Exam (elaborations)
Psych 160 Final Kondrad Questions answers latest update
- Course
- PSYCH 160
- Institution
- James Madison University
Psych 160 Final Kondrad Questions answers latest update
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Psych 160 Final KondradAdvanced Directive - legal document that outlines what kind of medical care you
want/don't want if you can't tell the medical staff
DNR - a doctor's order per patient wishes that no CPR if heart stopsor if you
stopbreathing; can be separate from AD. It does not apply to anything else, does
not mean not to treat.
living will - one type of AD that describes treatments you want or do not want if
you're terminally ill or permanently unconscious.
Durable power of attorney - another kind of AD that identifies who can make
decisions for you under certain circumstances. Not recognized as legal in some
states. Proxy needs to be aware!
Difficulty with AD - •Difficulty determining how long someone has to live. Would
you try life-lengthening drugs if it would give you another 10 years vs. 1 year?
•How do you know if someone can or can't make decisions on their own?
•Determining coma vs. persistent vegetative state can be hard.
•Don't bring me back to life vs. don't try to save me if I'm dying?•Is the person
pregnant? If in late pregnancy, your wishes take 2nd fiddle.
•Will quality of life be improved or diminished by a medical procedure?
,•Only half of patients have wishes entered on charts. •Medical professionals
often claim (truthfully or not) that they didn't know, because they are trained to
save or extend life, not permit death. Hard to plan for every possibility.
What to have in your AD - •Ventilation -if, and for how long, a machine takes over
your breathing.
•Tube feeding -if, and for how long, you get stomach or IV feeding tube
•Palliative care (comfort care) -comfort and manages pain. •Organ donation -
donate your organs, tissues, etc. for patients/research
•Dialysis -if, and for how long a machine removes waste •Choosing not to have
aggressive medical treatment is different from refusing all medical care.
•Comfort may prolong life: antibiotics, oxygen, nutrition, pain med
Janet Adkins - Seven years after Adkins' suicide, Oregon (1997) became the first
state to make it legal for physicians to prescribe lethal medications to help
terminally ill patients end their lives; the Death With Dignity Actwas upheld by the
United States Supreme Court in 2006. Two physicians must confirm the patient's
residency, diagnosis, prognosis, mental competence, and voluntariness of the
request. Two waiting periods, the first between the oral requests, the second
between receiving and filling the prescription, are required. Studies show these
safeguards prevent misuse.
Dr. Jack Kevorkian - Dr. Death helped with assisted suicide
Responses to those opposed to assisted suicide - •Personal autonomy = not
imposing own moral/religious beliefs on others
,•Coercion = studies in OR and Netherlands don't support
•Elderly/mentally ill vs. non-vulnerable groups•Rates of assisted dying were no
different between groups
•Because of safeguards, difficult to abuse
•No evidence that natural death assisted is a "better" experience •Research on
dying patients indicates that a good death is considered one in which the personal
values are congruent with how death occurs
•Mistakes about prognosis •Doctors are usually overly optimistic about life
expectancies for those with advanced and incurable diseases
Palliative Care - provided at point of diagnosis of serious illness•Team of doctors,
social workers, chaplains; nursing homes, outpatient, hospitals
Home care - •Stay in home, treated by family and visiting medical professionals
•Untrained family members may provide less than optimal care, costly, difficult
Hospital for terminally ill - Impersonal, rotating staff, many die alone, costly
hospice care - •Make last days comfortable, no focus on extending life, few
treatments
•Costly, usually only take patients very close to death, ~ 6 months or less
Signs of active dying - Active dying = end is very near, within 3 days usually
•Coolness of skin, color changes, fever
, •Confusion, increasing time spent sleeping, difficult to rouse•Incontinence,
congestion/gurgling, change in breathing, gasping
•Urine, fluid, food decrease
•Withdrawal, unresponsive, restlessness, hallucinations
•Out-of-character requests, seeking permission to let go
•Children have a similar process, but it can be harder to predict. They often stay
fairly active and continue to ask a lot of tough-to-answer questions.
Grief healthy vs not - Normal, healthy vs. Atypical, unhealthy
•OK = listlessness, sadness, can't concentrate, withdrawal.
•Get help = suicidal thoughts, persistent negativity, worthlessness, gets worse not
better, can't function/focus on anything else
hostile attribution bias - the tendency to perceive hostile intent in others
Assertive Discipline - spanking, yanking, slapping, yelling.
could result in bad parent children relations, increased risk for child abuse, etc.
death in infancy and childhood - US is worse than 50 other countries. car accident
most common
death in adolescence - --Personal Fable
-Understand mortality, but "Can't happen to me"
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