Culture, Spirituality, and Bioethics

Culture

• A unified set of values, ideas, beliefs, and standards of behavior, shared by a group.
• It defines how individuals accept, order, interpret, and understand experiences throughout life.

Spirituality

• Involves the ways individuals seek and express meaning.
• Encompasses how individuals experience connectedness.

Religion

• Centers on one's relationship with God and others.
• Potentially involves preparing oneself for the afterlife.

Suffering

• It is an actual or perceived threat to the integrity or continued existence of a person.

Life cycle

• The underlying order of human life's course.

Hospice

• Provides support and care in the final phases of an incurable disease.
• Aims to enable individuals to live as fully and comfortably as possible.

Palliative Care

• It is patient and family-centered.
• Optimizes quality of life by anticipating, preventing, and treating suffering.

Bioethics

• Addresses moral and ethical issues in clinical practice, medical and biological research.
• Deals with resource allocation and access to biomedical technology.

Core Concepts of Bioethics

• Autonomy: The right to make decisions about one's life and body without coercion, acting in terms of one's values.
• Beneficence: Acting in the best interest of the patient, helping others.
• Non-maleficence: To do no harm.
• Justice: Treating each patient impartially.

Patient Self-Determination Act (PSDA)

• Individuals have the right to make decisions regarding medical care.
• Encompasses the right to refuse, withhold, or withdraw treatment.

Advanced Care Planning (ACP)

• A process of planning for future care if a person cannot make their own decisions.

Life Support

• Involves mechanical devices like intravenous tube feeding.
• Sustains life when the patient would not otherwise remain alive.

End-of-Life (EOL) Decision Making

• Involves creating advance directives.
• Determines whether to continue, withhold, or withdraw life-sustaining treatment.
• Considers actively hastening death (e.g., stopping eating/drinking, assisted suicide, or voluntary euthanasia).

Search for Meaning

• Characterized by exploring questions of value and worth.
• Involves letting go of former roles/expectations and reframing events.
• Supports renewed hope and an enlarged sense of efficacy.

Passive Euthanasia

• It is the right to refuse medical treatment, even if it hastens death.
• Subject to controversy regarding the moral acceptability of "nature taking its course".

Cardiopulmonary Resuscitation (CPR)

• Medical procedures used to restart a patient's heart and breathing after heart failure.

Advance Directives

• Legal documents indicating a person's wishes regarding care.
• Applicable in case of terminal illness or during the dying process; includes proxy and living will.

Proxy

• A person with legal authority to make medical decisions for an incapacitated patient.

Living Will

• A person's written statement of treatment preferences in case of incapacity.

Do Not Resuscitate (DNR)

• A written order instructing medical professionals not to perform CPR.

Artificial Nutrition and Hydration (ANH)

• Life-sustaining treatment involving nutrients and fluids.
• Provided through a tube directly into the stomach, intestine, or vein.

Do Not Intubate (DNI)

• A written order telling medical professionals not to place someone on an artificial respirator.
• Activated in case of heart failure or cessation of breathing.

Euthanasia

• The intentional termination of life by someone other than the person concerned, at their request (Good Death).

Physician-Assisted Suicide

• The physician assists in the final action that causes death whether that be the patient or someone else.

Socialization

• Embedded in culture.
• The process by which people come to fit their culture and how others shape them to fit the culture

Anticipatory Grief

• Grief experienced before a loss.
• Includes reservations about the heuristic value of 'anticipatory grief' and 'anticipatory mourning'.

Prolonged Grief Disorder

• The bereaved individual's level of distress and ability to function is extreme, disabling, and persistent.

Grief Therapy

• Specialized techniques to help people with abnormal or complicated grief reactions.

Grief Counseling

• Supports individuals coping with normal or uncomplicated grief and mourning.

Bereavement

• Applied to individuals who have experienced death-related losses.

Grief

• Reactions to loss.

Mourning

• Intrapsychic and interpsychic processes of coping or learning to live with loss and grief.
• Social, public, or ritualized responses to loss.

Thanatology

• The study of death and dying.

Complicated Grief

• When a person has a prolonged or significantly difficult time moving forward after a loss (The third trajectory).

Ambiguous Loss

• It is when the individual is physically present but perceived as psychologically absent.
• Occurs during the later stages of illness with dramatic intellectual and social decline.

Disenfranchised Grief

• Grief that is not openly acknowledged, publicly mourned, or socially supported.

Intuitive Grieving Style

• Emphasizes experiencing and expressing emotion.

Instrumental Grieving Style

• Focuses on practical matters and problem-solving.

Discrepant Coping Styles

• Family members use different coping mechanisms to manage their loss.

Dissynchrony Grief

• Manifestations and duration of grief differ among family members.

Ritual

• A specific behavior or activity that gives symbolic expression to feelings and thoughts.

Cognitive-Based Coping

• Coping that involves comprehending implications, planning responses, and evaluating outcomes.

Sudden Infant Death Syndrome (SIDS)

• A form of death claiming the lives of young children.

Miscarriage

• The unintended, spontaneous end of a pregnancy resulting in fetal death.

Grief Work

• The key process in this conceptualization assumes that mourning entails experiencing and expressing difficult thoughts, emotions, and memories triggered by loss.

Death Education

• Can take place in history, biology, or specific death education courses within schools.

Resiliency Trajectories

• A relatively stable pattern of adjustment over time despite experiencing an extreme adversity.

Bibliotherapy

• The use of literature for therapeutic intervention with the hope to help people identify with characters or situations. The goal being that it will lead to increased insight into their own situation.

Death Before Intensive Care

• An individual was declared dead when breathing and circulation stopped.

Brain Death

• Irreversible loss of function in the entire brain, cortex and brainstem.

Tactical Socialization

• Strategies used by palliative care staff or hospice caregivers to informally educate people about death and dying.

Re-Socialization

• Uprooting and restructuring of basic attitudes, values, or identities.

Uniform Determination of Death Act

• Sustained either: irreversible cessation of circulatory and respiratory functions, or irreversible cessation of all functions of the entire brain, including the brain stem.

Cultural Competence

• The ability to explore, consider, and respond appropriately to cultural differences.

Autonomy

• The fundamental legal concept that proclaims the right of individuals to act on their own, make decisions, and determine their fate.

Traumatic Grief

• A response to loss that includes elements of sudden, horrific, shocking encounters.

Consent

• A legal term indicating agreement regarding something to be done.

Last Will and Testament

• A legal document stating an individual's wishes for the settlement of their estate after death.

Traumatic Death

• Responses may include annihilation anxiety or a repetition compulsion (intrusive thoughts, images, nightmares).

Survivors

• Those who experience the suicide of a loved one.

Childhood Traumatic Grief

• When trauma symptoms interfere with a child's ability to undertake the normal grieving process, parental bereavement and family sessions.

Burnout

• A state of physical, emotional, and mental exhaustion, depersonalization, and reduced personal accomplishment.
• Caused by long-term involvement in emotionally demanding situations.

Teachable Moments

• Parents and teachers are major sources of information about death.
• Their ability (or inability) impacts their skills to answer questions and reassure children about their fears and anxieties.

Compassion Fatigue

• A pattern of tiredness and emotional depletion from too much caring and too little self-caring.

Empathy

• The ability and willingness to understand the client's thoughts, feelings, and struggles from the client's point of view.

Boundary Violation

• Occurs when there is confusion between the needs of the professional and the needs of the client.

Boundary Crossing

• Brief excursions across boundaries that are often inadvertent or thoughtless.

Ethical

• Involving or expressing moral approval or disapproval as well as conforming to accepted professional standards of conduct.

Boundaries

• The margins of appropriate behavior.
• Lines drawn to help define roles and interactions in relationships.