death and dying

Question 1

death in the early 1900s

Answer 1

high childhood mortality
people died quickly after brief illnesses
died at home
death = familiar fact of life

Question 2

modern death

Answer 2

reduced childhood mortality
90% people die after protracted illness
80% people die in institutions
death is enemy that represents failure of medical tx

Question 3

criteria for being dead in virginia

Answer 3

• absence of cardiac/respiratory function
• loss of function of whole brain
  both of these are irreversible with standard medical practices

Question 4

dead donor rule

Answer 4

1960s- stated that vital organs should only be taken from dead patients and living patients should not be killed for organ procurement

Question 5

3 reasons why irreversible coma was an important addition to criteria

Answer 5

• allowed for termination of care for patients with irreversible brain damage who were maintained on life support
• relieved burden on families, hospitals and resources
• organ transplantations

Question 6

1995 AAN criteria (5)

Answer 6

• demonstration of coma
• evidence of cause of coma
• absence of confounding factors (drugs, hypothermia, electrolyte/metabolic disturbances)
• absent brainstem reflexes
• apnea
• confirmatory tests only if clinically indicated

Question 7

4 brainstem reflexes

Answer 7

• pupillary reaction to light
• oculocephalic/cold caloric
• corneal reflex
• cough/gag

Question 8

virginia criteria for declaring patient brain dead

Answer 8

2 licensed physicians agree (neurology/neurosurgery/EEG)
no brainstem reflexes
no spontaneous brain function
no spontaneous respiratory function
further attempts to resuscitate would be unsuccessful

Question 9

are brain dead people really dead?

Answer 9

yes

Question 10

5 stages of dying

Answer 10

denial 
anger
depression
bargaining 
acceptance

Question 11

in what stage will someone reach out to others and want to tell their story?

Answer 11

bargaining