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Chapter 13

PSYC 3490 Chapter 13.docx

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York University
PSYC 3490
Nadiah Habib

Chapter 13: Dying and Bereavement Definitions and Ethical Issues -dictionary definition: the transition between being alive and being dead, dying is the process of making this transition Sociocultural Definitions of Death -people around the world view death differently, the experiences of our culture may not be generalizable to others -death can be a truly cross-cultural experience and can be viewed in many ways socioculturally, death can be viewed as:  An image or object: tombstone, sympathy card  A statistic: mortality rate, murder rate  An event: funeral, family gathering  A state of being: time of waiting, being with god  As fear and anxiety: “will dying be painful?”, I worry about my family  An analogy: dead as a door nail, dead-end street  A mystery: will we meet family? , what is it to die?  A boundary: you can’t come back, what do I do now?  A thief of meaning: I feel cheated, I have much left to do  A reward and punishment: live long and prosper, the wicked will go to hell Legal and Medical Definations -Clinical death: Lack of heart beat and respiration, has been used for centuries as the criteria for death -Brain death: a neurological determination of death which should be made before death was confirmed includes eight specific criteria, all of which must be met (Refer to table 13.1):  No spontaneous responses to any stimuli  No spontaneous respiration for at least 1 hour  Lack of responsiveness to even the most painful stimuli  No postural activity, swallowing, yawning, or vocalizing  No eye movements, blinking, or pupil responsiveness  No motor reflexes  A flat EEG for at least 10 minutes  No change in any of these when tested again 24 hours later -persistent vegetative state: cortical function to cease while brainstem activity continues, from which the person does not recover Ethical Issues -Bioethics: examines the interaction between human values and technological advances, the most important bioethical issue is euthanasia -Euthanasia: the practice of ending life for reasons of mercy, two types of euthanasia are:  active euthanasia: deliberately ending someone’s life through some sort of intervention or action which may be based on a clear statement of the person’s wishes or a decision made by someone else who has the legal authority to do so, such as administering a drug overdose or disconnecting a life-support system)  passive euthanasia: ending someone’s life by withholding available treatment (for example, withholding chemotherapy for cancer patient) -Living will and durable power of attorney, personal preferences for medical intervention, the purpose of both is to make one’s wishes about the use of life support known in the event one is unconscious or otherwise incapable of expressing them – These can also serve as the basis for Do Not Resuscitate (DNR) medical order which is used when cardiopulmonary resuscitation is needed The Price of Life-Sustaining Care -A growing debate concerns the costs for keeping someone alive through technology and includes financial, personal, and moral costs, such that these people will die anyways -The most obvious are financial costs which are usually staggering, personal emotional costs are often underestimated, but can be devastating and long-lasting Thinking About Death: Personal Aspects A Life-Course Approach to Dying -Young adults report a sense of being cheated by death -Middle-aged adults begin to confront their own mortality and undergo a change in their sense of time lived and time until death -Older adults are more accepting of death Dealing with One’s Own Death KUBLER-ROSS’S THEORY -Kübler-Ross’s theory includes five stages that represented the ways in which people dealt with death: denial, anger, bargaining, depression, and acceptance  The first reaction is likely to be shock and disbelief – Denial is a normal part of getting ready to die  At some point people express anger as hostility, resentment, frustration, and envy, “Why me?”  In the bargaining phase, people look for a way out or a person sets a timetable, “Just let me live until my daughter graduates from college”  When one can no longer deny the illness, feelings of depression become common  In the acceptance stage, the person accepts the inevitability of death and often seems detached from the world and at peace -It is important to note that some people do not progress through all of these stages, and some people move through them at different rates and people may be in more than one stage at a time and do not necessarily go through them in order A CONTEXTUAL THEORY OF DYING -Emphasizes the tasks and issues that a dying person must face, and although there may be no right way to die, there are better or worse ways of coping with death -Corr identified four dimension of tasks that must be faced, bodily needs, psychological security, interpersonal attachments, and spiritual energy and hope Death Anxiety -complex, multidimensional construct -terror management theory addresses the issue of why people engage in certain behaviours to achieve particular psychological states -death anxiety is a reflection of one’s concern over dying, an outcome that would violate the prime motive -components of death anxiety included: pain, body malfunction, humiliation, rejection, non-being punishment, interruption of goals, and negative impact on survivors  Any of these components can be assessed at any of three levels: public, private, non-conscious -being afraid to die means that we often go to great lengths to make sure we stay alive, as argued by terror management theory HOW DO WE SHOW DEATH ANXIETY -Death anxiety is demonstrated in many different ways, including avoidance of things connected with death  Such as refusing to go to funerals  Directly challenging death, such as engaging in dangerous sports -Less common ways to express death anxiety include daydreaming, changing one’s lifestyle, using humour, displacing anxiety onto work, becoming a professio
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