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HCE Lesson 7 - Dignity in Death and Dying
Theoretical foundation of nursing (TFN1)
Riverside College
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Signs of Death - Algor Mortis ➢ Cooling of the body - Rigor Mortis ➢ Muscle stiffening due to depletion of ATP - Livor Mortis ➢ Purplish-blue discoloration of the skin due to collection of blood in skin vessels caused by gravitational pull Inviolable - “Life is inviolable - Never to be broken, infringed or dishonored - SACRED
Euthanasia - “Death without suffering”; ”easy death” - Greek word eu meaning easy, thanatos meaning death - It is painless, peaceful death - It is the deliberate putting to death, in an easy, painless way, of an individual suffering from an incurable and agonizing disease - “Mercy Killing” ➢ Merciful release from an incurable and prolonged suffering - In theory, euthanasia affirms an individual’s right to die in a painless and peaceful manner whenever he/she is confronted with a horrible disease and the quality of his/her life deteriorates
2 types of Euthanasia 1. Self-administered - Act of commission (active) ➢ Terminally-ill patient will be deliberately and directly terminate his life by employing painless methods - Act of omission (passive) ➢ one allows oneself to die without taking any medicine or by refusing medical treatment 2. Other-administered - Active and Voluntary ➢ Either by a physician, spouse, or a friend of the terminally-ill patient will terminate the patient’s life upon patient’s own request - Passive and Voluntary ➢ Terminally-ill patient is simply allowed to die by the physician, spouse or immediate relative upon patient’s own request - Active and Non-voluntary ➢ Physician, spouse, close friend, decides the life of the terminally-ill patient - Passive and Non-voluntary ➢ Terminally-ill patient is simply allowed to die as requested by family members or doctor
Safeguards and Guidelines for a Policy in Assisted Death (Commonly proposed by supporters of assisted death)
- Patient must have an incurable (not necessarily terminal) condition and associated with sever suffering without hope of relief
- All reasonable comfort-oriented measured have been considered and tried
- Patient must express a clear and repeated request to die that is not coerced (emotionally or financially)
- Doctor must ensure patient’s judgment is not “distorted”. Patient is competent to make rational treatment choices
- Physician-assisted death must be carried out only in the context of a meaningful physician- patient relationship
- Consultation must be obtained from another physician to ensure patient’s request is rational and voluntary
- There’s clear documentation that the previous six steps have been taken and a system of reporting, reviewing, and studying such deaths must be established. Dysthanasia
- “bad death”; artificially postponed death
- Opposite to the concept of euthanasia
- Slow, painful death without quality of life. Used to extend the process of dying that only prolongs the patient’s biological life. It neither has dignity or improvement.
- Aims to extend the life of the patient but subject them to so much suffering Orthothanasia
- Natural manner of death and dying
- Sometimes used to denote the deliberate stopping of artificial or heroic means of maintaining life Summary of the three types
- Euthanasia ➢ Painless; to accelerate death; peaceful ➢ To end a life after being asked to; “mercy killing”
- Dysthanasia ➢ Prolong death with lots of suffering ➢ Slow, painful death
- Orthothanasia ➢ Natural or correct death Should we be allowed to cut the thread of life when the weight of pain, suffering, and hopelessness becomes unbearable?
- Christian ethics says NO. It is murder
- Principle of double effect says legitimate under certain circumstances. Most Common Drug Used to End Life
- Barbiturates ➢ Causes brain activity and nervous system activity to slow down; sedatives ➢ Example; secobarbital, nembutan o Both can be used alone or in combination; also used in animal euthanasia Advance Directives
- A written statement of a person’s wishes regarding medical treatment, often including a living will, made to ensure those wishes are
carried out should the person be unable to communicate them to doctor.
- DNR ➢ End of life care plan ➢ DNR means Do Not Resuscitate. This is a medical order written by a doctor according to the wishes of the patient or the patient’s family when the patient is unable to speak for himself already. Usually included in a person’s advance directives ➢ DNR must be signed by the doctor and also the patient. Patient’s family members must also be aware of a DNR form. PHILIPPINES
- Euthanasia: Illegal
- Physician-Assisted Suicide: Illegal
- In June 1997, the Philippine Senate considered a bill to Legalize passive euthanasia (the withdrawal of treatment or life-sustaining machinery). The bill did not advance. On Oct. 14, 2013, Senator Miriam Defensor-Santiago filed Senate Bill 1887, which would have made passive euthanasia Legal. The bill died in the Senate. ➢ Sources: Amado S. Tolentino, Jr., “Mercy Killing: Yes, No, Why?” manilatimes, Apr. 16, 2014. Claire Wallerstein, “Philippines Considers Euthanasia Bill,” BMJ , June 7, 1997
HCE Lesson 7 - Dignity in Death and Dying
Course: Theoretical foundation of nursing (TFN1)
University: Riverside College
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