Fear of the Unknown: Enlightened Aid-in-Dying

Fear of the Unknown: Enlightened Aid-in-Dying

Fear of the Unknown: Enlightened Aid-in-Dying

Fear of the Unknown: Enlightened Aid-in-Dying

Synopsis

How do doctors and nurses communicate with frightened patients who are dying, address the needs and concerns of the patients, and help the patients arrive at an acceptance of death? This work deals with the relationship that the health care team has with the dying and how well that team is prepared to address the fears of the dying. In addition, the health care team must learn to deal with their own emotions and ignorance concerning death. This work should be of interest to those professions that deal closely with dying people.

Excerpt

As recently as thirty years ago, death was a taboo subject. At that time Geoffrey Gorer was able to argue that it was an "unmentionable" subject (Gorer 1965), that, like venereal disease or other social diseases, polite people did not talk about. In recent years, however, it has cornered us and has forced itself even into minds that had been closed to it.

One primary cause of death's present impact on our minds is the advances made in medical technology. In earlier times, people died in their homes surrounded by familiar and loved things and family. Now they die in hospital beds amid strangers and machines. The dramatic change in the locus of death has concentrated the thoughts of the nation on dying and death. Medical technology, often prolonging the dying process, also has concentrated thought on the right to refuse life-prolonging treatment, on the acceptance of do-not-resuscitate orders and dying with dignity. Medical technology, which also makes harvesting organs from cadavers and major organ transplantation viable options, has drawn the nation's attention further to the religious and ethical issues involved in the criteria for heart death and brain death. All fifty states now have some legislation regarding advance directives, in which patients give instructions relating to the termination of medical care should they become incapable of making choices. In 1991 Congress enacted the Patient Self-Determination Act to apprise patients of their rights to execute advance directives. In 1990, in the "right to die" case of Cruzan v. Director, Missouri Department of Health (497 U.S.261, 111 L.Ed. 224, 110 S. Ct. 841 [1990]), which involved the termination of artificial feeding for a woman in a persistent vegetative state, the U.S. Supreme Court held that, under the federal Constitution, an individual has . . .

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