Death is the inevitable conclusion of life, a universal destiny that all living creatures share. Although all societies throughout history have realized that death is the certain fate of human beings, different cultures have responded to it in different ways. Through the ages, attitudes toward death and dying have changed and continue to change, shaped by religious beliefs and philosophical tradit…
The processes of human life are sustained by many factors, but oxygen is key to life. Respiration and blood circulation provide the body's cells with the oxygen needed to perform their life functions. When an injury or a disease compromises respiration or circulation, a breakdown in the oxygen supply occurs. As a result, the cells, deprived of essential life-sustaining oxygen, deteriorate. Using these criteria, defining death was once quite simple—a person was considered dead once …
Defining death has become a complex matter. Innovative medical technology, while saving many lives, has also blurred the lines between life and death. The controversy about the definition of death is but one of the ethical issues, or principles of moral conduct, related to end-of-life care and decision making. For example, should a child request the withdrawal of nutrition and hydration from a par…
During the twentieth century the primary causes of death in the United States changed. In the 1800s and early 1900s, infectious (communicable) diseases such as influenza, tuberculosis, and diphtheria were the leading causes of death. These have been replaced by chronic diseases; heart disease, cancer (malignant neoplasms), and stroke (cerebrovascular diseases) were the three leading causes of death in 2001. (See Table 4.1.)…
To a parent, the death of a child is an affront to the proper order of things. Children are supposed to outlive their parents, not the other way around. And when a child comes into the world irreparably ill, what is a parent to do—insist on continuous medical intervention, hoping against hope that a miracle happens, or let nature take its course and allow the newborn to die? When a five-yea…
The Merriam-Webster dictionary definition of euthanasia, which derives from the Greek for "easy death," is "the act or practice of killing or permitting the death of hopelessly sick or injured individuals in a relatively painless way for reasons of mercy." This present-day definition differs from that of the classical Greeks, who considered euthanasia simply "one mode of dying." To the Greeks, euthanasia was a rational act by people who deemed their live…
The movement toward greater patient participation in health care that began in the 1960s and 1970s focused increasing attention on the desire for control over nearly all aspects of medical care, including critical care. Dramatic medical and technological advances further underscored the importance of planning ahead for end-of-life care. Baby boomers (the generation of people born between 1946 and …
Traditionally, death was defined as the total cessation of circulatory and respiratory functions. In 1968 the Ad Hoc Committee of the Harvard Medical School defined irreversible coma, or brain death, as a new criterion for death. As medical technology has become increasingly able to maintain patients who would otherwise die from severe injuries or illnesses, the debate about defining death, and ab…
Americans want quality medical care despite its increasingly high cost. In 1970 the United States spent a little more than 7 percent of its gross domestic product (GDP—the total value of all the goods and services produced by the nation) on health care. In 1995 health care expenditures were at a high of 13.4 percent ($990.2 billion) of the GDP. Between 1996 and 2000 that percentage dropped slightly, although actual dollars continued to rise. In 2001 and 2002, however, the cost of health c…
As of the early twenty-first century, the United States was on the threshold of a "longevity revolution." Dr. Robert N. Butler, the first director of the National Institute of Aging and chairman of the International Longevity Center, observed that during the twentieth century, life expectancy rose further and faster than during the entire period from ancient Rome (275 BCE, when life expectancy was about 26 years) through the year 1900.…
Since the dawn of history, many people have believed that human beings do not simply cease to exist upon their death. Numerous religions and cultures teach that the physical body may die and decompose, but that some element of the person goes on to what many call the "after-life." Between 1972 and 1982, when the Roper Center for Public Opinion Research asked the American public, "Do you believe there is life after death?," 70 percent said they believed in an afterlife…