Death and the Dying Process

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Death and the Dying Process

• Types of Death
• Basic Statistics
• Social Aspects of Death
• Do Not Resuscitate
• Euthanasia

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Types of Death

• Thanatologists People who study death and dying.
• Two types of death
• Functional Death
• Absence of a heart-beat and breathing.
• Brain Death
• Diagnosis of death based on the cessation of all
  signs of brain activity.
• Measured by electrical brain waves.

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Basic Statistics

• America has a very high infant mortality rate
• Ranks behind 35 other countries
• Why is this?
• Accurate statistics on our part.
• More drug use than almost any other country.
• In early adulthood the leading cause of death is
  accidents.
• Followed by Suicide, Homicide, AIDS, and Cancer

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Basic Statistics
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Social Aspects of Death

• Elisabeth Kubler-Ross
• Based on her observations, she suggested that
  people pass through five basic steps as they move
  toward death.

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Social Aspects of Death

• 1. Denial People resist the idea that they are
  going to die.
• A patient can flatly reject the diagnosis or
  request a second opinion.
• Sometimes memories of weeks in the hospital
• are forgotten.
• 2. Anger
• They can be angry at people who are in good
  health, their spouses and other family, those who
  are caring for them, and their children.
• Questions Asked Why are the bad people not dying
  and why am I? This can lead to the next stage.

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Social Aspects of Death

• 3. Bargaining Dying people try to negotiate
  their way out of death.
• If you are good, you will be rewarded
• The reward for being good is to live
• 4. Depression They become overwhelmed with a
  sense of loss.
• Reactive depression Based on events that have
  already occurred.
• Loss of dignity that may accompany medical
  procedures
• End of a job
• Knowledge that one will never return from the
  hospital.
• Preparatory depression Sadness over future
  losses.
• Death will bring an end to their relationships.

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Social Aspects of Death

• 5. Acceptance Final stage of dying is
  acceptance.
• Once acceptance has arrived they are fully aware
  that death is impending.
• They will have virtually no feelings,
• positive or negative, about the present or
  future.
• Denial and isolation It cant be!
• Anger Why me?
• Bargaining Just let me do this first!
• Depression withdrawal, crying, and grieving
• Acceptance a sense of peace comes

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Do Not Resuscitate

• No-Code Order
• Written order from a doctor that resuscitation
  should not be attempted if a person suffers
  cardiac or respiratory arrest.
• DNR is more commonly done when a person who has
  an inevitably fatal illness wishes to have a more
  natural death without painful or invasive medical
  procedures.
• DNR order came into being in the U.S. in the
  1960s when defibrillation allowed the reversal of
  cardiac arrest.

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Euthanasia

• Defined The practice of assisting people who are
  terminally ill to die more quickly.
• There are three types of euthanasia
• 1. Passive Euthanasia
• Withholding common treatments (Antibiotics,
  drugs, or surgery) or giving a medication
  (Morphine) to relieve pain, knowing that it may
  also result in death.
• Passive euthanasia is currently the most accepted
  form as it is currently common practice in most
  hospitals.
• 2. Non-aggressive Euthanasia The practice of
  withdrawing life support
• Quite controversial
• 3. Aggressive Euthanasia Using lethal substances
  or force to kill
• Extremely controversial
• Physician-Assisted Suicide Term for aggressive
  voluntary euthanasia.

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U.S. Denial and Avoidance of Death
Death and Cultural Contexts

• Funeral industry emphasizes lifelike qualities
• Euphemisms softening language for death
• Persistent search for fountain of youth
• Rejection and isolation of aged
• Concept of pleasant and rewarding afterlife
• Medical emphasis prolonging life, not easing
  suffering

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Attitudes Toward Death at Different Points in the
Life Span
A Developmental Perspective of Death
Infant has no concept of death perceptions of
death develop in middle/late childhood even very
young children concerned about separation and loss
Childhood
Develop more abstract concepts of death common
to think they are immune to death
Adolescence
Middle-aged adults fear death more than young
adults or older adults older adults think about
death more
Adulthood
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Suicide in U.S.
A Developmental Perspective of Death

• Adolescence
• 3rd leading cause of death in ages10-19
• 19 of high school students seriously considered
  or tried suicide in last 12 mos

• Adulthood and Aging
• Suicide rates increase in adulthood
• Older adults use more lethal ways, are more
  successful
• Racial and gender differences exist