1/75. Death in the home: the doctor's responsibility.The role physicians assume when patients die at home is nebulous and ill defined. Beyond the traditional function of providing comfort and condolence to family members, the physician's duties are directed toward how our society deals with the bureaucratic and legal aspects of death. statistics are maintained regarding the numbers of deaths in municipalities and states and the causes of death, and those numbers are used by individuals and organizations for a multitude of legal, medical, and political purposes. The state also has an obvious interest in uncovering and prosecuting crime. The physician has a vital part to play in providing essential medical information for those record-keeping, statistical, and legal purposes. physicians need to be mindful of the important functions being served when they are asked to complete death certificates and to report cases and provide information to the medical examiner. As with many other physician activities, the information we provide about our patients' deaths serves a singular societal need; thus, we should view that function not as a burden but as a vital aspect of the enriching and enobling work that is uniquely ours.- - - - - - - - - - ranking = 1keywords = death (Clic here for more details about this article) |
2/75. Near death: a nurse reflects.After reading about near-death phenomena in the December issue, this nurse was inspired to share her own experience. Her story and observations may help you better understand and help patients who've been to the brink of death and back.- - - - - - - - - - ranking = 1.2keywords = death (Clic here for more details about this article) |
3/75. injections and the fear of death: an essay on the limits of biomedicine among the Dagomba of northern ghana.This article offers a cultural ("indigenous") explanation of why people in their quest for therapy sometimes reject biomedicine. The argument is that in the current debate over the power of biomedicine, there is a lack of scrutiny of its "failures", i.e. of why people occasionally refuse to accept the offers of biomedicine and its most powerful therapy, injection-therapy. After introducing the problem, the relevant literature and the methods used, the article proceeds by first using historical material regarding vaccination campaigns and the treatment of endemic diseases in ghana and comparative data from elsewhere in africa to show that people may be ambivalent and have a mixed view of the power of biomedicine. In the context of their experiences, people (possibly, in particular, older ones) have come to know both the (early) failures as well as the successes of injection-therapy. Turning to the ethnographic present (1990-1997) the record of Dagomba notions of health and illness as well as two cases are analyzed to define this ambiguity also among younger members of Dagomba culture. Thus, the article oscillates between ethnography and history to define people's ambivalence and the conflict between biomedicine and local understandings.- - - - - - - - - - ranking = 0.8keywords = death (Clic here for more details about this article) |
4/75. Clinical supervision, death, Heidegger and Freud come 'out of the sighs'.In his recent paper on clinical supervision, 'Out of the sighs' - an existential-phenomenological method of clinical supervision: the contribution to palliative care', in this journal, Jones weds psychoanalytical ideas with Heidegger's existential-phenomenological concepts to provide a theoretical framework for clinical supervision in palliative nursing. Although this is an interesting undertaking, theoretical diversity is not a simple matter of merely interchanging concepts. Rather, it is a complex process that must account for varying philosophical assumptions upon which any theory attempts to explain or understand reality. This paper examines the major themes identified by Jones. In particular, it focuses on the spirit of ontological hermeneutics and psychoanalysis, represented by their respective founders, Heidegger and Freud, and in general, refers to other thinkers and ideas mentioned by Jones - as for instance, Schon's reflective practice, Polanyi's personal commitment, Husserl's lived experience, Schutz's intersubjectivity and Yalom's existential disidentification. Here, discussion concerns the subject-object polarity. The paper argues that many of these philosophies are incompatible. In particular, psychoanalysis and existentialism imply inconsistent aims in that psychology does not equate with fundamental ontology - and Jones has not adequately distinguished between these in his supervision discourse. The implications of the accompanying conceptual problems for the practice of clinical supervision in palliative nursing are exemplified by Jones's case study of Lindsey, a dying patient.- - - - - - - - - - ranking = 0.8keywords = death (Clic here for more details about this article) |
5/75. Is it ethical to practice intubations on the deceased?One-third to one-half of emergency departments in the united states and australia perform endotracheal intubations (ETI's) on the newly dead. Sixty-three percent of emergency medicine and 58% of neonatal critical care training programs allowed procedures to be performed on patients after death; only 10% of these programs required family consent for this practice. This article reviews the arguments for and against this ethical issue. A case study is included to highlight the issue's complexity, and to assist readers in identifying their beliefs (and those of their institutions) about the tissue. An overview of ethically related terms, definitions, and theories and a decision-making model are included to establish a knowledgeable baseline for dealing with any ethical issue.- - - - - - - - - - ranking = 0.24141344834792keywords = death, dead (Clic here for more details about this article) |
6/75. At one with death: destructive narcissism.In this paper, narcissism is considered to be the relation of self with an idealized internal object, and narcissus's romance with his reflection is taken to be a two-party affair. Destructiveness, an inborn capability, is distinguished from destructive narcissism, a two-party situation between the self and a sadistic internal figure built on the idealization of power. Too often, only half the narcissistic pair is analyzed. The internal object becomes the persecutor of self, while the sadism of self, projected onto the persecutor, goes unanalyzed. This paper takes up a clinical solution: how the analysis can seize the destructive internal object and resolve it down to its nucleus, the self.- - - - - - - - - - ranking = 0.8keywords = death (Clic here for more details about this article) |
7/75. life after death: a practical approach to grief and bereavement.This consensus paper describes the essential skills that clinicians need to help persons who are experiencing grief after the death of a loved one. Four aspects of the grieving process are reviewed: anticipatory grief, acute grief, normal grief reactions, and complicated grief. Techniques for assessment and recommendations about interventions and indications for referral are provided for each aspect.- - - - - - - - - - ranking = 1keywords = death (Clic here for more details about this article) |
8/75. Cardiac death after autologous stem cell transplantation (ASCT) for treatment of systemic sclerosis (SSc): no evidence for cyclophosphamide-induced cardiomyopathy.In patients with systemic sclerosis (SSc) treatment-related mortality after autologous stem cell transplantation (ASCT) appears to be increased as compared to patients with hematological malignancies. In our phase I/II study on ASCT in autoimmune diseases a patient with SSc died on day 2 after ASCT. Here we report the results of the autopsy which revealed advanced pulmonary and cardiac fibrosis as the most probable cause of death. In spite of detailed technical examination before enrollment, the cardiopulmonary function tests did not reflect the advanced stage of the disease. We conclude that in selected patients with SSc, biopsies should be performed to reduce mortality after ASCT.- - - - - - - - - - ranking = 1keywords = death (Clic here for more details about this article) |
9/75. Sperm harvesting and post-mortem fatherhood.The motives and consequences of harvesting sperm from brain dead males for the purpose of effecting post mortem fatherhood are examined. I argue that sperm harvesting and post mortem fatherhood raise no harms of a magnitude that would justify forbidding the practice outright. Dead men are not obviously harmed by the practice; children need not be harmed by this kind of birth; and the practice enlarges rather than diminishes the reproductive choices of surviving partners. Certain ethical and legal issues nevertheless require attention. As a matter of consistency with other harvesting protocols, there ought to be a mechanism for respecting the wishes of men who when alive do not wish to become fathers post mortem. Mechanisms governing entitlement to harvest and use sperm will also be required. I note that the law is unlikely to recognize the paternity of children born from harvested sperm, though there may be reasons to recognize that paternity in some instances.- - - - - - - - - - ranking = 0.041510155918973keywords = dead, brain (Clic here for more details about this article) |
10/75. When is dead, dead? The ethics of resuscitation in emergency care.Each year thousands of people suffer a cardiac arrest. technology, care provider education, and emergency services access have made it possible to successfully resuscitate many patients. The outcome however, may not always be positive for the patient or their family. This article looks at the ethics of resuscitation and how to determine when to start and stop resuscitation so that patients, families, and emergency care providers may make informed and acceptable decisions related to resuscitation and its potential outcomes.- - - - - - - - - - ranking = 0.33130758678337keywords = dead (Clic here for more details about this article) |
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