Chapter 17; Death, Dying, and Grieving Flashcards
twenty five years ago, it was simpler than it is today to determine whether someone was dead
yes
twenty five years ago, the end of what biological functions were considered as clear signs of death
- breathing
- blood pressure
- and the rigidity of the body (rigor mortis)
can defining death today be more complex
yes
brain death is the neurological definition of death which states that a person is brain dead when all …
electrical activity go eh brain has ceased for a specified period of time
what does EEG stand for when regarding death
electroencephalogram
a flat EEG (electroencephalogram) recording for a specified period of time is one criterion of
brain death
do the higher or lower portions of the brain often die sooner
high portions rather than the lower
the brains lower portions monitor […] and […], individuals
heartbeat
respiration
can an individual whose higher brain areas have died may continue to breath and have a heartbeat
yes,
b/c
the lower portion hasn’t died and the lower monitors heartbeat and respiration
the definition of brain death currently followed by most physicians includes the death of […] the higher cortical functions and the lower brain stem functions
both
do some medical experts argue that the criteria for death should include only higher cortical functioning
yes
p.s. the lower monitors heartbeat and breathing
if the cortical death definition were adopted, then what could physicians claim a person is dead by
if they don’t have cortical functioning, even if the lower brain stem is functioning
why do supporters of the cortical death policy argue of the functions of the higher cortical part of the brain (intelligence and personality) that we associate with being human, partake in the support for cortical death
that when these functions are lost, the “human being” is no longer alive
advance care planning refers to the process of patients thinking about and communicating their preferences regarding
end of life care
for patients in a coma, can it be clear what their wishes regarding termination of treatment might be if they still were conscious
no
researchers found that advance care planning […] life sustaining treatment, […] hospice use, and […] hospital use
decreased
increased
decreased
is completion of an advance directive associate with a higher or lower probability of receiving life sustaining treatments
lower
what did the organization “Choice in Dying” create after recognizing that some terminally ill patients might prefer to die rather than linger in a painful or vegetative state
the living will, a legal document that reflects the patients advance care planning
the living will, that was created by Choice in Dying organization is a legal document that reflects the patients advance care planning
yes
was advance care planning associated with [improved or decreased] quality of care at the end of life, including [more or less] in hospital death and [greater or less] use of hospice care
improved
less
greater
why were natural death legislations produced over
- physicians concerns over malpractice suits
and - the efforts of people who support the living will concept
what do laws in all 50 states now accept (such as a living will) in the concept of advance care planning
an advance directive
an advance directive states such preferences as whether life sustaining procedure should or should not be used to […] the life of an individual when death is imminent
prolong
in the concept of advance care planning; when must an advance directive be signed
while the individual is still able to think clearly
a study of end of life planning revealed that only […] % of patients 18 years of age and older had a living will
15
since 90 % of the patients reported that it was important to discuss health care wishes with their family, what is the % that had done so
60
do physicians have a positive or negative attitude toward advance directives
positive
in how many states is Physician Orders for Life Sustaining Treatment (POLST), available or being considered
34
the Physician Orders for Life Sustaining Treatment (POLST) is a more specific document that involves the health care professional and the patient or surrogate in stating the […] of the patient
wishes
POLST, (Physician Orders for Life Sustaining Treatment), translates treatment preferences into medical orders such as those involving cardiopulmonary […], […] of treatment, and artificial nutrition via a […]
resuscitation
extent
tube
Euthanasia (“easy death”) is the act of […] ending the lives of individuals who are […] from an incurable disease or severe disability
painlessly
incurable
what can euthanasia sometimes be called
mercy killing
distinctions are made between what two types of euthanasia
passive and active
passive euthanasia occurs when a person is allowed to die by […] available, such as withdrawing a life sustaining device
witholding
e.g.
turning off a respirator or a heart lung machine
Active euthanasia occurs when death is deliberately […] as when a physician or a third party ends the patients life by administering a […] dose of a drug
induced
lethal
can technological advances in life support devices raise the issue of quality of life
yes
in assisted suicide, a physician supplies the […] and/or the […] of committing suicide but requires the patient to self administer the lethal medication and to determine when and where to do this
information
means
(such as giving the patient a prescription for a lethal dose of sleeping pills)
assisted suicide differs from active euthanasia, in which a physician causes the death of an individual through a […] action in response to a request by the person
direct
in which countries is assisted suicide legal
- Belgium
- Canada
- Finland
- Luxembourg
- the Netherlands
- and Switzerland
is assisted suicide legal in the US by the US government
gov. has no official policy but leaves the decision up to the states
what are the six states in the US that allow assisted suicide
- california
- colorado
- montana
- Oregon
- Vermont
- and Washington + DC
in states where assisted suicide is illegal, what type of rim can it typically be considered
manslaughter or a felony
what are the percentages of physician assisted deaths ranging from in the US + Luxembourg and the Netherlands
US + Luxembourg;
0.1 to 0.2 percent
the Netherlands
1.8 to 2.9 percent
has the percentage of assisted suicide cases reported to authorities increased or decreased in recent years
increased
the individuals who are likely to die through assisted suicide are most likely to be females or males
males from 60 to 75 years of age
a recent Gallup poll found that […]% of US adults said euthanasia should be legal, […]% said they would consider ending their own lives if faced with a terminal illness, and […]% reported that physician assisted suicide is morally acceptable
69
51
50
Euthanasia is so controversial because those in favor argue that death should be […] and […], not a […] and […] ordeal. those against, stress that it is a criminal act of […] in most states in the US and in most other countries
calm
dignified
painful
prolonged
murder
what do many religious individuals, especially Christians, say that euthanasia is
taking a life for any reason is against God’s will and is an act of murder
too often death in America is lonely, […], and […]
prolonged
painful
have scientific advances sometimes made dying harder or easier though delaying the inevitable
harder
even though pain killers are available, do many people experience sever pain during their last days and months of life
yes
what is the percentage of dying patients that were in pain in the last year of life and where nearly one third had symptoms of depression and confusion prior to death
61
are care providers increasingly or decreasingly interested in helping individuals experience a “good death”
+
what does it involve
increasingly
+
physical comfort
support form loved ones
acceptance
and appropriate medical care
what does a good death involve for other individuals to accept
accepting one’s impending death and not feeling like a burden to others
what are the three frequent themes identified in articles on a good death
- preference for dying process (94%)
- pain free status (81%)
- emotional well being (64%)
what is a recent criticism of the “good death” concept emphasize about death
that it has shifted from being an event at a single point in time to being a process that takes place over years and even decades
since critics have criticized that death is a long process that takes over years and even decades rather than being an event at a single point in time, what do critics say to do when moving away from the “good death” concept
to a larger vision of a world that not only meets the needs of individuals at their moment of death but also focuses on making their lives better during the last years and decades of their lives
hospice is a program committed to making the end of life as free from
pain, anxiety, and depression as possible
a hospitals traditional goal is to […] illness and […] life
cure
prolong
hospice care emphasizes palliative care which involves reducing pain and suffering and helping individuals…
die with dignity
have US hospitals recently and rapidly decreased or expanded their provision of palliative care
expanded
(more than 85% of mid to large US hospitals have palliative care team)
hospice care professionals work together to treat the dying person’s […], make the individual as […] as possible, show […] in the person and the person’s family, and help everyone involved cope with death
symptoms
comfortable
interest
today more hospice programs are […]-based a blend of institutional and home care designed to […] the end of life experience for the dying person
home
humanize
today in the US, the deaths of older adults account for approx. […]-thirds of the 2 million deaths that occur each year
two
is youthful death more or less common
less
attitudes toward death vary across […]
cultures
in US, life expectancy has increased from […] years for a person born in 1900 to […] gears for someone born today
47
79
the historical changes involving death is
- the increasing complexity of determining when someone is truly dead
- the age group in which death most often strikes
what are the ages in life expectancy in the US for women and men
women - 81
men - 76
as our population has aged and become more mobile, how have a growing number of older adults died (in contrast to the 1900s where most people died at home, cared for by their family)
apart from their families
more than […]% of all US deaths occur in institutions or hospitals
80
as there are changing historical circumstances regarding death in old age, the care of a dying older person has shifted […] from the family and minimized our exposure to death and its painful surrounding
away
cultural variations characterize the […] of death and […] about death
experience
attitudes