyond.

As a 501(c)3 nonprofit, SWHPN is not permitted to endorse a specific candidate, nor are we allowed to oppose any candidate.

Last month, more than 125 SWHPN members, social work professionals, and students joined together for our virtual June Summit, “Cultural Competency in Hospice and Palliative Care.” Held on Juneteenth and during Pride month, we wanted to use the day as an opportunity to go beyond didactic presentations to showcase meaningful, actionable steps social workers could take to address racism, explicit and implicit bias, intersectionality, and more. During the post-Summit “networking happy hour,” attendees stayed online for an extra hour and a half to continue the discussion. It’s clear there is a hunger for more information about how to dismantle inequitable systems that harm Black people, Indigenous people, and people of color (BIPOC), whether they are patients, families, or social workers.

Post-Summit, what is SWHPN doing to address the changes that are needed?

As social workers in this pivotal moment, there are key lessons from the field of social work, and particularly the field of palliative and hospice social work, that we at SWHPN can apply to help some of us become better both in our work and our day-to-day lives.

We know there is a lot going on. In just the past twelve weeks, we’ve seen the COVID-19 pandemic blaze through our communities, resulting in more than 100,000 deaths. We’re seeing the related economic downturn affect workers, businesses, housing, food security, and more interrelated systems. We’re sharing the righteous anger from thousands of people across the country as they protest the impunity with which racial, ethnic, and xenophobic hatred and violence has been allowed to flourish. We echo the statement cried out on the streets and emblazoned across social media that Black Lives Matter.

Through it all, hospice and palliative care social workers have faced changing norms and practices head-on. We’ve grappled with determining who is considered an “essential” worker eligible for PPE. We’ve learned how to conduct family meetings in our living rooms and parking garages via videoconferencing and new apps. We’ve figured out how to show a smile behind a mask, how to show concern without being able to hug, and how to record memories and share presence for loved ones who couldn’t be physically present. 

AND we’ve done all of that while also grappling with the social justice issues that, due to hundreds of years building up layers upon layers of structural racism and inequities, are suddenly split open for all to see. Of the COVID deaths, we see the disproportionate impact it has had on Black people, Native Americans, Latinos, LGBTQ+ people, incarcerated people, and other marginalized communities, due directly to historical factors including redlining, unequal access to  to jobs, healthcare, and insurance, and stigma from healthcare providers. In the economic downturn, we see the same factors at play again, affecting those already struggling; and again in the police and judicial systems that overwhelmingly harm communities of color. It has been a lot to take in and process, even more for our social workers who are living it as a reality.