...Topic: Discuss the notion of futility of medical intervention especially in cases of terminal ill patients. Since the development of new medical knowledge, medicine has been able to keep terminally ill patients alive for longer periods of time without improving or curing their underlying disease condition. The widespread of use of artificial feeding and nutrition and ventilator support etc has meant that patients diagnosed with cancer, coronary artery disease, kidney failure and other life-threatening conditions no longer regard their diagnoses as fatal. Yet life-sustaining interventions have sometimes been a double-edged sword. Although patients live longer, they may find themselves confined to hospitals and intensive care units, where they are sedated and unable to interact meaningfully or to obtain comfort and support from the company of others but what does futility mean? Futility in medicine is an ancient concept. Hippocrates (460 BC-370 BC) clearly stated that physicians should “refuse to treat those who are overmastered by their disease, realizing that in such cases medicine is powerless. Webster’s dictionary defines futile as “serving no useful purpose, completely ineffective”. The word futile refers to a specific action, whereas futility is the relationship between an action and a desired goal. “Futile” should not be used to refer to a patient, or to care, as this may convey the impression that the patient is being abandoned or that comfort measures will no...
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...describe what can lead to “climates of futility” by examining negative expectations and professional pessimism. The essay will then go on to explain how the response from professionals to problem behaviour can become a contributing factor to a child’s sense of futility, through discussing positive and negative theories of behaviour. The second objective of this essay is to examine the concept of “learned irresponsibility” and to understand how youth cultures are able to contribute to such learned helplessness and rebellion through things like social exclusion and street gangs. Next, nearing the end of this essay I will offer my opinion as to how the child and youth care worker should approach the young person differently during the assessment as to avoid the young person becoming discouraged during the transaction. Before the conclusion I shall offer my self reflection as well as sharing the impact that this topic of “the seeds of discouragement” has had on me. Climates of Futility The climates of futility refers to those environments which may cause young people to experience feelings of deficiencies and that are able to contribute to their fears of failure. The negative transactions between the young person and others within these hostile environments can become “an ecological hazard in the lives of youth at risk” (Brendtro, Brokenleg and Van Bockern 2002, p. 8). There are a number of factors that can lead to climates of futility, one such important factor to investigate...
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...Abstract Research into trends concerning medical futility reveal that aggressive treatment at the end of life is not equating to better outcomes (Colello 2008). In fact, not only is it providing no benefit, all too often it imposes unnecessary pain and suffering. In the case of patients who lack decision making capacity and do not have an advance directive, families are often approached by nursing staff and asked “Do you want us to do everything?” or if they would prefer a Do Not Resuscitate status (DNR), meaning CPR will not be initiated if breathing or the patient’s heart were to stop. This sends a confusing message to families, that there is something worthy of offering their loved ones; when the reality is, there is nothing worthwhile left to offer. More often than not, despite a grim prognosis for the patient and the possibility of being in a persistent vegetative state (PSV), families routinely choose this option, largely because an informative conversation has never taken place as to the implications of these decisions. This is an issue which can no longer be overlooked. It is costing our nation dearly, both ethically and fiscally. As Americans, it is high time that we come to terms with our mortality and accept the reality that death awaits us all. Denial will not make it less likely to occur. As such, in an effort to promote awareness of this issue and the detrimental impact it has on patients and society as a whole, the following will define and explain the various...
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...depicts the harsh realities of war. One of the main ideas explored in the poem is the senseless waste of human life during the war. Dawe uses many techniques to convey his message. “All day, day after day”, the repetition emphasises the futility and senselessness and creates an image of a continuous flow of bodies; it implies that the war is never ending. This is not unique to the Vietnam War, and many still face these realities in war, this means the audience connects to and feels empathy for the situation, as it still exists today. Loss of hope is another prominent idea in the poem; the imagery in “telegrams tremble like leaves from a wintering tree” forces the reader to imagine the leaves, fragile and dying. Personification likens these leaves to the telegrams being opened. This idea is further shown in the last line “they’re bringing them home, now, too late, too early”, the paradox in the line expresses almost bitterness, a loss of hope and futility. It evokes strong emotions from the reader. The effects of war on the environment and communities can be seen in “the steaming chow mein”, in which Dawe uses a common Vietnamese food to express the destruction of the landscape. They all felt for the soldiers and respected their efforts, even the dogs who “raised muzzles in mute salute”. The war bound many in shared grief and sadness. ‘Homecoming’ is very effective; it explores a deeply sensitive issue that is very relevant today. It evokes a strong reaction from the...
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...How Afghan Peace Process can succeed? Abu Ezaan The prevailing stalemate in Afghan war amply validates the futility of military option in defeating insurgency. Erroneously, the political alternative has also been used to supplement the military option and weaken the insurgency to make it more amenable to reconciliation. It is now imperative that political negotiations in Afghanistan are pursued with sole objective of peace and stability in the country. An effort is made through these lines to suggest a workable way forward for successfully pursuing the reconciliation process in Afghanistan. Peace negotiations should be allowed to move forward while employment of reconciliation and reintegration as an instrument of military strategy to be abandoned once for all. The viability of fight and talk seems out of place and needs to be discarded for a more workable option. The strategy in place has failed to remove prevailing trust deficit among belligerents, an essential component of any peace process. Certain Confidence Building Measures (CBMs) that can be put in place include, delisting of Taliban leaders from UN sanction list, release of prisoners and agreement on power sharing mechanism. The strategy of pursuing talks with selected insurgent groups should be done away with and an all inclusive, broad based as well as comprehensive dialogue be initiated. The discrimination among various insurgent groups citing various reasons such as relations with al-Qaida, greater inclination...
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...American Classic The African Queen is a brilliant movie, starring Katherine Hepburn as Rose Sayer and Humphrey Bogart as Charlie Ullnet. Set against the backdrop of World War I, a touching love story quietly blossoms against the odds of circumstance and mismatched personalities. Facing a script revolving almost entirely around only two people, director John Huston adeptly develops a third viable character by filming the majority of the movie on location in Africa: nature. Rosie and Charlie must contend with nature throughout the film. As Rosie learns to love the parts of Charlie she cannot control or change, so she learns when to fight nature and when to give into it. The underlying theme of The African Queen is a lesson in the futility of fighting nature. Rosie has spent ten years in Africa doing missionary work with her brother; yet, after all this time, the movie opens during a church service where the native villagers appear to be as uncomprehending as to what is going on as if it were the Sayers’ first day there. This is the first evidence of Rosie’s inability to accept she cannot change nature. In this example, she cannot change the nature of the African culture. Charlie has, at this point, no desire to change anything. He patiently waits for the services to end and is amused at his inadvertently disrupting the services by offhandedly tossing his unfinished cigar to the ground, causing the villagers to scramble for it. Charlie is much happier accepting the...
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...Through the use of imagery, diction, and tone, Crane depicts the man in the maroon-colored flannel shirt as an isolated, irrational, and violent actor whose desire for control causes him to lose his sanity after the inability to do so. Desperate for confrontation, the man arrives at a lonely, Mexican village in seek of a challenge. He cries inhumanly loud to solicit a duel, yet his invitation is met with silence and stillness, which “formed the arch of a tomb over him. [His] cries of ferocious challenge rang against walls of silence” (crane). This description indicates the futility of his cries and solicitations. By comparing silence and stillness to a tomb in the opening paragraph, Crane suggests that silence and stillness are the man’s weakness. A tomb’s natural association with confinement and inevitability relates...
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...Ethical and Legal Issues in Nursing NUR/391 Ethical and Legal Issues in Nursing As nurses, it is our duty to advocate for our patients. At times, we are faced with personal and professional challenges that impact how and when we chose to advocate. It is imperative we have a healthy awareness of these potential challenges. Improvements in health care technology have provided patients with an array of treatment options as well as assumed or possible increased chance of survival. As a result, nurses are met with a rise in ethical decision making. This paper will discuss the legal, ethical, social, and personal factors that can impact our decision making process, with the focus on two specific case studies. American Nurses Association Code of Nursing Ethics Role in Practice The American Nursing Association (ANA) has created a set of ethical standards for the profession of nursing to abide by, which is entitled the ANA Nursing Code of Ethics. The ANA Code of Ethics states that collaboration is central to the care nurses deliver and to their ethical commitment to the patient (Garity, 2005). In the end-of-life case study, the nurse (she) has an unwritten obligation to the patient; the family appears to be in conflict with how to proceed with the patient's medical treatment. The medical team has an obligation to give the family all of their options and possible outcomes. If the family remains in conflict, it would then be appropriate for her to refer the family to...
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...On the dot of time in history, two very culturally distinct and ethnically dissimilar worlds sought to “negotiate” and homogenize for the sake of peace and progress in their individual realms but as it turned out, they got more than they bargained for, much more. Echoing the words of Herbert Hoover, that “Peace is not made at the council table or by treaties, but in the hearts of men”, is the inference of the effort and relationship of these two distinct worlds and how it all ended in futility. In Richard’s White pioneering work, “The Middle Ground”, where he expresses a ground on which the Europeans and the Indians found solace and succor as they “trade and formed alliance to become inseparable” (25). He relates the diplomatic relationship...
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...“We Should Legalize Drugs” It is frequently stated that illicit drugs are "bad, dangerous, destructive" or "addictive," and that society has an obligation to keep them from the public. There is nowhere that you can find reliable, objective scientific evidence that they are any more harmful than other substances and activities that are legal. In view of the enormous expense, the carnage and the obvious futility of the "drug war," resulting in massive criminalization of society, it is high time to examine the supposed justification for keeping certain substances illegal. Those who initiated those prohibitions and those who now so vigorously seek to enforce them have not made their objectives clear. Are they to protect us from evil, from addiction, or from poison? The concept of evil is derived from subjective values and is difficult to define. Why certain (illegal) substances are singularly more evil than legal substances like alcohol has not been explained. This complex subject of "right" and "wrong" has never been successfully addressed by legislation and is best left to the pulpit. Addiction is also a relative and ever-present phenomenon. It certainly cannot be applied only to a short arbitrary list of addictive substances while ignoring an overabundance of human cravings - from chocolate to coffee, from gum to gambling, from tea to tobacco, from snuggling to sex. Compulsive urges to fulfill a perceived need are everywhere. Some people are more susceptible to addiction...
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...In his short stories and novels, the author Liam O'Flaherty illustrates the impact of various events on human psyche. 'The sniper', an extremely tightly written and gripping story, proves to be no exception to this. In this short story the author illustrates the havoc disaster and loss that warfare wrecks in human lives. Through the central figure of a sniper the author brings out the futility of violence and shows how it destroys the lives of those who unleash it themselves. The story is narrated from the third person limited point of view. In the long twilight of a summer day in Dublin when the moon beams were piercing through the fleecy clouds and casting a faint light, there was heavy firing around the besieged Four Courts. The two conflicting groups namely the Republicans and the Free Staters were indulging in a civil war in Ireland for establishing their supremacy over the city of Dublin. The Republican sniper, a crack shot with his gun, perched himself on the rooftop keeping a close vigil on the enemy hiding on the opposite roof. He had a rifle laid beside and a pair of binoculars slung over his shoulders. He had the thin and earnest face of a student, but his eyes were profound, thoughtful and fearless. His determination and dedication to his cause could be visible from the cold gleam in his eyes that characterised a fanatic. He was eating a sandwich greedily as he had not eaten anything since morning. He quenched his thirst by having a draught of whisky and in spite...
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...“We Should Legalize Drugs” It is frequently stated that illicit drugs are "bad, dangerous, destructive" or "addictive," and that society has an obligation to keep them from the public. There is nowhere that you can find reliable, objective scientific evidence that they are any more harmful than other substances and activities that are legal. In view of the enormous expense, the carnage and the obvious futility of the "drug war," resulting in massive criminalization of society, it is high time to examine the supposed justification for keeping certain substances illegal. Those who initiated those prohibitions and those who now so vigorously seek to enforce them have not made their objectives clear. Are they to protect us from evil, from addiction, or from poison? The concept of evil is derived from subjective values and is difficult to define. Why certain (illegal) substances are singularly more evil than legal substances like alcohol has not been explained. This complex subject of "right" and "wrong" has never been successfully addressed by legislation and is best left to the pulpit. Addiction is also a relative and ever-present phenomenon. It certainly cannot be applied only to a short arbitrary list of addictive substances while ignoring an overabundance of human cravings - from chocolate to coffee, from gum to gambling, from tea to tobacco, from snuggling to sex. Compulsive urges to fulfill a perceived need are everywhere. Some people are more susceptible...
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...mama combed my hair, I could feel her soft hands, and she sang a pretty song. Erin's mother has always been a loving and caring person in her life. Home is where Erin feels most comfortable as a place to find solace and comfort. For Erin, touch is significant in her daily existence. She regularly seeks out touch from people that she knows, and a day without a hug never seems right to her. I remember when I’m standing out of the window. I wanted to play with a couple of girls who were jumping rope. My mother wouldn’t let me jump rope with them, and I started to cry. Nobody seemed to notice me when I ran off by myself.” the memory depicts a sense of rejection and hurt. Although Honey Grace tries to play with the other girls, her effort ends in futility. The memory evokes painful feelings, but there are also features of the remembrance which present more hopeful aspects. Honey Grace’s high degree of activity is evident and she seeks to be a part of a constructive experience with others. Basic mistake Emotional perfectionism: I should always feel happy, confident, and in control of my emotions. 2. Performance perfectionism: I must never fail or make a mistake. 3. Perceived perfectionism: People will not love and accept me as a flawed and vulnerable human being. 4. Fear of disapproval or criticism: I need everybody’s approval to be worthwhile. 5. Fear of rejection: If I’m not loved, then life is not worth living. 6. Fear of being alone: If I’m alone, then I’m bound...
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...SUMMARY of the extract from the novel "To Kill the Mockingbird" by Harper Lee In the novel "To Kill a Mockingbird" the scene is laid in a small American town in Alabama. The given extract depicts a trial of Tom Robinson, a coloured man, who is in the criminal dock on a capital charge of assaulting a white girl. His defending counsel Atticus Finch is an experienced lawyer and a progressive-minded man known for his humane views. His taking up the case was an act of courage in the American world of prejudice. The story is told by Jean Louise, Atticus's daughter, who watched the progress of the trial and being a lawyer's daughter did not fail to feel the atmosphere in the court-room and see the futility of her father's efforts to win the case. It is Atticus's speech to the jury that takes up the best part of the text. Moved by his sympathy for the black man and his desire to stand for his rights Atticus spoke most convincingly and with a great emotional force. He pointed it out to the jury that the case was simple enough. Having thoroughly considered every piece of the evidence submitted Atticus exposed the false testimony of the witnesses and proved that the defendant was innocent while the guilt lay with the white girl, the chief witness for the state. It was she who had tempted the Negro thus breaking the code of the society she lived in. Next she would throw the blame on Tom Robinson thus putting his life at stake. Atticus condemned Tom Robinson's accusers for their hypocrisy...
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...to get people to conform to our way of thinking. It is worth noting that if the movie were to continue on in say a sequel it would have to eventually turn back into black and white because that reality would become the new conformity and thus start to lose all the colour from that world. This is what life really is for those that choose to live a full life. One of constant change. That's why it is so important to realize the futility of trying to hold onto anything too tightly. 2. David (toby McGuire) and Jennifer (Reese Witherspoom) how does Pleasantville change them? David begins to realize that the perceived happiness in Pleasantville is not nearly as fulfilling as he hoped it would be. As a result, he slowly evolves from dreamy outcast to leader of the changes that take place in Pleasantville. Jennifer, through her own personality, sparks the initial changes in the town. However, as the story continues, she begins to understand the limitations she has placed on herself in her own life. Her reading of a D. H. Lawrence novel signifies her effort to change herself, and thus, affect her own transformation. By the end of the film she decides to stay and attend college. 3. What is the message the film presents 4. Language-how do the words set moods? 5. Is the real world, real? No. In the town of Pleasantville, nothing changes. The temperature is always the same, the weather is always nice, and no one has ever seen rain. Sex is an unknown word, passion...
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