Dying at Will
(practiced in Pacific region) 

when one senses death is coming & consents to it.
1. predictive
2. ancestral summons
3. "take my life instead" -> child illness, grandparent laments and grandparent dies in child's place 

Predilection of Death

1) bodily pain
2) love-death reunion
3) announcements shouldn't be dismissed
(element of truth) 

VooDoo Death

1) put cause on enemy through public display
2) bone-pointing ceremony
- through fear & guilt, die naturally 

Clinical Hexing

1) told by Dr. you're going to die, fe ar makes it happen prematurely
2) family has already arranged the funeral, so you "have" to die

(dying is psycho-social)

Vision

-takes place in a state of waking consciousness and can be visual or oral (minds eye/ear)
- result: person changes (but NOT a hallucination or a delusion) 

Apparition

see real non-material outline of a deceased person (usually full-body & clothed) which tends to move while environment remains unchanged.
(some occasions, can be seen publicy)
-satisfies normal needs 

Afterimage

Analogy: 'supernova' - collapses inwardly & releases elements outwardly

-release from dead body & death site
-carries recent memories & bodily looks, moves
-can go from person to person 

Natural Death Projectories

-dying: lasts 7 days
- telepathy becomes stronger as one nears death
-disappears after 1 year 

Shock Death Projectory

at time of death, psychic waves* are released & are split, this lasts about one year
(*Sudaism = holy sparks) 

Death Bed Visions

1. see the dead ; 2. reduction of pain
3. traveling clarvoyance (leave body apparitionally)

4. celestial music ; 5. acceleration of consciousness
6. silver cord connedted to body (Ecclesiastes)
7. "take away" dead coming to take to other side (lasts 15-30min, patient dies after)
8. reletivization ; 9. life review 

Near Death Experience (NDE)

-leaving the bodym "out of body" state
-mobility & site 

Otherworld Journey
(Gregory the Great) 

-conscious leaves the body & goes somewhere
- comes to a barrier & encounters deceased relatives/friends
-is enveloped in light
-conscious goes back to body & resumes life 

Basic Model of Christian Vision

1. Exit Body:

a) 2 deaths motif- notice how soul leaves body:
- agony = sinful character ; -no agony = saintly
b) angel(escort) descends &  opens gate
c) glimpses
2. Ordeals
a) fire ; b) test bridge ; c) weighing of deeds
3) Re-Entry

a) angel commands you to return
b) change personality ; c) tell story 

Albert Heim Model
(Switzerland, Geology Prof.) 

1. acceleration of consciousness
2. reduction of pain, anxiety
3. consciousness of death
4. projection of imagery
5. necessity
6. aura of emptiness 

Theory of Depersonalization

Threat: hyperalertness-depersonalization NDE
- in face of mortal danger, sensitivity increases
-reletivizes time

Death: die & come back, mystical NDE
-ecstacy of [...?]
 

Moody-Type NDE
(positive) 

by accident or non-fatal suicide attempt
1) sense of being dead  ; 2) pain reduced

3) lifeless body/ spiritual body
4) enveloped by darkness, tunnel
5) end of tunnel: meet deceased (each give msg)

6) given choice: die or go back & live
7) return with some reluctance
8) no fear of death ; 9) personality changes

Moody Type NDE
(negative)

1) has fire ; 2) daemon/devil ; 3) fear

outcome: fear of death remains, not resolved, personality doesn't change

Pediatric NDE
(based on moody-type) 

1) meeting/seeing the dead
(those close to family or deceased pets)

2) see the light
3) no life review 

Out of Body Experience

conscious leaves the body, but physical body remembers the out of body experiences

Autoscopic

disembodied consciousness on ceiling looking at the physical body

Anoxia

loss of oxygen in Brain
(not a cause of NDE) 

Near Death ExperiencERS
 

1) have decreased death anxiety
2) increased intellegience  
3) deepend spirituality
4) can't wear watches
5) light agent of change in personality
- if met the light = change
-no "light"  = no change 

Definition of Death Purpose

1) to show where life ends & death begins
2) to stop unneccesary medical care 

*Clinical Death

in judgement of the the physcian (no machines) 
absence of vital functions: consciousness, reflexes, circulation, respiration
is reversible with medical intervention
(child = full mobilization) 

Brain Death

1) neurocortical death - irreversible cessation of tissues in the cerebral cortex 
2) cerebral death - irreversible cessation of upper 2 levels of the brain excluding the brain stem
3) whole brain death - irreversible cessation of the entire brain including the brain stem 

Tests of Brain Death

1) lack of respiration (on own) 
2) no blood flowing to brain
3) no pupil response to light
4) no response to pain 

Cardiac Death

(with ventilator in place)

when medical team turns off ventilator depriving heart & lungs of oxygen

Cardiovascular Death

irreversible cessation of breathing with fixed/dialated pupils

Absolute/Biological Death

irreversible cessation of metabolic activity in the cells of the body- end of metabolism

Organ Tissue Transplantation

1) Pittsburgh Protocol 
- heparin & rigatone (organ protecting drugs) given, turn of ventilator, wait 2min, declare dead, start process

2)Dead Donor Rule
- patient must be declared dead before transplantation

3) Controversy
- no standard policy for cariac death
- PVS, Alzheimer's, brain damaged autonomy do no harm

Euthanasia

intent to put to death by act or omission to relieve suffering 
1) voluntary- person chooses to die
2) involuntary- "mercy killing"  

Double Effect

can't intentionally put to death, but if die because of medicine/natural causes = no liability

Hemlock Society

Self-deliverance suicide

Jack Kavorkian's Medicide

130 people
-had person contact him, gave interview & had consent.
-hooked person up to a machine with a tranquilizer and poison potion 

Physician Assisted Suicide (PAS)

terminally ill, wants to die but can't, asks physician to help & gets a lethal prescription

Dignitas

must be a member of a group
write a letter to the group's president with reasons for wanting to die and hand over medical charts.
if the president agrees, finds a doctor to write a lethal prescription 

Compassion Dying

request to die must come from patient in
writing or in a video.
must make 3 requests.
no mental illness, must be competent.
should discuss with family. 

Right to Refuse Treatment

any adult conscious and competent may refuse any medical treatment for any reason even at risk of death

2 exemptions: 
1) single parent
2) during pregnancy 

Origin of Rights

I. Common Law

a) bodily intergrity(permission to touch)

b) informed consent 
II. Constitutional Law  
a) privacy ; b) liberty interest (restricted right)
III. Advanced Directive (how to implement rights) 
a) living will ; b) durable power of attorney

IV. Nutrition & Hydration

a) catholics, neccesary ; b) Amer.Med.Assoc., optional
V. Unconscious/Incompetent (PVS)
a) subjective test - before incompetency
b) substituted judgement test - proxy makes desicions
c) post-interest test - burden vs. beneficial
VI. Cruzan vs. Missouri, US
a) right to refuse treatment  ; b) liberty interest
c) nutrition & hydration ; d) clear/convinving evidence 

Child Rights

rebutable presumption
- if parent(s) neglect/abuse the child, parent rights in decision making are removed

-if child has hindering medical issue (i.e. Down Syndrome) 

Jehovas Witnesses

don't accept blood products or transfusions
-adult: may refuse treatement
-child: state takes temporary legal guradianship & has child recieve treatment, then return guardianship to parents