Gaines depicts the process of transformation of a black young who accepts his execution with dignity in A Lesson Before Dying. There two personas of the protagonist, Jefferson, appear in this novel. The former seen in the black and white community is the persona of falsehood and submission, and the latter appeared in the black community is the true persona. The former, the pig persona in black-and-white community is created, forced onto them by whites and the human persona in the black community is made by their own standards without being forced. Jefferson has been depersonalized by his pig persona. He implements their false persona by mimicking pigs to confront its reality. And then he retrospects the pleasure of relationship throughout his own life. Grant's expensive gift, the radio, becomes a trigger to realize the significance of his existence and the social solidarity. Moreover, many black visitors look at him with expectant eyes of fulfilling their historical burden. After all, Jefferson is executed as a human being with dignity, and the transformation of Jefferson from a pig to a human is getting rid of the white values and standing on the black values. In other words, it is the procedure of creating the new myth out of the false myth, from meaningless life to meaningful death.
This is a descriptive study on the perception and attitude toward DNR in adults. Structured questionnaires were used and 210 subjects were studied. In recognition of DNR, DNR was helpful for 'a comfortable dying(64.3%)'. The need for DNR in situation investigated 'For dignified dying (41.3%)' and 'to alleviate patient suffering(23.9%)'. Respondents who do not agree with DNR are shown 'Because legal issues can arise(61.7%)', 'Because human dignity is the life-sustaining priority(16.7%)'. In the attitude toward DNR, the most significant result was 'I want to know if I have an incurable disease (4.21).' There was no difference in attitudes toward DNR among adults. The DNR is not a method of Withdrawing in lifeprolonging treatment, It should be addressed in a comprehensive context in which human beings exercise autonomy over the process of dying and death.
The purpose of this study was to identify the effects of death education on attitudes toward death and depression for older adults. A death education program consisted of needs of death education, alternatives for dignity on death, not ending death(I, II), hospice(I, II), and 9 patterns of death(I, II, III). Participants in this study were 38 older adults aged 60 years or older. Attitudes toward death and depression scales for Korean elders were employed. The data collection and intervention were performed from January to June, 2008. The subjects participated in a death education program for 1 time per week during 10 weeks. The data were analyzed with t-test, and Pearson correlation coefficients with SPSS/Window 14.0. After the intervention, the subjects showed significant difference in attitudes toward death compared to that of pre-intervention. The subjects after the intervention showed no statistical differences in change of depression compared to that of pre-intervention. Also, attitudes toward death were negatively related with depression both before and after interventions, but the change of relation was not significant. The findings of this study contributed to extend the base of program developments on death education enhancing attitudes toward death among Korean older adults.
The Law has intervened to define rare circumstances in which a person should choose continuing life in United States. On the one hand, the law has traditionally acted to preservelife and to respect the sanctity of life. On the other hand, one's control over one's own body, and the right to determine what kind of medical care one will receive, is equally well respected and historically grounded. The competent patients have the right to forgo life-sustaining treatment, courts in United States have left many unanswered questions about the nature of that right. The right to choose to forgo life-sustaining treatment is a manifestation of a patient's autonomy interest. In United States, The Karen Quilan case gave rise to legislative activity in the host of state capitals, and several states had adopted statutes that formally recognized some forms of written directives describing some circumstances in which certain kinds of medical care could be terminated. These statues were sometimes dominated 'living will' acts, sometimes 'right to die' acts and ocasionally 'natural death' acts. Today virtually every state has produced a living will statue. In Korea, courts do not permit a terminally ill person to withhold or withdraw life-sustaining treatment. Living wills apply in case of terminal illness owing to a defect in legislation. Now In Korea, these lively dispute of legal policy on the preconditions and concrete procedure of living will act and natural death act. Through the legislation of living will act and natural death act, we should prepare some circumstances to respect patient's autonomy on the right to die. We should frame the cultural standard to make a decision of forgoing life-sustainin1g treatment under the discreet procedure.
Journal of Korean Academic Society of Home Health Care Nursing
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v.25
no.3
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pp.204-214
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2018
Purpose: This study aimed conducted to investigate biomedical ethics awareness and attitudes toward dignified death and advance directives among nursing students. Methods: Data were collected through structured questionnaires from 222 nursing students with clinical practice experience, from November 7 to 23, 2015. Data were analyzed by independent t-tests, one-way ANOVA, Kruskal-Wallis test, and Pearson's correlation coefficients using SPSS WIN 22.0. Results: The scores for biomedical ethics awareness and attitudes toward dignified death were 2.89 and 3.15, respectively. Regarding attitudes toward advance directives (ADs), most students agreed with writing ADs. The main reason given for writing ADs is "I want to receive my treatment of choice." As for the range and explanation method for ADs, 45.7% of participants responded, "do not know well." Regarding willingness toward life sustaining treatment, "only pain control, no life sustaining treatment" was indicated by 83.4% and, "all information about symptoms and prognosis" by 91.9% of participants. For willingness to write ADs, 70.0% of participants responded "yes." Conclusion: Curriculum for nursing ethics should be included in clinical training courses to improve related courses and provide an opportunity to deal with practical problems, such as biomedical ethics, death with dignity, and ADs.
Purpose: The purpose of this study was to analyze and clarify the ambiguous concept of DNR, and to distinguish between DNR and euthanasia. Method: This study used the process of Walker & Avant's concept analysis. Result: The definable attributes of DNR were care for comfort, no further treatment and no CPR. The antecedents of DNR were the autonomy of patients and families feelings about death, the uselessness of treatment and the right to die with dignity. The process of the DNR decision should be documented and the antecedents of DNR also can be a basis for objective standards of DNR decision-making. The result of DNR was the acceptance of death by patients and families. Conclusion: DNR is decided and documented by the antecedents of DNR, and the result is a natural acceptance of death, the last process of human life. Hospice care should be activated and nurses must be patient's advocates and families' supporters in the process.
For patients who are near the end of life, an inevitable step is discussion of a do-not-resuscitate (DNR) order, which involves patients, their family members and physicians. To discuss DNR orders, patients and family members should know the meaning of the order and cardiopulmonary resuscitation (CPR) which includes chest compression, defibrillation, medication to restart the heart, artificial ventilation, and tube insertion in the respiratory tract. And the following issues should be considered as well: patients' and their families' autonomy, futility of treatment, and the right for death with dignity. Terminal cancer patients should be informed of what futility of treatment is, such as a low survival rate of CPR, unacceptable quality of life after CPR, and an irremediable disease status. In Korea, two different law suits related to life supporting treatments had been filed, which in turn raised public interest in death with dignity. Since the 1980s, knowledge of and attitude toward DNR among physicians and the public have been improved. However, most patients are still alienated from the decision making process, and the decision is often made less than a week before death. Thus, the DNR discussion process should be improved. Early palliative care should be adopted more widely.
The objective of this research is to provide the basic material for effective hospice care by analyzing the recognition of families who have terminally ill patients over death. To do so, this research is designed to investigate the general tendency toward death and changes after hospice care. To analyse the initial status of the recognition about the death, questionnaires were provided to the families of the terminally ill patients who were taken hospice care from June 1st, 2005 to September 10th, 2005 at Saemmul Hospice. The same questionnaires were distributed to research some changes of the recognition of the death after 3 weeks. As the Data Analysis Methodology, SPSS v.10.0 statistics program were utilized. The summary of this research is as follows. First, by gender, it is analyzed that women have more fear than men in terms of incompetence sense after death. By religion, Christians have less fear than other religious people in terms of fear toward after death and general sense of death. Second, those who experienced deaths of close family members, relatives, friends for the past 3 years have more fear toward the moment of death than those who did not experience it. Third, statistically valid difference was found in terms of fear toward the moment of death, fear toward incompetence, fear toward after death, and fear toward death before and after the hospice care was taken. Based on the result of this research, terminally ill patients' families facing death have shown significant differences on fear and incompetence before and after hospice care was offered. It is necessary that the hospice care should be settled more professionally by expanding the opportunities of hospice care and institutionalizing the system. In addition, hospice activities which are focused on providing hope after death and facing death with dignity and peace should be expanded increasingly as the family members who experienced deaths showed higher degree of fear and powerlessness and Christians have less fear toward death with the help of biblical influence. It is also required that hospice care specialized in recognizing the importance of terminal cancer patients and their families at the same time.
Journal of Korean Academy of Fundamentals of Nursing
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v.3
no.2
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pp.153-169
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1996
This study was designed to identify, describe and classify orientations of cancer patient's family members to death and to identify factors related to their attitudes on death. Death to the male is understood as a comprehensive system and believed to be highly subjective experience. Therefore attitude on death is affected by personalities. As an attempt to measure the subjective meaning toward death, the unstructured Q-methodology was used. Korean Death Orientation Questonaire prepared by Kim was used. Item-reliability and Sorting-reliability were tested. Forty five cancer patients' family members hospitalized in one university medical center in Seoul were sampled. Sorting the 65 Q-itmes according to the level of personal agreement ; A forced normal distribution into the 11 levels, were carried out by the 45 P-samples. The demographic data and information related to death orientation of the P-sample was collected through face to face in depth interviews. Data was gathered from August 30 till September 22, 1995. The Z-scores of the Q-items were computed and principal component factor analysis was carried out by PC-QUANL Program. Three unique types of the death orientation were identified and labeled. Type I consists of twenty P-samples. Life and death was accepted as people's destiny, They firmly believed the existence of life after life. They kept aloof from death and their concern was facing the and of the life with dignity, They were in favor of organ donation. Type II consists of Nine P-Samples. They considered that death was the end of everything and did not believed the life after life. They were very concerned about the present life. Type III consists of Sixteen P-samples. They regarded the death as a natural phenomena. And they considered that the man is just a traveller and is bound to head for the next life which is believed to be free of agony, pain or darkness. They neither feared death nor its process. Their conserns were on the activities to prepare themselves for the eternal-life after death. Thus, it was concluded that there were three distinctiven type of attitudes on death among cancer patient family members, and their death attitudes were affected by demographic and socio-cultural factors such as sex, education, and religion.
The adult guardianship system has been introduced through amendments of Korean Civil Code for the first time in the March 2011(Act No. 10429, 7. 1. 2013. enforcement). The adult guardianship system has the main purposes to provide a lot of help vulnerable adults and elderly, and protect them on the welfare related with property act, treatment, care, etc. There could be a controversy about whether the protection Legal Guardian's consent(formerly known as the Mental Health Act) or permission of the Family Court(revised Civil Code) are required to, or the Mental Health Act should be revised, when mental patient will be hospitalized forcibly. The author proposes that mental patient with Adult guardians should be determined by Legal Guardian's consent and approval of the Family Court, but mental patient without Adult guardians could be determined by Legal Guardian's consent. The issue of Withdrawing of life-sustaining treatment could be occurred due to the aging society and the development of modern medicine, and this has provided difficult, various problems to mankind in Legal, ethical, and social welfare aspects. The need of Death with dignity law or Natural death law has been reduced for a revision of the Civil Code. Therefore, on the issue of Withdrawing of life-sustaining treatment, in the future, intervention of the court is necessary in accordance with the revised Civil Code Section, and Organ Transplantation Act and the brain death criteria may serve as an important criterion.
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