lecture 10 - end of life and dying

Question 1

who was higher life expentancy in canada; men or women

Answer 1

women

Question 2

factors that make up a good death

Answer 2

painless
being asleep
feeling fulfilled
being w loved ones
aspect of control on death
completed what u wanted to
our will and intentions dont end when we die

Question 3

under the 12 principles of good death model, what are 3 broad themes

Answer 3

control
autonomy
- free will
independence
- not relying on someone else

Question 4

what is a flaw of the 12 principle of good death model

Answer 4

misses spiritual aspects

Question 5

list and explain the 12 principles of good death in the model

Answer 5

have control over
- what happens
- pain relief and symptom control
- where death occurs
- who is present

to be afforded dignity and privacy

to be able to issue advance directives which ensure wishes are respected

to have time to say goodbye and control over other aspects of timing

to be able to leave when its time to go and not having prolonged suffering

to know when death is coming and understanding what can be expected

to have access to
- info and expertise
- spiritual or emotional support
- hospice care in any location

Question 6

problems with hospital deaths

Answer 6

low patient-physician communication and knowledge of wishes

ICU can be traumatic and stressful

Question 7

where do most patients wish to die

Answer 7

at home

Question 8

what is palliative care for

Answer 8

managing the symptoms and pain as you lead towards care

Question 9

what is hospice for

Answer 9

more for last 6 months of life

helping someone prepare for death (counselling, spirituality, psychosocial support)

Question 10

explain how timing of deaths is associated to holidays

Answer 10

ppl more likely to die during or shortly after the holidays, related to gender/involvement

harvest moon festival
- chinese american women

passover
- jewish men (not women)

christmas and easter
- both men and women

Question 11

why is there a sharp increase in deaths the months after January 1, 2001?

Answer 11

desire of patients to live into the next century

suggests patients state of mind in postponing their death outcome

Question 12

mortality is higher during first _____ after death of spouse

Answer 12

6 months

Question 13

study: self perception and will to live of aging on dying

Answer 13

longitudinal 23 yr study

IV: self perception of aging, will to live

DV: mortality

RQ: does the idea of will to live rlly impact our ability to live longer?

asked questions abt will to live and perceptions of aging

kept track of who passed away

RESULTS:
- things got worse as ppl got older
- those who passed away earlier had more negative perceptions of aging
- those positive about aging lived on avg 7.5 yrs longer

CONCLUSION:
- will to live has an effect but it is not a driving force effect, its a mediator

Question 14

Carter V Canada outcomes regarding MAID

Answer 14

• the total ban on assisted dying was overbroad bc it applied to non vulnerable ppl and prevented them from receiving the assistance of willing physician
• part of criminal code that prohibited medical assistance in dying would no longer be valid as a part of satisfying the canadian charter
• its human right to choose when to die

Question 15

what is MAID

Answer 15

medical assistance in dying

Question 16

available MAID options in Canada

Answer 16

clinician administered MAID
- physician / nurse practitioner directly gives substance that causes death

self administered MAID
- physician / nurse gives patient a drug that lets them die

Question 17

eligibility for MAID in Canada

Answer 17

18 yrs old

mentally competent

have grievous and irremediable medical condition
- serious illness or disability
- be in advanced state of decline that cant be improved
- experience unbearable physical or mental suffering

make a voluntary request for MAID that isnt the result of outside pressure or influence

give informed consent to receive MAID

dont need to have fatal condition to be eligible

Question 18

belief in life after death is related to ______ and ____

Answer 18

better mental health and +ve relationship between prayer and symptom severity

Question 19

what can life after death provide for some ppl?

Answer 19

comfort in death, as death isnt the end

Question 20

explain Korean documentary abt daughter being recreated after mother lost her at young age

Answer 20

virtually recreated body and voice of kid so mom could interact w her

pro:
can allow for closure for mom

con:
may also impede grieving process and be unhealthy

could be taking advantage of vulnerable person

Question 21

canadian organ donor stats

Answer 21

2500+ transplants performed in 2021

in dec 2021, 4000+ were on waitlist, and 240+ ppl died while waiting

for every transplant that occured, 1.5 ppl were waiting to recieve an organ

Question 22

what influences organ donation? Shah et al

Answer 22

looked at public attitude on brain death and vital organ transplantation

performed meta analysis

found 3 main issues generally not understood
- uncontested biological facts about brain death
- legal status of brain death
- organs are procured from brain dead patient while their hearts are still beating and before their removal