DNR - Do Not Resuscitate Essays (Examples) Essays (Examples)

Deontology and DNR: Addressing the Issue
Introduction
Do Not Resuscitate (DNR) orders are an issue for a number of care providers in hospitals, especially those who work within the context of hematology and oncology care. As Weissman (1999) notes, DNR is a stumbling block for many nurses and nursing students: for example, he states that his students unanimously struggle to understand the purpose of asking terminally-ill patients what their preferences are on resuscitation—“We know it’s required under hospital policy to ask patients their preference about resuscitation, but these cancer patients . . . well . . . you know . . . they’re dying . . . it doesn't make sense” (Weissman, 1999, p. 149). Weissman (1999) states that while DNR orders were “designed to ensure patient autonomy while at the same time identifying patients in whom resuscitation is not indicated,” they have come to serve, unfortunately, as “an example…

An adult do not need to make all decisions in advance, but educating oneself is a vital first step. (Death with Dignity: Planning Ahead for End-of-Life Care) few guidelines for signing a DN order are given here. A Do Not esuscitate Order - DN is a physician's order to not to employ cardiopulmonary resuscitation - CP in case of cardiac or pulmonary arrest. Competent adult patients may relinquish CP for medical or non-medical reasons. The patient may make such requests verbally irrespective of whether or not he/she is fatally ill. An appeal to relinquish CP may also be part of an Advance Directive. When it has been determined that the patient is short of decision-making capacity, the suitable substitute decision-maker should be recognized to make treatment decisions, including decisions to relinquish CP, if no such person has been appointed by an Advance Directive. If the patient is out of action,…

References

Care of the Sick and Dying. Roman Catholic Bishops of Maryland. Retrieved at  http://www.mdcathcon.org/Care.htm . Accessed on 17th March 2005

Collins, Tony. Dealers of Death. Retrieved at  http://www.envoymagazine.com/planetenvoy/Update-TCollins-TerriS-Jan04-Full.htm . Accessed on 17th March 2005

Dealers of Death. 30 November, 2004. Retrieved at  http://www.catholicexchange.com/vm/index.asp?vm_id=2&art_id=26177Accessed  on 17th March 2005

Do not Resuscitate- DNR Orders. 1 January, 2001. Retrieved at  http://www.healthsystem.virginia.edu/internet/housestaff/policy-manual/dnr.cfmAccessed  on 17th March 2005

Illinois Department of Conservation Police Law Enforcement

The American system of local governance for the purpose of maintaining parks and other recreational areas is political as well as democratic, and is based on certain citizens' awareness and desire to create better living conditions as far as environment is concerned, for the benefit of future generations. This entails preservation and conservation of natural parks and wildlife to a large extent. This is especially true in the case of the citizens of Illinois, who are always on the campaign for more open spaces, more parks, and more as well as better recreational facilities for its citizens. Officials are elected for the purpose of looking after and governing the problems that arise from these forests and natural forest preserves, and these officials do believe and also demonstrate the same determination and strongly idealistic beliefs of their predecessors, of the days gone by. The…

References

Blagojevich, Rod. (April 2004) "Illinois's Multi-Year strategy to Control Drug and Violent Crime FFY2004" Retrieved at  http://www.icjia.state.il.us/public/word/Byrne/ByrneStrategy.doc . Accessed on 28 October, 2004

Carlile, Harry E. "Keeping our parks a safe place to play" Retrieved at  http://www.lib.niu.edu/ipo/ip960919.html . Accessed on 27 October, 2004

DUI, International Referral Database of DUI, DWI, Impaired and Drunk Driving, Drinking and Driving, Lawyers & Attorneys" Retrieved at http://www.lawyers.ca/international/summaryoflaw.asp. Accessed on 28 October, 2004

Educational information: Illinois Department of Natural Resources" (2003) Retrieved at http://dnr.state.il.us/lands/education/index.htm. Accessed on 27 October, 2004

But there will also be situations where clinicians are asked to discuss with a patient whether they want to or should have resuscitation if they have had a cardiac arrest or life-threatening arrhythmia. The potential likelihood for clinical benefit in accordance with the patient's preferences for intervention and its likely outcome, involves careful consideration, as with many other medical decisions, in deciding whether or not to resuscitate a patient who suffers a cardiopulmonary arrest. Therefore, decisions to forego cardiac resuscitation are often difficult.

Cardiopulmonary resuscitation (CP) is a set of specific medical procedures designed to establish circulation and breathing in a patient who's suffered an arrest of both. CP is a supportive therapy, designed to maintain perfusion to vital organs while attempts are made to restore spontaneous breathing and cardiac rhythm (Braddock 2).

The standard of care is to perform CP in the absence of a valid physician's order to…

References

Braddock, C.H. (1998) Termination of life-sustaining treatment. University of Washington School of Medicine. Seattle: Department of Medical History and Ethics. Retrieved 3/12/07 at  http://depts.washington.edu/bioethx/topics/termlife.html .

Frequently asked questions. (2007). The World Federation of Right to Die Societies. Retrieved at  http://www.worldrtd.net/faqs/qna/?id=8 .

Guru, V., Verbeek, P.R. And Morrison, L.J. (1999). Response of paramedics to terminally ill patients with cardiac arrest: an ethical dilemma. CMAJ. 61 Nov; 161(10).

Hilz, L.M. (1999). Psychology Terms: Transference and countertransference. Kathy's Mental Health Review. Riverside, CA: Mental Health. Retrieved at  http://www.toddlertime.com/mh/terms/countertransference-transference-3.htm .

With regard to the medication administration itself, in a life saving circumstance, which this clearly is not the weight of the potential for depression of respiration and cardiac status is clearly indicated, yet it would seem unethical under these circumstances, if the review of the documentation proves its validity and clearly indicates the patients wishes, to deny at least the smallest dosage (2mg) of ordered Morphine to reduce the pain and potentially allow the patient to regain calm, which will clearly improve his status with regard to short-term treatment.

If the fear of doing harm, drives every medical decision, based on the extreme notion that all patients can be saved under all circumstances then bioethical decisions are futile. The observations and communications of others in the immediate vicinity to care, including the family, other nurses, support staff and most importantly the orders of the doctor to administer palliative care for…

References

Andre, J. (2002). Bioethics as Practice. Chapel Hill, NC: University of North Carolina Press.

Forsythe, C.D. (2005). Protecting Unconscious, Medically-Dependent Persons after Wendland & Schiavo. Constitutional Commentary, 22(3), 475.

Mantz, a. (2002). Do Not Resuscitate Decision-Making: Ohio's Do Not Resuscitate Law Should Be Amended to Include a Mature Minor's Right to Initiate a DNR Order. Journal of Law and Health, 17(2), 359.

Saunders, D.E. (2003). Removing the Mask. The Hastings Center Report, 33(2), 12.

Martha must have been unconscious after she suffered the cardiac episode. She therefore had no intact decision making capacity. However, she had made it clear to her daughter Alice that she never wanted CP, something that Alice intimated to the hospital authorities before she left. This ought to have been respected. Martha's condition could not be cured.

Even if CP was administered, the quality of her life was so poor that meaningful survival was not expected. espect for autonomy requires that the patient and/or their family members be allowed to play a role with regards to Do-Not-esuscitate Order. Written DN Orders must be cosigned by the attending physician (University of Washington School of Medicine, 2008). Alice actually singed the color-coded DN order.

However, we are not told whether the attending physician signed it. It could have been ethically wrong not to subject Martha to CP if the DN order only…

Reference

University of Washington School of Medicine, (2008). Do not Resuscitate Orders. Retrieved September 20, 2012 from  http://depts.washington.edu/bioethx/topics/dnr.html

According to this second view, contemporaneous autonomy trumps precedent autonomy because honoring precedent autonomy imposes preferences and values of a different person, the formerly competent self (Buccafumi, p. 14).

The role that patient's families, doctors, health aides, pastors, chaplains and administrators, health educators and others play is crucial. Few people have executed an advanced directive, much less appointed a healthcare power of attorney by the time they enter a hospital with a debilitating condition. An informed consent form only marks the fact that a conversation has taken place in a health facility. The process that needs to or ought to take place concerning a patient's wishes and ensure one's wishes are empowered are part of the process involved as one fills out the advanced directive for themselves. In California the state has consolidated statutes for advanced directives and added some rights and included the best features of past laws. A…

REFERENCES WHICH I DID NOT USE (JUST for YOUR INFO, NOT to BE INCLUDED in THIS PAPER)

American Nurses Association. (1985). American Nurses

Association Code for Nurses with Interpretive Statements, Section 1.1. Washington, DC:ANA.

Docker, C. (1995). Deciding How We Die. The use Limits of Advance Directives. [Online]. Available:  http://www.finalexit.org/wfn27.3.html .

Fishback, R. (1996). Harvard Medical School Division of Medical Ethics. Care Near the End of Life. [Online]. Available: www.logicnet.com/archives/file2001.php.

Executive Assistant

This case study examines the decision making process from a collective viewpoint. It attempts to resolve issues within a community hospital that have arisen due to failed organizational management, ethical considerations and a poorly established communication system.

Framing the Problem:

Identify the Problem-

The primary problems that exist within Faith community hospital center around the following as outlined by the CEO: (1) a lack of organizational processes that ensure uniformity, (2) a lack of standardized procedures with regard to ethical considerations working in a medical environment, and (3) lack of appropriate communication systems to ensure that everyone is thinking alone the same lines.

At this point in time Faith Community Hospital has developed a mission statement that clearly identifies the organizations mission which is among other things to provide a quality continuum of service to community members.

However variant interpretations of the mission have led to a chaotic…

References:

Mattison, M. (2000). "Ethical decision making: The person in the process." Social Work,

45(3): 201

Reamer, F. (1995). "Social work values and ethics." New York: Columbia University

Press.

The researcher especially appreciated the "Rights, rongs, and hy" (Fielder 31-35) section relating to managing duck nests.

Content Analysis

Information about Paul C. Fielder, an avid outdoorsman, who has been a practicing wildlife biologist in ashington State for twenty-three years is plainly positioned to inform the reader. The reader learns that Fielder "manages a ood Duck Nest Box program in the enatchee vicinity of the Columbia River which involves over 100 nest boxes." Fielder's efforts in this program reportedly significantly increased the presence of ood Duck populations in North Central ashington (Fielder 2)

Fielder explains that the individual wood duck hens in ashington lays approximately 6 to 12 eggs per nest; with the average totalling 10 to 11 eggs. "The eggs are pale brown to tannish white and are generally 2 inches by 1-1/2 inches in size" (Fielder 12). The ducklings hatch 28 to 32 days after the female duck…

Works Cited

Ducks Unlimited. 2008 3 Mar. 2009. Ducks Unlimited, Inc. 3 Mar. 2009  http://www.ducks.org/ .

Fielder, Paul C.. Guidelines for Managing Wood Duck Nest Boxes in Washington State. 2000, Feb. 3 Mar. 2009  http://wdfw.wa.gov/wlm/game/water/woodduck.pdf .

Frahm, Randy. Duck Hunting. Capstone Press. 2007  http://books.google.com/books?id=4xI4KKus6KQC&pg=PA30&dq=protecting+duckwetlands&ei=bmitSenpAoXAMqDUmZIF#PPA30,M1 .

A www.questiaschool.com/PM.qst?a=o&d=5015011085

Agency's ole

The Federal Bureau of Prisons (BOP) is an agency under the prison health care systems. The Institution was established to provide a more humane and modern care for state prisoners, make the prison service more professional, and to oversee reliable and central management of the government prisons. The key role of this agency is to restrict perpetrator to a humane, safe, secure and cost-efficient location for them to spend time for the criminal offenses they have committed and receive the care that is needed. BOP also has a responsibility of reducing the possibility of future criminal offenses and law offenses wit programs where violators are prevented from breaking the law again. Statistically, these programs have proven to be very effective. BOP workers help criminals by offering a variety of services and programs to inmates, to help prepare them to regain a lifestyle with morals and live a life…

References

Siegel, L.J., & Bartollas, C. (2011). Corrections today. Belmont, CA: Wadsworth, Cengage Learning.

Whitehead, J.T., Jones, M., & Braswell, M.C. (2008). Exploring Corrections in America. Burlington: Elsevier Science.

Wit: Susie’s Nursing Metaparadigm
One of the pivotal characters in the movie Wit (2001) is that of Susie Monahan. Susie a nurse who has little knowledge of the poetry of John Donne so dear to the protagonist Vivian Bearing. Yet Susie shows expert mastery of the role of a healthcare provider in relation to her patients. Regarding the nursing paradigm of patient, environment, health, and nursing, Susie again and again demonstrates that she regards the patient as central in the ethical responsibilities of the nurse (Nikfarid, et al., 2018). Other characters, particularly the physicians and researchers handling Vivian’s case, place their own research needs above the needs of the patient. Vivian, although highly educated, admits she knows little of cancer research and does not fully understand she is being used as a test subject for research from which she is unlikely to benefit. For Susie, the patient is always first…

Additionally, the water intake near Chelsea may be used, at times, to supplement New York City's water supply, during times of drought. The Town of Waterford and the Town of Halfmoon both get their muncipal water supply from the Upper Hudson iver ("Hudson iver PCBs," 2008).

GE's Involvement in the Build Up of PCBs in the Hudson iver

From 1947 to 1977, the General Electric Company discharged as much as 1.3 million pounds of PCBs into the Hudson iver, polluting 197 miles of the river and creating America's largest Superfund site. Two of GE's facilities, one at Hudson Falls and one at Fort Edward are reported to be the source of the pollution. As Angelo (2009) notes, PCBs were used as high-temperature insulators in the manufacturing process of transformers and capacitors, at the GE facilities. Even today, more than three decades later, PCBs still leak into the river from GE's…

References

Angelo, W. (25 Feb 2008) Hudson River PCB cleanup projects under construction. Engineering News Record, 260(7). Retrieved December 9, 2009, from Academic Search Complete database.

(1 Jun 2009). PCB remediation work starts in the Hudson River. Engineering News Record, 262(17). Retrieved December 9, 2009, from Academic Search Complete database.

Historic Hudson River cleanup to begin after years of delay, but will General Electric finish the job? (23 Mar 2007). Retrieved December 9, 2009, from  http://www.nrdc.org/water/pollution/hhudson.asp .

Hudson River PCBs. (31 Dec 2008). Retrieved December 9, 2009, from  http://www.epa.gov/region02/superfund/npl/0202229c.pdf .

.. provide nourishment for the small organisms on which jellyfish feed. In waters where there is eutrophication, low oxygen levels often result, favoring jellyfish as they thrive in less oxygen-rich water than fish can tolerate. The fact is that jellyfish are increasing is a symptom of something happening in the ecosystem."

Researchers have been the ones that have as well contended that in some arias, such as the Gulf of Mexico or the Adriatic Sea, jellyfish have taken the role of fish, the former animals' number being far greater than the one of the latter's, and this can be as well put on the intensity with which the human intervene in the nature's life. Moreover, it has been observed that in the above-mentioned areas jellyfish have formed a sort of "gelatinous cover" of the water. In my opinion, this might be the reason for which during many years, Jelly researchers…

Bibliography

Pieribone, V. And D.F. Gruber, Aglow in the Dark: The Revolutionary Science of Biofluorescence. Harvard University Press, 2006, 288p;

Jacobson, Morris, Wonders of Jellyfish. New York: Dodd Mead, 1978

Jellyfish - Sea Science Series, at  http://www.dnr.sc.gov/marine/pub/seascience/jellyfi.html 

Kyle McGilligan Bentin, "Jellyfish up close," at  http://danenet.wicip.org/mmsd-it/jellyfish.html

Naturally, it is the new person's job to assist the CEO, but this does not mean that all of the workload for something so important as this should be dumped on this individual on his first day. The CEO appears to still not want to take much responsibility for looking at the problem and the solutions that may be needed, and this indicates a lack of desire to really manage the staff.

However, it must also be considered that the CEO has been in his job for 10 years, so he must be doing something right. If he were not performing up to the expectations of the Board of Directors, he likely would have been replaced. Despite this, though, there are clearly problems at the hospital that have to be dealt with and should have been dealt with some time ago. The media has caused some problems by relating stories…

This section lists my express recommendations and my reasons for presenting them.

First, Faith Community Hospital should cut its fixed costs by 10% by next year, at which point we will reassess our financial situation. The main way to cut costs at Faith Community Hospital will be through working more closely with our partners. Not only will working with our partners in the community improve our reputation and public relations, our teamwork will allow us to share equipment costs and services. Several organizations in the community share "the same vision and values" in offering optimal patient care. Therefore, we can trust our partners to assume their responsibilities, whether they include testing or care services. Specialists such as a hospice, burn center, addiction and recovery center, and midwifery services can all cooperate with Faith Community Hospital to prove a true "continuum of services." In fact, we might find that increasing our…

Nursing Theory Application

Case Study Overview from the viewpoint of a new EMT -- Patient was a 78-year-old mail presenting breathing difficulties. Patient had early stage cancer with a DRN bracelet and note. Patient's wife was aware of the DNR, but her natural reaction was to try to save her husband. The call, then, was more to assure the wife than the husband, who accepted the situation but was still distressed.

Nursing Theory Applied -- "Nursing as Caring" was developed by Boykin and Schoenhofer in the 1980s when looking at the dimensions of caring and how it applied to the overall patient/health care paradigm. In general, the theory is a framework that guides and acts as a tool box when dealing with common issues in modern health care. The central dimensions of the theory is that caring is what makes humans 'human,' that caring is a moment to moment and…

Works Cited

Cardinal Stritch University. (2010, June). Anne Boykin & Sarvina Schoenhoffer - Nursing as Caring. Retrieved from stritch.edu:  http://www.stritch.edu/Library/Doing-Research/Research-by-Subject/Health-Sciences-Nursing-Theorists/Anne-Boykin-Sarvina-Schoenhofer-Nursing-as-Caring/ 

Kubler-Ross, E. (2007). On Grief and Grieving. New York: Scribner.

Kubler-Ross, E. (2007, April). The Kubler-Ross Grief Cycle. Retrieved from Changing Minds::  http://changingminds.org/disciplines  / change_management/kubler_ross/kubler_ros s.htm

Kubler-Ross, E. (2013, January). On Death and Dying. Retrieved from ELR Foundation:  http://www.ekrfoundation.org/

Morality and ethics: what are they and why do they matter?

All you need to know about ethics approaches and theories

Means, ends, principles and virtues six step process of ethical decision making for you to follow

Surviving professional life ethically

Ethical dimensions of the professional -patient relationship

Special challenges: "difficult patients" and patients in suicidal crisis

This is a time of great change in our understanding of health, illness, and health care systems. Medical researchers, practitioners, and administrators must realize that these changes are taking place and look to current, valid research for some answers to the questions which come with increasingly complicated technology and better medications. Since knowledge is the basis for effective decision making, one goal for any medical leader should be to attain as much knowledge as possible.

Ethics has been defined as "rules of conduct recognized in respect of a particular class of human actions."…

Bibliography

Dunn, M. (1998). "Knowledge helps health care professionals deal with ethical dilemmas."

AORN Journal. p.1-2.

Eckberg, E. (April, 1998). "The continuing ethical dilemma of t he do not resuscitate order."

AORN Journal. April, 1998.

Body, Mind, and Soul in the Cancer Ward
Margaret Edson’s Wit dramatizes the death of a literature professor from cancer. The play is designed to show the limits of the intellect to fully understand human tragedy and existence. Although the central protagonist Professor Vivian Bearin was a rigorous academic fluent in the works of John Donne when she was healthy, ultimately the fact her old English professor is able to provide her comfort during her dying moments by reading a children’s book provides her the greatest solace more than her philosophy and more than intellectualism. Bearin embarked upon an academic career because she was primarily interested in the life of the mind, not the body. The central irony of the play is that she is being killed by her own body with ovarian cancer. Ultimately, human beings are unable to escape the body in the form of death. The play…

(Lynne, Kelly.)

Crocodiles are appreciated for their self preservation capacity and for their apex predator position. However, hundreds of people are killed every year as a result of their encounter with the beasts. In order to control the problem, people resorted to having crocodiles removed from human-inhabited areas. In spite of the fact that the situation ameliorated as a result of crocodiles being removed, people are still easy victims for stealthy crocodiles. (Lynne, Kelly.)

The Australian government is determined to put an end to crocodile attacks. Considering the fact that tens of thousands of crocodiles are found on the continent, people believe that it is virtually unavoidable for others to fall victims to crocodiles. (Lynne, Kelly.)

hile it is generally believed that only carnivores can be apex predators, omnivores can also be true killers. Brown bears, for example, have no natural enemy within the ecosystems that they reside in, and,…

Works cited:

1. Lynne, Kelly. Crocodile: evolution's greatest survivor. Allen & Unwin, 2006.

2. Prugh, R. Laura, and Stoner, J. Chantal, and Epps, W. Clinton, and Bean, T. William, and Ripple, J. William, and Laliberte, S. Andrea, and Brashares, S. Justin. "The Rise of the Mesopredator." Bioscience Vol. 59, No. 9.

3. Whyte Macdonald, David Sillero-Zubiri, Claudio. The biology and conservation of wild canids. Oxford University Press, 2004.

4. "Wolf Management Strategies." Wisconsin Departament of Natural Resources. 25 Nov. 2009

Any objective set of moral criteria must include: (1) the obligation not to cause pain unnecessarily to another; (2) the consideration of fetal survivability; and (3) recognition that a fetus undoubtedly becomes a living person at some point prior to full-term birth. On the other hand, even with the benefit of modern medical technology, there may be no way of identifying precisely at what point of gestation those moral concerns first materialize. For that reason alone, definitions of the relevant stages of development (and their corresponding fetal capabilities) must err on the safe side so that any inaccuracy unnecessarily protects the moral rights of the fetus prematurely, rather than protecting the moral rights of the fetus too late.

Conclusion:

A comprehensive analytical system designed to respect every conceivable moral concern arising in connection with abortion must also incorporate the autonomous rights of the mother, the comparative consequences to the fetus…

person within the Christian worldview. Specifically it will discuss technology, the environment, and the media as it relates to my personal Christian worldview. As noted in this course, understanding a worldview can help a person understand other people and all their roles in today's society. Today's culture is broad, and influenced by a variety of sources, from scientific to religious, and they combine to create a contemporary Christian worldview in others and myself. Personally, my worldview is one of balance between my Christian beliefs and scientific study and analysis, which may be fairly common for a modern Christian worldview.

First, it is necessary to define worldview and what it is. A worldview encompasses every aspect of life, so understanding it is crucial in decision-making and living life to the fullest. It is really a wide-ranging perception of the world around us, formed using a Christian viewpoint. In other words, it…

References

Editors. (2009). About us. Retrieved 22 June 2009 from the Evangelical Climate Initiative Web site:  http://christiansandclimate.org/about/ .

Gibson, T.S. (2004). Proposed levels of Christian spiritual maturity. Journal of Psychology and Theology, 32(4), 295+.

Holy Bible. New King James Version.

Schmeltekopf, D.D. & Vitanza, D.M. (Eds.). (2006). The future of Baptist higher education. Waco, TX: Baylor University Press.

Target's Strength in Branding Strategies Continue

As Target continually refines its branding strategy to set high expectations for shopping visits and then fulfills them through exceptional operational execution and having the right product in the right place at the right time, the company's future branding strategies will further differentiate them from discounter Wal-Mart. First, Target will continue to underscore its uniqueness with a Go International campaign features English designer Alice Temperley, known for her highly feminine designs, and also the development of an entirely new line of jewelry from well-known os Angeles-based designer Dominque Cohen (Heller, 2006). These strategies and comparable ones to them are meant to continually reinforce the unique value proposition of the store chain and deliver more value than customers expect, further earning greater levels of loyalty over the long-term.

References

James C. Anderson, James a Narus, Wouter van Rossum. (2006). Customer Value Propositions in Business Markets.…

Laura Heller (2006, April). HOW the HOUSE of MASS FASHION ALWAYS STAYS a STEP AHEAD. DSN Retailing Today, 45(7), 25-26. Retrieved May 5, 2008, from ABI/INFORM Global database. (Document ID: 1029378821).

Hafedh Ibrahim, Faouzi Najjar. (2008). Assessing the effects of self-congruity, attitudes and customer satisfaction on customer behavioural intentions in retail environment. Marketing Intelligence & Planning, 26(2), 207-227. Retrieved May 6, 2008, from ABI/INFORM Global database. (Document ID: 1462824211).

Soo-Young Moon (2005). An Analysis of Global Retail Strategies: A Case of U.S. Based Retailers. Journal of American Academy of Business, Cambridge, 7(1), 219-222. Retrieved May 7, 2008, from ABI/INFORM Global database. (Document ID: 850335101).

Community Health Statistics for Caddo Parish, Louisiana

Description of Caddo Parish, Louisiana

With about a quarter of a million residents, Caddo Parish, Louisiana is a fairly older community with almost two-thirds of its population aged 25 years or older. Most of the residents of Caddo Parish (82.3%) are high school graduate or higher and 22.3% have a bachelor's degree or higher compared to the national averages of 84.6% and 27.5%, respectively. There are slightly more females than males in Caddo Parish, and median family incomes are slightly lower than the national average at $48,522; per capita income is also slightly less than the national average at $22,323. There are also slightly more whites than blacks (50.3% compared to 46.4%, respectively) in Caddo Parish. ecent relevant statistical data for these and other areas of interest are presented below.

Table

Biophysical Considerations: Caddo Parish

Population Size

Census

Pop.

5,282

8,884

68.2%

12,140…

References

About the Parish of Caddo. (2011). Caddo Parish Official Web Site. Retrieved from http://

www.caddo.org/about.cfm/.

Annual report. (2007, 2010). Caddo Parish Official Web Site. Retrieved from http://www.caddo.

org/pdfs/.

That is to say that relationships are considered above and beyond medical reasoning. "Futility would not be measured by the medical effect on the patient but by the effect on social relationships" (2000, p. 140). This means that even if a physician were to believe from his or her educated medical perspective that treatment would not prolong life or have any impact on integrated functioning, there is still a purpose in treatment in that it services relationships.

The case of Baby K. was quite controversial and the court's judgment was equally as controversial as they held that it was not within their realm or that it was way beyond the scope of their judicial duties or function to consider the moral decorum of whether or not an emergency room should offer emergency care to sustain life in infants with anencephaly. There are several implications in the case of Baby K,…

References

O'Rourke, K.D. (2000). A primer for health care ethics. 2nd edition. Washington, D.C:

Paola, F.A. & Walker, R. (2009). Medical ethics and humanities. 1st edition. Burlington,

MA: Jones & Bartlett Publishers.

Bereavement

The interest in palliative care, or counseling for bereavement comes to different people in different ways, and one doctor came into it through home care as long ago as 1975. The doctor had just finished working as a house staff in the University of California in San Francisco. Then he got a job at Massachusetts General Hospital as a physician. The doctor was placed at Chelsea Memorial health Center. This was a neighborhood health center in a poor multi-ethnic community, yet not a great distance away from MGH. The doctor had come to replace a person who had come from Britain for a working experience of a year in United States and had gone to the houses of a few elderly patients. In the beginning itself, it was suggested to the doctor by the senior that he visit two patients who were being cared by relatives at home. This…

References

A Compendium of Hospital-Based Palliative Care Practices. Retrieved from  http://www.haponline.org/downloads/PPCN_Compendium_2004.pdf  Accessed on 31 May, 2005

Austenfeld, Jennifer L. Stanton

 http://www.blackwell-synergy.com/doi/abs/10.1111/j.1467-6494.2004.00299.x;jsessionid=iVt_UOAe61_b?journalCode=jopy  Accessed on 31 May, 2005

Bloomington School District. 20 November, 2002. Retrieved from http://www.shfsc.org/reports/BL2002.pdf Accessed on 31 May, 2005

This seems to be serious, but most of the people committing the crime are being released by the courts. (Understanding White Collar Crime)

Question 3a: What is a FOIA request and is it likely to be granted?

The request is under the Freedom of Information Act, and it is targeted to the United States Department of Justice, and there is no reason to think that the Department of Justice will refuse to reply. The question is of political interference occurring affecting the trial in the last stages of the trial against the cigarette industry. Let us not assume that the Department of Justice is now being totally controlled by the politicians, and that is why they will stop from replying. At worst, there will be the appointment of a committee to investigate and look into the matter. Even that will help the cigarette industry as they will get more time,…

References

About Southern Research. Southern Research Institute. Retrieved at  http://www2.southernresearch.org/ . Accessed on 17 June, 2005

About Us: A lasting partnership... born of dedication and cooperation. Retrieved at  http://www.atca.org/about_us.asp . Accessed on 17 June, 2005

Indicator Species. Department of Natural Resources. Retrieved at  http://www.michigan.gov/dnr/0,1607,7-153-10370_22664-60298  -- ,00.html. Accessed on 17 June, 2005

Moral Hazard. Retrieved at  http://www.investopedia.com/terms/m/moralhazard.asp . Accessed on 17 June, 2005

These calls are done in a rapid series of low-pitched throaty notes (Great1 pp).

A study titled, "A Comparative Analysis of Plasticity in Larval Development in Three Species of Spadefoot Toads," reported by David Reznick in the June 01, 2000 issue of Ecology, evaluated four salient features of the ilbur and Collins (1973) model for amphibian metamorphosis (Reznick pp) H.M. ilbur and J.P. Collins offered an evolutionary explanation for the labile nature of amphibian metamorphosis (Reznick pp). Their model has provided the most important framework for interpreting phenotypic plasticity in age and size at metamorphosis (Reznick pp). This model is attractive due to its simplicity, and the fact that it focuses on selection at the larval life stage, is time invariant, and ignores complex relationships between larvae and their predators (Reznick pp).

Reznick study performed an experiment on three species of spadefoot toads derived from environments that differ in their…

Works Cited

Aidem, Patricia Farrell. "Wildlife Shields Proposed Protected Areas May Expand." Daily

News. February 04, 2001. Retrieved October 08, 2005 from HighBeam Research Library Web site.

Biota Information System of New Mexico. Retireved October 08, 2005 at http://fwie.fw.vt.edu/states/nmex_main/species/020076.htm

Bransfield, Ray. "Lands of contrast, diversity, and beauty."

Blood by Suzan-Lori Sparks expands on the main theme of society's unfair disregard for its people of low condition in general, for women, and for adulterers. Hester La Negrita, the protagonist, is an African-American woman who struggles to survive in poverty along with her five base-born children. The family's outcast status is portrayed as a direct inducer and accelerator of emotional suffering, poverty, lack of education, and sexual exploitation.

(A) From a structural perspective, In the Blood is constructed in two acts and nine scenes, employing a linear plotline (ush, 2005). In this sense, the play debuts with the equilibrium of Hester striving to provide for her children in meager conditions, the inciting incident represented by the suggestion to seek help from the available former lovers and fathers of her children, the major dramatic question of whether or not she will attain it, the developing action as Hester approaches everend…

References

Bailin, D. (2006). "Our Kind: Albee's Animals in Seascape and the Goat Or, Who Is Sylvia?." The Journal of American Drama and Theatre, Vol. 18, No. 1.

Putnam, R.D. (2000). Bowling Alone: The Collapse and Revival of American Community. New York: Simon & Schuster.

Rush, D. (2005). A Student Guide to Play Analysis. Carbondale, Illinois: Southern Illinois Printing Press.

This could make it easier for everyone to deal with critical challenges and prevent the situation from becoming worse. (Medina, 2006) (Leddy, 1998)

However, because the son is engaging a confrontational attitude, means that these issues are becoming very complicated based upon the way he is acting. These elements are showing how new tactics must be utilized that will exercise health care professionals' power and control over the situation. The defining variables for this component are the primary caregiver does not want to cooperate and understand what is happening. This supports the answer to the assessment question by illustrating what options they have available, in dealing with these kinds of challenges over the long-term. (Medina, 2006) (Leddy, 1998)

egulation and Conflict

The basic regulations allow the caregiver to make decision concerning the treatment options the patient is receiving. According to the AAPS, the patient and the caregiver have a number…

References

Patient's Bill of Rights. (2013). AAPS. Retrieved from:  http://www.aapsonline.org/patients/billrts.htm 

Cohen, E. (2005). Nursing Case Management. St. Louis, MO: Mosby.

Leddy, S. (1998). Conceptual Basis of Professional Nursing. Philadelphia, PA: Lippencott.

Levine, C. (2004). The Cultures of Care Giving. Baltimore, MD: John Hopkins University Press.

Policies and procedures that are used by any hospital are vital to the care of its patients and can help decrease the length of the patients' stay by days or even weeks in some cases, depending on how these procedures and policies are implemented and enforced by the doctors, nurses, and other staff members at the facility. The policy of having wristbands of different colors for Allergies, DN Orders, and Fall isks helps to avoid errors with medications, procedures, and treatments that could otherwise take place due to misreading of charts or miscoding of a patient's condition (Polices, 2007). Those errors can cause significant and sometimes irreparable harm to a patient, and can lead to a much longer stay that could result in significantly more cost to the patient and insurance company, as well as stress, pain, and suffering that could have otherwise been avoided by taking a few simple…

References

Policies and Procedures (2007). California Hospital Association (CHA). Derived, with permission, from original works copyrighted by the Arizona Hospital and Healthcare Association (AzHHA).

Euthanasia

In addition to racism, political and philosophical ideologies, and abortion, euthanasia is one of the foremost issues that divide people in the United States and the rest of the world. Some deem euthanasia as mercy killing. Others simply call it, killing. It is the taking of one's own life when a medical condition or illness becomes unbearable in terms of physical or emotional manifestations. Euthanasia is also called Physician's Assisted Suicide. The political mongering and the role of the religions cloud the whole issue of euthanasia. The Hippocratic Oath also becomes a football that is tossed around with abandon. How literally can, "(Physicians) First, Do No Harm" be taken. (Miles, 2004) In fact, does prolonging pain serve the Oath to its original intent? This essay will discuss these manifestly arguable issues.

Dr Kevorkian is known as Dr. Death. (Vonnegut, 1999) This benevolent, unassuming medic made it his lifelong ambition…

Bibliography

Betterhhumans.org. (2003). No Good Arguments against Euthanasia: Report. Betterhumans.org. Retrieved August 20, 2003, from the World Wide Web:  http://www.betterhumans.com/Errors/index.aspx?aspxerrorpath=/searchEngineLink.article.2003-02-21-3.aspx 

Biblegateway.com. (2003). Bible. Biblegateway.com. Retrieved August 20, 2003, from the World Wide Web:  http://www.biblegateway.com/cgi-bin/bible 

Griffiths, J., Bood, A., & Weyers, H. (1998). Euthanasia and law in the Netherlands. Amsterdam: Amsterdam University Press.

Hare, R. (1971). Personality and Science: an interdisciplinary discussion. Edinburgh: CIBA Foundation.

Critical Thinking Case Study

Faith Community Hospital is a not-for-profit health care services organization that is currently facing a situation, which may compel it to resort to stringent cost cutting measures just to break even, and that too providing the average reimbursement rate does not change. Financial problems, however, are just one of the several problems that Faith Community Hospital must resolve in order for the organization to maintain and further build its reputation as a quality health care services provider. In brief, some of the other critical issues that the hospital needs to address are the conflict between the organization's spiritual heritage and values and the ethics of the medical profession; non-compliance with government, managed care, and insurance regulations; and non-adherence to hospital operational policies. Indeed, it is evident from the preceding list of issues that Faith Community Hospital has an organizational management problem on its hands, which needs…

Botany

Cypripedium eginae

Lifecycle

Structure

Evolution

Additional Interest

Cypripedium reginae is more commonly known as Pink and White Lady's Slipper, Queens Lady's Slipper or Showy Lady's Slipper (Kartesz, 1994). Coming from the plantae kingdom, it is of the order asparagales, and Orchidaceae, and the subfamily Cypripedioideae, of the genus cypripedium (Kartesz, 1994). This herbaceous perennial flower, which is a terrestrial temperate orchid, is the largest orchid native to North America. The plant may be found across a most of the eastern states in North America, including Atlanta, Arkansas and Tennessee, in the south to North Dakota in the west, and up to Canada where it is found in the eastern areas of Saskatchewan, Manitoba, Ontario, Quebec and Newfoundland (Nature Serve, 2014; Kartesz, 1994). In Minnesota, where it has been the state flow since 1902, it is one of the rarest wild flowers in state (Minnesota Department of Natural esources, 2014).…

References

Gray, Asa, (2010), The elements of botany for beginners and for schools, Nabu Press

Guignard, J. A, (1887), Beginning an acquaintance with wild bees, Annual Report of the Entomological Society of Ontario 17, 51-53

Felbaum, Mitchell, (1995), Endangered and Threatened Species of Pennsylvania, Harrisburg, PA: Wild Resource Conservation Fund

Kartesz, J.T. (1994), A synonymized checklist of the vascular flora of the United States, Canada, and Greenland, Portland, OR., Timber Press

individual person?

Much of this would be dependent on individual patients, in relation to their mental capabilities and understanding of the aspects concerned with their healthcare. I even support giving minor children a say in their healthcare, at least as far as they can comprehend those aspects and judge sensibly. With increased expert input, they experience greater control and exhibit greater likelihood of wholeheartedly participating and conforming to mandates that help improve their health status. Individuals feel significantly different about their care if healthcare providers allow them to voice their thoughts, feelings, and ideas, instead of being treated like little children or someone with impaired mental faculties, unable to decide aspects of their own healthcare. This forms another reason for my strong support of Do Not esuscitate (DN) orders and living wills. In fact, I even have my own living will specifying precisely what I desire in the event I…

References

Costantino, C., Falcitelli, F., Femia, A., & A. Tuolini. (2003, May). Human-Environmental Interactions. Retrieved from  http://www.uni-kiel.de/ecology/users/fmueller/salzau2006/studentpages/Human_Environmental_Interactions/index.html 

Kathryn, R. (2009). What is your central belief about patients as individuals. Retrieved from https://answers.yahoo.com/question/index?qid=20090318163605AAEWbMl

Stevenson University. (2016). Philosophy of Nursing. Retrieved from Stevenson University:  http://www.stevenson.edu/academics/undergraduate-programs/nursing/philosophy/ 

Tilburt, J. C. (2010). The Role of Worldviews in Health Disparities Education. J Gen Intern Med, 25(2), 178 -- 181.

Combining morphine and Ativan (lorazepam) can be deadly, making the Primary Care Physician (PCP) statement seem contradictory to medical ethics. The specific medical ethical issues addressed in this case include patient autonomy, beneficence, and nonmaleficence. However, there are other ethical issues and dilemmas raised by this case. The nurse faces professional ethical dilemmas in terms of the conflicts between Provision 2 and Provision 8 in the American Nurses Association (ANA) Code of Ethics. Provision 2 indicates that nurses have a primary commitment to the patient, followed by Provision 3, which calls for the professional nurse to actively advocate for and protect the "rights, health, and safety of the patient," (ANA, 2015). However, Provision 8 indicates that the nurse also "collaborates with other health professionals and the public to protect human rights, promote health diplomacy, and reduce health disparities," (ANA, 2015). This case shows how the nurse's primary obligation to protect…

References

American Nurses Association (ANA, 2015). Code of Ethics. Retrieved online:  http://www.vcuhealth.org/?id=1220&sid=13 

International Council of Nurses (2012). The ICN Code of Ethics for Nurses. Retrieved online:  http://www.icn.ch/images/stories/documents/about/icncode_english.pdf 

"Patients' Bill of Rights," (n.d.). Retrieved online:  http://www.aapsonline.org/patients/billrts.htm

North Mountain Medical is a super sniff facility as they specialized in high acuity level patient. The patient structure is respiratory, with staff trained in tracheostomy care and ventilator management. In house hemodialysis, in house physical therapy. This facility has been in operation since 2004. Patients in this facility do not self-diagnose. Patient diagnoses are from Medical doctors and Nurse Practitioners that work on site. Patient in the facility are cared for by interdisciplinary team. Certified nursing assistants that care for patient will normally report a Change in patient’s condition to the nurse. Nurse completes an assessment and report changes immediately to the doctor. In the event of an emergency patients are send to emergency room for further evaluation and treatment. Health is a right in this facility. Yes, most of the patient’s life style has impacted the health of the patient. Noncompliance with medication regimen and diet changes. Patients…

Also, overall organizational costs have increased as well. Thus, two central questions must be answered. First of all, what is the hospital's ethical policy on a patient's right to die? How can the policy be rectified so that it is coherent with the law and with the director's policies? The assistant cannot alone determine this statement, but can demand that the rights of the patient to refuse or accept treatment for their own physical persons and their children be clearly stated by some organizational manifesto. If there is a coherent organizational policy that the hospital can hereafter adhere to, then patients will have some idea what they are 'getting into' before coming to the hospital, and the board of directors can have some say as to the overall hospital policy. Secondly, regarding the increase of costs, the financial department must be consulted as to how many Medicaid and Medicare patients…

However, this might turn competent healthcare professionals away, who were angry that they no longer could exercise discretion over their treatment, in conference with their patients. Patients might refuse to come to the hospital. And those that did would cause costs to escalate, as they stayed longer, received more extensive care, and thus exhausted their insurance benefits.

A summary presentation of a comprehensive solution that would cover all of the issues

Firstly, the board of directors should be convened to establish a policy about what the religiously founded hospital considers to be a quality life and an ethical system of evaluating critical patients, when dispensing care. Doctors, nurses, and other involved personnel must be convened to discuss various issues that continually arise and a uniform policy must be established, so that such ethical decisions are not solely the burden of patients and healthcare providers in the field.

A press release…

Works Cited

National Coalition on Health Care. (2004) "Health Insurance Cost." Retrieved 2 June 2005 at  http://www.nchc.org/facts/cost.shtml 

National Coalition on Health Care. (2004) "Health Insurance Coverage." Retrieved 2 June 2005 at  http://www.nchc.org/facts/coverage.shtml

hospital is that it does not any longer believe in the promises that it made when the founders set up the hospital. The second problem is due to the large differences that exist among the members of the Board and as a result the CEO is not finding it possible to control these differences. The third problem can be viewed as an extension of the same lack of control by the CEO over the lower levels employees of the organization. In normal circumstances these employees are expected to report to the CEO, but here the employees could be seen acting according to their interests. In continuation of this is the lack of setting up rules under which these employees should be operating.

This is also the responsibility of the CEO, but it is clear that this has not been done. This leads back to the third problem that if these…

REFERENCES

Baldwin, Fred. (May/June, 2001) "Emergency Room Drama: Be Prepared before a Crisis

Happens" Retrieved from  http://www.icepts.com/pennmed/25-147.htm 

Accessed on 12 July, 2005

Donoghue, Richard J. (December, 1990) "Evaluation of hospitals as entities able to continue as

Rules of Engagement: Video, Mobile Devices Key to Online Marketing (Lipke, 1) many excellent insights are shared with regard to marketing high-end products and services to affluent men. The article begins by citing recent research studies by iProspect and comScore indicating that the approximately 19 million men in the U.S. who are over 18 years of age and earning $100K a year or more are changing how they choose to learn about and purchase products. A study by Johnston & Murphy is also cited. The most significant findings from these studies include the finding from the iProspect and comScore studies that online video advertising, combined with a multichannel-based strategy, is the best platform for reaching these consumers. The iProspect and comScore studies predict that the compound annual growth rate of online video ad spending will be 38% from 2010 to 2015. The studies predict that these approaches to advertising will…

Works Cited

Lipke, David. "Rules of Engagement: Video, Mobile Devices Key to Online Marketing." WWD 203.92 (2012): b.1. ABI/INFORM Complete. Web. 21 May 2012.

Genetically Modified Trees

Scientists and environmentalists must join one another in support of genetically modified trees. Biotechnology has afforded mankind a new method for preserving and restoring the natural landscape of the earth through genetic engineering. The use of genetically modified trees will not only help support the natural landscape but also improve preservation efforts and encourage balance between the needs of environmentalists and commercial enterprises.

For thousands of years mankind has relied on trees for economic and health reasons. In recent years however the landscape has significantly changed as more and more natural forests are depleted to due natural and unnatural causes. This has resulted in multiple deleterious effects on both the health, economy and well being of mankind and the environment. Biotechnology has afforded new hope however, allowing researchers to produce artificial trees offering many of the same benefits, if not more benefits than natural forests offer both…

References:

Avise, J.C. 2004. The Hope, hype & reality of genetic engineering: Remarkable stories from agriculture, industry, medicine and the environment." New York: Oxford University Pres.

Booth, D.E. 1994. Valuing nature: The decline and preservation of old growth forests.

Lanham: Rowman Littlefield Publishing.

Sedjo, R. 2004. Genetically engineered trees: Promise and concerns. Resources for the Future.  http://www.rff.org/rff/News/Features/Genetically-Engineered-Trees.cfm . Accessed 10/21/2005.

Health Disparities of Uninsured

Statistics show that approximately 47 million of America's population lacks medical coverage, and another 38 million has inadequate health insurance. What these statistics imply is that one-third of Americans are insecure and unsure about whether they would afford healthcare if they fell sick or needed medical help today. The State of Texas tops the list, with an uninsured population of approximately 8 million, representing 25.1% of the total (Code ed, 2006). Minority groups form a bulk of the uninsured population (Wu & ingwalt, 2005). The impact of a large uninsured population, however, is massive -- the uninsured affect both themselves and the communities in which they live, compromising the quality of care and placing everyone at risk. They do not often have a primary care physician, which means that they neither seek out medical care when they are supposed to, nor turn up for preventive care…

References

Abdullah, F., Zhang, Y., Lardaro, T., Black, M., Colombani, P.M., Chrouser, K., Pronovost, P.J. & Chang, D.C. (2009). Analysis of 23 Million U.S. Hospitalizations: Uninsured Children have Higher All-Cause In-Hospital Mortality. Journal of Public Health, 32(2), 236-244.

ACEP. (2013). The Uninsured: Access to Medical Care. American College of Emergency Physicians. Retrieved 22 July 2014 from  http://www.acep.org/News-Media-top-banner/The-Uninsured  -- Access-To-Medical-Care/

ANA. (2008). ANA's Health System Reform Agenda. American Nurses Association (ANA). Retrieved 22 July 2014 from  http://www.nursingworld.org/content/healthcareandpolicyissues/agenda/anashealthsystemreformagenda.pdf 

Bernstein, J., Chollet, D. & Peterson, S. (2010). How does Insurance Coverage Improve Health Outcomes? Mathematica Policy Research Inc. (No. 1). Retrieved 22 July 2014 from  http://www.mathematica-mpr.com/~/media/publications/PDFs/health/reformhealthcare_IB1.pdf