Abstract In this article, the writer points out that cases like those of Terri Shiavo and Robert Kenneth Durksen put the moral quandaries regarding comatose victims to the forefront of the public's mind. The writer notes that only by fully understanding the condition, and answering questions such as whether or not there is awareness in comatose patients, can the public make informed decisions, when sensitive situations occur. This paper provides an overview of the comatose condition, followed by a review of literature regarding awareness in comatose patients. The writer then presents conclusions drawn from this information, in hopes of shedding further light on such a delicate topic.
Outline:
Introduction
Comatose Overview
Literature Review Regarding Comas and Coma Awareness
Analysis of Findings
Conclusion
From the Paper "The medical term comatose is derived from the Greek word koma, meaning a deep sleep. A comatose patient is in a deep state of unconsciousness that is characterized by the loss of reactivity to external stimuli and absence of spontaneous nervous activity, and cannot be awakened. Coma victims have usually experienced injury or disease of the cerebrum."
"The origin of the injury affects the different patterns of coma. Losses of consciousness for short durations may be caused by concussions, whereas the lack of oxygen, or anoxia, may lead to a coma that lasts for several weeks or is fatal. Sudden loss of consciousness in some patients may be caused by a stroke, which is a rupture or blockage of the vessels that supply blood to the brain."
Abstract This paper looks at issues of death and the medical ethics involved . The author examines the phenomena of comas and brain death and the moral and ethical dilemmas concerned.
From the Paper "Looking back throughout the history of medicine, there was a time when people believed that death occurred when the heart stopped and breathing ceased. Cessation of respiration was often determined by placing a feather beneath the nose of the patient where it would move with the slightest breath. A doctor simply placed their ear on the patient's chest and listened for a heartbeat to determine if the person was still alive. However, since little was known about states of limited or nonexistent consciousness in which a heartbeat was undetectable to the human ear, some people were buried alive. Tragedies like this made it clear that new methods were needed to determine when a person was considered dead. "
Abstract This paper looks at myxedema, a potentially deadly endocrine regulation disease that usually arises in connection with pre-existing hypothyroidism when the normal homeostatic mechanisms for responding to hypothyroidism are overwhelmed. It explores how myxedema is a potentially serious disease, owing to its potential to develop (or "decompensate") into myxedema coma, which is nearly always fatal.
Outline
Background and History
Causes and Frequency
Diagnosis
Treatment
Prognosis
From the Paper "In the context of the disease, coma has a different meaning than its usual connotation, since myxedema coma rarely includes any loss of consciousness, and is far more readily (and often) diagnosed by progressive mental decline in the absence of other causes (Wall, 2000). Luckily, myxedema only progresses to the point of myxedema coma in approximately one out of every thousand cases of hypothyroidism (Manifold, 2001). Since the most likely precipitating factors for the progression of hypothyroidism into myxedema coma include infection such as pneumonia and urosepsis, blood and urine cultures along with chest X-rays are required, and one school of thought also
recommends broad spectrum antibiotic administration concurrent with initial treatment of myxedema."
Abstract This paper presents a detailed description of the ways that acute head trauma affects the brain. Using the author's personal experience with a head trauma several factors of the injury are related and explained in conjunction with the brain itself. Issues such as causes of head injuries and side effects are discussed.
From the Paper "The treatment and care of a person with a head injury will vary depending on the severity of the injury and the complications that are encountered with it. As in the case of the author, the stitches were the most immediate need, however there were several side affects such as extreme fatigue, dizziness, and headaches. The first course of action is to assess vital signs and be sure that the person is stabilized. Watching for signs of coma, internal bleeding and other problems is also part of the initial assessment."
Tags: Concussion, MRIs, CAT, scan, National, Institute, of, Health, Traumatic, Coma, Data, Bank
Abstract This paper describes the moral and ethical issues surrounding euthanasia or assisted suicide and analyzes the current U.S. law. It distinguishes between the two types of euthanasia -passive euthanasia, withdrawal of life support and active euthanasia, the right of a patient to request for a doctor to perform. It investigates the concept of a living will which allows one to specify the circumstances under which you wish to receive particular types of life sustaining treatment should you become terminally ill and unable to convey your decisions to your physician and examines their legalities in different States.
From the Paper "The State of Maryland have laws that permit you to appoint a health care agent or Power of Attorney, someone who makes decisions for the patient if they become incompetent or can no longer speak for themselves. The appointment of these health care agents is most often accomplished through filling out the forms known as health care proxies. Some health care proxy forms allow you to direct your agent to make specific medical treatment decisions in particular situations. These health care agents have the power to make all medical decisions for incapacitated persons, including decisions concerning life-sustaining medical interventions."
Abstract This paper looks at the history of the issues concerning the "right to die" for terminally ill patients. The "right to die" is not a new issue and it has been debated for many years in the courtrooms of America. It examines how the "right to die" debate focuses on a patient's right to decide whether their life should end or when a family of a vegetative patient asks for permission to let their loved one die. It evaluates how, as the medical community becomes even more advanced, it will become important to decide the right to die issues. The author uses analytical skills to dissect and argue several right to die cases that have been presented in court in America and discusses the ethics of the practice as well as presents ideas about the future "right to die" arguments and cases.
From the Paper "One of the first and most famous cases in the right to die debate was the case of Karen Quinlan. Quinlan slipped into a coma and was pronounced in a permanent vegetative state. For many years she was kept alive by tubes and machines though her brain was not showing activity and her body could not fend for itself even in the most simple of tasks such as eating or breathing. Her family wanted her suffering to end not to mention that the financial burden was almost never ending for a person who was never going to recover or improve. The family took the caregivers to court to get the court to give them the right to unplug her feeding tube and allow her to die a natural death. They were refused. It was the first such case in the courts in the nation in recorded history and it received worldwide media attention."
Abstract This paper explains the pros and cons of human cloning and provides enough information on both sides of the argument for the reader to make his or her own informed decision on whether human cloning is ethical or not. This paper presents several areas, including the definition of cloning, an explanation of why questions concerning the cloning of humans have arisen, and a discussion of the facts and opinions that support cloning.
From the Paper "A young couple were married for only three years when the husband was in a terrible car accident. He was unconscious at the scene of the accident and went into a coma shortly after arriving at the emergency room. Although he eventually awoke from the coma, he never returned to his previous level of consciousness. He had suffered severe head trauma and would live out the rest of his days as a vegetable. The wife was very distraught because they had both wanted to have children and now they would be unable to do so. Over the past several years, she had heard a lot amount cloning but wasn't sure it could be done in her case. She believed it was the only way that she and her husband could have children together. Introduction The ethics of human cloning has become a great issue in the past few years. The advocates for both sides of the issue have many reasons to clone or not to clone."
Abstract This paper researches the use of heroin. It reports that this highly addictive and often fatal drug was first developed in the 19th century from morphine and its abuse has become prevalent in North American society. It explains the effects such as nausea, vomiting, constipation, and a feeling euphoria and reports that tolerance can develop to the drug, and if not treated an individual can die or go into a coma.
From the Paper "Heroin, also known by street names such as "ferry dust", "smack", "brown sugar" and "junk," is the most abused and rapidly acting of the opiates. In its purest form, heroin is a white, fluffy powder with a bitter taste. Most illicit heroin ranges in color from white to dark brown due to the impurities from the manufacturing process as well as additives. Heroin also comes in a dark sticky substance commonly known as "black tar heroin." While injection remains the predominant method of use for addicted users, sniffing and smoking heroin, especially among younger users, is rapidly on the rise."
Abstract The paper explains that neisseria meningitidis bacteria cause a variety of diseases, the most common being meningitis or septicemia. The paper discusses how the infection causes bleeding into the skin and organs and, in a matter of hours, shock, coma, and death can occur even with appropriate treatment. The paper further discusses which patients are at an increased risk for neisseria meningitidis.
From the Paper "Edmonton and Quebec are the only 2 outbreaks where statistics can be found, and they offer a good framework to discuss all the headings. Introduction Neisseria meningitidis bacteria cause a variety of diseases, the most common being meningitis or septicemia. The infection causes bleeding into the skin and organs, and in a matter of hours shock, coma and death can occur even with appropriate treatment. People who have asplenia and complement deficiencies are at increased risk for Neisseria meningitidis."
Abstract This paper details the effects that alcohol has on all body systems, including the brain, liver, heart and digestive track. Arguments for the moderation consumption of and abstinence from alcohol are presented, as well as information about alcoholism and its genetic cause. Next, the paper explains how alcohol is metabolized from the point of ingestion. Finally, the paper presents the long term cause of CDV, dementia, and diabetes. There are six figures to support the research, including charts of the chemical metabolization of alcohol, and the progressive effect of intoxication on body and behavior by BAC.
From the Paper "There are three phases in the metabolism of alcohol: absorption, distribution and elimination. Absorption is the phase in which the greatest level of intoxication is experienced, a state that may be quantified by assessing blood alcohol content (BAC). At any point in metabolism, a drinker's blood alcohol content measures grams of ethanol per 100 milliliters of blood. However, since metabolic rate varies in different individuals, BAC is not necessarily a direct indication of how many drinks were consumed. Instead, BAC is influenced by such factors as the amount of food in the stomach, sex, and body weight and composition. Generally speaking, females have a lower body weight and higher percentage of body fat, making them more sensitive to alcohol. "
Abstract The paper lists eight questions that evaluate a case of head injury to a child, which could help the emergency response team assess whether the patient is alert and cognizant of his or her surroundings and whether risk exists for severe injury. The paper explains the risk factors in this patient's condition and notes the possibility of latent injury.
From the Paper "This case study involves an 8-year old with obvious trauma to the face and head. There is no apparent fractures of the extremities, and while the patient is awake, he is only semi alert. The following eight questions will be crucial in evaluating this case. The questions are simple, given the patients age and the likelihood the boy may suffer from some form of shock following the injury. Each question focuses on assessing the extent to which neurological impairment exists, with some questions assessing the potential for cervical spinal damage, and others assessing whether the boy suffers from a concussion or related injury. Immobilization of the cervical spine will help prevent additional injury to the patient during questioning (NICE, 2003). "
Abstract This paper examines the arguments for and against the various philosophical understandings of the composition of human beings and whether or not consciousness exists. It looks at how the question of how to consolidate an understanding of our (physical self) body with our (immaterial self) soul is not a new discussion and how an understanding of how these aspects of our humanity interact fuels our belief system and our worldview, about subjects as diverse as life after death, stem cell research, the value of therapy for the brain injured and whether or not to pull the plug on an individual in a coma.
From the Paper "The study of consciousness has become more popular recently. Its interdisciplinary focus further highlights the problem of definitions since, for example, a psychologist, a physicist and a philosopher would not use the word in the same way. Beichler defines consciousness as the "growing 'entanglement' or awareness of 'life,' 'mind' and the interconnections of all things in the universe via the fifth dimension" (p. 110). Physicists would argue that for consciousness to exist something must be alive, meaning that it is first necessary to determine whether something is alive or not. It is also important to consider whether this living thing has "self-motivation". I agree with Beichler when he suggests that while we detect our world in three or four dimensions there could in fact be more, within which an understanding of consciousness and intuition could be found. "
