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End of life care strategies and summary of development essay
End of life care strategies and summary of development essay
Chapter 38 end-of-life care
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A terminal illness can generally be defined as an illness for which there is no cure and the prognosis is fatal. We all know that we will die someday but most of us think of this as some distant time. For individuals who have been diagnosed with a terminal illness, though, they must face the reality of their own mortality and are forced to re-evaluate their lives and must make choices about how to best spend the remainder of their days. For the purposes of this paper I am focusing on the cultural differences between how American society copes with a terminal illness and how Jewish American’s cope. Coping with a terminal illness is not unique to any particular culture. How an individual reacts and prepares for their own inevitable death however is quite different depending on one’s past life experiences, education and religious background. Some know exactly what to do, while others may be devastated and feel helpless and powerless to do anything.
According to a 2005 Pew Research Center Survey, American’s overwhelmingly support an individual’s right to decide whether he or she want to be kept alive through medical treatment. 84% of those polled said that they approved of laws which say medical treatment which is keeping a terminally ill patient alive can be stopped if that is what the patient desires. 70% said there are some circumstances when a patient should be allowed to die while 22% said medical personnel should do everything possible to wave the life of the patient. (Parker, 2009)
There has been much debate in our society over whether physicians should disclose the prognosis terminally ill patients. Often physicians intentionally overestimate survival times when communicating with patients in order to give the...
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When death has taken someone from your life, you think of everything you said to them, your last words, memories, and the talks that happened. During this assignment, one will see the grieving process from me about a tenant that I took care of, and the impact this lady’s passing away, left me. Polan and Taylor (2015) says “Loss challenges the person’s priorities and importance of relationships.” (pg 226) When an individual loses someone that you see everyday and take care of, this effects you because, you build a relationship and get to know each other on a personal level. When my tenant was passing away it was painful. I didn’t know what to feel when I seen what was happening and knew what was taking place.
When considering “the four primary dimensions of care for those who are comping with dying,” both similarities and differences can be found between African-American cultural beliefs and what have been considered traditional American cultural beliefs when making end of life decisions. Although both cultures share a physical need to have their bodily needs met, they differ on how physical distress is viewed. American culture often wants to minimize the distress and discomfort felt as a way of coping. However, some cultures may ignore the natural desire to minimize discomfort (Corr, 2009). The African-American culture is one such culture. African-Americans who are making end of life decisions of...
A divergent set of issues and opinions involving medical care for the very seriously ill patient have dogged the bioethics community for decades. While sophisticated medical technology has allowed people to live longer, it has also caused protracted death, most often to the severe detriment of individuals and their families. Ira Byock, director of palliative medicine at Dartmouth-Hitchcock Medical Center, believes too many Americans are “dying badly.” In discussing this issue, he stated, “Families cannot imagine there could be anything worse than their loved one dying, but in fact, there are things worse.” “It’s having someone you love…suffering, dying connected to machines” (CBS News, 2014). In the not distant past, the knowledge, skills, and technology were simply not available to cure, much less prolong the deaths of gravely ill people. In addition to the ethical and moral dilemmas this presents, the costs of intensive treatment often do not realize appreciable benefits. However, cost alone should not determine when care becomes “futile” as this veers medicine into an even more dangerous ethical quagmire. While preserving life with the best possible care is always good medicine, the suffering and protracted deaths caused from the continued use of futile measures benefits no one. For this reason, the determination of futility should be a joint decision between the physician, the patient, and his or her surrogate.
However, it has been reported that telling a patient the truth may significantly improve their wellbeing as they approach the end of their life. One study revealed that truth telling may reduce terminal cancer patients’ uncertainty and anxiety, as indicated by lower scores on a Hospital Anxiety and Depression scale, and higher scores on a Spiritual Well-being scale (Kao et al. 2013). Furthermore, while there is no explicit principle regarding lying within the Hippocratic Oath, honesty is a virtue that is closely associated with physicians and health care providers. In fact, honesty can be closely related to respect for persons, which implies that it is necessary for the maintenance of the physician-patient relationship. Honesty about all relevant aspects of a patient’s diagnosis, prognosis and treatment are necessary to build trust, and to obtain informed consent.
When it comes to a bad diagnosis it is often difficult for doctors to tell their patients this devastating news. The doctor will likely hold back from telling the patient the whole truth about their health because they believe the patient will become depressed. However, Schwartz argues that telling the patient the whole truth about their illness will cause depression and anxiety, but rather telling the patient the whole truth will empower and motivate the patient to make the most of their days. Many doctors will often also prescribe or offer treatment that will likely not help their health, but the doctors do so to make patients feel as though their may be a solution to the problem as they are unaware to the limited number of days they may have left. In comparison, people who are aware there is no cure to their diagnosis and many choose to live their last days not in the hospital or pain free from medications without a treatment holding them back. They can choose to live their last days with their family and will have more time and awareness to handle a will. Schwartz argues the importance of telling patients the truth about their diagnosis and communicating the person’s likely amount of time left as it will affect how the patient chooses to live their limited
Death and Grieving Imagine that the person you love most in the world dies. How would you cope with the loss? Death and grieving is an agonizing and inevitable part of life. No one is immune from death’s insidious and frigid grip. Individuals vary in their emotional reactions to loss.
End-of-life care in the United States is often fraught with difficult decisions and borne with great expense. Americans are often uncomfortable discussing death and
Death is a tragic thing that affects everyone around the deceased, including the deceased themselves. While there are many ways to deal with such matters, one thing is for certain, it’ll be a hard time no matter what you do.
Do people have the right to die? Is there, in fact, a right to die? Assisted suicide is a controversial topic in the public eye today. Individuals choose their side of the controversy based on a number of variables ranging from their religious views and moral standings to political factors. Several aspects of this issue have been examined in books, TV shows, movies, magazine articles, and other means of bringing the subject to the attention of the public. However, perhaps the best way to look at this issue in the hopes of understanding the motives behind those involved is from the perspective of those concerned: the terminally ill and the disabled.
Death alone is a scary thought to most individuals. People who live their life in fear of death don’t really get the most out of life. Someone who is terminally ill would be in a similar situation. There are two ways to live life after being diagnosed terminally ill. One way would be to get the most out of what remains of the person’s life. This would be considered the positive outcome. In the story “Letter from a Sick Person” the narrator recently has been informed he is terminal. Instead of panicking or being upset he embraces it. He accepts that his death is unavoidable and it gives him a brand new meaning in his life. He states, “In journeys, the greatest grief is hidden”. This life explains while he is not exactly happy he has discovered a way to cope with his illness. He feels as if it was his time stating, “I tell you I wanted death to come like a captain and carry me off”. Even in his death he knew that it wasn’t him who would be forced to overcome his death but the people left
As patients come closer to the end of their lives, certain organs stop performing as well as they use to. People are unable to do simple tasks like putting on clothes, going to the restroom without assistance, eat on our own, and sometimes even breathe without the help of a machine. Needing to depend on someone for everything suddenly brings feelings of helplessness much like an infant feels. It is easy to see why some patients with terminal illnesses would seek any type of relief from this hardship, even if that relief is suicide. Euthanasia or assisted suicide is where a physician would give a patient an aid in dying. “Assisted suicide is a controversial medical and ethical issue based on the question of whether, in certain situations, Medical practioners should be allowed to help patients actively determine the time and circumstances of their death” (Lee). “Arguments for and against assisted suicide (sometimes called the “right to die” debate) are complicated by the fact that they come from very many different points of view: medical issues, ethical issues, legal issues, religious issues, and social issues all play a part in shaping people’s opinions on the subject” (Lee). Euthanasia should not be legalized because it is considered murder, it goes against physicians’ Hippocratic Oath, violates the Controlled
The concept of human mortality and how it is dealt with is dependent upon one’s society or culture. For it is the society that has great impact on the individual’s beliefs. Hence, it is also possible for other cultures to influence the people of a different culture on such comprehensions. The primary and traditional way men and women have made dying a less depressing and disturbing idea is though religion. Various religions offer the comforting conception of death as a begining for another life or perhaps a continuation for the former.
People cope with the loss of a loved one in many ways. For some, the experience may lead to personal growth, even though it is a difficult and trying time. There is no right way of coping with death. The way a person grieves depends on the personality of that person and the relationship with the person who has died. How a person copes with grief is affected by the person's cultural and religious background, coping skills, mental history, support systems, and the person's social and financial status.
Newsome, B. R., & Dickinson, G. E. (2000). Death experiences and hospice: Perceptions of college students. Death Studies, 24(4), 335-341
Should a patient have the right to ask for a physician’s help to end his or her life? This question has raised great controversy for many years. The legalization of physician assisted suicide or active euthanasia is a complex issue and both sides have strong arguments. Supporters of active euthanasia often argue that active euthanasia is a good death, painless, quick, and ultimately is the patient’s choice. While it is understandable, though heart-rending, why a patient that is in severe pain and suffering that is incurable would choose euthanasia, it still does not outweigh the potential negative effects that the legalization of euthanasia may have. Active euthanasia should not be legalized because