Chapter 11- Death and Dying

A proposal that established uniform guidelines for determining when death has occured

Uniform Determination of Death Act

Final cessation of bodily activity, used to determine when death actually occurs; circulatory and respiratory functions have irreversibly ceased, and the entire brain (including the brain stem) has irreversibly ceased to function

Brain death

A condition of deep stupor from which the patient cannot be roused by external stimuli

Coma

Severe mental impairment characterized by irreversible cessation of the higher functions of the brain, most often caused by damage to the cerebral cortex

Persistent Vegetative State

Circulatory and respiratory functions have irreversibly ceased, entire brain (including brain stem) have irreversibly ceased to function

Parameters of brain death

Patients can recover from a coma, but cannot recover from

Persistent vegetative state

Cannot breather without assistance, no coughing or gagging reflex, no pupil response to light, no blinking reflex when cornea touched, no grimace reflex when head rotated or ears flushed with cold water, no response to pain

Tests to determine is death has occurred

What death technically results from

Lack of oxygen

Number of autopsies has

Declined

Referring to patients who are expected to die within six months

Terminally ill

Causes of terminal illness

Disease has progressed beyond effective treatment or there is no cure

The study of death and the psychological methods of coping with it

Thanatology

Goal is to help dying people exercise their rights to control end-of-life medical care

The Right to Die Movement

Case that made the Right to Die Movement a thing

Karen Ann Quinlan in 1976

A federal statute passed in 1989 to guide state legislatures in constructing laws to address advanced directives

Uniform Rights of Terminally Ill Act

First federal act concerning advanced directives

Patient Self-Determination Act

Conscious medical act that results in the death of a dying person

Active euthanasia

Act of allowing a dying patient to die naturally, without medical interference

Passive euthanasia

Act of ending a dying patient;s life by medical means with his or her permission

Voluntary euthanasia

Act of ending a terminal patient's life by medical means without his or her permission

Involuntary euthanasia

Greek for "good death

Euthanasia

Most states have laws against

Physician-assisted suicide, but you can challenge in court

Only US state that allows physician-assisted suicide

Oregon

Treatment of a terminally ill patient's symptoms in order to make dying more comfortable, also called comfort care

Palliative care

Treatment directed toward curing a patient's disease

Curative care

A facility or program, often carried out in a patient's home, in which teams of health care practitioners and volunteers provide a continuing environment that focuses on the physical, emotion, and psychological needs of the dying patient

Hospice

Federal law passed in 1990 that requires hospitals and other health care providers to provide written information to patients regarding their rights under state law to make medical decisions and execute advance directives

Patient Self-Determination Act

An advance directive that specifies an individual's end-of-life wishes

Living will

An advance directive that confers upon a designee the authority to make a variety of legal decisions on behalf of the grantor, usually including health care decisions

Durable power of attorney

Durable power of attorney issued for purposes of health care decisions only

Health care proxy

Passed in 1984, a statute that provides grants to qualified organ procurement organizations and established an Organ Procurement and Transplantation Network

National Organ Transplant Act

A national statute allowing individuals to donate their bodies or body parts, after death, for use in transplant surgery, tissue banks, or medical research or education

Uniform Anatomical Gift Act

National Organ Transplant Act passed in 1894 in response to

National shortage of organs

UNOS

United Network for Organ Sharing

Age range for organ donors

Newborn to 70

Human reaction to loss

Grief

5 stages of grief

Denial, Anger, Bargaining, Depression, Acceptance

Right to refuse medical treatment

Cruzan v Director

Philosophy of Hospice

Dying patients should be allowed to live their final days in comfort

Encouraged individuals to prepare advanced directives

Patient's Self-Determination Act

Hospice programs do not support

Euthanasia

Durable power does not only pertain to

Medical choices