Understanding Dying, Death, And Bereavement 7th Edition By Michael R. Leming -Test Bank

Understanding Dying, Death, And Bereavement 7th Edition By Michael R. Leming -Test Bank

 

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Sample Questions Are Posted Below

 

CHAPTER 7

 

            DYING IN THE AMERICAN HEALTH CARE SYSTEM

 

Chapter Outline

 

The Medical Model Approach to Dying

Dying as Deviance in the Medical Setting

Labeling Theory

Deviance Results in Punishment

Normalization of Dying in the Medical Setting

Dying in a Technological Society

The Environment of the Dying Person

Hospital

Home

Nursing Home

Hospice Inpatient Care

End-of-Life Education in Medical and Nursing Schools

Gross Anatomy Lab in Medical Schools

Developing a Sensitivity to Social/Psychological Needs

Developing Communications Skills

The Cost of Dying

Conclusion

Summary

Discussion Questions

Glossary

Suggested Readings

 

True-False Questions

 

1. The Chinese believe that the family and the physician are responsible for the patient’s treatment. True

 

2. The Chinese favor open and frank talk with the patient regarding his or her terminal condition. False

 

3. Like the United States, dying in China primarily occurs in an institutional setting. False

 

4. In the United States the dying patient within the typical acute-care hospital is a social deviant. True

 

5. The dying patient is a deviant in the medical subculture because death poses a threat to the image of the “physician as healer.” True

 

6. Labeling theory focuses on the act or actor rather than on the audience observing. False

 

7. Inherently the dying patient poses a threat to the image of the “model physician.” True

 

8. According to Leming and Dickinson, the dying person can seldom assume normal role functioning. True

 

9. The technological imperative requires that there must be cost-effectiveness in medical treatment. False

 

10. The primary reaction to deviance of any type is punishment of some sort. True

 

11. Dying in America is one activity that by its nature cannot be bureaucratized. False

 

12. In American society, for the patient, the hospital is the preferred place to die. False

 

13. Hospice patients cannot receive both home care and inpatient care. False

 

14. Medical schools in the United States have historically offered only limited assistance to the medical student concerning dying and death. True

 

15. Recent surveys of physicians revealed that they prefer less emphasis on the topic of death and dying in medical schools. False

 

16. The majority of medical schools in the United States offer a required course in thanatology for students. False

 

17. The medical training of most physicians historically seems to be primarily concerned with the patient’s physical state rather than with social-psychological needs. True

 

18. Public policy in the United States relative to health care is based on utilitarianism. False

 

19. The cost of health care in the United States in 2007 was more than $2 trillion. True

 

20. Public health expenditures such as Medicare and Medicaid accounted for nearly half of U.S. health care dollars in 2007. True

 

21. Indirect costs of health care typically include the overhead costs of running a hospital. True

 

22. Part A of Medicare is supplementary medical insurance for physicians’ services, outpatient care, laboratory fees, and home health care. False

 

23. The systematic description of a culture based on firsthand observation is called ethnography. True

 

24. The first U.S. hospital was established in 1713 in Boston. False

 

25. More than 40 percent of Americans over age 65 are expected to spend some time in a nursing home. True

 

26. The author of Living and Dying at Murray Manor is Jaber Gubrium. True

 

 

Multiple-Choice Questions

 

1. Which contributes to the fact that physicians are ill prepared to deal with dying patients?

 

1. Lack of personal experience with death
2. Lack of training provided by medical schools
3. Assumption that physicians are supposed to save lives; thus, the dying patient is a losing battle

*d. All of the above.

 

2. Why is the terminally ill patient considered a deviant in the medical subculture?

 

1. They are always fussy and difficult to handle.
2. Death poses a threat to the image of the “physician as healer.”
3. Death creates embarrassing and emotionally upsetting disruptions in the scientific objectivity of the medical system.

*d. Both b and c.

1. None of the above.

 

3. Which of the following statements is true regarding the Chinese?

 

*a. The Chinese believe the family and the physician are responsible for the patient’s treatment.

1. The Chinese favor open and frank talk with the patient regarding his or her terminal condition.
2. Like the United States, dying in China primarily occurs in an institutional setting.
3. None of the above.

 

4. Which of the following statements is false regarding dying in the United States?

 

1. The idea of dying does not fit within the medical model held in the United States.
2. The dying patient is a social deviant within the typical acute-care hospital.
3. The dying patient is a deviant in the medical subculture because death poses a threat to the image of the “physician as healer.”

*d. Labeling theory focuses on the act or actor rather than on the audience observing.

 

 

5. A federal and state program that uses general revenues to fund health care for the poor is called

 

1. Medicare.

*b. Medicaid.

1. managed care.
2. third-party payments.

 

6. Which of the following statements is true regarding a dying patient?

 

*a. Seventy-five percent of patients are hospitalized at some point during the year before they die.

1. Dying in America is one activity that by its nature cannot be bureaucratized.
2. In American society, for the patient the hospital is the preferred place to die.
3. None of the above.

 

7. Which of the following statements is false regarding medical education in the United States?

 

1. Medical schools have historically offered only limited assistance to the medical student concerning dying and death.
2. Recent surveys of physicians revealed that they prefer more emphasis on the topic of death and dying in medical schools.

*c. The majority of medical schools offer a required course in thanatology for students.

1. The medical training of most physicians historically seems to be primarily concerned with the patient’s physical state rather than with social-psychological needs.

 

8. A federal program of health insurance for persons 65 years of age and older in the United States is

 

1. Medicaid.
2. managed care.
3. third-party payments.

*d. Medicare.

 

9. When sick, we go to a physician to be made well. In the United States this is known as the

 

*a. medical model.

1. wellness program.
2. health initiative.
3. go-well program.

 

10. A prevalent idea in most Western societies, especially the United States, that if the technological capability to do something is available, then it should be done is called

 

*a. the technological imperative.

1. technology in action.
2. a technosolution.
3. none of the above.

 

11. The first hospital was established in the United States in 1713 in

 

1. New York City.
2. Boston.

*c. Philadelphia.

1. New Haven, Connecticut.

 

12.More than  ____ percent of individuals aged 65 and over are expected to spend some time in a nursing home.

 

1. 20
2. 30

*c. 40

1. 50

 

13. The author of Living and Dying at Murray Manor is

 

1. C. Saunders.
2. T. Parsons.

*c.  J. Gubrium.

1. M. Weber.

 

14. A model hospice inpatient care facility in the United States is the

 

1. California Hospice.
2. Minnesota Hospice.
3. Kentucky Hospice.

*d. Connecticut Hospice.

 

15. In Body of Work, Christine Montross observed that in medical schools in _____ the cadavers are treated with much respect.

 

1. China
2. England

*c. Thailand

1. Poland

 

Essay Questions

 

1. Deviance may vary with time and place. What is meant by this statement?

 

2. How could steps be taken to overcome the diminished social and personal power of the hospital patient? Are such limitations on patients necessary for an orderly hospital?

 

3. If a patient’s death represents a failure to a physician, how can medical schools assist in creating an attitude of acceptance of death as the final stage of growth?

 

4. What is “labeling theory”? How does labeling theory apply to terminally ill patients?

 

5. How would health care for the dying patient change in the United States if social policy were based on utilitarianism? Would this be desirable? What would be the manifest and latent consequences of such a social policy?

 

6. Contrast health maintenance organizations with private health carriers such as Blue Cross and Blue Shield. What are the advantages and disadvantages of each?