Deck 6: End-Of-Life Issues and Decisions

Question 1

"Transplantation tourism" refers to:

A) organ donations that are obtained from tourists who experience fatal accidents while traveling
B) a recent documentary that focuses on the increase in abductions of tourists who are forced to undergo organ transplantation
C) a surge in the number of individuals who when faced with the need for an organ transplant will travel to other countries such as India in order to access this procedure.

Answer 1

C

Question 2

When first introduced in 1968, the living will proved to be limited in its effectiveness because:

A) instructions were not specific enough
B) instructions did not cover all possible situations
C) obeying the living will was not required by law
D) all of the above.

Answer 2

D

Question 3

An issue that influenced the initial implementation of the living will included that:

A) the documents were too specific regarding the list of heroic measures allowed
B) medical care professionals might not have been aware that a patient had a living will
C) physicians were strongly in favor of abiding by living wills, whereas nurses were strongly against such restraints
D) all of the above.

Answer 3

B

Question 4

The Patient Self-Determination Act:

A) requires that patients make an advance directive or living will
B) recognizes a mentally competent adult's right to refuse life-support procedures and the right to select a proxy
C) makes it illegal to give another person the durable power of attorney for health care
D) establishes penalties for health-care providers and agencies who do not obey a patient's advance directive.

Question 5

In a survey conducted by the University of Rochester (2002) of college students enrolled in history of sociology and medicine classes, findings indicated that:

A) African-American students were the least likely to request a DNR order
B) Hispanic students were the least likely to request life-sustaining measures
C) students who self-identified as atheist were the most likely to request a DNR order
D) both a and b.

Question 6

According to Charles P. Sabatino (2005), an attorney who specializes in advance directives:

A) an advance directive legal in one state generally will be legal in all others
B) pain control and comfort care would be continued regardless
C) a form approved by our home state can be revised to better express our preferences
D) all of the above.

Question 7

A health-care proxy is:

A) a state law allowing physicians to withdraw from a case and allow another physician to take the case
B) the person with the ability to represent our wishes and see that they are fulfilled if we are unable to do so ourselves
C) the patient who is unable to make his or her wishes known in a life-threatening situation
D) an attorney who will settle the estate of a patient refusing medical treatment.

Question 8

The term CAD refers to:

A) a national group, Citizens Against Dying, that has advocated for fair treatment of patients who are dying
B) a more comprehensive advance directive that combines a broad range of end-of-life options
C) alternative versions of an advance directive document that have been developed by various groups of concerned and informed citizens
D) both b and c.

Question 9

According to the Vermont Ethics Network, a CAD should address specific care wishes such as if an individual wants:

A) sufficient pain medication even if it would hasten death
B) hospice care when dying, if possible and appropriate
C) to die at home if this is possible
D) all of the above.

Question 10

As a follow-up to the results of the original SUPPORT study conducted in 1995, in 2007 a research team investigated the role of advance directives and determined that:

A) physician communication with the patient and family remained the same without an advance directive
B) emotional support improved for patients with an advance directive
C) more people with an advance directive were on a respirator or intubated for feeding
D) about a quarter of the patients with advance directives experienced inadequate pain control.

Question 11

More recent SUPPORT study findings also indicated that:

A) seven out of ten individuals did have an advance directive
B) those who died in hospitals were least likely to have an advance directive
C) bereaved family members felt that doctors were doing a better job of keeping them informed
D) both a and b.

Question 12

Despite strides that have been made with the Patient Self-Determination Act, informed consent and living will patients still feel rushed into making an informed decision especially when:

A) health-care professionals are under pressure
B) the overall quality of health care is inadequate
C) physicians feel compelled to "doctor" the information that they are willing to share with a patient
D) all of the above.

Question 13

A common myth about Walt Disney is that he:

A) lost a parent during childhood
B) died before he was able to fulfill his dreams
C) was placed in cryostasis, which is the practice of having one's dead body placed in a hypothermic (frozen) condition

Question 14

The first person to choose to have his certified dead body placed in a hypothermic condition, James Bedford, was a:

A) physician
B) sociologist
C) psychologist
D) Hollywood celebrity.

Question 15

Advocates who believe that it is possible to maintain the bodies of deceased people at a very low temperature for longer periods of time and later restore them to life are supportive of the following approach:

A) cathartic
B) charismatic
C) cryonic
D) colonic.

Question 16

Attempts to extend life:

A) began more recently when genetic/stem cell research opened the door to this possibility
B) began in the nineteenth century by physicians who believed that the practice of importing monkey glands into one's body would extend one's life span for many more years
C) extend as far back as pretechnological times when magical spells, secret rituals, and experiments with a variety of substances and concoctions were utilized.

Question 17

The cryonics procedure cannot begin until:

A) a physician has certified that a patient is dead
B) the deceased has been certified as dead for more than 24 hours
C) family members have had the opportunity to confirm that the body is intact.

Question 18

Scientists believe that at this point in time:

A) no person has actually been placed in this condition
B) people have been placed in this condition, but no attempts have been made to reanimate
C) a few attempts have been made at reanimation, but none have succeeded
D) Swedish scientists claim to have reanimated a person, but with no lasting results.

Question 19

All of the following represent major changes in cryonics EXCEPT:

A) head-only preservation has replaced whole-body preservation
B) water in the cells are replaced with antifreeze compounds
C) cooled tissues are transformed into a custard-type substance; water in the cells is replaced with antifreeze compounds
D) the temperature is lowered to -130 Celsius.

Question 20

The practice of vitrification is intended to:

A) establish the definitive cause of death
B) allow for the preservation and regeneration of a whole body from neural DNA
C) expedite the organ transplantation process
D) none of the above.

Question 21

The organs most sought for transplantation are:

A) kidneys and livers
B) hearts and kidneys
C) pancreas and livers
D) heart-lung sets.

Question 22

At any one time, the number of patients in the U.S. on the waiting list for an organ transplant is estimated to be:

A) 25,000
B) 120,000
C) 150,000
D) 300,000.

Question 23

According to Tuttle-Newhall et al. (2009), the approximate number of deaths each year due to waiting for an organ transplant is:

A) 18
B) 25
C) 30
D) 50.

Question 24

Each of the following factors influences the number of successful transplantations EXCEPT:

A) willingness of people to donate
B) the condition of donated organs
C) biological match between donor and recipient
D) willingness of health-care professionals to impose on grieving survivors.

Question 25

The most common type of organ donor is a:

A) living person who donates to a family member or others that s/he knows
B) cadaveric donation
C) living person who is likely to survive an anatomical gift (such as a kidney).

Question 26

At least one study has reported the illegal but prospering sale of organs from living human donors taking place in:

A) the United States
B) Thailand
C) India
D) Japan.

Question 27

Cross-cultural research on organ transplantation has indicated that:

A) in Japan, where the exchange of gifts is woven into the social fabric, the donation of an organ such as a kidney, while a distinctive and nontraditional gift, would be viewed as expected behavior
B) in America, from a Christian perspective, offering an organ would be a matter of personal choice
C) in China, from a Confucian perspective, an organ donation is likely to be viewed as a morally praiseworthy act
D) both a and c.

Question 28

When registering as a prospective organ or tissue donor, the participation of a disinterested witness is required when a person:

A) makes or amends an anatomical gift
B) revokes or refuses such a gift
C) is not eligible to receive an anatomical gift and is not a relative or guardian of the person making the decision
D) all of the above.

Question 29

When it comes to planning a funeral, public interest groups such as AARP recommend that:

A) whatever your loved one would have wanted should be honored regardless of expense
B) a written list of prices should be requested and compared before making a final decision
C) the options of simple and immediate burial and cremation should also be explored
D) both b and c.

Question 30

The single most expensive part of a traditional funeral is the:

A) musicians
B) minister or the one officiating the service
C) flowers
D) casket.

Question 31

The famous composer Johann Sebastian Bach's end-of-life activities serve as a powerful example of:

A) the crudeness of the medical knowledge known at that time about mental illness
B) what happens when a dying person gives up hope
C) how mental and emotional processes can still be sharp even though one's physical body may be failing
D) how cruel a misdiagnosis can be.

Question 32

Renewed interest in end-of-life decision-making has re-emerged in recent times due to the increasingly widespread application of life-support systems and the emergence of the hospice care movement.

Question 33

According to one study, health-care professionals who worked with terminally ill people had a greater likelihood of working through their own thoughts and feelings about end-of-life decisions.

Question 34

A living will, the first advance directive, was introduced in the United States in 1992.

Question 35

Introduced in 1991, the Patient Self-Determination Act (PSDA) is a state law in California that has since been copied by most other states.

Question 36

The term durable power of attorney for health care refers to a legal attorney who has been assigned responsibility for making health-care decisions for an individual who is no longer able to do so.

Question 37

The PSDA allows patients to choose which treatment option they prefer, but it does not allow a patient to choose to have no treatment at all.

Question 38

Despite the opportunity to complete advance directives, research indicates that members of ethnic groups who have a tendency to distrust the health-care system and a reluctance to disclose their feelings to strangers have a low rate of participation in the advance directive process.

Question 39

Available research has validated the lingering fear in the medical tradition that people just cannot deal with dying and death.

Question 40

CAD stands for "Combined Advanced Directive."

Question 41

Cryonics as an alternative to the traditional death system has been available since 1967.

Question 42

Bedford, a renowned physician, was the first person to test the possibilities of cryonic preservation and restoration with his own body.

Question 43

The switch in the cryonics movement to neural vitrification was partly done in order to save space and money.

Question 44

Currently there are fewer than 100 cremains in the world that are awaiting reanimation in the future.

Question 45

All organ donors must have registered their wishes and be certified as dead before their organs can be harvested.

Question 46

Victims of fatal motor vehicle accidents are some of the most available sources of organ transplants.

Question 47

In the medical community one of the greatest concerns surrounding organ donation is the practice known as "donation after cardiac death" (DCD) which had led to increased worry that brain death will be certified prematurely in order to advance the removal and transplantation of organs.

Question 48

One suggestion for resolving the issue of competition in organ donation is to operate a survival lottery for people on a list who are waiting for an organ.

Question 49

Funeral homes are not required to provide price lists prior to a funeral arrangement.

Question 50

Generally, obituary notices and music are included as part of the overhead cost of a funeral service.

Question 51

Unbeknown to many consumers, individuals who wish to purchase a casket from the Internet or any other outside source for use during their funeral service cannot be charged extra by a funeral home for doing so.

Question 52

What is the definition of the terms

-Anatomical gift

Question 53

What is the definition of the terms

-Cryonics

Question 54

What is the definition of the terms

-Combined advanced health-care directive

Question 55

What is the definition of the terms

-Cryostasis

Question 56

What is the definition of the terms

-Disinterested witness

Question 57

What is the definition of the terms

-Durable power of attorney for health care

Question 58

What is the definition of the terms

-Health care proxy

Question 59

What is the definition of the terms

-Informed consent

Question 60

What is the definition of the terms

-Living will

Question 61

What is the definition of the terms

-Patient Self-Determination Act

Question 62

What is the definition of the terms

-Physical restraints

Question 63

Explain the difference between a living will and durable power of attorney for health care.

Question 64

Discuss the major findings from the study of college students in history of medicine and sociology classes at the University of Rochester.

Question 65

According to attorney Charles P. Sabatino, what should individuals know about advance medical directives and other decisive steps about end-of-life decisions?

Question 66

List the five sections of the combined advance directive and briefly discuss the advantages of this form.

Question 67

List the general findings from the follow-up study conducted by a research team who focused on the role of advance directives more than a decade after the original SUPPORT study was conducted and after the introduction of the Patient Self-Determination Act.

Question 68

Explain the historical progression of cryonics, its goals, and the substantive concerns that it raises.

Question 69

Explain the concept and process of "neural vitrification."

Question 70

Describe the situations of organ donation that lead to competition, tension, and controversy.

Question 71

List the five primary factors that serve to currently restrict the number of successful organ transplants.

Question 72

List four of the six suggestions Kastenbaum gave regarding funeral-related financial decisions.