Disability Rights Toolkit for Advocacy Against Legalization of Assisted Suicide-Not Dead Yet

“Legalized assisted suicide sets up a double standard: some people get suicide prevention while others get suicide assistance, and the difference between the two groups is the health status of the individual, leading to a two-tiered system that results in death to the socially devalued group. This is blatant discrimination.”

“Proponents of legalized assisted suicide are willing to treat lives ended through assisted suicide coercion and abuse as “acceptable losses.”  We are not.”

NDY

Not Dead Yet is a US-based grassroots organisation of disabled activists fighting against euthanasia and assisted suicide legislation from a social justice perspective, viewing the push in favour of assisted suicide as a deadly form of ableist discrimination.

This is far from a black-and-white issue. But, lots of healthcare workers and would-be radicals  make the mistake of uncritically viewing assisted suicide as being somehow progressive, while ignoring the structural ableism that underpins the drive behind legalisation. Choice is obviously paramount, but NDY argue that legalising assisted suicide will only give choice to doctors, not to disabled people. Fundamentally, the suffering of disabled people is socially constructed by an ableist society, and we shouldn’t wish death on people just because they’re discriminated against.  

I’ve reprinted NDY’s toolkit here…

If this bill passes, some people’s lives will be ended without their consent, through mistakes and abuse. No safeguards have ever been enacted or proposed that can prevent this outcome, which can never be undone.”

– Marilyn Golden, Disability Rights Education & Defense Fund

 

Introduction

 

The purpose of this Toolkit is to give disability rights advocates an organized set of resources to assist in defeating proposals to legalize assisted suicide in state legislatures.  The Toolkit is divided into seven brief sections, each consisting of basic information and links to related resources with more information.  The seven sections are:

  1. Why disability advocacy groups oppose legalizing assisted suicide
  2. Educating and organizing disability opposition
  3. Meeting with legislators and policy leaders
  4. Testifying at hearings
  5. Working with the media
  6. Conducting direct actions – leafleting, rallying
  7. Working in coalition

All of the major national disability groups that have taken a position on assisted suicide oppose bills to legalize the practice as a matter of public policy.  The disability role in defeating these bills has increased in visibility and importance in the last few years as both media and various stakeholders have acknowledged our effectiveness.  It is critical that our voice be heard wherever assisted suicide bills are introduced and considered.

 

1. Why disability advocacy groups oppose legalizing assisted suicide

 

Proponents of legal assisted suicide for the terminally ill frequently claim that the opposing views of disability organizations aren’t relevant.  Nevertheless, although people with disabilities aren’t usually terminally ill, the terminally ill are almost always disabled.   People with disabilities and chronic conditions live on the front lines of the health care system that serves (and, sadly, often underserves) dying people.  One might view us as the “canaries in the coal mine,” alerting others to dangers we see first, but, unlike the canary, we loudly object to being seen as expendable.

A.  Background:

Not Dead Yet initially formed in 1996 to help articulate a disability rights critique of proposals to legalize assisted suicide.  Some of our initial observations, issues and concerns are as valid today as they were in the early years,[1] some even more so:

Suicide v. Assisted Suicide

It should be noted that suicide, as a solitary act, is not illegal under any state’s statutes. Disability concerns are focused on the systemic implications of adding assisted suicide to the list of “medical treatment options” available to seriously ill and disabled people.

Physicians Are Assisted Suicide Gatekeepers

Anyone could ask for assisted suicide, but physicians decide who gets it. Physicians must predict, however unreliably, whether a person will die within six months. Physicians judge whether or not a particular request for assisted suicide is rational or results from impaired judgment.

Disability is the Issue

Although intractable pain has been emphasized as the primary reason for enacting assisted suicide laws, the top five reasons Oregon doctors actually report for issuing lethal prescriptions are the “loss of autonomy” (91%), “less able to engage in activities” (89%), “loss of dignity” (81%), “loss of control of bodily functions” (50%) and “feelings of being a burden” (40%). (Death With Dignity Act Annual Reports) These are disability issues.

We Don’t Need To Die to Have Dignity

In a society that prizes physical ability and stigmatizes impairments, it’s no surprise that previously able-bodied people may tend to equate disability with loss of dignity. This reflects the prevalent but insulting societal judgment that people who deal with incontinence and other losses in bodily function are lacking dignity. People with disabilities are concerned that these psycho-social disability-related factors have become widely accepted as sufficient justification for assisted suicide.

Physicians Misjudge Quality of Life

In judging that an assisted suicide request is rational, essentially, doctors are concluding that a person’s physical disabilities and dependence on others for everyday needs are sufficient grounds to treat them completely differently than they would treat a physically able-bodied suicidal person. There’s an established body of research demonstrating that physicians underrate the quality of life of people with disabilities compared with our own assessments.  Nevertheless, the physician’s ability to render these judgments accurately remains unquestioned. Steps that could address the person’s concerns, such as home care services to relieve feelings of burdening family, are not explored. In this flawed world view, suicide prevention is irrelevant.

Broad Agenda, Incremental Strategy, Not Just for the Terminally Ill

The political agenda of many assisted suicide organizations includes expansion of eligibility to people with incurable but not necessarily terminal conditions who feel that their suffering is unbearablewithout examining the cause of the suffering or whether it can be alleviated.

Health Care Cuts Severe

For seniors and people with disabilities who depend on publicly funded health care, federal and state budget cuts pose a very large threat. Many people with significant disabilities, including seniors, are being cut from Medicaid programs that provide basic help to get out of bed, use the toilet and bathe.

Involuntary Denial of Care

Most people are shocked to learn that futility policies and statutes allow health care providers to overrule the patient, their chosen surrogate or their advance directive and withhold desired life-sustaining treatment. With the cause of death listed as the individual’s medical conditions, these practices are occurring without meaningful data collection, under the public radar.

Window Dressing Safeguards, Immunity Law for Physicians

The Oregon law grants civil and criminal immunity to physicians providing lethal prescriptions based on a stated claim of “good faith” belief that the person was terminal and acting voluntarily. This is the lowest culpability standard possible, even below that of “negligence,” which is the minimum standard theoretically governing other physician duties.  The Oregon Health Division does not investigate the reports filed by doctors who issue lethal prescriptions.

Disability Discrimination

Legalized assisted suicide sets up a double standard: some people get suicide prevention while others get suicide assistance, and the difference between the two groups is the health status of the individual, leading to a two-tiered system that results in death to the socially devalued group. This is blatant discrimination.

Unacceptable Losses

Disability is at the heart of the assisted suicide debate. Some people fear disability as a fate worse than death. Proponents of legalized assisted suicide are willing to treat lives ended through assisted suicide coercion and abuse as “acceptable losses.”  We are not.

B.  Where We Are Today

Assisted suicide advocates paint themselves as “compassionate progressives,” fighting for freedom against the religious right.  That simplistic script ignores inconvenient truths that are all too familiar to disability advocates, such as:

  • Predictions that someone will die in six months are often wrong.
  • People who want to die usually have treatable depression and/or need better palliative care.
  • Pressures to cut health care costs in the current political climate make this the wrong time to add doctor-prescribed suicide to the “treatment” options.
  • Abuse of elders and people with disabilities is a growing but often undetected problem, making coercion virtually impossible to identify or prevent.

Despite the frequent claim that Oregon’s experience has disproven the concerns of opponents of the Oregon law, the Oregon Reports as well as independent news reports and journal articles show otherwise:

  • People who are not within six months of dying are getting lethal prescriptions.
  • Depression is not identified or treated (only 6% have been referred for a psychological consult).
  • People have been denied prescribed medical treatments by insurers but offered assisted suicide as an alternative.
  • About half of the assisted suicide deaths in Oregon did not have a health provider present at the time of death, so there is no evidence of self-administration of the lethal dose or consent in those cases.

Because assisted suicide is such a controversial topic, discussions can often turn into debates.  A short cartoon video by disability activist Norm Kunc captures some of the flavor of such discussions:

Euthanasia at the Water Cooler

In order to be well prepared for debate on the issue, and even just to answer one’s own questions about the various key arguments, it is a good idea to become familiar with the kinds of information and resources that have been compiled by the Disability Rights Education & Defense Fund (DREDF).  Everything on DREDF’s public policy page on assisted suicide is useful, but the following short items are especially important:

The key arguments against legalizing assisted suicide can be summarized as follows:

  • Deadly mix: Assisted suicide is a deadly mix with our profit-driven healthcare system. At $300, assisted suicide will be the cheapest treatment. Assisted suicide saves insurance companies money.
  • Abuse: Abuse of people with disabilities, and elder abuse, are rising. An heir or abusive caregiver may steer someone towards assisted suicide, witness the request, pick up the lethal dose, and even give the drug — no witnesses are required at the death, so who would know?
  • Mistakes: Diagnoses of terminal illness are too often wrong, leading people to give up on treatment and lose good years of their lives.
  • Careless: No psychological evaluation is required. People with a history of depression and suicide attempts have received the lethal drugs.
  • Pressure: Financial and emotional pressures can also make people choose death.
  • Unnecessary: Everyone already has the right to refuse treatment and get full palliative care, including, if dying in pain, pain-relieving palliative sedation.
  • No true safeguards:  The safeguards are hollow, with no enforcement or investigation authority.
  • Our quality of life underrated: Society often underrates people with disabilities’ quality of life. Will doctors & nurses fully explore our concerns and fight for our full lives? Will we get suicide prevention or suicide assistance?

For a longer and thoroughly referenced article, structured with a very helpful table of contents, DREDF Senior Policy Analyst Marilyn Golden’s Why Assisted Suicide Must Not Be Legalized is excellent.

 

2.  Educating and organizing disability opposition

 

Similar to most members of the general public, many disability advocates have only heard the assisted suicide debate as conveyed through the lens of the media, limited by sound bites and other constraints.  Disability rights leaders in each state are needed to educate and organize our community, ensuring that people with disabilities, as well as family members and professionals, have the tools to work effectively in opposing assisted suicide bills.

To introduce advocates to the issue, an article in an organizational newsletter can be a good start.  Feel free to use “Why Do Disability Rights Organizations Oppose Assisted Suicide Laws?”  or contact Not Dead Yet about reprinting one of the published  op-eds linked on our website.  The handouts listed in Section 1 above are also excellent educational resources.  In addition, a leaflet summarizing the key arguments above is available.

Well-informed disability advocates are important to organizing disability opposition by:

  • Enabling disability organizations to take formal positions opposed to assisted suicide proposals.
  • Enabling disability advocates to communicate effectively to policy makers, media and the general public.

Disability organizations and advocates can obtain assistance from Not Dead Yet and DREDF in educating members, consumers, staff and board by emailing dcoleman@notdeadyet.orgjkelly@notdeadyet.org or mgolden@dredf.org.

If disability advocates in your state want to form a disability organization to help carry the message, two approaches have been taken:  a) establish a state Not Dead Yet group such as Not Dead Yet Colorado, or b) establish a state Second Thoughts group such as Second Thoughts (Massachusetts) or Second Thoughts Connecticut.  The name “Second Thoughts” reflects the notion that assisted suicide laws may sound like a good idea at first, but on second thought, the dangers of mistake and abuse are too great.

 

3. Meeting with legislators and policy leaders

 

A critical process throughout a state’s consideration of an assisted suicide bill is individual meetings with legislators and other key policy makers.  Disability organizations should not be new to this, considering the work that so many do to resist budget cuts and other policy changes that threaten great harm to people with disabilities.

As with many disability issues, there’s potential for bipartisan support of our position.  However, the partisan trend on assisted suicide runs the reverse of most of our issues.  This makes our perspective all the more critical in the debate.

To help disability advocates convey our perspective, DREDF has developed a legislative briefing booklet which we encourage advocates to print and distribute to legislators:

A Progressive Case Against Assisted Suicide Laws

Most assisted suicide bills use the same language as the Oregon assisted suicide law, with some variations and exceptions.  Information and analyses of some specific state bills can be found at http://www.patientsrightscouncil.org/site/ and http://www.choiceillusion.org.

 

4. Testifying at hearings

 

Legislative committee hearings are an important opportunity to communicate the reasons for disability rights opposition to assisted suicide laws.  When disability advocates are able to describe personal experiences that relate to the reasons for opposing these laws, the effect can be both powerful and persuasive.

For example, one advocate in Massachusetts spoke about being diagnosed with ALS and told how little time he had to live.  Decades later, he is still alive, and grateful that there was no assisted suicide law back at the time that he might have used it and then lost so many good years of life.  A disabled geriatric social worker talked about the sad realities of elder abuse and how the so-called “safeguards” in assisted suicide laws cannot protect vulnerable elders from assisted suicide coercion and abuse.

For online examples of testimonies by disability advocates in various states, some are included on the NDY website under “Legislative Efforts.”  Additional examples are attached to Not Dead Yet Press releases, such as Second Thoughts Massachusetts to Testify against Assisted Suicide Bill H 1998  and Disability Advocates From Not Dead Yet and New Jersey Disability Organizations Testify Against Assisted Suicide Bill Despite Short Notice of Committee Hearing.

 

5. Working with the media

 

Assisted suicide is different than many disability issues in that the press often considers it an important subject to cover.  There are six primary ways to work with the media:

  • Give interviews on camera or by telephone
  • Issue media advisories stating your basic position on the issue and availability for interviews, and providing contact information
  • Issue press releases describing key activities such as giving testimony, participating in press conferences
  • Submit letters to the editor and online comments to stories on the issue
  • Write and pitch opinion pieces for the editorial pages of key newspapers
  • Meet with editorial boards to urge them to oppose assisted suicide proposals

If you are contacted for an interview, please contact NDY or DREDF (dcoleman@notdeadyet.orgjkelly@notdeadyet.org or mgolden@dredf.org) for helpful tips and relevant updates on the issues.

When speaking with a reporter, who may be focused on an individual story of someone who favors legalizing assisted suicide, remember two key points:

  • If you only consider an individual, assisted suicide laws might seem OK—but we must look broadly across society, at all the people who stand to be harmed. And there are many!
  • If assisted suicide is legal, some people’s lives will be ended without their consent, through mistakes and abuse. No safeguards have ever been enacted, or even proposed, that can prevent this outcome, which can never be undone.

Hopefully, you will have the chance to go into greater depth with reporters about the significant dangers, risks, and harms that concern us. Assisted suicide is a unique issue that breaks typical ideological boundaries and requires us to consider those potentially most vulnerable in our society—those who bear risks that are not well understood by the general public. E.g.:

  • There’s a deadly mix between our profit-driven health care system and legalizing assisted suicide, which will be the cheapest so-called treatment. In insurers deny, or even merely delay, expensive live-saving treatment, the person will be steered toward assisted suicide. Will insurers do the right thing, or the cheap thing? Direct coercion is not even necessary.
  • A similar thing happens to people with disabilities, who have often been denied treatment and care that we need, because our lives are undervalued, or people think we’re better off dead. Our community is keenly aware of these dangers.
  • Elder abuse, and abuse of people with disabilities, are a rising problem. Where assisted suicide is legal, an heir (someone who stands to inherit from the patient) or abusive caregiver may steer someone towards assisted suicide, witness the request, pick up the lethal dose, and even give the drug — no witnesses are required at the death, so who would know?
  • Diagnoses of terminal illness are too often wrong, leading people to give up on treatment and lose good years of their lives.
  • Financial and emotional pressures can also make people choose death.
  • There are no real safeguards; for example, for people with depression and psychiatric disability. Michael Freeland, with a 40-year history of major depression, got lethal drugs in Oregon. Do we want death on demand for anyone, regardless of the risk?
  • For anyone dying in discomfort, palliative sedation is legal in all 50 states, providing comfort from pain at the time of death. The patient is sedated to the point where the discomfort is relieved while the dying process takes place. Thus, today there is a legal solution to any remaining painful and uncomfortable deaths; one that does not raise the very serious hazards of legalizing assisted suicide.
  • Assisted suicide bills are defeated when people learn the facts. In 2014, they failed in Massachusetts, New Hampshire, and Connecticut.

It should also be emphasized that arguments that refer to religious principles or “pro-life” concerns are counterproductive with a general audience and media.  While other groups may articulate those arguments, they are not part of the disability rights framework.  When disability advocates have raised those arguments along with the other concerns, reporters have tended to focus only on the “culture war” issues, which fits the narrative promoted by pro-assisted suicide organizations.  The talking points above are more consistent with a disability rights analysis.

Some of the key dangers of legalizing assisted suicide are summarized in a short leaflet.  It’s often helpful to have this leaflet or a similar short summary with you during an interview.  For additional information, updates and tips in preparing for a press interview, please email dcoleman@notdeadyet.orgjkelly@notdeadyet.org or mgolden@dredf.org.  In addition:

a)    Make sure the media outlet reporter has your name, and any title and organization affiliation you may want to use, as well as your e-mail address and phone number.

b)   Record for your records the reporter’s name, which media outlet they’re from, and their e-mail address and phone number.

c)    Ask them at the beginning or end of the interview, to please e-mail you a link to the story, when it appears.

The NDY website contains examples of:

Media advisories and releases can be distributed through professional services such as PRWeb or PRNewswire for a fee, or by email or fax to a distribution list that advocates develop locally.  Press contacts for submitting letters to the editor and opinion pieces are usually posted online by each publication.

Most of these activities require an advocate to be well versed on the issue.  Consulting the materials in Section 1 above is critical.  Disability organizations and advocates can obtain additional guidance from Not Dead Yet and DREDF in working with media by emailing dcoleman@notdeadyet.orgjkelly@notdeadyet.org or mgolden@dredf.org.

 

6. Conducting direct actions – leafleting, rallying

 

Sometimes direct action strategies are useful.  Proponents of assisted suicide may conduct public gatherings to discuss the issue, but it is all too common for them to say that their only or primary opposition comes from the religious right.  They ignore or minimize the opposition of physician organizations, hospice and palliative care organizations and disability rights organizations.  Disability advocates can download and peacefully distribute a leaflet at such events to counter that false message.

Other forms of direct action are possible, depending on the skills and experiences of the disability group involved.  Sometimes these strategies are also initiated by other groups that oppose these bills.  Not Dead Yet has experience with a variety of types of direct action and strongly advises careful consultation with NDY leaders before considering these strategies in the context of state assisted suicide proposals.  (Contact dcoleman@notdeadyet.org or jkelly@notdeadyet.org.)

 

7. Working in coalition[2]

 

Disability advocates in several states have now had experience working in cross-constituency coalitions against proposals to legalize assisted suicide (another name for the same thing would be multi-constituency coalitions, or single-issue coalitions).

Many of us, as disability advocates, are surprised, and sometimes uneasyto find that some of our allies in working against legalization are right-to-life groups and other organizations that are faith-based.  We’re “strange bedfellows,” as the saying goes.

It’s important to remember, and to remind the media and the general public, about all the groups that also oppose legalization: the American Medical Association, the National Hospice and Palliative Care Organization, the League of United Latin American Citizens; all groups in the political center.  Thus, the coalition spans the political spectrum from right to left.  The centrist groups are often forgotten; the media ignore them; and disability advocates are alleged to be somehow under the influence of the Catholic Church, or a tool of the right wing.  Other times, we are simply ignored by the media. In some states, it requires great persistence to get our opposition taken seriously—to get the reporters out of their stereotypes and ruts.

All these things can be challenges. Yet, even so, most of the time, the only way to successfully beat back proposals to legalize assisted suicide is our ability to form multi-constituency coalitions, where each group leaves its views on other issues outside the door, and we come together to work on one thing: opposing the legalization of assisted suicide.

 

Conclusion

 

The perspective of the disability rights organizations and advocates that oppose legalization of assisted suicide are an essential part of the public debate, in keeping with the fundamental principle, “Nothing About Us Without Us!”  By using this Toolkit and the related resources and links, disability advocates can bring our wisdom to the public debate and, if we are successful, protect the lives of all who are endangered by the public policies that assisted suicide proponents would enact.

 

 

 


[2] Adapted from DREDF Senior Policy Analyst Marilyn Golden’s remarks at the Disability Rights Leadership Institute on Bioethics.

 

 

 

 

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DISPUTE CLOSED WITH ALPHA CARE -Liverpool Solidarity Federation

 SF B&W

Last Monday we reached an agreement with Alpha Care which satisfies the economic demands made by a former worker. This company, specialising in home-care, owed the worker some unpaid hours, mileage and holiday pay. She decided to leave the company because of the working conditions.

Liverpool SolFed supported the worker’s demands and distributed, along with other workers, a leaflet giving information about the dispute and encouraging them to organise for better working conditions.

Finally, Alpha Care agreed to pay the full amount demanded. However, the company did not acknowledge any debt and accused the worker and SolFed of “…not having followed the right procedures and acting in bad will”. According to them they only paid in order to not to see our faces anymore. Whatever the reason, at least the worker got the owed wages.

In today’s climate of privatisations and undermining working conditions, care workers are suffering a lot. Liverpool SolFed urges care workers to organise in order to fight back and improve working conditions in the sector. Among other problems, carers are suffering:

  • No guaranteed or uncertain hours
  • Unpaid travel time between jobs
  • Below minimum wage in real terms
  • Unpaid/unplanned breaks and expected to rest between jobs
  • Inadequate training, left feeling unprepared and unsupported
  • Unsafe manual handling and under staffing
  • Lone-working in high risk environments.

Muting the SWAN- A Radical Alternative to Trotskyist Social Work-The Sedge Wick

damned boss

 

Who are SWAN?

The Social Work Action Network are a campaigning group which aims to bring social workers and other interested parties together to campaign against austerity. ‘Radical’ social work has been around as an idea since the ’70s[1]. These days, in the UK at least, SWAN have a monopoly on the term. The 2011 book Radical Social Work Today, the textbook Critical and Radical Social Work, an Introduction, and the book series Critical and Radical Debates in Social Work are all edited by and feature contributions in heaps from members of SWAN’s twenty-person national steering committee.  SWAN have links to prestigious university social work departments and, anecdotally at least, the senior managers of at least a handful of NHS trusts and other big statutory employers.

What’s wrong with SWAN?

SWAN’s influence on social work seems to be chiefly top down. They hold a position of influence in the profession, while operating from within a relatively small circle of social work writers and theorists, with very little presence among the frontline social work workforce. The problems with ‘radical academia’ have been discussed at some length[2]. Fundamentally, though, it would be a mistake to assume that social work lecturers and academics have common political interests with social workers themselves. Actual social workers trying to build genuinely radical social work should be wary of an organisation which claims to speak for social work while existing outside of the industry, in a position of relative privilege.

When they’re not cornering the textbook market, SWAN protest. Their activism happens in the classroom or on the streets, but not in the workplace itself. This is a strategic mistake. Social workers’ power lies in the fact that the work we do is indispensable. At work, we have the levers of the whole social care system in our hands. This gives us power that we lack when protesting or lobbying. Social care policies are made in government but are made reality in the offices where we work; a concerted effort by organised social workers to boycott, sabotage, and strike against cuts and privatisation could disrupt the whole apparatus. By ignoring the workplace and only challenging austerity by protest and debate, SWAN are relinquishing real, grassroots power in exchange for symbolic opposition and impotent theory. There’s nothing radical about an organisation which marches against austerity in public but has no capacity to support social workers to defy the cuts, in the place where it actually matters.

SWAN’s connections to the Socialist Workers Party are also indefensible. SWAN’s links to the SWP are informal but nevertheless very real; several members of SWAN’s controlling body, the national steering committee, are connected to the SWP, leading to justified speculation as to how far SWAN takes its marching orders from the SWP. For anyone who doesn’t know, The SWP became a pariah among the left and radical communities in the UK after party leaders were accused of the rape and sexual assault of young activists[3], which the party bureaucracy then covered up. Everyone should be appalled by an organisation which enables rapists, but if anyone should stand up against gendered violence and institutional abuse, it’s social workers. Doing so is our job. SWAN’s obeisance to the SWP is collusive, discredits the reputation of the profession, and will ultimately distance SWAN from other, braver organisations who are prepared to stand up to the SWP cult.

SWAN and class

SWAN’s constitution states that, “While recognizing that social work is one of the mechanisms through which the State controls the behaviours of poor families, we believe nevertheless that social work is a valuable activity which can help people address the problems and difficulties in their lives.“ I can relate to this ambivalence, but without actually trying to resist the coercive State influence within social work, statements like this represent little more than Liberal guilt. The idea is to fight authoritarianism, not to ‘recognise’ it.

SWAN’s problem here is that, in framing social workers as agents of the status quo, they draw a line between social workers and the working class. Some anarchists share SWAN’s view of social workers as softcore law enforcement, although typically with less sympathy; The Class War party have railed against social workers in their publications, lumping us in with cops, lawyers and middle managers as being irredeemably ‘middle class’; privileged pawns of the coercive State (teachers get a similarly raw deal). For Class War, as with SWAN’s analysis, the fact that social work is a middle-class industry and the fact that it is a repressive force are linked; social workers are bourgeois themselves, so they prop up the bourgeois State. By marking out social workers as being a distinct social class from the ‘poor families’ we work with, SWAN’s analysis is not dissimilar to Class War’s.

The problem with this analysis is that the distinction doesn’t exist. In describing a profession of privileged individuals whose interests are closer to those of the State’s than the workers’, SWAN are only really describing themselves. Frontline social workers often live on the edge of hardship; like nurses, teachers and other public sector workers, social work salaries have stagnated in recent years as the cost of living has rapidly caught up and overtaken. Average salaries in many of the traditional industries typically seen as ‘working class’, including mining[4] , steelworking[5] and transport and logistics[6] often exceed the pay of supposedly ‘middle class’ social workers and other health workers by a considerable amount. Social work itself is a gruelling, thankless job, frequently dangerous[7], with shocking stress levels[8] and breakneck staff turnover. In an era of cuts and privatisation, pay and terms in local authorities and the NHS are frequently subject to change and review, and healthcare workers’ jobs are increasingly insecure[9]. My own team of thirty has seen four job lost this year. Of the people that I trained with, roughly half have left the profession in the two years since I qualified. SWAN’s line in the sand, between social workers and the ‘poor families’ we work with, has no basis in reality. Social workers shouldn’t let a traditionalist view of who is and isn’t working class blind us to the material fact that we, too, are the victims of capitalist exploitation; that we are coerced, more than we coerce, by the state and capital. By identifying social work with the forces of state repression, rather than with the lives of the people we work with, SWAN prove how out of touch their cohort of social work lecturers is with the real lives of underpaid and exploited frontline social workers.

There is no denying that working class children and families are over-represented on the caseloads of many social workers, especially in child protection services and other areas of social work where statutory powers shape the job role and where collusion with the police is the norm of the job. But ruling class collaboration isn’t fundamental to social work; while government social care policies are progressively coercive, the rank and file social work workforce share common material and political interests with service users and with the wider working class.  We need the services that give us jobs, just as our service users need services for care and support. We need to negotiate Capitalism for our food and shelter, just like everyone else does. SWAN separate themselves from the working class, and so can offer only guilty paternalism dressed up as radicalism. Genuinely emancipatory social work needs to recognise its own plight, and fight for itself as well as for others.

What might real radical social work look like?

The false divide between social workers and service users needs to be broken down, and the natural class animosity between workers and our managers and policy makers needs to be rekindled. Genuinely radical social work practice needs to be combative, whilst as far as possible integrating ourselves with the daily lives and struggles of our clients and the class as a whole. Doing this isn’t easy. I’ve outlined some possible strategies below.

Community autonomy. In some ways, social work lends itself more easily to radicalism than other health work does, because it has the potential to be much more democratic. You can’t easily teach patients to perform complex medical procedures on themselves, but you can certainly teach communities to feed, clothe and house each other, to counsel each other, and to protect each other. Radical social work should be educational. By teaching social work knowledge we can replicate ourselves, and democratise social work, to build communities which are not only resilient but autonomous, and independent from the increasingly fickle State for support.

Common ownership. Social workers handle public resources; sometimes (in the case of adult care workers commissioning social care, for example) we directly oversee the flow of money from the State to the client. Don’t forget that common ownership isn’t the same as State ownership; when you allocate budgets to clients, you are only giving them back their own money. Don’t ‘gatekeep’ resources.

This has implications for how we work. Social work managers are hell bent on stemming the flow of local authority money into the hands of service users, usually by tightly controlling the allocation of budgets and the thresholds for who can and can’t access services. This managerial control will manifest itself in a whole host of organisational policies and procedures. My own local authority, for example, has recently introduced a policy called the ‘options directorate’, which stipulates that patients in hospital should be discharged out of area rather than staying in hospital until a suitable local bed can be found. Another common example of managerial theft of resources is through the care commissioning process and social work funding panels, where social workers will apply for funds for service users’ care packages and managers will either authorise or decline them based on the current managerial zeitgeist. This is the kind of bullshit which we can, and should, be fighting against. To ensure clients have as much access to their own money as possible we need to be clever and think about some creative ways to sabotage these kinds of policies. When the law is on our side, we need to use it; this could mean learning to write water-tight panel applications, and being prepared to escalate, to support service users to complain, and to contact outside agencies like the Local Government Ombudsmen, regulators, and even the Press, to pressurise managers into doing what clients want them to. Be sneaky, learn the law and its loopholes, and don’t give up just because your boss stops talking to you.

Service users’ self-organisation. To their credit, SWAN have been effective in building links with user led campaigning groups. To be effective, though, political solidarity between social workers and service users needs to move beyond marches and become a real, concrete force within the lives of service users and the working lives of frontline social workers. We should be building solidarity through our work, not just in the political spheres around and outside our working lives. Doing this could involve talking about politics to service users as part of our therapeutic work with them, talking about our own experiences of using services, our own problems with landlords and bosses, and in doing so validating both ours’ and our clients’ legitimate anger at our shared political experience. We should try and use peer-run resources rather than statutory resources as far as possible, as our first choice not as an add-on to our care plans.

Suggest joining or forming autonomous organisations to service users who haven’t considered it yet. Get to know as much as you can about these organisations, both current and historic, so when clients feel self organising is impossible you can give them hope. Encourage clients to meet other people in the same situation. Consider facilitating groups where you can see multiple service users at the same time, and they can meet and support each other. If you live in an area which already has prominent self-organised service user groups then get to know them, find out what they do and how they see the world, meet up with the people involved. Let them direct your work, and be accountable to them as far as possible. If there is a lack of autonomous service user organisations in your area, then encourage service users to start them. Research and write leaflets on the benefits of peer support and self-organised service user groups. Try and use your skills and resources, the use of your office space and facilities, to lend solidarity and practical support to these groups, especially in their infancy when they may need help to get off the ground. This will allow clients to build their collective strength and put them in a better position to defend their own interests.

Service user self-organisation is important both for therapeutic and political advancements. Sue Holland’s Social Action Therapy case study is a good example of how a worker can facilitate this in practice, to encourage the development both of mutual support networks and of militant political organisations, both of which are invaluable in the current political climate.

Workers’ self-organisation Social workers will make themselves unpopular with their bosses if they do all of this. We will need to be able to protect themselves at work from repercussions, bullying, threats and intimidation which we might attract. To do this, we will need to build fighting organisations within our own workplaces, so we can use our collective power as workers to protect ourselves from vengeful managers, and to begin fighting for own political and economic advancement. Start by building close relationships with colleagues, and fostering workplace cultures where workers support each other collectively against management harassment and bullying.  As I’ve argued above, social workers share common interests with service users, so we need to fight to defend ourselves as well as defend our clients. Social workers should organise in the workplace to fight for better pay and conditions, for lower caseloads and less unsupported risk-taking, and to resist privatisation and the insecurity that comes with it. A union of social workers with radical politics will also be a powerful tool for fighting for wider political change. If we don’t like a particular cost-saving measure or repressive piece of legislation, we can simply refuse to implement it, and if we are well organised we can refuse on a huge scale, using our collective power to move beyond individual disobedience, to strike, sabotage and boycott to bring down iniquitous social care legislation or coercive government policy. As stated above, it is at work, not on the streets or at the ballot box, where we have the most power. If we organise at work, we can begin to use it.

These aren’t off-the -shelf models of radical social work which we can simply memorise and implement. Building the structures and cultures necessary to do this will take time, and may be a process of trial and error. These measures are far from perfect; relying on communities rather than the State to provide care could lead to an uneven distribution of services, as some communities hold more resources than others. ‘Care in the community’ has long been a by-word for care by the family, and over-emphasises the roles of traditional, patriarchal institutions in which women may be lumped with the burden of providing care unpaid. Transferring resources from the State into the pockets of service users may seem like something of a pyrrhic victory so much of the provision of care is now carried out by private companies. That said, theory is built up from the bottom. The ideas above might be enough to get us started.

As well as a criticism of SWAN and their Trotskyist ilk, I wanted to outlines a blue print for a new kind of genuinely radical social work which we can start building ourselves, now, without having to wait for a change of policy or another new radical social work textbook. Useful theory grows symbiotically with real struggle and action. We don’t need leadership from theorists.

 

[1] https://www.theguardian.com/social-care-network/2016/may/24/radical-social-work-quick-guide-change-poverty-inequality

[2]See  http://libcom.org/blog/against-academic-alibis-best-education-struggle-%E2%80%93-george-ciccariello-maher-23082013 or http://www.wildcat-www.de/en/wildcat/96/e_w96_berufubewegung.html

 

[3]http://socialistunity.com/swp-party-members-write-full-narrative-comrade-delta-rape-case/, https://www.theguardian.com/society/2013/mar/09/socialist-workers-party-rape-kangaroo-court,

https://libcom.org/blog/swp-crisis-some-analysis-some-thoughts-13032013

 

[4] http://www.bbc.co.uk/news/uk-england-15445418

[5]http://www.payscale.com/research/UK/Employer=Tata_Steel/Salary

[6] https://www.glassdoor.co.uk/Salaries/train-driver-salary-SRCH_KO0,12.htm

[7] http://www.communitycare.co.uk/2014/09/16/violence-social-workers-just-part-job-70-incidents-investigated/, https://www.theguardian.com/commentisfree/2015/aug/18/social-workers-job-dangers-fears

[8] http://www.management-issues.com/news/1820/teaching-and-social-work-are-the-most-stressful-jobs/

[9] http://www.unitetheunion.org/uploaded/documents/guidetonhsprivatisation11-10734.pdf

Bristol Care Workers Network statement on the STPs and social care cuts in Bristol.

Bristol City Council recently announced £30 million in spending cuts, which will impact on social care as well as other services. Alongside this, Bristol CCG plan to cut 30% of hospital beds across the Bristol area as part of the new NHS Sustainability and Transformation Plans. The response from Bristolians to these cuts has been fierce. BCWN would like to thank all the groups and campaigners that have been organising resistance against these cuts. We are especially grateful to Bristol and District Anti-Cuts Alliance; The BADACA-organised demo in central Bristol last month highlighted the good work BADACA have done in bringing together activists from a range of political spaces into a unified movement. It was inspiring to be part of.

The cuts are particularly troubling for us because we not only use health and social care services but also work in them. At the BADACA demo, a speaker from Bristol Anarchist Federation made the point that the working class creates the wealth which the politicians are now trying to withhold from us. Or, to put it another way, that everything in society that’s valuable gets its value from the workers who make it. We share this belief, and we think it is especially true in the health and care sector. A hospital without its staff is just a lot of concrete and empty beds. Bristol’s hospitals, care homes, social care offices and day centres are only worth anything because of the skills and time of the workers in them.

They belong to us, and to the people who use them. They do not belong to the politicians. They are not theirs to cut.
Neither do they belong to the bosses. Politicians will order the cuts but it is the managerial class, within the services we work for, who will wield the axe. It is hospital managers and social services bureaucrats who pile up the caseloads in community teams, who cut the hours from home care packages, who kick patients out of inpatient beds when they’ve got nowhere else to go. It’s them, as much as the councillors, who create the relentless downward pressure on us and take our time and resources away until we can’t do our jobs properly any more. And, like the politicians, they have nothing to offer of any value to the running of these services. They can’t bandage, or prescribe, or counsel, or protect. Our bosses may work in the same institutions as us but they have no more ownership of them than the politicians in the council offices do.

Fighting the cuts means fighting the bosses within our workplaces, as well as fighting the politicians on the streets outside City Hall. We can fight, not only in our work but through our work, by defying our bosses and using our skills and resources in the interest of ourselves and our class. This means nurses not discharging patients unsafely just to free up beds, social workers not agreeing care plans which fail to meet basic needs, A&E staff refusing to shame patients into not using emergency services. Eventually, this will mean building new fighting organisations in the workplace; we’ve got no love for the existing trade unions, who march us out of work to protest the cuts on the streets and then march us straight back in again to do what we’re told. We need new unions, which let us use our collective strength as workers.

We wanted to make a final point on what is at stake in the struggle against cuts. Research by the Royal Society of Medicine showed that spending cuts in the NHS and social services were responsible for 30,000 deaths in 2015. This figure was rightly shocking to many people, but to those of us who work in health and care services, it shouldn’t be surprising. Anyone who has worked in the industry for any length of time will know a patient who has died, or had their quality of life drastically reduced, because of a lack of resources. This means we will have known people, and sometimes known people very well, who this government and the capitalist class have maimed or killed. This is why we are fighting.

Ultimately, the fight for our services will take place within the services themselves. Marching on the streets shouldn’t be a substitute for organising in the workplace. We can fight in the workplace for political goals, and for a better health service for everyone, as well as for better pay and conditions for ourselves. We’ve always known our bosses and politicians can’t run our services properly. If even they are now realising this, they should move over and let us run them ourselves.

Organising in the Care Sector-Calderdale Solidarity Federation

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An account of a workplace campaign in the social care sector, from Calderdale Solidarity Federation.

A member of our Local was recently involved in organising and industrial action within the social care sector.

They work for an individual with a personal budget – where a person who has care workers is given the money by Social Services for them or their family to employ their care workers directly. This method of commissioning services is very much the future of social care (“Personalisation”) and currently is highly unregulated. Issues for workers and people who use support include:

Cuts to individual budgets being much easier to make on review than cuts to block services, resulting in reduced hours and people not getting the support they should have.

Deskilling of care profession – employees in personal budgets do not need any training whatsoever and there is little oversight of who and how people are being employed.

Insecure working conditions with zero hours contracts and insecure working conditions abound and people employing workers are driven into this by lack of funds. The typical money awarded for a budget is often less than is really needed.

Because personalisation is basically the wild west of social care a variety of new, highly unstable companies and roles have grown up around helping people to manage their budgets (“brokerage management”), often taking large fees from budgets and with very, very minimal regulation by anyone of the work that is actually done.

The person who our member worked for had a personal budget managed and administered by their relative but they struggled with the workload and various issues e.g. lack of cover staff so a “brokerage management” company was paid relatively high fees to solve issues.

The brokerage managements approach was to appoint a “temporary” manager who quickly told staff she expected to be their permanent manager. The manager employed their friends as bank staff without interviewing them and granted them permanent hours taken from existing staff – to the point where one staff member had their hours cut in half. The manager introduced new contracts in which all staff were given less hours than they had previously worked, were to restart their probationary period despite many working for the person for years, and the manger threatened the team leader with the sack if they did not get other staff to comply with the contracts and harassed them constantly on a range of other issues to the point where they were struggling to sleep, had skin conditions caused by stress and were interviewing for other jobs.

Staff initially raised grievances individually, joined reformist unions who wouldn’t help because they hadn’t been members long enough, etc – they were dealt with by divide and rule by the manager and most considered quitting. The atmosphere was poisonous, dispirited and not good for the person being supported let alone the staff.

After a talk on workplace organising from the Manchester Local, our Local’s newest member introduced the idea of workplace organising in wildcat fashion. They held workplace meetings, decided on a set of objectives, including 1) to ensure contracts did not contain a probationary period and stated the correct number of hours, and, 2) to get rid of the manager.

They formulated a list of demands related to the contracts and the way staff were treated and took them as a united front to the manager. She responded by phoning the complainants up individually to try and sow discord and lie about different things that had happened. When staff held more meetings and stood firm she agreed to a group meeting with the person’s relative who held ultimate responsibility but did not want to be involved too closely. By lying and generally sweet talking the relative the meeting was commuted to staff having individual meetings which they were then told were performance reviews.

Staff responded by refusing to attend the meetings. Instead they contacted the relative and arranged a separate meeting where they raised a list 20 issues including serious concerns about the way the manager treated the person we worked for, this with the backing understanding that we were very close to walking out of employment en masse. At this point the relative seeing that staff were united in opposition, the duplicity of the manager and the seriousness of the issues sacked the brokerage management company and contracts were rewritten without the probationary period and with the correct number of hours. Both demands were achieved relatively quickly by organising, sticking together and not being intimidated.

A quick victory was achieved in an unregulated sector by organising and sticking together. The Calderdale Local member would like to thank Manchester Local for their help and clear advice.

Calderdale Solfed are interested in speaking to others in the Social Care sector about setting up a social care sector network to act in solidarity and discuss issues e.g. how to organise in the face of the massive cuts the sector is experiencing, how to organise with the people we work with so we can fight for better living and working conditions together rather than being divided into employees and employers.

What do we mean when we say “Syndicalism”?-The Sedge Wick

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What is Syndicalism?

The word syndicalism comes from the French word for an industrial or trade union. Put simply, syndicalism just means revolutionary unionism. Syndicalists are revolutionary socialists who believe that unions, rather than socialist parties or activist groups, are the driving force for social change.

All socialists and communists think that unions are important to some extent. Most socialists believe that workplace unions are useful because they let the workers protect themselves from being exploited by the bosses. If bosses try and cut pay or push up hours, for example, the union defends the workers with strikes and industrial action.

For most socialists, though, this is all the union is good for. Most socialists and communists believe that, while the unions can be useful in the short term, to make meaningful political changes a separate political party is needed outside of the workplace, to represent the workers in government. This can be a revolutionary party, like the Bolsheviks in the Russian revolution, or a parliamentary party, like the UK’s Labour party.

Syndicalists reject this. They see the separation between the workplace union and the political party as false. Instead,  they argue that if the union can fight for economic improvements in workers’ lives then it can also fight for social and political change.

How?

Socialists (including syndicalists) believe that capitalism exploits workers by making them work. Workers produce goods and services through the work they do. Because goods and services have value, the workers, by working, also produce wealth. But if the worker works for a boss, then it is the boss who gets the wealth, in the form of profit. The worker usually gets paid a wage instead, which is a small fraction of the overall profit made. The boss can do this because, under capitalism, the boss owns the factory, shop, office or other workplace where the goods and services are produced. Socialists believe that the workers should get all the money that they make through their labour, not just the small part which the boss pays them. To do this, the working class as a whole (all the waged workers in any society) need to take over the workplaces (called the ‘means of production’) and run them themselves, without bosses, sharing the wealth between them.

Different groups of socialists and communists have disagreed about the best way to do this. Marxist Leninists (the types of communists who took over Russia, China, Cuba, North Korea, and the other countries we usually think of as ‘communist’) believe that a communist party is needed to do this. Rather than the workers seizing the means of production themselves, Marxist Leninists use the Communist Party to take over the whole economy of a country, with the aim of distributing its wealth out to the whole county’s population. The result is usually a Government dictatorship in which the economy is strictly regulated. Syndicalists think this is the wrong strategy. Instead, syndicalists think the workers in each specific workplace should try and take control of that workplace themselves, and run it democratically, without a boss or manager. This is called Industrial Democracy or, more simply, Workers Control. Syndicalist workers aim to do this by using strikes and other forms of industrial action to challenge and undermine the boss’s control over the workplace. Crucially, syndicalists aim to do this without relying on governments or political parties to do it for them.  Workers in their places of work have a lot of power. Whether it be growing food, caring for the sick or designing computer programs, nothing in society gets done without waged workers being paid to do it. Why would the workers rely on outside organisations to beat the bosses when they have so much power themselves?

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What does a syndicalist union look like?

In the UK, when we think about unions, we tend to think about the big trade unions like Unite, Unison or the GMB. These are called ‘representative’ or ‘service’ unions. The members pay into the union, and when they need help, the union fights their corner for them.

Syndicalist unions work differently to this. A syndicalist union is an associational union rather than a representative one. In an associational union, the members, i.e. the workers in the workplace itself, are the union. There is no hierarchy or organisation above them that run their campaigns for them.  If ten workers decide to walk out of work one day, and not come back until they get a pay rise, then those ten workers are acting as a union. Whether the ‘official’ unions approved their action is not important.

This kind of strike action, where workers use their own initiative to organise a strike without involving outside agencies, is sometimes called a ‘wildcat’ strike. Wildcat strikes can seem difficult to organise, but it is worth remembering that most of famous strikes in UK history, from the General Strike of 1926 to the Miner’s Strike of 1984, actually began as wildcat strikes, with the representative unions only making the strike official well after it had already started.

Because of this, syndicalist unions can be very flexible and tend to vary in size, structure and composition depending on what sort of workplace they are in. Syndicalist unions are run democratically, from the ‘bottom up’, with as much power as possible being given to the workers themselves rather than to reps, stewards, or steering committees. There are lots of different ‘types’ of syndicalist unions, ranging from the ‘one big union’ of the IWW, which aims to organise all workers across the globe into one big, democratic union, to the loose, informal networks of activists and agitators favoured by some anarcho-syndicalists.

Revolution and the general strike

As we said, syndicalist unions are revolutionary. They are not just concerned with protecting the workers’ pay and conditions, but seek to bring down the whole capitalist system through revolution. Syndicalists believe that, rather than using revolutionary political parties to seize control of the government, the best way to bring about the revolution is through industrial action in the workplace. Specifically, they aim to do this using something called a revolutionary general strike. A general strike occurs when a large number of workers, across a range of different sectors and industries, go on strike at the same time. General strikes are very powerful political tools and have historically brought down governments and caused massive upheaval and social change. It was widespread union militancy which ousted Edward Heath’s Conservative government in 1974, for example.

Bringing down one government is not a revolution, though. A general strike becomes revolutionary when the striking workers seize control of their workplaces and begin to run them themselves, without bosses or the government. Worker’s control often happens organically during times of industrial unrest, simply as a point of common sense; workers realise that even during a strike, work still needs to be done, so rather than give up and hand control of the workplace back to the boss they simply begin doing the work themselves without the bosses. At various times in history, striking transport workers have delivered food to striking mine workers as a sign of solidarity, striking firemen have given lights and heaters to picket lines of office workers, and striking tram workers have given lifts to their fellow workers in other industries. Small scale acts of solidarity like this can sometimes escalate to much larger acts of industrial democracy. Sheila Cohen, in her study of the ’78/’79 general strike known as the Winter of Discontent, wrote that ‘within a short time, strike committees were deciding what moved in and out of many of the ports and factories… In some cases, strike committees controlled the public services of whole cities’

This is called dual power, when the bosses and managers haven’t been beaten yet but the workers are beginning to run their workplaces without them, based on solidarity and mutual support. Syndicalists believe these solidarity actions that arise during industrial unrest are not just important for practical reasons but are in fact the first actions in the revolution. If workers can run their workplaces themselves then there is no need for bosses. Without bosses, there will be no more capitalism. What’s more, if the workers are running their industries by giving their products and their labour to those who need it, not just to those who can afford it, then they are not only bringing down capitalism but building socialism.

The syndicalist revolution is not planned or staged; it arises spontaneously as individual industrial actions escalate into strikes, strikes become general strikes and general strikes become revolutionary. This can only happen under the right conditions; syndicalists see their role as building those conditions, organising their fellow workers into unions and preparing them for the revolution.

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