Death and Dying Exam 2 – Flashcards
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By acknowledging the inevitability of death we
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can prepare for it.
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In which of the following is the individual's right to autonomy violated?
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An older man whose physician and family coerce him to have foot surgery
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Three principles of medical ethics are
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autonomy, beneficence, justice.
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What is a fundamental principle in medical care which involves doing good or conferring benefits that enhance personal or social well-being?
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Beneficence
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What is a fundamental principle in medical care which is the injunction to "do no harm?"
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Nonmaleficence
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Informed consent is based on a patient's competency to give consent, adequate understanding of proposed treatment, and
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consent must be given freely.
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What year did informed consent achieve formal legal definition?
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1957
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Informed consent ideally occurs within a context where the
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patient and health-care provider share in decision making.
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A study in 1961 found that, __________ doctors had a strong tendency to withhold information.
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most
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The SUPPORT STUDY was designed to
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assess communication between physician and patient at the end-of-life.
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Patients at the end-of-life may not want disruptive medical interventions. The preference can be recognized in a medical setting by designating the patient as
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comfort measures only.
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Ethical questions regarding the "right to die" first came to public attention in the landmark court case involving
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Karen Ann Quinlan.
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All of the following occurred with Karen Ann Quinlan EXCEPT
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the Supreme Court of New Jersey ruled in favor of the hospital officials and Karen remained on the respirator.
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The controversy surrounding the Karen Ann Quinlan case centered on the
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right to forgo life-sustaining treatment.
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What position did the state of Missouri initially take in the Nancy Beth Cruzan case?
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It contended that Nancy's parents did not have the right to remove artificial feeding.
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What is a state of profound unconsciousness lasting a few days or weeks?
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Coma
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What disorder of consciousness has been characterized as "awake but unaware" and also has been called "hopelessly conscious?"
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Vegetative state
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The case of Terry Schiavo was compounded by the fact that
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she had not completed her advance directive.
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Studies of the Oregon Death with Dignity Act show that the decision to request a prescription for lethal medication was associated mainly with patients' concerns about loss of dignity, loss of ability to have an enjoyable life, and loss of
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autonomy.
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Currently, physician-assisted death is permitted by legislation enacted in
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Oregon and Washington.
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In May 2013, which state senate passed and the governor signed the Patient Choice and Control at End-of-Life Act?
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Vermont
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Which act allows physicians to prescribe lethal medication to terminally ill patients?
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Oregon Death with Dignity Act (ODDA)
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Who provided aid-in-dying to more than 100 people and led a crusade to legalize physician-assistant suicide?
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Jack Kevorkian
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In the medical management of pain, what rule states that a harmful effect of treatment, even if it results in death, is permissible if the harm is not intended and occurs as a side effect of a beneficial action?
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Rule of double effect
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Euthanasia comes from the Greek
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easy death.
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Which industrialized countries are identified in the text as permitting euthanasia to patients who request death?
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2.Netherlands and Belgium 3. Belgium and Luxembourg
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Which of the following statements presents a case against euthanasia using the "wedge" or "slippery slope" argument?
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"Euthanasia may or may not be moral, but by permitting it we may unwittingly pave the way for acts that are clearly immoral."
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Which of the following is a statement by a competent person about choices for medical treatment, should he or she become unable to make such decisions or communicate them in the future?
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Advance directive
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An advanced directive is best defined as
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any statement made by a competent person about choices for medical treatment, should he or she become unable to make or communicate such choices.
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The living will is a
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type of advance directive.
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A living will allows an individual to
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refuse life-sustaining treatment in the event he or she is terminally ill.
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Which state became the first to adopt a Natural Death Act giving legal recognition to the living will?
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California
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Which state was the first to give legal recognition to the living will?
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California
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Which organization created the Five Wishes document?
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Aging with Dignity
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What document combines a living will and a health care power of attorney?
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Five Wishes
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The Patient Self-Determination Act requires providers of services under Medicare and Medicaid to do which of the following
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Inform patients of their rights to appoint a health care proxy and draw up written instructions regarding treatment.
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According to Barton Bernstein, the first legal stage in cases of terminal illness
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. involves the patient in long-range planning and arranging legal and financial affairs.
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According to Barton Bernstein, the second legal stage in cases of terminal illness involves which of the following activities?
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Medical personnel being notified if the dying patient intends to make an organ donation or anatomical gift
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What type of will is made orally?
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Nuncupative will
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A codicil relates to
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amending a will.
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What is the condition when a person dies without having left a valid will?
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Intestate
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The conventional written legal document used for specifying a person's wishes for the distribution of his or her estate after death is a/an
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formally executed will
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How can a will be amended?
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By executing a codicil.
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In attempting to settle an estate, the court will make a determined effort to locate heirs. If none can be found the proceeds go to the
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state.
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If a person dies without leaving a valid will, his or her property will be distributed according to
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state rules
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According to the laws of intestate succession, when no surviving heirs can be found, then proceeds from the estate go to
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the state.
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The potential benefits of life insurance include all of the following EXCEPT it
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increases social security benefits.
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In the United States, the first insurance company was established
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by the Presbyterian Synod for its ministers.
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When was the first life insurance company established in the United States?
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1759
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What type of settlement allows a person with terminal illness to sell his or her life insurance policy before death and receive a percentage of its face value?
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viatical
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Personal autonomy is restricted when passengers on an airline are required to wear seat belts.
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TRUE
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Physicians in the 1960s tended to withhold information regarding a life threatening condition.
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TRUE
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The New Jersey Supreme Court allowed Karen Ann Quinlan's parents to discontinue her artificial respiration
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TRUE
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In the case involving Nancy Beth Cruzan in 1990, the Missouri Supreme Court ultimately ruled that her parents could have her feeding tube removed.
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TRUE
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The right to refuse treatment remains constitutionally protected even when a patient is unable to communicate.
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TRUE
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Passive euthanasia is the bringing about of death through the administration of lethal injection.
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FALSE
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There is no medical or ethical distinction between withholding and withdrawing treatment.
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TRUE
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Some people view removal of artificial nutrition and hydration as intentional killing.
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TRUE
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By the end of the twentieth century, less than half of the U.S. had passed some form of living will legislation
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FALSE
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Most Americans lack living wills.
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TRUE
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Living wills contain physician orders and must be followed by emergency medical technicians.
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FALSE
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The health care proxy must be an attorney not a relative to carry out your wishes.
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FALSE
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Do-not-resuscitate orders are a type of advance directive.
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TRUE
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Paramedics and EMT's are legally required to initiate CPR unless there is clear evidence of a valid DNR order.
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TRUE
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State laws specify a minimum age of 21 to make a legal will.
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FALSE
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Financial advisors do not recommend the "family love letter" as it often contains emotional information and confuses EOL issues and personal desires after death.
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FALSE
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Ethical wills are a twentieth century, new means to pass on wisdom, love, and personal values.
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FALSE
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Statistics show that most people die without leaving a will.
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TRUE
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End-of-life issues and decisions are a private matter bearing directly on families and do not affect the realm of public policy.
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FALSE
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What current illness symbolizes the worst fears about dying?
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Cancer
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Which of the following terms BEST describes the process of a person who questions, "Am I responsible for bringing this illness on myself?"
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Magical thinking
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Corr's primary dimensions in coping with dying are physical, psychological, spiritual, and
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social.
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Which statement best reflects the closed awareness context of family interactions in response to a life-threatening illness?
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The dying person is not aware of his or her impending death although others may know about it.
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According to Glaser and Strauss, which of the following communication styles are used by families when a family member is diagnosed with a life-threatening illness?
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1. Closed awareness 2. Open awareness 3. Mutual pretense
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Which of the following statements is an example of the open awareness context of family interactions in response to a life-threatening illness?
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Death is acknowledged and discussed.
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Mutual pretense, as a way of coping with painful circumstances such as a terminal illness,
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can be a useful short-term strategy for coping with a painful situation.
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How many stages are associated with the model of coping with life-threatening illness presented by Elisabeth Kübler-Ross?
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Five
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In Kenneth Doka's "Tasks in Coping with Life-threatening Illness," which phase is characterized by living with the disease and managing symptoms and side effects?
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Chronic
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According to Kubler-Ross, all of the following are associated with a life-threatening illness EXCEPT
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belief
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According to Avery Weisman, the process of coping with a terminal illness can be divided into how many interrelated tasks?
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. Three
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According to Avery Weisman, coping with life threatening illness involves tasks of maintaining a sense of optimism and hope and confronting the problem and
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revising one's plans as necessary.
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The real estate wanted advertisement in the text is used to illustrate which of the following?
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Desires to accomplish plans that previously had been put off to be done in the future
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Which of the following are the three major psychological and behavioral patterns that individuals use in coping with the threat of death as identified by Therese Rando?
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1. Retreat and conservation of energy 3. Attempting to master or control the threat of death 4. Exclusion from the threat of death
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What is the aim of meaning-based coping?
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To maintain a person's sense of positive well-being
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The spreading of cancer to various parts of the body is known as
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metastasis.
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A biopsy is BEST defined as
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the surgical removal of a small amount of tissue for diagnosis.
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What is the oldest effective form of cancer therapy?
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Surgery
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Side effects experienced by patients receiving chemotherapy can include all of the following EXCEPT
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cyanotic lymph nodes
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The therapies included under complementary and alternative medicine are sometime referred to as
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integrative medicine.
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Bioenergetics, homeopathic medicine, and yoga are what form of cancer treatment option?
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Complementary and alternative therapies
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What is visualization?
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The patient imagines the therapeutic agent inside the body helping to restore well-being.
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What is ikigai ryoho?
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A psychotherapy that helps patients live fully and meaningfully
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What is ethnomedicine?
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Conventional biomedicine and folk beliefs
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What is the positive response to a treatment that a person believes to be an effective therapy?
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Placebo effect
