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Chapter 15 Psych

The document discusses several topics related to dying and death, including: 1. Elisabeth Kübler-Ross's stage theory of dying is not considered the final truth, as patients experience a variety of emotions and may not fully comprehend their fate, termed "middle knowledge." 2. Religious sources view good deaths as peaceful, surrounded by loved ones, relatively free of pain and anxiety, with a sense of control and closeness to loved ones. 3. Our culture expects mourning to last about a year, but chronic grief may be more common after traumatic events like losing a child or during cataclysmic events like the COVID-19 pandemic. 4. Hospitals'

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75 views2 pages

Chapter 15 Psych

The document discusses several topics related to dying and death, including: 1. Elisabeth Kübler-Ross's stage theory of dying is not considered the final truth, as patients experience a variety of emotions and may not fully comprehend their fate, termed "middle knowledge." 2. Religious sources view good deaths as peaceful, surrounded by loved ones, relatively free of pain and anxiety, with a sense of control and closeness to loved ones. 3. Our culture expects mourning to last about a year, but chronic grief may be more common after traumatic events like losing a child or during cataclysmic events like the COVID-19 pandemic. 4. Hospitals'

Uploaded by

kelemadu.15
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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Elisabeth Kübler Ross, in her stage theory of dying, proposed that people pass through denial,

anger, bargaining, depression, and acceptance when learning they have a fatal disease.
However, we cannot take this landmark theory as the final truth. Patients often shy away from
discussing death.

They may not want doctors to be totally honest about their prognosis. Dying people feel many
different emotions - especially hope. Rather than emotionally approaching death in "stages,'
people may experience a state called middle knowledge, both knowing and not fully
comprehending their fate. Even when they accept death, terminally ill people still have life goals.
Religious sources showcase the defining qualities of good deaths: It's best to die at peace after
a long life, surrounded by our loved ones. Specifically, people want to die relatively free of pain
and anxiety, feel in control » they die, and end their lives feeling close to their attachment
figures.

Believing that we have fulfilled our purpose in living and appreciating that death is part of the
universal human cycle of life is also important in accepting death.
Our culture has clear conceptions about typical mourning. After an initial period spent absorbed
with their loss, we expect people to recover emotionally after about a year. Mourners who still
show intense symptoms after this time are diagnosed with a controversial mental health
condition called persistent complex bereavement-related disorder, or chronic grief.

However, chronic grief may be typical in the face of cataclysmic events like
COVID-19 and especially when parents face the death of a child. In this traumatic situation, it
helps to openly discuss dying (if that child understands what is happening) and to keep the child
"alive" in one's thoughts. Transforming these deaths into a redemption sequence allows grieving
parents to restore a sense of life as predictable and fair. Marriages can become closer as
couples seek comfort from the one person who can understand their pain: their spouse.

The Health-Care System


A classic study of dying trajectories showed that, since dying doesn't proceed according to a
"schedule" - but medical personnel assume it does - the way hospitals manage death leaves
much to be desired. Because traditional medicine is focused on cure-at-all-costs, the pressure
to use futile heroic measures also impairs humane care at the end of life. Remedies include: (1)
offering end-of-life care instruction to health-care personnel (2) establishing palliative care
services; and (3) relocating dying from hospitals to home-based hospices.

Home hospices in the United States offer backup services that allow families to let their loved
ones spend their final months dying naturally, at home. Faraily caregivers can expect different
trajectories to death depending on the person's illness. They confront scary issues relating to
pain control. It may be hard for doctors and families to label patients as dying; also, minorities
may have unique hospice concerns. Home deaths may not be the best choice when
attachment-related issues, such as not wanting to burden loved ones, matter most to people
facing a fatal disease.
The Dying Person: Taking Control of How We Die
Advance directives provide information about whether to use heroic measures when individuals
can no longer make their treatment wishes known. These documents include the living will and
durable power of attorney for health care, filled out by the individual while healthy, and Do
Not Resuscitate (DNR) and Do Not Hospitalize (DNH) orders, filled out by surrogate! when
the person is mentally impaired. The best advance directive is the durable power of attorney, in
which a person gives a specific family member decision-making power to determine end-of life
care.
With active euthanasia and physician-assisted death, physicians move beyond passive
euthanasia (withdrawing treatments) to actively help fatally ill people who want to end their
lives. Paramount among the objections to legalizing active euthanasia is the idea that we may
open the door to killing people who don't really want to die.

A related issue is age-based rationing of care, whether to hold off on using expensive death-
defying technologies with people who are old-old. At this moment, age-based rationing of care is
poised to move center-stage in Western nations, as the massive baby boom cohort enters their
old-old vears. The timeless message of this chapter - and the book - is that love (or, in
developmental science terminology, our attachments) is at the core of human life.

CHAPTER 15

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