Death and Dying - Week 8

Inside hospitals, decisions are driven by routines of ____________

life in a professional bureaucracy.

____________ are specialists who assist with difficult decisions about medical treatments and end-of-life care.

Bioethicists

 By the year 2000, ______ percent of general hospitals offered ethics consultation or were starting up a consult service.

95

________ were once used by the U.S. Department of Transportation to measure the effectiveness of various crash protective devices in automobile collisions

Cadavers

What are the arguments for using machines rather than live or dead patients to train surgical residents on how to perform operations?

- Avoiding ethical dilemmas 

-  surgical residents can perform “operations” on machines rather than patients in a growing number of teaching hospitals.

- surgical residents can perform “operations” on machines rather than patients in a growing number of teaching hospitals.

- The simulator makes the surgeon feel like she or he is actually cutting into tissue.

- Residents can also practice life-support techniques on a lifelike

simulated patient who has a chest that rises and falls with each “breath”

What are the arguments against using machines rather than live or dead patients to train surgical residents on how to perform operations?

• High cost

•  Some physicians are leery of these simulation techniques and are not convinced that a computerized system, no matter how realistic, can teach residents the skills they will need in a real operating room.

•  simulated procedures do not carry the anxiety of working against the clock in a real setting on a live patient.

Xenotransplantation refers to the transplantation of organs across ________ animal species.

different

According to the Department of Health and Human Services, one organ donor can save up to _____ lives.

Eight

The most common reason for [organ] nondonation is denial of consent by the donor’s _______.

family

British ethicist John Harris has suggested that bodies should become ________ on death, allowing surgeons to harvest usable organs without going through the traumatic process of asking grieving relatives for consent.

public property

The original Greek meaning of euthanasia was “a _____ death” or “a ______ death.”

good, gentle

Recent Gallup opinion poll data reveal that ___ percent of Americans are in favor of allowing doctors to end a terminally ill patient’s life by painless means if the patient requests it.

73

Recent Gallup opinion poll data indicate that ___ percent of Americans agree that physicians should be allowed to assist a terminally ill patient living in severe pain “to commit suicide if the patient requests it.”

67

A physician who administers a strong dose of liquid morphine to a hospice patient with the intended goal of reducing her severe pain, while the physician is clearly aware that such a does would hasten the patient’s death, illustrates the ethical principle of __________.

double effect

 The view that all “natural” life has intrinsic meaning and should be appreciated as a divine gift refers to a __________ orientation

sanctity-of-life

In terms of race and ethnicity, Mebane and colleagues (1999) found that ____________ tend to request more life-sustaining treatments than _______ patients.

African American, White

In terms of race and ethnicity, Black physicians are more likely than white physicians to prefer ___________ medical treatments for themselves if they were in a persistent vegetative state

aggressive

The view that death is preferable to life when life no longer has meaning refers to a ___________ orientation

quality-of-life

What did the High Court judge in England decide in the 2004 case of the husband of a critically ill wife who wanted to take her to Switzerland to end her life through medically assisted euthanasia?

He decided that it was not for him to decide and that it should be up to police

________________ is a federal law mandating that health care providers inform patients about their right to refuse and accept treatment, even when they have lost decision-making ability.

Patient self-determination act

Many palliative care professionals cite ________ and ________ as some of the most disabling symptoms of terminal illness.

weakness, fatigue

If a person wishes to die “naturally” and not be kept alive by extraordinary means, then allowing that person to die constitutes ________ euthanasia. 

passive

 If a person wishes to be helped to die, and the physician ends the patient’s life through direct action (e.g., injecting a lethal drug into the patient), then helping that person to die constitutes ____________- euthanasia.

active voluntary

What is the law in Belgium with respect to someone under the age of 18 who requests euthanasia?

Lifted age restrictions for those under 18 if the child understands what euthanasia means and with parental or guardian consent

What is the law in the U.S. in regard to allowing a patient to die naturally by withholding medical treatment or removing life-support equipment?

Patient self-discrimination Act

The direct cause of all “natural” deaths tends to be __________

dehydration

Concerning different orientations on the meaning of life, CPR (cardiopulmonary resuscitation) follows a ______________ view for an individual in a terminal condition.

sanctity-of-life

Concerning different orientations on the meaning of life, DNR (do not resuscitate) follows a ___________ view for an individual in a terminal condition.

quality-of-life

According to Timmerman’s (1999) participant observation study, what was the behavior of emergency room physicians after paramedics arrive with a patient who has been administered CPR (cardiopulmonary resuscitation)?

 ER staff do not always aggressively revive all clinically viable patients, nor do they give up on all biologically dead patients.

Since introduced in 1960, the procedure of CPR (cardiopulmonary resuscitation) continues to be used ____________

indiscriminately

Which form of assisted dying was most common in the Netherlands in 2015?

Active voluntary euthanasia

________  is the primary health problem affecting those choosing assisted dying in the Netherlands. 

Cancer

According to the Hemlock Society (now known as Compassion & Choices), what is the distinction between suicide and self-deliverance?

Suicide is considered by many to be an irrational act that is a permanent solution to what is often a temporary problem. In contrast, self-deliverance should be considered a positive action taken to provide a permanent solution to long-term pain and suffering for the individual and her or his significant others faced with a terminal condition

According to the Hemlock Society (now known as Compassion & Choices), what is the distinction between self-deliverance and mercy killing?

Self-deliverance is a completely voluntary act on the part of the patient, whereas mercy killing involves other people’s behavior that may or may not be sanctioned by the patient.

___________ is an organization that opposes right to die legislation because they believe the healthcare industry will promote it to contain costs

Patients Rights Council

The slippery-slope argument [in opposition to euthanasia] alleges that society moves toward a disregard for human life in predictable steps:

1. passive euthanasia,

2. active voluntary euthanasia,

3. then active involuntary euthanasia,

4. the last being “Auschwitz,”

 How does public opinion regarding physician-assisted death and active voluntary euthanasia compare to the opinion of physicians?

•  In 1950, only one-third of individuals in the United States supported active euthanasia for incurably ill patients if they and their families requested it. Yet, by 1973, a Gallup poll in the United States found that 53 percent of those interviewed said that physicians should have the legal right to painlessly end the life of a person with a terminal illness if the patient and family request it. As noted earlier, by 2017, 73 percent of Americans supported euthanasia

• Surveys just prior to the 21st century of 938 physicians in the state of Washington revealed polarization regarding euthanasia. Though polarized, a slight majority favored legalizing PAD and euthanasia in at least some situations, but most would be unwilling to participate in these practices themselves

•  (1997) found that 587 South Carolina physicians had attitudes remarkably similar to those of the physicians in Washington

The Oregon guidelines for assisted suicide state that the patient must request a physician’s assistance in suicide _____ times, the last in writing, with the statement dated and signed by the patient in the presence of _____ witnesses.

three, two

According to the Oregon guidelines for assisted suicide, ____ physicians must determine that the patient has a life expectancy of ____ months or less

two, six

According to the Oregon guidelines for assisted suicide, the physician must wait at least ___ days after the initial request, and at least ___ days after the final request, before writing the prescription for the lethal drugs.

15, 2

The Oregon guidelines for assisted suicide state that the ________ must determine the patient is not suffering from a psychiatric or psychological disorder or depression causing impaired judgment

physician

List the three qualifications that at least one of witnesses must have concerning the patient’s written request for the lethal prescription in the state of Oregon.

1. A person who is not a relative of the patient

2. Does not stand to benefit from the estate of the patient

3.  Not an employee of the institution where the patient is being treated

As the narrator describes in the video presentation, “Terri Schiavo Documentary: The Case’s Enduring Legacy,” Terri Schiavo suffered a ___________ in February 1990 that left her several minutes without oxygen

cardiac arrest

As the narrator defines in the video presentation, “Terri Schiavo Documentary: The Case’s Enduring Legacy,” __________________  is a condition in which the part of brain that controls thinking and awareness is damaged or destroyed, and only the part of the brain that controls basic reflexes remains.

Persistent Vegetative State, PVS

 In the video presentation, “Terri Schiavo Documentary: The Case’s Enduring Legacy,” the narrator states that Michael Schiavo petitioned [the court] in 1998 to have his wife’s __________ removed.

feeding tube

In the video presentation, “Terri Schiavo Documentary: The Case’s Enduring Legacy,” the narrator states that, despite numerous court appeals from the parents of Terri Schiavo, all of the decisions were in Michael Schiavo’s favor because of clear and convincing evidence that ______________

Terri wouldn’t want to be kept alive.

According to bioethicist Arthur Caplan in the video presentation, “Terri Schiavo Documentary: The Case’s Enduring Legacy,” what was the motive behind people who rallied behind Terri’s parents?

Became a cause, fear of assisted suicide, euthanasia, abortion and abandonment of disabled

As the narrator explains in the video presentation, “Terri Schiavo Documentary: The Case’s Enduring Legacy,” opponents of the bill to give Terri’s parents a chance to continue their fight [to keep Terri alive] in federal court argued that politicians had no place interfering in ________________

personal medical decisons

According to the narrator in the video presentation, “Terri Schiavo Documentary: The Case’s Enduring Legacy,” most of the doctors who examined Terri Schiavo believed she was in a _____________

vegetative state

As Bobby Schindler (i.e., brother of Terri Schiavo) emphasizes in the video presentation, “Terri Schiavo Documentary: The Case’s Enduring Legacy,” why did his family not want Terri’s life support removed? 

They still wanted to care for her / believed she still had consciousness

According to the narrator in the video presentation, “Terri Schiavo Documentary: The Case’s Enduring Legacy,” Terri Schiavo’s death inspired an initial increase in ____________ and ____________.

living wills and advanced wills

As Michael Schiavo states in the video presentation, “Terry Schiavo Documentary: The Case’s Enduring Legacy,” he inscribed “I KEPT MY PROMISE,” at the bottom of his wife’s gravestone. What promise did he keep?

• To not have her live in a permanently vegetative state

• Would not keep her alive artificially