End of Life Kristin Adler - Free Essay Example

Sample details Pages: 7 Words: 2117 Downloads: 4 Date added: 2017/09/17 Category People Essay Type Argumentative essay Did you like this 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 p ossible 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 c omfort. 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 contra dict a patient’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 ski lls to treat 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 pleasure 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 ano ther culture’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 consequences 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 lif e support 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 ali ve at the 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 patie nt 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-we bster. com/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 | | Don’t waste time! Our writers will create an original "End of Life Kristin Adler" essay for you Create order

A Critical Analysis Of Principles Over People ...

A Critical Analysis of Principles over People: Abolitionist Feminism and Human Trafficking In the paper, â€Å"Principles over People†, the author seeks to persuade the reader to think critically about the abolitionist feminism as it relates to human trafficking and prostitution. The author believes the abolitionist feminist movement further perpetuates the very principles they argue against. He believes the abolitionists’ stance that all prostitution is forced and a form of human trafficking removes a woman’s right to choose what she does with her body. He further believes the stigmatization of prostitution by the abolitionist harms the women who are willingly choosing to be sex workers. By doing these things, the author feels the†¦show more content†¦Although I understand the perspective of the critics, I do not believe criminalization of purchasing sex would further put women at risk. The risk will continue to exist with or without the laws in place. In places where sex work has been completely decriminalized, there are many regulations in place. These regulations are necessary and are in place to protect the workers. Sex workers are not allowed to freely sell sex on the streets; rather the transactions must be made in specific places and under specific conditions. These conditions are not ideal for every â€Å"john† or sex worker therefore the underworld of purchasing sex will continue to exist. There will still be individuals seeking to have sexual encounters outside of regulations of age requirements, condom usage, location, and security. The regulated brothels will command higher prices due to overhead and the workers themselves are basically employees. This puts them at risk of disciplinary actions for not following rules, micromanagement, and possible dismissal. There will also be competition for limited positions at the brothel. The women, who have health issues, are underage (or perhaps too old to be a desirable â€Å"professional† sex worker), drug addicts, and others not suitable for legitimate employment will still potentially seek illegal sex work. Some johns will not want to pay the higher prices of legitimate brothels or may seek the anonymity of dark alleys and by-the-hour motels. The women who need

Medical Doctor free essay sample

En verified after discharge that all infants who were recruited in this study had normal brainstem auditory responses (a routine procedure in all infants who are discharged from our NICE). The study was approved by the local institutional review board, and written informed consent was obtained from both parents of each infant. Design This study was a prospective, randomized trial with crossover of the effect of music (compared with no music) on ERE. The sequence in which exposure was given music first followed by no music or the opposite) was selected by randomization, by using random numbers. Each infant was studied on 2 consecutive days.We tested only the music of Mozart present on the Baby Mozart CD (Baby Smart, Revolt, Israel), which was played on a mini-CD device at a volume of 65 to 70 db. Before the study, the CD system was calibrated according to the American Academy of Pediatrics recommendations not to exceed volume of 75 db and to maintain background noise near the infants ear 45 db. We will write a custom essay sample on Medical Doctor or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page According to this acoustic measurement, speakers were laced inside the incubator at a distance of 30 CM from the infants ears. In both cerements, the environment was controlled to minimize possible unwanted noises and maintain noise constancy. The monitor alarms were kept silent (visual alarm only), and the wards doors were closed to minimize outside noise. Music was Initiated 10 minutes before the beginning of the metabolic measurements and was continued for the 30 minutes of ERE recording. The same procedure was applied during the no-music exposure period. Importantly, no music was heard by the infants during the whole study period except for the 30 minutes of exposure related to the duty. Metabolic studies were conducted while the infants were prone and asleep and at the same time of the day (noon time) for all infants, starting 1 hour after the completion of the last feed.The same type (breast milk versus formula) and amount of food was given to the infants on both study days. Measurements were stopped during body movements ( 5% of the time of measurement). During the metabolic study, infants were cared for in their own, convective incubator. Air temperature inside the incubator was skin corticosteroids to keep temperature over the back at ICC. Thus, the 2 energy expenditure measurements were made in nearly identical thermal environments. Measurements Metabolic measurements were performed by indirect calorimeter, by using the Deliberate II Metabolic monitor (Dates-Mohamed, Helsinki, Finland).This instrument uses the principle of the open-circuit system that allows continuous measurements of oxygen consumption and carbon dioxide production using a constant flow generator. The measurement ranges for both oxygen consumption and carbon dioxide production of 5 to 2000 mini allow measurements in preterm infants with small tidal volumes. Before the mean METHODS Patients The study was conducted in the NICE at the Lisp Maternity Hospital, Tell Aviva Medical Center (Tell Aviva, Israel). We aimed to study healthy, growing, of 30 to 37 weeks.Postmenopausal age was calculated in completed weeks on the basis of last menstrual period, consistent 1 week with early, fritterers ultrasound examination. All infants were clinically and thermally stable while cared for in a skin corticosteroids incubator. At the time of the study, they all were tolerating full internal feeding (1 50-160 ml/keg weight per day) without significant gastric residuals 5% of total feed), were PEDIATRICS Volume 125, Number 1, January 2010 cerement, the device performs a collaborations that is based on independently measured barometric pressure.In addition, periodic testing for accuracy was performed by alcohol burning according to the manufacturers instructions. This method is safe and allows prolonged measurements while allowing reasonable access to the infant for routine care. Validation studies have shown the technique to give results equivalent to direct measurements. 8,9 In our hands, the instrument has an intra-assay coefficient of variation of 3%. For controlling for introverted variation, all measurements were performed by a single investigator (Dry Lubberly). Statistical Analysis This study is a pilot study that was designed to estimate the effect size of music on ERE.Thus, an empirical number of 20 infants (e, 40 measurements) was chosen. Comparison of energy expenditure values between groups was performed by using paired t test. For this purpose, ERE results (recorded every minute by the instrument) were averaged over the first, second, and third 10-minute periods of the consecutive 30-minute total study time, whether it was a music or music exposure period. Results are expressed as means SD; P . 05 was considered significant. Assessed for eligibility (n = 20) Excluded (n = 2) Enrollment Is it randomized?Tachycardia (n = 1) Excessive movements (n = 1) Music first: n = 5 No music first. N ; = 13 Allocation Lost to follow-up (n = O) Follow-Up Lost to follow-up (n Analyzed (n = 5) Analysis Analyzed (n = 13) Cohort flowchart. RESULTS Twenty preterm infants were recruited to the study (Fig 1). One of them was excluded because of tachycardia before the beginning of the measurement. Another 1 was excluded because of excessive body movements during the second measurement. He excessive movements of the infant were observed during the no-music session and thus could not have been an adverse effect of music. Characteristics of the study infants are listed in Table 1 and describe their eye LUBBERLY et al gender, birth weight, gestational age, Pagan scores, weight, and chronological age at the time of the study, as well as major medications given or procedures undertaken. Of note, 8 of 18 infants received caffeine for a history of previous apneas of prematurely but did not have any active apneas, and there were no changes in drug dosage during both periods of the study. By randomization, 5 of 18 infants were first studied during the music period. Table 2 depicts the results of ERE measurements.ERE was similar during the first 10-minute period of both randomization groups. During the next minute period, infants who were exposed to music had a significantly lower ERE than when not exposed to music (P . 028). This was also true during the third 10-minute period (P . 03). Thus, on average, the effect size of music on ERE is a reduction of 10% to 13% from baseline, an effect obtained within 10 to 30 minutes. When multiple regression analysis was used, the effect of music on ERE manned significant, even after we introduced the caffeine intake as a potential confounder.DISCUSSION As hypothesized, we found in this pilot randomized clinical trial with crossover of music versus no music exposure that within 10 minutes of listening to Mozart music, healthy infants studied at a postmenopausal age of 30 to 37 weeks had a 10% to 13% reduction of their ERE. In our study, this effect TABLE 1 Demographic and Clinical Characteristics Characteristic Maternal age, y Mean SD Range Gravity, median (range) Parity, median (range) Prenatal steroids (Siltstone), n (%) Gender of infants (male/ female)

The Panama Canal Essays (1187 words) - Macro-engineering

The Panama Canal 1. The panama canal It is the canal across the Isthmus of Panama, in Central America, that allows vessels to travel between the Pacific and Atlantic oceans The waterway measures 82 km (50 mi), including dredged approach channels at each end. The Panama Canal handles a large volume of world shipping and enables vessels to avoid traveling around South America, reducing their voyages by thousands of miles and many days Built by the United States from 1904 to 1914, the Panama Canal posed major engineering challenges The canal consists of artificially created lakes, channels, and a series of locks, or water-filled chambers, that raise and lower ships through the mountainous terrain of central Panama It was the largest and most complex project of this kind ever undertaken at that time, employing tens of thousands of workers and costing $350 million The canal cuts through the central and most populated region of Panama, and it has been a point of dispute between the governments of Panama and the United States through most of its existence. Under a 1903 treaty, the United States controlled both the waterway and a large section of the surrounding land, known as the Panama Canal Zone, riots and international pressure led the United States to negotiate two new treaties, which were signed in 1977 and took effect in 1979. The treaties recognized Panamas ultimate ownership of the canal 1. Traveling through the panama The canal consists of dredged approaches and three sets of sets of locks at each end; The canal employs about 240 highly trained and experienced pilots to handle the complex job of steering ships through the waterway. As soon as the pilot takes over, the ship is under canal jurisdiction. Very large or hard-to-maneuver ships may require two or more pilots and assistance from tugboats. The ship travels south-southeast about 7 miles and enters the first lock at Gat?n Line handlers at the lock attach steel mooring cables that are controlled by powerful electric locomotives, called mules. The mules guide the ship through the locks and steady it while the chambers are filled with water To conserve water, smaller ships often go through the locks together The entire trip through the canal takes between 8 and 10 hours plus waiting time. The canal operates 24 hours a day year-round. Each ship that travels through the canal pays a toll based on its capacity 2. Traffic volume A large volume of the worlds ships, cargo, and passengers travel through the canal every year A wide variety of general cargo vessels and specialized ships pass through the canal The most common are bulk carriers for ore, grain, and liquids; automobile carriers; container ships; refrigerated ships; tankers; liquid-gas carriers; and passenger liners Many naval vessels, fishing boats, barges, dredges, floating drydocks, and ocean-going tugs also use the canal The size of ships using the Panama Canal has steadily increased. About 27 percent of the vessels that use the canal are built to the maximum dimensions that can pass through it (a category called Panamax) However, some of the worlds commercial and military ships are too large for the canal. Since the 1940s, new U.S. battleships and aircraft carriers have been built exceeding the canals dimensions 3. Military uses The canal was built in part for military reasons, to give the U.S. Navy rapid access to both the Atlantic and Pacific oceans Many U.S. Army, Navy, and Air Force bases were built in the canal zone to defend the vital channel. However, since World War II (1939-1945) the canal has been considered vulnerable to attack A single bomb or a scuttled ship could disrupt canal traffic for a long period, and the jungles along the canal could be used by guerrilla forces Therefore, the canal was considered less valuable as a military asset 4. Canal administration The canal is operated by the Panama Canal Commission, a U.S. government agency under the Department of Defense The commission was established in 1979 to manage the canal during the 20-year transition from U.S. to Panamanian control The commission manages and maintains the canal and all its related functions and equipment Tolls and other canal fees generally pay all the costs of running and