Monday, January 27, 2020

Ethics In The Health Care Industry Social Work Essay

Ethics In The Health Care Industry Social Work Essay Ethics as it is being used in the health sector is a concept that has evolved over time. There is no doubt that every player in the sector seeks to continually improve their services delivery as well as attaining maximum patient satisfaction in the process. In the last few years, ethics in health has developed through a number of stages. Hippocratic culture dominated traditional ethics in the 1960s where health care providers established relationships with patients. The core values of this relationship were derived from culture. The technological advancements and intensive research has seen developments in biological sciences and biotechnology. With such changes, a new ethical dimension was introduced. Ethical principles of human dignity, compassion, non-malfeasance and social justice However, with time a dilemma arose from the liberalization of health care industry. There emerged a need to harmonize the differences in health needs and resources availed for filling the gap. The scope of health ethics was thus expanded to include quality control, economics, policy formulation and implementation as well as massive research and development. Such efforts and resource harmonization gave birth to an era of health policy and ethics. As time advances there are debates on human rights protection and respect of human dignity (Bryant, Hyder and Kauser, 2007). It is now a fundamental right for every individual to enjoy quality health care without discrimination of any kind. The most recent dimension of health ethics is the fusion of lauded human rights and the fundamental right to obtain quality health services. Contrary to direct definition of health, as the entire state of well being in terms of mental social and physical status of an individual, ethics and human dignity issues are more complicated to completely expound on them. Ethics is solidly founded on cultural convictions developed over time. It derives its relevance and strength from religious and philosophical advocacies deeply embedded on the present leadership systems. It is considered as the ability of a community to clearly and amicably draw a boundary separating what is perceived as wrong and what remains a right thing. Such a boundary touches on the aspects of life right from the way of doing things to the general perception of life. It becomes a big understatement to define ethics without mentioning the famous dimensions used to describe it. It is a cumulative approach of respect to humanity with specific focus on maintenance of autonomy of a person, delivery of justice, rights and upholding of human dignity. Ethics in health policy formulation and implementation focuses on the most cost effective means of delivering a quality health care to all. It is in this light therefore, that ethics attempts to strike a balance between the policies and values cherished by an entire community. Equity is another paramount aspect of importance which cannot be neglected. It is about all that appertains to fairness in the ultimate distribution of gains derived from a robust health advancement which is socially acceptable. It is a concept that goes beyond just accessing health care products but touches on the response aimed at meeting the needs of all persons. Equity aims at ensuring that no one individual is favored in the allocation of resources as well as availing of equal chances of accessing health care (Bankowski, Bryant and Gallagher, 2007). It is therefore a process justified by the outcome. It is important to examine the impact of decisions made on equity. The specific health decisions must go a long way in fostering equity in access to health care services. The health status of most vulnerable groups remains the action points of equity development. There are no specific parameters of determining a group to be classified as vulnerable. However, there are general features which help us in this. There are those who are vulnerable due to social construction while others are as a result of congenital disability. It is usually possible to get an overlap between the two possible causes of vulnerability. The United Nations charter identifies the promotion of human dignity to be one of its core principles. This is evident in the ratifications, conventions and declarations of numerous international agreements in respect of this. One thing that we cannot fail to talk about at the mention of health care is this core principle of promotion of human rights and upholding of human dignity. A good example is the right to information an individual is entitled to on everything that affects his or her health. It is this right that compelled cigarette manufacturing companies to put an information label on their packets. In the recent past, efforts have been put on the reduction of public health burden on the rights of individuals (Sen, Germain and Chen, 2004). Trampling on the rights of a few individuals through quarantine, mandatory testing and isolation in the name of benefiting the majority is no longer ethically acceptable. A good and most recent example is United Nations advocacy of elimination of discrimination against people living with HIV. Together with human rights, dignity is considered an inherent and universal concept. Wide scopes of research in the biomedical field have continued to become the center of discussion on the inherent issues on human dignity. Law enforcers must also expand their focus to other sources of human dignity violation originating from areas outside medical field. Such determinants as political influence, economic factors, technological innovations, environmental concerns and changes in demographics must be looked into. It is important to note that advances have been made so far in the maintenance of human dignity and respect of human rights. Majority of institutions dealing with human health care services have a deliberate way of issuing instructions aimed at improving ethics amongst their staff members. The extent at which ethics instructions are being given is a clear indication of a continuous increase in the expansion in respect of human dignity. The unprecedented attention given to research on health care ethics cannot be attributed to one particular factor. There are a number of reasons as to why every player is shifting focus to this study. To start with, the knowledge explosion on the biotechnology field has availed a number of avenues available for a medical professional in the fight against diseases. It is now possible to handle situations which were once thought to be untreatable. However, this milestone in medical field has not been a bed of roses. A series of mixed reaction continue to emanate from various sections of the society on how ethical are some of these methods. Secondly, the cost of accessing basic health care is sky rocketing across the world. Most governments of the day are spending a substantial portion of their Gross Domestic Product on health care expenses yet most citizens cannot get the care they need. This leaves us in total agreement with Howard Hiatt who say that we have a few resources to use in provision of health care and therefore as a society, we need to ask ourselves two important questions. That is how we spend and allocate them. It is as a result of financial constraints that have made us witness denial of adequate health care, limited access and unfair rationing (Hiatt, 2005). Situational analysis Issues of ethics in health care are numerous. They range from an individual responsibility to the entire corporate obligations. That is why such issues can be approached from two distinct sides. To start with, macro ethical situations entail what cannot be addressed by a specific practitioner. Such issues are those in which the entire body of health professionals and the community at large must deal with in a bid to ensure that health care ethics are defined and respected. As an illustration, issues such as termination of pregnancy, health care resources allocation and organ transplants are in the category of macro situations. On the other hand, micro situations lie squarely on the hands of a single individual health care professional. It must be realized that ripple effects of macro issues are flow into micro situations. Ideally, the topic of health ethics should commence from the generally accepted responsibility a medical officer have towards meeting the needs of patients. This brings to our thoughts the issues of competence and trustworthiness of the health care practitioners. Competency goes beyond possessing enough knowledge to deal with a situation. It includes the ability to articulate issues of health and deliver the services timely and accurately. It is also equally important for a patient to have confidence in the person he or she has entrusted his or her body to. Trustworthiness therefore forms a core factor in the satisfaction of patients which finally culminate to enhancement of health care ethics (Berger, 2003). Legal and ethical rights We are living in an era with serious awakening in discovery of personal rights. The medical professionals have always been assumed to be an all knowing class. A patient would accept to undergo a surgery, take drugs and have a laboratory test without any question or hesitation. This trend referred to as medical paternalism is gradually dying. Patients are becoming consumers with a right to choose what they perceive to best suit them. It is therefore a mandatory standard practice to seek a patients consent before carrying out any procedures aimed at restoring health. Doing anything different from this will not only be unprofessional but totally unethical. The overstepping of a practitioners mandate in administering health care can also attract serious legal action whose far reaching effects can be detrimental in the career of a defendant. Just like any other customer, a patient desires to attain a definite level of satisfaction. Health professionals who are unable to meet the needs of their patients may not be such attractive in future if they survive legal actions. The legal rights of individuals are what we cannot avoid to talk about at the mention of health care ethics. The rights are those privileges a person enjoys as provided and defended in the Constitution of a country. Several legislations avails a patient with a series of rights. A patient seeking the attention of health care providers expects that clinical officers will utilize their gained experience coupled with their knowledge in striving to meet their needs. The patients rights ensure that independent individuals can expect the health care providers to meet their wishes of getting well without fear of otherwise. From a broader view, health care systems are primarily based on the rights of individuals seeking treatment. Patients have a sole responsibility of selecting who or what best suits them in terms of health care facilities and doctors. It is required that the patient gives a go ahead of any process through a fairly attained informed consent. This scheme may look very attractive to a person whose has enough economic muscle to meet the cost of treatment. The patients right assumes that everyone patient can comfortably settle hospital bills. On contrary, this right is as good as not being there for the patient who does not have a medical cover or enough money to pay (Bankowski, 2006). Although United Nations Declaration of Human Rights says that that all persons have a right medical treatment you cannot walk to a health care facility and demand for treatment. It is not enough to receive medical treatment; safety and effectiveness of the services are two paramount features that a treatment seeker is entitled to put into consideration. Ethical rights impose a responsibility on health care practitioners. The Hippocratic Oath results in a duty by the health professionals to do all they can in benefiting the patients and avoidance of any foreseeable harm. It can be argued that the health care providers must act at the best interest of the patients with disregard to how others are affected by their actions. A legality dilemma created by this Hippocratic Oath is diffused by the controversial exposition by Rem Edwards who claims that the health care providers are obligated to alleviating the aching and suffering of health care seekers. The defects in this point of view are evident on the side of health professionals who operate under strict constraints of laws. The responsibilities of health professionals are thus in conflict with earlier mentioned rights of the patients in the light of ethical and legal correctness. Ordering a health care expert to pursue a personal approach and do what contradicts the law, yet ethical, process in the patient with total disregard of what may befall them legally is as good as telling them to suppress what is important to them in favor of the patient. Ethical analysis It is important for a health care provider to continually examine his action so as to ascertain whether he is doing the right thing or not. In 1989, Robert Veatch proposed a four step blueprint which can be used by the health practitioners. This method of analysis involves making sure that there is sufficient knowledge backed by facts for every situation. The second step is bringing in to play whatever is morally upright in relation to the situation at hand. Ethical principles are given a consideration it deserves at the third step. Once the three steps have been taken care of, a fourth and last step of looking in to ethical theories is done. This provides health practitioners with a reliable, powerful tool available for use when faced with a situation demanding an ethical decision making. This theory formulated by Veatch approaches situation in a chronological manner. He goes ahead to argue that an ethical dilemma can be sorted not necessarily through the four steps but by just laying down the actual facts about a condition. If the application of step number one cannot provide a way out, step two is considered. This focuses on the moral rules guided closely by confidentiality or patients consent. At the event that dilemma persists, ethical guidelines of step three are used. The ethical principle encompasses aspects such as maintenance of autonomy, fidelity, nonmaleficence and beneficence. At this point, the stalemate must have been broken. However, it is possible to have unclear solutions even with the application of ethical principles. It is because of such a situation that a health care professional is compelled to use an ultimate tool available in step four. Ethical theories are the final solution finder in a hard decision making procedure. A particle and most recent example is seeking of consent of an organ donor. There have been several conflicting issues surrounding organ transplants. The ever growing imbalance between the number of organs demanded and those available for sale has played a major role in heightening the differences between proponents and opponents of this process. It is the obligation of clinicians to make sure that the wishes of prospective organ donors are respected to the later (Beauchamp and Childress, 2009). Various regulations have been put in place to ensure the respect of free will and human dignity of a donor whether death or alive. Conclusion The challenges facing health care professionals continue to rise with technological advancements and sky rocketing costs of health care. It is therefore of paramount importance to equip them with sufficient knowledge of ethical tools for use in such situations today or in days to come. Totally relying upon ethical codes, principles and theories may not be enough in decision making but serves by providing a rough idea.

Sunday, January 19, 2020

How does Shakespeare examine the themes of revenge in Hamlet Essay

The revenge tragedy established itself within Elizabethan theatre as a tremendously popular genre. The style of the play had gradually evolved from the works of Seneca, an ancient Roman playwright. Once translated these plays performed, steadily rose in popularity, with plays such as Middleton’s ‘The Changeling’, Kids ‘The Spanish Tragedy’ and Tourneurs ‘The Revenger’s Tragedy’ being most popular. The ‘typical’ revenge tragedy play has several important conventions within it, which are key to the genre. see more:revenge hamlet A five part structure of: Exposition, anticipation, confrontation, partial execution and completion, portray the central character – the revenger, discovering the deed he must avenge, wrestling with his conscience over the justification and validity of the act, then planning and eventually executing the act of revenge. Often Jacobean revenge tragedy often questioned the revengers’ morality. How far does the task of revenge affect the revenger? How far does it taint the person? How can the audience be sure the protagonists’ madness is not actually real? Is it possible that the conflicting morality suffered by him brings unto the revenger real madness and mental instability? The questions over morality are furthered by the death of the protagonist another generic feature. Elizabethans generally firmly believed in the concepts of ‘heaven’ and ‘hell’, dying without forgiveness from God would mean eternity in perdition like the limbo in which Old Hamlet is in, in Hamlet ‘When I to my sulph’rous and tormented flames Must render up myself’. As the revenger usually dies at the end of the play after carrying out revenge, he dies without the chance of confession and absolution. This means the act of murder has not been forgiven. Inevitably this leads us to assume the protagonist will spend eternity in hell. We can debate the authenticity of the spirit demanding for revenge. If they were once a loved one of the revenger why would they make them vow to perform a deed, which would lead them to damnation? Could it be that the spirit is not in fact the spirit of the deceased but an evil spirit taking their form, tricking the revenger? After dispensing with some of the generic features, such as narrative by the ghost, it retains many of the conventions of the revenge tragedy. Hamlet is summoned to avenge the murder of his father, by his father’s spirit, the murderer being Hamlets’ uncle, now stepfather and newly crowned King Claudius. Hamlet feigns madness to disguise his intentions of revenge and has a play entitled ‘The Mousetrap’ performed, in which the murder of Old Hamlet is re-enacted. On preparing to kill Claudius Hamlet is set back by Claudius asking for forgiveness from God in a moment of prayer. This leads to an inevitable climax, which results in the death of Hamlet, Claudius and Laertes in a typically bloody ending. All of these events are to be expected from a revenge tragedy. Further more, Hamlet contains several scenes, key to its portrayal of the revenge theme. In act one, scene five Hamlet follows the supposed spirit of his father and is informed of his fathers murder â€Å"I am thy fathers spirit†¦ sleeping in mine orchid a serpent stung me†. This scene conveys the task of revenge being set, the whole of the play hinges on this event. The imagery within this scene is also telling. Old Hamlet is dressed in battle fatigue, thus symbolizing him as a war-king; the audience having been informed of the war he started against Old Fortinbras. This suggests that Old Hamlets position in hell is right and not solely due to him being unable to confess before his untimely death. This suggests repercussion on whether or not Hamlets’ soul will actually be damned, having not confessed but essentially living a good life. If the nature of damnation does in fact relay solely on whether or not one has lived a good life, and not whether or not one has confessed ones sins, then it is possible Hamlet has gone to heaven, thus Shakespeare can be seen to be subverting the ideas of religion within the revenge tragedy genre. Young Fortinbras comments â€Å"Bear Hamlet like a solider†, in death Hamlet is viewed as a hero, in this context it is not difficult to assume he has escaped damnation The theme of kingship is continued in Act two, scene two. We are presented with an image of Claudius, which is in direct contrast to the one presented of his predecessor. Talk of Claudius averting war with Young Fortinbras, shows the new king to be one which favour’s diplomacy to war. Surely such a king is more advantageous for Denmark than a bloodthirsty leader like the image we are presented of Old Hamlet. This furthers the question of whether Hamlet has enough moral justification to take a life, especially one that is so beneficial to the country. This scene is also important as the first signs of Hamlet feigning madness are demonstrated to the audience. In act three, scene two the feature of a play within a play is portrayed. Claudius is outraged by what he sees â€Å"Give me some light. Away†. Hamlet interprets Claudius’ reaction to the play as unequivocal proof of his guilt. This a crucial turning point in the play. Up to now Hamlet has been unsure of whether or not to perform his ‘duties’. That he is assured by Claudius reaction (poor evidence in hindsight) may illustrate Hamlets degradation by the mission he has been set. â€Å"I’ll take the ghost’s word for a thousand pound† In Act three, scene four the death of Polonius can be seen to serve multiple purposes. In its most insignificant form it leads Ophelia further into the madness, which eventually leads to her death. Also it demonstrates how the revenge plot has affected Hamlet â€Å"A bloody deed. Almost as bad as kill a king and marry his brother. † He has killed, in cold blood and without provocation, the father of his love and yet seems to show little remorse. Can Hamlet still be seen as the hero of the play when he himself is placed in the same situation as Claudius? Polonius’ death introduces a secondary revenge plot. Laertes now has to avenge his father’s death, inviting the audience to compare Laertes and Hamlet as revenger. The alleged actions of Claudius have provoked a cycle of revenge plots, in which all involved are led to their deaths. The penultimate scene of the play affects the resolution of the three revenge plots. Hamlet and Laertes both achieve revenge, in doing they so they sacrifice their earthly bodies and possibly their eternal souls. Young Fortinbras revenge on Denmark for his country as he and his armies easily occupy, thus turning previous defeats on their head. Both Hamlet and Laertes at the beginning of the play were both well-liked and talented men; Hamlet had the possibilities of becoming king bestowed upon him. Yet at the end each die as a murderer who is damned to Hell. Hamlet in this form can be seen as a severe commentary on the idea of revenge, that it is the role of God to act upon those who have wronged, not the individuals’. A modern audience may read Hamlet in ways different to that of a Jacobean counterpart would have viewed it in. Themes of religion are very strong in the play, and while an Elizabethan audience may have had a strong belief in the concepts of divine retribution, a modern audience may be less convinced by this. Religion is not as central to modern life as it was in the era the play was written. Thus issues such as deeds on earth having direct consequences on a persons’ fate in the afterlife- a crucial part of the genre, lessen in their importance.

Saturday, January 11, 2020

Internal and External Conflict in the Age of Innocence by Wharton Essay

Archer Newland faces a huge internal conflict with having to marry May and being in love with Ellen at the same time. This conflict is never resolved because all around Newland his friends including Ellen, have made everything so confusing to him that he ends up feeling lonely all over again. Newland doesn’t want to be scandalous because it wouldn’t be proper to show his true feelings towards Ellen. However Newland hints them in many ways. When Medora comes up to Newland and mentions Ellen’s name, as he is meditating, he is surprised to find that his heart jumps. So she is _but she’s got to come home first to pick up Ellen. Ah – you didn’t know Ellen had come to spend the day with me? Such fol-de-rol, her not coming for the summer; but I gave up arguing with young people about fifty years ago. †(page 138) Ellen’s aunt tells him that Ellen is staying at the Blenkers in Portsmouth. â€Å"Run down and fetch her, like a good grandson, this pretty lady will describe the party to me, she said; and Archer stood up as if in a dream. †(page 138) This shows the internal conflict that Newland faces to hide his feelings for Ellen. Archer stood up as if in a dream† he can’t believe that he is finally going to see Ellen again and that Medora is asking him to go get her. He is in shock! Reality hit Newland later on â€Å"in the pagoda a lady stood, leaning against the rail, her back to the shore. Archer stopped at the sight as if he had waked from sleep. That the vision of the past was a dream, and the reality was what awaited him in the house on the bank overhead† (page 139) This passage shows us imagery of Ellen â€Å"leaning against the rail, her back to the shore†. Shows how he is admiring her looking out at the water. Again he is in shock â€Å" the sight as if he had waked from sleep. That the vision of the past was a dream, and the reality was what awaited him in the house on the bank overhead† he felt like none of this was real at first until reality hit him and he was looking at her from a far. He just couldn’t believe it. Newland puts in his head that if it is meant to be Ellen will turn around see him and come up with him. â€Å"Archer waited till a wide space of water sparkled between the last reef of the island and the stern of the boat; but still the figure in the summer-house did not move. He turned and walked up the hill. † (page 140) Newland gave up and turned away. He gave up on waiting, gave up on Ellen. â€Å"All night he lay awake in the big chintz bedroom at May’s side, watching the moonlight slant along the carpet, and thinking of Ellen Olenska driving home across the gleaming beaches behind Beaufort’s trotters† (page 141) Newland couldn’t sleep he spent to much time thinking â€Å"all night he lay awake†. He was laying next to May while thinking hard about Ellen â€Å"in the big chintz bedroom at May’s side† â€Å"thinking of Ellen†. This shows the internal conflict he is dealing with himself being married to May but in love with Ellen. He stares into the moonlight which shows he is in deep thought about this situation. Newlands internal conflict causes him to lie to May and Mrs. Welland. He tells them he is going to spend his afternoon going to look for a new horse to buy â€Å"Archer said that he thought of hiring a run-about and driving up the island to a stud-farm to look at a second horse for her brougham. † (page 143) but instead he goes to the party. He was not sure that he wanted to see the Countess Olenska again; but ever since he had looked at her from the path above the bay he had wanted, irrationally and indescribably, to see the place she was living in, and to follow the movements of her imagined figure as he had watched the real one in the summer-house† (page 144) Newland was curious of where she lived, he wanted to know what it looked like â€Å"to see the place she was living in†. Through Newlands internal conflict he feels empty. We see this when he says â€Å"He simply felt that if he could carry away the vision of the spot of earth she walked on, and the way the sky and sea enclosed it. The rest of the world might seem less empty. † (Page 144) He uses imagery to show how the sky and sea are trapping the world â€Å"the sky and sea enclosed it†. When Newland visits the party he finds a pink parasol. He thinks the pink parasol he found in the Blenker’s garden is Ellen’s. â€Å"But instead, he crossed the lawn and turned toward the box-garden. As he entered it he caught sight of something bright-coloured in the summer-house, and presently made it out to be a pink parasol. The parasol drew him like a magnet: he was sure it was hers. He went into the summer-house, and sitting down on the rickety seat picked up the silken thing and looked at its carved handle, which made of some rare wood that gave out an aromatic scent. Archer lifted the handle to his lip. † (Page 145) Newland is admiring this parasol because he feels it was a symbol of something once close to Ellen. This causes him to want to be closer to it and feel closer to Ellen â€Å"Archer lifted the handle to his lip†. His description of the parasol shows how much thought he puts into something that has to deal with Ellen. Throughout these chapters Newland faces these internal conflicts and try’s to resolve them. The external conflicts around him help to make the internal ones more difficult. Newland hides his feelings everyday. We see that deep down inside he still wants Ellen.

Friday, January 3, 2020

An Outline Of Physician Assisted Suicide - 1944 Words

OUTLINE Title: Physician Assisted Suicide: Right to life, Right to death I. A. Introduction 1. (problem – PAS): In today’s society, Physician Assisted Suicide is one of the most questionable and debatable issues. Many people feel that it is wrong for people to ask their doctor to help them end their life; while others feel it is their right to choose between the right to life and the right to death. â€Å"Suffering has always been a part of human existence.† (PAS) â€Å"Physicians have no similar duty to provide actions, such as assistance in suicide, simply because they have been requested by patients. In deciding how to respond to patients requests, physicians should use their judgment about the medical appropriateness of the request.† (Bernat, JL) Physician Assisted Suicide differs from withholding or discontinuing medical treatment, it consists of doctors providing a competent patient with a prescription for medication to aid in the use to end their life. 2. generally right to decide treatment: Patients generally have the right to decide their treatment however; others measures of treatment should be discussed with the patients. Patients should be competent when deciding to refuse treatment and understand what their options are, however; this should not include physician assisted suicide. Patients do not have to suffer or be in pain, there are many medical options to help the patient through palliative care that will keep them comfortable. 3. flaws includingShow MoreRelatedOutline for Persuasive Essay on Physician Assisted Suicide754 Words   |  4 PagesTitle: Physician Assisted Suicide Topic: Assisted Suicide Specific Purpose: To persuade my audience on the right to choose your path with P.A.S. Thesis Statement: Physician Assisted Suicide should be a matter of free will and not just law. Introduction Attention Material: â€Å"But it may also be within my power to take a life, this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play God†Read MorePersuasive Speech : Physician Assisted Suicide1308 Words   |  6 PagesCheyenne Jamison 4/19/17 Persuasive Speech Outline Topic: Physician Assisted Suicide Specific Purpose: To persuade the audience to favor the legalization of Physician Assisted Suicide. 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