Lesson 12: End of Life Flashcards
Passive Euthanasia
not providing a treatment or a resource that a person needs in order to continue living
Active Euthanasia
directly engaging in some behavior that will, for humane reasons, lead to a person’s death
*more controversial
living will
a legal document that states the person’s intentions regarding how he or she wants to be treated should the individual become unable to express his or her intentions
durable power of attorney
a legal document in which the individual assigns another individual with the legal right to make medical (and sometimes other) decisions on behalf of the person should he or she become incompetent
Kübler-Ross
studied terminally ill patients and found that they progress through a series of five stages:
- denial
- anger
- bargaining
- depression
- acceptance
- -> may be applicable to loved ones too
Bereavement
the state one is in after experiencing the loss of a loved one
-no control over whether someone dies or not
Grief
sadness, hurt, anger, and other feelings that the individual feels after experiencing the loss of a loved one
-varies between individuals
Mourning
the manner in which grief is expressed behaviorally
-usually pretty common between people
clinical death
*old definition
lack of heartbeat and respiration
whole-brain death
*today’s definition
declared only when the deceased meet the 8 criteria
8 criteria that define “whole-brain death”
- no spontaneous movement in response to any stimuli
- no spontaneous respirations for at least one hour
- total lack of responsiveness even to painful stimuli
- no eye movements, blinking, or pupil responses
- no postural activity, swallowing, yawning, or vocalizing
- no motor reflexes
- a flat EEG for at least 10 minutes
- no change in any of these criteria 24 hours later
persistent vegetative state
situation in which a person’s critical functioning ceases while brainstem activity continues
Kübler-Ross: denial
- first reaction: shock/disbelief
- shop around for more favorable Dx
- find assurance in religion
Kübler-Ross: anger
- hostility, resentment, and envy towards health care workers, family, and friends
- “why me?”
- unfair
Kübler-Ross: bargaining
- look for a way out
- ask God to live longer “until ____ happens”
Kübler-Ross: depression
-deep loss, sorrow, guilt, shame over illness and it’s consequences
Kübler-Ross: acceptance
- accepts inevitability of death
- detachment from world, peace
Terror management theory
addresses the issue of why people engage in certain behaviors to achieve particular psychological states based on their deep rooted concerns about death
How can we reduce death anxiety?
death education and awareness
final scenario
making one’s choices known about how they do and do not want their lives to end
-make amends, resolve conflicts, affirm love, provide peace
hospice
approach to assisting dying people that emphasizes pain management or palliative care, and death with dignity
palliative care
relieving pain and symptoms
active process of grief
- acknowledge the reality of the loss
- work through emotional turmoil
- adjust to the environment where the deceased is absent
- loosen ties to the deceased
anticipatory grief
grief before expect death, supposedly to buffer the impact of loss after death –> facilitate recovery
grief work
coming to terms with bereavement
5 themes of the grieving process
- Coping: what people do to deal with loss in terms of what helps them
- Affect: emotional reactions to death of loved one
- Change: what changes are made as a result to the death
- Narrative: stories survivors tell about loved one
- Relationship: reflecting on who the deceased person was, nature of ties between them and the survivor
Four Component Model of grief
understanding that grief is based on…
- context of loss
- continuation of subjective meaning associated with the loss
- changing representations of the lost relationship over time
- role of coping and emotion-regulation
Typical reactions to death in early childhood
guilt for causing the death denial displacement repression wishful thinking that the dead will return
At what stage of thinking do children realize that death is permanent and final?
concrete-operational thinking
The most devastating type of loss for an adult is the loss of a _____.
child