Cv-Death, Near Death, Disease, The Light, The Tunnel, And A Physician's Role

Front 1

What is the accepted definition of death?

Back 1

the permanent termination of the biological functions that define a living organism

Front 2

Clinically speaking, when is a person considered to be dead?

Back 2

when brain activity ceases

Front 3

Persistent vegetative state can also be described how?

Back 3

brain stem function without cerebral cortical function

Front 4

What fraction of Americans die in an institution?

Back 4

4/5

Front 5

What percent of Americans will die from something they have lived with for months or years?

Back 5

70-80%

Front 6

What are the 2 categories for advanced directives?

Back 6

proxy and instructive

Front 7

A living will is an example of what?

Back 7

instructive directive

Front 8

A proxy allows for what?

Back 8

somone to make medical decisions on the dying person's behalf if they become incapacitated

Front 9

T or F: a physician is usually correct when making ballpark estimates with terminal disease.

Back 9

false

Front 10

What 4 things should a physician know when caring for a dying person?

Back 10

1. the patient's story
2. the body
3. medical care system available to the patient
4. themselves

Front 11

When can CPR be withheld?

Back 11

1. advanced directive
2. futile to do so

Front 12

What are the 2 kinds of medical futility?

Back 12

1. quantitative-likely that it won't work
2. qualitative-it may work, but quality of life will be exceedingly poor

Front 13

If there is no advanced directive, and family wants CPR performed, but physician feels it is medically futile, what should be done?

Back 13

1. communication will usually solve this crisis
2. if communication fails, do CPR

Front 14

What are key features of a "good death"?

Back 14

1. know when death is coming, and to understand what can be expected
2. be able to retain control of what happens
3. be afforded dignity and privacy
4. have control over pain relief and other symptom control
5. have choice and control over where death occurs (at home or elsewhere)
6. be able to leave when it is time to go, and not to have life prolonged pointlessly
7. have access to information and expertise of whatever kind is necessary
8. have access to any spiritual or emotional support required
9. have access to hospice care in any location, not only in hospital
10. have control over who is present and who shares the end
11. be able to issue advance directives which ensure wishes are respected

Front 15

What are the steps to breaking bad news?

Back 15

1. getting started
2. find out how much patient knows
3. find out how much patient wants to know
4. sharing information
5. respond to patient's feelings
6. planning and following through