Sociology General Education Capstone - End of Life Options Analysis

This sociology capstone report provides a comprehensive overview of end-of-life options, exploring various choices available to individuals facing terminal illnesses. The paper delves into topics such as death with dignity, examining its legal and ethical implications, and analyzes different approache...Read More

Sociology
General Education Capstone
4/14/2019
End of life options

Sociology 1
Contents
Introduction......................................................................................................................................2
End of life options...........................................................................................................................3
Death with dignity as an end of life options................................................................................3
Not starting treatment or stopping treatment...........................................................................3
Hospice and Palliative (Comfort) Care....................................................................................4
Palliative Sedation...................................................................................................................5
Voluntary Stop Eating and Drinking (Vsed)...........................................................................6
Suicide as an end of life options..................................................................................................6
Suicide versus homicides.........................................................................................................8
Natural death as an end of life options........................................................................................9
Legal law for death with dignity....................................................................................................10
Case support...............................................................................................................................11
Conclusion.....................................................................................................................................13
References......................................................................................................................................14

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Introduction
Death is the inevitable end of life. It is believed that people should be assisted to have what they
consider “good death” whenever it is possible. The word good death differs from one person to
person as per the medical condition, personality, as well as the personal circumstances. This
paper offer a discussion related to end of life options solution. It presents the argument, rational
or any of the solution related to concern topic. In the present world, the awareness is increasing
for the end of life options in the market that makes the individual aid in failing and to believer
for Death with the Dignity law for terminally ill which is present at California, Colorado, District
of Columbia, Hawaii, Oregon, Vermont, and Washington. The paper will throw light on the
different types of options that are available with the individual that is adopted by them due to
different reasons. This includes the end of willingness for living life, for ill people who do not
want to live. It is essential to conduct the research on the topic of end of life options, as it is
significant to comprehend why people want to die. The numbers of deaths are increasing across
the world that includes the natural factors due to which death occurs as well as options that are
adapted for ending life.

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End of life options
In the world, numbers of people who are willing to end their life are increasing in number
because their willingness ends. In addition to this, different countries are offering the right to die,
which is a thought that is grounded on the opinion that every human being is permitted to end
their life or suffer voluntary euthanasia (Moller, 2018). There is the presence of different options
through which an individual can end their life. These options are discussed below-
Death with dignity as an end of life options
Death with dignity is considered as one of the ends of life options that permit particular
terminally ill people with the motive to voluntarily as well as legally receive and request a
medication prescription from the doctors to hasten their death inhumane, peaceful as well as in a
dignified manner. It has been found that death with dignity is majorly administered by state
legislation (Strouse, 2019). Some people who consider the choice of death with dignity should be
alert of some of the options that are presented below -
Not starting treatment or stopping treatment
Presently, some people are terminally ill who find that violent treatment might not be obliging
for them and prolong the procedure of dying. In those circumstances, the aggressive treatment
might increase their sorrow, impair a individual's residual quality of life or might reduce the life
span. In addition to this, there are different people who are unaware of the fact that if they will
not undertake the treatment it will lead to a peaceful death. For instance; individual or persons on
dialysis for the disappointment of the kidney may be able to die in a peaceful manner which can
be by stopping the dialysis (End-of-Life Washington, 2019). Thus, this has been found stopping
medical treatments might increase the level of suffering as well as discomfort. The stopping of

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the medical treatment is possible after consulting it with the physician and by arranging for the
palliative (comfort) care that is vital before ending the cure related to the disease. Thus, it can be
said that in some circumstance stopping the treatment can get combine with the hospice as well
as the palliative care or voluntary stopping drinking and easting to reduce the process of dying as
well as decreasing the level of the suffering (Hedberg & New, 2017).
Hospice and Palliative (Comfort) Care
The palliative, as well as the hospice care, often get confused because the meaning of both the
words remain very alike when it originates to the greatest essential issue for the people who are
dying.
Palliative (Comfort) Care: - The palliative care is a major action of the symptoms, distress, as
well as the stress of the thoughtful illness along with the comfort and quality of life as chief
goals. It offers the comfort of relief from the different symptoms of distressing which include
pain, nausea, breath, sleep, anxiety and the different side effects of the medications. This has
been found that palliative care is provided to those individuals who are dealing with any kind of
serious illness (End-of-Life Washington, 2019). This care is offered to any kind of person with
any age and any stage of an infection that also include the healing treatment. This has been found
that people usually attain palliative care majorly at hospitals or clinics. However, in these cases,
people majorly prefer to remain at home due to which the home visits increase (Gardner, 2017).
Hospice: - On the other hand, Hospice is a form of palliative care that searches to enhance the
quality of life at the end of life while neither delaying nor quickening the procedure of dying. It
is essential to avail the important Medicare benefit for patients who are terminally ill and will
live for only a few months. Hospice is considered as the medical care that allows the probability

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related to the nonviolent death for most of the persons (Dworkin, Nagel, Nozick, Rawls, &
Jarvis-Thomson, 2017). This care benefits persons to continue in regulator and peacefully die at
home because most of the persons prefer the same. However, this has been found that these
services are available at hospitals, nursing homes and many others.
In the research, this has been found of life Washington believes that hospice is an important
constituent of end-of-life care and inspires all the individual persons who have gained a terminal
diagnosis with the motive to enrol in hospice (Wang, et al, 2016). Hospice is important for the
people who are ill as they select to stop the conduct and voluntarily stop drinking as well as
easting even when they wish to remain at their homes.
Palliative Sedation
The palliative sedation is known as the terminal sedation, which is the practice that is conducted
with the motive of dismissing difficult-to- manage the distress for the terminal individual in the
last days as well as periods of life. This is typically done by the means of the sedative drug that
reduces the unconsciousness of the patient (End-of-Life Washington, 2019). The palliative
sedation is generally offered in a hospital or the capable nursing or inpatient hospice facility.
This system majorly stops all the nutrition as well as hydration that makes the patient dies in the
next few days. However, this has been found that unlike adequate symptom and management,
palliative sedation is not considered as the right thing to do. Although, there are many
individuals who request for it with the motive to end their life as it is up to the medical provider
to identify that it will remain appropriate or not (Barry, 2017). In case, the individuals are willing
to avail the option of palliative sedation then it becomes essential for them to discuss it with the
medical providers.

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Voluntary Stop Eating and Drinking (Vsed)
In the present world, people deal with dangerous diseases like cancer that makes them lose their
appetites due to which they stop eating and drinking in many cases. This is a fact that if any
person stops eating and drinking then it will ultimately lead to death in the coming few days (one
to three weeks). In this option of the end of life, it is essential to evade the sips of water or any
other fluid as it might delay process (Hirsch, 2016). The individual individual who starts VSED
proceeding to natural occurrence should imagine hunger with dehydration for a few days. Thus,
it is essential to have swabs majorly for the dry mouth as well as for the reliable access to
medication that reduce the symptoms.
When the person properly attains the process of VSED then they found that it usually results in
the death of a human in a peaceful manner that shows that they have used this method
effectively. End of life Washington suggests that individuals selecting VSED initially debate
their choices with the family associates, caregivers, as well as involved medical sources with the
motive to offer them from discouragement the procedure by encouraging the consumption of
food and water (Chen, et al, 2016).
In the research, this has been found that in some of the cases, VSED might be used to hasten the
death for the person who is incurable and in the condition of the progressive illness that can
eventually lead to fatal but not required within the 6 months that are obligatory for the Death
with the dignity act.
Suicide as an end of life options
Suicide is considered as one of the options that can end the life of a person. Suicide occurs when
people direct violence at themselves in order to end their lives and lead to death due to the

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actions (American Psychological Association, 2019). There are numerous reasons due to which
men and women commit suicide. It often stems from a deep feeling of hopelessness. It is an
inability to look towards solutions that are related to the problem to cope with challenging life
situation that might lead people to look towards suicide. Depression is one of the key factors,
which leads to the suicide, and with this, there are some other factors also which include
psychiatric disorders, chronic pain, family situations, and many others (Den Hartogh, 2016).
Most of the youth who attempt suicide deals with the impulsiveness that plays a major role in
adolescents. It has been found that there are different types of myths related to the attempt of
suicide and one of is the mistaken belief that makes the person attempt suicide (Battin, Rhodes &
Silvers, 2015).
In the research, this has been found that Suicide or ending one’s own lie is one of the tragic
events with the tough repercussions majorly for the survivors and relatives of the victims. In the
year 2016, it was found that more than 45,000 people in the US killed themselves as per the
views off the Centers for Disease Control and Prevention that is creation it the 10th leading cause
due to which death takes place. The rate of suicide attempts has been increased in 44 states
between the year 1999 and 2016 with the fact that half of the state reports a rise with 30%
(Psychology Today, 2019). However, it has been found there are many suicide avoidance
programs that major focuses on serving the teenagers. The uppermost number of suicides
occurred in the US in the year 2015 between the people with the age group of 45 to 54 years.
This has been found that men are at high risk in terms of the suicide rate with around four times
higher than women that are in the US. It has been found that there are major disparities among
the ethnic as well as racial groups with the Alaskan Natives and American Indian being at the
high risk. In addition to this, it has been found that there is a significant rise in the suicide rates

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of youth within the age group of 10 to 14 years (National Institute of Mental Health, 2019).
Suicide ranks are considered as the second foremost cause behind the death for the age group of
10 to 14 years according to the 425 deaths that take place every year.
Suicide versus homicides
In the report, this has been found that the Gun homicides become far more attention in the
widespread press but this has been found that most of the gun deaths lead to suicide. In the year
2016, this has been found that there were 22,938 peoples dedicated suicide by firearm while on
the other hand, 14,415 people faced death in Gun homicides (Matthews, 2018).
(Source: Matthews, 2018)

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The image given above shows the comparison between both Firearm homicides as well as
firearms suicides. In total 38,658 people died because of the firearm injuries that occurred in the
year 2016.
Natural death as an end of life options
End of life options also includes natural decease that can occur due to natural causes. When any
person dies of old age or due to the health conditions then this death is considered as the natural
death. If the death occurs unexpectedly or in such circumstance that means there is the end of life
that occurs in the form of death of person (Richards, 2017). In addition to this, death due to the
factors of the accident is also considered as one of the ways that cannot be stopped. However,
some of the researchers consider that accident and murder by the other person are not considered
at the end of life options.
As per the latest data that is presented by the CDC, 2,596,993 people died in the US in the year
2013 and the majority of the death occurred 92.5% due to the natural causes. Thus, these are
considered as the natural death that ends the life of the person.

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(Source: Chalabi, 2015)
The image given above shows the most common causes of the natural death and out of this, the
death due to heart disease as well as cancer is on the top that means most of the person dies
because of these factors.
Legal law for death with dignity
The Washington Washington Death with Dignity Act, Initiative 1000, codified as RCW 70.245,
passed on November 4, 2008, and then came into the effect on March 5, 2009 (Department of
Health, 2019). This act permits the fatally ill grown-ups looking for in order to end their life due
to which they appeal for the lethal measures of the medicine from therapeutic as well as
osteopathic physicians. These terminally ill patients need to be the Washington populaces who
have less than 6 months to live. In addition to this, it has been found that Columbia district has
also brought the act into enforcement. The District of Columbia Death with Dignity Act of 2016,
D.C. Law 21-182, was effective on February 18, 2017, and applicable as of June 6, 2017 (DC
Health, 2019). This act majorly allows the terminally ill adults who are looking for voluntarily
end their life.
In the research, this has been witnessed that there are five states that permit the physician-
assisted death: Oregon, Washington, Vermont, Montana and New Mexico. In addition, this has
been found that only Oregon, Vermont and Washington have enacted the particular laws related
to death with dignity. Under the laws, mentally competent, terminally ill state residents can
appeal and attain the prescription medicine in order to accelerate their deceases. According to the
Portland, Oregon-based Death With Dignity National Center, this has been found that there are
numerous end-of-life care options that are present at these states (Blanke, LeBlanc, Hershman,

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Ellis & Meyskens, 2017). The law is applied on the separate basis among the approved doctors
as well as the eligible candidates. The eligibility is essential to be considered for Death with
Dignity national centre. The eligibility criteria are presented below -
 Terminally ill patients who require to attain a medicine under the Oregon, Washington or
Vermont law which must be a local of one of the 3 states and also apply a sequence of
process in order to get specialized.
 Other requirements of the patients include - 18 years of age or older, a resident of
Vermont, Washington or Oregon. In addition, a person should be skilful of making and
interactive the decision related to health care. Further, persons should be diagnosed with
the terminal disease that might lead to the decease of the person within the next six
months.
Case support
End of life options is increasing due to which the persons have wide options to finish their life in
the US. The legal obligations related to death with dignity have made it easier for persons to die
when they have no willingness to live their life. This can be supported with the case Brittany
Maynard, a 29-year-old woman from California, selected to die on Saturday, November 2014
(Petronzio, 2014). She had detected with the terminal brain cancer on January 1 and at that point,
of the time she was assumed with a prognosis of 6 months in order to live.
Wishing to die on her terms was preferred by the women instead of aggressive cancer due to
which she moved to Oregon that is one of the only a handfuls of the states that is present with the
laws related to the Death with dignity. This case raised a question of whether death with dignity
should be considered or not.

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This case is supported with the death with dignity option of end of life that is adopted by the
Maynard in order to receive the death without any pain and in peace and not from any kind of
treatment or disease.

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Conclusion
In the end, this can be concluded that the end of life options is considered as one of the emerging
topics that are discussed. Thus, these reports include the discussion related to the different ways
through which any person can end their life. The major options that have been witnesses include
death with dignity, attempting suicide for ending life, natural death and many others. This has
been found that death with the dignity is legal in California, Colorado, District of Columbia,
Hawaii, Oregon, Vermont, and Washington states of US. In these states, death with dignity is
allowed if in case any person is suffering from the issue of terminally ill disease. Talking about
the rest of the world, the governments are not able to approve the death with dignity. In death
with dignity, there are different ways that can be selected by the person such as not starting
treatment or stopping treatment, hospice and palliative (Comfort) care, palliative sedation and
voluntary stop eating and drinking (vsed). Further, the legal laws are discussed which shows
their enforcement and how they are effectively maintained within US. It has been found that the
individuals in US are more inclined towards the suicide activities as well as death.
In addition to this, the suicide deaths, as well as the natural death, are also discussed, as these are
also used by the persons in order to end their life. However, there are some reasons due to which
they want to end their life.

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References
American Psychological Association. (2019). Suicide. Retrieved from:
https://www.apa.org/topics/suicide
Barry, R. (2017). Breaking the thread of life: on rational suicide. New York: Routledge.
Battin, M. P., Rhodes, R., & Silvers, A. (2015). Physician assisted suicide: expanding the
debate. New York: Routledge.
Blanke, C., LeBlanc, M., Hershman, D., Ellis, L., & Meyskens, F. (2017). Characterizing 18
years of the Death with Dignity Act in Oregon. JAMA oncology, 3(10), 1403-1406.
Chalabi, M. (2015). What Does It Mean To Die Of Natural Causes?. Retrieved from:
https://fivethirtyeight.com/features/what-does-it-mean-to-die-of-natural-causes/
Chen, H. P., Huang, B. Y., Yi, T. W., Deng, Y. T., Liu, J., Zhang, J., ... & Jiang, Y. (2016).
Attitudes of Chinese oncology physicians toward death with dignity. Journal of palliative
medicine, 19(8), 874-878.
DC Health. (2019). Death with Dignity Act of 2016. Retrieved from:
https://dchealth.dc.gov/page/death-dignity-act-2016
Den Hartogh, G. (2016). Two kinds of suicide. Bioethics, 30(9), 672-680.
Department of Health. (2019). Death with Dignity Act. Retrieved from:
https://www.doh.wa.gov/YouandYourFamily/IllnessandDisease/DeathwithDignityAct

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Dworkin, R., Nagel, T., Nozick, R., Rawls, J., & Jarvis-Thomson, J. (2017). Assisted Suicide:
The Philosophers' Brief. The New York Review of Books.
End-of-Life Washington. (2019). End-of-Life Options. Retrieved from:
https://endoflifewa.org/end-life-options-2/
Gardner, M. (2017). Death and Dignity. Brigham Young University Prelaw Review, 31(1), 4.
Hedberg, K., & New, C. (2017). Oregon's Death With Dignity Act: 20 years of experience to
inform the debate. Annals of internal medicine, 167(8), 579-583.
Hirsch, J. (2016). The wish to die: assisted suicide and mental illness. Journal of social work in
end-of-life & palliative care, 12(3), 231-235.
Matthews, D. (2018). There are more gun suicides than gun homicides in America. Retrieved
from: https://www.vox.com/2015/10/1/18000510/gun-suicide-homicide-comparison
Moller, D. W. (2018). On death without dignity: The human impact of technological dying. New
York: Routledge.
National Institute of Mental Health. (2019). Suicide in America: Frequently Asked Questions.
Retrieved from: https://www.nimh.nih.gov/health/publications/suicide-faq/index.shtml
Petronzio, M. (2014). What are Death With Dignity laws?. Retrieved from:
https://mashable.com/2014/11/03/death-with-dignity/#rwDiFjMkCPqr
Psychology Today. (2019). Suicide. Retrieved from:
https://www.psychologytoday.com/us/basics/suicide

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Richards, S. M. (2017). Death with Dignity: The Right, Choice, and Power of Death by
Physician-Assisted Suicide. Charleston L. Rev., 11, 471.
Strouse, T. (2019). End-of-life options and the legal pathways to physician aid in dying.
Retrieved from: https://www.mdedge.com/hematology-oncology/article/136230/patient-
survivor-care/end-life-options-and-legal-pathways
Wang, L. H., Elliott, M. A., Henson, L. J., Gerena-Maldonado, E., Strom, S., Downing, S., ... &
Benditt, J. O. (2016). Death with dignity in Washington patients with amyotrophic lateral
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