...individuals who are unable to achieve adequate nourishment orally because of various medical problems. However, the delivery of nutrients by tube feeding can cause ethical dilemmas in cases where the effectiveness of tube feeding diminishes and medical complications increase. The decision to tube feed is often influenced by regional and cultural preferences, as well as the high cost of providing mealtime assistance. The effectiveness and appropriateness of tube feeding has been the subject of much debate as it applies to those with severe cognitive impairments and those who are in a persistent vegetative state (PVS). Recent research shows that in these vulnerable populations, tube feeding alone does not necessarily prevent malnutrition and risk of infection or improve functional status and comfort. While advanced directives allow an individual to make decisions about his or her care at the end of life, court cases and religious doctrine examine the individual’s right to autonomous decision making in opposition to preserving the sanctity of life. As long as the outcome of this debate is largely undecided, the process of dying may be prolonged for those who can no longer advocate for themselves. Keywords: Enteral feeding, tube feeding, ethics, persistent vegetative state, dementia, palliative care Introduction Nutrients are introduced into the body in two ways: by enteral feeding through the digestive tract, and by parenteral feeding through a tube inserted in a vein...
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...Running head: EUTHANASIA Euthanasia: A Silent Plea for Mercy Shannon Curry University of Southern New Hampshire Professor Henson Tuesday December 23, 2014 Euthanasia: A Silent Plea for Mercy All over the world there are amazing technological advances in medicine happening every day, despite that there are neonatal patients suffering from painful life limiting medical conditions that have no treatment or cure. “Advances in medical technology make it possible to extend life, at times, the focus on ‘cure at all costs’ overshadows the obligation to provide dignified, humane, and compassionate care” (Rushton, 2005). In an effort to provide legal, humane and compassionate end-of-life care to infants, the Dutch developed the Groningen Protocol in 2003. Developed in collaboration with the prosecutor’s office, the Groningen Protocol was designed to guide a transparent medical and legal decision making process for parents and their doctors considering neonatal euthanasia (Catlin, 2008; Petrou, 2005). Neonatal euthanasia is the practice of hastening the death of a terminal ill newborn in an effort to relive their suffering. Most countries current laws make it illegal for the neonatal population to benefit from euthanasia. Research is suggestive that albeit in secret neonatal euthanasia maybe disguised and illegally practiced around the world. Legalizing neonatal euthanasia would not only allow transparency...
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...THE LAW ON ASSISTED SUICIDE On July 26, 1997, the U.S. Supreme Court unanimously upheld decisions in New York and Washington state that criminalized assisted suicide. These decisions overturned rulings in the 2nd and 9th Circuit Courts of Appeal which struck down state statutes banning physician-assisted suicide. Those courts had found that the statutes, which prohibited doctors from prescribing lethal medication to competent, terminally ill adults, violated the 14th Amendment. In striking the appellate decisions, the U.S. Supreme Court found that there was no constitutional "right to die," but left it to individual states to enact legislation permitting or prohibiting physician-assisted suicide. (The full text of these decisions, plus reports and commentary, can be found at the Washinton Post web site.) As of April 1999, physician-assisted suicide is illegal in all but a handful of states. Over thirty states have enacted statutes prohibiting assisted suicide, and of those that do not have statutes, a number of them arguably prohibit it through common law. In Michigan, Jack Kevorkian was initially charged with violating the state statute, in addition to first-degree murder and delivering a controlled substance without a license. The assisted suicide charge was dropped, however, and he was eventually convicted of second degree murder and delivering a controlled substance without a license. Only one state, Oregon, has legalized assisted suicide. The Oregon statute...
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...J Indian Acad Forensic Med. April-June 2012, Vol. 34, No. 2 ISSN 0971-0973 Review Research Paper Euthanasia Revisited: The Aruna Shanbaug Verdict *Arsalaan. F. Rashid, **Balbir Kaur, ***O.P. Aggarwal Abstract Euthanasia and its procedure have long history of locking horns as a vexed issue with laws of countries across the world. Every human being of adult years and sound mind has a right to determine what shall be done with his/her own body. It is unlawful to administer treatment to an adult who is conscious and of sound mind, without his consent. In patients with Permanently Vegetative State (PVS) and no hope of improvement, the distinction between refusing life saving medical treatment (passive euthanasia) and giving lethal medication is logical, rational, and well established. It is ultimately for the Court to decide, as parens patriae, as to what is in the best interest of the patient. An erroneous decision not to terminate results in maintenance of the status quo; the possibility of subsequent developments such as advancements in medical science, the discovery of new evidence regarding the patient’s intent, changes in the law, or simply the unexpected death of the patient despite the administration of lifesustaining treatment, at least create the potential that a wrong decision will eventually be corrected or its impact mitigated. Key Words: Consent, Permanent Vegetative State, Passive Euthanasia, Parens patriae Introduction: Euthanasia is the intentional premature...
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...legal systems; which has been in debate for almost two million years. The word ‘euthanasia’ comes from the Greek origin and means “good death, or easy death.” (Pozgar, 2010) When considering a physician acting in the best interest of the patient, the “legal system must ensure that the constitutional rights of the patient are maintained, while protecting society’s interests in preserving life, preventing suicide, and maintaining the integrity of the medical profession.” (Pozgar, 2010)Euthanasia is a highly controversial issue, especially when patients and their families recognize the quality of life being greatly decreased, with no end to the pain and suffering, the real problem occurs for both the patient and family, but for the health care professionals as well. Surely we all remember Dr. Jack Kevorkian, one of the most controversial and most publically followed physicians held liable for his actions in physician-assisted suicide. The medical staff is trained to save lives, preserve life, treat illness, and bandage wounds, so it would be considered very unethical for any medical profession to aid in euthanasia. “The prohibition against killing patients ... stands as the first promise of self-restraint sworn to in the Hippocratic Oath, as medicine's primary taboo: 'I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect'. (Kass, 2006) There are two types of euthanasia. Active euthanasia is the “intentional commission of an...
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...ID # A00293212 Program: Ph.D. Health Services Specialization: Health Management and Policy Faculty Mentor: Dr. Robert Hoye, robert.hoye@waldenu.edu Faculty Assessor: Dr. Jim Goes, jim.goes@waldenu.edu Walden University May 10, 2013 Abstract Breadth Component In this age of rapidly evolving technological advances, many of the legal and ethical issues that are challenging the delivery of health care and the health care profession are new. As we confront the legal, moral, and ethical aspects of health care, we are seldom faced with decisions that require or are resolved by simple right or wrong answers (Edge & Kreiger, 1998). In the Breadth component of KAM VI, I focus on several ethical theories and how those theories influence the way ethical issues and concerns are addressed and managed in the allocation and delivery of health care services. I critically assess and evaluate those theories, concepts, and derivative principles as they impact important decisions and the implications of those decisions within the context of social change and with special emphasis on health care management and policy. In addition, I discuss the key assumptions on which the selected theories are constructed, compare and contrast the writers’ interpretations across theories, and conclude by providing a critical commentary on the merits of the selected theories. Abstract Depth Component In the Depth Component of KAM VI, I review and critically analyze selected articles on contemporary...
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...PHYSICIAN-ASSISTED SUICIDE: LEGALITY AND MORALITY Wednesday - May 8th, 2002 By Martin Levin, 107 Irving Street, Cambridge, MA 02138 (617)-497-6828 mlevin@levinlaw.com On Sunday, June 21, 1992, Jennifer Cowart, age thirty-two, and her brother George Kowalski, age twenty-eight, traveled to Pensacola Beach, Florida, for a day of relaxation. At the end of the day, Jennifer and George were heading back to their vehicle when Jennifer noticed a go-kart track. The two entered the track, bought tickets, and began riding. Within one minute, Jennifer’s go-kart bumped into one of the side guardrails, flipped on its side, and burst into flames. Jennifer was seat-belted in the go-kart and could not get out. George tried to run into the fire to save his sister, but the flames were too intense. Bystanders attempted to use a fire extinguisher, but it did little to lessen the inferno. Jennifer was trapped in the burning go-kart for two minutes when her seat-belt finally burned through and she fell to the ground. George grabbed his sister and pulled her away from the fire. Jennifer was alive. She was lying on the asphalt alert, oriented, and coherent. She had suffered 3rd and 4th degree burns covering ninety-five percent of her body. She was suffering the worst pain imaginable. At the scene, Jennifer begged the rescue personnel to “let me die.” Instead, Jennifer was flown to a burn center in Mobile, Alabama, where she remained for one year until she was overcome by an infection...
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...International Journal of Mental Health Nursing (2008) 17, 236–245 doi: 10.1111/j.1447-0349.2008.00539.x Feature Article Whose life is it anyway? An exploration of five contemporary ethical issues that pertain to the psychiatric nursing care of the person who is suicidal: Part one John R. Cutcliffe1,2,3 and Paul S. Links4,5 1 ‘David G. Braithwaite’ Department of Nursing, University of Texas, Tyler, USA, 2Stenberg College, Vancouver, Canada, 3University of Ulster, Jordanstown, UK, 4Department of Psychiatry, University of Toronto; and 5 Arthur Rotter Somnerburg Chair in Suicide Studies, St. Michael’s Hospital, Toronto, Ontario, Canada ABSTRACT: It is self-evident that ethical issues are important topics for consideration for those involved in the care of the person who is suicidal. Nevertheless, despite the obvious relationship between Mental Health nurses and care of the person who is suicidal, such nurses have hitherto been mostly silent on these matters. As a result, this two-part paper focuses on a number of contemporary issues which might help inform the ethical discourse and resultant Mental Health nursing care of the person who is suicidal. Part one of this paper focuses on the issues: Whose life is it anyway? Harming of our bodies and the inconsistency in ethical responses and, Is suicide ever a reasonable thing to do? The authors find that this contemporary view within the suicidology academe and the corresponding legal position in most western (developed) countries...
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...1. Compare and contrast traditional Hmong birthing practices with those in the United States. Because the Hmong culture varies so differently from that of American practices, significant traits can be compared from each way of life. One of these differing practices is childbirth. Typically, Hmong women do not go for regular checkups, let alone see any medical professionals, for the duration of their pregnancy. Once it comes time to deliver the child, the mother gives birth in her own home, by herself, without making a sound as to not “thwart the birth” (Fadiman 1997, 3). No epidurals, medication, housewives, or nurses are utilized and the mother tends to take care of everything on her own. The only assistance the woman receives is a cup of hot water, upon request, from her husband who must avert his eyes. The woman would stand as she delivers, pushing the newborn into her arms. Her husband would then cut the umbilical cord with a pair of heated scissors. Because the spiritual side of life is so important to the Hmong, the placenta would be buried in the family’s hut so that “when the [child dies] his or her soul [can] travel back from place to place, retracing the path of its life geography, until it reaches the burial place of its placental ‘jacket’ and [puts] it on” (Faiman 1997, 5). After birth, women were to eat and drink warm liquids and follow a strict diet of steamed rice and chicken boiled in water with five special herbs (Fadiman 1997, 9). The child’s body would be...
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...ETHICAL ISSUES IN HEALTH To evaluate the impact of moral philosophy on medical practice we must first look at what a moral philosophy is, also which philosophies that will be included. Moral philosophy is the area of philosophy concerned with theories of ethics, with how we ought to live our lives. Deontology and utilitarianism are the two philosophies that I shall be evaluating and applying throughout this essay. These are two time-honoured philosophical positions that apply to a wide variety of topics. Deontology is an ethical system that is attributed to the philosophical tradition of Immanuel Kant. Deontology demands that the actions, or means themselves must be ethical. This philosophy is based upon principles of duty and obligation, we have the freedom to act morally (right) or otherwise (wrong) based on General Universal Laws. To respect life means that you must not kill, to respect others is not to steal these moral laws are black and white as you must do what is right and do not do what is wrong regardless of circumstance or outcome. Deontologists argue that there are transcendent ethical norms and truths that are universally applicable to all people. Deontology holds that some actions are immoral regardless of their consequence; these actions are wrong in and of themselves. We should not act out of feeling, inclination, love or compassion, but out of our moral duty according to the universal moral laws. Kant gives a ‘categorical imperative’ to act morally at all times...
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...CONTENTS Click on the up arrow to return here 1) INTRODUCTION 2) DEFINITIONS 3) ETHICAL THEORY 4) ETHICAL DECISION MAKING 5) NEGLIGENCE 6) CONSENT IN COMPETENT ADULTS 7) CONSENT IN CHILDREN 8) CONSENT IN INCOMPETENT ADULTS 9) CONSENT CONCERNING UNUSUAL IDEAS 10) ADVANCE DIRECTIVES 11) CONFIDENTIALITY 12) CONFIDENTIALITY AUDIT 13) EUTHANASIA 14) ABORTION 15) BIOTECHNOLOGY 16) SUGGESTED READING ONE – INTRODUCTION (Registrar) The importance of Ethical thinking in General Practice is becoming more and more apparent. It should not be thought that Ethics merely relates to the “Life and Death” issues in our Professional life – Abortion, Contraception, Euthanasia and the like. Ethical issues affect some part of almost every consultation, even if the ethical issue is something more mundane like obtaining adequate consent for an examination or respecting a patient’s dignity. Indeed, it could be argued that the Consultation skills that we foster so assiduously are actually Ethical skills – and that we need to know the patient’s “Ideas, Concerns and Expectations” in order to respect his Autonomy as well as in order to improve the outcome of the Consultation. In the 1998/99 academic year, I was appointed the deanery’s Medical Ethics fellow with a bursary from the MDU. I developed an approach to the teaching of GP ethics based on two half day sessions, which...
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...LEARNING SOLUTIONS FOR SCOTLAND’S COLLEGES F0K9 34 Calculations and Practical Techniques in Health Care August 2007 © COLEG Calculations and Practical Techniques in Health Care F0K9 34 Acknowledgements No extract from any source held under copyright by any individual or organisation has been included in this publication. © COLEG – Material developed by Cardonald College. This publication is licensed for use by Scotland’s colleges as commissioned materials under the terms and conditions of COLEG’s Intellectual Property Rights document, September 2004. No part of this publication may be reproduced without the prior written consent of COLEG and SQA. © COLEG 2 Calculations and Practical Techniques in Health Care F0K9 34 Contents Section 1: Introduction to this teaching pack Information about the HNC Health Care Group Award Information about this Unit Why the packs have been written How the pack is organised How to use the pack Scottish Credit and Qualifications Framework (SCQF) and the HNC Health Care Section 2: Session Plans Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7 Week 8 Week 9 Week 10 Week 11 Week 12 Week 13 Week 14 Week 15 Week 16 Introduction / Mentor / Holistic care / Models Roper-Logan-Tierney Model / Safe practice in placement Respiration / Peak flow / Oxygen saturations Blood pressure / Pulse / Temperature Height / Weight / Body Mass Index / Fluid balance Specimen collection/ Urine testing Explanation of Skills Booklet Calculations...
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...Clinical guidelines Diagnosis and treatment manual for curative programmes in hospitals and dispensaries guidance for prescribing 2010 EDITION © Médecins Sans Frontières – January 2010 All rights reserved for all countries. No reproduction, translation and adaptation may be done without the prior permission of the Copyright owner. ISBN 2-906498-81-5 Clinical guidelines Diagnosis and treatment manual Editorial Committee: I. Broek (MD), N. Harris (MD), M. Henkens (MD), H. Mekaoui (MD), P.P. Palma (MD), E. Szumilin (MD) and V. Grouzard (N, general editor) Contributors: P. Albajar (MD), S. Balkan (MD), P. Barel (MD), E. Baron (MD), M. Biot (MD), F. Boillot (S), L. Bonte (L), M.C. Bottineau (MD), M.E. Burny (N), M. Cereceda (MD), F. Charles (MD), M.J de Chazelles (MD), D. Chédorge (N), A.S. Coutin (MD), C. Danet (MD), B. Dehaye (S), K. Dilworth (MD), F. Fermon (N), B. Graz (MD), B. Guyard-Boileau (MD), G. Hanquet (MD), G. Harczi (N), M. van Herp (MD), C. Hook (MD), K. de Jong (P), S. Lagrange (MD), X. Lassalle (AA), D. Laureillard (MD), M. Lekkerkerker (MD), J. Maritoux (Ph), J. Menschik (MD), D. Mesia (MD), A. Minetti (MD), R. Murphy (MD), J. Pinel (Ph), J. Rigal (MD), M. de Smet (MD), S. Seyfert (MD), F. Varaine (MD), B. Vasset (MD) (S) Surgeon, (L) Laboratory technician, (MD) Medical Doctor, (N) Nurse, (AA) Anaesthetist-assistant, (Ph) Pharmacist, (P) Psychologist We would like to thank the following doctors for their invaluable help:...
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...the battlefield * Hospitalers – specialized soldiers who at the end of battle returned to the outposts to care for the sick and injured * Army nursing service – organize nurses and hospitals and coordinate supplies for the soldiers during the Civil War * Clara Barton a. Provided care in tents set up close to the fighting b. Did not discriminate c. Establishment of the American Red Cross * Harriet Tubman – helped slaves escape to freedom on the underground railroad * Walt Whitman – a poet * Louisa May Alcott – an author * Dorothea Dix – union’s superintendent of female nurses during the Civil War B. Nurses fighting diseases * Florence Nightingale d. Epidemiology – the study of the distribution and origins of disease e. Air, light, nutrition, and adequate ventilation and space assist the patient to recuperate * Lillian Wald & Mary Brewster f. Founded the Henry Street Settlement in NY to improve the health and social conditions of poor immigrants g. Improve health and prevent illness by promoting safe drinking water, adequate sewage facilities, and proper sanitation Florence Nightingale (1820-1910) * “Lady of the Lamp” * Walked through the camp at night providing care to the sick and wounded during the Crimean War * Major contributions: * Establishment of nursing as a distinct...
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...Final Exam Study Guide Important to Know the function of anterior and posterior pituitary gland. Anterior Pituitary Gland: (Adenohypophysis) The anterior pituitary gland regulates several physiological processes including stress, growth, reproduction and lactation (Adrenal, liver, bone, thryroid and gonads). -It is regulated by negative feedback and the hypothalamus. Major hormones: ACTH: Stimulates the adrenal cortex. TSH: Thyroid stimulating hormone, promotes secretion of thyroid hormone. FSH: Follicle-stimulating hormone, promotes growth of reproductive system. LH: Luteinizing hormone. Promotes sex hormone production GH: Growth hormone, promotes growth, lipid and carbohydrate metabolism. PRL: Prolactin, Milk production and progesterone/estrogen. -Hormones are secreted from the hypothalamus to the A. Pituitary so these hormones can be released. Posterior Pituitary Gland: Mainly axons extended from the hypothalamus. These axons contain and release neurohypophysial hormones oxytocin and vasopressin. Oxytocin: Targets the uterus, and mammary glands causing contractions and lactation. Vasopressin (ADH): Antidiuretic hormone, arginine vasopressin, argipressin. Stimulates water retention absorbs it back into blood causing raises blood pressure by contracting arterioles, and inducing male aggression. Very Important to know and understand Diabetic Ketoacidosis Pathophysiology: -In DKA, the lack of insulin prevents glucose from being utilized by the tissues...
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