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Death by exsanguination not painful?

Death by exsanguination not painful?


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Several places on the internet seem to purport that animal sacrifice is painless because exsanguination causes no pain. That sounds unscientific to me and an attempt to appease culture than than using science. For instance this question on the se and others like it on the internet. Is there a difference between pig and cow anatomy that makes religious slaughter of the latter less painful?

Could someone comment on the validity of this research?

Schulze W, Schultze-Petzold H, Hazem AS, Gross R. Experiments for the objectification of pain and consciousness during conventional (captive bolt stunning) and religiously mandated (“ritual cutting”) slaughter procedures for sheep and calves. Deutsche Tierärztliche Wochenschrift 1978 Feb 5;85(2):62-6.


This is of course a controversial topic with there being supporters for both methods of slaughter. First of all, The research paper that you have mentioned is a highly cited one and it is the foremost study that supporters of exanguination use to support their method of slaughter. However, the author himself (Wilhelm Schulze) has stated and I quote

"objective results presented for the captive bolt application in sheep indicates that the captive bolt device used is suspect" and that these initial "scientific findings and the results presented are only a very first contribution" and that they "need to be followed as a high priority by further investigations in the continuation of the scientific clarification of the issues of loss of pain and consciousness during slaughter of this kind with and without stunning using the same experimental approach with a representative number of grown cows of various breeds." (reference)

Since stunning methods have advanced (reference) from the time this paper was published (1978), it would probably be a bit unfair to hold onto this paper as proof for supporting exsanguination. Moreover, in another study, in which measurements were done with an electro-corticogram it was found that

Captive bolt stunning followed by sticking one minute later resulted in immediate and irreversible loss of evoked responses after the stun. Spontaneous cortical activity was lost before sticking in three animals, and in an average of 10 seconds after sticking in the remaining five animals. The duration of brain function after shechita was very variable, and particularly contrasted with captive bolt stunning with respect to the effects on evoked responses. These were lost between 20 and 126 seconds (means of 77 seconds for somatosensory and 55 seconds for visual evoked responses) and spontaneous activity was lost between 19 and 113 seconds (mean 75 seconds) after slaughter (reference).

The two questions that have to be answered in exsanguination are

-- Does the neck cut cause pain?

-- How long does it take for the animal to lose enough blood for insensibility to occur and for any perception of pain or suffering associated with slaughter to disappear?

With regard to pain, in the process of cutting the major blood vessels leading to and from the brain a number of other tissues are also severed by the extensive neck cut including muscle, skin, sensory and motor nerves etc. There is a chance that this might cause significant shock and fear to the animal. The time to lose consciousness is highly variable in exsanguination. (reference)

Very good arguments are presented in this article and I highly recommend that you go through it.


Xniquet's middle finger technology

“I would fatally slit my wrists if I wasn't such a friggin' coward when it comes to pain. Anyone know of a practically painless way to commit suicide that doesn't involve buying special equipment?”


Since Death is on sales here, here another list of the worst ways to die:

-Go to the time displacement chamber travel back to the year before you were born, and kill your mother!

-Staying in an infinite loop that you can't get out of.

-Getting run over by an ambulance that was suppose to come and save you.

-Making out with a hyeana or rabid wolverine.

-Being raped and decapitated by a teddy bear with a thirst for blood and man flesh.

-Cracking open a egg and finding a fully formed chicken --- And then cooking it into your omelet anyway --- and then choking on its tiny bones.

-Accidentally drinking that milk that you had left in the cupboard for the last month or so.

-Being run over by a trailer ---- seven times.

-Waking up a dead person, and then realizing that they are dead, makes you have a heart attack, and then THEY wake YOU up dead.

-Being a vampire and sucking out someones blood and after they yell "haha, I have AIDS!!"

-Attempting to solve hunger by not eating.

-Papercut inflicted by Giant Paper.

-Alien lays eggs inside your chest.

-Castration By Wooden Spoon.

-Eaten by zombies, turned into a zombie, then eaten by zombie eating superzombies.

-Choking on your own vomit.

-Fatal Watermelon-related accident.

-Gaining super strength, but not super toughness then crushing yourself trying to bench a car on a park bench.

-Driving a burning car into a burning building where they store chainsaws and acid and then the firemen come but they're actually alligators in acid proof fireman disguises and they spray you with vinegar and lemon juice and swallow you whole and inside the alligator's stomach is this little guy who's like "This is my home get the hell out!" and he shoots you with a shotgun full of rock salt and sicks his pet badger on you and saws your leg off and he kicks you out and you get a staph infection in the alligator's colon and you're pooped out into the sewer where you drown in filth and the city power main breaks and lands in your eye electrocuting you and your spleen explodes and you find out you have AIDS and a ninja turtle fucks you to death and now he has AIDS and you're covered in radioactive ooze and your ass becomes a mutant crab that starts pinching your ass and a hobo steals your skin and they take you to the morgue and freeze you to death and the coroner is that damn ninja turtle who fucks you to death again and gives you AIDS again and a spider lays eggs in your hair and they bury you alive and you suffocate and the bottom falls out of your grave and you fall into a bottomless pit and you go to hell.


++update: this is actually a reply of the comment on one of my previous post. how to slit your wrist the right way


The Biology of Grief

Scientists know that the intense stress of grieving can affect the body in various ways, but much remains a mystery.

In 1987, when my 18-year-old son was killed in a train accident, a chaplain and two detectives came to my house to notify me. I didn’t cry then, but a wall came down in my mind and I could do nothing except be polite and make the necessary decisions. When friends and relatives showed up, I was still polite, but the wall had now become an infinite darkness and I was obviously in shock, so they took over, helping me to eat and notify people and write death notices.

I’ve been thinking a lot lately about the more than 565,000 people who have died from Covid-19 in the United States. Each of them has left, on average, nine people grieving. That’s more than five million people going through the long process of grief.

Manisha Patel, a senior business systems analyst in Bensalem, Pa., lost her father, Ramesh Patel, to Covid-19 in June. “I have been through the toughest time of my life,” she said. “I feel heavier, but I weigh no more and I eat less. And there’s a lot of gray hair I didn’t have. My heart aches for him, it longs for him, it looks for him.”

When someone you love dies, experts have a pretty good sense of the path that grief takes through the mind, but have only a general sense of how it progresses through the rest of the body. First is a shock in which you feel numb or intensely sad or angry or guilty or anxious or scatterbrained or not able to sleep or eat or any combination of the above. During those first weeks, people have increased heart rates, higher blood pressure and may be more likely to have heart attacks. Over their lifetimes, according to studies done mostly on bereaved spouses, they may have a higher risk for cardiovascular disease, infections, cancer and chronic diseases like diabetes. Within the first three months, research on bereaved parents and spouses shows that they are nearly two times more likely to die than those not bereaved, and after a year, they are 10 percent more likely to die.

With time, most people stabilize they begin to learn — gradually and on their own timeline — how to more or less continue with their lives and function in society. But studies suggest that after six to 12 months, about 10 percent of bereaved people have not begun to function better. They get stuck in what’s called “complicated grief”: they stay completely preoccupied with loss and persistent yearning, and remain socially withdrawn.

Scientists know that grief is not only psychological, it’s also physical. They know that it causes the brain to send a cascade of stress hormones and other signals to the cardiovascular and immune systems that can ultimately change how those systems function. But nobody knows how those systems act together to create the risks of diseases and even death.

One reason scientists don’t know more about the biology of grief is that only a handful of researchers study it, and they are usually psychologists with biological interests. Mary-Frances O’Connor, a psychologist who researches grief at the University of Arizona, studies both the psychology of grief and its biological changes in the laboratory and is one of the few researchers who straddles both fields. Hybrid science is seldom funded well grief is neither a disease nor is it classified as a mental disorder, and the main funding agency, the National Institutes of Health, has no single established channel for funding it.

Nevertheless, researchers have found enough people to take surveys and get blood tests and scans to note some patterns.

Chris Fagundes, a psychologist at Rice University, said that in his own lab, he and his team have found links between grief, depression and changes to the immune and cardiovascular systems. In one study published in 2019, he and his team performed psychological assessments on 99 bereaved people about three months after the deaths of their spouses, and then took blood samples. Those who experienced higher levels of grief and depression also had higher levels of the immune system’s markers for inflammation.

“Chronic inflammation can be dangerous,” Dr. Fagundes said. “It can contribute to cardiovascular disease, Type 2 diabetes, some cancers.” In another study of 65 people, published in 2018, Dr. Fagundes and his colleagues found that bereaved spouses who had higher levels of markers for inflammation also had what experts refer to as lower heart rate variability — a characteristic that can contribute to an elevated risk for cardiovascular disease.

Other studies have found effects on the cardiovascular system, too. In one, published in 2012, researchers measured the heart rates of 78 bereaved people twice — once for 24 hours within the first two weeks of a spouse or child’s death, and again for the same amount of time six months later. They found that their heart rates were initially faster, then returned to normal, suggesting that the bereaved may have been at least temporarily at higher risk for heart disease. Another study published in 2012 found that those with higher scores on grief assessment tests also had increased levels of cardiovascular clotting factors, possibly raising the risk of developing blood clots.

And in one review of 20 studies, published in 2020, people who scored higher on psychological measures of grief also had higher levels of certain stress hormones like cortisol and epinephrine. Over time, chronic stress can increase the risk of cardiovascular conditions as well as diabetes, cancer, autoimmune conditions and depression and anxiety.

Put the studies together and on the whole, Dr. Fagundes said, “everything starts with the brain.” It responds to the death (and to intense stress in general), by releasing certain hormones that fan out into the body, affecting the cardiovascular system and the cells of the immune system. Aside from that generality, however, the biology of grief has no clear chain of cause-and-effect that the biology of, say, diabetes, has. That’s because the goals of these studies are to better understand the griever’s risks for disease, not to understand the path of grief through the body.

The one exception is with the study of the brain. In 2001, Dr. O’Connor first began imaging the grieving brain, and a handful of similar studies have been done since. In these studies, a person lies immobile in a functional magnetic resonance imaging (or fMRI) scanner, looks at certain pictures and listens to certain words, and the machine maps the blood flow to parts of the brain. In one study published in 2003, Dr. O’Connor found three areas of the brain that were triggered by words related to grief (like “funeral” or “loss”) and a fourth triggered by pictures of the person who died. Some of the brain areas were involved in the experience of pain, others in having autobiographical memories. These findings were “not world-stopping,” Dr. O’Connor said, “like, sure, that’s what happens in grief.”

But the responses recorded in another area, called the nucleus accumbens, were more surprising. This region is part of the brain’s network for reward, the part that responds to, say, chocolate, and it was active only in people with complicated grief. Nobody knows why this is so, but Dr. O’Connor theorized that in the continuing yearning of complicated grief, being reminded of a loved one with pictures and words might have the same reward as seeing a living loved one. In regular, uncomplicated grieving, the reminder is no longer connected to a living reward but is understood as a memory of someone no longer here.

All of these studies, however, have limitations. Many of them are small and haven’t been replicated. The researchers also don’t have the resources to follow the participants over time to see whether those with higher risks for a disease eventually develop that disease. Many studies are also a snapshot of one point in time, and will miss the changes that occur in most people over months and years. Studies using fMRI have limits all their own, too: “A lot of things could make the same areas light up,” Dr. O’Connor said, “and the same thing might not make the same areas light up in everyone or in one person over time.”

Grief, biological and psychological, is of course the result of another hard-to-study state, human attachment or love. “Humans are predisposed to form loving bonds,” Dr. O’Connor said, “and as soon as you do, your body is loaded and cocked for what happens when that person is gone. So all systems that functioned well now must accommodate the person’s absence.” For most people, the systems adjust: “Our bodies are amazingly resilient,” she said.

In a recent issue of the research digest UpToDate, medical doctors outlined the most current scientific studies on bereavement. One way to think about grieving, they said, is that the feeling of connection to the person who died “gradually moves from preoccupying the mind to residing comfortably in the heart.” I’m unsure about that word, “comfortably,” but yes, I’m no longer preoccupied. Now, 34 years after my son’s death, I’m back in charge, and if pain never quite goes away, then neither does love.

Ann Finkbeiner is a freelance science writer who usually writes about astronomy and the science of national security. She lives in Baltimore.


Cause, Mechanism, and Manner of Death

When a death occurs, a physician or medical examiner must fill out a death certificate. In order to properly complete this document, they must determine three things: the cause, the mechanism, and the manner of death. There is often confusion about which is which. The cause of death is the disease or injury that produces the physiological disruption inside the body resulting in death, for example, a gunshot wound to the chest. The mechanism of death is the physiological derangement that results in the death. An example of a mechanism of death due to the gunshot wound described above is exsanguination (extreme blood loss). Last but not least, the manner of death is how the death came about.

Manner of death can be classified in six ways:

1) Natural
2) Accident
3) Suicide
4) Homicide
5) Undetermined
6) Pending

A natural death occurs as a result of aging, illness, or disease. An accidental death occurs when an injury or poisoning causes death, but it is unintentional. In this case, there can be no evidence supporting the idea that the poisoning or injury occurred with an intent to harm or cause death. A suicide results from an injury or poisoning occurring from a deliberate, self-inflicted act committed to harm or cause death to oneself. A homicide occurs when death is caused by another person. Undetermined is used as a classification when the information pointing toward one manner of death is no more compelling than any others. A pending death is one that is waiting on more evidence or analysis before the examiner can make a determination.

These characteristics of deaths are helpful for various reasons. The families of the deceased will have peace of mind if they know exactly what caused their loved one’s death. Insurance claims may not be accepted if the manner of death was a suicide. Also, many legal proceedings focus their attention to these characteristics during the trial and prosecution of murderers. This information is necessary to compile statistics for monitoring health and crime in the population. As you can see, characteristics of death are very important details to be aware of under several different circumstances.


Just because you're not bleeding on the outside doesn't mean you're okay. Internal bleeding can often be very hard to detect, and may show up only as discoloration or swelling, if it shows up at all. However, internal bleeding can be extremely serious, especially from major arteries.

Internal bleeding can be hard to diagnose, and the signs (including weakness, dizziness, and difficulty breathing) are often mistaken for something else - as in the case of Ivan Massow, who almost perished after a massive internal hemorrhage was mistaken for a case of food poisoning.


Assuming the person is not taking anticoagulants, it's actually quite difficult to bleed to death from dismemberment of small members (hands, feet, penis, ears, nose, etc). Even large members such as arms and legs are often survivable because the body is very good at protecting itself from blood loss. For example, transected arteries will spasm and clamp off blood flow, and loss of blood will cause the body to divert blood flow away from the extremities and to the vital organs, thereby slowing the bleeding and allowing it to clot. In fact, the whole shock process can be viewed as a set of defensive measures by the body to ensure survival in the face of serious injury. This was a bitter lesson learned by emergency medicine only fairly recently. The standard practice used to be to infuse hypovolemic patients with fluids to maintain normal blood pressure. The trouble is, a normal blood pressure prevents the body from realizing it has inadequate blood volume and turns off its defensive measures, thus allowing the bleeding to continue unabated.

Left to fend for himself, a healthy adult would almost certainly survive having his penis removed. With modern medical care, that becomes a certainty.

Could he still urinate? Sure, as long as the urethra wasn't blocked. It could become blocked by clotted blood, but eventually the pressure of a full bladder would overcome the blockage.

The problem is there are too many unknowns. First, the speed of clotting varies from person to person. There are lab tests that measure clotting time (e.g. INR), especially useful when a patient takes anticoagulants. One respondent mentioned the absence of anticoagulants, but anticoagulants include substances not specifically prescribed to reduce clotting, such as supplements and even food items that reduce clotting. Further, there are genetic factors (i.e. Factor VIII and others) that modulate clotting time, operating independently of medical intervention/prescribed drugs or anything consumed. Age is another facet in the clotting process, as infants often do not clot quickly. Couple that fact with the smaller quantity of blood in an infant's body and it makes sense why some infants actually die from circumcision related bleeding. An infant may retain his penis after circumcision but still die from operation related blood loss.

Additionally, the penis is different than other appendages and extremities. Besides the difference in tissue composition (smooth muscle vs. skeletal muscle elsewhere), penile arteries dilate more than arteries elsewhere and veins constrict more than veins elsewhere (assuming one has generally healthy blood vessels prior to injury). The unique elasticity of penile blood vessels mean that a traumatic injury like penile amputation is more likely to bleed continuously than many other amputations when taking into account the relative area of tissue amputated and blood vessels severed. Other than the femoral or carotid arteries, which, due to their own unique locations, are more likely to cause death from dissection than severing other arteries, the penis is again unique in that the arteries both inside and leading to it do not always clamp off- sometimes, they remain dilated even after a severing injury.

One of the biggest factors of survival (a somewhat controllable factor) in this case is time. The more time elapses after amputation without subsequent medical intervention, the more likely death becomes.

Death from penile amputation can arise not simply from blood loss but also from related issues such as overall stress and pain. Stress hormones and an inflammatory chemical cascade following such a traumatic injury can overwhelm the heart.


10 Worst Ways to Die

While religion and politics are two topics that are considered taboo for polite conversation, there's no denying they can get a boring cocktail party hopping, fast. Let the same be said for an attempt to engage a passing acquaintance in banter about what — in his or her opinion — is the absolute worst way to die.

What, are you unsure of how to begin? You've come to the right place. In the next few pages, we'll provide plenty of information, sources and grisly details to create or bolster nearly any argument one could have about the worst ways to die.

Yes, from animals gnawing at you as you watch them — fully cognizant — to how your mind must embrace and accept death as you spend much too long hurtling toward Earth in a crashing plane, you'll find loads of ways to both spice up (or end!) any cursory conversation.

(Note: if you're really thinking of ending your life, please call the National Suicide Prevention Lifeline in the U.S. at (1-800-273-TALK/8255).

For many of us, eating is pretty much the best part of any day. It serves to reason that not eating — in any capacity — would be a horrible way to live life. Even worse, though, is depriving your body of food to the point of death.

First of all, a body can live for a surprising one to three months without food (although liquids like water or even coffee must be taken) [source: Berg, et. al.]. But what a miserable couple of months they are. After less than a week, the body begins to develop dangerous symptoms as it begins to feed off stored fat for energy. The liver begins to panic first, producing toxins that can be harmful in large quantities. Before a month is up, you're losing about 18 percent of your starting weight.

And then, of course, your body begins to consume its own muscle and organs to be sated with energy. You can prolong the starvation process by ingesting much-needed salt, but it's hard to deny how miserable your final days would be.

Here's the thing about the worst ways to die: Some of them don't sound that bad if you can forget that you die in the end. Case in point: being adrift at sea.

Sure, you might be thinking, being adrift at sea sounds miserable but at least you have the hope that a passing cruise ship will spot you, or that a mermaid will befriend you and teach you how to breathe underwater. (We all have our fantasies.) But we're not talking about the 10 coolest ways to get rescued, remember.

Reading through tales of those lost at sea — and some of them don't have the luxury of having a boat, and are just bobbing in open water — you start to realize how crushing it must be to be surrounded by endless possibilities for demise. Will it be a shark that takes a bite out of you . or chomps your boat, which leaves you thrashing in the water waiting for the shark to return? Will it be starvation? Will it be hypothermia after your boat capsizes in a storm?

The possibilities are endless, awful and the only thing left to think about. Which is why being adrift at sea is safely on our list of worst ways to die.

Now bear with us here. "Falling into a volcano?" you say. "Sure, that sounds bad but you're pretty much dead, dead, dead before you could blink, right?"

Well, surprise, my morbid friends! Because of the relative density of lava, you'll be delighted to know that if you were to fall into a volcano Gollum-style, you will probably not be swallowed like a rock plopping into the water [source: Wolchover]. Instead, you will land on top of the lava with a soft little hiss (OK, I made that up) and then basically burst into flame. Which is pretty miserable and sad.

If burning on top of the lava crust isn't bad enough for you, you'll be glad to know that another scientist tested this theory by throwing a 66-pound (30-kilogram) bag of food into a volcano to discover — hooray! — sometimes the crust can be penetrated by bags of organic matter (i.e., humans). So, if you're really looking for a miserable way to die, jumping into a volcano might just be the way to do it.

So imagine this: You're not only going to die, but you have to — believe? pretend? — that you're being ritualistically killed because you're a perfectly beautiful and physically unblemished specimen. Unfair, man.

And with that we come to human sacrifice, another Worst Way To Die. In this case, we're talking about the Incan tradition of human sacrifice. Usually involving a chief's child, human sacrifice was a pretty cold affair. Literally, actually — the ritual would take place high on an Andes summit [source: Clark]. (They did feed the victim some liquor however, the day of the ritual, presumably to arm them a little against the weather and pain.) Archaeologists aren't too sure how painful a death the victims encountered many of them do have skull fractures, which leads them to believe if they were not killed by the blow, they were at least knocked out before they died of exposure. Which, considering the gruesome nature of the process, still seems like cold comfort. (Har har.)

But human sacrifice is out of most of our wheelhouses. Let's all ruminate darkly on something most of us can relate to: dying a horrible death in a fiery plane crash.


Medical examiner says Kassidi Kurill’s death likely wasn’t caused by Moderna vaccine

Utah’s chief medical examiner urged the public not to jump to conclusions about the death of a 39-year-old woman four days after she received the second dose of Moderna’s COVID-19 vaccine — insisting there is no evidence the jab was connected to her passing.

After receiving her second jab on Feb. 1, Kassidi Kurill became sick and was hospitalized. Four days later, the single mom died under mysterious circumstances.

But Dr. Erik Christensen, chief medical examiner for Utah’s Health Department, told Fox News that the tragic mom’s second dose and her death are only “temporally related.”

“We don’t have any evidence that there are connections between the vaccines and deaths at this point,” he insisted. “We don’t have any indication of that.”

Kassidi Kurill became sick and died mysteriously four days after receiving her second dose of the Moderna COVID-19 vaccine. Facebook

Christensen said side effects from inoculations are to be expected, but that how people respond to the vaccine will ultimately be determined by their biology.

“Certainly, there are side effects of a vaccine that are directly linkable to the vaccine and what’s going on in your body,” Christensen said. “You know, the pain in the arm … the fever-like symptoms related to your immune response to what was put into you. Those kinds of things clearly happen.”

Kurill, who received the vaccine due to her work as a surgical tech, experienced a sore arm after the first dose, but had no other side effects, her father, Alfred Hawley, told KUTV.

But things took a tragic turn after she received her second dose when she soon became ill and ended up in a hospital, where doctors determined that her liver was failing, Hawley said.

The Food and Drug Administration requires that vaccination providers report any deaths after COVID-19 jabs to the Vaccine Adverse Report System, which shows that there have been four deaths reported involving Utah residents, according to Fox News.

One of the four matches Kurill’s age, while the other three were all in their 80s, the outlet reported.

Utah’s Health Department told Fox News that the Office of the Medical Examiner will “investigate any death where the COVID-19 vaccine is mentioned on the death certificate.”

However, there is currently no evidence that the jab is dangerous.

An autopsy was performed on Kassidi Kurill, but privacy laws have kept the state Medical Examiner’s Office from commenting. Facebook

“There is no evidence COVID-19 vaccines have caused any deaths in Utah. Reports of adverse reactions and death following vaccination do not necessarily mean the vaccine caused the reaction or death,” it said.

“Reports of concern are verified and undergo scientific study. The CDC also follows up on any report of death to request additional information and learn about what occurred and to determine whether the death was a result of the vaccine or unrelated.”

Christensen said that cases involving post-vaccine deaths are worth investigating, but added that until we know all the results, it’s just “speculation.”

An autopsy was performed on Kurill’s body, but the state Medical Examiner’s Office could not comment on it due to privacy laws.


What are the signs that someone is close to death?

If a person or loved one is elderly or has a terminal illness, knowing death may be near is often difficult to deal with or comprehend. Understanding what to expect may make things a little easier.

This article explores 11 signs that death is approaching. It goes on to look at the signs that indicate a person has died and discusses how to cope with the death of a loved one.

When a person is terminally ill, they may be in hospital or receiving palliative care. It is important for their loved ones to recognize the signs that death may be near. These signs are explored below.

1. Decreasing appetite

Share on Pinterest A decreased appetite may be a sign that death is near.

As a person approaches death, they become less active. This means their body needs less energy than it did. They stop eating or drinking as much, as their appetite gradually reduces.

If a person is caring for a dying loved one who loses their appetite, they should let them eat when they feel hungry. Offering them ice pops helps them to stay hydrated.

A person may completely stop eating a few days before they die. When this happens, it helps to keep their lips moistened with lip balm, so that they are not uncomfortable.

2. Sleeping more

In the 2 or 3 months before a person dies, they may spend less time awake.

This lack of wakefulness is because their body’s metabolism is becoming weaker. Without metabolic energy, a person will sleep a lot more.

If a person is caring for a dying loved one who is sleepy, they should make them comfortable and let them sleep. When their loved one does have energy, they should encourage them to move or get out of bed to help avoid bedsores.

3. Becoming less social

As a dying person’s energy levels are reduced, they may not want to spend as much time with other people as they once did.

If a dying person is becoming less social, their loved ones should try not to be offended.

It is not unusual for a person to feel uncomfortable letting others see them losing their strength. If this is the case, it is advisable to arrange visits when the person dying is up to seeing someone.

4. Changing vital signs

As a person approaches death, their vital signs may change in the following ways:

    drops
  • breathing changes
  • heartbeat becomes irregular
  • heartbeat may be hard to detect
  • urine may be brown, tan, or rust-colored

A person’s urine color changes because their kidneys are shutting down. Seeing this and the other changes in a loved one may be distressing. But these changes are not painful, so it may help to try not to focus overly on them.

5. Changing toilet habits

Because a dying person is eating and drinking less, their bowel movements may reduce. They may pass less solid waste less often. They may also urinate less frequently.

When they stop eating and drinking completely, they may no longer need to use the toilet.

These changes can be distressing to witness in a loved one, but they are to be expected. Speaking to the hospital about a catheter for the person may help.

6. Weakening muscles

In the days leading up to a person’s death, their muscles may become weak.

Weak muscles mean the individual may not be able to carry out the small tasks that they were able to previously. Drinking from a cup or turning over in bed may no longer be tasks they can do.

If this happens to a dying person, their loved ones should help them lift things or turn over in bed.

7. Dropping body temperature

Share on Pinterest A drop in body temperature may mean there is very little blood flowing to the hands.

In the days before a person dies, their circulation reduces so that blood is focused on their internal organs. This means very little blood is still flowing to their hands, feet, or legs.

Reduced circulation means a dying person’s skin will be cold to the touch. Their skin may also look pale or mottled with blue and purple patches.

The person who is dying may not feel cold themselves. Offering them a blanket is a good idea if a relative or friend thinks they may need one.

8. Experiencing confusion

When a person is dying, their brain is still very active. However, they may become confused or incoherent at times. This may happen if they lose track of what is happening around them.

A person caring for a loved one who is dying should make sure to keep talking to them. Explaining what is happening around them and introducing each visitor is important.

9. Changing breathing

A person who is dying may seem like they are having trouble breathing. Their breathing may suddenly change speed, they might gasp for air, or they may pause between breaths.

If a person caring for a loved one notices this, they should try not to worry. This is not usually painful or bothersome when being experienced by the dying person.

It is a good idea to speak to the doctor for advice if someone is concerned about this change in breathing pattern.

10. Increasing pain

It may be difficult to come to terms with the unavoidable fact that a person’s pain levels may increase as they near death.

Seeing a pained expression, or hearing a noise that sounds pained, is never easy.

A person caring for a dying loved one should speak to the doctor about options for pain medication to be administered. The doctor can try to make the person who is dying as comfortable as possible.

11. Hallucinations

It is not unusual for a person who is dying to experience some hallucinations or distorted visions.

Although this may seem concerning, a person caring for a dying loved one should not be alarmed. It is best not to try to correct them about these visions, as doing so may cause additional distress.

In the hours before a person dies, their organs shut down and their body stops working. At this time, all they need is for their loved ones to be around them.

A person caring for a dying loved one in their last hours should make them feel as comfortable as they can.

It is a good idea to keep talking to a dying person right up until they pass away. They can often still hear what is going on around them.

If a dying person is attached to a heart rate monitor, those around them will be able to see when their heart has stopped working, meaning that they have died.

Other signs of death include:

  • not having a pulse
  • not breathing
  • no muscle tension
  • eyes remaining fixed
  • bowel or bladder releasing
  • eyelids partially shut

When it is confirmed that a person has died, their loved ones may want to spend some time at their side.

Once they have said goodbye, the family should make contact with a funeral home. The funeral home will then remove the person’s body and prepare for their funeral.

When a person dies in the hospice or hospital, the staff will contact the funeral home on the family’s behalf.

Even when it is expected, the death of a loved one is never easy to cope with for those who were close to them.

It is essential that people give themselves the time and space to grieve. They should also seek support from friends and family.

Every person deals with grief in a different way. But there are some common feelings and experiences that people may want to share. For this reason, bereavement support groups may be useful.


Cruel and Usual?: Is Capital Punishment by Lethal Injection Quick and Painless?

About two thirds of the states use a combination of barbituric, paralytic and toxic agents for executions, despite a lack of scientific evidence supporting their effectiveness. Although the procedure may be subject to FDA approval, the agency has avoided any ruling on the cocktail's efficacy in delivering a merciful death

A shortage of sodium thiopental, a fast-acting barbiturate and general anesthetic used in lethal injections of death-row convicts, has delayed several such executions throughout the U.S. and reignited a long-standing debate over the combination of chemicals used to carry out capital punishment. Most recently, Arizona inmate Jeffrey Landrigan was executed Tuesday night only after a delay caused by a legal battle over the source and quality of the sodium thiopental used as part of the lethal injection.

Lethal injection is used for capital punishment by the federal government and 36 States, at least 30 of which use the same combination of three drugs: sodium thiopental (a barbiturate to induce anesthesia), pancuronium bromide (a muscle relaxant that paralyzes all the muscles of the body) and potassium chloride (a salt that speeds the heart until it stops). This protocol was developed in 1977 for the state of Oklahoma by then&ndashChief Medical Examiner Jay Chapman, but it has never been codified or sanctioned by the U.S. Food and Drug Administration (FDA).

The only U.S. maker of sodium thiopental, Hospira, Inc., in Lake Forest, Ill., has reported a shortage of the raw materials needed to make the drug. When Arizona law enforcement last week declined to identify its source of the sodium thiopental intended for Landrigan, his lawyers seized on the opportunity. On October 21, they requested a stay of execution, contending that their client could suffocate painfully if the anesthetic comes from an unknown source and did not work properly before the pancuronium bromide and potassium chloride kicked in. U.S. District Judge Roslyn Silver initially blocked the execution, but she was overruled Tuesday by the U.S. Supreme Court, which voted 5-4 that a condemned prisoner does not need to know the source of the drugs used in his execution.

The Superior Court of Maricopa County, Ariz., originally sentenced Landrigan to death in 1990 after convicting him of first-degree felony murder in the strangulation and stabbing death of Chester Dean Dyer of Phoenix. At the time of the murder Landrigan was an escapee from an Oklahoma prison, where he was serving time following a conviction in that state of assault and battery with a deadly weapon, second-degree murder, and possession of marijuana.

Regardless of whether Landrigan's legal team was simply using the drug shortage as stalling tactic, their legal maneuvering brings to the fore a contentious dispute over the science (or some would say lack thereof) behind lethal injection executions in the U.S. For more than two decades, it has been argued that the FDA should be required to certify the safety and effectiveness of drugs used to carry out executions (as it does for drugs used to euthanize animals). The FDA, wanting to stay out of the capital punishment debate, disagrees.

In 2008 the U.S. Supreme Court (pdf) upheld a lower court ruling that the state of Kentucky's three-drug method of lethal injection did not constitute "cruel and unusual punishment," as defined by the Eighth Amendment. Some scientists disagree. Scientific American spoke with University of Miami Miller School of Medicine molecular biologist Teresa Zimmers about this controversial topic.

[An edited transcript of the interview follows.]


You and a group of colleagues in 2007 published a report in PLoS Medicine that examined public records of executions. What was the purpose, and what sort of reaction did you receive?
We were actually trying to look at whether there was any evidence that the three-drug protocol&mdashsodium thiopental, pancuronium bromide and potassium chloride&mdashacted in the way it was supposed to act. We analyzed the time to death or the time to different events, such as cardiac arrest, in order to understand what might be the mechanism of death. We found no evidence to support the use of this protocol, the dosage of the drugs or the order in which the drugs were administered in executions.

A lot of responses to the study were negative&mdashpeople assumed that we had a specific political agenda. This began to change as people looked at our data more closely. We were invited to the March 2008 Fordham Urban Law Journal Symposium, "The Lethal Injection Debate: Law and Science," by Fordham University School of Law professor Deborah Denno to represent the medical and scientific aspects of it. Supreme Court Justice Stephen Breyer also used our studies as part of his research for Baze v. Rees in 2008, which upheld an earlier ruling in Kentucky that the state's approach to administering lethal injections does not violate the "cruel and unusual punishments" ban promised in the Eighth Amendment. Breyer's research&mdashour paper&mdashdid not uphold the constitutionality, but rather argued for the likelihood of unrecognized pain and suffering.

What concerned you and your colleagues about the way lethal injections are administered?
There's no record of a medical or scientific inquiry into whether this would be the best method. And there isn't any medical evidence to support this approach. Part of the paradox is that it looks like a medical procedure, but it hasn't been rigorously tested. There are no controlled trials, data collection, analysis or peer review of the processes to determine whether it works the way it's been said to work.

Why is sodium thiopental used as part of a lethal injection execution?
Sodium thiopental was chosen to render the person deeply unconscious and unable to feel the paralysis brought on by the pancuronium bromide, which causes the person to lose the ability to breathe. And the potassium chloride is extremely painful. Some people have said that three to five grams of sodium thiopental alone should be enough to induce death. [In December 2009 Ohio became the first state to use a single dose of sodium thiopental to execute death-row inmates.] We looked at whether inmates died reliably after the sodium thiopental, and it's not clear this is the case. We also determined that the doses of sodium thiopental used are not always as "massive" as claimed. It's not even clear how much a massive dose is in this context. We found that, at most, the highest doses were two times the lethal dose for animals, regardless of the inmate's weight.

It has been reported that in addition to a shortage of sodium thiopental, the doses that some states stockpile are set to expire before scheduled executions can be carried out. What sort of shelf life does sodium thiopental have?
Sodium thiopental has quite a long shelf life&mdashup to 48 months in its unconstituted form. Once you add liquid, it's been reported to be stable for 24 hours or, if it's kept cold, it can last for seven days. They typically prepare it on the day of execution. Shelf life may be a problem because states perform executions infrequently and now don't have a supply of new doses.


Watch the video: Λευκοπενία: Συμπτώματα και θεραπεία (February 2023).