It is no secret and no surprise that social work is a tough profession. Social workers are notoriously overworked, overstressed, underpaid, and underappreciated. Social workers are graceful absorbers of spite and voluntary experiencers of traumatic stories and events. Social workers are the keepers of burdens and secrets, the withholders of assumptions and judgements, the givers of hope and care.

Among social work’s core values is that of an individual’s right to self-determine. If you are a social worker, I need not remind you that self-determination is an ethical principle that recognizes the rights and needs of clients to be free to make their own choices and decisions. If you are a social worker, then you know what the fuck self-determination is and have since at least the very first day of graduate school.

As a social worker myself, I recognize the fundamental importance of self-determination for every human being on Earth. If there are other life forms somewhere else in this universe, I also recognize and respect their right to self-determine. I do not apply the right of self-determination selectively.

A person who has committed a heinous crime, afflicted abuse on a child, taken their own or another’s life or otherwise made a decision that conflicts with more widely accepted values has the complete, utter and unarguable right to do so. If I did not believe this, I would be an interior designer that insisted each client have at least a splash of turquoise in their home, or an eccentric novelist with a hallucinated muse. But instead I am a social worker, and the value of self-determination roots firmly through my being.

In social work, we talk about self-determination a lot. We talk about why it is important, the fact that it exists despite illness or disability, how it supports recovery, how policies impact it, how we can foster and cultivate it, and how we can help implement it.

But for some strange reason, we never seem to talk about how difficult it is to watch our clients, fellow human beings with whom we have bonded and for whom we care, make choices that cause them harm. We meet people where they are and we accept, respect and support their right to choose, to self-determine. Yet at the end of the day, the belief in a person’s right to self-determine does not make it any easier to watch that person drink themself to death or live vulnerably on the streets instead of an in apartment.

It is grueling to stand by, never silently but always humbly, while people make choices that will ultimately result in injury, death, or otherwise impactful consequences. My boss recently called this, the part of social work that simply involves showing up for someone “being a god damn human being.”

Sometimes, being a god damn human being is a struggle. It feels heavy, it feels sad. But when I think about my job from this perspective, as the simple act of showing up and genuinely engaging, I am reminded that I make a difference, albeit not the one I expected, even in the lives of people who are self-determined to self-destruct.

And at least these individuals get to self-destruct with the dignity of choice and with the knowledge that their social worker honored that choice, if nothing else.