DIGNITY IN DEATH AND DYING Flashcards
Sum total of all the vital life processes by which the physical integrity of the body is maintained.
life
- Termination of life and the complete cessation of vital functions without the possibility of resuscitation. It
is an irreversible loss of the properties of living matter. - Complete and persistent cessation of respiration, circulation, and other vital life functions
death
A continuous process while death is an event that takes place at a precise time.
dying
- State of wakefulness
- Fluctuating awareness of self and environment
- Potential for re-activation or “emergence” – being able to do or be able to respond to stimuli.
minimally conscious state
- Unable to interact with the environment.
- “Eyes-open” state (vs coma which is “closed-eyes” state)
permanent vegetative state
Permanent vegetative state if > 3 months after an ___ or > 12 months following ___
anoxic injury
traumatic injury
– Absence of oxygen to the brain for 30 minutes or more
anoxic
- Cessation of cardiac physical and electrical activities
cardiac death
- Irreversible cessation of all brain function (cortical and brainstem)
- Absence of EEG waveforms
- Legally dead
brain death
clinical determination of brain death
- absence of cortical functions
- absence of brain stem functions
- no brain activity on EEG
true or false - The civil personality of a natural person is extinguished by death.
true
true or false - The property of a person is transmitted to the heirs at the time of death.
true
true or false - The death of a partner is not a cause of dissolution of partnership agreement
false
true or false - The criminal liability is not extinguished by death.
false
true or false - The civil case for claims which does not survive is dismissed upon the death of the defendant
true
- Interpreted as to mean that everyone, regardless of the state of health, is not to be used as means, and is to be treated with dignity because he/she is valuable.
inviolability of human life
The deliberate and painless acceleration of death of a person usually suffering from
incurable and distressing disease.
euthanasia, mercy killing
- Intentional and deliberate application of the means to shorten life of a person.
- It may be done with or without the consent or knowledge of the person.
active euthanasia
- Putting to death of a person in compliance with the wishes
of the person to shorten his or her suffering.
active euthansia demand
- There is absence of the application of the means to accelerate death, but the natural course of the
disease is allowed to have its way to extinguish the life of a person
passive euthanasia
– Die a natural death without any operation or treatment.
orthonasia
When there is attempt to extend the lifespan of a person using extraordinary
treatments without which the person would have died earlier
dysthanasia
true or false - Dysthanasia does not comply with the definition of euthanasia.
true
Clinical action serving no useful purpose in attaining a specified goal for a given patient.
prolongation of life
Treatment that is effective in ameliorating or correcting all life-threatening conditions
medically indicated treatment
- An act of commission
- Decide and commit to discontinue ongoing treatment.
withdrawing
- An act of omission
- Treatment is not given in the first place.
- No obligation for healthcare providers to provide disproportionate, ineffective, or even
experimental treatment.
withholding
discussion concerning withdrawing or withholding happens in the presence of the following:
- patient is terminal
- patient is irreversibly comatose
- burden of treatment far outweighs the benefit
- Allows physicians to prescribe or administer a lethal dose of medication to mentally competent
but terminally ill adult patient for the purpose of achieving the end of life. - A complex ethical and legal issue
- Physician-assisted suicide is legal in 6 US states, Canada, and 5 European countries.
physician assisted suicide
3 major symptoms of dying patients
respiratory distress
pain
cognitive failure
o Primary treatment of respiratory distress in the dying
o Cautiously titrated to increase comfort and reduce tachypnea to 15 to 20 breaths per minute
opioids
o May be given at 2-3 lpm and humidified to avoid exacerbation of dry mouth.
o May bring subjective relief.
o Independent of observable changes in pulse oximetry
supplemental oxygen
o Music therapy
o Guided Imagery
o Hypnosis
o Massage therapy
o Pet therapy
non-pharmacologic therapy
- Developed to carry into the future the autonomous choices of competent adults regarding healthcare decisions.
- Useful when illness or impending death cause patient incapable of exercising their autonomy in deciding for their care
advance directives
If there is no written will and the patient becomes incapacitated to decide, then the ___ of the patient must be implemented (doctrine of substituted judgment)
presumed wishes
true or false - Informal advance directives (e.g., sworn testimony about patients made before the occurrence of their incapacitation) is not accepted in courts.
false
- Made by an individual in anticipation of the treatment options and choices in the event of incapacitation by a terminal illness.
- Patient indicates which treatment he or she wishes to permit or prohibit.
living will
– A phenomenon wherein healthy patients cannot reliably predict their
preference when they are sick.
affective forecasting
- The patients identify surrogate decision makers and invest them with the authority to make healthcare decisions on their behalf if they are incapacitated.
- This is done in the hope that the surrogate will be able to make decisions that reflect the choices that the patients themselves would make if they were able
power of attorney
- Refers to orders issued when a determination is made that the level of life that could be sustained
following a resuscitative effort would be such that it would not be in the best interest to perform
resuscitation
DNR, DNI
