Thursday, January 30, 2020
Government Capital Punishment Essay Theories of punishment have significant role to play in the ongoing debate on capital punishment, especially for murder. Some retributivists appeal to the lex talionis, the law of retaliation, to determine the appropriate amount of punishment . This principle specifies that the punishment should inflict on offenders what they have done to their victims; Ã¢â¬Å"an eye for an eye, a tooth for a toothÃ¢â¬ , and Ã¢â¬Å"a life for a lifeÃ¢â¬ . Capital punishment is therefore the only appropriate punishment for murder. But the lex talionis is deeply flawed. It focuses on the harm done by offenders without regard to their mental states. A life may be taken intentionally or accidentally; a person may be killed for personal gain or in order to relieve him or her of the agony of a terminal illness. Even if we restrict the scope of the lex talionis to cases in which the wrongdoing is fully intentional, there is still the problem about the level at which the punishment should imitate the crime (Singer, 1993). Should murderers be killed in exactly the manner that they killed their victims? In any case, it is impossible to apply the lex talionis to many offenders; the penniless thief, the tooth assailant who knocks out his victimÃ¢â¬â¢s teeth, the tax evader, etc. If conscious of the defects of the lex talionis, retributivists merely insist that the punishment should be appropriate to the moral gravity of the offence, then this requirement can be satisfied so long as the murderer is punished more severely than less serious offenders. There is no need for capital punishment. From the utilitarian point of view, capital punishment can only be justified if it produces better consequences than less severe forms of punishment. This condition would be satisfied if capital punishment is a superior deterrent to alternative forms of punishment such as long periods of imprisonment. So a utilitarian will try to settle the issue on the basis of the evidence about the effects of capital punishment. The statistical evidence is based on comparisons of murder rates in countries where there is capital punishment with those in socially similar countries where there is no capital punishment, and no comparisons of the murder rates in one and the same country at different times when it had capital punishment and when it later abolished it, or when it restored capital punishment after a period of abolition. The evidence does not show that capital punishment is a superior deterrent. However, the utilitarian approach is rejected by those who wish to place greater value on the lives of the innocent victims of murder than on the lives of convicted murderers. It is suggested that the evidence does not conclusively rule out the superior deterrence of capital punishment, and in the presence of such uncertainty, it is better to have capital punishment. If there is capital punishment, and it turns out that capital punishment is not a superior deterrent, then convicted murderers have been unnecessarily executed. If, on the other hand, we abolish capital punishment, and it turns out that it is a superior deterrent, then there would be additional victims of murder. But this argument is unacceptable because where there is capital punishment, it is certain that convicted murderers will die, but in the absence of capital punishment and in the light of available evidence there is only a remote probability that there would be more innocent victims of murder (Conway, 1974). In any case, there is a risk of a few innocent people being wrongly convicted of murder and executed if there is capital punishment. This has to put on the scales against capital punishment.
Wednesday, January 22, 2020
In "The Story of an Hour" by Kate Chopin, there are many moments when Chopin's craft of writing feeds the irony of the story. One perfect example, "assure himself of its truth by a second telegram" (772). This sentence subdued me into believing that Mrs. Mallard's husband was dead, when in fact, we learn that he never died. In addition, Mrs. Mallard is a woman with a strong sense of passion and detest. In the end, she dies by the nature of story. Chopin brings a style of writing that has irony. In the beginning of the story, Chopin's introduces you to the heart trouble that afflicts Mrs. Mallard. Her condition is significant later because this ailment drives the story. However, the notion of this heart condition can be overlooked as being meaningless. Many readers could argue that this heart condition foreshadowed the climax of the story instantaneously but it does not. In the end of the story, we realize the significance of her sickness. It was a clever way to secretly introduce the weakness that ends Mrs. Mallard's life. Another, well deceptive measure used by Chopin'...
Tuesday, January 14, 2020
Nurs 2500: Ethical, Legal and Moral aspects of Nursing School of Advanced Nursing Education The University of The West Indies Melissa Balbosa Craigwell 811005170 Biography of Terri Schiavo On the 25th February 1990, 26-year-old Terri Schiavo suffered severe brain damage when her heart stopped for five minutes. In June of 1990, Michael Schiavo, TerriÃ¢â¬â¢s husband, was appointed her plenary guardian by the courts. In September of 1993, Michael Schiavo authorized the nursing home she resides in to write a DNR (Do Not Resuscitate) order for Terri.Schiavo spent the following years in rehabilitation centers and nursing homes but never regained higher brain function. In 1998 her husband, Michael Schiavo, filed a legal petition to have Schiavo's feeding tube removed, saying that his wife had told him before her medical crisis that she would not want to be artificially kept alive in such a situation. Terri Schiavo's parents, Bob and Mary Schindler, fought this request. Florida judge Georg e W. Greer ruled in 2000 that Schiavo was Ã¢â¬Å"beyond all doubtÃ¢â¬ in a persistent vegetative state and that her husband could discontinue life support.But as legal appeals in the case continued, the case became widely known as some religious groups and pro-life activists began to insist that Schiavo should be kept alive. Schiavo's feeding tube was removed in 2003, but reinserted six days later when the Florida legislature passed Ã¢â¬Å"Terri's Law,Ã¢â¬ which allowed the state's governor to issue a stay in such cases. The law was later ruled invalid by the courts. At this time, there may also have appeared to be a conflict of interest, as Michael had two children with a long-term girlfriend.In March of 2005 Schiavo's feeding tube was again removed, and the case became a greater public sensation when the U. S. Congress was called into special emergency session to pass a bill allowing federal courts to review the case, with President George W. Bush flying from Texas to Washin gton especially to sign the bill into law. However, federal judges and the U. S. Supreme Court refused to intervene. After two weeks without food and water, Schiavo died of dehydration on the 31st March 2005 at the age of 41.Some the ethical issues involved in this case include; autonomy, beneficence and non-maleficence, justice, religious views Ã¢â¬â Roman Catholic Ã¢â¬â sanctity of life, no advance directives, TerriÃ¢â¬â¢s pre incapacitation verbal comments, and conflict of interest (familial, financial and institutional). The patient had severe brain damage. This followed a history of a sudden collapse secondary to cardiac arrest which resulted in prolonged cerebral hypoxia. She was diagnosed as being in a persistent vegetative state. Prognosis for patients in this state is poor. This condition is deemed to be chronic and irreversible.The goal of treatment is to alleviate pain and suffering. The probability of success cannot truly be determined as the patient is unable to communicate. In this case rehabilitative efforts were found to be unsuccessful, and a court order was issued for life support to be ended. The patient benefits from medical care through treatment that alleviates any pain or distress. Nursing care also seeks to alleviate pain and distress through palliative care which seeks to provide comfort and maintain dignity. Harm is avoided when there are no conscious efforts to hasten or prolong death.Terri Schiavo was not mentally capable and, therefore, not legally competent. The evidence of her incapacity lay in her inability to communicate. Buchanan 2004, stated that legal competence is specific to the task at hand. It requires the mental capacities to reason and deliberate, hold appropriate values and goals, appreciate one's circumstances, understand information one is given and communicate a choice. If the patient were found to be competent, then according to Michael Schiavo, she would be asking for treatment to be withheld and ongoing treatment to be withdrawn.A patientÃ¢â¬â¢s ability to self-govern is grounded in cognition (Fine, 2005). So, assuming she had the mental capacity to make her own decisions, her autonomy would have been respected and her decision upheld by the legal system. As a part of informed consent, all information would have been given to the patient concerning benefits and risks specific to her circumstances. She would have voluntarily indicated her understanding of treatment options available and given her consent in a written or oral form or possibly by some type of implied behaviour.In her incapacitated state, the appropriate surrogate should, by moral and ethical standards be her husband Michael Schiavo and indeed, he was her court appointed guardian. Butts and Rich (2008) defines a surrogate as a court appointed individual who has the authority to make decisions on behalf of the patient. The question as to whether Mr. Schiavo used appropriate standards in his decision making can be meas ured against the principles for proxy decisions with incompetent patients as set out by Olick (2001).These principles in relation to Terri Schiavo say that competent patients have a right to refuse life sustaining treatment, and he testified in court that prior to her collapse she verbalized that she did not wish to live like that, to be a burden to anyone. Incompetent patients have the same rights they are, however, exercised differently. No right is absolute, instances in which a patientÃ¢â¬â¢s right to refuse life support is outweighed by societal interests is rare, this case was one of those rare instances.Withholding and withdrawing treatments from a terminally ill or permanently unconscious patient, does not constitute killing or assisted suicide. Terri was not diagnosed to be either terminally ill or permanently unconscious. A subjective standard of implementing the patientÃ¢â¬â¢s wishes should have been used, and it was. It is recorded that the patient while competent cl early made her wishes known through informal conversations with several individuals, including her husband. There were no advance directives to rely on for guidance in this case.Local processes of review in the clinical setting in order to facilitate the resolution of disagreements were denied by Mr. Schiavo, therefore, recourse to the courts which should have been rare were frequent. This analysis indicates that appropriate standards for decision making were utilized. Whether they were adequately utilized can be debated. Advance directives, as discussed by Butts and Rich (2008), include the use of formal, written legal documents, which may take one of three forms; a living will, a medical care directive or a durable power of attorney.None of these, however, were used to express the patientÃ¢â¬â¢s preferences. Terri had been medically assessed to be in a persistent vegetative state, with no higher brain function. In this state, it was judged that she would have been unable to coop erate with medical treatment. To say that she may have been unwilling would be denying her medical diagnosis, suggesting that she did have the higher brain power necessary to choose between quality and quantity of life. In summary, I do not believe that the patientÃ¢â¬â¢s right to choose was being respected to the extent possible in ethics and in law.This is reflected in the absence of compliance with several of the principles for proxy decisions. These would be; the attempt to enable her to express her wishes, respecting societyÃ¢â¬â¢s interest for the continuation of life support, facilitating patient review to determine capacity and competence and finally not withholding and not withdrawing treatment from a patient who was not terminally ill or permanently unconscious. The New England Journal of Medicine (1994) discusses the prospect of return to a normal life with treatment. Ã¢â¬ËTherapy aimed at reversing the persistent vegetative state has not been successful.There have been occasional reports of a benefit from dopamine agonists or dextroamphetamine, but the benefit has been modest at best, direct electrical stimulation of the mesencephalic reticular formation, nonspecific thalamic nuclei, or dorsal columns has been attempted experimentally in patients in a vegetative state, with claims of recovered consciousness in a few instances. The quality of the recovered state was not described in detail, however, and these approaches remain experimental. Overall, there is no published evidence that coma sensory stimulation improves the clinical outcome in patients in a persistent vegetative state. It continues to note that Ã¢â¬â¢If the decision is to treat the patient aggressively, diligent medical treatment and nursing care are required to prevent and treat the complications that are likely or inevitable in states of severe brain damage. The survival of patients in a persistent vegetative state is, to some degree, related to the quality and intensity of the medical treatment and nursing care that they receive. Preventive care is foremost. Daily exercises in a range of movements slow the formation of limb contractures, which otherwise become particularly severe in patients in a persistent vegetative state.Daily skin care and frequent repositioning of the patient prevent decubitus ulcers. A tracheostomy may be required to maintain airway patency and prevent aspiration pneumonia. Bladder and bowel care is desirable for hygienic reasons. Since pulmonary and urinary tract infections are common, appropriate monitoring and, if necessary, treatment with antibiotics are required. Placement of nasogastric, gastrostomy, or jejunostomy feeding tubes is usually necessary to maintain adequate nutrition and hydration. Ã¢â¬ËThe outcome probability at 12 months was determined in patients who remained in a vegetative state at 3 months and at 6 months. In addition, the probability of functional recovery was determined for two possible outcomes: goo d recovery or recovery with moderate disability, and recovery with severe disability. On the basis of these probabilities, a persistent vegetative state can be judged to be permanent 12 months after a traumatic injury in adults and children; recovery after this time is exceedingly rare and almost always involves a severe disability.In adults and children with nontraumatic injuries, a persistent vegetative state can be considered to be permanent after three months; recovery does occur, but it is rare and at best associated with moderate or severe disability. Ã¢â¬â¢ NEJM (1994) Ã¢â¬ËPatients with a good recovery have the capacity to resume normal occupational and social activities, although there may be minor physical or mental deficits or symptoms. Patients with moderate disability are independent and can resume almost all activities of daily living.They are disabled to the extent that they can no longer participate in a variety of social and work activities. Patients with severe disability are no longer capable of engaging in most previous personal, social, and work activities. Such patients have limited communication skills and abnormal behavioral and emotional responses. They are partially or totally dependent on assistance from others in performing the activities of daily living. Ã¢â¬â¢ NEJM (1994) A bias does exist, according to Viswanathan et al. (2012), a reporting bias is the difference between reported and unreported findings.This would have made a big difference to the results obtained from any form of continuous assessments at the hospice. Based on the very minimal treatment options chosen by Michael Schiavo, reflective in a refusal to allow physiotherapy, oral hygiene or antibiotic administration, we may deduce that a continuation of life, with contractures, infections and poor dental state would be undesirable. There was a plan to discontinue life support by having her feeding tube removed. There was also a DNR order in place. The reason for both of these actions was to prevent prolongation of her death.The documentation suggests that there were plans for palliative care, as Butts and Rich (2008) points out that palliative care includes the choice to forego, withhold or to withdraw treatment, it also includes DNR orders. Palliative care does not hasten or prolong death, but provides relief from pain and suffering and maintains dignity in the dying experience. Michael Schiavo had a long-term girlfriend, with whom he had fathered two children, according to Funaro (2007). There may have existed a conflict of interest in balancing the affairs of his new family with the needs of his wife. He claimed that a part of him had moved, yet he still oved his wife so much that he was willing to fight to carry out her wishes. This conflict may have had an influence on his decisions. Provider issues that may have influenced treatment decisions, lie in the fact that the institution in which Terri was being cared for was one in which end -of-life management was carried out. The treatment provided by the hospice staff would only have recommended palliative care. Are there financial and economic factors? Yes. Fine (2005) tells us that Ã¢â¬ËFamilies may bankrupt themselves caring for patients in a persistent vegetative state, at which point Medicaid steps in.Medical costs are the leading factor in bankruptcy. her parents objected to her being supported by government funds. The hospice caring for Terri Schiavo provided $9. 5 million of charity care to patients in the past year. Another question of distributive justice relates to insurance. Can a society that cannot find enough resources to insure the 44 million persons (25% of whom are children) with no government or private health insurance really afford to maintain patients in a persistent vegetative state at a cost of $40,000 to $100,000 each per year? The lack of health insurance costs lives.According to the Institute of Medicine, 18,000 deaths per year are direct ly attributable to a lack of health insurance. Ã¢â¬â¢ Terri Schiavo had been a devout Roman Catholic, Lynn (2005) this religion upholds the sanctity of life. It was difficult for her parents to believe that she would not have wanted to hold on to life at all costs. They questioned whether Terri would have wanted to be starved to death. TheirÃ¢â¬â¢s and by extension TerriÃ¢â¬â¢s prior existence was a culture of life. There are limits on confidentiality, the incompetent patient still has a right to privacy and confidentiality. This right should be upheld by the legal guardian.Treatment decisions are largely affected by the laws that govern options for patients to be able to choose to accept or refuse care, and for legal guardians to make decisions on their behalf when they are not able to. A great deal of clinical teaching and research is involved on an ongoing basis. It brings about new information and better ways of managing conditions. Yes there was a conflict of interest on the part of the institution. Lynn (2005) Ã¢â¬Ëregulations generally prohibit a hospice from taking a patient who is not terminally ill and expected to live longer than six months to a year.But Felos was chairman of the board of directors of the hospice at the time, according to the non-profitÃ¢â¬â¢s annual reports, and was likely able to arrange for her admission. He subsequently stepped down from the post. Ã¢â¬â¢ George Felos was Michael SchiavoÃ¢â¬â¢s attorney. The committeeÃ¢â¬â¢s specific findings related to this case are as follows; Ã¢â¬Ëdecisions near the end of life, whether to maintain a treatment that may not be beneficial or to withdraw or withhold a life-sustaining treatment, should be effectively handled in the majority of cases by the primary treatment team.Ethics consultations are available and can be particularly valuable in cases of uncertainty or conflict. Palliative care consultations are available in cases of uncertainty or when needed to help manage c omplex symptoms, including physical, psychological, social, and spiritual suffering. Such suffering is often at the root of many an apparent conflict, and when the suffering is properly addressed, the conflict resolves.When these efforts fail to resolve conflict over decisions near the end of life, the rule of law suggests that the conflict be resolved in a court and not in legislative deliberations for a single patient. At the end of all of the medical, legal, and ethical argument, it is most important to remember that no matter how certain any of us may be of our analysis, decisions near the end of life should never be easy. We must remind ourselves that true wisdom comes with the acknowledgment of uncertainty and admitting that we cannot know all there is to know.This uncertainty is neither an excuse to engage in endless moral relativism or to engage in intellectual nihilism, refusing to search for the best possible solution or the least terrible outcome for a troubling moral pro blem. Ã¢â¬â¢ Fine (2005). In light of the above discussions, with heavy emphasis on the seven principles for proxy decisions with incompetent patients, the committee has decided against the removal of the feeding tube. The rationale for this decision, lies mainly in the fact that these principles were not upheld as best as they could have been.As shown in the above discourse, a thorough attempt had not been made to closely follow these principles. As such, the committee recommends that the feeding tube not be removed. In conclusion, there is no traditional moral obligation to provide non-beneficial treatments based upon the classic goals of medicine, which are, according to Hippocrates, Ã¢â¬Å"the complete removal of the distress of the sick, the alleviation of the more violent diseases, and the refusal to undertake to cure cases in which disease has already won mastery, knowing that everything is not possible to medicineÃ¢â¬ .There is a traditional duty to relieve suffering, ni cely restated by Sir William Osler 1849-1919: Ã¢â¬Å"To cure sometimes, to relieve often, to comfort always. Ã¢â¬ References Author unknown, 2004, Terri Schiavo Biography (Medical Patient), J R Soc Med; 97(9): 415Ã¢â¬â420. PMCID: PMC1079581, retrieved from www. infoplease. com/biography/var/terrischiavo. html Fine, R. , 2005, From Quinlan to Schiavo: medical, ethical, and legal issues in severe brain injury, retrieved from www. ncbi. nlm. nih. gov Ã¢â¬ º Ã¢â¬ ¦ Funaro, S. 007, Why didn't Michael Schiavo seek a divorce? , retrieved from www. legalzoom. com/planning-your-estate/living-wills/why-didn Lynn, D. 2005, Life and Death Tug of War-The Whole Terri Schiavo Story, retrieved from www. wnd. com/2005/03/29516/ Ã¢â¬â 115k, Published: 03/24/2005 at 1:00 AM New England Journal of Medicine, 1994, Medical Aspects of the Persistent Vegetative State, N Engl J Med 1994; 330:1572-1579 DOI: 10. 1056/NEJM199406023302206, retrieved from www. nejm. org/doi/full/10. 1056/NEJM199406023 302206 Olick, R. S. 2001.Taking advance directives seriously: Prospective autonomy and decisions near the end of life. Washington, DC: Georgetown university Press, p. 30. Viswanathan M, Ansari MT, Berkman ND, Chang S, Hartling L, McPheeters LM, Santaguida PL, Shamliyan T, Singh K, Tsertsvadze A, Treadwell JR. , 2012, Assessing the Risk of Bias of Individual Studies in Systematic Reviews of Health Care Intervention, Agency for Healthcare Research and Quality Methods Guide for Comparative Effectiveness Reviews, retrieved from effectivehealthcare. ahrq. gov/index. cfm/search-for-guides-rev Ã¢â¬â 148k
Monday, January 6, 2020
Every society has mythology. In some societies, its religion. Our religion is consumerism.Ellen Weis, San Franciscos Museum of Modern MythologyConsumerism fuels the capitalist fire. In a capitalist society, the goal is to make money, by whatever means possible, exploiting whichever potential weakness that might exist. The human race is one with a wild imagination, and this wild imagination, though a great strength, can, like all great strengths, serve as a potential weakness.It is our imaginations that advertising exploits, and it is our imaginations that religion and myth traditionally played the role of satiating, telling stories that have morals to them, lessons to be learned. Now consumerism fulfills this role. The consumerÃ¢â¬ ¦show more contentÃ¢â¬ ¦All of its lessons seem to be based upon this underlying assumption that more is better, that we need the things were being sold, and that somehow buying them will make us happier and better people.Of course the medium for these lessons are the ads themselves. Advertising nearly always has some emotional appeal to them. Instead of catering to our intellect and giving us rational reasons why we should consume the products they flaunt, rather they cater to our emotions. What better way to stimulate our imaginations? This is almost directly analogous to the emotional appeal traditionally found in sermons. Especially before our society has become so secular and scientific, sermons were heavily driven by emotion.One heavy emotion that were susceptible to is fear. Fear tactics are used in advertising just as they are in sermons. For example, the Dial soap ads use the slogan, quot;arent you glad you use Dial? Dont you wish everyone did?quot; This slogan seems to assume that the consumer already uses their product which cant possibly be the case because if it were, why would they need to advertise? Thus they seem to be implying that if you arent using Dial, youd sure better redeem yourself quickly before they find out! Similar fear tactics are also used in religious sermons. One extreme example ofShow MoreRelatedEssay : Affecting The American Dream1061 Words Ã |Ã 5 Pagesmore individualized. Society has moved to interpret the dream of what America can do for the one. Instead of the unified nation, America has been known for in the past, a shift has started creating an inconsistency in who can realize the dream. The myth of the Ã¢â¬Å"American DreamÃ¢â¬ has been hugely affected by increased materialism, the gap in economic status, and the fantasy of Ã¢â¬Å"rags to richesÃ¢â¬ idea. 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