DIGNITY OF DEATH AND DYING, ADVANCE DIRECTIVES AND DO NOT RESUSCITATE (DNR) Flashcards
painless and peaceful death: it is deliberate putting to death in an easy, painless way, of an individual suffering from an incurable and
agonizing disease.
Euthanasia
in which the terminally ill patient will deliberately, directly terminate his/her life by employing painless methods- it is an act of commission as it is voluntary and deliberate.
COMMISSION
active (positive) euthanasia
in which one allows oneself to die without taking any medications or by refusing medical treatment it is an act of omission as one simply refuses to take anything to sustain life
OMISSION
Passive (negative) euthanasia
is one in which either a physician, a spouse or a friend of a patient will terminate the patient’s life upon his/her request.
Active and voluntary euthanasia
is one in which the terminally ill patients is simply allowed to dies by the physician, spouse or an immediate relative upon the patient’s request
Passive and voluntary euthanasia
occurs when it is the physician, spouse, friend or relative who decides that the life of the
terminally ill patient should be terminated.
Active and non-voluntary euthanasia
is one in which a terminally ill patient is simply allowed to die, as requested to immediate family members or the attending physician
Passive and non-voluntary euthanasia
is the direct and willful destruction of one’s own
life
suicide
Refers to undue prolongation of life and delay of the occurrence of death which in effect lengthens the suffering of the person.
turning death difficult
medical stubbornness or a futile treatment
Dysthanasia
It means correct dying, or allowing to die or letting die.
Allowing and acceptance of natural death in its definitely inescapable occurrence in due time as the final moment of one’s earthly life.
Orthothanasia
when the treatment to prolong life is useless or futile for the patient, and therefore ought not to be given. We remember the world of the poet: For man to want to live when God wants him to die is madness.
First possibility
when the prolongation of life or the postponement of death is unduly burdensome in the first place for the patient. Also for the family. On this point, the Catechism of the Catholic Church summarizes the traditional teaching of the magisterium: “Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of ‘over-zealous’ treatment. Here one does not will to cause death; one’s inability to impede it is merely accepted”
Second possibility for letting die
when the patient needs painkillers or medical sedation, which does not intend the death of the patient. These painkillers directly mitigate suffering and indirectly may shorten life.
Third possibility for allowing to die
is an option of last resort for patients whose symptoms cannot be controlled by any other means. It is not a form of euthanasia, as the goal of this is to control symptoms, rather than to shorten the patient’s life.
is the practice of relieving distress in a terminally ill person in the last hours or days of the dying patient’s life, usually by means of a
continuous intravenous or subcutaneous infusion of a sedative drug, or by means of a specialized
catheter designed to provide comfortable and discreet administration of ongoing medications via
rectal route.
Palliative sedation
Is a legal document in which a person specifies what actions should be taken for their health if they are no longer able to make decisions for themselves because of illness or incapacity.
Advance Directives
more restricted type of advance directive because you only make decisions about life sustaining procedure in the event that your death from a terminal conditions is impending.
living will
Is a document (legal instrument) with which a patient appoints an agent to legally make health care decisions on behalf of the patient, when he or she is incapable of making and executing healthcare decisions
Healthcare proxy
Written authorization to represent or act on another ‘s behalf if private affairs, business, or some other legal matter, sometimes against the wishes of the other party
Power of attorney
means that in the event of cardiac arrest, no CPR or electric shock will be performed to restart the heart.
DNR
means that the proposed therapy should not be performed because available data show that it will not improve the patient’s medical condition.
Medical Futility
occurs when we sense that there is a moral problem, but are not sure of the morally correct action;
Moral Uncertainty
a problem that requires a choice between two options that are equally unfavorable and mutually exclusive.
Moral/ethical dilemma
binds all of a person’s moral virtues into a coherent package it creates a wholeness and stability of character that leads to trustworthiness.
Moral integrity
they hear what patients
say and understand the meaning
Sensitivity, compassion, and caring
has a sense of duty to the patient, an obligation to do whatever is necessary, within reason, to care for the patient or solve a problem
Responsibility
suggests that a person has self-confidence
that he or she can effect change.
Empowerment
During a crisis, people struggle to understand the situation and their feelings. They work to clarify and articulate their views and relate them to a framework of values. The nurse must listen and be patient and able to live with vagueness, confusion, uncertainty, and paradox. The nurse should provide a safe environment and gently assist patients, families, and colleagues as they work through the ethical decision-making process.
Patience and willingness to deliberate
occurs when a terminally ill, mentally competent adult patient, who is likely to die within six months, takes prescribed medicines, which must be self-administered, to end suffering and achieve a peaceful death
Medical aid in dying
occurs when someone other than the patient administers medication in any form with the intention of hastening the patient’s death
Euthanasia
Hallmarks of end-of-life care
Respect for patient self-determination
Nonjudgmental support for patients’ end-of-life preferences and values
Prevention and alleviation of suffering
defined as the irreversible cessation of all vital
functions especially heart, respiration, and higher brain
function
Death
Assessing the Physiological signs of approaching death.
- Physical Care
- Psychological Care
- Social Care
- Spiritual Care
The suffering person dies with another person’s help.
- Refers to cases where the person who is going to die needs help to kill themselves and asks for it.
- It may be something as simple as getting drugs for the person and putting those drugs within their reach.
Physician Assisted Suicide
How many person must be a witnessed when signing a healthcare directive?
2 persons
Is it possible that the witness is related to the patient or expect to inherit anything from the patient and can they be a hospital employees, staff, attending doctors or employees of the
attending doctor?
NO
is the medical term for cessation of blood circulation and breathing, the two necessary criteria to sustain human and many other organisms’ lives. Occurs when the heart stops beating in a regular rhythm, a condition called cardiac arrest.
Clinical death
Separation of soul and body
Religious or philosophical
Brain is completely destroyed, cessation of all other organs are imminent and inevitable (EEG and ECG)
Brain death
Disintegration and breakdown of the metabolic processes of the body’s substance. Irreversible loss of neo-cortical activity
Cellular
Signs of Death (Traditional)
Rigor mortis (putrefaction)
* Absence of breathing and heartbeat
* Cessation of SPONTANEOUS heart and lung functions (clinical signs)
* DUE TO ADVANCES IN
TECHNOLOGY NEW SET OF
CLINICAL SIGNS OF DEATH WERE CONSIDERED
- Euthanasia made with consent of patient
- Is committed with the willing and autonomous cooperation of the subject. This means that the subject us free from direct or indirect pressure form others.
Voluntary Euthanasia
Occurs when the person is unconscious or otherwise unable to make a meaningful choice between living and dying.
-An appropriate person takes the decision on their behalf.
Non- voluntary Euthanasia
Occurs when the person who dies chooses life and is killed anyway
This is usually called murder, but it is possible to imagine cases where the killing would count as being for the benefit of the person who dies.
Involuntary Euthanasia
Pattern of decision making
- Recognizing a problem
- Gathering data
- Comparing options/action implies uncertainty
- Making a choice/implemented decision
