Dysthanasia

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In medicine, dysthanasia means "bad death" [1] and is considered a common fault of modern medicine. [2]

Medicine The science and practice of the diagnosis, treatment, and prevention of physical and mental illnesses

Medicine is the science and practice of establishing the diagnosis, prognosis, treatment, and prevention of disease. Medicine encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness. Contemporary medicine applies biomedical sciences, biomedical research, genetics, and medical technology to diagnose, treat, and prevent injury and disease, typically through pharmaceuticals or surgery, but also through therapies as diverse as psychotherapy, external splints and traction, medical devices, biologics, and ionizing radiation, amongst others.

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Dysthanasia occurs when a person who is dying has their biological life extended through technological means without regard to the person's quality of life. [3] Technologies such as an implantable cardioverter defibrillator, [4] artificial ventilation, ventricular assist devices, and extracorporeal membrane oxygenation can extend the dying process.

Quality of life (QOL) is an overarching term for the quality of the various domains in life. It is a standard level that consists of the expectations of an individual or society for a good life. These expectations are guided by the values, goals and socio-cultural context in which an individual lives. It is a subjective, multidimensional concept that defines a standard level for emotional, physical, material and social well-being. It serves as a reference against which an individual or society can measure the different domains of one’s own life. The extent to which one's own life coincides with this desired standard level, put differently, the degree to which these domains give satisfaction and as such contribute to one's subjective well-being, is called life satisfaction.

Artificial ventilation Assisted breathing to support life

Artificial ventilation, is means of assisting or stimulating respiration, a metabolic process referring to the overall exchange of gases in the body by pulmonary ventilation, external respiration, and internal respiration. It may take the form of manually providing air for a person who is not breathing or is not making sufficient respiratory effort on their own, or it may be mechanical ventilation involving the use of a mechanical ventilator to move air in and out of the lungs when an individual is unable to breathe on their own, for example during surgery with general anesthesia or when an individual is in a coma.

Ventricular assist device

A ventricular assist device (VAD) is an electromechanical device for assisting cardiac circulation, which is used either to partially or to completely replace the function of a failing heart. The function of VADs is different from that of artificial cardiac pacemakers; some are for short-term use, typically for patients recovering from myocardial infarction and for patients recovering from cardiac surgery; some are for long-term use, typically for patients suffering from advanced heart failure.

Dysthanasia is a term generally used when a person is seen to be kept alive artificially in a condition where, otherwise, they cannot survive; sometimes for some sort of ulterior motive.[ citation needed ] The term was used frequently in the investigation into the death of Formula One driver Ayrton Senna in 1994.[ citation needed ]

Death of Ayrton Senna

Three-time Formula One World Champion Ayrton Senna died on 1 May 1994 after his car crashed into a concrete barrier while he was leading the 1994 San Marino Grand Prix at the Autodromo Enzo e Dino Ferrari in Italy. The previous day, Roland Ratzenberger had died when his car crashed during qualification for the race. His and Senna's accidents were the worst of several accidents that took place that weekend and were the first fatal accidents to occur during a Formula One race meeting in twelve years. They became a turning point in the safety of Formula One, prompting the implementation of new safety measures in both Formula One and the circuit, as well as the Grand Prix Drivers' Association to be reestablished. The Supreme Court of Cassation of Italy ruled that mechanical failure was the cause of the accident, although this has been disputed.

Formula One is the highest class of single-seater auto racing sanctioned by the Fédération Internationale de l'Automobile (FIA) and owned by the Formula One Group. The FIA Formula One World Championship has been one of the premier forms of racing around the world since its inaugural season in 1950. The word "formula" in the name refers to the set of rules to which all participants' cars must conform. A Formula One season consists of a series of races, known as Grands Prix, which take place worldwide on purpose-built circuits and on public roads.

See also

Brain death is the complete loss of brain function. It differs from persistent vegetative state, in which the person is alive and some autonomic functions remain. It is also distinct from an ordinary coma, whether induced medically or caused by injury and/or illness, even if it is very deep, as long as some brain and bodily activity and function remains; and it is also not the same as the condition known as locked-in syndrome. A differential diagnosis can medically distinguish these differing conditions.

Death with Dignity National Center

Death with Dignity National Center is a 501(c)(3) nonpartisan nonprofit organization, headquartered in Portland, Oregon, that has led the legal defense of and education about Death with Dignity laws throughout the United States for 20 years. The Death with Dignity National Center helped write and defend in courts the nation's first successful assisted dying law, the Oregon Death with Dignity Act, protecting the right of persons with terminal illness to control their own death. The Death with Dignity National Center is affiliated with the Death with Dignity Political Fund, a distinct and separately incorporated 501(c)(4) organization responsible for the promotion of death with dignity legislation in other states around the U.S.

Euthanasia is the practice of intentionally ending a life to relieve pain and suffering.

Related Research Articles

Cardiac arrest sudden stop in effective blood flow due to the failure of the heart to contract effectively

Cardiac arrest is a sudden loss of blood flow resulting from the failure of the heart to effectively pump. Symptoms include loss of consciousness and abnormal or absent breathing. Some individuals may experience chest pain, shortness of breath, or nausea before cardiac arrest. If not treated within minutes, it typically leads to death.

Artificial cardiac pacemaker medical device that uses electrical impulses to regulate the beating of the heart

A pacemaker is a medical device that generates electrical impulses delivered by electrodes to contract the heart muscles and regulate the electrical conduction system of the heart.

Defibrillation treatment for life-threatening cardiac dysrhythmias, specifically ventricular fibrillation (VF) and non-perfusing ventricular tachycardia

Defibrillation is a treatment for life-threatening cardiac dysrhythmias, specifically ventricular fibrillation (VF) and non-perfusing ventricular tachycardia (VT). A defibrillator delivers a dose of electric current to the heart. Although not fully understood, this would depolarize a large amount of the heart muscle, ending the dysrhythmia. Subsequently, the body's natural pacemaker in the sinoatrial node of the heart is able to re-establish normal sinus rhythm.

Brugada syndrome heart conduction disease that is characterized by abnormal electrocardiogram (ECG) findings and an increased risk of sudden cardiac death

Brugada syndrome (BrS) is a genetic disorder in which the electrical activity within the heart is abnormal. It increases the risk of abnormal heart rhythms and sudden cardiac death. Those affected may have episodes of passing out. The abnormal heart rhythms seen in those with Brugada syndrome often occur at rest and may be triggered by a fever.

Do not resuscitate

Do Not Resuscitate (DNR), also known as no code or allow natural death, is a legal order, written or oral depending on country, to withhold cardiopulmonary resuscitation (CPR) or advanced cardiac life support (ACLS) in case their heart were to stop or they were to stop breathing. Many countries do not allow a DNR order. In most countries which do, the order is made by a doctor. In some countries this is based on the wishes of the patient or health care power of attorney.

An artificial organ is an engineered device or tissue that is implanted or integrated into a human — interfacing with living tissue — to replace a natural organ, to duplicate or augment a specific function or functions so the patient may return to a normal life as soon as possible. The replaced function does not have to be related to life support, but it often is. For example, replacement bones and joints, such as those found in hip replacements, could also be considered artificial organs.

Life support refers to the treatments and techniques performed in an emergency in order to support life after the failure of one or more vital organs. Healthcare providers and emergency medical technicians are generally certified to perform basic and advanced life support procedures; however, basic life support is sometimes provided at the scene of an emergency by family members or bystanders before emergency services arrive. In the case of cardiac injuries, cardiopulmonary resuscitation is initiated by bystanders or family members 25% of the time. Basic life support techniques, such as performing CPR on a victim of cardiac arrest, can double or even triple that patient's chance of survival. Other types of basic life support include relief from choking, staunching of bleeding by direct compression and elevation above the heart, first aid, and the use of an automated external defibrillator.

Palliative care is an interdisciplinary approach to specialized medical and nursing care for people with life-limiting illnesses. It focuses on providing relief from the symptoms, pain, physical stress, and mental stress at any stage of illness. The goal is to improve quality of life for both the person and their family. Evidence as of 2016 supports palliative care's efficacy in the improvement of a patient's quality of life.

Implantable cardioverter-defibrillator device implantable inside the body, able to perform cardioversion, defibrillation, and (in modern versions) pacing of the heart

An implantable cardioverter-defibrillator (ICD) or automated implantable cardioverter defibrillator (AICD) is a device implantable inside the body, able to perform cardioversion, defibrillation, and pacing of the heart. The device is therefore capable of correcting most life-threatening cardiac arrhythmias. The ICD is the first-line treatment and prophylactic therapy for patients at risk for sudden cardiac death due to ventricular fibrillation and ventricular tachycardia. Current devices can be programmed to detect abnormal heart rhythms and deliver therapy via programmable antitachycardia pacing in addition to low-energy and high-energy shocks.

Ventricular tachycardia fast heart rhythm that originates in one of the ventricles of the heart

Ventricular tachycardia is a type of regular, fast heart rate that arises from improper electrical activity in the ventricles of the heart. Although a few seconds may not result in problems, longer periods are dangerous. Short periods may occur without symptoms, or present with lightheadedness, palpitations, or chest pain. Ventricular tachycardia may result in cardiac arrest and turn into ventricular fibrillation. It is found initially in about 7% of people in cardiac arrest.

T wave alternans

T wave alternans (TWA) is a periodic beat-to-beat variation in the amplitude or shape of the T wave in an electrocardiogram.

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Transcutaneous pacing

Transcutaneous pacing is a temporary means of pacing a patient's heart during a medical emergency. It should not be confused with defibrillation using a manual or automatic defibrillator, though some newer defibrillators can do both, and pads and an electrical stimulus to the heart are used in transcutaneous pacing and defibrillation. Transcutaneous pacing is accomplished by delivering pulses of electric current through the patient's chest, which stimulates the heart to contract.

Morton Mower American cardiologist and inventor

Dr. Morton M. Mower is an American cardiologist and the co-inventor of the automatic implantable cardioverter defibrillator. He has served in several professional capacities at Sinai Hospital and Cardiac Pacemakers Inc. In 1996, he became the Chairman and Chief Executive Officer of Mower Research Associates. He was inducted into the National Inventors Hall of Fame in 2002 for the development of the automatic implantable cardioverter defibrillator with Michel Mirowski in the 1970s. He now continues his research in the biomechanical engineering laboratories at Johns Hopkins University.

Marlin Stephen "Doc" Heilman is an American physician, entrepreneur and inventor. He is credited with inventions in the fields of contrast enhanced medical imaging, the first implantable cardioverter defibrillator or ICD, the first wearable defibrillator or LifeVest defibrillator, and heart assist devices. His first inventions, a flow controlled angiographic injector and pressure tolerant disposable angiographic syringes, advanced the fields of radiology and cardiology by improving the diagnostic image quality and eliminating the imaging risk of blood borne disease transmission from patient to patient. He founded Medrad Inc, now part of Bayer Healthcare, to manufacture and supply these imaging devices on a worldwide basis. In 2013, an estimated 65 million medical imaging procedures were performed using Medrad products.

Management of heart failure requires a multimodal approach. It involves a combination of lifestyle modifications, medications, and possibly the use of devices or surgery.

Wearable cardioverter defibrillator

A wearable cardioverter defibrillator (WCD) is a device worn by patients who are at risk for sudden cardiac arrest (SCA). A WCD allows physicians time to assess for their patient's arrhythmic risk and make appropriate plans.

Cardiac psychology is a specialization of health psychology that focuses on the primary and secondary prevention of heart disease by incorporating strategies to address the emotional and behavioral barriers to lifestyle changes, and that seeks to enhance recovery in cardiac patients by means of providing patients tools to cope with life and physical changes associated with their disease. Cardiac psychologists can help cardiac patients across the lifespan: prevention, pre-surgery, post-surgery, and rehabilitation of cardiac disease with a particular emphasis on achieving optimal quality of life outcomes. Cardiac psychology includes both research and clinical practice aspects.

Yaariv Khaykin Canadian cardiologist

Yaariv Khaykin is a Canadian cardiologist and a clinical researcher in the area of electrophysiology. He is the director of the Newmarket Electrophysiology Research Group at the Southlake Regional Health Centre. He has published research into complex ablation and pioneered cardiac ablation methods.

Cyborg data mining is the practice of collecting data produced by an implantable device that monitors bodily processes for commercial interests. As an android is a human-like robot, a cyborg, on the other hand, is an organism whose physiological functioning is aided by or dependent upon a mechanical/electronic device that relies on some sort of feedback.

References

  1. Kothari, M; Mehta, L; Kothari, V (2000). "Cause of death--so-called designed event acclimaxing timed happenings". Journal of Postgraduate Medicine . 46 (1): 43–51. PMID   10855082.
  2. Batchelor, A; Jenal, L; Kapadia, F; Streat, S; et al. (2003). "Ethics roundtable debate: Should a sedated dying patient be wakened to say goodbye to family?". Critical Care . 7 (5): 335–8. doi:10.1186/cc2329. PMC   270714 Lock-green.svg. PMID   12974961.
  3. de Menezes, MB; Selli, L; de Souza, AJ (August 2009). "Dysthanasia: Nursing professionals' perception". Revista Latino-Americana de Enfermagem. 17 (4): 443–8. doi:10.1590/S0104-11692009000400002. PMID   19820848.
  4. Kaufman, SR; Mueller, PS; Ottenberg, AL; Koenig, BA (2011). "Ironic technology: Old age and the implantable cardioverter defibrillator in US health care". Social Science & Medicine . 72 (1): 6–14. doi:10.1016/j.socscimed.2010.09.052. PMC   3032945 Lock-green.svg. PMID   21126815.

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