Will To Live Research Articles

Rhys matters: new critical perspectives

Foreword Mary Lou Emery Introduction Mary Wilson and Kerry L. Johnson PART I: ALTERNATIVES AND ALTERITIES: MARKET, TIME, LANGUAGE 1. Menu, Memento, Souvenir: Suffering and Social Imagination in Good Morning, Midnight Andrea Zemgulys 2. Clockwork Women: Temporality and Form in Jean Rhys's Interwar Novels Nicole Flynn 3. Language and Belonging in Jean Rhys's Voyage in the Dark Ania Spyra PART II: BEING AND BELIEVING: JUDEO-CHRISTIAN INFLUENCES AND IDENTITIES 4. Religion and Rhys Steve Pinkerton 5. Pride, No Name, No Face, No Country: Jewishness and National Identity in Good Morning, Midnight Jess Issacharoff PART III: THE LOCATION OF IDENTITY: WRITING SPACE AND PLACE 6. The Country and the City in Jean Rhys's Voyage in the Dark Regina Martin 7. '...that misty zone which divides life from death': The Concept of the Zombi in Jean Rhys's Short Fiction Melanie Otto 8. Reclaiming the Left Bank: Jean Rhys's 'Topography' in Left Bank and Quartet David Armstrong PART IV: PLEASURE, POWER, HAPPINESS 9.The Trouble with 'Victim': Triangulated Masochism in Jean Rhys's Quartet Jennifer Mitchell 10. The Good Life Will Start Again: Rest, Return, and Remainder in Good Morning, Midnigh t Andrew Kalaidjian 11. The Un-happy Short Story Cycle: Jean Rhys's Sleep it off, Lady Paul Ardoin

Grado de conocimiento y actitudes de los profesionales ante el Documento de Voluntades Anticipadas: diferencias entre distintos profesionales y provincias de una misma autonomía

ObjectivesPrimary: To determine the differences, by occupational category and province, in the knowledge and attitudes of health professionals on the Living Wills Document (LWD) in 4 Andalusian provinces: Cordoba, Jaen, Cadiz, and Granada. Secondary: To determine the number of documents prepared in these areas and the number consulted in terminal situations. Material and methodsDescriptive observational multicenter study, with 17 health areas in 4 Andalusian provinces. Target population: Family doctors, nurses and social workers of the areas studied (n=340).Interventions Validated self-administered questionnaire about advance directives. Descriptive and bivariate (×2) analysis of data was performed. ResultsMean age 46±8.8 years, 53.2% women. Physicians 56.1%, nurses 41.1%, social workers 2.6%. The mean score (0-10) of their knowledge was 5.42±2.41, with 78.4% believing that LWD are regulated in Andalusia (provinces differences, P=.001). More than one-third (36.7%) had read the document (differences by occupation, P=.001). The mean score on the advantage of preparing a LWD for the patient was 8.27±2.16 (significant differences between provinces P=.02). Mean score about the practitioner would respect the wishes of a patient in a LWD was 9.14±1.64 (significant difference between provinces P=.03). The mean score of the question about expressing the desires of the professional on preparing their LWD in the following year was 4.85±3.74 (P=.02). ConclusionsThere are different behaviors between professions on reading the LWD. There are differences between provinces in the following aspects: whether the documents are regulated, whether the professionals prepare the LWD, and whether the professionals respects the provisions of the LWD.

Practical resource for creating a Catholic living will.

Dear Editor, I read with interest the recent issue of the Linacre dedicated to geriatrics and end-of-life care. This is such a timely topic! With the implementation of Obamacare – which is government-run health care funded at the rate of economic inflation, not the more rapidly increasing healthcare inflation – there will be ever-increasing healthcare rationing. This will lead to escalating pressure to withhold life-preserving treatment (including food and water) especially to vulnerable populations including the elderly, the disabled, and the poor. As a result, end-of-life documents are already incredibly important and will become ever moreso. The article by Dr. Morrow articulates several key principles that should be present in an end-of-life document that adheres to Catholic principles – one that recognizes and respects the inherent dignity for human life for its own sake, one that ensure ordinary care and comfort care, and one that is “personalized” by appointing a healthcare proxy who understands and can implement your wishes according to the situation at hand. While there are several end-of-life document templates available, most do not adhere to the principles outlined in Dr. Morrow's article. A practical, easy-to-use resource for developing an end-of-life document that adheres firmly to the principles outlined in Dr. Morrow's article is the Will To Life Project developed by the National Right To Life Committee. From this website, one can download a legally valid document for any of the fifty states. While creating a Catholic end-of-life document can be daunting, this resource provides a practical starting point and a template anyone can complete. For more information, check out: http://www.nrlc.org/medethics/willtolive/.

Características sociosanitarias de quienes formalizan el documento de voluntades anticipadas

IntroductionThe Living Will (LW) is well publicised, and still largely unknown to the general public and health professionals. ObjectiveTo describe the characteristics of the subjects that formalize a LW related to socio-demographic situation, health status, degree of dependence, healthcare characteristics and psychosocial aspects. MethodDescriptive observational study conducted in the Health Area of Albacete including 123 people who formalized the LW in a Will Register in 2011. Study variables included: self-perceived health, functional status, morbidity, socio-demographic characteristics, use of health services, attitudes towards the LW, and psychosocial aspects. ResultsThose that made an LW, were mainly women (64.2%), had a mean age of 53.3 years (SD: 14.5), higher levels of education (61% with at least secondary education), and a lifestyle other than living with a partner, and with children (67.5%). The majority were self-sufficient for their daily living activities (98.4% to 94.3% for basic and instrumental), and suffered from chronic disease (73.2%). Despite lasting relationships with their physicians (9.4 years; SD: 7.9), there was very little talk about the end of life (18.3%). More than a half had a family member who had previously signed a document (54.5%). More than two-thirds (68.5%) considered this document useful in the death of a relative, and also a 56.7% had also served as a caregiver of a terminal patient. ConclusionsMiddle-aged people, predominantly women, formalized an LW most often. They are usually chronic, but self-sufficient for their daily living activities, and are convinced that they can influence their health situation.

A New Approach to the Ethics of Life: The 'Will to Live' in Lieu of Traditionalists' Notion of Natural/Rational and Progressives' Autonomy/Consciousness

A New Approach to the Ethics of Life: The 'Will to Live' in Lieu of Traditionalists' Notion of Natural/Rational and Progressives' Autonomy/Consciousness

The will to live and death-related decline in life satisfaction.

This study examined the relationship between the will to live (WTL) and death-related decline in life satisfaction in 382 decedents who participated in a national 3-wave study (mean age at study entry 79 years). Growth-curve models revealed that distance to death was more predictive of declines in life satisfaction than chronological age. WTL moderated, but did not mediate, death-related decline in life satisfaction. Those with high WTL did not show a decrease in life satisfaction as death approached. This study highlights an important motivational construct, WTL, which regulates life satisfaction when death approaches.

Honoring Patient Care Preferences: Surrogates Speak

A growing body of evidence has pointed to the stressful experience surrounding surrogate decision-making on behalf of incapacitated patients. This study (N = 59) asked surrogates to speak about their experiences immediately after having made a life-sustaining treatment decision. Grounded theory analysis revealed four themes: (1) the emotional impact of the decision-making process on the surrogate; (2) the difficulty of watching a loved one's health deteriorate; (3) the importance of having a Living Will (LW) or other written/verbal instructions; and (4) the reliance on spirituality as a means of coping with the surrogate experience. Findings of this study suggest that engaging surrogates at the time of patient admission may be essential in order to clarify patient preferences and strengthen communication between surrogates and the interdisciplinary healthcare team.

Pathways From Religion to Advance Care Planning: Beliefs About Control Over Length of Life and End-of-Life Values

To evaluate the extent to which religious affiliation and self-identified religious importance affect advance care planning (ACP) via beliefs about control over life length and end-of-life values. Three hundred and five adults aged 55 and older from diverse racial and socioeconomic groups seeking outpatient care in New Jersey were surveyed. Measures included discussion of end-of-life preferences; living will (LW) completion; durable power of attorney for healthcare (DPAHC) appointment; religious affiliation; importance of religion; and beliefs about who/what controls life length, end-of-life values, health status, and sociodemographics. Of the sample, 68.9% had an informal discussion and 46.2% both discussed their preferences and did formal ACP (LW and/or DPAHC). Conservative Protestants and those placing great importance on religion/spirituality had a lower likelihood of ACP. These associations were largely accounted for by beliefs about God's controlling life length and values for using all available treatments. Beliefs and values about control account for relationships between religiosity and ACP. Beliefs and some values differ by religious affiliation. As such, congregations may be one nonclinical setting in which ACP discussions could be held, as individuals with similar attitudes toward the end of life could discuss their treatment preferences with those who share their views.

Do You Wish to Live to the Age of 100? A Survey of Older Men

Do You Wish to Live to the Age of 100? A Survey of Older Men

Conocimientos y actitudes sobre las instrucciones previas de los médicos de Atención Primaria y Especializada del área sanitaria de Ferrol

ObjectivesTo evaluate the knowledge, the experience and the attitudes of the health professionals of Primary (PC) and Specialized (SC) Carein our Health Area with respect to Living Wills (LW). Material and methodDescriptive, cross-sectional study, by means of a survey addressed to PC and SC doctors Ferrol (Galicia, Spain) Health Area ResultsA total of 120 (42.85%) doctors completed the questionnaire.The professionals self-assessed their level of knowledge with a mean of 3.83 (rank from 0 to 10). Only 21 professionals (17.5%) had objective knowledge of LW, that is to say, they fulfilled the following premises: they had read some pieces of LW legislation, had read an LW document and knew the elements that could figure in it. There were differences that verged on the statistical significance in the objective knowledge between PC and SC doctors (11.7% versus 23.3%, P= .093) and between professionals with under 10 years of professional experience and those with more than 10 years (6.9% versus 21.1%, P=.081). These differences reached statistical significance in some of the items that valued the objective knowledge. A few professionals (28 (23.3%)), had explained to their patients the convenience of having written an LW document, and even fewer (8 (6,7%)) had helped patients with writing one. ConclusionsThe knowledge of health care professionals can be clearly improved. The highest deficiency was found between PC professionals and those with less experience. Nevertheless, they showed a favourable attitude towards them.

Public Policy: Where we've been…Where we need to go

Advance care planning in its modern guise started nearly a half-century ago in the US with Living Wills, graduated to include durable powers of attorney, and various special formats including...

Articles and Publications

Articles and Publications Christopher Densmore and Barbara Addison An annotated bibliography of the titles listed below is available at the Friends Historical Association website: www.haverford.edu/library/fha Alice Southern, "The Rowntree History Series and the Growth of Liberal Quakerism," Quaker Studies, 16.1 (Sept. 2011), 7-73, puts forward the thesis that Quakers in the late nineteenth and early twentieth century used history to construct a liberal view of Quakerism. Keeping Us Honest, Stirring the Pot: a Festschrift in Honor of H. Larry Ingle, edited by Chuck Fager; associate editor: Becky Ingle (Fayetteville, NC: Kimo Press, 2011), includes scholarly essays on Quaker history, reminiscences about Larry Ingle, a selection of his shorter works, and a complete bibliography of his writings. John Woolman and the Affairs of Truth: the Journalist's Essays, Epistles, and Ephemera, edited by James Proud (San Francisco, CA: Inner Light Books, 2010), gathers together in one volume all the known writings of John Woolman (excluding the Journal) which were intended for general readers, including previously unpublished texts. Jon Kershner, "The (Com)Motion of Love: Theological Formation in John Woolman's Itinerant Ministry," Quaker Religious Thought, no. 116/117 (Dec. 2011), 23-36, provide another perspective on Woolman. Dear Friend: Letters & Essays of Elias Hicks; edited by Paul Buckley (San Francisco: Inner Light Books, 2011), includes letters and essays by Hicks as well as notes by the editor. Historical Dictionary of the Friends (Quakers), Margery Post Abbott et al. (Lanham, Md.: Scarecrow Press, 2012), is an expanded second edition. Geoffrey Durham, The Spirit of the Quakers (New Haven, CT: Yale University Press, 2010), is an overview of Friends and their beliefs through selected writings including passages from the journals of George Fox, John Woolman, Mary Penington and Pierre Ceresole. The first generation of Quakerism continues to be a major interest. Hillary Hinds, George Fox and Early Quaker Culture (Manchester: Manchester University Press, 2011), examines the distinctiveness and cultural practices of early Quakerism. David L. Wykes, "Early Religious Dissent in Surrey after the Restoration," Southern History, [England] 33 (2011), 54-75, examines the treatment of Quakers and other dissenters under the Act of Conformity from 1662 to 1672. Other works include Carme Font Paz, "'I Have Written the Things Which I Did Hear, See, Tasted and Handled': Selfhood and Voice in Katherine Evans' and Sarah Cheevers' A Short Relation of Their Sufferings (1662)," Sederi-Yearbook of the Spanish and Portuguese Society for English Renaissance Studies, 20 (2010), 27-56; Erin Bell, "The Early Quakers, the Peace Testimony and Masculinity in England, 1660-1720," Gender & History, 23.2 (August 2011), 283-300; La Tonia Winston, No Sex in the Soul: Proto-Feminist Theology in 17th [End Page 39] Century British Quakerism - Toward Egalitarian Relationships Between Women and Men in Ministry (Thesis (M.A.) — Regent University, 2010); James Mawdesley, "Quakers, Tithe Opposition, and the Presbyterian National Church: the Case of Cartmel, Lancashire, c. 1644-1660," Journal of Historical Sociology, 24.3 (Sept. 2011), 381-408; Krista J. Kesselring, "Gender, the Hat, and Quaker Universalism in the Wake of the English Revolution," The Seventeenth Century, 26.2 (Oct. 2011), 299-322; and Richard Bailey, «Muggletonian-Quaker Debates,» Quaker Studies, 16.1 (Sept. 2011), 74-84, focusing on theological understandings of the nature of Christ. Leslie Forster Stevenson, Open to New Light: Quaker Spirituality in Historical and Philosophical Context (Exeter [UK]; Charlottesville VA: Imprint Academic, 2012), is about the "the meaning of life" or "the spiritual quest" from Socrates to Kant, George Fox and Robert Barclay. The Experience of Revolution in Stuart Britain and Ireland: Essays for John Morrill, edited by Michael J. Braddick and David L. Smith (Cambridge: Cambridge University Press, 2011), includes two Quaker-related essays: "On Shaky Ground: Quakers, Puritans, Possession, and High Spirits" by Tom Webster, and "The Cromwellian Legacy of William Penn" by Mary K. Geiter. Recent Quaker interpretations of the importance of seventeenth century Friends include Anne Adams, "The Vision of Early Friends," The Friends Quarterly, 39.3 (Aug. 2011), 34-40; David Ian Hamilton, "Formed in the Will of Life: Isaac Penington and Spiritual Growth," The Friends Quarterly, 39.4 (Nov. 2011), 41-46; and Lu Harper, Plow Up the Fallow Ground: a Meditation...

A Revolution of Dignity and Poetry

The most famous slogan chanted in Tunisia in January, then in Egypt, Yemen, Libya, and Syria, is a reincarnation of opening lines of the poem “The Will of Life,” written in 1933 by the Tunisian poet Abou el-Kasem Chebbi (1909–1934), which now form the closing part of Tunisia’s national anthem and have been sung by some of the most influential Arab stars, written on protest banners, and shouted by students in the face of French and English occupiers and their own governments. The couplet even entered the folklore of global protest music and poetry, and was adopted by the International Solidarity Movement. On January 14, 2011, in front of the forbidding Ministry of the Interior in Tunis, crowds shouted their version of the poem–“The people want to bring down the regime”–and fate responded. One key feature of the system during Ben Ali’s rule was a duality or parallel existence of two opposing systems of values and cultural production. One was dominant, while the other was repressed but survived in various forms and in uneven ways. The present essay is, in part, the story of that survival and eventual victory. I draw on printed material, extensive fieldwork, and personal observation in Tunisia and Egypt, personal recordings, interviews, the media, and Internet sites in an attempt to provide a more complex story of culture during and before the wave of revolts, particularly in Tunisia.

Life Will Never Be the Same Again: Examining Grief in Survivors Bereaved by Young Suicide

This article explores existing assumptions about the nature of bereavement by suicide. Drawing on data from a U.K. study of student suicide, we hope to contribute to a fuller understanding of the uniqueness of bereavement by suicide and new pathways for grief research. In this article we argue that bereavement by suicide has a number of common themes and characteristics. Analyzed in accordance with Jordan's (2001) review, our data supports the idea that the thematic content of the grief associated with suicide bereavement is distinctive and guilt is a particularly important feature. We argue that no other type of death is likely to bestow this particular negative emotion on survivors in equivalent measure. Findings on the impact of social processes and family systems were mixed. Explanations to account for these data along with recommendations for intervention and research are discussed.

“Take My Organs, Please”: A Section of My Living Will

“Take My Organs, Please”: A Section of My Living Will

Advance Directives in an Oncologic Intensive Care Unit: A Contemporary Analysis of their Frequency, Type, and Impact

Our objective was to provide a contemporary analysis of the prevalence, types, and impact of advance health care directives in critically ill cancer patients. We retrospectively reviewed all intensive care unit (ICU) admissions (January 1, 2006 to April 25, 2008) at an oncologic center and identified all patients who completed a living will (LW), or health care proxy (HCP), or neither prior to ICU admission. Demographics, clinical data, end-of-life (EOL) parameters and outcomes were compared among three groups: LWs, HCPs, and no LW or HCP. Of 1,333 ICU admissions, 1,121 patients (84%) were included for analysis: 176 patients (15.7%) had LW, 534 (47.6%) had HCP and 411 (36.7%) had no LW or HCP. Patients with LW were significantly more likely to be older and white as compared to patients with HCP alone, or no LW or HCP. There were no significant demographic differences between patients with HCP or no LW or HCP. Patients with HCP alone, or no LW or HCP, were significantly more likely to have Medicaid than patients with LW. There were no differences noted in ICU care, EOL management, or outcomes among the three groups. The prevalence of LWs in patients admitted to our oncologic ICU is low. More than half of the remaining patients had designated HCPs. Older age and white race were associated with the presence of LWs. However, the presence of LWs or HCPs did not influence ICU care, EOL management or outcomes at our institution.

Our Stories: Essays on Life, Death, and Free Will, by John Martin Fischer.

Our Stories: Essays on Life, Death, and Free Will, by John Martin Fischer.

Literacy-Fair Measurement of Health-Related Quality of Life Will Facilitate Comparative Effectiveness Research in Spanish-Speaking Cancer Outpatients

Health-related quality of life (HRQL) assessment is frequently used in comparative effectiveness research, but low-literacy patients are often excluded. Appropriately translated and user-friendly HRQL measures are essential to ensure inclusion of low-literate and non-English-speaking patients in comparative effectiveness research. To compare HRQL responses across literacy levels in Spanish-speaking patients with cancer using a multimedia touch screen program. A total of 414 adult patients with cancer (213 with low literacy and 201 with high literacy). The touch screen system administered 3 questionnaires: The Functional Assessment of Cancer Therapy-General, the Short Form-36 Health Survey, and the Standard Gamble Utility Questionnaire. Measurement bias was evaluated using item response theory. Effects of literacy on HRQL were evaluated using regression models. Patients rated the touch screen easy to use and commented favorably on the multimedia approach. There was statistically significant item response theory measurement bias in 6 of 10 HRQL subscales; however, only 3 showed meaningful bias. Low-literacy patients had significantly lower mean scores on 3 of 4 Functional Assessment of Cancer Therapy-General subscales, before and after adjustment for patient characteristics. Low-literacy patients also had significantly lower mean scores on 5 of 6 Short Form-36 subscales; adjustment for patient characteristics attenuated or eliminated differences. Similar proportions of low- and high-literacy patients valued their current health as equivalent to perfect health. This study demonstrates the feasibility of this multimedia touch screen program for low-literacy patients. The program will provide opportunities to evaluate the effectiveness of interventions in more diverse patient populations.

Ask a Different Question, Get a Different Answer: Why Living Wills are Poor Guides to Care Preferences at the End of Life

Living wills have a poor record of directing care at the end of life, as a copious literature attests. Some speculation centers on the questionable correspondence between the scenario described in living wills versus the real-life circumstances that typically arise at the end of life. To assess the strength of association between responses to a standard living will question and preferences for treatments in six end-of-life scenarios. Cross-sectional. Telephone interviews. Two hundred two community-dwelling men and women 70 years of age or older in the greater Philadelphia area. Strength of preferences for four life-sustaining treatments in each of six poor-health scenarios. Associations between responses to the standard living will question and preferences for treatment (means across the four) in six specific scenarios were statistically significant but modest in size, accounting for 23% of variance at most. The association for the worse-case scenario (severe stroke with coma) was significantly stronger than for any other association. The modest correspondence between living will responses and wishes for life-sustaining treatment in specific scenarios helps to elucidate the living will's poor performance. Presentation of more realistic end-of-life scenarios should improve the living will's ability to guide care, as well as preparing patients and families better for the end of life.

Will to Live

A presente resenha busca analisar os principais aspectos abordados por João Biehl na obra Will to Live: Aids Therapies and the politics of survival. Perpassando por questões econômicas e sociais relacionadas à saúde pública, o trabalho não ignora sua missão antropológica, lançando um olhar individualizado sobre os pacientes e suas histórias de vida. Para bem retratar tais objetivos, utiliza-se de uma metodologia descritiva crítica, tecendo comentários sobre cada um dos pontos de investigação do antropólogo, sem, contudo, pretender esgotar a riqueza do seu trabalho investigativo.