Decision-making towards the end of life • Most people die in institutions, facilities • Up until the 1930s/40s, most people died at home, surrounded by loved ones in familiar surroundings with limited interferences/distractions; it was about keeping the patient comfortable rather than alive. o The notion of a “good death” entailed death at home, where one could make one’s peace with one’s maker surrounded by loved ones, eased into death without aggressive measures to prolong the dying process. • Today we don’t have that in practice. How do we define “the good death” today? It is no longer clear. • ICU psychosis: detachment from reality from being in this womb like environment, filled with people all listening to your every need hallucinations, confusion. • ICU is meant to provide the most high-tech, aggressive interventions to PROLONG YOUR LIFE because you have a critical illness. o
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This note was uploaded on 04/21/2008 for the course D s taught by Professor F during the Spring '08 term at Columbia.