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Growth & Development

Death & Dying
- Deciding How to Die -

Growth & Development

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