End-of-Life Care, Legal Frameworks, and Body Disposal

Practice flashcards covering types of death, end-of-life care participants, ethical frameworks, legal precedents including Carter v. Canada and Malette v. Shulman, MAID considerations, and body disposal methods.

What are the four types of death?

Expected (anticipated death allowing preparation), Unexpected (sudden death with little preparation), Natural (resulting from illness, ageing, or natural processes), and Unnatural (resulting from external circumstances, including accidents or violence).

Who are the three main participants in medical end-of-life care and what are their roles?

Patients (experience illness and make decisions about treatment), Families (provide support and may participate in decisions), and Medical professionals (diagnose, treat, manage symptoms, and communicate medical information).

What challenges do physicians face when treating dying patients?

Medical training often emphasizes curing illness, death may be perceived as professional failure, physicians must communicate difficult information, and emotional exhaustion along with treatment disagreements may occur.

What factors influence quality of life near death?

Pain and symptom management, emotional and psychological well-being, autonomy and independence, meaningful relationships, and personal dignity and identity.

What is personhood, and why is it important in end-of-life care?

Personhood refers to an individual's identity, dignity, and recognition as a person. It is important because serious illness may threaten independence and self-identity, and respecting patient preferences helps preserve personhood.

How does hospice care differ from curative treatment?

Curative treatment attempts to eliminate disease or restore health, whereas hospice care prioritizes comfort, dignity, emotional support, and quality of life, recognizing that prolonging life is not always the patient's primary goal.

Why are communication and choice important in end-of-life care?

Communication allows patients to understand options and express preferences, while choice supports autonomy and control. Patients benefit from having actual choices and feeling involved, whereas poor communication can increase distress and family conflict.

What are Shweder's three ethical frameworks and how do they explain end-of-life disagreements?

Autonomy (individual rights and freedom), Community (family and social responsibilities), and Divinity (sacredness and spiritual obligations). Differing ethical priorities among these frameworks can lead to disagreements regarding MAID, treatment refusal, and body disposal.

What are the overt and covert functions of law regarding death?

The overt function is maintaining external order through rules and regulations, while the covert function is maintaining internal or symbolic order by reinforcing moral values.

What is advance care planning?

Considering and communicating preferences for future medical treatment (such as life-sustaining treatment, comfort care, and substitute decision-makers), which helps preserve autonomy if the patient loses decision-making capacity.

What is the difference between a medical proxy and a power of attorney?

A medical proxy makes healthcare decisions when authorized, whereas a power of attorney provides legal authority over specified decisions, often financial or property-related.

Why was the Supreme Court case Carter v. Canada (2015) significant?

The Supreme Court of Canada ruled that the blanket prohibition on assisted dying violated constitutional rights in specified circumstances, providing the foundation for Canada's MAID legislation while emphasizing autonomy and protection from intolerable suffering.

What was the significance of the Malette v. Shulman (1990) legal ruling?

It reinforced the right to refuse medical treatment and demonstrated that bodily autonomy remains important even when refusing treatment may result in death.

What are the main ethical considerations surrounding MAID?

Voluntary and informed consent, decision-making capacity, medical eligibility, intolerable suffering, and balancing patient autonomy with safeguards for vulnerable individuals.

What is the distinction between pain and suffering in end-of-life care?

Pain is physical or sensory discomfort, whereas suffering is broader physical, psychological, social, or existential distress. Someone may experience significant suffering without severe physical pain.

What is the dual-process model of decision-making in death-related contexts?

It consists of analytical processing (deliberate, logical evaluation) and intuitive processing (fast, emotional judgment); both influence death-related decisions and may produce conflicting preferences.

What are taboo trade-offs in funeral decisions?

Conflicts between sacred values and financial considerations that occur when families associate spending money with demonstrating respect or love, making funeral purchasing emotionally difficult.

What are the four stages of the death cycle?

Flesh 1 (internal decomposition), Flesh 0 (external decomposition), Bone 1 (skeletal remains), and Bone 0 (gradual breakdown of skeletal material).

What are the three approaches to body disposal?

Preventative (delays decomposition, such as embalming), Facilitative (encourages decomposition, such as natural burial), and Accelerative (speeds bodily reduction, such as cremation or alkaline hydrolysis).

What is alkaline hydrolysis, and what is the identity preservation motive?

Alkaline hydrolysis uses water, alkaline chemicals, and heat to break down bodily tissues. The identity preservation motive is the desire to preserve the deceased person's identity or bodily continuity, which may influence emotional reactions to unfamiliar disposal practices.