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There are rules surrounding when certain emotions can be shown. These are regulated by norms. |
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ALS, 2-5 years. Control over one’s destiny Belief in the afterlife alleviates the fear of death |
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Physician assisted death; encompasses euthanasia and suicide |
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Pro life, emphasize the RIGHT to life. |
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Pro-Choice Arguments, emphasize the RIGHT to die |
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Pro-Socially Normative Argument, notion that people have a duty to die. Individuals have a duty to the large of society to exit, to die. |
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(Strauss) You should NOT talk about death. Everyone knows it will happen, but you don’t mention it. Still cultures where this is the case; DON’T TELL THEM THEY ARE DYING. |
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One is suspicious of their dying. Body talks to them. Nobody will confirm this for them. They get curious. |
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Fully aware they are dying, figured it out. Aware that everyone else knows. Everyone knows. No conversation. |
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Karen Ann Quinlan USA 1976 |
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Parish priest said that God should have his will, let her pass away. DETERMINED THAT PARENTS COULD TERMINATE HER CARE and allow her to die. She was unplugged, she DID not die. PASSIVE EUTHANASIA Won the right to terminate treatment, NOT to kill her. |
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The Patients Rights Movement |
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Right to be informed Right to decide (consent) Right to decide in advance Right to designate a decision-maker aka power of attorney |
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Object to major intervening care, but still want to be cared for. ID themselves as pro-life… despite being there to help people die. |
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Passive euthanasia. Went into a coma, then veggie state. Spouse elected to let her die. Took 2 weeks, why not do int humanely then? |
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Informed Voluntary Consent |
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Be informed about conditions, about treatments offered, can agree or decline. |
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Advance Personal Directive |
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Specify what is to be done for you |
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Success rate for seniors when revived in nearly 0. |
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Orthodox Jewish Man, 2008 |
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Sometimes we're FORCED to be treated. 84-year-old father be kept alive as long as possible, per tenets of their religion, despite the recommendation of several doctors that care be discontinued. Doctors felt it was WRONG, BUT, if family asks, you can MAKE the doctor treat you. |
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Minimally conscious. Wife refused to give consent. Doctors argued that they were not required to provide treatment of no medical benefit, and did not need consent to stop treatment |
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remains illegal to assist in someone’s suicide. That means HELP. You wouldn’t do it, but you would give the means |
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Dr. Jack Kevorkian USA 1990s |
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Definition
From Assisted Suicide to Active Euthanasia. Jailed 1999-2007 |
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ALS, challenged law against physician-assisted suicide. BC Supreme Court judge ruled that prohibiting physician-assisted suicide is unconstitutional. Taylor given an exemption for assisted suicide. Taylor died of natural causes in Oct 2012 |
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Dr. Nancy Morrison Canada 1997 (Voluntary) |
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Definition
Had a patient who was dying super painfully, she killed him with a lethal injection. Was not reprimanded. |
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Robert Latimer Canada 1993 |
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(daughter Tracy, Non-voluntary). Jailed 2001-2008. Exceeded limits of a parent. Logic of people dying painfully a la Sue Rodriguez is that we ought to do something, we can justify euthanizing. Daughter has CF, 12 years old (2 years mentally, cannot speak for herself). Killed her via exhaust. Disabled lobbyists didn’t like this. |
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Twins, deaf from birth, Belgium. @ age 45. Begin going blind.Voluntarily requested euthanasia, died December 14, 2012 by lethal injection
Voluntary Active Legal Euthanasia Their today, our tomorrow? |
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End of life care's future |
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Definition
Palliative Care. Dr.’s recognizing the limits of medicine, increasing recommendations of palliative care. Physician-Assisted Suicide. |
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Legal Dr. Assisted suicide |
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Definition
Benelux Countries: Belgium 2002 (not illegal), Netherlands 2002 (legalized long-standing practice), Luxembourg 2009 (legalized)
Switzerland: “Suicide Tourism” People visit for assisted suicide. Foreigners are able to receive medical care. |
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Dr assisted because they are non invested and are capable |
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Refusing care, Advance directives, Do not resuscitate, Palliative care, Withholding futile care) We do a lot that hasten deaths. Death embracing. We make decisions. |
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Active voluntary euthanasia |
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Openly wishing for death. option in Belgium countries. Has to be able to volunteer. |
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Active non-voluntary euthanasia |
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Person cannot express their opinion |
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Active involuntary euthansia |
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Person is screaming for help. Aka murder or capital punishment. Holocaust… |
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Honor killings, ask people to kill themselves if they dishonor family. |
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Degrees of psychological life |
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Definition
1) Comatose 2) Persistent Vegetative State 3) Minimally Conscious State 4) Dementia/psychological death (Alzheimer’s, stroke, etc.) 5) Insanity? |
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ALLOW death to happen. Stepping out of the way. Normally done by Dr. |
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MUCH more common than female. Peak at 45, and at 90; bimodal. Suffocation, firearms |
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Poison, suffocation. Peak at 45 More likely to ATTEMPT from 15-19 |
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Rules are too ambiguous, lack of culture. No meaning. |
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TOO supported, done for the good of the community. |
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Too little support, done for themselves. Mostly men; few social supports. Life conditions. |
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Societal rules are way too oppressive, lack of control in life. |
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South African photographer. Took Pulitzer prize photo of girl with vulture. Killed himself later. What kind of suicide? |
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17 yr old metis foster child. Went through 16 foster homes. Deficiencies in child care system; he never got to go home. Done for egoistic, anomic, fatalistic reasons |
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NEVER advocated for assisted suicide/euthanasia. Not someone who would kill self due to support and coherence. |
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#1 common is spirits of friends/family welcoming #2 is glimpse of place they're going |
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2 types of people who see visions |
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dying slowly and near death experiences |
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Claim not hallucination, always relatives, EEG is flatlined, NDE evidence = spirit evidence |
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Unconscious feeding material to experiences |
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HUGE variations in determining, little role played by surgeons. Might be wrong! |
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low quality of life. Want to spend last days at home, hospital #2. |
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Physical, psychological, social, spiritual |
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inability to perform made feel in decay |
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Axniety, uncertainty, desire to be home |
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visits from family & friends |
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Overshadows all patient needs |
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Culturally sensitive care |
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inflexible to cultural/religious tradition |
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Cannot transfuse blood, can get court order for minors |
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patient wastes time with family |
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SUDEP, weird unknown ways to pass. ~500 a year. |
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seen as ordinary and morally obligatory. |
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Use a tech just because we can |
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1990 decision that food and water are medical treatments, and are optional |
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Better to do that to withdraw |
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Symptom control and human presence |
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Feeding tubes for those when someone is cognitively aware and wants to live |
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Usefulness and Burdonsomeness |
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2 criteria of treatment decisions |
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Helped 130 people, legit & ethical medical practice, |
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ultimate goal of Kovorkian. Place people where they will die and harvest organs/experiment |
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Reached by small steps. Requests of organ donation and then euthanasia |
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BAD. Gives an incentive to the depressed and devalued of society. gives them meaning |
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deaths are worth more than lives |
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experience and context for dealing with death |
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not prepared for death, revolted and scared |
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No collective family stance |
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Cuz less experience with death |
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children realize finality of parents; middle ages orphans; huge deal |
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determines if organs are to be harvested |
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Less important; see science as what cures. Funeral industry taken over. |
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Ambulance workers, nurses, physicians & assistants |
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Most time with dying persons. Provide the most care |
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MOST hands on care; advocates for family |
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trained to preserve life only |
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frequent in canada now, written in hospital |
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of bed are for palliative care |
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10x as expensive as palliative, home is 1/2 palli |
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help someone or to cause another's death |
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Kids live far away and only talk when someone dies, unprepared! |
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Occur from withdrawn/withheld care |
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#1 way to dispose. Half price of funeral (5-10K!) Flexible where body goes |
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replace fluids with chemicals to preserve |
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Far away, don't concern themselves with it. |
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Young people. Old are close and worry. |
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course that person follows over time into death. |
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make people worry about being a burden |
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Seen as the best, short trip into death |
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Control over final moments via assisted suicide |
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Manage emotions & focus on love |
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both good deaths due to manner of dealing with strife |
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Desirable traits in death |
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Dignity, fortitude, courage, endurance, self control. |
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scarier than death. Driven by fears of loss and suffering. |
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Encourage women's emotional outlet, make perverse men's. |
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loss of order in one's life from illness, pain, etc. |
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(re)gaining a sense of order and control |
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Comprehensibility (make sense), Manageability (resource and support), Meaningfulness (find meaning). |
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mortality is scary because it can invalidates the life lived. |
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Most pervasive and enduring mechanism for making death not scary |
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21st century spirituality =/= religion. Is a construction to assign meaning |
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suggests life has no value |
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Not all want to die, want to make an attempt at help |
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is comfortable and not a fight for life |
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