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20 Cards in this Set
- Front
- Back
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Important right to die cases
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Karen Ann Quinlan (OD'd at party, in persisten vegetative state, family =kill but doctor = no, judge says family has right remove respirator)
Nancy Cruzan = (crash, PVS but no need for respirator. Judge rules family can't deny food and water, unless individual said so) |
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Issues of Right to Die early stages info:
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doctors increasingly turning to technologies to prolong life (respirator, IVs, etc)
= a legal and ethical dilemma |
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euthanasia defnition*
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act of killing or permitting death of hopelessly sick in a relatively painless way
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Types of Euthanasia and defs
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Active Euthanasia: deliberate intervention to end life (PAS and mercy killings)
Passive Euthanasia: Allowing death to occur (Withdraw 1) tubes, 2) respirators 3) treatment (antibiotics, esp Alz patient) |
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Hospice Care definition
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Philosophy and approach to care at the end of life that allows patient to die comfortably and with dignity
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What hospice care offers*
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Palliative care to patient 24/7 as needed with a particular emphasis on pain management (care to patient and family (psychosocial/spiritual too)
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Hospice care stats, settings, payer
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-1700 total in US
-mostly offered in home, but often institution -Medicare is primary payer source) |
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Suicide and Depression in old ppeople
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-Older people at greatest risk of suicide, esp elderly white men (17-25 % suicide occur in 13% population)
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3 Types of suicide according to Durkheim (1951)
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Altruistic suicide: self-sacrifice b/c are a burden
Anomic suicide: feel hopeless, no hope of improvement Egoistic Suicide: not integrated with society,e.g. outlived all friend family, children) |
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5* Characteristics preceding suicide in late-life (LIDDS)
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Loneliness
Illness or disability Depression Diminished economic resources Social Isolation |
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What % elderly seen physician previous month who then committed suicide
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70
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**Legal options at End of Life
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Informed Consent and
Advance Directives (3 types) |
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3 Types of Advance Directives
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Living Will (online software)
Durable Power of Attorney (online software) DNR (has to be visible at nursing home/hospital) |
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Patient Self-Determination Act of 1990
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requires hospital and other health care facilities to provide all patient info on their rights (advanced directives and informed consent)
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Advance Directive definition/info:
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Written instructions about end of life care (very important to do before needed, ideally at younger adult age)
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Living Will definition:
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expresses wishes about medical treatment in advance should patient become incompetent
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Durable power of attorney for health care definition:
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designates a health care surrogate to make decisions about medical care if patient is unable to do so
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DNR defnition:
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Do Not Resuscitate: forgo CPR if patients quits breathing or heart stops
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Advance Directives (how many people have, what to do if none)
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-less than 20% of people have
-decisions made by family and health care providers in consultations then |
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In re Guardianship of Estelle M. Browning 1990 (advance directives info)
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Living will does not answer all questions about end of life care (example is coma "terminal" and "irreversible" that enough to end feeding tube?) court withdrew tube eventually
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