Death and Dying

Question 1

True or False: modern medicine has enabled people to survive illnesses that once caused death

Answer 1

true

Question 2

Ventilators and feeding tubes allow medical practitioners to do what for patients?

Answer 2

sustain their life from weeks, months even years after traditional standards would say they’re dead.

Question 3

21 y/o admitted to NJ, suffered cardiopulmonary arrest, placed on ventilator, tracheotomy, nasogastric tube, comatose, permanently vegetative, EEG was absnormal, brain scan was within normal limits

Answer 3

Karen Ann Quinlan Case

Question 4

How many months was Karen Ann Quinlan comatose while her body deteriorated?

Answer 4

9 months

Question 5

True or False: Loss of heartbeat, body color, and stiffness (rigor mortis) are considered criteria for death

Answer 5

true: debate over using cardiac definition or brain oriented definition of death.

Question 6

Cardiac Death

Answer 6

heart stops functioning, legal death, irreversible loss of cardiac function

Question 7

True or False: patients who are clinically dead may not be resuscitated with CPR

Answer 7

false, they can (dnr?)

Question 8

caridiac death causes problems with what?

Answer 8

organ transplants ( heart needs to be beating)

Question 9

When can cessation of pulse and breathing be reversable?

Answer 9

drug overdose, hypothermia

Question 10

brain oriented death

Answer 10

irriversible cessation of all brain function

Question 11

brain is dead the person is considered

Answer 11

deceased, dead

Question 12

An irreversible brain condition where the patient is in a deep state of unconsciousness is called…

Answer 12

Persistent Vegetative State (PVS)

Question 13

What are the three Harvard Criteria for irreversible coma ?

Answer 13

Patient is unreceptive and unresponsive, unaware of external stimuli, no spontaneous movements of breathing, no reflexes, fixed dilated pupils, lack of eye movement, lack of dep tendon reflexes.

Question 14

Irreversible coma is also known as

Answer 14

brain death

Question 15

Before the ventilator can be removed, what must be declared?

Answer 15

Brain death

Question 16

What requires an EEG to determine absence of brain activity, then repeated again in 24 hours?

Answer 16

Harvard Criteria

Question 17

Any individual, who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead.

Answer 17

Uniform Determination of Death Act (1980)

Question 18

Withdrawing life sustaining treatment

Answer 18

discontinues treatment after it’s been started (artificial ventilation)

Question 19

withholding life-sustaining treatment

Answer 19

never started, harder to stop once started,

Question 20

euthanasia

Answer 20

good death

Question 21

right to die, aid in dying, assisted suicide

Answer 21

euthanasia

Question 22

intentional killing of terminally ill

Answer 22

active euthanasia

Question 23

withholding medical interventions to only serve to sustain life

Answer 23

passive euthanasia

Question 24

dying process is neither inhibited or accelerated

Answer 24

passive euthanasia

Question 25

Jack Kevorkian, MD

Answer 25

Active Euthanasia

Question 26

Arguments in favor of euthanasia

Answer 26

autonomy, harvesting viable organs, relief for family of patient with incurable disease, end terminal ly ill person's suffering

Question 27

Arguments against euthanasia

Answer 27

terminally ill patients known to recover, modern tech may find a cure, people may use it to relieve financial burden, it could be used indiscriminately, not good for society to have physicians kill patients or patients to kill themselves

Question 28

Against permitting assisted suicide saying it would eventually lead to diminishing respect for life

Answer 28

slippery slope

Question 29

woman PVS for 8 years after auto accident. feeding tube, , parents fought to have it removed. died 12 days after removal

Answer 29

Nancy Cruzan (1983)

Question 30

woman PVS, medical malpractice lawsuit won, husband wanted to remove wife's feeding tube, parents opposed, pathologists said she uttered "stop", died 15 years and 13 days after her accident

Answer 30

Terri Schiavo Case (1990)

Question 31

Death is the result of another persons intended action or inaction

Answer 31

direct killing

Question 32

death is the result of an unintentional action of another person

Answer 32

indirect killing

Question 33

an action may have two consequences, desired and undesired

Answer 33

principle of double effect

Question 34

treatment or procedures that is morally required

Answer 34

ordinary means

Question 35

procedures and treatments that are morally expendable

Answer 35

extraordinary means

Question 36

Right to Die Legislation or Right to Refuse treatment

Answer 36

patients have the right to refuse treatment, courts have rules that patients must be mentally competent, patient's refusal places their lives in danger, legal action sometimes results (guardian appt)

Question 37

stages of dying

Answer 37

denial, anger, bargaining, depression, acceptance | DABDA

Question 38

Who came up with the five stages of the dying process?

Answer 38

Dr. Elizabeth Kubler-Ross

Question 39

Refusal to believe dying is taking place

Answer 39

denial

Question 40

patient is angry with everyone

Answer 40

anger

Question 41

gain time by making promises, be patient

Answer 41

bargaining

Question 42

deep sadness over loss of health, independence and eventually life. sadness about leaving loved ones, withdrawn

Answer 42

depression

Question 43

sense of peace and calm, i am ready to die

Answer 43

acceptance

Question 44

These measures can assist with making healthcare decisions based on clinical factors, cost and issues that the patient believs are important

Answer 44

Quality of Life Issues

Question 45

Quality of Life Measures include (name 4)

Answer 45

general health, physical functioning, role limitations, pain, social function, vitality, mental health

Question 46

True or False: Most terminally ill patients wont live long enough to become addicted to heavy doses of narcotics

Answer 46

true, although physicians are still reluctant to do prescribe them

Question 47

True or False: dying patients often spend most of their last days in comfort

Answer 47

false, they are in moderate to severe pain

Question 48

The fundamental responsibility of physicians to relieve pain

Answer 48

HIppocratic Oath

Question 49

True or False: Few physicians believe that patients pain and suffering should be controlled with the use of adequate medications

Answer 49

False: MANY physicians believe it.

Question 50

9 million Americans live with cancer, 2/3 with advanced disease have significan pain. How much receive adequate pain control?

Answer 50

only half!

Question 51

Originated in France to keep terminally ill patients as pain free as posible

Answer 51

Hospice Care

Question 52

Hospice Care is also known as

Answer 52

death with dignity

Question 53

Focuses on comfort measures, emotional support and pain free environment

Answer 53

Hospice Care

Question 54

Hospice patients are typically there during their last few ____ of life.

Answer 54

weeks

Question 55

True or False: During hospice, patients are kept awake and alert so they can spend some of their last moments with their family members.

Answer 55

True

Question 56

Total care of patients whose disease in no longer responsive to curative therapy

Answer 56

Palliative Care

Question 57

Palliative care is meant to provide ____ of pain and suffering.

Answer 57

relief

Question 58

Allows people with terminal illness to obtain money from life insurance policies by selling them

Answer 58

Viatical Settlements

Question 59

Viatical Settlements are _% - __% percent discount on face value of patients insurance to have ___ access to money

Answer 59

20 - 50, immediate

Question 60

What are some things Viatical Settlements are used for?

Answer 60

medical and nursing care during final illness, vacation with family, experimental medical treatment that health insurance wont cover.

Question 61

Mandates that adult patients receiving either medicare or medicaid be asked if they have an advanced directive or want information on the patient self-determination directives (living will)

Answer 61

Advance Directives | The Federal Patient Self-Determination Act (1991)

Question 62

If someone attempts suicide they may be place in ________ care if the present ______ to themself or others

Answer 62

psychiatric, danger