End of Life Care

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IToday in the 21st century the options for end of life care is innumerable; nursing homes, hospices, outpatient nurses, live-in aides, family support, etc. are just a few of the possible choices. Techniques and approaches regarding end of life are similar: there is surgical care; there is palliative care, living wills, euthanasia, artificial organs/replacement, “full code” as opposed to “DNR” in hospitals, etc. While some argue that more options can be overwhelming, the quality of life and end of life solutions are undisputedly better than before in American history. (1)

Until the mid 1900’s, end of life could be summarized succinctly: if you were rich and merely elderly rather than infirm, you had the means to hire attendants and support yourself well with material goods. If you were poor, you had to rely on family for care or you would be living a beggar’s life and or dwindling in an almshouse aka poorhouse, where your fellow residents ranged from drug/alcohol addicts, the mentally insane, to homeless, or criminals. In addition, if you were ill coming from a poor background, death was near certain: In 1900, life expectancy was a mere 49 years, even a statistic toward the beginning of life expectancy improvement; life spans were even shorter prior. (1), (2)

Even the rich citizen would be hard pressed to survive if sick. Antibiotics/modern medicine was not developed (Sir Alexander Fleming did not discover penicillin until 1928!) and money could only buy relief rather than remedy to illness. Today we associate churches and religion with health services such as Red Cross, and with concepts such as “sanctuary”. In the past, the church did not provide a general sanctuary to the infirm or the aged for end of life care. Certain privi...

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...ometimes suspect of ethics and morality. For example, some hospital personnel follow an informal “slow code”, where instead of attempting to rescue a patient; delays are made before aid is offered so that the incident becomes finality, avoiding prolonged care, suffering, life, truly whatever interpretation one chooses to make. (8)

Works Cited

1. http://www.4fate.org/history.html

2. http://www.nytimes.com/2006/09/27/business/27leonhardt_sidebar.html

3. http://inventors.about.com/od/pstartinventions/a/Penicillin_2.htm

4. http://www.pitt.edu/~dash/folktexts.html

5. http://www.cdc.gov/nchs/fastats/nursingh.htm

6. http://www.cancer.gov/cancertopics/factsheet/support/end-of-life-care

7. Principles of Biomedical Ethics Beauchamp, T.L.,Childress, J.F., 6th Ed, Oxford Press, 2009

8. http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2004/08/02/MNGMJ816F41.DTL
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