RT205: MODULE 6 : DEATH AND DYING

Uniform Health Care Decisions Act

Under the UHCDA, any healthcare decision will be made by the first available in the hierarchy:
1.The patient, if competent

2.The patient, through an individual instruction

3.An agent appointed by the patient in a written power of attorney for health care, unless a court has given this authority explicitly to a guardian

4.A guardian by the court

5.A surrogate appointed orally by the patient

6.A surrogate selected from the list of family members and others who can make health care decisions on behalf of the patient

Life

- is the entire state of living thing
- Is the foundation of all other values of a patient.
- Is the foundation of a patient's rights

sanctity of human life

- entails an obligation not to infringe on an individual's decisions regarding life and an obligation not to take human life.

Suicide

- is the act of knowingly ending one's own life
- Active or passive (omitting treatment)

Arguments against suicide

-Many religions forbid suicide
-Life is the greatest good
-Suicide causes harm to the community
-Suicide causes harm to friends and family

Passive Suicide

- It is the refusal of treatment by a person who knows
that refusal will lead to death.

Active Suicide

- It is the taking of one's own life through a conscious act

Reasons for the Imaging Professional's Duty not to
cooperate with Suicide

- Assisting in or supplying the means to suicide is
generally illegal.

- Health care providers are devoted to healing.

- Assisting in suicide is incompatible with professional
obligation.

Euthanasia

- is the act of painlessly putting to death a person suffering from an incurable and painful disease
or condition.

Passive euthanasia

-May be committed through the withholding of nourishment or through a decision not to perform cardiopulmonary resuscitation (CPR) on a patient who has stopped breathing (e.g., DNR, DNI)

-It is considered legal in certain instances because no
one delivers a method of death.

Active euthanasia

- Is the performance of a specific act on the request or
behalf of the patient to end life.
- Ending of another person's life by an aggressive method
to end suffering.

Slippery slope

- is present when one act leads to another and then to another at an accelerating rate.

the person should have experienced the five stages of coming to terms with death:

- Denial
- Anger
- Bargaining
- Depression
- Acceptance

Surrogate

- Is a person who substitutes for another, often in decision-making processes.

Quality of life

- encompasses essential traits that make
life worth living

Justice Benjamin Cardozo

- established the 1914 Schloendorff case that "every human being of adult years and sound mind has a right to determine what shall be done with his own body.

Persistent Vegetative State (PVS)

- differs from brain death because the brainstem continues to function and the body is not dead.

Minimally Conscious State (MCS)

- is a condition of severely altered consciousness in
which minimal but definite behavioral evidence of self-
awareness or environmental awareness is
demonstrated.

CPR (cardiopulmonary resuscitation)

- is the only form of life-sustaining treatment that is
provided routinely without the consent of the patient, and
it may be the only medical treatment of any kind that is
generally initiated without an order of a physician.

Living will

- generally allows patients to state in advance that in the event of terminal illness they wish to forgo life-sustaining treatment

Durable power of attorney for health care decisions

- is broader than a living will and provides for a substitute decision make to make health care decision
when the patient is not able

Declaration Relating to Life-Sustaining Treatment and Durable Power for Health Care Decision

- which states the person's desire, in the event of terminal illness, not to have life prolonged by life- sustaining procedures and also created a substitute decision maker with regard to health care.

No-Code Orders

- CPR is generally provided unless a formal "do not
resuscitate" order is entered on the patient's chart

Slow-codes or pencil DNR

- meaning that staff would be instructed to provide resuscitation guaranteed not to be successful.

1976 Karen Quinlan

- a trend of statutes that formally recognize certain forms of written statements requesting that some types of medical care
be discounted.

Family Consent Laws

- This is the concept that when no advance directive
exists, physicians and health care facilities should look
to family members to make health care decisions

Jobes Court

- stated that " if the particular patient clearly would
have refused treatment under the circumstances, treatment
should be withdrawn

PVS

- describes a body that is functioning entirely in terms of its
internal controls. It maintains temperature. It maintains heartbeat and pulmonary ventilation.