Ψ Preparations for dying are not only normal: they are psychologically healthy.
Ψ Adults hope that they will die swiftly, with little pain & great dignity, however; this hope runs counter to modern medicine.
The Patient & Family
Medical hubris - may result in an attempt to do everything to maintain life. Avoid by using:
Living will - A document that indicates what medical intervention an individual wants if she or he becomes incapable of expressing those wishes. A "good" idea with some problems.
Proxy Designations - Problems follow;
Without explicit instructions, many proxies do not know what to do.
Family members may disagree with the proxy.
Even with an advance directive and a proxy, more than half the time such directives are ignored by hospital staff.
Medical Personnel - notes
DNR - Do Not Resuscitate
Double Effect - A situation in which medication has the intended effect of relieving a dying person's pain and the secondary effect of hastening death.
Hospice - An institution in which terminally ill patients receive palliative care.
Palliative Care (a.k.a. "comfort care") - Care designed not to treat an illness but to relieve the pain
& suffering of the patient & his or her family.
Ψ Barriers to Entering Hospice care:
• Hospice patients must be terminally ill, with death anticipated within six month. Such predictions are difficult for Doctors to make.
• Patients & caregivers must accept death.
• Hospice care is expensive,
especially if curative therapy is continued.
• May not be available. FYI: Hospice is
available in Abilene, Texas. Western states have more hospices than do southern states.
Controversial Community Polices
Physician-assisted suicide - when a doctor provides the means for someone to end his or her own life.
Voluntary Euthanasia - Active euthanasia occurs when, at the patient's request, someone else acts to ends his or her life. Passive euthanasia occurs
when a person is allowed to die (DNR).
Despite concerns about a "slippery slope" leading to abuse; in places such as Oregon & the Netherlands where both forms of
Euthanasia are legal, few people use them & safe-guards seem effective in preventing abuse.
Epilogue: Death & Dying
Robert C. Gates
Then with no fiery throbbing pain,
No cold gradations of decay,
Death broke at once the vital chain,
And freed his soul the nearest way.
- Samuel Johnson