Psychologists have done little research on the psychological aspects of life support. Research in other areas of psychology has produced results applicable to the life support situation, however. The results of directly and indirectly applicable research indicate that both patients and their intimates suffer less psychological distress if those who have a close positive relationship with the patient maintain emotional closeness to the patient and participate in making decisions concerning life support. Decisions to end treatment are difficult because ending treatment changes the social structure and identity of the survivors. Death is less stressful if the death comes at the right time of life, and the process of dying is neither too long nor too short. People feel less distress if they have appropriate information concerning the situation and have some control.
Get full access to this article
View all access options for this article.
References
1.
ColenB. D., Hard Choices; Mixed Blessings of Modern Medical Technology, G. P. Putnam's Sons, New York, 1986.
2.
LaddJ., Ethical Issues Relating to Life and Death, Oxford University Press, New York, 1979.
3.
OdenT. C., Should Treatment Be Terminated?, Harper & Row, New York, 1976.
4.
JeffkoW. G., Redefining Death, in Death; Current Perspectives, (2nd Edition), ShneidmanE. S. (ed.), Mayfield Publishing Company, Palo Alto, California, pp. 131–137, 1980.
5.
TowersB., Changing Concepts of Death: Clinical Care, Death Education, 6: 2, pp. 125–135, 1982.
6.
HeifetzM. D., The Right to Die, G. P. Putnam's Sons, New York, 1975.
7.
HooglandT., Dying: A Family Affair, Journal of Psychology and Christianity, 4: 3, pp. 5–27, 1985.
8.
BokS., Lies to the Sick and Dying, in Death; Current Perspectives, (2nd Edition), ShneidmanE. S. (ed.), Mayfield Publishing Company, Palo Alto, California, pp. 171–186, 1980.
9.
ToynbeeA., The Relation between Life and Death, Living and Dying, in Death; Current Perspectives, (2nd Edition), ShneidmanE. S. (ed.), Mayfield Publishing Company, Palo Alto, California, pp. 215–222, 1980.
10.
SchulzR. and SchlarbJ., Two Decades of Research on Dying; What Do We Know about The Patient?Omega, 17, pp. 299–317, 1988.
11.
FullerS. and SwensenC., Quality of Life on Cancer Patients and their Spouses, in preparation.
12.
RobertsJ. C.SnyderR., and KjellstrandC. M., Withdrawing Life Support—the Survivors, Acta Medica Scandinavica, 224: 2, pp. 141–148, 1988.
13.
PearlmanR. A. and JansenA., The Use of Quality of Life Considerations in Medical Decision Making, Journal of the American Geriatrics Society, 35: 5, pp. 344–352, 1985.
14.
LackS., I Want to Die While I'm Still Alive, in, Death; Current Perspectives, (2nd Edition), ShneidmanE. S. (ed.), Mayfield Publishing Company, Palo Alto, California, pp. 362–369, 1980.
15.
Wakefield-FisherM., Balancing Wishes with Wisdom: Sustaining Infant Life, Nursing and Health Care, 8: 9, pp. 516–520, 1987.
16.
AbramsonM. and BlackR. B., Extending the Boundaries of Life: Implications for Practice, Health and Social Work, 10: 3, pp. 165–173, 1985.
17.
IngramT. L.HurleyE. C., and RileyM. T., Grief-Resolution Therapy in a Pastoral Context, Journal of Pastoral Care, 39: 1, pp. 69–72, 1985.
18.
ParkesC. M., Bereavement, British Journal of Psychiatry, 146, pp. 11–17, January, 1985.
19.
SolomonH. M., Grief and Bereavement, International Journal of Social Psychiatry, 23: 3, pp. 211–222, 1977.
20.
LynchJ. J., The Broken Heart, Basic Books, New York, New York, 1977.
21.
BeckerD.DulongO., and IgoinL., The Application of the Rorschach to Adolescents on Chronic Hemodialysis, Evolution Psychiatrique, 39: 3, pp. 605–619, 1974.
22.
DeNourA. K.FisherG.MassM., and CzaczkesJ. W., Diagnosis and Therapy of Families of Patients in Chronic Hemodialysis, Mental Health and Society, 1: 4, pp. 251–256, 1974.
23.
LePontoisJ.MoelD. I., and CohnR. A., Family Adjustment to Pediatric Ambulatory Dialysis, American Journal of Orthopsychiatry, 57: 1, pp. 78–83, 1987.
24.
O'BrienM. E., Effective Social Environment and Hemodialysis Adaptation: A Panel Analysis, Journal of Health and Social Behavior, 21: 4, pp. 360–370, 1987.
25.
PrichardJ. G.BaleR. M.Abou-SamraM.DialL. K., and HortonL. S., Severe Cerebral Injury and Brain Death: Management of the Patient's Family, The Journal of Family Practice, 21: 3, pp. 341–248, 1985.
26.
MahanC. K.KruegerJ. C., and SchreinerR. L., The Family and Neonatal Intensive Care, Social Work in Health Care, 7: 4, pp. 62–78, 1982.
27.
SwensenC. H., Introduction to Interpersonal Relations, Scott, Foresman and Company, Glenview, Illinois, 1973.
28.
CarrA. C., Bereavement as a Relative Experience, in Bereavement; Its Psychosocial Aspects, SchoenbergB.GerberI.WeinerA.KutshcerA.H.PeretzD., and CarrA. C. (eds.), Columbia University Press, New York, pp. 3–8, 1975.
29.
ParkesC. M., Psycho-Social Transitions: A Field for Study, Social Science and Medicine, 5, pp. 101–115, 1971.
30.
Anonymous, The Tenth of July, Pediatrics, 63, 1979.
31.
MannesM., Last Rights, Wm. Morrow and Company, New York, 1974.
32.
LangoneJ., Vital Signs; the Way We Die in America, Little, Brown and Company, Boston, Massachusetts, 1974.
33.
NeugartenB. L. and HagestadG. O., Age and the Life Course, in Handbook of Aging and the Social Sciences, BinstockR. H. and ShanasE. (eds.), Van Nostrand Reinhold, New York, pp. 35–55, 1976.
34.
WalworkE. and EllisonP. H., Follow-up of Families of Neonates in Whom Life Support Was Withdrawn, Clinical Pediatrics, 24: 1, pp. 14–20, 1985.
35.
PaulayD., Slow Death: One Survivor's Experience, in Death, Dying, and Transcending, KalishR. A. (ed.), Baywood Publishing Company, Amityville, New York, pp. 37–42, 1980.
36.
ShneidmanE. S., Some Aspects of Psychotherapy with Dying Persons, in Death; Current Perspectives, ShneidmanE. S. (ed.), Mayfield Publishing Company, Palo Alto, California, pp. 202–212, 1980.
37.
BentonR. G., Death and Dying; Principles and Practice in Patient Care, Van Nostrand Reinhold, New York, 1978.
38.
RagatzS. C. and EllisonP. H., Decisions to Withdraw Life Support in the Neonatal Intensive Care Unit, Clinical Pediatrics, 22: 11, pp. 729–735, 1983.
39.
RyanC. and RyanK., A Private Battle, Simon and Schuster, New York, 1979.
40.
GatzM.PopkinS. J.PinoC. D., and VandenBosG., Psychological Interventions with Older Adults, in Handbook of the Psychology of Aging, BirrenJ. E. and SchaieK. W. (eds.), Van Nostrand Reinhold, New York, pp. 755–788, 1985.
41.
PomerleauO. F. and RodinJ., Behavioral Medicine and Health Psychology, in Handbook of Psychotherapy and Behavior Change, GrafieldS. L. and BerginA. E. (eds.), John Wiley and Sons, New York, pp. 483–524, 1986.
42.
MillerS. M., Why Having Control Reduces Stress: If I Can Stop the Roller Coaster, I Don't Want to Get Off, in Human Helplessness; Theory and Applications, GarberJ. and SeligmanM. E. P. (eds.), Academic Press, New York, New York, pp. 71–96, 1980.
43.
ZaritS. H., Aging and Mental Disorders, The Free Press, New York, Chapter 11, 1980.
44.
WortmanC. B. and Dunkel-SchetterC., Interpersonal Relationships and Cancer: A Theoretical Analysis, The Journal of Social Issues, 35: 1, pp. 120–155, 1979.
45.
ZittounR., Quality of Life in Adults with Acute Leukemia, in The Quality of Life of Cancer Patients, AaronsonNeil K. and BeckmannJ. H. (eds.), Raven Press, New York, pp. 183–192, 1987.
46.
HintonJ., Sharing or Withholding Awareness of Dying between Husband and Wife, Journal of Psychosomatic Research, 25: 5, pp. 337–343, 1981.
47.
NorthouseL., The Impact of Cancer on the Family: An Overview, International Journal of Psychiatry in Medicine, 14: 3, pp. 215–241, 1984.
48.
BlumbergB. D.KernsP. R., and LewisM. J., Adult Cancer Patient Education: An Overview, Journal of Psychosocial Oncology, 1: 2, pp. 19–39, 1983.
49.
PetersonC. and SeligmanM. E. P., Causal Explanations as a Risk Factor for Depression: Theory and Evidence, Psychological Review, 91, pp. 347–374, 1984.
50.
McLeodB., Rx for Health: A Dose of Self-Confidence, Psychology Today, 20: 19, pp. 46–50, 1986.
51.
ParmeleeP. A. and LawtonM. P., The Design of Special Environments for the Aged, in Handbook of the Psychology of Aging, (3rd Edition), BirrenJ. E. and SchaieK. W. (eds.), Academic Press, San Diego, pp. 465–489, 1990.
52.
DufaultK., Helping Patients and Families Make Life-Sustaining Treatment Decisions, AORN Journal, 39: 7, pp. 1128–1133, 1984.
53.
JacksonD. L. and YoungerS., Patient Autonomy and “Death with Dignity”: Some Clinical Caveats, in Death; Current Perspectives, (2nd Edition), ShneidmanE. S. (ed.), Mayfield Publishing Company, Palo Alto, California, pp. 331–340, 1980.
54.
JenkinsR. A. and PargamentK. I., Cognitive Appraisals in Cancer Patients, Social Science and Medicine, 26: 6, pp. 625–633, 1988.
55.
EllK. O.MantellJ. E.HamovitchM. B., and NishimotoR. H., Social Support Sense of Control, and Coping among Patients with Breast, Lung, or Colorectal Cancer, Journal of Psychosocial Oncology, 7: 3, pp. 63–89, 1989.
56.
NoyesR., The Dying Patient: Establish His Role to Improve Care, Psychosomatics, 18, pp. 42–46, 1977.
57.
ErstlingS. S., The Shared Burden: When Physicians and Families Decide to Forego Life-Sustaining Treatment, The Journal of Family Practice, 20: 4, pp. 393–399, 1985.
58.
StevensonB. S., Helping the Partner of the Cancer Patient, in The Family Therapy Collections, Aspen Systems Corporation, Rockville, Maryland, pp. 27–34, 1984.
59.
WarnerJ. and SwensenC. H., Stress Management Training for the Control of Pain in Terminal Cancer Patients, Purdue University, W. Lafayette, Indiana, in preparation.
