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
