Chapter 17 Flashcards
State the official definition of "brain death," and explain why is this somewhat
controversial.
brain death: neurological death when all electrical activity of the brain has ceased for a specified
period of time
- ex. flat EEG reading for a period of time = brain death
- includes higher cortical functions and lower brain stem functions
advance care planning:
process of patients thinking about and communicating their preferences
about end-of-life care
living will:
legal document that reflects the patient’s advance care planning
advance directive:
a document (ex. living will) that indicates whether life-sustaining procedures
should / should not be used to prolong an individual’s life when death is imminent
- must be signed when individual can still think clearly
- 15% of patients 18+ had a living will
- 90% said it was important vs. 60% who actually did discuss health care wishes
passive euthanasia:
a person is allowed to die by withholding available treatment, such as
withdrawing a life-sustaining device
- ex. turning off a respiration / heart-lung disease
active euthanasia:
death is deliberately induced
ex. lethal dose of drug is injected
assisted suicide:
process that requires the patient to self-administer lethal medication + to
determine when and where to do this
- legal in several countries and in an increasing number of U.S states
Hospice care:
program committed to making the end of life as free from pain, anxiety, and
depression as possible
palliative care:
reduces pain and suffering, helps individuals die with dignity
- (huge emphasis on palliative care!)
regular medical care vs palliative&hospice care:
regular medical care is based on getting patients cured / feeling better. hospice / palliative care
revolves around ensuring that death is painless and easy
Discuss the American attitude toward death, compared to different cultures.
over 80% of death in America has occurred in institutions / hospitals →
minimized exposure to death + painfulness
According to research, where do most individuals say they would rather die? Where do
most Americans actually die?
more than 50% of Americans die in hospitals, and nearly 20% die in nursing homes
increasing number choose to die in hospice acre
most people would rather die at home
- some who do not want to die at home feel that they will be a burden, there is limited space,
may alter relationships
Name and describe Kubler-Ross' stages of dying
denial + isolation: first stage of dying. the person denies that death is really going to
take place. common reaction to terminal illness and is a temporary defense
→ replaced with increased awareness when the person is confronted with
other matters. “No. It can’t be me. It’s not possible.”
anger: second stage of dying. denial can no longer be maintained. becomes increasingly difficult to
care for as anger is projected onto caretakers, family members, and even God. “Why me?”
bargaining: third stage of dying. person develops hope that death can be postponed / delayed.
enter negotiation with a higher being. asks for a few days, weeks, or even a completely reformed
life dedicated to God / service of others. “Yes, me, but…”
depression: fourth stage of dying. accepts certainty, but meets it with negativity by becoming
silent, refusing visitors, or spending time crying / grieving. attempts to cheer up a person should be
discouraged as they are needing to contemplate impending death.
acceptance: fifth and final stage of dying before death. person develops peace, acceptance of fate,
and a desire to be left alone. feelings + physical pain is essentially absent. the end of the dying
struggle, the final resting stage before death.
Critizms of Kubler-Ross’s stages of dying
criticisms are the fact that these are not stages. these are simply reactions to death. some people
experience all these emotions at different durations or never experience them at all
the existence of the five-stage sequence has not been demonstrated by research
fails to consider variations in patients’ situations
- extent to which people have found meaning + purpose in life → how
they approach death
According to most psychologists, should dying individuals know they are dying? What
should interactions with them focus on?
people who know they’re dying should know, and significant others should also know.
- close their lives in accord with their own ideas about what their proper death looks like
- complete plans, projects, make arrangements for survivors, and participate in decisions
about a funeral and burial
- dying individuals have the opportunity to reminisce, converse with others who have been
important in their life, and end life conscious of what life has been like
- more understanding of what is happening within their bodies and what the medical staff is
doing to them
conversations should focus on person’s strengths and preparation for the remainder of life
