Character and Stories

Out of the many an(prenominal) stories that we reach to comp atomic number 18, the best would have to be The Candide and Dantes Inferno. There are many contrary ways that you can compare these two analogous stories. The most obvious comparison from the beginning would have to be righteousness. several(prenominal)(prenominal)(prenominal) of these stories begin with a man that has some type of issue or tries to decide how to agglomerate and question religion. Another way to compare these stories is how both stories were controversial at the time because of their religious meanings.Dantes inferno was passing controversial because of the point that it described hell in such(prenominal) a detailed way and painted a vivid picture for such a negative place. Candied was controversial because of the way it concluded. Since both of these stories had to do with religion it makes sense that it would have controversy. Most stories that have to do with religion in matchless way or anot her have some sort of controversy with them.There are too many citizenry that have many incompatible beliefs and ideas of what religion is for it not to be one of the more(prenominal) controversial storylines. Another way to compare both of these stories is by noticing the fact that both Dante and Candide both end up having mentors or plenty that answer them guide them through the story. This is another connection that religion brings together Virgil as a guide to attend him perish through hell. In Candide, Pangloss helps Candide travel through his journey as well.This is a common theme in stories that have to do with religion because a lot of religious stories deal with a person either not believing or having raise up finding religion and using a guide or a mentor having their own connection to religion. For example, Pangloss was a philospher that had many strong theories nearly religion. On Dantes inferno Virgil was an pagon so he was deeply attached in the religion to help the main character to understand and help himcome to a conclusion about what his conflict is and how to solve it. Both stories similarly had very elaborate sexual scenes.In Candide, Pangloss contracted syphilis from a fille de chambre named Panquete. In Dantes Inferno the second circle was designed for people who committed lust crimes while on earth. I imagine that different sexual partners were not received and were also frowned upon making these acts known in both stories helped signify what people believed was right or wrong. I believe some of the issues that they had would be replaced that we find wrong in our society or magnified so that religion can help separate what is accepted and what is not. For example, I believe if it as this day and age that peoples sexual orientation would play a much bigger affair in Dantes inferno. Also, in both stories there are triplex people that meet throughout the story that all have different outlooks on life, religion, and philosoph y. I believe this helps to make the story more gratifying so the main character does not only have one idea to believe in. it also makes the story more realistic by making the main character choose between different people to trust or different people to help him guide him through the story.

The Geranium

Date 15/02/10 Title The Geranium Text type Short theme Author Patricia grace This short story, The Geranium, by Patricia decorate and published 1993, is a perfect framework of Battered woman syndrome and the mental effects it has on a individual in this case Marney. In the geranium, the main character, Marney is a stay at home mother. She cleans intensely all solar day and seems rather dull. She does not ensue the house even when one of the girls tells her to come for a stretch. You know she is hesitant and you foundation feel that there is something stopping her from leaving.There seems to be a routine of non-stop cleaning, because when her friends, Sandra and Joe, come over this doesnt stop her from making certain(predicate) things atomic number 18 clean, she even sets down paper to stop the floor compactting soggy again. Her demeanor is so boring that the highlight of her week is the arrival of the paper that came on a Wednesday. The paper is a widow to the outsi de valet that she is no longstanding able to access. Although the paper shows her all kinds of things she could do and clubs she could enter, she cant because of a mental block built up by the continuous contumely from move.The infringe becomes more clear with the return of trail her husband. When Bob comes home he immediately starts demands what she has been doing all day. He asks questions close whether shes been digging and cleaning and whos been over. He is so commanding that he has to know ever little detail to make sure he does not find out different. When he finds out close The Geranium he tells her to chuck that thing out. This is a clear demonstration of his visualize, because Marney throws it extraneous without question even though ahead we see that she really cute it.These demonstrations of Bobs dominance show us the reason for Marneys resistance to leave for the shops earlier and why she finds the housework so important. The conflict is resolved when Marne y throws out the Geranium at Bobs command. This part of the story is significant because it is Marneys chance to stand up for something she wants. We see earlier in the story that the Geranium is something that she has wanted it is something to bring some colour into her dull, boring, hoary conduct. A bit of change to brighten her days.But she is damaged from her abuse, and shows she has no freewill. Immediately faltering under Bobs orders she put it into a folderol bucket as if it was of little matter to her. The sink emptying is her life being drained away. She watches as her life is taken away from here, because she was unable to speak up. She has let her chance slip away and has been doomed to the said(prenominal) dull days. I think the ideas that Patricia Grace is trying to get crossways is that domestic violence isnt all physical, that it can happen rattling much female genital organ the scenes and the ways in which it can affect people.Although we get hints that Marne y is physically abused such as when Grace mentions that Marney would put on her cardigan to hide her arm, and when Bob grips her arm until it hurts, we never actually get either evidence of serious physical abuse. When the Sandra and Joe come over they dress Bob up as an amazing guy compared to their drunkard partners. Bob of all time has the groceries, and doesnt come home drunk all the time. But behind the scenes he is very different from the picture the girls have made. He is jeopardize towards Marney and extremely controlling.He has scared into such an intense routine that she is no longer able to change that routine and is stuck to doing whatever he wants her to. This shows us that domestic violence can occur without the knowledge of the people that surrounding. Grace has showed us the way abuse can affect someone finished the way Marney is. She has been so controlled by Bob that she can no longer even think for herself. She has Battered Woman Syndrome and is completely unde r his control that she can not even reach out for help. These effects of her abuse show us how badly the aftermath of abuse affect someone just as bad as the abuse itself.The thing that I didnt enjoy about this story is the style of writing. It is written in a boring way to emphasis the way Marneys life is, and although it serves the purpose it left me feeling uninterested. What I did like the storyline. The way in which the conflict developed. I liked the way it starts off with what seems like Marney pass about a normal day and then it turns into a day that that brings forth all her abuse and problems. Mainly starting with the arrival of her friends. These developments come about us a great insight into a day in the life of Marney. And it is not a pretty picture.

Tkam Theme Essay

Kiah Lyons Mrs. Farrands Honors English II 30 October 2012 As children, we argon taught simply that something whether it is a person, object, or depression is simply good or dreadful. We can classify or nominate what is good or bad using three sources. Typic whollyy our beliefs are primarily based on what our fellowshiphold understands. Society also has a large role in our views as well. If something is illegal, outlawed, or even frowned upon by society it is considered bad. However, saying something is accept sufficient or not acceptable is something tout ensemble different from what our actions say. Many parents use the saying Do as I say, not as I do.Sometimes we know something goes against what is discipline or against or morals just now we do it regardless. storeynt scout sees that in most instances what those in her category tell her, what society tells her, and what her family and society does do not each coincide. This is evident when analyzing two main topics of the book which are race and sizz Radley. genus Atticus always tells outlook and Jem the importance of treating colourise plurality every bit if not better. While talking to Mr. Raymond, Scout tells him that Atticus told her cheatin a colored man is ten times worse than cheatin a lily-white man, Says its the worst thing you can do (Lee 205).While reason tom Robinson, Atticus told the woo The truth is this some inkinesses lie, some Negroes are immoral, some Negro men are not to be trusted around women-black or white. But this is a truth that applies to the human race and to no accompaniment race of men showing his strong belief of equality among all men no matter what their skin color may be (Lee 208). flush though Atticus strongly believes in the quote from doubting Thomas Jefferson that All men are created equal, aunty Alexandra tended to take over a different perspective regarding colored men and women (Lee 208).This is strongly evident in the way she treats and talks about Calpurnia. When aunt Alexandra first arrived, instead of a cordial greeting she tells Calpurnia right away Put my bag in the front bedroom, Calpurnia which shows that aunty Alexandra views Calpurnia of a different class and has no appraise for her. Aunt Alexandra disapproved of practically everything that Calpurnia did, and if it could be avoided, she did not want Scout and Jem disbursal any extra time with her. Although Scout looks forward to going to Calpurnia, Aunt Alexandra is not fond of the idea, and actually encourages Atticus to fire Cal.She believes Cal is not a good role mole which leads her to tell Atticus to face it to begin with or later We dont need her now (Lee 138). Aunt Alexandra felt that just because Calpurnia was black, she was not suited as a get down figure, and allowed her assumptions about blacks affect her view of Calpurnia. Throughout the summer, Jem, Scout, and Dill esteem to reenact Boo Radleys life and play games which include messing with the house, which Atticus does not approve of. When he caught the kids he told them that what Mr. Radley did was his own business. If he wanted to capture out, he would (Lee 50).Although the rest of his family may not make the same beliefs as Atticus, he takes highly his standards and morals of treating men of all types and colors with measure and equality. It is clear that Maycombs society does not agree with Atticus defending Tom Robinson. Scout does not realize that she would face this opposition until a few members of Maycomb make remarks about Atticus to her, not having the guts to say anything to Atticus face. In school, Scout faces her first opposition from Cecil Jacobs when he says Scout Finchs daddy defended niggers (Lee 77).Even some of her family disapproves of Atticus defending Tom. Francis, only restate what his grandmother says, tells Scout that Atticus is a nigger-lover and well never be able to walk the streets of Maycomb agin. Hes ruinin the family, which of cour se leads to Scout punching Francis (Lee 85-87). Passing by Mrs. Dubose, Scout and Jem get more of the usual harassment when she says makes a arch(a) remark about a Finch in the courthouse lawing for niggers and that Atticus is no better than the niggers and trash he works for (Lee 105).As for Boo Radley, most everyone in Maycomb has a different story for Boo Radley and why he stays at home all day. Stephanie Crawford even claims she woke up in the middle of the darkness one time and saw him looking straight through the window at her (Lee 13). Jem said that Boo dined on raw squirrels and any cats he could catch, his eyes popped, and he drooled most of the time, obviously a tale but no one said anything different. (Lee 13). It would be easy for Scout to fall in line with what the majority of what people think so that she would be accepted.The characters actions throughout the book show if they actually live by what they preach. For example, Atticus knows that he will face disappro val defending Tom Robinson. He tells Jack that reasonable people go stark ravingly mad when anything involving a Negro comes up (Lee 91). Knowing that he cannot go against what he believes, he defends Tom despite the opposition. He also defends Calpurnia when Aunt Alexandra talks negatively about her saying Calpurnia is not leaving this house until she wants to. You may think otherwise, but I couldnt have got on without her all these years.Shes a faithful member of this family and youll simply have to accept things the way they are later adding She tried to bring them up according to her lights, and Cals lights are pretty good ? and another thing, the children love her (Lee 138). Atticus could have easily taken his sisters side, but he really appreciates everything that Cal has done for his family. Society believes that black people are of a lesser class which is the focal point of the Tom Robinson case. Even though Tom had more evidence to prove him innocent than the complainant had to prove him guilty, his race was what ultimately convicted Tom.Atticus makes the statement in front of the court that the case is not a difficult one It should have never come to trial. This case is as simple as black and white (Lee 207). Regarding Boo Radley, no one attempts to make an effort to stand up against the unruly rumors such as that Boo went out at wickedness when the moon was down, and peeped in windows. When peoples azaleas froze in a glacial snap, it was because he had breathed on them. and the Radley pecans would kill you (Lee 9). It was more important to have a good story, than to have the not-so lively truth.Their actions showed their true beliefs. We can be molded into good people by taking the good and bad from each source, or we can be brainwashed into one source. distributively source has their pros and cons, which is why it is important to take what people say with a grain of salt, before immediately adapting their views. Regardless, we can all learn things from our households beliefs, what society says, and what peoples actions say. As we grow as a people and we gain experience, we gain a better understanding of what is good and bad, right and wrong.

Investment Arbitration: Thesis Proposals Essay

I. Implications of Naming a close to genial Nation in International Investment Contract Disputesa. What is meant by clauses containing the engagement of jurisdiction to the Most Favorable Nation?b. How does this affect international transaction?c. What is the present validity of such contract clauses?d. What are some cognize instances of Most Favorable Nation clauses being accepted or rejected?e. If surveyed, what are peoples perspectives on the naming of a Most Favorable Nation?II. Investments to Widow of Deceased Husband Her Stepchildrens literary argumenta. What is fair is the allocation of investments to the widow of a deceased husband when he attributes them to her?b. What are some arguments which may be posed by his children, her stepchildren?c. Would it be fair to divide the investments between all parties?d. How could one assert the rule that the investments belong solely to the wife, the named inheritor?e. If surveyed, what are peoples perspectives regarding the inhe ritance rights of family members?III. International Investment Arbitration One Judicial Oversighta. What is the rule for having one international judiciary for resolving investment disputes?b. How would regional judiciaries do a better job than one international judiciary?c. What would rifle of US city, state, and national laws with the intrusion of a larger judicial dead body?d. Would individual freedom and democracy be affected negatively by one world judiciary?e. If surveyed, what are peoples perspectives regarding legion(predicate) regional judiciaries versus one international judiciary?

Ethical Leadership Reputation Matrix Essay

1. at that place is no I in Team. One for each(prenominal) and all for matchless best signalizes utilitarianism 2. There is no I in team, but at that place is an M and a E (me). To seek the greatest amount of recreation for self and the majority of the group best describes Hedonism. 3. I will do my best to do my duty To strive for excellence in everything you and others do and say best describes Deontology.Multiple Choice4. fit in to the Executive respectable Leadership Reputation Matrix, is an executive characterized as a weak lesson person and a strong moral manager. a) wrong leaderb) ethical leaderc) goodly neutral leaderd) hypocritical leader5. According to the Executive Ethical Leadership Reputation Matrix, is an executive characterized as a strong moral person and a strong moral manager. a) Unethical leaderb) Ethical leaderc) Ethically neutral leaderd) Hypocritical leader6. Which of the following is false? Ca) Any attempt to castrate an governings ethics must con sider the entire ethnic system. b) A cultural system accepts both clump and daily systems. c) An utile ending change may take as long as 1 to 2 years. d) New rules and values must be fortify via educational activity programs and reward systems.7. Weak organizational floricultures argon Ba) suited if an organization has many subcultures.b) plummy if an organization wants diversity of thought and action.c) desirable if an organization wants lookal consistency. d) undesirable in all situations.8. unbent or trumped-up(prenominal)?Given the less hierarchical organizational structures that ar more(prenominal) common place today, it is less important to have strongly line up ethical culture to incline employees in their independent decision-making. sham9. It is adequate for executive leaders to be ethical persons and see ethical decisions. Employees do as they see. sullen10. Cognitive moral development tells us that nigh people are looking outside of themselves for g uidance on decision-making. This convey that stated organizational policy can be an important get-go of guidance for employees in making decisions. True11. The more a solid demands unquestioning obedience to authority, the more likely the firm will pursue across higher levels of unethical conduct among their employees. True12. Describing the decision-making process in the lyric of ethics does not help individuals make more ethical decisions. False13. An ethical culture is maintained through alignment between the formal and informal systems. True14. A 2006 study found that 82 part of Americans would prefer to be paid less but work for an ethical company than be paid more and work for an unethical company. TrueReference Matching Key Terms and Definitionsa) Strong organizational cultureb) Weak organizational culturec) Socialization (or enculturation)15. Standards and guidelines that are known and astray shared by all. A16. Subcultures within divisions or departments that are mo re likely to guide behavior. B17. Process promoted through formal and informal transmission of norms. CReference Matching Key Terms and Definitionsa) Heroesb) Normsc) Ritualsd) Myths18. symbolically tells employees what the organization wants them to do and how it expects them to do it. C19. Standards of behavior that are original as appropriate by members of a group. B20. Symbolic figures who rig standards of performance by modeling certain behaviors. A21. Anecdotes intimately a sequence of events drawn from an organizations history. DTrue or False?22. It is unethical for managers to control employees ethical behavior through subscribe to management and the organizations formal and informal cultural systems. FalseMultiple Choice23. Students may need more ethics training because research has found that they rank lower in moral reason than other students. a) Philosophyb) Political sciencec) Businessd) Medicine24. Ethical behavior can be influenced bya) an individuals trustb) an organizations culturec) ethical trainingd) an individuals personalitye) all of the above25. According to the authors, ethical behavior is delimit as a) a set of moral principles or values that guide an individual b) rules of behavior set by the Federal governmentc) principles, norms, and standards concur upon by societyd) none of the aboveTrue or False?26. According to the authors, most people are guided by a strict internal moral compass and will False27. When employees come to an organization, they have already developed intogood or bad apples. Therefore, there is little a manager can do to impact an employees ethical behavior. False28. Federal laws define what is ethical. Therefore, all unethical behavior is considered unlawful. False29. Discarding the few bad apples will usually solve all of the ethical problems within an organization. FalseMultiple Choice30. of the following statements about the Organization for Economic Cooperation and Development (OECD) Anti-Bribery Conve ntion (the Convention) which are untrue.a.Participating countries acknowledge countries in Western Europe and North America b.The Convention requires signatories to make it a crime to bribe foreign public officials c.The Convention includes the coating of criminal penalties d.The Convention bans gifts to political partiese.The Convention outlaws tax deductibility for bribesf.All are statements are trueg.Statements d and e are untrueBonus QuestionsIBriefly describe and provide examples of three steps involved in changing an organizations culture. 1. Diagnosis of the current state of the organizations culture 2. Implementing a plan of change3. Evaluating the state of the organizational culture after(prenominal) a plan has been implemented.IIIs there a difference between ethics, and morality? Explain your answer. Ethics is what is considered a right course of actions. (The Norm) Morals are what you consider a right course of action. (Personal Belief)IIIExplain why ethics without d evotion appears beneficial to the Theist as well as the Non-theist (Atheist)? Ethics without faith is an acceptable norm for theists and non-theists. An example of ethics without religion may include traffic lights. They are created for the greater good of society without regards to religious beliefs.

Terri Schiavo

Nurs 2500 Ethical, Legal and Moral aspects of Nursing civilize of Advanced Nursing Education The University of The West Indies Melissa Balbosa Craigwell 811005170 Biography of Terri Schiavo On the 25th February 1990, 26- stratum-old Terri Schiavo suffered arch encephalon damage when her heart stopped for quintette minutes. In June of 1990, Michael Schiavo, Terris husband, was ap come ined 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 reformation centers and nursing homes but never regained high(prenominal) brain function. In 1998 her husband, Michael Schiavo, filed a sub judice petition to consider Schiavos feed tube removed, hypothesizeing that his wife had told him before her aesculapian crisis that she would non want to be artifici lovelyy unplowed alive in much(prenominal) a situation. Terri Schiavos p arnt s, Bob and Mary Schindler, fought this request. Florida calculate George W. Greer ruled in 2000 that Schiavo was beyond tout ensemble doubt in a continual vegetive put in and that her husband could discontinue bread and butter support.But as legal appeals in the shift continued, the case became widely known as some religious groups and pro- feeling activists began to insist that Schiavo should be kept alive. Schiavos victuals tube was removed in 2003, but reinserted six days laterward when the Florida legislature passed Terris Law, which allowed the states governor to issue a stay in such cases. The law was later ruled invalid by the courts. At this succession, in that respect may also check appe ard to be a contravention of arouse, as Michael had two children with a long-term girlfri subvert.In March of 2005 Schiavos sustenance tube was again removed, and the case became a greater public sensation when the U. S. Congress was called into spare emergency session to pass a snoot allowing federal courts to check the case, with President George W. Bush flying from Texas to Washington especially to sign the b untoward into law. However, federal judges and the U. S. Supreme Court ref usanced to intervene. After two weeks without sustenance and water, Schiavo died of dehydration on the 31st March 2005 at the age of 41.Some the honourable issues involved in this case include autonomy, beneficence and non-maleficence, justness, religious views Roman Catholic sanctity of life, no advance directives, Terris pre incapacitation verbal comments, and conflict of interest (familial, financial and institutional). The persevering had severe brain damage. This followed a muniment of a sudden collapse secondary to cardiac arrest which resulted in prolonged cerebral hypoxia. She was diagnosed as macrocosm in a tenacious vegetal state. Prognosis for uncomplainings in this state is poor. This condition is deemed to be chronic and irreversible.The goa l of discourse is to placate pain and paroxysm. The probability of success nominatenot rattling be rigid 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 with(predicate) encompassment that alleviates any pain or distress. Nursing care also seeks to alleviate pain and distress through palliative care which seeks to provide drag and take for dignity. Harm is avoided when in that respect are no conscious efforts to bucket along or prolong death.Terri Schiavo was not cordially capable and, therefore, not legitimately competent. The evidence of her incapacity lay in her inability to communicate. Buchanan 2004, stated that legal competency is peculiar(prenominal) to the task at hand. It requires the mental capacities to moderateness and deliberate, capture enchant values and goals, appreciate ones circumstanc es, understand information one is given(p) and communicate a choice. If the patient were found to be competent, then fit to Michael Schiavo, she would be asking for word to be withheld and ongoing treatment to be withdrawn.A patients ability to self-govern is grounded in cognition (Fine, 2005). So, assuming she had the mental capacity to make her own endings, her autonomy would countenance 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 uncommitted 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 incorrupt and ethical standards be her husband Michael Schiavo and indeed, he was her court appointed guardian. Butts and fat (2008) defines a s urrogate as a court appointed case-by-case 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 measured against the principles for delegate decisions with incompetent patients as set out by Olick (2001).These principles in resemblance to Terri Schiavo say that competent patients have a just to stand firm 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. bumbling patients have the same rights they are, however, exercised differently. No right is absolute, instances in which a patients right to refuse life support is outweighed by societal interests is rarified, this case was one of those rare instances.Withholding and withdrawing treatments from a terminally ill or indissolublely 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 patients wishes should have been used, and it was. It is record that the patient while competent clearly made her wishes known through informal conversations with several individuals, including her husband. in that respect 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 re resultant role 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 patients preferences. Terri had been medically assessed to be in a determined vegetative state, with no higher brain function. In this state, it was judged that she would have been unable to cooperate with medical treatment. To say that she may have been un willing would be denying her medical diagnosis, suggesting that she did have the higher brain power necessary to choose amidst quality and amount of life. In summary, I do not believe that the patients right to choose was being respected to the extent assertable in ethics and in law.This is reflected in the absence of compliance with several of the principles for representative decisions. These would be the attack to enable her to express her wishes, respecting societys 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 uncon scious. The mod England daybook of Medicine (1994) discusses the prospect of return to a normal life with treatment. Therapy aimed at reversing the persistent vegetative state has not been successful. in that respect have been occasional reports of a benefit from dopamine agonists or dextroamphetamine, but the benefit has been modest at take up, 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 bring backd 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 make evidence that coma sensory stimulation improves the clinical outcome in patients in a persistent vegetative state. It continues to note that 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 required 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 proceed 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 hold back airway noticeableness and prevent aspiration pneumonia. Bladder and bowel care is desirable for well 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. The outcome probability at 12 months was unconquerable in patients who remained in a vegetative state at 3 months and at 6 months. In addition, the probability of functional reco actually was determined for two possible outcomes good recovery or recovery with apply 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 outflank associated with see to it or severe disability. NEJM (1994) Patients 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 mod erate disability are independent and can resume almost all activities of daily living.They are disabled to the extent that they can no continuing 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 parley skills and abnormal behavioral and emotional responses. They are partially or whole dependent on assistance from others in performing the activities of daily living. NEJM (1994) A bias does exist, according to Viswanathan et al. (2012), a reporting bias is the oddment 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 withhold 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 match the affairs of his new family with the needs of his wife. He claimed that a part of him had moved, in time he still oved his wife so much that he was willing to fight to carry out her wishes. T his conflict may have had an learn 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 worry was carried out. The treatment provided by the hospice staff would only have recommended palliative care. be there financial and economic factors? Yes. Fine (2005) tells us that Families may burst 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 kindness 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 wellness insurance really afford to maintain patie nts 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 directly attributable to a lack of health insurance. Terri Schiavo had been a dear(p) 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. Theirs and by extension Terris 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) regulations generally suppress 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 lineup of directors of the hospice at the time, according to the non-profits annual reports, and was likely able to put for her admission. He subsequently stepped down from the post. George Felos was Michael Schiavos attorney. The committees specific findings related to this case are as follows decisions pricy 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 question or conflict. Palliative care consultations are available in cases of uncertainty or when needed to help manage complex 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 in good order addressed, the conflict resolves.When these efforts fail to resolve conflict over decisions right 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 unfeigned 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 good relativism or to engage in intellectual nihilism, refusing to search for the best possible solution or the least terrible outcome for a troubling moral problem. 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 conventional moral obligation to provide non-beneficial treatments based upon the classic goals of medicine, which are, according to Hippocrates, 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 a lready won mastery, knowing that everything is not possible to medicine.There is a traditional duty to relieve suffering, nicely restated by Sir William Osler 1849-1919 To cure sometimes, to relieve often, to comfort always. References Author unknown, 2004, Terri Schiavo Biography (Medical Patient), J R Soc Med 97(9) 415420. 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 Funaro, S. 007, Why didnt Michael Schiavo seek a divorce? , retrieved from www. legalzoom. com/planning-your-estate/living-wills/why-didn Lynn, D. 2005, Life and Death fight of War-The Whole Terri Schiavo Story, retrieved from www. wnd. com/2005/03/29516/ 115k, Published 03/24/2005 at 100 AM New England Journal of Medicine, 1994, Medical Aspects of the Persistent Vegetative State, N Engl J Med 1994 3301572-1579 inside 10. 1056/NEJM199 406023302206, retrieved from www. nejm. org/doi/full/10. 1056/NEJM199406023302206 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 character reference Methods Guide for Comparative Effectiveness Reviews, retrieved from effectivehealthcare. ahrq. gov/index. cfm/search-for-guides-rev 148k

Chemical Reactions

chemical Reactions chemical Change reorganization original substances mannikin new substances with different formulas may or may not contain a change of state symbols spendd to describe chemical reply are known as a chemical equation Chemical equations do not have equal signs (=) they have an arrow Chemical Equations Must follow the Law of Conservation of Matter atoms can incomplete be created or destroyed during a chemical reaction What goes in mustiness come tabu Chemical Equations Reactants = Products same number of atoms of from each one element on each side of the reaction arrow Equations must be balanced other symbols (s)solid (l)liquid (g)gas (aq)aqueous, dissolved inwater Balancing Chemical Equations starting time check all ionic formulas to see if they are correct louver steps to balancing equations 1. Count the number of atoms of each element (or polyatomic ion) on the reactant side and then on the product side. You may requisite to use a chart o r table. 2. Determine which are out of balance these need to be balanced 3.Pick an element or polyatomic ion to start with Balance using coefficients. Do not use coefficients of 1 No changes may be made to the subscripts use least common multiples 5. Check and recheck Practice balancing these equations H2(g) + O2(g) H2O KCl + BaSO4 K2SO4 + BaCl2 Types of Chemical Reactions faction /Direct Combinationsynthesis 2Na(s) + Cl2(g) 2 NaCl(s) Single shifting single substitution anion ceaselessly replaces anion cation always replaces cation Mg + 2 HCl MgCl2 + H2 Complete the following Single switching (formula is correct) Al + CuSO4 Double Displacement 2 substitutions ion-exchange MgSO4 + BaCl2 BaSO4 + MgCl2 Types of Chemical Reactions Double Displacement What are the expected products of MgSO4 + BaCl2 Types of Chemical Reactions KOH + MgCl ( check formulas and complete) Decomposition HgO Hg + O2 (balance) 2 HgO 2 Hg + O2 carbonic acid in lab practise Oxi dation / Reduction oxidize iron into rust 4Fe + 3O2 ( 2Fe2O3 Oxidation reactions gibe O (or take aim H) Reduction reactions add H ( or remove O) Redox reaction Combination of oxidation and reduction Practice How legion(predicate) grams of diatomic oxygen (O2) are needed to make 4 moles of magnesium oxide (MgO) from magnesium ribbon (Mg)? Hint balance equation and use coefficient as mole. Energy in a Chemical Reaction Endothermic inflame in requires activation energy A + B + 100kcal = C + D Exothermic heat out A + B = C + D + 100 kcal