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."

Tags:coma, brain, Terri, Schiavo, life, support, consciousness

Abstract
This paper reviews literature on the debate of administering artificial nutrition and hydration (ANH) to terminal or comatose patients. The paper offers an extensive discussion on the opinions of those both for and against administration. It explores the views of science and medicine and expands on religious, moral and ethical ideas on the topic.

Table of Contents:
Introduction
Literature Review
Method
Findings and Discussion
Conclusion
Bibliography

From the Paper
"A feeding tube brings benefits to a temporarily ill person who cannot swallow and is hungry or thirsty (FamilyDoctor.org 2005). Dehydration or a lack of sufficient fluids in the body can make a person confused and giving him fluids and nutrition can help as he recovers. But a person with an advanced life-threatening illness and is dying may not derive many benefits from ANH, which can extend life but not always. Moreover, there are risks to tube feeding. The liquid being administered may enter the lungs and cause coughing and pneumonia. These feeding tubes can also cause discomfort. They can get plugged up and cause pain, nausea and vomiting or infections. The patient may also tend to pull the feeding tube out. The patient's medical condition, in combination with the risks and benefits of ANH, should be the basis for a decision on whether to administer it. Every situation is different from another (FamilyDoctor.org)."

Tags:debate, feeding, terminal, comatose

Abstract
This paper argues that legally recognizing a patient's "right to die" does not solve the dilemma of whether or not a patient's life should be medically prolonged even if that patient has no hope of recovering from a comatose state. Furthermore, this paper argues that proponents of the rights of the terminally ill should instead focus on other programs that will provide comfort and medical care. The first part of the paper looks at the arguments for recognizing the right to die. The next part then examines the social costs of legal euthanasia, or physician-assisted suicide, as seen in the experience in the Netherlands. This part also evaluates the possible consequences of legalizing euthanasia in the United States. In the conclusion, the paper looks alternatives to legalizing euthanasia, such as hospice care and pain management.

From the Paper
"Proponents of the right to die movement believe that their actions are a compassionate response to the pain of those who are terminally ill. Others add that euthanasia upholds the rights of many individuals, particularly the elderly, the ill and the handicapped. Many physicians thus believe that a case-to-case approach is necessary where, subject to strict regulation, physician-assisted suicide can be an option for the dying."

Tags:diseases, terminal, terry, schiavo, husband, parents, vegetative, state, legal, status

Abstract
This case study discusses two possible nursing diagnoses in a comatose patient post-intracranial hemorrhage secondary to an AVM bleed. Tracheotomy care and providing comfort, particularly through touch, were discussed. Each diagnosis and intrevention is justified in the context of the patient's present state, followed by a detailed discussion of possible interventions and associated issues.

From the Paper
"The placement of an endotracheal tube and eventually a tracheotomy tube was necessary in Mrs. Trans's case because of her impaired consciousness (Durbin, 2005).On day one, her arterial blood gases results showed the following: Vent. Rate NA L/min FIO[2] NA % pH 7.42 (7.35-7.45) pCO[2] 39 mmHg (35-45) pO[2] 143 mmHg (80-110) HCO[3] 24 mmol/L (22-30) Std HCO[3] 25 mmol/L (22-30) Base Excess 0 mmol/L (-3/+3) O[2] Sat 99 % (>94) Note that the immediate concern at the time was the emergency neurosurgery that was undertaken, in which case, general anesthesia would have been the more immediate indication for an artificial airway and oxygen therapy (Baillie, Corben & Higham, 2005)."

Tags:nursing, tracheostomy, diagnosis

Abstract
This paper explains that, in the case of Woodrow, his action of shooting his brother out of compassion for his condition qualifies as active euthanasia, the action of conscious and determined taking of specific steps to cause a patient's death. The author points out that there are three types of euthanasia: voluntary euthanasia, the explicit and voluntary consent of the patient in either verbal form or written consent such as in a living will; non-voluntary euthanasia, the killing of a patient who is unable to make his or her intentions known because of their unconscious, comatose, or other disabled state; and involuntary euthanasia, the killing of an individual whose consent is either explicitly or not explicitly given because they do not wish to die. The third type is obviously morally wrong and will not be discussed in this paper. The paper relates that, if by allowing doctors to eliminate the unnecessary suffering of patients based on either the vocal expression of permission or based on the obvious facts in the case, then situations such as Woodrow's would not occur.

From the Paper
"The case of Woodrow Collums is an example of euthanasia. Woodrow Collums went to the Oak Hills Care Home in Poteet, Texas on November 16, 1981, and saw his brother J.K. Collums. J.K. was a victim of severe Alzheimer's disease, and was unable to care for his bodily needs, could not speak, and could not respond to others. He was fed through a tube. Woodrow made the conscious decision, on that day, to shoot and kill J.K. His defense for his actions was that is brother was suffering greatly, and he could not, in good conscience, allow that suffering to continue. This is euthanasia: the decision to take a life out of compassion."

Tags:consent, voluntary, non-voluntary, involuntary, compassion

Abstract
This essay is a book review of "Paula" by Isabel Allende (Harper Collins 1994). The author proposes that Allende's earnest 'letter' to her comatose daughter, Paula, is a highly textured memoir, which explores the links between memory and the search for identity. The book documents Allende's recovery of the memories of her life and thereby the creation of an identity for herself and her daughter. The novel is engaging both as a highly personal record of a mother's struggle for hope for her lifeless daughter, and as a political statement against the subjugation of immigrant women. Drawing on her background as a journalist, Allende maintains a sober and factual tone to reveal the difficulties faced by a woman often displaced in foreign cultures.

Abstract
The paper discusses the basic moral principles that require one to respect the choice of a patient in end-of-life issues and that physician assisted suicide should be a legal option for terminally ill patients. The paper highlights that the principal objection to physician-assisted suicide stems from traditional religious and moral values that consider human life sacrosanct. The paper notes further that the distinction between passive euthanasia and active euthanasia is largely arbitrary. The paper concludes that religious beliefs regarding the sanctity of human life are still reflected in secular laws prohibiting physician-assisted suicide, but no terminally ill patient should be prevented from choosing euthanasia, particularly where the purpose is to avoid prolonged suffering, a painful death, or profound disability.

Outline:
Introduction
Argument
Conclusion

From the Paper
"However, today, the increased life expectancy resulting from advances in medical science have raised the issue because so many patients now survive well beyond what they perceive to be the end of a life worth living. In many cases, patients suffering from debilitating and painful diseases face the prospect of continual pain and death by slow suffocation or gradual paralysis because legislators have prohibited physician-assisted suicide for any reason. Similarly, this prohibition often applies even to the removal of artificial life support systems of permanently comatose patients whose express wish was to avoid artificial life support."

Tags:prohibiting, legally, refuse, constitutional, issues, comatose, patients

Abstract
This paper argues that the lack of a clear law regarding euthanasia or physician-assisted suicide continues to result in confusion and more suffering. It goes on to argue that many debates regarding euthanasia fail to recognize a social component to the practice. Furthermore, because of tremendous societal costs, the paper argues that government at the national, state, and local levels should take a strong stand to keep euthanasia illegal.

From the Paper
"The high-profile case of Terri Schiavo has once again focused attention on the issue of euthanasia. Schiavo, who has been in a vegetative state for the past 13 years, brings a face to the legal question of when can a third party decide the fate of patients who cannot decide for themselves. According to Schiavo's husband, Terri would not want to live in her present state. Schiavo's parents, however, disagree. The parents have managed to convince Florida governor Jeb Bush to issue a stay, preventing Terri's husband from having her feeding tube removed (Stern and Goddard)."

Tags:legal, status, patients, comatose, unconscious, life, artificially, prolonged, physician-assisted, suicide