End of Life Kristin Adler - Free Essay Example

Kristin Adler Contemporary Moral Problems December 15, 2009 End of Life I would like to start off by answering two questions: â€Å"What is a person? and â€Å"What is death? † When I started looking up a definition for â€Å"person† it amazed me how many different variations there are. I feel that a person is one that is recognized by the law and has rights and duties. A person also has the moral right to make its own life-choices and to live without interference from others. Death is an eternal termination of all vital functions. The website death-and-dying. rg says â€Å"death is the cessation of the connection between our mind and our body†. I do agree with this statement with the thought that when death occurs our consciousness leaves the body to go on to the next life. Dying is the final portion of the life cycle for all of us here on earth. Providing excellent, humane care to patients near the end of life, when healing means are either no longer possible or, no longer desired by the patient, is an essential part of medicine. For physicians and health care providers to provide excellent care to dying patients and their families, they need expertise as well as compassion. Making excellent care for dying patients regularly available will require improvements in the professional education. There should be added teachings on the life of and the care of a terminal person. The care of the dying patient, like all medical care, should be guided by the values and preferences of the individual patient. Independence and dignity are central issues for many dying patients. Maintaining control and not being a burden can also be relevant concerns. I believe the patient â€Å"maintaining control† is the first concern of someone who has been given a terminal diagnosis. Sometimes the hardest part about dying is the effect it has on family and friends. Helping them deal with the pending death also helps the patient find peace and comfort. By maintaining control of medical decisions and helping others deal with the imminent death, helps the patient be at peace with his or her own mortality. As a member of the hospital Ethics Committee, I would like to say, there are many hospitals with poor end-of-life policies or inadequate palliative care training for their physicians. We live in a death denying culture and too often hospital policies cause the dying patients often to suffer needlessly with their pain and symptoms going uncontrolled or the doctors make the decisions on the treatment or care without first consulting the patient or family. I want to introduce programs to make doctors more comfortable caring for the dying, including respecting a patient’s wishes even if the physician does not agree with them. A policy of â€Å"patient-centered care† where the doctors consult dying people about their desires and priorities should be put in place. This policy should not allow doctors to contradict a p atient’s wishes or make decision on their own, even when they think a bad choice has been made. The doctor should be able to discuss the options and alternatives with the patient but ultimately the patient makes the choice and the doctor follows through with the decision. If the patient is unable to decide for themselves the doctor should defer to someone with legal authority to make the decision on behalf of the patient and then follow this decision. I propose a project that teaches staff to recognize when a patient is within days or hours of death. It then instructs them to follow specific procedures, including counseling patients and families through decisions about end-of-life care. With the goal being to ensure more people spend their final days in comfort and dignity. What I want to see is people who are not experts in palliative care learn the skills and model them so that they become the standard for doctors. â€Å"By equipping more physicians with the skills to t reat the routine cases, palliative specialists such as Dr. Bhimji say they can focus on patients with more complex needs. The palliative care team doesnt need to see every dying patient in the hospital, she says. Every physician should have a base level of competency in providing good quality end-of-life care. (www. canada. com/ottawacitizen) I agree with caring for a dying patient however they wish. It should not matter if it is physician assisted suicide, extraordinary treatment, euthanasia or the standard hospice or palliative care. How the patient wants to spend their remaining days should be their choice not a doctor’s decision. The Utilitarian says that you should be free to do what you like as long as the consequences of what you do don’t harm anyone else. I’m struggling with the notion of the Utilitarian agreeing with ending someone’s life. On the one side I see where assisting in the person’s death upon their request will bring pleasur e and relief but the family will be affected by the consequences also. The action of ending the patient’s life will be hurtful to the family by taking the life earlier than nature intended. This is then contrary to utilitarianism. Deontological argument is the simplest moral outlook on suicide and holds that it is necessarily wrong because human life is sacred. Therefore this moral theory is opposite to how I see things, I agree life is sacred but when death is imminent and the patient is in pain or no longer able to function and the person chooses to end their life, then I feel their wishes should be met. There are two main type of relativism. Descriptive ethical relativism claims as a matter of fact that different people have different moral beliefs, but it takes no stand on whether those beliefs are valid or not. Normative ethical relativism claims that each culture’s beliefs are right within that culture, and that it is impossible to validly judge another cul ture’s values from the outside. So what the norm is for our culture is what is accepted. So this does not agree with my views, since our society is a life driven culture and frowns on ending any person’s life. Ethical Egoism is a moral theory that states that each person ought to act in his or her own self-interest. This is the view that best fits my ideal recommendation on the issue of early termination of life. By letting the dying patient decide what is best for them and giving that person total control of how and when they will die goes along with the ethical egoist’s position. An article from â€Å"The Honolulu Advertiser† dated December 13, 2009 â€Å"Attempted killing puts issue of terminally ill back in spotlight† shows to what extent a dying person or a family member will go to. When someone you love is in extreme pain and does not want to suffer any longer, you no longer consider â€Å"Is this legal? † or â€Å"What are the con sequences of what I am doing? † â€Å"Court documents say Yagi shot his wife shortly after 6 p. m. Tuesday at Castle Medical Center. He used a shotgun round from a flare gun, police said. Yagi has no criminal record in Hawaii and he has been released on bail. † Dennis Arakaki, a former legislator who serves as executive director of the Hawaii Family Forum and the Hawaii Catholic Conference, said the shooting at Castle should be seen as a case of a lone individual who apparently wasnt getting the help he needed. Here is an example where further education of the medical staff and policies in place in caring for dying patients may have kept her husband from going to such extreme measure to relieve his wife of her suffering. I am trying to put myself in the position of a terminal patient and from my own life experiences look at things from the family’s side as well. I am having a hard time coming up with discussion against my point of view. I know there is more than one side to this debate but it is hard for me to believe anyone would want someone they love to suffer. I know we always want to hope there will be a miracle cure that will come before our loved one dies, but we must not let them suffer any more than necessary. I am a Christian and know murder is a sin, but I feel that watching someone suffer is also a sin. Why would God want someone to suffer extremely before death? How can family and friends standby and wait for the end to come? How long will the family keep coming around to see the dying person in this state? They usually want to remember them in happier settings and do not want to deal with the end. So by letting the patient make the decisions and keep control of their medical treatment, it alleviates the family of this tremendous responsibility hanging over them about letting their loved one go. I know active euthanasia is illegal in the United States but the passive euthanasia is legal. So we can remove life suppor t and let the patient starve or dehydrate and give large doses of morphine but we cannot legally be justified in ending it quickly for them. To me this is confusing, but I do understand as I stated earlier we live in a death denying culture (death by any means except natural is not acceptable). The physician assisted suicide (PAS) which is legal in Oregon and Montana seems to me a good option available to dying patients. Just having the option to choose how and when to die gives the patient the control we all strive for in life. So taking it from us at the end of our life seems cruel. Physician assisted suicide allows terminally-ill Oregonians to end their lives through the voluntary self-administration of lethal medications, expressly prescribed by a physician for that purpose. The statistics show that in 2008 physicians wrote 88 prescriptions and only 54 of the patients took the medication to end their life. Others died naturally of their disease and some were still alive at th e end of 2008. So just because the person decides to make this choice it is still up to them when they take the medicine, the patient has ontrol. This cannot be an easy request to make of your doctor no matter how much you want to end the pain. A patient must make sure they go through counseling and psychiatric evaluations and consider all medical options available before making this decision. Many patients in the United States opt for hospice care or palliative care when diagnosed as terminal (6 months or less to live). Hospice and palliative care both provide physical, emotional and spiritual comfort care for the patient and their family. So, when does someone choose palliative care or hospice care? Upon a persistent, debilitating and life-limiting illness, a person can include palliative care in the treatment plan. This will clarify goals and ensure that they will be followed, no matter who is providing the care and where it is delivered. With palliative care the patient will be allowed to have any treatment the patient wants. It is the patient’s decision and terminal sedation is allowed. The palliative care gives the control back to the patient. In the later stages of the illness the patients and caregivers needs increase and it is then time to change to hospice care. With hospice care all treatments are stopped and the focus is on comfort only. I have always liked a saying by Albert Einstein â€Å"There are only two ways to live your life. One is as though nothing is a miracle. The other is a though everything is a miracle. † I try to think each day is something great and I would like to be able to continue to have this outlook even at the very end of life. By allowing people to have choices at the end of their life and let them be in control of the final decisions may help keep the outlook that everything is a miracle, even death. End of Life – Resources https://www. ospicenet. org/html/dying_guide. html www. merriam-webster. c om/dictionary www. death-and-dying. org www. hospicenet. org A Dying Person’s Guide to Dying by Roger C. Bone, M. D. www. canada. com/ottawacitizen By The Ottawa Citizen April 26, 2005 Dying in hospital: Care in a culture of cure https://deadpanthoughts. com/2009/01/euthanasia-justified-according-to-utilitarianism https://ethics. sandiego. edu/LMH/E2/Glossary. html https://www. oregon. gov/DHS/ph/pas/index. shtml https://www. americanhospice. org Hospice Care or Palliative Care: Whats the Right Care for Me? By Johanna Turner | |

What Is Art. R. James Essay - 724 Words

What is Art? C.L.R. James, in full Cyril Lionel Robert James (born Jan. 4, 1901, Tunapuna, Trinidad—died May 31, 1989, London, Eng.), West Indian-born cultural historian, cricket writer, and political activist who was a leading figure in the Pan-African movement . He wrote several books, including his well-known study of the Haitian Revolution, The Black Jacobins, and Beyond a Boundary . Key Words: Cricket, Tactical Value, Significant Form, Movement or Motion Thesis, James in his essay, (What is Art) argues that cricket must be included amongst the arts and not as bastard or a poor relation, but a full member of the community. Additionally, â€Å"He claims that cricket is an art, with aesthetic values as rich as sculpture or theater or painting.† (p. 416) James opens his essay with those questions what is art? Is it mere entertainment or is it an art? He emphasizes that cricket is art, and not mere entertainment: â€Å"It is a game and we have to compare it with other games. 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Analysis Of Grace Nichols s The Fat Black Woman s Poem

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Computer Usage in Schools Essay - 2085 Words

Computer Usage in Schools A computer is, â€Å"a programmable electronic device that can store, retrieve and process data† (Merriam-Webster). This tool once predominately used in homes and offices is making its way into our educational system. Technology is a growing part of our society today. We are beginning to see the use of computers in classrooms more and more. The increase of computer usage in schools, primarily elementary, has enhanced student learning. The study I looked at recognized the importance of technology in education, but then examined teachers’ educational background and knowledge of technology and its effect on their integration of computers and computer software into classroom†¦show more content†¦Once the elementary school children arrived, each sophomore observed two pairs of children as they accessed the software and explored its capabilities. Afterwards they would rate the software again and right reports based on their observations. 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Local literature about playing online games free essay sample

Incident Hypertension Hypertension Risk Factors such as : Sedentariness, Smoking Method specified in the study: A 4-year prospective study of health risk factors and their effects on the incidence of hypertension in a national Thai Cohort Study from 2005 to 2009. Adjusted relative risks associating each risk factor and incidence of hypertension by sex, after controlling for confounders such as age, socioeconomic status, body mass index (BMI) and underlying diseases. Locale: As Thailand is transitioning from a developing to a middle-income developed country, chronic diseases (particularly cardiovascular disease) have emerged as major health issues. Hypertension is a major risk factor for heart attack and stroke and cross-sectional studies have indicated that the prevalence is increasing. Participants/Subjects: A total of 57? 558 Sukhothai Thammathirat Open University students who participated in both the 2005 and 2009 questionnaire surveys and who were normotensive in 2005 were included in the analysis. Data Gathering Instrument: A 20-page health risk questionnaire which focused on sociodemography, habitation, work, health services, injury, sedentary habits, physical activity, transport, underlying diseases, family history, personal behaviours, body mass index (BMI), and consumption of foods, vegetables and fruit. Data Analysis Used: All analyses were performed using SPSS software. The incidence of hypertension and its 95% CI were calculated for each value of each categorical variable in both male and female participants and the influence on incidence by each variable was evaluated by test. For statistical inference, all p values were two tailed and significance was set at 5%. Relative risks (RRs) in a large study of an uncommon disease (incidence less than 10%) can be accurately estimated as odds ratios (ORs). Accordingly, for each risk variable, the RR and 95% CI were estimated using logistic regression to calculate the bivariate OR for hypertension. Adjusted RRs (ARRs) were estimated by calculating multivariate logistic regression ORs. ARRs were controlled for confounding by age, marital status, socioeconomic status (SES), BMI, underlying diseases and personal behaviours (cigarette smoking and alcohol drinking). A variable was included in a multivariate model if bivariate analysis had indicated a statistically significant association with incidence of hypertension. Some variables were included because earlier analyses reported elsewhere had shown a significant or substantial association with hypertension. The overall 4-year incidence of hypertension was 3. 5%, with the rate in men being remarkably higher than that in women (5. 2% vs 2. 1%). In both sexes, hypertension was associated with age, higher BMI and comorbidities but not with income and education. In men, hypertension was associated with physical inactivity, smoking, alcohol and fast food intake. In women, hypertension was related to having a partner. In both men and women, hypertension was strongly associated with age, obesity and comorbidities while it had no association with socioeconomic factors. The cohort patterns of socioeconomy and hypertension reflect that the health risk transition in Thais is likely to be at the middle stage. Diet and lifestyle factors associate with incidence of hypertension in Thais and may be amenable targets for hypertension control programmes. Bibliography (APA Format) Major Objectives/Research Questions Themes/Variables Method Major Findings Dogan, N. , Toprak, D. , Demir, S. , (2012). Hypertension pre- valence and risk factors among adult population in Afyonkarahisar region: a cross-sectional research. Anatolian Journal of Cardiology, 12(1), 47-52, DOI: 10. 5152/akd. 2012. 009. Hypertension is a major public health problem worldwide with increasing prevalence. The purpose of this study was to examine the prevalence of hypertension and related risk factors among adult population in Afyonkarahisar region. Gender BMI, kg/m2 Education Level Income Smoker Family history of Hypertension Diabetes Mellitus Coronary Heart Disease Parity (number of births) Method specified in the study: The study planned as a cross-sectional research. The present study was approved by the Afyon Kocatepe University, Faculty of Medicine Clinical Research Ethics Committee and written, informed consent was obtained from all participants. A total of 2035 people, from 75 different screening regions (18 urban, 57 villages) of our city were detected according to the population records of the year 2000, which represent the population of the area appropriately. A total of 7000 km of roadway was driven for the research by a team of 15 physicians, 1 nurse and a driver. The records of the regional health institutions were used in order to determine the subjects. Locale: The study was conducted in Afyonkarahisar, a middle Anatolian city, between November 2005 and February 2006. Participants/Subjects: In this study, people older than 18 years were grouped together, as were 19-29 years old, 30-39 years old, 40-49 years old, 50-59 years old, 60-69 years old, 70 and over. According to the 2000 census of the Turkish Statistical Institute, the total population of the city was 812. 416 (403. 105 women and 409. 311 men). Ratios of the district to the total population, sex and age factors were taken into account to determine the sample population. Our research is a part of a comprehensive study in which the individuals were selected regarding the age groups (0-18 years old, 19-40 years old, 41-64 years old, 65 and over) and gender. Data Gathering Instrument: Questionnaire The questionnaire included two main sections. The first section included questions about sociodemographic characteristics. The second section included questions about the risk factors related with hypertension. Blood pressure measurement Systolic blood pressure (SBP) and Diastolic blood pressure (DBP) were measured after the participant had been seated and rested for 5 minutes. Two measurements were taken at an interval of minimum one hour between readings, and the average of the 2 recordings was accepted as the subject’s blood pressure. Participants were advised to avoid cigarette smoking, alcohol, caffeinated beverages and exercise for at least 30 min before their blood pressure measurement. Definitions BMI was categorized in three groups as ? 24. 99 kg/m2, 25-29. 99 kg/m2 and ? 30 kg/m2. BMI value ? 30kg/m2 was accepted as obesity. Blood pressure categories were defined according to the JNC-7 guidelines report: HT was defined as SBP ? 140 mmHg or DBP ? 90 mmHg, for both men and women (17). CHD patients were determined by a positive history of the disease. According to the American Diabetes Association report criteria people who had fasting glucose level ? 126 mg/dl were accepted as DM (18). Data Analysis Used: All statistical analyses were performed with the SPSS 13. 0 for Windows (SPSS, Inc. , Chicago, USA). The comparisons of prevalence between dichotomous categories were made using Chi-square test. Student’s t-test was used for comparison of continuous variables. Continuous variables are expressed as mean ±standard deviation. Epidemiological data were analyzed by using binary logistic regression models to evaluate possible risk factors associated with the presence of HT. In the logistic regression, HT (positive, negative) was a dependent variable and age groups, gender, level of education, household income, BMI, DM, family history HT, cigarette use and CHD were independent variables. Forward Wald stepwise elimination of all non-significant variables was applied to obtain a minimal model containing only significant variables. Odds ratios (OR) and 95% confidence interval (CI) were estimated. A p

Fulfilling Satisfactory As Farnsworth House â€Myassignmenthelp.Com

Question: Discuss About The Fulfilling Satisfactory As Farnsworth House? Answer: Introducation The twentieth century gave rise to a growing culture of integrating art and culture into architecture and the Farnsworth House is one of the few examples. Despite the negative publicity drawn to it during its construction, the house successfully management to merge both art and architecture to produce a work of self-expression. The Farnsworth House is a perfect example of a house meeting the objective or purpose for which it was designed. This is because it was built as a relaxation house and that is the purpose which it served. On the theme of art meeting architecture, it is important to architecture is not just about design logic and practicality. Aside from that, architecture should also provide for the expression of ones thoughts, desires and emotional manifestations just as a painting would. Caroline Constant was captured mirroring this sentiment in an article when she described Grays house as not an object to be apprehended through visual detachment, but a flexible structure given life by its occupant (Constant 1994). The Farnsworth Houses architect, Ludwig Mies van der Rohe, has been vocal about architecture as an art form and in a letter to the editor of the Werkbund journal, Die Form, he states that, Form as a goal always ends in formalism. For this striving is directed not towards an inside, but towards an outside (van der Rohe 1970). This indicated his stand on the purpose of architecture not in producing just a form as this was only an external component. His belief in architecture being an art was the greatest asset behind the Farnsworth House. Drawing from the two readings, art and architecture can be merged and only then can the product be as fulfilling and satisfactory as the Farnsworth House. References Constant, Caroline. "E. 1027: The economics modernism of Eileen Gray." Journal of the Society of Architectural Historians 53, no. 3 (1994): 265-279. van der Rohe, Ludwig Mies . 1970. "On Form in Architecture." In Programs and Manifestoes on 20th-Century Architecture, by Ulrich accounting, 102. Cambridge, Massachusetts: MIT Press.