Care at The End of Life

CARE AT
THE END
OF LIFE
EUTHANASIA AND PHYSICIAN
ASSISTED SUICIDE
One’s values regarding life and
death are reflected in how one dealt
with the dying. If one cannot bear to
see suffering, then one resorts to an
“advance” death, such in
euthanasia, suicide, or physician
assisted suicide.
- CARE AT THE END OF LIFE
If one sees life as the highest value with
death as a form of human defeat, or if
one is overly influenced by available
new technology and biological idolatry
then one does everything to prolong life
beyond one’s one time and this is
known as dysthanasia.

On the other hand, if one sees death as
the culmination of a good life, to be
valued only until its natural end, one
looks for a good death this is
orthothanasia.

MOMENT OF DEATH
Inevitable and critical moment when organism ceases to
function as specified, unified, homeostatic system and
becomes disorganized into a mere collection of
heterogeneous chemical substance. To know that body is
disorganized we must at least become sure of three things:
MOMENT OF DEATH
• The body does not now exhibit specific human behavior.

• The body does not function humanly in the future.
• The body has no more radical capacity for human functions
due to its lost of basic structure required for human unity.
MOMENT OF DEATH
The third reason is necessary due to the fact
that medical experience had shown that
persons who are in coma nevertheless have
sometimes recovered full human
consciousness. Such resuscitation is possible,
however, after true human death some cells or
even organs of the human body for a time by
artificial respirator, continue to exhibit some
life functions but these functions are not those
of human organism but simply a residual life at
level of organization similar to a plant or animal.
Thus, the essential point of determining human death is not to decide whether
any life is present, but whether human life in the most radical sense of a
unified human person is still present.
• life force of cell is no longer united to the matter with which it was at
any times united.
• religious orientation, the separation of the body and the soul
(medically, it is understood as, body’s lack of sensation and
self-movement.
• the lose of touch irrevocably with a person who previously was able to
communicate and to share our human community of thought, of love,
of freedom and or creativity.
1. Human organism is irreversibly
dysfunctional and dead
2. Less conclusive, absence of breathing and

heartbeat
-SIGNS OF DEATH
SIGNS OF DEATH
Now, the signs are not a guaranteed bases and
signs of death due to some technological
advancement that is perfected to aid the lungs
and heart to functions artificially as in
resuscitation.
an artificial sustained heart and lung activity is
not a proof that human life still remains. That is
why as long as this heart and lung is sustained by
mechanical device that runs it artificially the
traditional bases of death is impossible to verify.
SIGNS OF DEATH
Aside from the new technology used, another
reason is the possible organ transplant of heart
and kidney. It is said to be that the success of
transplanting of heart will likely to be very
successful if the organs to harvested from a body
through which blood is circulating. Hence,
surgeons, kept the body alive in the respirator.
So then, how is it possible to be sure that the

donor is in fact dead?
1. cardiovascular clinical signs (this is used when the person is not attach
to respirator. Thus, reliance on technology must be moderated rather than
encourage)
2. the new clinical sign must be ascertained by the well-trained

professionals (basis must be properly observed. That is for no less than 24
hours when it uses the EEG or electroencephalogram as it is done in the
USA: Harvard Criteria for Brain Death of 1968, this is used to person who is
under a hypothermia and drug-induced coma. But today, short intervals is
now allowed within 6 hours, and the EEG is being replaced by an
Angiogram it is an apparatus to test the blood flow in the cerebellum of the
patient)
-SIGNS OF A DEAD PERSON

Angiogram Electroencephalogram
TYPES OF DEATH
1. Euthanasia means an action/omission
which of itself or by intention causes
death, in order that suffering may be
eliminated. It procures/imposes death
before one’s time.
Types of Euthanasia:
•Voluntary and involuntary (patient’s initiative)
•Active and passive (healthcare provider’s initiative)
Human life must be promoted because we are as
stewards of it. Filipinos have seen that disabled
newborn as “good luck” and caring a sick person is a
privilege. In solidarity, one can’t abandoned, replaced,
worst of all, kill another person. May it be in the name of
economy, practicality, compassion or autonomy.
procuring death is a perversion of a diseased society
made worse if done by a family or healthcare provider.
-EUTHANASIA
TYPES OF DEATH
2. Dysthanasia is the delaying or postponing death

beyond its natural time by all means available
Dysthanasia is popular for the following reasons:
• Doctor’s training (reasons: treating is more comfortable than not
treating, doctor’s felt guilty to abstain, death of patient is seen as a
failure of management).
• Technologic imperative (reasons: advances and success pushes the
doctor to use everything, that is, malignant over-diagnosis and
over-treatment. It is also biology rather then personhood is the object
of medical attention).
• Ignorance (reasons: proxy’s are unaware of the distinction between
killing and letting die; lack of information with regard on prognosis pain
high quality of end of life care, the best place to die).
Dysthanasia is popular for the following reasons:
• Hospital culture (reasons: rights of patients are considered as

preference rather than directives).
• Fear (reasons: doctor’s worry about on the accusation of legal liability
and malpractice if everything were not done).
• Philippine culture (to add in the Filipino hospital context) (reasons: the
Filipino non-confrontational attitude makes all concern hesitate to hear
‘badnews’, instead the ‘status quo’ is the main focus).
Living should not be a penalty to be
prolonged at all cost. To cause suffering
unnecessarily in unworthy of trust and
respect the healthcare provider has.
PRIORITY OF USING THE LAST MOMENT OF LIFE MUST BE

GIVEN TO FINISH ONE’S OWN RESPONSIBILITIES TO OTHERS.

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CARE AT

- CARE AT THE END OF LIFE

- CARE AT THE END OF LIFE

• The body does not now exhibit speciﬁc human behavior.

2. Less conclusive, absence of breathing and

So then, how is it possible to be sure that the

2. the new clinical sign must be ascertained by the well-trained

-SIGNS OF A DEAD PERSON

2. Dysthanasia is the delaying or postponing death

• Hospital culture (reasons: rights of patients are considered as

PRIORITY OF USING THE LAST MOMENT OF LIFE MUST BE

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