1. Discovering the Lifespan - Robert S. Feldman Copyright © 2009 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. Chapter 9: Death and Dying Module 9.2 Confronting Death

2. Discovering the Lifespan - Robert S. Feldman Copyright © 2009 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. CONFRONTING DEATH

3. Discovering the Lifespan - Robert S. Feldman Copyright © 2009 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. Are there steps toward death? Kübler-Ross Developed a theory of death and dying Built on extensive interviews with people who were dying With input from those who cared for them 481

4. Discovering the Lifespan - Robert S. Feldman Copyright © 2009 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. Kübler-Ross Theory 481

5. Discovering the Lifespan - Robert S. Feldman Copyright © 2009 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. Evaluating Kübler-Ross’ Theory PROS One of first people to observe systematically how people approach their own deaths Increased public awareness and affected practices and policies related to dying CONS Largely limited to those who are aware that they are dying Less applicable to people who suffer from diseases in which the prognosis is uncertain Stage-like increments questioned Anxiety levels not included 482

6. Discovering the Lifespan - Robert S. Feldman Copyright © 2009 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. Other Theorists Edwin Shneidman –“Themes” in people’s reactions to dying that occur—and recur—in any order throughout the dying process Charles Corr –People who are dying face a set of psychological tasks 482

7. Discovering the Lifespan - Robert S. Feldman Copyright © 2009 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. Should people be free to select the nature of their own death?

8. Discovering the Lifespan - Robert S. Feldman Copyright © 2009 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. Choosing the Nature of Death DNR –Issues Differentiates of “extreme” and “extraordinary” measures from those that are simply routine Determines of individual’s current quality of life and whether it will be improved or diminished by a particular medical intervention Determines of decision-maker role 483

9. Discovering the Lifespan - Robert S. Feldman Copyright © 2009 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. Doctors and Decisions 483 Medical personnel are reluctant to suspend aggressive treatment. Physicians often claim to be unaware of patients’ wishes Physicians and other health care providers may be reluctant to act on DNR requests –Trained to save patients –To avoid legal liability issues

10. Discovering the Lifespan - Robert S. Feldman Copyright © 2009 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. Living Wills Health care proxy Durable power of attorney See figure 9-2 on page 485 for an example of a living will… 485

11. Discovering the Lifespan - Robert S. Feldman Copyright © 2009 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. Euthanasia and Assisted Suicide Euthanasia –Passive –Voluntary active Assisted suicide –Kevorkian 485

12. Discovering the Lifespan - Robert S. Feldman Copyright © 2009 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. What are the arguments? PROSCONS 485

13. Discovering the Lifespan - Robert S. Feldman Copyright © 2009 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. Caring for the Terminally Ill Place of Death –Home care –Hospice care –Hospital care 486

14. Discovering the Lifespan - Robert S. Feldman Copyright © 2009 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. Review and Apply REVIEW Elisabeth Kübler-Ross has identified five steps toward dying: denial, anger, bargaining, depression, and acceptance. Issues surrounding dying are highly controversial, including the degree of measures that physicians should apply to keep dying patients alive and who should make the decisions about those measures. 487

15. Discovering the Lifespan - Robert S. Feldman Copyright © 2009 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. Review and Apply REVIEW Assisted suicide and, more generally, euthanasia are highly controversial and are illegal in most of the United States, although many people believe they should be legalized if they are regulated. Although most people in the United States die in hospitals, increasing numbers are choosing home care or hospice care for their final days. 487

16. Discovering the Lifespan - Robert S. Feldman Copyright © 2009 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. Review and Apply APPLY Do you think assisted suicide should be permissible? Other forms of euthanasia? Why or why not? 487