Sunday, February 16, 2020

The purpose of this assignment is to broaden awareness of the cardiac

The purpose of this is to broaden awareness of the cardiac client, and to evaluate the relevance of the article to nursing practice - Assignment Example The benefits of nursing support have been documented by various studies, and it has been found that such nurse led educational and support programs lead to improved understanding of the disease and a greater awareness of lifestyle changes that can lead to faster recovery, and reduce the risks of recurrence. In recent times health professionals have been focusing on ways of rehabilitating patients with cardiac ailments, in order to help them return to a normal life at the earliest. Studies have shown that this is possible when patients understand their condition; its causes and the lifestyle changes that will enable them regain their health and prevent such events in future. Kadda states that â€Å"The significant role of integrating education in a rehabilitation programme has been widely acknowledged by all health professionals†. (Kadda, 2012, pg 635) The article gives new insights into the mental stresses under which cardiac clients labor and health professionals could use these insights into the management of cardiac patients. Many health professionals are unaware of the psychological stress under which a patient labors, because they consider it a normal reaction to the stress of acute myocardial infarction. The fear in the patient’s mind and that of close family members is not taken into account; hence the problem persists despite medication. The dispelling of this fear and the reassurance that the patient can look forward to going back to a normal life; if certain precautions are taken and certain lifestyle changes are brought about, can go a long way in a faster recovery and prevention of recurrence. The article emphasizes the importance of educating patients and their families. Although this is essential, it has not received due recognition among the medical fraternity. This is due to a lack of trained personnel to impart this education, or lack of time on the part of health professionals or even patients; and

Sunday, February 2, 2020

If all the links in the Internet were to provide reliable delivry Essay

If all the links in the Internet were to provide reliable delivry service, would the TCP reliable delivery service be redundant, - Essay Example 2007). For instance, if workstation 1 is downloading a file from Workstation 2, after receiving a data packet, computer 2 sends an acknowledgement for receiving a packet to workstation 1. However, if workstation 1 do not receives an acknowledgement from workstation 2, TCP regenerates the packet again and send it to Workstation 2. In this way, the transmission is reliable and data is transmitted an in efficient manner. In a real world scenario, an executable file that is downloaded from the Internet must be complete in size in order to be operational and TCP is up for this task. Whereas, if any chunk of the executable file fails to download, it will not work and become corrupted. Whereas, User Datagram Protocol (UDP) a connection less protocol that is operational on a layer 4 of the OSI model. Likewise, UDP is not a reliable protocol for data transmission that supports transaction oriented services (User Datagram Protocol. 2007). However, UDP can be advantageous for application such a s live video streaming, VoIP services etc. likewise, if any frame is missed from a video, the video will still carry on resulting in high availability. Moreover, the response of UDP is faster, as no acknowledgment is made for every packet. Many of the functions of an adapter can be performed in software that runs on the node’s CPU. What are advantages and disadvantages of moving this functionality from the adapter to the node? As shown in fig 1.1, data link layer pertaining to the sender is responsible for hardware encapsulation. However, the source end is responsible for hardware valuation. Similarly, network layer pertaining to the sender is responsible for performing Network address translation (NAT). NAT is a method of mapping IP addresses from one group of users to another, at the same time ensuring transparency. Likewise, NAT is also used for privacy issues i.e. it cannot be used from the outbound network for security purposes (Network Address Translation. 2007). Moreov er, the receiver’s end on the network layer ensures network valuation, as shown in Fig 1.1. Moreover, the transport layer of both the sender and receiver’s end conducts port encapsulation and port valuation. Furthermore, session layer is responsible for establishing and terminating data sessions, followed by the presentation layer that ensures data compression and sequencing for both the sender’s and receiver’s end. However, there is a visible communication between the smallest program generating sequence and the amount of compression achieved (Sayood 2005) lastly, the presentation layer network interaction. Figure 1.1 A primary disadvantage comprises of computing a datagram from the application layer that relies on resources pertaining to central processing unit and memory integrated in a dedicated hardware i.e. Ethernet Adapter. However, an advantage would be to get more control of an application interacting with users that will work with dedicated hard ware resulting in a complex task. Moreover, software approach is more efficient for upgrading technology, as hardware upgrades only require a hardware replacement. Likewise, new hardware upgrades provide adequate abstraction for ensuring user protection. As illustrated in Fig 1.1, software based deployments require a large amount of metadata to analyze the requirements. As network access layer enforces overheads

Saturday, January 25, 2020

Pain and pain management in the dying patient

Pain and pain management in the dying patient For many years there has been a question as to whether or not providing pain medication to a dying patient is ethical or not. This subject practices on what is considered morally ethical as well as medically ethical. Allowing a person to sit in pain at the end of life, hits as both medically and morally unethical. Especially, when health care professionals can manage and control the pain. There are many medical ethics principles as well as the directives that apply from the Catholic religion side of it. Some of the principles that will be discussed are the principle of double effect, informed consent, veracity, beneficence, non-malfeasance, extraordinary versus ordinary means, and proportionate and disproportionate means. This paper is going to discuss the ethical implications regarding the barriers that are encountered when administering pain medications to patients that are in the last part of the dying phase. It is my position that patients that are dying should receive pain medication as desired and expressed by the patient. The pain medications should be administered and titrated accordingly to maintain the appropriate therapeutic level to allow the patient to maintain his or her dignity. There are several barriers that arise when providing pain relief in the dying patient. The barriers include failure of clinicians to identify pain relief as a priority in patient care, insufficient knowledge among clinicians about the assessment and management of pain, fear of regulatory scrutiny of prescribing practices for opioid analgesics, failure of the healthcare system to hold clinicians accountable for pain relief, the persistence of irrational beliefs and unsubstantiated fears about addiction, tolerance, dependence, and adverse effects of opioids, and the resistance of patients and/or their family members to the use of opioid analgesics in the management of pain (Rich, 2000). The most common barrier is under treatment due to fear of hastening death. Assessing pain and the administration of pain medication in the dying client is very important. This nursing assessment is vital through all aspects of life but is also very important in the end of life to try and maintain as much of a persons autonomy and dignity as possible. AS in life people who are dying must also be able to have and make choices surrounding the way in which they choose to spend that last portion of their life. Before getting down to the ethical concerns of pain and pain management, it is important to define what pain is and how it is assessed. Pain and suffering is often linked together and some even use it interchangeably. However, there is a difference between the two. Pain is considered a negative and unpleasant sensory felt by the person that is inhibitory to the comfort of the person, it is considered to be mainly physical in nature (Kelly, 2004). Suffering is considered to be roughly the same as pain but the effects are more geared towards a persons spirituality and mentality (Kelly, 2004). The way in which people experience pain and suffering is different from person to person. Pain is a subjective experience and is to be assessed on an individual basis. There are many ways in which pain can be assessed. There are many different scales that are used to assess pain and each scale has different characteristics that allow health team members to be able to assess every type of person for which they care for. Some of the most common scales used are the descriptive scales in which you circle the word that best describes you ranging from none to excruciating, the numerical scale which is the most common scale used allows a person to say or circle a number that reflects the amount of pain they are in ranging from 0 being no pain to 10 being the worst pain they have ever felt. There is a also a visual analog scale that allows a person to mark a place on a line or pick out a face on a faces scale ranging from no distress/pain to worst pain ever. The last scale mentioned is one of the least used and it is the functional interference scale which allows a person to circle a word that best describes the persons degree of impairment ranging from n one to incapacitated. In addition to these subjective scales there has been evidence that has helped with the ability of healthcare professionals to be able to approach pain from an objective point of view. This approach has been divided up into four different categories: sympathetic discharge signs, positional relief signs, sensory avoidance signs, and common pain distraction signs. Some of the sympathetic signs associated with pain are tachycardia, high blood pressure, dilated pupils and vasoconstriction (Leavitt and Tennant, 2008). There are several more approaches but this is just a few that are used in healthcare. Positional relief signs include; walking imbalanced, leaning while sitting or standing, lying on the floor, and differences in temperature between sides of the body (Leavitt and Tennant, 2008). Sensory avoidance signs include; speaking slowly, delays answering questions, avoids noise, shallow breathing, and wont brush teeth (Leavitt and Tennant, 2008). Some of the common pain distraction s igns include; grinding of teeth, clenching of feet and hands, bites lips, gouges or squeezing of skin (Leavitt and Tennant, 2008). The other aspect to consider is the type of pain medication being administered. When pertaining to the end of life the typical drug of choice are the ones that fall into the opioid family. These drugs are chosen for people that have pain that is moderate to severe in intensity and is unrelieved by non-opioid drugs. These drugs provide pain relief and can cause some adverse effects such as constipation, nausea and vomiting, respiratory depression, fatigue and sometimes light sedation is amongst the most common effects. The amount and type is determined on an individual basis and prolonged use can lead to dependence and the need for increased dosages due to an increased tolerance for the desired therapeutic effect. The way in which drugs are chosen is divided into 3 steps as developed by the World Health Organization. Step one is when the pain is assessed as mild to moderate and has had no previous treatment and so non-opioid drugs are used such as tylenol, ibuprofen, and toradol (Cla sen, Jonas and Whitecar, 2000). Step two is when the pain is measured at a moderate level and has been treated previously but has not responded to the treatments from step one, the medications used in step two are weak analgesics such as Tylenol with codeine, and tramadol (Clasen, Jonas and Whitecar, 2000). Step three is considered when the pain is described as severe pain or pain that does not respond to one and two. In this instance the patients should be treated with strong opioids such as morphine, dilaudid, and Demerol (Clasen, Jonas and Whitecar, 2000). Morphine is one of the most commonly used opioids because there is no therapeutic ceiling and extremely large doses can be used safely and effectively if the drug is titrated properly (Clasen, Jonas and Whitecar, 2000). Part of treating every person as an individual and respecting them as an individual is being sure to respect their autonomy. This principle applies here because to be able to treat a person that is in pain, they have to be assessed individually and be treated according to their individual needs. Every person feels pain differently and every person has a different threshold for pain. What is considered mildly painful to one person may be severe to excruciating to the next. As a health care member you have to be able to allow the patient to express what they are feeling and to allow them to be involved in the decisions regarding their pain management. The ability for them to be able to make decisions allows the people that are dying the ability to be able to have some form of control of how they live the last part of their lives. Allowing the dying person to make small decisions such as whether or not they receive pain medication allows the person to feel as though they still have a voice and a place within the world that they are about to leave. The fear usually involved with giving dying patients pain medication is hastening the death process. However, as the health care members the opinions that we may have about whether or not it does hasten death does not matter because the patient has the right to make his or her own decisions regarding their personal healthcare interventions. Due to the fact that pain is mostly a subjective matter healthcare members do not have the authority to decide whether or not a patient is in fact in pain or not. Withholding pain medication in the dying patient would be a violation against the patients human rights by allowing that person to die in pain. Allowing a person to die in pain does not allow the person to be able to concentrate on their spiritual needs, psychological needs, and family needs at the time of death. Violation of the ethical principle of autonomy is a violation of ones human rights. â€Å"There will be times when it easier to surrender to the determination, decisions, and goals of influential parties such as the primary physician† (Andrews, Constantino, and Zalon, 2008, Pg. 94). Furthermore the ANA Code of Ethics for Nurses requires that nurses practice â€Å"with compassion, and respect for the inherent dignity, worth, and uniqueness of every individual† (ANA, 2001). As nurses we are obligated to do everything within our power to relieve the persons pain when the person is requesting pain relief. It is also our responsibility to reassess the persons pain without prompt by the patient. Another responsibility that nurses own is providing accurate information to the patient regarding the medications ordered for pain, so as to allow the patient to make informed decisions about receiving the medications or not. The next principle is veracity, veracity is when a person tells another person the truth without any form of deception. In this case it would be the health care member speaking truthfully to the dying patient. Under this principle the nurse has the obligation to provide the patient with accurate information about his or her right to effective pain relief. The nurse also has the obligation to provide information about the pain medication being administered. The other thing to remember when this principle is applied is that nurses need to be aware that people that experience chronic pain exhibit behaviors that are vastly different than those who are experiencing acute pain. This becomes a very important principle because there have been instances in which the nurse will just bring in a medication and just tell the patient that the medication is for pain. Little does the patient know that the medication the nurse is administering is tylenol or ibuprofen. The patient trusts the nurse and assumes that their pain will be taken care of. Instead without directly having to lie to the patient, the patient is deceived. Granted the medication given is for pain but, the type of pain being referred to in the end of life is usually moderate to severe and the medications listed above are not made for intense pain. Violation of this principle is what leads patients to distrust the healthcare providers and the care that they are given. From this, patients start to feel they need second opinions and the continuity of care for the patient is then lacking. As we know to be able to properly control pain in our patients it has to be done with trust between the patient and healthcare members as well trust between the nurses and other members of the healthcare team. According to the ANA Code of Ethics for Nurses, the nurses primary responsibility is to the patient (ANA, 2001). So, if the patient is not given the proper information about the pain medications being used and it isnt being treated effectively the patient then loses part of their dignity and we as the healthcare members just robbed the patient of any value they might have felt like they had left. Before a person can make a decision about accepting or denying an intervention of any kind, that person has to be completely informed. This begins the discussion of the principle of informed consent. This principle is very important because it allows the person that is dying to be able to continue to make decisions about their lives all the way to death. When administering pain medication to a person that is dying it would be unethical to not inform that person of the affects that the pain medication may have on them. If medication was given to the patient and it either sedated them or it did hasten their death, their dignity and autonomy would have been taken away from them. That person would not have been able to decide whether or not they wanted to make preparations for the remainder of their life. The ability of a person that is approaching death to be able to maintain a sense of belonging and still feel as though they have authority over themselves allows for a sense of calm. The patient is able to make amends if wanted or needed. By informing them of the affects of the pain medications that person can feel comfortable about taking them and as that person is passing they wont be wondering â€Å"what if† when it is time for them to pass. Every person has the right to decide how they are going to die. The benefit of doing it pain free or as close to pain free as they can get is that it leaves the person in a state where they are more able to concentrate on important things. Such things include their spirituality, family, and even death preparations. â€Å"Do unto others as you would have them do unto you,† this is a very important saying that we are taught and is reinforced throughout our entire lives. This word of advice rolls into the next principle I would like to talk about and it is beneficence. Beneficence requires that the duty is to help the patient by managing the pain effectively. This principle goes as far as to say that not only will the nurse not harm the patient but is obligated to take positive actions that will benefit the patient whenever applicable. It would be a violation of this principle if the nurse was to give the patient pain medication and did not follow up with the patient to see if the pain has been reduced or if the dosage of the medication needed to be titrated. Any nurse can give their dying patient pain medication but it takes follow through and communication with the patient to ensure that the pain is being managed. The act of giving the pain medication is the part that is considered not doing harm to the patient. The follow through and reassessment of pain as well as dosage of medication is what is considered taking positive actions to benefit the patient. The ANA Code of Ethics for Nurses states that nurses are responsible for their practice and are therefore required to provide a standard of care that takes an appropriate action to manage the pain in their patients (ANA, 2001). This can be stretched even further by stating that they are expected to take action when incompetence, unethical, illegal, and impaired practices are suspected. This goes back to the age old fundamental nursing practice of advocating for your patient. Nurses are to be the advocates as well as the educators for their patients. If a nurse is caring for a dying person that person may assume that after so much pain medication that they will not be able to experience relief and as said before it is then the nurses duty to educate that patient about the ability to switch drugs or to increase dosages in cases of increased tolerance. Non-Malfeasance has a lot to do with beneficence; you wont normally see one without the other. Non-malfeasance is just the simple task of doing no harm to your patient. In the dying patient the nurse has a duty to protect the patient from pain. Suffering plays a big role in this principle. As recalled from earlier in this paper suffering is more of the emotional and mental effects that pain has on the patient. The patient is most likely to suffer if they are not properly medicated for their constant pain. The suffering is what inhibits the patient from being able to enjoy and participate in the final moments of their lives. Allowing the patient to go under medicated and allow their mental capacity to reduce to a suffering state is a violation of the principle of non-malfeasance. This impacts their dignity by not allowing them to eat, dress themselves, helping with a transfer, or walking around if they are permitted to do so. This could result in the patients last and even most precious moments of their lives to be reduced to a non-significant and traumatic experience. By withholding or under treating someone for pain it is indirectly causing harm to the patient. Another way to look at it would be that under prescribing the pain medication is the same thing as inflicting pain on the person. Looking at it from this point has made it so that I look at my own practices and every time that I think about the times that I didnt ask patients if they were in pain I was consequently inflicting pain and suffering thereby doing harm which is a direct violation of the principle of non-malfeasance. The competence of the nurse plays a large role within this principle. To properly be able to prevent doing harm to the patient the nurse must be aware and competent regarding pain and the medications or techniques that are used to manage the pain. â€Å"Further, competence in pain management entails demonstrating a basic knowledge of the nature and action of the drug, proper dosages, the length of coverage, the time it takes for the drug to take effect, the variety of routes of administration, the recognition of drug tolerance, and dealing with problems with break-through pain† (Silverman, Croker, 2001, Pg. 185). When talking about the care of dying patients, it cannot be forgotten that even though the client that is dying needs care, usually that patient is not the only person that the nurse is caring for. Time is one of the worst barriers for most nurses and although everyone that is in the hospital and needs care deserves the undivided attention of the nurse, this is just not reality. According to the principle of justice every patient has the right to be given their â€Å"dues.† This doesnt mean just fairness; it is giving something to a person to which they are entitled. Every dying person is entitled to being as pain free as possible by the healthcare members, especially when it comes to providing pain medication. This can become an issue for nurses caring for these patients because there are not enough nurses to be able to adequately staff to be able to provide the closer one on one care that may be needed. This becomes a dilemma because the nurses then have to then make decisions that result in less care being provided to one or all of the other patients. Under treating for pain in the dying patient is a violation of the principle of justice because everyone is entitled to a pain free death. The technology and advancements are available to make this happen and again this allows the patient to be able to address other needs at the time of death other than concentrating on how much pain they might be in. A good way to help in this type of situation would be a PCA pump, which allows the patient to manage their pain, but also allows the nurse to concentrate more on the other needs of the patient. Allowing the patient the extra time and energy to spend with their families or to spend relaxing is a right that all people have and should be upheld to the very last breathe that the person takes. Although administering pain medication to dying patients that are in pain produces a good effect by relieving the patients pain, it can also produce a negative affect that was unintended such as hastening death. The principle that this relates to is the principle of double effect. The true definition of this principle is that the â€Å"action that is good in itself that has two effects, an intended and otherwise not reasonably attainable good effect, and an unintended yet unforeseen evil effect† (NCBC, 2006). This principle has to be considered when there is a question or a discrepancy between doing good (beneficence) and doing no harm (non-malfeasance). The problem with this principle is that most healthcare professionals believe in it and therefore giving higher dosages of pain medication does in fact hasten death. Studies have been performed and revealed that although 89% of physicians and nurses agreed that sometimes it is appropriate to give pain medication to relieve suffering, even if it may hasten a patients death (Fohr, 2005). Out of the 89%, 41% agreed that clinicians give inadequate pain medication most often out of fear of hastening a patients death (Fohr, 2005). â€Å"Fohr has found that there is little research to support the notion that increasing the dose of opioid analgesics for terminally ill patients hastens their death† (Fohr, 2005). The belief in this principle has in fact allowed and caused unnecessary suffering in the dying patients. There are also state by state statutes that have been developed to protect health care members in instances such as this. The Indiana statute states as follows: â€Å"This statute provides that a licensed health care provider who administers, prescribes, or dispenses medications or procedures to relieve a persons pain or discomfort, even if the medication or procedure may hasten or increase the risk of death, unless such medications or procedures are intended to cause death is not liable for assisting suicide† (Sexton, 2000). There are four criteria that pertain to the double effect principle and the action has to meet these criterions to make the action morally ethical. The first criteria is that the action has to be good and that the action can be acceptable by Gods standards and must be considered good to the other person as well as yourself (NCBC, 2006). The second criterion that has to be accomplished is that the act that is to be good cannot come from or be the effect of a bad act (NCBC, 2006). So, the act of providing pain relief cannot be as a result of hastening the patients death. Hastening the patients death is in fact the unforeseen effect of the good action provide pain relief. The third criterion states that there is an equal or greater proportion that exists between the good effect of the action and the bad effect of the action (NCBC, 2006). The last criterion suggests that the person the action was used upon has to be moved more towards the good effect of the act of giving the pain medicat ion in the dying person. The untoward effect has to be just tolerated and prevented as much as possible by the healthcare members. To administer the medication to a dying patient in severe pain would be acting morally ethical according to the principle of double effect. The action which would be administering the drug is considered to be a good action because it is relieving a persons pain and suffering. The intention of using the pain medication and administering it was to just relieve the pain of that person; the intention was not to harm or hasten death. Giving the medication to the patient achieves pain relief so that relief was brought about by mean of the good act not the bad effect of early death. Lastly the pain felt by most people that are dying is so severe that treating it is completely justifiable although a side effect could in fact produce an early death. If any of these criteria is violated then it can be considered as euthanasia or physician assisted suicide. Another question to be asked in this scenario is whether or not the action of giving pain medication is proportionate to the condition. In this case the condition is the severe amount of pain that the patient is feeling. There are two principles that are brought up here and they are the principle of proportionate and disproportionate means and the principle of ordinary and extraordinary means. These two principles are usually together and one is not usually applied without the other. These two principles are very important when making end of life decisions because they are about what is considered ethically acceptable when making end of life decisions and which ones are not according to Catholic ethics. These two principles generally refer to life sustaining actions by the health care staff but it can be expanded into what is considered proportionate or disproportionate interventions when caring for a patient that is dying and is in severe pain. In a situation in which a person is dying and is in severe pain, providing them with pain medication would not be considered disproportionate or extraordinary. Giving a person pain medication is not considered making a decision of whether or not that person should undergo or forgo a type of treatment. It is not making the decision of whether or not to sustain life. Providing the person in pain who is also dying is providing that person with a better quality of life for their end of life. The fact is, is that there has not been enough evidence to prove that administration of pain medication does promote an earlier death. It cannot be concluded that the giving of the persons medication and maintaining a persons pain by increasing the medication if needed does hasten death. There is no good or easy answer when tragedies occur. But to try and understand, we must step back and look at the big picture. God made everything perfect. When man sinned, that perfection was spoiled and our entire environment was tainted. The fact is we live in a world where evil abounds. It is rampant throughout every aspect of creation. We are subject to the actions of the people around us. God can and does intervene in some events, but why not others? Only he knows that answer, but the Bible teaches that there will be a time when he will end this world as we know it. In heaven, there will be no more death, sadness, pain, sickness, or suffering of any kind. One reason many of us suffer is because we do things that cause us pain. We dont eat right, so we have heart attacks. We drive carelessly or fast, so we have accidents. We smoke, so we get lung cancer. What about innocent children who are not responsible for their suffering? Why do they get sick? Maybe its because we do not live in a perfect world. God intended for us to have perfect bodies, perfect health, and freedom from pain and suffering. The world He created was originally perfect, just as he had planned it. But evil destroyed our perfect world. When sin entered the picture, it brought with it death, pain, and suffering. Dont misunderstand me, people do not suffer because of their own personal sins, necessarily; but because the world is changed because of sin being in the world. Jesus said, In this world, you will have tribulation. Just as in the case with Job, I believe that evil forces attack us and cause much suffering in an attempt to get people to blame God and turn away f rom Him. In order for God to preserve our rights as individuals (to choose for ourselves), he had to allow us the freedom to sin. He also had to allow the consequences of our behaviors. That means that he does not normally interfere with things which happen naturally in this world, such as sickness and disease caused by toxins in the environment, accidents as a result of risky behaviors, and natural disasters. God does not cause these natural consequences, but he does allow them. However, many times, he does intervene miraculously or work even in the worst of situations to bring about something good from them. Why would God allow anyone to suffer? Maybe so that people can increase their faith in him, increases their compassion for others, or be better able to encourage and help other hurting people (2 Corinthians 1:3-5). When reading through the Ethical and Religious Directives for Catholic Health Care Services, there is one important directive that particularly applies to this situation. Directive number 61 states that all patients should be kept as free from pain as possible. This again goes to say that people that are dying need to be able to die with their dignity intact. It also states that a dying person should not be denied pain medication even if the indirect action of shortening their life occurs. There is one stipulation that applies to this directive. If the medications being used cause sedation of any kind, the health care member has an obligation of informing the patient of the effect. â€Å"The dying person has the right to be able to prepare for their death while being completely conscious† (USCCB, 2005). If for any reason that person is not able to be conscious there has to be a legitimate medical reason behind the decision. Under treating has become a large ethical dilemma in the healthcare world. More often than not there are people that are living and dying in pain. The problem with this is that with the readily available drugs that are out there to treat this problem, they are not being utilized (Miller, 2009). One of the biggest problems that arises is the lack of education amongst the health care professionals. The insufficient knowledge base surrounding the different pain medications and the research surrounding the effects on death has not been incorporated into the plan of care. As stated above the principle of double effect creates a problem for the health care professionals. The belief in this principle prevents them from properly treating the patient who is dying and has a severe amount of pain. The dignity of the patient has to remain as the top priority when approaching death. Part of maintaining a persons dignity is allowing the patient to make the informed decision of receiving pain medication. Every person has the right to a peaceful and painless death. It is essential that patients are given the proper types of medication needed for the type of pain they might be experiencing. The type of pain most commonly referred to at the end of life is moderate to severe pain. This requires due diligence on all health care professionals side of it. If the medication that is prescribed is no longer providing effective pain relief then the drug needs to be titrated accordingly. If the medication being used is at its highest dosage amount, then the drug needs to be changed. If this is the case then the patient needs to be informed of the change and educated on the new drug. This again allows the patient to be able to make decisions in their care, and allows them the sense of belonging that is still needed at the time of death. When the pain is not being managed in a person that is dying it is taking away their ability to be able to have the calm, spiritual, and family and friend oriented passing that is usually needed amongst the dying. By administering pain medication the patient is then able to concentrate on more important aspects of their life. Health care professionals have the ability to be able to control pain and suffering. To allow someone to die in pain or suffer would be not only medically immoral but it woul

Friday, January 17, 2020

Free Will Philosophy Essay

I strongly believe that W. T. Stace is correct while arguing for the view of soft determinism, also known as compatibilism. Stace believes in compatibilism, which states that determinism is true, but free will still does exist. He puts both views together by studying the definition of free will. Stace asks, â€Å"How can anyone be punished or rewarded for his or her actions if they have no control over their actions? † That statement seemed extremely convincing to me because both d’Holbach and Chisholm supported one side of the argument. d’Holbach and Chisholm argued that we are either strictly determined by the laws of nature and physics or that we are not determined, rather being we have the power to do as we choose. Stace on the other hand, put both positions together and made them work together. He explained that the laws of nature and physics do have an impact on our choices, but we do have the ability to choose what we want to choose when making a decision. Outside forces may push on our decision, but we are the ones responsible for choosing what we want to choose. He persuasively defends his view of soft determinism by explaining the definition of free will. He states, â€Å"In order for one to define free will, one must look into how the phrase is commonly used. † The way a philosopher interprets free will is different than the way a common person will do so. Stace defines free acts as acts that are directly caused by a person’s internal thoughts or desires coming directly from the person. Not free acts are those that have outside forces pushing a person to do something a certain way such as a threat or harm. This was very different from what other philosophers have stated in the past. By providing examples of free will, Stace points out that free will clearly does exist. It wouldn’t make sense for free will not to exist since it is compatible with determinism.

Thursday, January 9, 2020

Soviet Imperialism And The Soviet Union - 817 Words

The United States and the Soviet Union operated as associates and fought against the Nazi regime during World War II, however, the merger did not last long and ultimately became the Cold War. Americans had for some time been careful about Soviet socialism and worried about Russian pioneer Joseph Stalin s overbearing, ruthless guideline of his own nation. As far as concerns them, the Soviets loathed the Americans decades-long refusal to regard the USSR as a real part of the universal group and also their postponed section into World War II, which brought about the passing of a huge number of Russians. After the war ended, these grievances aged into a staggering feeling of shared doubt and animosity. After the war, Soviet expansionism in Eastern Europe drove numerous Americans fears of a Russian arrangement to control the world. In the meantime, the USSR came to disdain what they saw as American authorities pugnacious talk, arms development and the interventionist way to deal with g lobal relations. In such an unfriendly air, no single gathering was total to fault for the Cold War; truth be told, a few history specialists trust it was unavoidable (, 2009) When the fall of the Berlin Wall in 1990, president George H. W. Bush through his secretary of state James Baker promised Soviet premier Mikhail Gorbachev that in exchange for Soviet cooperation on German reunification, the Cold War era NATO union would not increase â€Å"one inch†. Baker stated, â€Å"Look, if youShow MoreRelatedThe World War II And The Cold War1199 Words   |  5 Pages When speaking to the Soviet leader Joseph Stalin about the fate of Europe, Winston Churchill said â€Å"Might it not be thought rather cynical if it seemed we disposed of these issues, so fateful to millions of people in such an off-hand manner?† In what would come to be known as the â€Å"Percentages† Agreement, Churchill and Stalin had begun discussing a new age of imperialism that would follow the end of World War II. The imperialism they discussed was one of political and commercial influence as a wayRead MoreHow the Revolutionary-Imperial Paradigm Shaped Soviet Foreign P olicy during the Early Cold War1559 Words   |  7 PagesHow did the revolutionary-imperial paradigm shape Soviet foreign policy during the early Cold War? The defeat of Germany and its satellites in the war radically changed the balance of forces in the world. The Soviet Union became one of the leading world powers, without which, should not have been resolved then no question of international life. And so, its features began to have impact on world relations and became clearer for foreign diplomats and observers. However, during the war U.S. powerRead MoreRusssian Empire Guilty of Imperialism954 Words   |  4 Pagesregime Russians have been accused of empire-building and imperialism. It is not always without a reason, since the Tsarist Russian Empire was clearly and undeniably imperialistic. (Beissinger 1995) However, the case of Soviet Union and especially their rule over Central Asia is more ambiguous and unique. It is highly disputable whether Soviet actions were actions of state-building or actions of empire-building. In this essay I examine Soviet rule in Central Asia in order to find out if it was imperialisticRead MoreWhy Did The Industrial Revolution Begin?1535 Words   |  7 Pagesliving, creation of new jobs, encouragement of technological progress, and political effects of the Industrial are all social effects of the Industrial Revolution. What were the causes of the New Imperialism of the 19th century, and how did it differ from European expansion in earlier periods? New Imperi alism an era of colonial expansion by the European powers, the United States, and Japan around the late 19th and early 20th centuries. This era is pro-faced by a diversion of overseas territorial acquisitionsRead MoreEmergence of the Modern World1842 Words   |  7 Pagesaddition, it has also provided the monetary support for the rise of the line of work, population expansion, and upgrading of living standards and remains the most important ambition of less developed countries (Industrial Revolution, 2012). Imperialism can be simply defined as the expansion of rule or authority by a government, people, or the social order over another. It was reintroduced in the West when the modern nation-state and the age of discovery emerged. The world witnessed the establishmentRead MoreWas President Truman Responsible for the Cold War? Essay1105 Words   |  5 Pagescontrolled by the Soviet Union. This situation led to increased tensions between the United States and the Soviet Union because of the two nations’ different political and economic systems. The Soviet Union began to view the United States as a threat to communism, and the United States began to view the Soviet Union as a threat to democracy. On March 12, 1947, Truman gave a speech in which he argued that the United States should support nations trying to resist Soviet imperialism. Truman and his advisorsRead MoreThe Persistence of Imperialism Essay1315 Words   |  6 PagesThe Persistence of Imperialism Following World War II, the concrete nature of imperialism, or the subjection of people or groups based on a social, economical, or racial hierarchy, was seemingly in decline. For instance, India and Pakistan had both gained their independence from Britain in 1947 (p.761), and the French, though unwillingly, gave up their colonies in Vietnam (p.754), but with the development of the Cold War there became a need to ideologically separate the free â€Å"First World†, whichRead MoreKarl Marx And Marxism1229 Words   |  5 PagesMarx would have imagined. During this time Russia was not economically advanced and had many farmers. Lenin felt he had to change the aspects of Marxism to fit Russia Lenin argued that the capitalists in European countries engaged in a policy of imperialism, or empire building, to extract the wealth from colonies and use part of that wealth to buy the proletarian class into submission. Thus, according to this new take on Marxism, class exploitation is not just a domestic phenomenon but occurs betweenRead MoreThe German Invasion Of The Soviet Union1447 Words   |  6 PagesThe German invasion of the Soviet Union marked the shift of murder throughout World War II. To understand how the invasion was directly responsible for the Holocaust, one must understand the relationship between the Soviet Union and Germany through the Molotov-Ribbentrop Pact. From this pact, Hitler decided to betray his Soviet ally, sparking Operation Barbarossa, and the massive need for resources. Hitler’s decision to invade Russia then became a race for Moscow, and this meant that anyone, otherRead MoreSino-Cuban Fallouts and Make-Ups1568 Words   |  7 Pageswhat caused the rift, one reason becomes clear. In order to bolster his Anti-United States agenda, Castro needed the resources provided by Soviet Union, and, at a time in which Soviet and Chinese policy opposed each other, he had to choose one over the other. Because the Soviet Union could prove to be more useful to him, Castro aligned himself with the Soviets, sometimes purposely alienating the Chinese. Although Chinese foreign policy and stances concerning the road to revolution in Third World countries

Wednesday, January 1, 2020

Aggression Is It ‘Nature’ or ‘Nurture’ - 2434 Words

Aggression is it ‘Nature’ or ‘Nurture’ During our lifetime every one of us feels anger and aggression occasionally, some more than others, maybe as a child in the play ground or later as an adult when somebody cuts you up when you are driving along. But what causes anger and aggression and why do we all suffer from it? Well there are lots of different theories to what causes aggression and where aggressive behaviour comes from. So throughout this essay I will examine the different concepts and theories from different psychologist and develop and show an understanding of Aggression Aggression is defined as behaviour directed towards another living being with the intent of harming or injuring them in someway, and can be defined as either†¦show more content†¦Males will either fight the current alpha male for the role of leadership or submit to him and become a follower of that gang and follows the orders of the alpha male (gang leader) for fear of reprisals. Humans are likely to develop similar behaviour patterns to that of other animals, Lorenz listed the four main drives which are what makes us do what we do and these are: (hunger, reproduction, fear, and aggression). McIlveen, Gross (1998, pp124) Hogg, Vaughan (2002, pp449) The trouble with these two theories is that they are both very hard to prove through research, for example Freud’s theory is difficult to test empirically. As Mummendey (1996) has quoted ‘the essential concepts such as that of destructive energy are so global and inexact that one can derive no precise predictions or hypotheses that can then be tested. The psychoanalytic approach is really only able to attempt an explanation of events or behaviour that have already taken place’. McIlveen, Gross. (1998, pp125) Anthropologist John Dollard and his psychologist colleagues Doob, Miller, Mowrer and Sears believed the Frustration and Aggression hypothesis and according to Dollard et al. ‘aggression is always a consequence of frustration and, contrariwise†¦Ã¢â‚¬ ¦ the existence of frustration always leads to some form or aggression’. He believed there was a link between frustration and anger. Frustration or some kind of frustrating situation or event always leads to anger and anger is alwaysShow MoreRelated The Nature of Aggression (or is it Nurture?) Essay1462 Words   |  6 PagesThe Nature of Aggression (or is it Nurture?) Every night on the news there are reports about murders, wars, and rapes. But the news isnt the only place where people encounter violent or aggressive behavior. Driving home from work, people get cut off and cussed at on a daily basis. At school, children fight over who will be the first in the lunch line. On the street, people get pushed out of the way if they are not walking fast enough. The list could go on and on and on. The point is that humansRead MoreEssay on Nature vs Nurture: Genetics vs Environment1617 Words   |  7 Pagesresearch about. The nature vs. nurture topic has been a continuing debate for many aspects of human behavior, including aggression/violent behavior and criminal behavior. There have been many studies indicating that chemical relationships between hormones and the frontal lobe of the brain may play a key role in determining aggressive behavior as well as genetics, while other studies have explored environmental and social factors that have been said to c ontrol patterns in human aggression. Aggressive/violentRead MoreNature Vs. Nurture : Nature Versus Nurture1337 Words   |  6 PagesNature vs. Nurture There are many different ways that behavior can be explained, especially on the terms of nature vs. nurture. Aggression is a behavior that has been extensively analyzed in a complex manner and the causes of it can be explained many different ways. Aggression can be defined as hostile or destructive behavior that can cause injury or destructive outlook especially when caused by frustration. Nature can be defined as aspects of behavior that have been inherited or are genetic, whileRead MorePsychology, Nature Vs. Nurture971 Words   |  4 Pagesthese are forms of aggression, but does anyone stop and think why we are that way? The answer is found in the classic debate in Psychology, Nature vs. Nurture. Aggression is caused by learned behavior, not through genetics. There are two sides of this debate, Nature and Nurture. Nature refers to something that you’re born with and are not able to change. People that follow this are called Nativists. They believe that the traits that you have are passed down through genetics. Nurture means that yourRead MoreNature Vs Nurture : The Biological Approach962 Words   |  4 Pages Nature vs Nurture is something that has been researched for many years especially when it comes to finding the reason for someone committing a crime. When talking about nature, I am talking about how you are born. The genes that you are born with that make you who you are. When referring to nurture I am talking about how someone is raised. Such as the environment you live in and what is taught to you. As humans we cannot control our nature it is simply what you are born with. When you are born youRead MoreThe Effect Of Environmental And Genetics On The Development Of A Person1000 Words   |  4 Pageshistory of psychology is the debate of whether or not ones environment or genetic background plays more of a role in the development of a person. Both nature and nurture have been proven to play an important role in one’s development. Nature is what we think of as pre-wiring and is influenced by genetic inheritance and other biological factors. Nurture is generally taken as the i nfluence of external factors after conception e.g. the product of exposure, experience and learning on an individual. ThroughoutRead MorePosition Paper: Aggression847 Words   |  4 PagesPhysical assault and aggression is the second leading cause of death among 14 to 17 year olds, next to vehicular accidents (Loeber). But why are humans so aggressive in the first place? There are two sides of the debate: Nature, and Nurture. Some say that it’s human nature, genetics that cause most behaviors, while others say that we act as we learned during childhood. This argument applies to aggression as well. Aggression is mainly caused by things during childhood and adolescence where peopleRead MoreHow Nature And Nurture Influence Substance Abuse1259 Words   |  6 PagesFrom John Locke’s blank slate to modern scientists arguments, nature versus nurture is one of the most debated topic in psychology. Nature refers to genes and hereditary features that plays a role in a personâ €™s growth, whereas nurture refers to any environmental stimuli that contribute to the development of behaviors. A lot of people though believe that nature and nurture are separate, only one can influence a person. In this modern era, majority of experts and people will now agree that both equallyRead More Gender Differences and Gender Stereotypes from a Psychological Perspective1085 Words   |  5 Pagesgender differences. The majority of people seem to believe that males are more aggressive than females. Aggression, is defined as behavior intended to harm another person. Aggression can be found in physical behavior and verbal behavior. The difference in the degree of aggression between the two genders seems much more obvious in people’s youth. Young boys are known to fight a lot, but there aggression seems to fade as they mature. There have been many studies involving gender differences in aggressiveRead MoreNature Versus Nurture Has Been A Big Debate In The Past1433 Words   |  6 Pages Nature versus nurture has been a big debate in the past few years. Debates and arguments from both sides has its own statements which makes their side stronger. Some argue that it is in the genetics if a person is intelligent where some state the opposite, that surroundings make a person intelligent which improves them in a person mentally and physically. In the 1950s psychologist Harry Harlow studied the effects of maternal deprivation on the development of baby monkeys. Some philosophers such

Monday, December 23, 2019

Immigration Policy And Foreign Policy - 1274 Words

Immigration policy and foreign policy are in many ways interlinked, as they are often used to meet goals in one another’s policy areas. Together, they are used to enhance the safety of our citizens, making this topic particularly important. Immigration is specifically linked to our foreign policy efforts with underdeveloped countries (Keely 1978). To fully understand one policy area, you must understand aspects of the other. Thus, one should consider these relationships when analyzing and evaluating Hillary Clinton and Donald Trump’s policies on immigration reform. Immigration policy can often be used as a tool for foreign policy goals. This usually occurs when national safety is threatened, and it is sparked by merely the perception that immigration and terrorism are linked. Many believe that terrorists can enter our country by manipulating Immigration laws such as refugee asylums, which leads to stricter immigration policy to better secure our national safety (Franzblau 1997, 4-11). Even now, the Republican Nominee for President of the United States, Donald Trump, makes statements like, â€Å"our immigration system is being used to attack us† (Hensch 2015). Regardless of the truth value behind his statement, it is relevant to note that the notion itself by such an important political figure could create a push for stricter immigration policy. The change in policy may be surrounding the issue of immigration, but the actual goal is the foreign policy goal of enhanced nationalShow MoreRelatedCanadas Policies On Immigration With Foreign In vestments1435 Words   |  6 Pages(2015) of the Vancouver Sun, and Troy Landereville (2015) of The Maple Ridge Times. This paper will argue that Canada needs to change its policies on immigration with foreign investments in order to solve the rising issue with housing prices that are not affordable to the average citizen and to reclaim lost revenue. Issues should be seen as foreign investments, tax dodging, and how the system is being abused. The paper will begin with looking at the current market within Vancouver and how itRead MoreImmigration Is A Foreign Policy Hot Topic1296 Words   |  6 PagesImmigration according to definitions online is â€Å"the movement of people into a destination country to which they are not native or do not possess its citizenship in order to settle or reside there, especially as permanent residents or naturalized citizens, or to take-up employment as a migrant worker or temporarily as a foreign worker.† However, in order to understand why immigration has become a foreign policy hot topic, we must understand the history of immigration. Since the initial settlersRead MoreAmerican Immigration Policy, Citizenship, And The Relationship Between Foreign Policy And Constitutional Law1477 Words   |  6 PagesAbstract This research describes the legal ins and outs of American immigration policy, citizenship, ‘border control’, and the relationship between foreign policy and constitutional law, regarding refugees. Since the birth of the United States in 1776, citizens, from countries all around the world have considered making the trek to America, in hopes of pursuing a different, more prosperous life. Yet, many of history’s hopeful travellers have learned- legally entering America is potentially theRead MoreAustralia s Historical Fear Of Invasion951 Words   |  4 Pagescontinue to influence Australia’s foreign policy today. This essay believes that the fear of invasion in Australia has evolves and changes over time from a traditional realist perspective that focused on states, to one focused on individuals and non-state actors. Firstly, this essay will briefly discuss the previous fears of invasion, from the introduction of the White Australia Policy to the War on Terr or, and how events in Australia’s past shaped foreign policy. Secondly, this essay will discussRead MoreAustralia s International Relations Between Australia And Japan1234 Words   |  5 Pagescurrently living in Australia. The Immigration Act 1909 - most popularly known as the White Australia Policy - which caused upset within Australia’s international relationships with Britain and Japan. This caused other nations to criticise Australia’s racial views and eventually immigration restrictions were gradually loosened and Australian’s began to be less fearful of people from a wide range of different countries and backgrounds. The big push for the Immigration Act 1901 in the first place wasRead MoreEssay on Texas Policy Report1242 Words   |  5 Pagesï » ¿ Immigration Reform Impacts at the State and Federal Levels GOVT 2306-21405 Fall 2013 Word Count: 1082 Texas has a reputation throughout history of differing views from the federal government in laws and politics pertaining to social, fiscal, and educational issues. On the whole, Texas operates as a largely conservative state. Because of this, policy-making is often right wing. With the institution of a Democratic, liberal president, the State’s dissent from the Federal governmentRead MoreImmigration Policies Of The United Arab Emirates982 Words   |  4 Pageswithin the sphere of immigration policies. A few examples are Italy, Japan and United Arab Emirates. Now that being said all of these places aren’t necessarily unfavorable places for immigrants, they are just found to still hold restricting policies. These policies include paying money for immigrants to leave, detaining them, and refusing rights. Through all established immigration policies there is heavy debate and controversy, but it’s usually pretty easy to agree on policies that come off as tooRead More Relationship Between Foreign Aid And Migration1414 Words   |  6 Pagesexplaining the relation between immigration and foreign aid. They hypothesis that (1) donor countries use this foreign aid to ‘aid’ or to further their own individual immigration policy goals, and (2) migrants, who have already moved, lobby their new countries for an increase in aid to their home countries. Anti-immigration parties and policies have come out of developed donor nations including Austria, Denmark, and the Netherlands. This social unrest stems from immigration of low skilled migrants toRead MoreForeign Service Officer For Citizenship And Immigration Canada878 Words   |  4 Pagesand benefit society at large. I am interested in a career as a Foreign Service Officer for Citizenship and Immigration Canada (CIC) because of the international scope and dynamism of its long-term career path as well as the opportunity to contribute to Canadian society as a member of the public service. Alth ough these aspects of the career appeal to me, I also recognize them as the two most challenging aspects of working as a Foreign Service Officer. First, the prospect of moving from posting toRead MoreThe Effects Of Immigrants On The Economy908 Words   |  4 PagesIntroduction From terrorism, to global warming, to immigration, hot-button political issues often affect many parts of people’s lives. When looking at the many issues facing the country, there are a rare few that only affect one aspect of life. Instead the problems in the country have diverse and extensive impacts and therefore need all-encompassing solutions. One of the issues that garners a great deal of discussion is immigration and its impacts on the economic environment. As a nation of immigrants