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Chapter 19- part 2: Death and Dying

Explore Kübler-Ross's theory of death and dying, ethical dilemmas in end-of-life care, and societal debates on assisted suicide and euthanasia. Discuss stages of dying, legal aspects, and care options.

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Chapter 19- part 2: Death and Dying

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  1. Chapter 19- part 2: Death and Dying Module 9 Confronting Death

  2. CONFRONTING DEATH

  3. Are there steps toward death? Kübler-Ross • Developed a theory of death and dying • Built on extensive interviews with people who were dying • With input from those who cared for them 481

  4. Kübler-Ross Theory 481

  5. PROS One of first people to observe systematically how people approach their own deaths Increased public awareness and affected practices and policies related to dying CONS Largely limited to those who are aware that they are dying Less applicable to people who suffer from diseases in which the prognosis is uncertain Stage-like increments questioned Anxiety levels not included Evaluating Kübler-Ross’ Theory 482

  6. Other Theorists • Edwin Shneidman • “Themes” in people’s reactions to dying that occur—and recur—in any order throughout the dying process • Charles Corr • People who are dying face a set of psychological tasks 482

  7. Should people be free to select the nature of their own death?

  8. Choosing the Nature of Death • DNR • Issues • Differentiates of “extreme” and “extraordinary” measures from those that are simply routine • Determines of individual’s current quality of life and whether it will be improved or diminished by a particular medical intervention • Determines of decision-maker role 483

  9. Doctors and Decisions • Medical personnel are reluctant to suspend aggressive treatment. • Physicians often claim to be unaware of patients’ wishes • Physicians and other health care providers may be reluctant to act on DNR requests • Trained to save patients • To avoid legal liability issues 483

  10. Health care proxy Durable power of attorney See figure 9-2 on page 485 for an example of a living will… Living Wills 485

  11. Euthanasia and Assisted Suicide • Euthanasia • Passive • Voluntary active • Assisted suicide • Kevorkian 485

  12. PROS CONS What are the arguments? 485

  13. Caring for the Terminally Ill Place of Death • Home care • Hospice care • Hospital care 486

  14. Review and Apply 487 REVIEW • Elisabeth Kübler-Ross has identified five steps toward dying: denial, anger, bargaining, depression, and acceptance. • Issues surrounding dying are highly controversial, including the degree of measures that physicians should apply to keep dying patients alive and who should make the decisions about those measures.

  15. Review and Apply 487 REVIEW • Assisted suicide and, more generally, euthanasia are highly controversial and are illegal in most of the United States, although many people believe they should be legalized if they are regulated. • Although most people in the United States die in hospitals, increasing numbers are choosing home care or hospice care for their final days.

  16. Review and Apply APPLY • Do you think assisted suicide should be permissible? Other forms of euthanasia? Why or why not? 487

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