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Lecture 9

PSY333H1 Lecture Notes - Lecture 9: Forego, First Nations, Assisted Suicide


Department
Psychology
Course Code
PSY333H1
Professor
Nevena Simic
Lecture
9

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according to current estimates, the average canadian will live to about 81 years of age and will die of something that he or she
knew about 5-10 years before actually dying !
- Despite it's good life expectancy Canada's infant mortality rate is high, 5/1000, higher for aboriginals and low SES families.!
- Sudden Infant Death syndrome SIDS, is a major cause of infant death, could be related to sleeping position or smoking during
pregnancy!
- instructuing parents to put babies to sleep on their backs has helped reduce SIDS, !
- Deaths under 15 often attributed to autormobile accidents, poisonings or accidnts in the home !
- Young adults diagnosed with Cancer or other terminal illnesses express acute feelings of injustice!
- Sudden deaths may be better because they are assoicated with limited pain and less financial burden and less deterioration!
- A good death is one that is free from avoidalbe suffering for paitens, families and carevgivers in general acccordance with the
patients' and family's wishes!
- Some people decide to forego treatement without being motivated by a depressive disorder!
- euthanasia or physician assited dying is an issue of major concern!
- Important to differentiate between withether the choice is genuine or the result of insufficient care or even influence and
coersion from doctors !
- Kubler Ross' five stage model of death, denial, anger, bargaining, depression, acceptance!
DENIAL: defense mechanism adaptive at the beginning but needs to move over to realization!
ANGER: WHY ME!!!!???!!!!!!!!!!!?!!!!
BARGAINING: pacts with God!
DEPRESSION; Accepting things won't change!
Acceptance: coming to terms with the diagnosis and eventual outcome !
THANATIVE CARE INVOLVES CARING FOR THE DYING, WITH REGARDS TO THERAPY, UNLIKE NORMAL THERAPY
THIS IS MORE SHORT TERM, REFRAINING FROM DISCUSSIN G TISSUES THAT THE PATIENT FINDS UNCOMFOROTABLE
OR DOES NOT WANT TO TALK ABOUT SHOULD BE RESPECTED. !
CAring for Terminal children represents new challenges which is why,Clinicans do limited rotations with the children due to the
psychological effects. !
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People who are left after their loved ones have past are in particular need of help to deal with the grieving process, This includes
children who can sometimes feel responsible for the death of a loved one, it's important to stop thinking of death as taboo and
to tackle the issue of the dying and those who care for them. !
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Avery Weisman outlined goals for medical staff when dealing with death!
1. Informed Consent: patients to be told the nature of their condition and treatement!
2. Safe Conduct: the physician and other staff should act as helfpful guide for the patient!
3. Significant survival: the physician and other staff should help the person do the best with the time he/she has left!
4. Anticipatory Grief: patient and family members should be aided in working through their anticipatory sense of loss and
depression!
5. Timely and appropriate death: the patient should be allowed to die when and how he or she wants to as much as possible. The
patient should be allowed to achieve death with dignity!
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TERMINAL ILLNESS!
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psychological issues in advancing and terminal illness!
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cancer #1 cause of death in Canada, then heart problems, stroke, respiratory, and accidents !
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Death as a function of Age!
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Average Canadian life expectancy: 80.3 years!
-World wide; 78 years!
Beginning of the 20th century: 47.3 years!
- Why the huge increase? !
death from acute illnesses!
decreased infant mortality !
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1940: 47 deaths/ 1000 live births!
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2006: 6.7 deaths/1000 live births !
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Infant mortality rate: ratio of deaths to live births 5.1/1000 births (stats canada) !
Relatively high compared with Western Europe !
- Used to be in 6th place --> 24th in 2007 !
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Effects of SES!
4.0/1000 in richest neighborhood!
6.5/1000 in poorest (stats Canada, 1996) !
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Effects of Culture!
- First nations> non first nations, supersede SES !
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Birth to 1 year: congenital abnormalities and Sudden infant death syndrome (SIDS) !
- SIDS 3 babies die/week in Canada (2005) !
babies simply stop breathing!
more likely to occur in lower-class urban environments, when mom smoked during pregnancy, when baby is put to sleep on
stomach!
- Back to sleep campaign (1999) reduced SIDS by ~50% !
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From Ages 1-15, the causes shift to accidents (i.e. poisonings, falls) childhood lekeumia!
- leukemia: cancer of bone marrow --> excess white blood cell+ severe anemia (80% survival rate today!)!
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Children's Understanding of Death!
- Up to age 5: death as "great sleep"!
No understanding of death as final / irreversible!
No fear- they are curious!
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- Age 5-9: Death as final may develop!
Most children fail to understand the biology of detah.!
some children believe death is a shadowy figure (devil or ghost)!
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- 9-10: "death is universal and inevitable" !
Understand processes that go along with death!
Realize that person will not return !
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Death in young adulthood !
Leading causes of death for youth (aged 15 to 24):!
1. Unintentional injury (usually automobile accidents)!
2. Suicide!
3. Cancer!
4. Homicide!
Leading cause of death for yojng black males!
- Heart/ Respiratory diseases and congenital abnormalities !
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Diagnosis of terminal illness --> long and drawn out period of dying b/c fewer biological competitors for death !
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Death in middle age!
- Death becomes more realistic for two reasons:!
- More common!
- Development of chronic health problems ultimately leads to death !
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Premature death: death that occurs before age 79 !
- Main cause is heart attack or stroke (brain attack)!
- death rates on the decline - less smoking! !
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Midlife Crisis!
- May occur in the 40's or 50's!
- Stems from realization of impending death!
- Set off by death of a parent, friend, or bodily signs that one is aging!
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