Death studies
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Comparative Study
End-of-life and palliative care issues in medical and nursing schools in the United States.
Medical and nursing schools in the United States have traditionally had a limited emphasis on end-of-life care. The present study is a comparison of these 2 professional programs' current offerings on death education. Data were gathered via a mailed survey from the 122 medical schools in 2005 and the 580 baccalaureate nursing programs in 2006. ⋯ Whereas nursing programs rely almost solely on nurses for end-of-life course provisions, medical schools are more interdisciplinary by faculty. End-of-life issues are presented in both medical and nursing curricula, though on a limited basis. This emphasis exposes students to the issues, though not in an in-depth way.
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Deciding for or against a life-prolonging treatment represents a choice between prolonged life and death. When the death alternative is not described, individuals must supply their own assumptions. ⋯ Beliefs were diverse, loneliness was commonly assumed, and palliation was rarely mentioned spontaneously. Results underscore needs for improved understanding of the dying process and palliative care and for fuller communication between patients and healthcare providers.
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A small proportion of deaths result from the use of drugs with the intention to hasten death without an explicit request of the patient. Additional insight into its characteristics is needed for evaluating this practice. In the Netherlands in 2001, questionnaires were mailed to physicians that addressed the decision making that preceded their patient's death. ⋯ Most of them were incompetent patients nearing death. Characteristics of this practice in 1995 were quite comparable, as were characteristics of this practice in Belgium, Denmark, and Switzerland. The use of drugs with the intention to hasten death without an explicit request of the patient is part of medical end-of-life practice in the studied countries, regardless of their legal framework, and it occurs in similar fashion.
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Comparative Study
Parental grief following the brain death of a child: does consent or refusal to organ donation affect their grief?
The purpose of this study was to investigate the grieving process of parents who were faced with the dilemma of donating organs and tissues of their underage brain dead child, and to explore the impact of their decision on their grief process. A grounded theory methodology was adopted and a semi-structured interview was conducted with 11 bereaved parents who consented to, and 11 parents who declined organ donation. ⋯ Consent or refusal of organ donation per se does not seem to affect the overall grieving process. It is the meaning attributed to the act of donation that affects how parents perceive the child's death and subsequently facilitate or hinder their adjustment to loss.
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Psychological intervention with the bereaved can provide critical assistance to individuals, families, and communities contending with the loss of significant others. In the organizational paradigm of the Two-Track Model of Bereavement, the outcome of both successful and problematic mourning are manifest along two distinct but interrelated tracks of functioning and relationship to the deceased. Reworking relationships to the deceased can help people resume authorship of their life narratives following loss. ⋯ The ongoing relationship with the complex of memories, thoughts, emotions, and needs associated with the person who has died is no less important. Although the domains of general functioning and relationship to the deceased are related, they are far from identical. Attending to the memories and emotions bound up with the deceased should continue to demand our sustained attention as therapists.