Bhartrhari Language Thought and Reality - Mithilesh Chaturvedi_Part1
Language and Reality at the End of Life
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Transcript of Language and Reality at the End of Life
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Language and Reality at the End of LifeLanguage and Reality at the End of Life
Raphael Cohen-Almagor
University of Haifa, ISRAEL
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Every Profession Has Its
Keywords That Are Important to Help Categorize Phenomena, Save Time and Provide a Framework for Working Together.
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The Thesis: The Keywords Primarily Serve the Physicians, at
Times at the Expense of the Patients’ Best Interests.
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Death With Dignity» To have dignity means to look at
oneself with self-respect, with some sort of satisfaction.
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‘Quality of Life’
• Positive connotations, for example, in rehabilitation, cosmetic treatments, psychiatry, and psychology
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• However, when dealing with end of life issues, ethicists who support euthanasia use the term ‘quality of life’ in a negative sense more often than in a positive one, meaning that they do not seek to improve the patient’s life but to end it
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• This phrase often serves to justify the termination of life
• A subjective concept, meaning that one’s quality of life is determined by one’s personal life circumstances
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Patients in ‘Persistent Vegetative State’
• Prolonged unawareness and post-coma unawareness (PCU)
• The term ‘vegetative’ dehumanizes patients and therefore is offensive to patients and their beloved people
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• We should strive to describe the condition without offending patients or their beloved people
• We should not strip patients of their human and moral characteristics
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‘Terminal’ Patients• The doctor’s task is to help patients to live
when they want to continue living, not to hold a clock over their heads and count their days
• When patients are labeled ‘terminal,’ doctors send them several simultaneous negative messages:
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• Not only that death is near, but also that the medical staff are giving up,
• The patient’s beloved people should begin the mourning period while the patient is still alive
• A difference exists between discussions among medical staff, and discussions that involve the patients and their beloved people
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‘Futility’
• Means any effort to provide a benefit to a patient that is highly likely to fail and whose rare exceptions cannot be systematically produced
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• First, a treatment that does not produce positive effects
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Second, it is futile to provide a radical treatment whose side-effects outweigh the good emerging from the treatment
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Third, it is futile to treat a disease when the patient is suffering from another life-threatening
disease
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• Concerns about costs often underlie the appeals to futility in the clinical setting and public policy discussions
• In public policy, the concept of futility can sanction restrictions in the allocation of health care resources
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• The problem is that physicians disagree about the type of clinical evidence necessary to justify a futility claim
• What is required is a fair process approach for determining and subsequently withholding or withdrawing, what is felt to be futile care
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‘Double Effect’
Two basic presuppositions: • (1) the doctor’s motivation is to alleviate suffering• (2) the treatment must be proportional to the
illness• The rule is not a necessary means to adequate pain
relief because informed consent, the degree of suffering, and the absence of less harmful alternatives suffice
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‘Brain Death’• 1) when should life support be withdrawn for
the benefit of the patient?
• 2) when should life support be withdrawn for the benefit of society?
• 3) when is a patient ready to be cremated or buried?
• 4) when is it permissible to remove organs from a patient for transplantation?
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• there is a significant disparity between the standard tests used to make the diagnosis of brain death and the criterion these tests are purported to fulfill.
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Conclusions• A need to introduce more ethics into the
medical school curriculum, equipping the medical staff with communication skills
• A need to invest more time talking with patients and their beloved people
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• Clean the language and clarify it sincerely
• Use elaborate explanations instead of concise, obscure or unethical terms