Death and Dying - Week 7

Since death poses a threat to the image of the “physician as healer,” the dying patient in the medical subculture is a _____.

deviant

The labeling theory of deviance focuses on the _____.

audience

According to sociologist Howard Becker (1963), how might people respond to having been labeled deviant, and subsequently, denied meaningful participation?

Don’t have any incentive to comply with social norms

From the view of sociologist Elliot Freidson, how might people respond after they have been labeled deviant?

Deviant person may elicit certain aversive attitudes

Often, the worst part of living with HIV is the _____ and _____ experienced

stigma and discrimination

Because of an inability to respond to treatment and get well, the dying person is permanently cast into a _____ role

deviant

_____ refers to the work of maintaining roles, relationships, and identity, through dying.

Normalization of dying

In attempting normalization for the patient, the [hospital] staff tries to keep the patient from slipping into an exaggerated state of _____

patienthood

According to Freund and McGuire (1999), the _____ is a cultural value in the United States that makes it difficult to decide to let nature take its course and allow death to happen.

technological imperative

_____ to _____ percent of Americans spend their last days in an intensive care unit.

18 to 20

In the United States, _____ of Medicare spending goes to the final year of life

one-third

According to German sociologist Max Weber, the more the nature of bureaucracy is developed, the more the bureaucracy is _____.

dehumanized

According to Moller (1996), the more the hospital succeeds in eliminating purely personal and emotional elements from its daily operation, the closer the bureaucracy comes to _____

perfection

Prior to the 20th century, a hospital was popularly regarded as much the same thing as a_____.

prison

For most of the history of the United States, dying in a hospital was not an option, because they _____.

barely existed

An estimated one in _____ Americans who reach the age of 65 dies in a nursing home.

four

According to textbook co-author George Dickinson, who toured St. Luke’s Hospice in Sheffield, England, a _____ sticking up under the top sheet on a gurney awaited the arrival of anew patient.

bed warmer

The average stay before death in an inpatient hospice facility is about ____

3 weeks

Of all health professionals, _____ are in the most immediate position to provide care,comfort, and counsel at the end of life for patients and families.

nurses

In a study of first-year medical students’ reactions to the gross anatomy lab, Dickinson,Lancaster, Winfield, Reece, and Colthrope (1997) discovered that the gross anatomy course tends to _____ students to death.

desensitized

Some researchers find that, over time, medical students in the gross anatomy lab become increasingly _____ to the cadaver’s presence and more capable of feeling awe and amazement about the process of dissecting a human being

habituated

The medical training of most physicians historically seems to be primarily concerned with the patient’s _____ state.

physical

List the five goals for first- and second-year medical students at the Yale School of Medicine seminar on problems in communicating with dying and seriously ill patients

1. learn to talk with, and listen to, sick persons;

2.  learn to establish a professional relationship without the intrusion of friendship

3. ascertain the meaning of compassion without sentimentality and the need for humility in the context of the physician’s ignorance

4.  learn of our common frailty as human beings, the finality of death, and the need that we all have for companionship when death is near

5.  enrich the students’ understanding of those in their care

_____ percent of 347 veterinarians surveyed in South Carolina agreed that their “veterinary training well prepared them for relating to owners of terminally ill animals.”

35%

What effect do the values, ethics, and communication skills presented and learned in nursing and medical school have on the clinical practice of health care professionals?

• learn to talk with, and listen to, sick persons;

•  learn to establish a professional relationship without the intrusion of friendship

• ascertain the meaning of compassion without sentimentality and the need for humility in the context of the physician’s ignorance

•  learn of our common frailty as human beings, the finality of death, and the need that we all have for companionship when death is near

•  enrich the students’ understanding of those in their care

Physicians in Sweden are paid according to the number of _____ rather than the number of_____.

hours worked / patients treated

What types of health care services are covered under Medicare Part A or Medicare Part B insurance?

• Part A of Medicare is hospital insurance;

•  Part B is supplementary medical insurance for physicians’ services, outpatient care, laboratory fees, and home health care.

How is Medicare different from Medicaid?

• Medicare was created by legislation enacted in 1965 to finance acute medical care mainly for older Americans.

• Medicaid is for poor Americans

As shown in the video presentation, “Swedish Healthcare vs. U.S. Healthcare,” Gallup poll data from 2020 reveal that _____ percent of Republicans are satisfied with the total cost of healthcare in the U.S. compared to _____ of Democrats?

44% / 16%

As shown in the video presentation, “Swedish Healthcare vs. U.S. Healthcare,” Gallup poll data from 2020 reveal that _____ percent of Americans believe it is the responsibility of the federal government to make sure all Americans have health care coverage

56%

As defined in the video presentation, “Swedish Healthcare vs. U.S. Healthcare,” what is meant by the Swedish term, “vårdcentral?

Local health centers

As explained in the video presentation, “Swedish Healthcare vs. U.S. Healthcare,” _____ is the Swedish word used to indicate a referral to a medical specialist.

remiss

In the video presentation, “Swedish Healthcare vs. U.S. Healthcare,” one of the narrators estimates that someone in Sweden who suffered a serious ski accident that involved a helicopter airlift to a hospital, 5 days in the hospital, daily pharmaceutical treatment for a year, and dental work, might expect to pay a total of _____ U.S. dollars

$855

According to one of the narrators in the video presentation, “Swedish Healthcare vs. U.S.Healthcare,” a helicopter airlift in the U.S. costs about _____ U.S. dollars after insurance

$20,000

Data presented in the video presentation, “Swedish Healthcare vs. U.S. Healthcare,” indicate that _____ percent of Americans have experienced a health care expenditure in the past year that was catastrophic to their well-being compared to _____ percent of Swedish citizens.

7.4% / 1.8%

Data presented in the video presentation, “Swedish Healthcare vs. U.S. Healthcare,” indicate that Americans born in 2017 could expect to live _____ fewer years than Swedish born citizens

four

According to one of the narrators in the video presentation, “Swedish Healthcare vs. U.S.Healthcare,” wait times for surgeries in countries with universal health care can be _____ longer compared to the U.S.

4-6 months

In the video presentation, “Swedish Healthcare vs. U.S. Healthcare,” what conclusion do the narrators reach about Swedish health care vs. U.S. health care?

In Sweden you know you will receive care, better for the general public

As discussed in the classroom lecture, how does the American health care system differ from the Chinese health care system with respect to the following three issues?

• the primary caretakers of the terminally ill person

• physician salaries

• the medical training of physicians

• Physician has primary responsibility in America; Family and physician has primary responsibility in China

• Men: $286,000, Women: $239,000 in America; Average: $13,764

• In America they receive training in western medicine; China they receive training in traditional Chinese and western medicine

As explained in the classroom lecture, dying people may face many physical, emotional, and mental challenges, and many of them also experience _____ in the American health care system.

burnout

According to psychiatrist and author Stephen Bergman (2105), emergency room doctors sometimes refer to patients who are frequently admitted to the hospital with complicate and incurable conditions as ____

GOMER

According to sociologist Howard Becker (1958), medical school students that he observed in his research sometimes referred to patients having many subjective symptoms but not objective or identifiable physical problems as _____

CROCK

Dr. Robert McDermid said in the classroom video presentation, “Why Talking About Dying Matters,” that one of his dying patients told him the greatest lesson a parent could teach a child is_____.

how to die well

According to Dr. Robert McDermid in the classroom video presentation, “Why Talking About Dying Matters,”complaints about how we [in the health care system] treat diseases are _____.

rare

According to Dr. Robert McDermid in the classroom video presentation, “Why Talking About Dying Matters,” complaints [in the health care system] are almost always about how we treat_____.

patients as people

Dr. Robert McDermid said in the classroom video presentation, “Why Talking About Dying Matters,” that statistics show most of us will die in a _____.

hospital

According to Dr. Robert McDermid in the classroom video presentation, “Why Talking About Dying Matters,” connecting deeply with patients is the antidote to _____.

burnout

According to General Social Survey data presented in the lecture on dying in the American health care system, _____ % of sampled Americans in 1973 reported having a great deal of confidence in the institution of medicine compared to ______ % of Americans sampled in 2022

54% / 33%

According to research from the Reith (2018) study on burnout among American health care professionals, which was presented in the classroom lecture on dying in the American health care

Burnout comes from spending too much time at the computer doing bureaucratic tasks

According to research from the Reith (2018) study on burnout among American health care professionals, which was presented in the classroom lecture on dying in the American health care system, five symptoms of burnout in the workplace include _____, _____, _____, _____, and_____.

• Malaise

• fatigue

• frustration

• cynicism

• inefficacy