The Basics of Death and Dying

1. The Basics of Death and Dying Unpleasant, but nonetheless inevitable

2. Death: • The is the termination of the biological functions that sustain a livingorganism • Caused by (ultimately) by lack of oxygen to the brain • Can occur in various ways • It is VERY difficult to have a “moment of death” • Process • Many organs, cells, systems must cease • Biophysical/metabolic processes stop • All results in oxygen deprivation to the brain • Exception- SUDDEN death • Catastrophic occurrence

3. Topic Terminology: • Murder: Ending the life of a person who wished to be alive • Kill: Lawfully or unlawfully ending the life of a person • Mercy Killing: Ending the life of a person without their explicit request in the belief that it is the only compassionate thing to do (this term is loosely used to describe all acts of euthanasia) • Suicide: Deliberately ending one's own life • Assisted Suicide: Providing someone else with the means, such as drugs or other agents, for them to take their own life (assisted suicide differs from euthanasia in that it is only assistance)

4. Continued: • Physician Assisted Suicide: A doctor providing the lethal drugs with which a dying person may end their life • Euthanasia: Helping yourself or someone else have a good death (euthanasia differs from assisted suicide in that it is actively participating - rather than assisting - a person end their life) • Types of Euthanasia: • Passive Euthanasia: Deliberately disconnecting life support equipment, or stopping any life-sustaining medical procedures, to permit the natural death of the patient ("passive" refers to an act that indirectly causes death) • Active Euthanasia: Deliberately taking action that directly end the life of a dying patient to avoid further suffering ("active" refers to an act that directly causes death)

5. Active Voluntary Euthanasia: A lethal injection by a doctor into a dying patient when the patient has consented to it • Active Non-voluntary Euthanasia: A lethal injection by a doctor into a dying patient when the patient's consent is unknown (usually a patient who is no longer able to communicate) • Active involuntary Euthanasia: A lethal injection by a doctor into a dying patient when the patient has refused (this is so-called "Nazi euthanasia")

6. Other Important Terminology: • Hospice: A program of care for a person in the last six months of life, providing pain management, symptom control, and family support (palliative care is the medical term for hospice) • Double Effect: Giving large amounts of opiate drugs to a patient to relieve pain while at the same time recognizing that these will hasten death • Slow Code: The deliberate slow response to a medical alert of heart or breathing stoppage which is designed to make resuscitation impossible (also known as "blue code") • Persistent Vegetative State: A severely brain-damaged person in a permanent coma from which they will not recover (the person is almost always on life-support systems) • Coma: Prolonged unconsciousness from which a patient may or may not recover