Suffering & Death Quiz 2

Question 1

Definition of structural violence

Answer 1

Any kind of social structure that prevents an individual or group from reaching their full potential.

Question 2

What is meant by blood memory, historical trauma?

Answer 2

Build-up of emotional and psychological trauma

• results in anger, anxiety and depression
• Diabetes, Substance Abuse, FASD

Blood memory: can result in changes in the DNA

Question 3

Native Concepts of humanity, the Great Spirit, the interconnectedness of all with the Divine and the holiness of all beings?

Answer 3

-Higher Power/Great Spirit - many different names. Creator of all, seen and unseen.

• We are all related and interconnected - life force flows through all living things.
• All in creation (including rocks, trees, clouds, etc) are considered holy beings.
• Good health of one’s family community is dependent on one’s good relationship, alignment and harmony with Great spirit and creation.
• All four aspects of being (Physical, Spiritual, Mental and Emotional) must be addressed to be healthy.

Question 4

Basic Christian understandings of humanity?

Answer 4

Tethered to God - on their own, humans are finite, dependent and insufficient. BUT, we are made in the likeness of God, we are valuable and we should be celebrated and protected.

Question 5

Imago Dei & dignity

Answer 5

Means that we’re made in the image of God.

This is what results in human dignity - given to all humans and is indestructible.

Question 6

What is face? Defacement?

Answer 6

Defacement is any assault on the dignity of another person. Could be as small as ignoring someone or as big as genocide.

Face is originally a mysterious concept - a channel through which otherness presents itself to us - a way that we know “thou shalt not kill.” (Levinas)

The writer (Mitchell) took it at a more concrete leve - the physical human face (and body) connecting us to everyone else. Is sacred -commands that we don’t remain indifferent to the face of another.

Question 7

What is the social dimension of human dignity?

Answer 7

Our own personal need for reciprocity, to have our personhood affirmed and our dignity acknowledged.

IT’s so strong that if it’s denied, it creates feelings of humiliation.

Indication that our humanness is tied to that of every other person.

Question 8

What is the political dimension of human dignity, and how does partisanship relate?

Answer 8

Politics are the values, behaviors and institutions that relate to the making of policy in society.

These policies/practices will either uphold dignity or deny them. We must use these as guiding principles.

Furthermore, we must be unapologetically (but not obnoxiously) partisan - choosing the side that preserves and defends human dignity.

Question 9

What is meant by the “hollow bone”?

Answer 9

The caregiver is supposed to BE the hollow bone - emptying themselves of all preconceived notions, thereby allowing the Divine to direct the caregiver.

Question 10

What are two key design goals of programs designed to reach Native Americans?

Answer 10

Family-focused, collaborative, “circle of care” model for culturally and developmentally appropriate care coordination. Integration of services is a focus.

Systems of care should include mentors, natural helpers and elders in order to increase support

Question 11

What is self-donation of the body and the language of the body?

Answer 11

The human body speaks a language, but its author is the embodied human being.

One’s body can’t express the person if it’s ill - the person turns on himself to preserve it.

The doctor and patient both use their bodies - healing and vulnerability - in order to heal and be healed.

Question 12

What are the Four Noble Truths?

Answer 12

• Life is suffering
• Suffering arises from attachment
• Eliminating attachment eliminates suffering
• The noble 8-fold path is how to eliminate attachment

Question 13

What is the noble Eight-fold path?

Answer 13

Right intention
Right Speech
Right action
Right livelihood 
Right effort 
Right mindfulness

It’s what ends attachment, which in turn, ends suffering

Question 14

What are the three marks of existence?

Answer 14

Suffering (dukkah)

Impermanence (anicca) - everything changes

No-self (abata): there is no permanently existing self or should. We’re made of 5 clusters (bodily matter, sensations, perceptions, mental formations, bits of consciousness).

Motivates

Question 15

How do Buddhist teachings shape Buddhist views of illness and death?

Answer 15

• Karma can lead to a detached, resigned attitude towards death
• Sickness, dying and suffering are unavoidable, therefore Buddhists might not feel that they need to be cured.
• Calm, peaceful mind is important in death
• Might want to avoid analgesics and sedatives to that the mind can be filled with wholesome thoughts.

Question 16

Charmaz’s model of adaptation

Answer 16

Adapting to illness (might want to control your illness and your body)

Changing identity goals (might create new goals and develop new identity)

Surrendering to the sick body (might mean giving up the idea of victory and control)

Question 17

Process and signs of dying

Answer 17

Symptoms may increase in the last 24h before death
Scariest part is not knowing what to expect
Body slows down - more time asleep than awake
Decreased appetite
Decreased UO
Gets harder to swallow
Weakness, breathing becomes erratic
Cheyenne-Stokes, Death rattle (don’t suction)
Talking to others, confusion, speaking in metaphors

Question 18

Hindu worldview of death

Answer 18

Karma: cause/effect that shapes fate and motivates moral behavior.

Mukti as the ultimate goal - the breaking of the cycle of life and death. Uniting with God, eternal bliss.

Death is not the end - each life improves until the cycle ends (ideally).

Physical body is material, but the soul (the subtitle body) is eternal

What a person is holding in their mid at the time they die determines what they can attain - chanting mantras, singing devotions, visualizing God in death.

Question 19

Passivities of diminishment

Answer 19

The “evil” things that happen to us that will eventually contribute to our death. We struggle against them (which is good) but eventually submit to them.

When we do submit, we realize that we’re on the next stage of our journey - which will lead us to union with god.

Question 20

What is the inner person and the outer person?

Answer 20

Two kinds of personal existence.

Outer person: our whole self, which is subject to troubles, diminishments, wasting away, dissolution.

Inner person: the spirit, which we’ll know fully in the age to come. Renewed daily in anticipation of the future, which will bring a new Spirit and heart.

Question 21

What is meant by death as descent to chaos and ascent to God?

Answer 21

These are the two fundamental currents of energy.

Descent: decline into chaos. As structures break down, disorder increases and energy dissipates.

Ascent: union with God, the spiritual energy “within of things”. Brings us together in unity and is the energy of love. Is capable of increasing even as our energy declines.

There will be a final separation between these opposing currents of build-up and decay - a split in the universe and an escape of spirit. Dying is the way to life.

Question 22

What are the two extremes that must be avoided in the use of life-sustaining technology?

Answer 22

An insistence on useless or burdensome technology even when a patient might wish to forgo it.

The withdrawal of technology with the intent of causing death.

Question 23

What are the criteria for withholding or withdrawing treatment? What are ordinary/proportionate and extraordinary/disproportionate means?

Answer 23

If there is hope for a cure and the treatment is moral, tolerable and affordable, it’s considered “ordinary/proportionate” and is not okay to withhold or withdraw treatment.

If there is no hope for a cure, or if the treatment creates an excessive burden or bears an extreme cost, it’s okay to withhold or withdraw treatment.

Question 24

Principle of double effect and its criteria

Answer 24

Acts with good and bad effects may be justified.

Criteria:

• original act must be good or morally neutral
• good must outweigh the bad and the bad must not be directly intended
• good effect must not be achieved as a result of the bad effect
• there must be a sufficient or proportionate reason for performing the proposed act.

Question 25

Rules for Death with Dignity (OR)

Answer 25

• Terminal illness with less than 6m to live
• two verbal requests, 15d apart, plus a written report
• pt must be informed of pain control, comfort care and hospice
• pt must be 18+ and an Oregon resident

Question 26

Difference btw good death and dying well?

Answer 26

Good death: defined by what people would prefer to avoid.

Dying well: how a person can journey through yet another life experience.