Chapter 12 Death and Dying Flashcards
brain death
- circulatory and respiratory functions have irreversibly ceased
- the entire brain including the brains stem has irreversibly ceased to function
Uniform determination of death act
a proposal that established uniform guidelines for determining when death has occurred
coma
deep stupor from which the patient cannot be roused by external stimuli
persistent vegetative state (PVS)
a result of sever mental impairment, characterized by irreversible cessation of the higher functions of the brain, most often caused by damage to the cerebral cortex
signs of death
- cannot breathe without assistance
- has no coughing or gagging reflex
- has no pupil response to light
- has no blinking reflex
- has no grimace
- has no response to pain
reasons why autopsies are performed
- information that may clarify death
- postmordem exam that determines cause of death
- must be performed in cases of suspicious or due to homicide
reasons why autopsies are on the decline
- families are reluctant to give consent
- insurance companies and government health care programs usually do not pay
- some clinician argue technological advances have made diagnoses more accurate
palliative care
treatment of terminally ill patient’s symptoms to make dying more comfortable; also called comfort care
curative care
treatment directed toward curing a patient’s disease
hospice
a facility or program in which teams of health care practitioners and volunteers provide a continuing environment that focuses on the physical emotional and psychological needs of the dying patient.
euthanasia
the greek term meaning good death
terminally ill
referring to patients who are expected to die within 6 months
thanatology
the study of death and of the psychological methods of coping with it
Landmark cases that effected the right to die
- Karen Ann Quinlan
- Nancy Beth Cruzan
- Terry Shiavo
Uniform Rights of the terminally ill act
a 1989 recommendation of the Nation Conference of Commissioners on Uniform State Laws that all states construct laws to address advance directives.
Two states where physician assisted suicide is legal
Oregon passed this is November 1997
Washington in 2010
active euthanasia
a conscious medical act that results in the death of a dying person
passive euthanasia
the act of allowing a dying a patient to die naturally, without medical interference
voluntary euthanasia
the act of ending a dying patients life by medical means with his or her permission
involuntary euthanasia
the act of ending a terminal patients life by medical means without his or her permission
patient self determination act
a federal law passed in 1990 that requires hospitals and other health care providers written information to patients regarding their rights under state law to make medical decisions and execute advance directives
different types of advance directives
- living will
- durable power of attorney
- health care proxy
living will
an advance directive that specifies an individuals end of life wishes
durable power of attorney
an advance directive that confers upon a designee the authority to make a variety of legal decisions on behalf of the grantor, usually including health care decisions.
health care proxy
a durable power of attorney issued for purposes of health care decisions only
DNR
orders written at the request of patients or their authorized representatives that cardiopulmonary resuscitation not be used to sustain life in a medical crisis.
National organ transplant act
passed in 1984, a statue that provides grants to qualified organ procurement organizations and established an organ procurement and transplant network
organ donor directives
- in addition to having a card patients should discuss their wishes with their families
Uniform Anatomical Gift Act
A recommendation of the National Conference of Commissioners on Uniform State Laws, that all states accepted allowing individuals to donate their bodies or body parts after death for use in transplant surgery, tissue banks or medical research or education.
Organs/Tissue for Transplantation
- heart, kidney, pancreas, lungs, stomach small and large intestines
Stages of Grief
- denial and isolation
- anger, rage, resentment
- bargaining, and guilt
- depression or sadness
- acceptance
The author of the 5 stages of grief
Elisabeth Kubler-Ross MD
The author of Solace: Finding your way through grief
Roberta Temes PhD
3 stages of grief
- numbness, characterized by mechanical or rote functioning
- disorganization
- reorganization
