Lesson 7: Bio-Medical Perspective Attention
Learning Outcomes Upon completion of this lesson's material, students will be able
Teaching Begin Reading: Facing Death: Images, Insights, and Interventions Chapter 1: Establishing the Perspective
And the New York Time’s brief report regarding Terri Schiavo. The overriding themes of this lesson are the medical definitions and statistical information regarding death and dying. Biological, anatomical, physiological and underlying mechanisms of health and disease will be explored. Students will explore these concepts by examining “health” and the functions of a healthy human; and, “death” / “dying” and the functional issues involved in these processes. What do these terms mean, in medical terms? Or, social terms? The functions of a healthy human suggest an understanding of the underlying mechanisms of life and death, health and disease. Read this article regarding The Ethics of Ending Life: Euthanasia and Assisted Suicide The Center for Disease control and Prevention compiled data in a report spanning 75 years in the United States, 1935-2010. Key findings of the 75 Years of Mortality in the United States are as follows:
What explanations can you offer for these differences? What was happening in the United States during this time period? What was changing? Use the bio-psycho-social model to better understand the interconnectedness of these improvements and/or changes. Reductions in deaths and death rates are often used as an indicator of the success of public health initiatives to improve the health and well-being of the U.S. population, as well as to set national goals for reducing disparities in the burden of mortality across groups. Anti-tobacco campaigns, AIDS prevention programs, and cancer screening promotions all use lives saved as a measure of success. What other historic phenomenon was occurring during this time period? What about wars, epidemics, cultural upheavals, counter-culture movements and improvements in technology? Death From: http://medical-dictionary.thefreedictionary.com/Death Definition Death is defined as the cessation of all vital functions of the body including the heartbeat, brain activity (including the brain stem), and breathing. Description Death comes in many forms, whether it be expected after a diagnosis of terminal illness or an unexpected accident or medical condition. Terminal illness When a terminal illness is diagnosed, a person, family, friends, and physicians are all able to prepare for the impending death. A terminally ill individual goes through several levels of emotional acceptance while in the process of dying. First, there is denial and isolation. This is followed by anger and resentment. Thirdly, a person tries to escape the inevitable. With the realization that death is eminent, most people suffer from depression. Lastly, the reality of death is realized and accepted. Causes and symptoms The two leading causes of death for both men and women in the United States are heart disease and cancer. Accidental death was a distant third followed by such problems as stroke, chronic lung disorders, pneumonia, suicide, cirrhosis, diabetes mellitus, and murder. The order of these causes of death varies among persons of different age, ethnicity, and gender. Diagnosis In an age of organ transplantation, identifying the moment of death may now involve another life. It thereby takes on supreme legal importance. It is largely due to the need for transplant organs that death has been so precisely defined. The official signs of death include the following:
Current ability to resuscitate people who have "died" has produced some remarkable stories. Drowning in cold water (under 50 °F/10 °C) so effectively slows metabolism that some persons have been revived after a half hour under water. What is life? What is death? When do we pass from one to another, and can we move back and forth? Who decides when someone is alive? Dead? What are some factors in evaluating ‘treatment’? A valuable resources to explore is: http://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm This document contains the Detailed Tables for the National Vital Statistics Report (NVSR) “Deaths: Final Data for 2013.” Death in the United States
Number of deaths for leading causes of death:
Source: Deaths: Final Data for 2013, tables 1, 7, 10, 20 The CDC Wonder interactive tool to explore the underlying cause of death of groups between the years 1999-2013 can be found here: http://wonder.cdc.gov/controller/datarequest/D76 The CDC also explores conditions that are often present when “disabilities” are present, what do these co-occurring conditions indicate in a holistic picture of health?
All individuals need preventative health care and health programs & interventions for the same reasons—to stay well, active, and a part of the community. Being healthy means the same thing for all of us—getting and staying well so we can lead full, active lives. That means having the tools and information to make healthy choices and knowing how to prevent illness. These correlated indicators, called: secondary conditions can include pain, depression, and a greater risk for certain illnesses. Secondary Conditions People with physical or mental conditions are often at greater risk for other health problems that can be prevented. Some of these other health conditions might include:
http://www.cdc.gov/ncbddd/disabilityandhealth/relatedconditions.html Issues regarding Bio-medical Ethics and Death and Dying
Review this article/website and listen to the podcast. Review the resources on this website: https://cbhd.org/resources Assessment
Lesson 7 Jouranl Entry Examine ideas related to dying and death in health care settings, end-of-life ethics, dying as it relates to terminal or life-threatening illness and the concepts of grief and loss related. What is your opinion re: the two cases at the beginning of the lesson (Munoz & Schiavo)? Discuss your thoughts & feelings re: the cases, and then briefly take the opposite stance and present an argument for the ‘other side.’ Lesson 7 Discussion The lesson resources estimated, at that time, that up to $5000/day for ‘health-care’ costs may accrue for patients for whom the definition of death becomes unclear. Assess health care practices with which you are familiar, and as mentioned in this lesson, based on your understanding of the biological and social factors that contribute to definitions of death/life present your view on health care practices for cases for which death/life can be debated. (You may want to look at Dying on Life Support: is it fair?) Lesson 7 Quiz
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