Objectives. Dying and Death. Thinking About Death. Understanding Death. Lecture 4. HEAL 101: Health and Lifestyle Kevin Petti, Ph.D.
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1 Lecture 4 Dying and Death HEAL 101: Health and Lifestyle Kevin Petti, Ph.D. Department of Natural Sciences, Health, Exercise Science and Nutrition San Diego Miramar College Objectives! Define death and analyze why people deny death in western culture! Discuss the stages of the grieving process and how to cope with death! Describe the ethical concerns that arise from the concepts of the right to die and rational suicide! Review the decisions that need to be made when someone is dying or has died, including hospice care, funeral arrangements and organ donations Thinking About Death Understanding Death! Is death an eventuality we all accept?! How do most people want to die?! Where do most people want to die?! How and where do most people die? Defining death! Dying decline in body functions resulting in death! Death final cessation of the vital functions! Brain death irreversible cessation of brain stem
2 Denying Death! High level of discomfort associated with death and dying in U.S. " Avoidance of people who are grieving " Fail to validate a dying person s frightening situation " Substitute euphemisms (pass away, better place) " Giving false reassurances to people who are dying " Avoid touching dying people The Process of Dying! Coping emotionally with our impending death! Elizabeth Kübler-Ross major figure in Thanatology study of death! Her book, On Death and Dying, outlined the stages of grieving as:! Denial Not me, there must be a mistake! Anger Why me?! Bargaining If I m allowed to live, I promise! Depression It s really happening to me! Acceptance I m ready Kübler-Ross s Stages of Dying Coping With Loss! Bereavement loss or deprivation experienced by a survivor of a loved one who dies! Grief state of mental distress occurring in reaction to significant loss! Mourning culturally prescribed and accepted time periods and behavior patterns for the expression of grief
3 What is Normal Grief? A Child s Response to Death " Waves of physical distress " Feeling of emptiness " Anxiety, insomnia, memory lapse " Loss of appetite, difficulty concentrating " Do we only grieve for short periods, or is it life long? " Is it normal to be sad on birthdays or anniversaries of the deceased?! Questions frequently asked! Did I cause the death to happen?! Is it going to happen to me?! Should adults include children in funerals? " Grief also experienced in Quasi-Death Experiences! Divorce, loss of limb, retirement Life and Death Decisions Medical Directive! Serious ethical and moral implications! The right to die:! If condition is terminal and existence depends on artificial life support devices, do you have the right to hasten death by refusing treatment or intervention?! Artificial life support! Electrical or mechanical heart resuscitation, mechanical respiration by machine, nasogastric tube feeding, intravenous nutrition...! Consider a Medical Directive to your physician! A conscious and competent person has the right to refuse treatment! Advanced directives or living wills have sometimes not been honored by medical institutions or physicians! Choose a physician and hospital that will carry out the directives of the living will! Make your wishes known to your family
4 Euthanasia! Active euthanasia ending the life of a person who is suffering and has no chance for recovery such as a lethal injection! Passive euthanasia intentional withholding of treatment that would prolong life Hospice Care! Hospice programs have grown dramatically in recent years! Allow families to improve the quality of care at the end of life! Hospice care goals:! Relieve dying person s pain - Palliative Care! Offer emotional support (often legal too)! Restore a sense of control to dying person, family, friends! Allow to die at home or home-like settings Making Funeral Arrangements! All cultures throughout history have some kind of funeral ritual! Wake or viewing body is usually embalmed prior to viewing memorial service may follow! Methods of body disposal burial in ground, entombment above ground in mausoleum, cremation, anatomical donation! Expenses may include: burial casket, burial vault, container for remains if cremated
5 Pressures on Survivors! Do you want to have a large funeral, be buried, or cremated?! Do you want to have your organs donated or your body used for anatomical study?! Have you conveyed your wishes to your family? Organ Donation Wills! Do you have a will? - Inheritance could be difficult! Intestate without a will if will is nonexisting, courts (state laws) will decide the disposition of the estate
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