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RT 205 > 5. Death and Dying > Flashcards

5. Death and Dying Flashcards

1
Q

is the entire state of the living thing

A

Life

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2
Q

may be considered as an element of human

autonomy through which a person experiences a sense of self.

A

Life

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3
Q

it encompasses the value of the self

A

Life

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4
Q

is a determining factor in a person’s “preconscious” standard of judgment.

A

Life

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5
Q

The imaging professional should consider the following aspects of life when making determinations in ethical dilemmas:

A
  • Life is the foundation of all other values of a patient.
  • Life is the foundation of a patient’s rights.
  • The preservation and maintenance of a good quality of life are the goals of the patient entering the health care environment.
  • A patient is motivated to enter the health care environment when capabilities and potentialities are radically affected. If a patient can regain these capabilities and potentialities, quality of life is greatly improved.
  • A patient, except in the most extreme circumstances, has no rational desire greater than the desire for life. Nevertheless, in extreme circumstances a desire for death may not be irrational.
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6
Q

is the ideal underpinning the obligation not to take human life

A

Sanctity of human life

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7
Q

Respect for the _________ entails an obligation not to infringe on an individual’s decisions regarding life and an obligation not to take
human life.

A

Sanctity of human life

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8
Q

is the act of knowingly ending one’s life

A

Suicide

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9
Q

The individual

must also have the intention to die

A

Suicide

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10
Q

ARGUMENTS AGAINST SUICIDE

A
  • Many religions forbid suicide.
  • Life is the greatest good.
  • Suicide causes harm to the community.
  • Suicide causes harm to friends and family.
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11
Q

Some find suicide unacceptable for _______ reasons —God has lent life to the individual, and therefore that life is not the individual’s to end

A

religious

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12
Q

______ to the community is another argument

against suicide

A

Harm

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13
Q

is the refusal of treatment by a person who knows that refusal will lead to death

A

Passive suicide

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14
Q

is the taking of one’s own life through a conscious act

A

Active suicide

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15
Q

REASONS FOR THE IMAGING PROFESSIONAL’S DUTY NOT TO COOPERATE WITH SUICIDE

A
  • Assisting in or supplying the means to suicide is generally illegal.
  • Health care providers are devoted to healing.
  • Assisting in suicide is incompatible with professional obligation.
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16
Q

is deliberately ending the life of another to end suffering

A

Euthanasia

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17
Q

is the ending of another person’s life by withdrawing treatment

A

Passive euthanasia

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18
Q

is the ending of another person’s life by an aggressive method to end suffering

A

Active euthanasia

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19
Q

is present when one act leads to another and then to another at an accelerating rate

A

Slippery slope

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20
Q

is the ability to grow and continue the life process.

A

Development

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21
Q

is the expulsion or removal of a usually nonviable fetus

A

Abortion

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22
Q

a fetus that cannot live outside the uterus at that time

A

nonviable fetus

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23
Q

is the act of painlessly putting to death a person suffering from an incurable and painful disease or condition

A

Euthanasia

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24
Q

The difference between the passive and active euthanasia lies in
the _____, not the _____

A

methods,

consequences

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25
Q

may be committed through the withholding of nourishment or through a decision not to perform cardiopulmonary
resuscitation (CPR) on a patient who has stopped breathing

A

Passive euthanasia

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26
Q

It is considered legal in

certain instances because no one delivers a method of death. “Nothing” is done and that “nothing” leads to death

A

Passive euthanasia

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27
Q

is the performance of a specific act on the

request or behalf of the patient to end life

A

Active euthanasia

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28
Q

The legal ramifications of euthanasia, especially active euthanasia, are tied to the act of

A

murder

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29
Q

Five stages of coming to terms with death (Kubler-Ross Theory):

A
  1. Denial
  2. Anger
  3. Bargaining
  4. Depression
  5. Acceptance
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30
Q

is a person who substitutes for another, often in decision-making processes.

A

Surrogate

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31
Q

who act on behalf of patients and may make decisions and grant consent for them in quality-of-life judgments

A

Surrogate

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32
Q

are increasingly important elements in decisions regarding euthanasia

A

Advance directives and surrogates

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33
Q

A written explanation of the patient’s
wishes in the form of a ________ hastens the processes leading to
passive euthanasia.

A

living will or advance directive

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34
Q

The idea of lethal injections evokes perceptions of “______” and “______”

A

doctors of death,

angels of mercy

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35
Q

________ is still generally illegal, however, and many roadblocks stand in the way of its becoming an accepted procedure.

A

Active euthanasia

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36
Q

encompasses essential traits that make life worth living

A

Quality of life

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37
Q

Factors influencing quality of life may include:

A 
Biologic functions, 
Intellect, 
Creativity, 
Emotions, 
Contact with others
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38
Q

is one way to ensure that people’s wishes regarding

treatment in relation to their quality of life are honored

A

Living will

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39
Q

identify specific
treatments to be initiated or discontinued when patients become terminally ill, are in great pain, or fi nd themselves in a life-threatening situation.

A

Living wills

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40
Q

If a living will is not present and the patient’s wishes are unknown, quality-of-life decisions are difficult to make.
In such situations, the _____ requirements for quality of life must be recognized.

A

minimal

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41
Q

The principles of ______ and _____ and ______ are critical issues in a discussion of quality of life.

A

beneficence,
nonmaleficence,
respect for autonomy

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42
Q 
Problem solving can be aided by the use of the 
following points (with modifications for imaging) from \_\_\_\_\_\_\_\_
A

Jonsen, Siegler, and Winslade

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43
Q

Many hospitals have formed ________ to help health care professionals address the ethical problems surrounding termination of treatment and related issues.

A

Ethics Committees

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44
Q

First, they educate the hospital, its employees, and its other constituencies.
Second, they develop policies regarding problem areas, especially
the problems of death and dying.
Third, they act as advisory consultants to health care
providers and families.

A

Ethics Committees

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45
Q

serve in an advisory capacity only

A

Ethics Committees

46
Q

Ethics Committees recommendations are exercised with _______ in the patient’s best interest.

A

practical wisdom

47
Q

is crucial for the well-being of the patient and the patient’s family.

A

Professional empathy

48
Q

He established in the ______ case that “every human being of adult years and sound mind has a right to determine what shall be
done with his own body.”

A

Justice Benjamin Cardozo,

1914 Schloendorff

49
Q

The findings of 1914 Schloendorff case also underpinned the ________ —because patients have a right to determine whether to consent to a particular treatment, they also have a right to refuse to consent to a particular treatment.

A

right to forgo treatment

50
Q

The principle that competent patients have a right to forgo life-sustaining treatment was not articulated by any court until _____

A

1984

51
Q

has been evidenced by the contemporaneous cessation of heart and lung function for centuries

A

Death

52
Q

the ____ and ___ test of death became not only the evidence of death but also the actual definition of death.

A

Heart,

Lung

53
Q

Uniform Determination of Death Act was enacted in _____

A

1980

54
Q

established two tests to determine death

A

Uniform Determination of Death Act of 1980

55
Q

Uniform Determination of Death Act establishes that an individual is dead if he/she has sustained:

A

(1) irreversible cessation of circulatory and respiratory functions, or
(2) irreversible cessation of all functions of the entire brain, including
the brainstem

56
Q

There is now nearly a consensus among philosophers
that the irreversible cessation of all brain function constitutes ______, whether it be measured through tests of brain function itself or tests for cardiopulmonary activity

A

death

57
Q

the criterion in cases in which the use of life support systems or the potential for use of the decedent’s organs for transplant made the traditional criteria impossible or ineffi cient

A

newer “brain death”

58
Q

promulgated the Uniform Determination of Death Act (UDDA) of 1980

A

National Conference of Commissioners on Uniform State Laws

59
Q

UDDA

A

Uniform Determination of Death Act of 1980

60
Q

recommended some procedures for the declaration of death:

  • the ventilator should be removed after death is declared;
  • the physician (and not the family) should make the decision to declare death;
  • the physician may choose to consult with others (although the physician may choose not to) before declaring death; and
  • the declaration should not be made by someone with an interest in the subsequent use of the tissue of a patient.
A

National Conference of Commissioners on Uniform State Laws

61
Q

states that this determination is to be made “in accordance with accepted medical standards.”

A

UDDA

62
Q

In _____, the Ad Hoc Committee for the Harvard Medical School to Examine the Definition of Brain Death proposed a new criterion to reflect the need for an alternative definition of death.

A

1968

63
Q

The new criterion for an alternative definition of deaath is

A

irreversible coma

64
Q

includes the following characteristics: unreceptiveness and unresponsiveness, no movement or breathing, no reflexes, and a flat electroencephalogram

A

irreversible coma

65
Q

was used to describe patients who are now generally
referred to as in a persistent vegetative state (PVS), when all higher brain function is
lost

A

irreversible coma

66
Q

PVS

A

Persistent Vegetative State

67
Q

it differs from brain death because the brainstem continues to function and
the body is not dead.

A

Persistent Vegetative State (PVS)

68
Q

Patients in a ___ may even seem to be awake but have no awareness of themselves or their environment.

A

PVS

69
Q

MCS

A

Minimally Conscious State

70
Q

PVS and MCS distinctions were brought to light in the case of

A

Terri Schiavo

71
Q

is a condition of severely altered consciousness in which minimal but definite behavioral evidence of self-awareness or environmental awareness is demonstrated

A

Minimally Conscious State (MCS)

72
Q

is the only form of life-sustaining treatment that is provided routinely without the consent of the patient, and it may be the only medical treatment of any kind that is generally initiated without an order of a physician.

A

CPR

73
Q

CPR

A

Cardiopulmonary Resuscitation

74
Q

Early cases that paved the way for recognition of directives include the:

A

1976 Karen Ann Quinlan case 11 and the 1990 Nancy Cruzan case

75
Q

In response to the highly publicized
Quinlan case, many states adopted statutes designed to give formal recognition to some
form of written directives by patients; these directives are generally called

A

Living Wills

76
Q

resulted in a Supreme Court split
decision that refused to allow life-sustaining measures to be withdrawn from a woman
in a PVS

A

Nancy Cruzan case

77
Q

established in her opinion (which concurred
in the result with the majority, but differed in the reasoning) some further guidelines and
encouragement for use of durable powers of attorney

A

Justice Sandra Day O’Connor

78
Q

is an advance directive that is not limited to terminal conditions
or specified treatments but instead appoints a person or persons to assume a substitute
decision-maker role in the event the patient is unable to make decisions

A

Durable power of attorney for health care decisions

79
Q

is a condition that leaves the patient irreversibly comatose or will lead to death within a year

A

Terminal illness

80
Q

The American Medical Association’s position on physician-assisted suicide is stated in

A

AMA Opinion 2.211

81
Q

occurs when a physician facilitates a patient’s death by providing the
necessary means and/or information to enable the patient to perform the life-ending act (e.g.,
the physician provides sleeping pills and information about the lethal dose, while aware that
the patient may commit suicide.)

A

Physician-assisted suicide

82
Q

is the ability to make choices

A

Competence

83
Q

Courts have tried to use the traditional law of
_____ and _____ in dealing with the issue of competence regarding
decisions about life-sustaining treatment

A

guardianship,

conservatorship

84
Q

a term that focuses on the actual decision to be made

A

decisional capacity

85
Q

a term that focuses on the actual status of the patient

A

competency

86
Q

some courts have rejected the all-or-nothing approach and have recognized the concept of “______” rather than “_____”

A

decisional capacity,

competency

87
Q

This concept accepts that a person may have the attributes to make some simple health care
decisions and not to make other, more complex decisions.

A

decisional capacity

88
Q

the most widely accepted test for determining patient competence comes from the _____ President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research.

A

1980

89
Q

Competent decisions requires “to a greater or lesser degree” each of the following:

A
  • Possession of a set of values and goals
  • Ability to communicate and understand information
  • Ability to reason and deliberate about one’s choice
90
Q

allows patients to
state in advance (in addition to other treatment preferences) that in the event of terminal illness they wish to forgo life-sustaining treatment.

A

Living Will

91
Q

this directive is broader than a living will

A

Durable Power of Attorney for Health Care Decisions

92
Q

provides for a substitute decision maker to make health care decisions when the patient is not able

A

Durable Power of Attorney for Health Care Decisions

93
Q

has traditionally been treated differently from other forms of
life-sustaining treatment.

A

CPR

94
Q

DNR

A

Do Not Resuscitate

95
Q

meaning that staff members would be instructed to provide resuscitation guaranteed not to be successful

A

“slow codes” or “pencil

DNRs”

96
Q

is generally provided unless a formal “do not resuscitate” (DNR) order is entered on the patient’s chart

A

CPR

97
Q

DNI

A

Do Not Intubate

98
Q

started a trend of statutes that formally recognize certain

forms of written statements requesting that some types of medical care be discontinued

A

1976 Karen Quinlan case

99
Q

formulated a uniform statute that could be adopted by states

A

Uniform Health Care Decisions Act of

1993

100
Q

is a document executed by a competent person (the principal) to appoint another (an agent) to make health care decisions when the principal becomes incompetent

A

Durable Power of Attorney for Health Care Decisions

101
Q

This is the concept that when no advance directive exists,
physicians and health care facilities should look to family members to make health care
decisions

A

Family Consent Laws

102
Q

Generally they become effective only when a patient becomes incompetent; some require a certification of incompetence before the family is authorized to make health care decisions

A

Family Consent Laws

103
Q

UHCDA

A

Uniform Health Care Decisions Act

104
Q

was developed to replace the Uniform Rights of The Terminally Ill Act, state durable powers acts, and parts of the Uniform Anatomical Gifts Act.

A

Uniform Health Care Decisions Act (UHCDA)

105
Q

It was approved by the National Council of Commissioners

on Uniform State Laws in 1993 and by the American Bar Association House of Delegates in 1994

A

Uniform Health Care Decisions Act (UHCDA)

106
Q

This act, for those states that choose to adopt it, takes a comprehensive approach by placing into one statute

  • the living will, called the “individual instruction”;
  • the durable power of attorney, called the “power of attorney for health care”;
  • a family consent law; and
  • some provisions involving organ donation.
A

Uniform Health Care Decisions Act (UHCDA)

107
Q

individual instruction

A

Living Will

108
Q

power of attorney for health care

A

Durable Power of Attorney for Health Care Decisions

109
Q

Under the UHCDA, any health care decision will be made by the first available in the hierarchy:

A
  1. The patient, if competent
  2. The patient, through an individual instruction
  3. An agent appointed by the patient in a written power of attorney for health care, unless a court has given this authority explicitly to a guardian
  4. A guardian appointed by the court
  5. A surrogate appointed orally by the patient
  6. A surrogate selected from the list of family members and others who can make health care decisions on behalf of the patient
110
Q

This court, which has narrowly defined even a competent patient’s right to forgo treatment, has declared that adults who have been incompetent since birth should be treated the same as children

A

New York Court of Appeals

RT 205 (10 decks)

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