Developmental Psychology - Dying and Bereavement - CH 16

Summary

This script delves into the multifaceted aspects of death and dying, highlighting cultural perspectives and the clinical definitions of death. It explores the differences between clinical death and whole brain death, the role of bioethics, and the evolving concept of euthanasia. The script also discusses the stages of grief as outlined by Elisabeth Kubler-Ross and the unique challenges of grief in various life stages. It touches on the importance of advance healthcare directives and the grieving process, emphasizing the individuality of each person's experience with loss.

Takeaways

• 🌟 Cultural perspectives on death and mourning vary widely, with different practices like New Orleans Jazz Funerals, Ghanaian coffins, and Catholic funeral services reflecting these differences.
• 🏴 Clinical death is characterized by the absence of heartbeat and respiration, which can sometimes be reversed, unlike whole brain death where the brain has irreversibly ceased functioning.
• 🧠 A glucose metabolism study can distinguish between clinical death, whole brain death, and a persistent vegetative state by measuring brain activity levels.
• 📜 Bioethics has emerged to address ethical questions in end-of-life care, including decisions around ventilator use and living conditions, stemming from cases like Karen Ann Quinlan's.
• 调 Euthanasia is divided into active and passive forms, with active euthanasia involving a deliberate action to end life due to terminal illness, while passive euthanasia involves forgoing treatment.
• 💊 Physician-assisted suicide is a regulated process requiring multiple requests, mental competency, and the ability for the patient to self-administer the medication.
• 🌐 In some countries, there are dedicated programs and facilities for end-of-life care, providing a more structured approach to euthanasia compared to the United States.
• 👵 Grief and mourning are distinct; grief is the emotional response, mourning is the cultural expression of that grief, and bereavement is the state of loss.
• 👶 Children's understanding of death is limited by their developmental stage, with pre-operational children struggling with the concept of death as permanent and magical.
• 🧓 As people age, their perception of death changes, with younger adults often feeling a sense of unfairness when others die young, while older adults may view death as a natural part of life.
• 👴 The death of a parent, particularly for adult children, can lead to a significant loss of support and guidance, with the impact varying based on the child's age and the parent's role in their life.
• 📝 Legal documents like living wills, durable power of attorney for health care, and DNR orders are crucial for communicating end-of-life preferences and ensuring they are respected.

Q & A

How do cultural perspectives on death and dying vary globally?

Cultural perspectives on death and dying can vary significantly. Some cultures may view death as a celebration of the beginning of another life, like the Egyptians, while others may focus on the grief associated with the passing of a person. The script mentions examples such as the New Orleans Jazz Festival, customized coffins in Ghana representing one's life, and a traditional Catholic funeral service, illustrating the diversity in cultural practices surrounding death.

What is the clinical definition of death?

Clinical death is defined as a lack of heartbeat and respiration. It is a reversible state, meaning that people can be brought back from clinical death, which is often referred to as 'coming back from the dead' in common language.

How is whole brain death different from clinical death?

Whole brain death is characterized by an irreversible loss of brain function, where there are no more EEG wave patterns, indicating that the brain has died. This is different from clinical death, which is a temporary state of no heartbeat and no respiration but can be reversed.

What is the role of bioethics in end-of-life decisions?

Bioethics involves ethical questions and decisions about life, including the quality of life and the conditions under which people are kept alive. It plays a significant role in discussions about keeping people on ventilators, living conditions, and individual rights to make decisions about their lives, as seen in the case of Karen Ann Quinlan.

What are the two types of euthanasia recognized in the United States?

The two types of euthanasia are active and passive. Active euthanasia involves deliberately ending one's life due to a terminal illness, while passive euthanasia is the desire to not pursue further treatment, such as stopping dialysis or chemotherapy.

How does physician-assisted suicide work in states where it is legal?

Physician-assisted suicide requires a terminal illness diagnosis by more than one person to prevent mistakes. The patient must make oral and written requests separated by at least 15 days and be declared mentally competent. The patient must also self-administer the dose under the guidance of a healthcare professional.

What are the stages of grief as described by Elisabeth Kübler-Ross?

The stages of grief, according to Elisabeth Kübler-Ross, are denial, anger, bargaining, depression, and acceptance. It's important to note that not everyone goes through all these stages or in this exact order, but these are the most commonly observed emotional reactions.

How does the concept of a 'final scenario' influence how people plan for their end-of-life?

A 'final scenario' is a concept where individuals envision how they would like their end-of-life to be, including their funeral and any specific wishes they have. This plan helps provide closure for both the dying person and their family and is often respected to encourage future generations to honor similar wishes.

What is the importance of a living will and durable power of attorney for healthcare?

A living will is a formal document that outlines an individual's preferences for life-sustaining treatments. A durable power of attorney for healthcare designates a person to make healthcare decisions on the individual's behalf if they are unable to do so. These legal instruments are crucial for ensuring that an individual's end-of-life wishes are respected and followed.

How does grief manifest differently across various age groups?

Grief manifestations vary by age group. Preschoolers may not understand the finality of death and grieve in short bursts. Adolescents may experience a heightened awareness of mortality after the death of a peer. Young adults may feel cheated out of life when they lose a partner. The death of a child, regardless of the parent's age, often results in a profound and lasting grief. The loss of a parent can lead to a significant shift in an individual's support system.

What is the significance of discussing grief and mourning in the context of different cultures and age groups?

Discussing grief and mourning across cultures and age groups helps to highlight the diversity of human experiences and the importance of understanding these differences in end-of-life care, mental health support, and social interactions. It also underscores the need for sensitive and informed approaches to supporting individuals and families through the grieving process.