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Chapter 9:
Death and Dying
Module 9.2
Confronting Death
Discovering the Lifespan - Robert S. Feldman
Copyright © 2009 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved.
CONFRONTING DEATH
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
Discovering the Lifespan - Robert S. Feldman
Copyright © 2009 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved.
Kübler-Ross Theory
481
Discovering the Lifespan - Robert S. Feldman
Copyright © 2009 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved.
Evaluating Kübler-Ross’ Theory
PROS
CONS
• One of first people to
observe systematically
how people approach
their own deaths
• Increased public
awareness and affected
practices and policies
related to dying
• 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
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
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?
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
Discovering the Lifespan - Robert S. Feldman
Copyright © 2009 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved.
Doctors and Decisions
• 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
483
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
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
Discovering the Lifespan - Robert S. Feldman
Copyright © 2009 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved.
What are the arguments?
PROS
CONS
485
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
Discovering the Lifespan - Robert S. Feldman
Copyright © 2009 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved.
Review and Apply
487
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.
Discovering the Lifespan - Robert S. Feldman
Copyright © 2009 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved.
Review and Apply
487
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.
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
Discovering the Lifespan - Robert S. Feldman
Copyright © 2009 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved.