Death And Dying Final Exam

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Symbolic Interactionist Perspective on Death

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-Meanings are created by Humans
-Idea of transcendence from religion helps keep us grounded

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Anomic

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without order

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Common Cosmological / Spiritual concepts of death shared by most societies

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-Each person possesses a soul with a certain level of immortality
-Death rituals
-Belief in ghosts, positive and negative

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Hopi Indians believe

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each person who dies is reborn and renamed

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Hindus believe

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in reincarnation, soul is placed into another body

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Islamic death beliefs

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-Life and realm of dead are separated by a bridge that souls must cross on the Day Of Judgment
-7 Layers of afterlife
-Death is "A certainty of life from which no one is exempt"

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Hinduism Death beliefs

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-ones present life is determined by the events in ones previous life
-reincarnation and transmigration of souls

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Buddhism Death beliefs

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-Focus on life and detachment from life with the acceptance of the impermanence of life

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Medical Model

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In the U.S. when we are sick we go to the doctor to be "made" well

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Terminal illnesses do not fit into the ____ category

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Medical Model

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Main proponent of Structural Functionalist Perspective

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Talcott Parsons

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Structural Functionalist Perspective

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-Society must function and living well people must contribute to that functionality
-Doctors are trained to treat the sick person as a disease or ailment
-Therefore the "illness" makes things dysfunctional

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______ is deviant

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Dying

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The Deviant Path of Rejection

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-Physical Disruption - person is removed from social life
-Emotional Disruption
-Explanations of deviance - stigmatized person fulfills deviance
-Punishment for deviance - rejection, phobias toward illnesses

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Normalization of Dying

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-Key step in last stage of life
-maintainence of roles, relationships and identities
-targets self esteem and goal orientation
-community becomes redefined

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Living with AIDS

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-Has a morality judgment
-Has nothing to do with living too long
-Poor judgment, lack of protection, poor infrastructure, zero education

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Cancer definition

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-Uncontrolled group of diseases by an uncontrolled growth and spread of abnormal cells
-Causes: bad habits, bad working conditions, bad luck

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Top cancers in US, Japan, India and China

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US - Lung Cancer
Japan - Stomach
India - Mouth
China - Esophageal

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Palliative Care

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-Immediate relief from suffering, pain control
-Not to prolong life, but to make it tolerable

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Hospice Care

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Hospice care always provides palliative care. However, it is focused on terminally ill patients-people who no longer seek treatments to cure them and who are expected to live for about six months or less.

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Why can the process of dying be more terrifying than death itself

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-Does not ofter occur - only die once
-State of dependency, loss of physical capabilities

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1st question when faced with terminal prognosis

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"How long do I have to live?"

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Ways you may know you are about to die if you were unaware before

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-Confined to healthcare institution
-Societal disengagement
-Controlled resources - patient is denied access to records or information
-Restricted mobility - family withdraws or limited visits

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Kubler-Ross Model

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1) Denial
2) Anger
3) Bargaining
4) Depression
5) Acceptance

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Social / Environmental ways to help someone accept death

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-Being home vs. place of confinement
-Family support vs. No family support

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Ways to help someone deal with dying

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-Make contact, visit
-Show care, express concern
-Personal care, help with medication or other personal needs
-Family stress- counseling or support

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Helping children cope with death

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-Prepare older children more
-Visits offer concrete evidence
-Explaining soon to be death allows for anticipatory grief
-Re-engage routines
-Encourage emotional expression, drawing, talking

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Palliative Care

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-Immediate relief from suffering, pain control
-Not to prolong life, but to make it tolerable

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Hospice Care

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Hospice care always provides palliative care. However, it is focused on terminally ill patients-people who no longer seek treatments to cure them and who are expected to live for about six months or less.

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Why can the process of dying be more terrifying than death itself

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-Does not ofter occur - only die once
-State of dependency, loss of physical capabilities

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1st question when faced with terminal prognosis

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"How long do I have to live?"

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Ways you may know you are about to die if you were unaware before

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-Confined to healthcare institution
-Societal disengagement
-Controlled resources - patient is denied access to records or information
-Restricted mobility - family withdraws or limited visits

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Kubler-Ross Model

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1) Denial
2) Anger
3) Bargaining
4) Depression
5) Acceptance

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Social / Environmental ways to help someone accept death

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-Being home vs. place of confinement
-Family support vs. No family support

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Ways to help someone deal with dying

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-Make contact, visit
-Show care, express concern
-Personal care, help with medication or other personal needs
-Family stress- counseling or support

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Helping children cope with death

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-Prepare older children more
-Visits offer concrete evidence
-Explaining soon to be death allows for anticipatory grief
-Re-engage routines
-Encourage emotional expression, drawing, talking

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PSDA

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Patient Self Determination Act
-A person may rightfully refuse medical treatment

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Living Will

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Document which makes a persons last wishes known to family and medical personnel

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Two Perspectives on Euthanasia

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Sanctity of Life and Quality of Life

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3 points for Sanctity of Life

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-All "natural" life has meaning
-Life should be appreciated as a diving gift
-Direct euthanasia weakens the privilege of life we are given

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3 points for Quality of Life

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-Once life no longer holds "quality" or meaning, death is preferable to life
-All levels of "quality" are loosely based on the individual situation
- This notion has spilled over into the hospice movement

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Passive Euthanasia (PE)

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"Allowing a patient to die"
-removing life support
-ex. withdrawing hydration and nutrition

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Ordinary and Extraordinary measures of passive euthanasia

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Ordinary - normal treatment
Extraordinary - excessive expense

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CPR

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Cardiopulmonary resuscitation

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DNR

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do not resuscitate

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Active Euthanasia

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-helped to die

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2 types of Active Euthanasia

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Physician Assisted Death (PAS, PAD)
-the patient technically takes their own life
Active Voluntary Euthanasia (AVE)
-a more aggressive form where they actually help through direct action

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Fetal Death

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-infant dies in the first month of life (neonate)
-includes abortion

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Induced Abortion

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intentionally ended pregnancy

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Spontaneous Abortion

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does not reach full term

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Spontaneous Abortions are often intensified by

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the fantasy relationship established by the patient prior to death

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Still Birth

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Baby born in utero

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Preemies

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Death of a baby born premature , before 9 months and under 5 lbs.
-underdeveloped organs
-parents leave without child
-death if they do not survive

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Chronic Death

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dying person may not accept, act unacceptably
-families unwilling to accept
-may be long and painful process
-can be very expensive

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Special problems associated with sudden death

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-Sudden death: accidents, disasters, war, suicide
-Survivors are unprepared, no group support in place
-Grief may be more intense
-Survivor Guilt

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Leading cause of death of ages 1-24

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Accidents

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Accidents leave survivors with the tendency to

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reinterpret the situation
-what if i had / had not done something
-How much did they suffer

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November 18, 1999

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Texas A&M

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Disasters

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increased number of lives lost on one occasion

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Problems associated with disasters

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-Identification problems
-Difficulties based on non-disclosure, uncertainty (no body to mourn)
-Higher levels of group grief
-National remembrance with memorials and statues

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May 27, 1997

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Jerrell Texas Tornado

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April 10, 1979

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Wichita Falls Tornado

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Murder is most tragic because

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it is perceived as preventable

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Murder highly complicates the mourning process because of

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legalities

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Suicide

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Any death resulting from either a deliberate act of self-destruction or from inaction when it is known that inaction will have fatal consequences

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Suicidal Acts

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Suicidal behavior that could be evaluated based on varying degrees of self-threat

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Complete Suicide

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Suicide act is carried out with intention of dying, may or may not be successful

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Gesture

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Suicide act is not intended to be successful, only a cry for help

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Functionalist

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Emile Durkheim

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Social Facts

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strengthen of ties to a community

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4 types of suicide

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egotistic, altruistic, anomic, fatalistic

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Egotistic Suicide

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person inadequately integrated into society, no conventional link (stars)

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Altruistic Suicide

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Overly integrated into society, willing to die for group (pilots)

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Anomic Suicide

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Lack of regulation, failure of social institutions (workers)

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Fatalistic Suicide

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Too much control and feel of oppression (newest version)

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Conflict Theory

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Karl Marx
-Alienation and Capitalism
-not everyone has equal access to power and material objects

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Ages most common for suicide

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-peaks during adolescence for men
- rises for females between 45-50
-rises for both in elder years

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Gender most associated with suicide

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males

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Marital status most likely to commit suicide

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Single

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Socioeconomic factors and suicide

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suicide high at both ends of the spectrum

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Suicide and race

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Whites - High
Blacks - Lowest
Native Americans - Highest

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Group that tends to talk about suicide before attempting

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Adults

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Killing

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intervening in an ongoing physiological process that would have otherwise supported life

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Letting Die

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not intervening to aid physiological processes that have become inadequate to support life

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October 16, 1991

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Lubys

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Euthanasia

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Administration of death to the dying, a hastening or advancing of death