Death and Afterlife - McGinley (Test 1)

Acute care

an approach in which a patient receives active (short-term) treatment for a severe injury or an episode of illness

Palliative care

an approach to care that tries to improve the life quality of a patient facing the issues with a life threatening illness (allowed to continue treatment!)

Hospice

(Cicely Saunders) a type of palliative care, a home providing care for the ill, must have 6 months or less to live, must end curative treatment (acute care), patient must freely consent

Standards for Hospice:

1) Treat the patient and family as one unit

2) Interdisciplinary team (nurse, aid, chaplain, counselor, therapist, nutritionist, doctor, etc.)

3) Continuity of care

4) Home care services (4 hours)

5) Symptom control - pain management

6) Aid in bereavement (after death, help grieving family)

7) Quality assurance

Holism

resurrection, body and soul

Dualism

the old body doesn't matter, personal identity in afterlife

Eschatology

(Greek: eschaton) concern about the end of time; the part of theology concerned with death, judgement and the final destiny of the soul and of humankind

Etimmu

the soul or shade of an individual (leaves the body after death); personality after death

Gilgamesh

character from The Epic of Gilgamesh who travels to the ends of the Earth in search of eternal life (after the death of his friend, Endiku).

Utnapishtim, six days and seven nights, fails

Endiku comes back, ghostly, you need descendants!

Underworld

the dark and dreary abode of the dead in Mesopotamian thought

Libation

the pouring out of beverages to the dead as offerings

Ra

the sun god-reborn into a new Pharaoh every time the previous one died and "went to the stars"

Ka

essence of the person; consists of the personality of the individual that travels to the hereafter

Ba

the essence of the body; remains close to the corpse is this world after death, frightens off grave-robbers

Field of Rushes

the afterlife realm in which the spirits of those who have successfully passed judgement might enjoy a new life like that on Earth

Osiris

the god of the underworld, serves as judge of dead spirits, (brother murdered and dismembered him, wife puts him back together, but his phallus has been cast into the Nile. His wife prays for him to be restored back to life-he rises as king of the underworld. The Nile was said to have been made fertile by the phallus.)

Hades

god of the underworld, a place also called Hades or Tartarus

Shade

the spirit of a dead person, residing in the underworld

Psych

the aspect of the individual that survives bodily death (becomes the shade in death); soul or mind

Plato

Greek philosopher, promoted the idea of DUALISM of body and spirit and argued for the survival of the spirit beyond bodily death

Pythagoras

Greek philosopher and mathematician whose cult promoted the idea of REINCARNATION and remembering past lives

Sheol

the underworld in the Jewish bible (sometimes anthropomorphized) that is described as a dark hole in the ground to which all the dead are bound, awaiting resurrection

anthromorphize

giving a god, animal, or object a human look/qualities

Gehenna

(idea developed after Sheol) a Jewish view of hell, like Tartarus (Greek), in which those deemed by God to deserve punishment for behavior in life

Shiva

"sitting Shiva"; the week long mourning period in Judaism (NO LEAVING THE HOUSE), followed by Sheloshim, the thirty day mourning period that continues on after shiva has ended (YOU CAN LEAVE THE HOUSE)

Yahrzeit

the anniversary of the passing of a family member (one year)

Talmud

Jewish instructions on daily life, interprets the bible

Tahara

the Jewish custom of annointing and taking care of bodies for burial

(NO EMBALMING, try to bury in 24 hours)

Maimonides

Jewish philosopher who believed in the separation of body and soul, did NOT believe in reincarnation

Sadducees

upper class, maintaining tradition, against the idea of resurrection

Pharisees

modernization, believed in resurrection of the body

Essenes

monotheistic, somewhere in the middle, mysticism

Heaven

the state of being with God obtained after resurrection by those who have committed themselves to following the teachings of Jesus Christ

Angels

messengers of God said to exist in a spiritual form and to which Jesus compared the state of humans after resurrection

Hell

the state of place of ETERNAL damnation expressly mentioned by Jesus in the Gospels as the fate, after resurrection, of those who do not follow him

Jesus

"rabbi", "prophet", "Son of God", born into Judaism, reflected Jewish views, preached from a personal understanding of the word of God

Old Testament + New Testament

Was crucified, was resurrected

Apocalyptic

the religious belief that there will be an apocalypse, a revelation; the Last Day; Judgement day

Resurrection

the belief that the dead will be raised again in a new body at the Final Judgement at the end of time; debate has raged over whether the resurrection will be a spiritual or a physical one

Reincarnation

a living being starting a new life in a different physical body

(Gnostics: Christianity, Druze: Islam)

Salvation

being delivered from sin and consequence; achieved through a belief and relationship with Christ

Rapture

the idea that believers, living and dead, will be carried to heaven immediately before (or during) the end-times and its cataclysmic Armageddon

Purgatory

the state of the temporary fate of all people after death, during which the dead are punished by degrees to purge and purify them for the coming resurrection in heaven or eternal damnation

Origen

accused of allowing too much paganism into Christianity, argued that the resurrected body was NOT the exact same body as that in life; "universal salvation"; sinners are tormented in hell but only as a preliminary stage before eventual resurrection to the afterlife

Martin Luther

believed that the idea of Purgatory was no more than a tool used by the church to fleece believers as they paid tribute in order to "save" deceased souls, readopted the Judaic concept of "sleeping" dead

Muhammad

an orphan living in the city of Mecca, raised among a clan charged with the care of a local temple; received divine revelations from Allah through Archangel Gabriel. These messages were recorded and together became the Qur'an.

Qur'an

the hold book of Islam, word account of the revelations that Muhammad was delivering from Allah (they were not MUHAMMAD'S revelations!! He was just the messenger)

Jahilyyah

the "time of ignorance" before Islam took form

Hanifs

purely Arabia monotheists

Barzakh

intermediary state; a spiritual barrier that keeps the dead from returning to the living

Jinn

spirits described in the Qur'an that are said to have been created before humankind (could be good, evil, neutral)

Mahdi

the title of Imam, leader of the Muslim community, messiah of Islam, etc

Mi'raj

"night journey"; Muhammad ascends to heaven, meets several prophets, and learns that there are seven levels in heaven. The higher you go, the closer you are to Allah. He speaks to God, and after some bargaining and a second trip, God tells him to have Muslims pray five times a day. There is no written distinction of what level people go to when they die.

Standards of death

1) Cardiopulmonary (heart, lungs)

2) Whole brain standard (autonomic, cognitive)

3) Higher brain standard (cognitive)

Aries' 4 historical periods of Western attitudes towards death

1) "Tamed" death
-refers to death that was forewarned; the dying person could prepare; customs and religions

2) Death of the self
-We all have a "destiny"; individual existence; judgement is determined at time of death; appearance of individual tombs

3) Death of the other
-western literature begins to romanticize death (i.e. Romeo and Juliet)

4) Wild death/forbidden death
-We do everything to avoid death/shield us from it

Elisabeth Kübler-Ross's 5 stages of dying

1) Denial

2) Anger

3) Bargaining

4) Depression

5) Acceptance

Corr's task-based model of dying

1) Physical

2) Psychological

3) Social

4) Spiritual

Awareness contexts surrounding dying (the death of Ivan Ilyich)

1) Open - when everyone knows about a patient's diagnosis (patient, doctor, family)

2) Closed - the doctor does not tell the patient their diagnosis, only the family

3) Mutual pretense - (the death of Ivan Ilyich) both the patient and the doctor will not openly admit that the patient's diagnosis is terminal, but they both know

Nancy Cruzan Case

Car accident victim, feeding tube inserted. Family wanted tube removed, hospital wouldn't remove it without court order.

Missouri court said keep her on life support, Missouri supreme court reversed it, US supreme court upheld original decision saying there wasn't enough evidence of patients wishes.

Then the family found three friends to testify that thats what the patient would have wanted and they removed feeding tube.
**emphasized need for written directives (when to stop treatment and specific treatments that can be discontinued)

Forms/types of euthanasia

Active - giving a shot for death

Passive - pulling a feeding tube

Voluntary - do they want this

Involuntary - do they not want this

The ethical principle of Double Effect

an effect (or outcome) that would be morally impermissible if caused intentionally is permitted as long as it is not intended-even if that affect (outcome) is foreseen

Provisions of Death with Dignity Laws

Required:
- An adult (18 or older)

- A resident of Oregon

- Capable of communicating health care decisions

- Diagnosed with a terminal illness that will lead to death within six months

- Make two oral requests (15 days apart)

- Written request signed with two witnesses

- Two physicians must confirm diagnosis

- Two physicians must determine that patient is capable

- If either physician believes the patient's judgement is impaired by psychiatric/psychological disorder, a psych eval must be given

- Prescribing physician must inform patient of alternatives

- The prescribing physician must REQUEST patient to notify next of kin