1. Copyright © Allyn & Bacon 2007 Death, Society, and Human Experience 9 th Edition Robert Kastenbaum This multimedia product and its contents are protected under copyright law. The following are prohibited by law: Any public performance or display, including transmission of any image over a network; Any public performance or display, including transmission of any image over a network; Preparation of any derivative work, including the extraction, in whole or in part, or any images; Preparation of any derivative work, including the extraction, in whole or in part, or any images; Any rental, lease, or lending of the program. Any rental, lease, or lending of the program.

2. Copyright © Allyn & Bacon 2007 Chapter Six: End-of-Life Issues and Decisions This multimedia product and its contents are protected under copyright law. The following are prohibited by law: Any public performance or display, including transmission of any image over a network; Any public performance or display, including transmission of any image over a network; Preparation of any derivative work, including the extraction, in whole or in part, or any images; Preparation of any derivative work, including the extraction, in whole or in part, or any images; Any rental, lease, or lending of the program. Any rental, lease, or lending of the program.

3. Copyright © Allyn & Bacon 2007 Advance Directives Documents that specify the type of health care an individual wishes to receive should that individual not be in a position to express his or her wishes in a critical situation Documents that specify the type of health care an individual wishes to receive should that individual not be in a position to express his or her wishes in a critical situation Living Will (introduced in 1968)Living Will (introduced in 1968) Self-Determination Act (state legislation started in 1976 in California)Self-Determination Act (state legislation started in 1976 in California) Established health care proxies and durable power of attorney clauses Established health care proxies and durable power of attorney clauses

4. Copyright © Allyn & Bacon 2007 Patient Informed Consent The legal right to refuse treatment The legal right to refuse treatment Patients must be given adequate information regarding: Patients must be given adequate information regarding: Nature of the proposed treatmentNature of the proposed treatment Probabilities of successProbabilities of success Possible side-effectsPossible side-effects Other treatment options (and no-treatment option)Other treatment options (and no-treatment option)

5. Copyright © Allyn & Bacon 2007 Living Will Advantages Advantages First advance directiveFirst advance directive Empowered individuals to make their choices knownEmpowered individuals to make their choices known Brought private, public, and professional awareness to end-of-life issues and decisionsBrought private, public, and professional awareness to end-of-life issues and decisions Disadvantages Disadvantages Can be ambiguous in interpretationCan be ambiguous in interpretation Doesn’t include provisions for assisted deathDoesn’t include provisions for assisted death May not be available to medical care providers when neededMay not be available to medical care providers when needed

6. Copyright © Allyn & Bacon 2007 The Patient Self Determination Act Started in California in 1976; now laws passed in every state Started in California in 1976; now laws passed in every state Recognizes a mentally competent adult’s right to refuse life support procedures Recognizes a mentally competent adult’s right to refuse life support procedures Patients were given the right to designate a person who would see that the advance directive is respected if they were unable to act in their own behalf Patients were given the right to designate a person who would see that the advance directive is respected if they were unable to act in their own behalf Designated person = a health proxyDesignated person = a health proxy Responsibility give the health proxy is durable power of attorney for health careResponsibility give the health proxy is durable power of attorney for health care

7. Copyright © Allyn & Bacon 2007 Facts about Advance Directives (Sabatino, 2005) They are legal in every state They are legal in every state One that is legal in one state is generally legal in all states One that is legal in one state is generally legal in all states Can change the wording of preprinted forms Can change the wording of preprinted forms A lawyer is not required to make it a legal document A lawyer is not required to make it a legal document It doesn’t restrict treatment efforts within accepted medical standards; allows for pain control and comfort care It doesn’t restrict treatment efforts within accepted medical standards; allows for pain control and comfort care Health care providers are legally obligated to follow it Health care providers are legally obligated to follow it

8. Copyright © Allyn & Bacon 2007 A Right Not to Die? The Cryonics Alternative Available since 1967 Available since 1967 Choosing to have your certified dead body placed in a hypothermic (frozen) condition for the possibility of resuscitation at a later time Choosing to have your certified dead body placed in a hypothermic (frozen) condition for the possibility of resuscitation at a later time No attempts have been made (yet) to resuscitate from a cryonic state No attempts have been made (yet) to resuscitate from a cryonic state First person to chose a cryonic alternative was a psychologist, Dr. James H. Bedford First person to chose a cryonic alternative was a psychologist, Dr. James H. Bedford

9. Copyright © Allyn & Bacon 2007 The Cryonics Alternative: Three Purposes or Visions Restoring a “dead” person to continue his/her life where it had left off (perhaps with a cure to their terminal illness) Restoring a “dead” person to continue his/her life where it had left off (perhaps with a cure to their terminal illness) Equipping the reanimated with a body that will be resistant to aging and other forces of mortality Equipping the reanimated with a body that will be resistant to aging and other forces of mortality Reanimating the brain so that it may grow a new body in the future Reanimating the brain so that it may grow a new body in the future

10. Copyright © Allyn & Bacon 2007 Cryonics: Radical New Developments Neural Preservation (head only) has replaced whole-body Neural Preservation (head only) has replaced whole-body Focus is on brain preservationFocus is on brain preservation A body can be regenerated from neural DNAA body can be regenerated from neural DNA The cooled tissues are vitrified (transformed to a stone-like substance) The cooled tissues are vitrified (transformed to a stone-like substance) Replaces water inside cells with antifreeze compoundsReplaces water inside cells with antifreeze compounds Temperature is dropped to -130 degrees CelsiusTemperature is dropped to -130 degrees Celsius Flesh turns into a form of glassFlesh turns into a form of glass

11. Copyright © Allyn & Bacon 2007 Organ Donation Kidneys and livers are the most needed Kidneys and livers are the most needed Restraining influences on the number of successful transplantations: Restraining influences on the number of successful transplantations: Willingness of people to donateWillingness of people to donate Condition of the donated organsCondition of the donated organs Biological match between donor and recipientBiological match between donor and recipient Overall condition of the recipientOverall condition of the recipient Expense and timely deliveryExpense and timely delivery

12. Copyright © Allyn & Bacon 2007 Organ Donations Approximately 7,000 people donate organs while they are still alive (such as donating a kidney) Approximately 7,000 people donate organs while they are still alive (such as donating a kidney) Victims of fatal motor vehicle accidents are one of the most available sources Victims of fatal motor vehicle accidents are one of the most available sources About 75,000 people are on the waiting list is the U.S. at any given time About 75,000 people are on the waiting list is the U.S. at any given time Demand and short supply creates: Demand and short supply creates: DiscriminationDiscrimination ConflictConflict Illegal sales of organs to affluent clientsIllegal sales of organs to affluent clients

13. Copyright © Allyn & Bacon 2007 Funeral-Related Decisions Funeral homes are required to provide a price list Funeral homes are required to provide a price list Do thorough comparison shopping Do thorough comparison shopping Be aware of additional charges for additional services and products Be aware of additional charges for additional services and products Do not hesitate to inquire about simple and immediate burials or about cremation Do not hesitate to inquire about simple and immediate burials or about cremation The most expensive item in a traditional funeral is the casket The most expensive item in a traditional funeral is the casket Use good judgment to resist services or products that your family really doesn’t want Use good judgment to resist services or products that your family really doesn’t want

14. Copyright © Allyn & Bacon 2007 Glossary: New Terms Advance Directive Advance Directive Cryonics Cryonics Cryostasis Cryostasis Durable Power of Attorney for Health Care Durable Power of Attorney for Health Care Health Care Proxy Health Care Proxy Informed Consent Living Will Patient Self- Determination Act Physical Restraints