End of Life Flashcards
Tame death
Something to be avoided. If you don’t have a good death the spirit will be upset and take it out on the living
Death of self
Closing eyes, preparing body– marking that individual is no longer a person
Remote and imminent death
Shift to logic and rationality– Public health and sanitation shift toward scientific approach
Death of other
Romanticization of death where everything looks picture perfect
Invisible death
Technology and science cheat death. Death is a failure of medicine
3 definitions of death
Cessation of heart and lung function
Cessation of brainstem and higher cortical area functioning
Cessation of higher cortical functioning
Dead donor rule
Removal of organs must not result in donor’s death
Physiological futility
No way to reverse physiological effects. No resuscitation after 3 hours
Futility in relation to patients goals
QOL and dignity are taking a hit and there is a finite limit to what they can handle
Futility in relation to standards of professional integrity
May not have knowledge or resources to do it safely so doctor refuses to do procedure
Principle of double effect
If an action is intended to bring about a good effect but it can achieve this effect only at risk of producing a harmful effect, the action is ethically permissable
Terri Schiavo
Collapsed and husband fought to remove her feeding tube but parents wouldnt allow it. Removed 15 years later
Advance directives
Less formal, sometimes oral instructions regarding end of life care for the individual
Living will
Formal written legal document specifying measures that may be taken to save or prolong life
Hierarchy of substitute decision makers
Guardian of person (authority for health decision) Attorney of personal care Representative from Consent and Capacity board Spouse or partner Child or parent Parent with right of access Brother or sister Any other relative Office of public guardian and trustee
Rules for substitute decision maker
Capable with respect to treatment proposed
16 years old, unless they are parent of incapable person
No court order for separation/ prohibited access
Is available
Willing to assume responsibility
Euthanasia
Deliberate treatment designed to end life of patient in a terminal state or suffering from intractable pain
Voluntary euthanasia
Request by competent person
Non-voluntary euthanasia
Person is not competent and surrogate decision maker makes request
Involuntary euthanasia
Person is competent and does not want to die
Active euthanasia
Direct actions that will result in death
Passive euthanasia
Withholding or withdrawing life-sustaining treatment to allow patient to die of underlying illness
4 points in favour of active euthanasia
Patient self-determination
Autonomy
View as merciful death
Respect for dignity of person
Robert and Tracy Latimer
Tracy had scoliosis, intelligence of infant and seizures so her father mercy killed her and got charged with 2nd degree murder
