Euthanasia vs Palliative Sedation Essay Example for Free

Euthanasia vs Palliative Sedation Essay In this paper the author will discuss the difference between euthanasia, physician assisted suicide, and palliative sedation. The author will discuss the legal and ethical side of palliative sedation. Palliative sedation is where they use education to induce or decrease awareness of ones intractable suffering at the end of life (Olsen, Swetz, Mueller, 2010, p. 949). They use this type of sedation when other most common forms of pain control does not relieve the pain the patient is feeling. Not only is it used to treat pain but it is also used to treat delirium, pain, dyspnea, nausea or other physical symptoms (Olsen et al. , 2010, p. 950). In the aftermath of Hurricane Katrina reviewers concluded that physicians choice of benzodiazepines instead of barbiturates indicated a goal of palliative rather than euthanasia, stating that barbiturates were more deadly. Some institutions used ketamine or propoful in patients condition is refractory to opioids and midazolam. Opiates should not be used for primary purpose of sedation, but rather should be continued adjunctively during palliative sedation for analgesic purpose to prevent opiate withdrawal (Olsen et al. , 2010, p. 950). Usually palliative sedation is given in a form of continuous drip but there has been times when palliative sedation has been given intermittently. Palliative sedation should be given in the areas of general care or hospice settings, ICU settings can be too hectic and uncomfortable for families. Cardiac monitoring is no good in achieving the goals of palliative sedation (Olsen et al. , 2010, p. 951). Before palliative care is given written consent should be obtained by the patient or the patients family. In the state f Arizona the Arizona State Board of Nursing has develop an advisory opinion of the scope of practice of what palliative sedation is. it states that it is in the scope of practice for the register nurse to administer medications that provide palliative sedation at the end of life (Brewer Ridenour, 2010, p. 1). Arizona State board of Nursing defined palliative sedation as follows: The monitored use of medications intended to provide relief of refractory symptoms but not to intentionally hasten death (Brewer Ridenour, 2010, p. 1). What is a refractory symptom? It is one that cannot be adequately controlled in a tolerable time frame despite aggressive use of usual therapies and seems unlikely to be adequately controlled by further invasive or noninvasive therapies without excessive or intolerable acute or chronic side effects or complications (Brewer Ridenour, 2010, p. ). In Arizonas advisory opinion they rote general requirements that must be followed and they are listed below: * Written Policy and Procedure is maintained by the employer. * Administration of medications must be on the order of a person licensed in this state to prescribe such medications. * The patent has to have sufficient level of nursing care to maintained sedation. * The agency has identified medications allowed for palliative sedation, preferably y an interdisciplinary committee including nurses. * Pre-sedation symptom assessment is performed by the RN Post-sedation symptom assessment and ongoing assessments performed by the RN (Brewer Ridenour, 2010, p. 1) * Only an RN with all of the following criteria are permitted to administer medications for palliative sedation. * Current certification in basic Life Support ( BLS). * The RN must possess sufficient knowledge about the issues surrounding the use of palliative sedation to inform patients, families, and other health care providers in making decisions about its use. (Brewer Ridenour, 2010, p. 1). Palliative sedation is also referred to as terminal sedation. The role of the oncology nurse is to be able to administer the medications used n palliative sedation, be able to teach the patient and family what palliative sedation is and its purpose(Lawson, 2011). She has to be able to assess the patients signs and symptoms to know if the palliative sedation is working . One must understand the role of palliative sedation and its role in management of the patients symptoms in providing care of patients with advanced cancer at the end of life(Lawson, 2011). Euthanasia is defined as the act of a third party, usually physician, ending a patients life in response to severe pain or suffering. Euthanasia can be voluntary meaning that the physician has obtained the patients informed consent, on it can be involuntary meaning without the knowledge of consent of the patient (Olsen et al. , 2010, p. 953). Voluntary euthanasia is not legal in most parts of the world but the Netherlands and Belgium are currently the only countries who allow the practice (Olsen et al. , 2010, p. 954). Involuntary euthanasia is not legal anywhere. Physician-assisted suicide is the act of the physician writing a prescription for a lethal dose of medication that the patient takes himself to cause death. The main difference here is that the patient has to take the medication himself no other person can give it to him (Olsen et al. , 2010, p. 955). Physician assisted suicide is legal in the states of Oregon and Washington and in a handful of other countries (Olsen et al. , 2010). It can only be done when a patient has a terminal diagnosis and is suffering and wants to control when and how they die. If a physician or family member or a friend would give this legal dose of medicine it would not be considered physician assisted suicide but euthanasia. In considering the legal ramifications of palliative sedation we will discuss beneficence, non malfeasance, doctrine of double effect, and the principle of proportionality. Beneficence refers to the practice of treating individuals in an ethical manor. Not only by respecting their decisions and protecting them from harm, but also by making efforts to secure their wellbeing(Olsen et al. , 2010). The moral obligation of beneficence is paramount to ethics since actions are weighed for their possible good against the cost of possible Harm. Beneficence provides benefits to the patient and balances the benefits against risk and cost(Olsen et al. , 2010). Any treatment embarked upon should be with the intent to benefit and burden or discomfort o the treatment (Lawson, 2011). If the treatment will not benefit the patient it would be sound clinical judgment to withhold the treatment or even withdrawal the treatment after the discussion with the patient, family members and other members of the care team. Such decision-making would be considered both legal and ethically acceptable (Berghs, Dierckx, Gastmans, 2013).

The Music Lessons Essay -- essays research papers

In the play â€Å" The Music Lessons† by Wakako Yamauchi two of the main characters are in engaged in a dialogue which is common for a mother and a daughter to have. In act two, scene four, Chizuko and Aki seem to express frustration to each other after Aki coming home late after a music lesson with Kaoru.   Ã‚  Ã‚  Ã‚  Ã‚  Chizuko knows something is very wrong for her young daughter spending so much time with a grown man, causes her to be so upset with Aki: â€Å"CHIZUKO: I mean other people! How do you think it looks: you all the time in a man’s room?† (2,4). For a mother, trying to get through to her daughter is a very frustrating task. It’s hard for Chizuko to show Aki that all her frustration is in the best interest for her: â€Å"CHIZUKO: I have lots to worry about. I got to see you have enough to eat, give you an education, see you’re dressed decent-so people won’t say, â€Å"Those kids don’t have a father.† See you’re not left with debts, like what happened to me. See you don’t make a mess (of) ...† (2,4). Chizuko is trying to protect her young daughter, she is afraid that Aki is going to get hurt if she pours all her emotions towards this grown man, by Aki not understanding this Chizuko becomes angry: â€Å"CHIZUKO: I know you don’t care ... right now. I’m just saying you shouldn’t let your emotions run away with you† (2,4). Chizuko feels that Aki should be spending time with kids her age: â€Å"CHIZUKO: If you want a friend to talk to, find someone your age who can understand you...

Global Tourism and the Causes and Effects on the Aboriginal Hospitality Sector Essay

Abstract Of all the industries in contemporary global times, it is apt to say that tourism plays an important role in the economy of a certain country. According to some studies made about tourism, it contributes around 3.6 Trillion US Dollars in the economic activity of different countries worldwide. Nowadays, global tourism is considered as one of the most enormous forces that move people from one place to another and it is also considered as the best way to introduce people to different cultures and social exchanges. With this thought, it can be said that tourism has a very special capability of touching each and every one around the world. Since the emergence of global tourism in the 19th and 20th century, localities and cultural interactions and changes have always been major catalysts in promoting each and every area in different countries. Country governments have seen the effect of culture thus a call to develop aboriginal sectors to be developed. Different indigenous communities now recognize the importance of tourism and its role in bridging the nations thereby cooperation between societies and communities that include aborigines and aboriginal sectors have been established recently. It can also be seen that different cultural places were developed and renovated to attract more tourists and visitors that could be interested in the cultural exchange that tourism brings and this also starts their career in tourism most especially that the main goal for visiting these cultural and aboriginal places is the culture itself. However, are the effects mainly good or beneficial? Do the aborigines like the way their places are being used for tourism or can they not just find a way to protest against these all? This paper aims to answer these questions at the same time present the relationship that lies between the global tourism and aboriginal sectors and the causes and effects global tourism brings to these aboriginal hospitality sectors. The Aborigines Aborigines are the original inhabitants of a certain country. In the past, there were reports of aborigines’ survival most especially in Australia, Taiwan, Canada and other places. There are different types of aboriginal people all over the world and for them; the most important thing is their land. Before invasions and colonization occurred in many different places of the world, aborigines used to live in not so permanent communities. They do agriculture, fishing, hunting and animal-raising. Since the advent of industrialization, most to these aborigines were forced to transfer and move and some of them are now in towns living a very bad condition of life. In some countries, they work as low-class laborers and in some countries, they live as pan-handlers and beggars in order to keep up with their lives. Country 2005 2006 2007 Australia 400,000 517,200 450,000 Canada 938,800 1.1M 1.2 M Taiwan 398,000 379,000 484,00 Looking at the above table, it may be noted that though aborigines have not been treated equally as the rest, the population has been high however in the past two years, there was a gradual decrease in their population because of certain diseases that were not given much attention to. These people are said to be the original land-owners but most of their lands were stolen to them. Fortunately, there are laws now protecting the aborigines. In Australia, British people claimed that when the invasion happened, the land was vast and empty. Fortunately, there are laws now that aims to protect the rights of the aborigines and there were bills saying that their lands should be returned to them. There were some who are still against this bill saying that the lands will end up useless if given to them and that these lands should never be returned to these people. Some were even massacred and others because they are being deprived of the basic rights either commit suicide or died because of the disease such as cholera and other epidemic. Compared to others, these people have high rate of birth and suicide as well (Aborigines 2008). Some people see the need to give them back their lands and recently, the problem and the call of these people has been addressed through tourism. Some of them now have already secured ownership of their lands and were given the signal to go back under certain conditions and terms as stipulated under the ruling of global tourism. The question is if they are going to cooperate with these terms and conditions. Global Tourism and the Aborigines Culture and tourism can never be separated. Since the advent of technology and industrial revolution, culture seemed to be drifting away or is becoming independent of tourism. Now, there are many amusement centers such as Disneyland, man-made tourist attractions and sightseeing but what most people are looking for now and are wishing to see is something that would connect them and link them to the past. This is the start of aboriginal lands being converted into cultural attractions. In Canada and in Australia, many cultural attractions have been built and these places are continuously drawing the attention of mass tourists. To some aborigines, it is good and government started talking with them and the start of global tourism also implied the beginning of renewed hope for these people. Some lands were converted to attractions and people go there everyday to see how aborigine’s cultural heritage. Aboriginal sectors and organizations have been established and the commendable development is that most of these sectors encourage cooperation with government and society. Now the government recognizes the opportunity for travel and the importance of culture as part of travel. Educational tourism also recognizes the importance of these people and most institutes and schools se them to educate students who were long been taught of history and culture. Because of these, aborigines were also given the chance for education unlike before when they were all illiterate and uneducated. If in the past, these people were fearful of others and vice versa and cooperation and coordination is now seen. Most of them have now decent forms of survival. They are not only in their lands; they were also slowly and gradually being exposed to others which is a good thing for them. Nowadays, aborigines have been gradually rising and they are now playing a very important role in the society. Looking at the graph above, the property of aborigines is now becoming greater. The properties of aborigines now range from corporations down to private enterprises. The Causes of Global Tourism to Aboriginal Sectors In 1999, a conference was held and presented to the WTO or World Tourism Office. This conference was about the Global Code of Ethics for tourism (The Global 2007). Accordingly, there is a continuing desire and goal in tourism to play a very essential role in understanding the cross culture. It was said in this conference that through the direct and straight spontaneous contacts engendered by different lifestyle and cultures, the only way to make these people meet is through tourism. Nowadays, many indigenous communities now participate in tourism-related activities to further support the revival of culture as well as to sustain the economy and to further understand the cross-cultural needs and differences. Indeed there is an underlying relationship between culture, indigenous heritage, and the themes for interpretation, authenticity, traditional lands protection, IPO or Intellectual Property Rights and the evidence of traditional knowledge. Aboriginal cultural tourism around the world is relatively young and it is believed that they are still new in the industry. Some may have liked the idea of becoming a subject for studies and tourism and some do not. The causes of global tourism may be considered two-faced: good and bad. To some aborigines, the idea of meeting people of these times is good. They learn to mingle and be appreciated as well. However, this is something new for them and some sociologists and psychologists assert that this may cause these people to be over-shocked and consequently be mentally affected. They are still considered to be different and they are still indigenous in any way we look at it. Their breeding, education, lifestyle, and culture are totally different from the norm. They know this for sure, and like any other minor ethnicities being joined with the many, they also feel different and this is bad for them. This is one reason why some still feel deprived and used inequitably. The mental effect for these people is considered to be a psychological outcome of environment. Their worlds were suddenly opened to the universe; thus, to comprehend and address the psychological needs of these people is imperative. They should undergo counseling, psychological treatment and psychotherapy to be able to reach closure with regards to issues about their cultural heritage that haunt them in contemporary times. The Effects of Global Tourism to Aboriginal Organizations and Sectors Accordingly, it of utmost importance to understand the host and tourist relationship; and there are some pertinent issues to be considered in this regard. Primarily, the nature of cultural exchange needs to be understood. In some studies made in tourism, it is asserted that activities should be understood between non-indigenous and indigenous people. To tourists and visitors, the effect is good because their awareness, appreciation and understanding of the aborigines are improved. The used to be harsh and fear-filled relationship is changed because tourists become aware of the underlying needs of these people. However, to aboriginal sectors and organizations, there is a critical perspective to create cross-cultural understanding and education among various cultures. The questions that need to be answered are the following: What is the nature of the activities that are to be done? To what extent will these people (aborigines) be used for global tourism and to what extent will global tourism be used by these people (aborigines)? What are the mechanisms and processes that need to be utilized to make sure that interpretation are laid in a sensitive manner? How important is education in recognizing the connection between various cultures? As many analyze this situation continuously, the very important factors that could give good effect to these aboriginal sectors and organizations are the following (Aboriginal 2007): cultural tourism industry cross-cultural understanding cultural revival policy, legislation and committees consent and the recognition of deeds operating agreements and shared revenues management training, skills and authenticity indigenous status and identity consultation process, protocols and status How to Sustain Cultural Tourism Aboriginal sectors and cultural tourism are always connected. There is an authentic and real depiction of the cultures of the aborigines in such a way that the effect on culture and community will not have a negative long-term effect. Accordingly, in order to support and sustain the cultural tourism, there should be a focus in owning, sustaining, as well as accepting the desire in which the aboriginal sectors and organizations are affected. This is also extremely important in sustaining the economic activities. However, though these needs are named, there are still elements that need to be addressed and that is to fill the gap between the barriers to support the economic and infrastructure operations. The Type of Cultural Exchange between Aborigines and Global Tourism There are different ways in which the cultural tourism is managed and the most important part of it is the cultural exchange between global tourism and aborigines. First and foremost, it is very important to understand the types of the cultural exchange that occurs and how to support or work on them. The reason for this is that there are many types of aborigine and that the way they are treated and educated should also be different. Accordingly, the most important thing to overcome is the traditional knowledge. The traditional knowledge includes storytelling, oral history, teachings of the elders and contemporary exhibits and displays. There are also traditional cultural presentations, traditional teachings, historical reenactments and food preparation. The information about these is treated separately. These things can be addressed by many formats, guidelines, guided tours, audio visual presentation and interactive workshops. Significant emphasis should also be given and to avoid problems and conflicts. This is to provide boundaries between the cultural practice and sacredness; thus best practices should be ensured. What are the Best Practices to be Observed? In order to develop and deliver the cultural heritages and programs, it is necessary that certain tools and mechanisms be used. The very first mechanism should be predominant in ensuring the cultural products authenticity and the community based processes should be recognized. Because the aborigines follow a community based relationship, decisions should always be approved by the elders before going ahead with the operations. In souvenirs and cultural products description, there should also be recognition in the participation of these people. Moreover, the history by which the cultural tourism in a certain place that includes the aborigines should also be recognized, introduced and emphasized. This way, these aboriginal sectors and organizations will not be bypassed. Conclusion The relationship between global tourism and aboriginal sector cannot be separated much more on the basis of the evaluation of the long-term implications of global tourism on aboriginal sectors and organizations and vice versa. While it is true that there are many things that are mutually beneficial in such a relationship, it is still very much essential to take hold of the bad effects and find ways on how these will be overcome. Aboriginal sectors and organizations are composed of human beings that are not different from us. The only difference that lies between the aborigines and common people is the fact that they are born with a different culture and that in the past; they were shattered and deprived of their own lands by colonizers and invaders. Understanding these things will help us address their needs and will greatly help in the empowerment of the global tourism industry. The only key is understanding and give and take relationship. With this, both sides will benefit; the aborigines who will benefit from getting back their lands at the same time being given jobs and means for living, the business entities who also get profit from their business and from tourism, the visitors and tourists being greatly aware of the culture and cross-cultural diversity and lastly the nature that is given much care by the people who lived in these places originally and at the same time being taken care of by people who are starting to be aware of their needs. It is rather simple to do all these things. Proper knowledge, education, increased awareness and respect are the key factors that will create a good case which will be positive and sustainable for all parties involved. References Reference Canada Government. (2007). Resources for Aboriginal Entrepreneurs. Retrieved March 09, 2008. from http://www.wd.gc.ca/289_ENG_ASP.asp Aboriginal Business Canada is a program that endorses commerce for a self-sufficient economy for all aborigines in Canada. Different kinds of services are available for viewing. These are all designed to help aborigines in commerce and in business. Survival. (2008). Aborigines. Retrieved March 09, 2008. from http://www.survival-international.org/tribes/aborigines Survival was founded in 1969. Survival (The Movement for tribal people) is the site designed for all Australian aborigines especially for the people of Torres Island. Services and campaigns can be seen here. The services range from education to shopping and any concerns that can help these aborigines. World Tourism Organization. Retrieved March 09, 2008. from http://www.world-tourism.org/code_ethics/eng.html Worldtoursim.org is the official website of World Tourism Organization. This website is designed to show and provide information about global and world tourism. The basic ethics for tourism can be found in this site. The Global Ethics for Tourism was designed in 2001.

The Strength Test Of The Cardiovascular Endurance Test My...

1. So what were your scores? Were there any surprises? How so? (5 pts) Some of my scores did not surprise me but they were disappointing. During the cardiovascular endurance test my heart beat was 119 beats per minute. I was expecting this and was not surprised at all because I have always avoided doing cardio, the most I do is walk my dog, take the stairs, or use the elliptical. I cannot even remember the last time I ran. Actually, I thought I was going to do a lot worse. The flexibility test, I had a lot of confidence going into it and was not surprised to be in the good range with a score just above 18.75 inches. During the balance test, which was the hardest out off all of them, I had a disappointing score of 21†¦show more content†¦During my four years of high school I was a shot-putter on my high school track team and I have to say a cumulative workout of cardio, endurance training, and weightlifting made me more physically fit. I never lost weight while on the track team but I did feel better physically and I can only presume that I woul d have done significantly better had I maintained the health habit of working out. The reason I knew I would do well during the flexibility test is because I did gymnastics till I was 14 years old and I have to stretch like crazy before I take my dog out for walks or the park because I get cramps in my legs very easily. Overall, I had the right idea in what my score would be. 3. List the five basic components of fitness. Give an example of each component. (10 pts) The five basic components of fitness are cardiorespiratory endurance, muscular strength, muscular endurance, flexibility, and body composition. Cardiorespiratory endurance measures how efficiently the heart, lungs, and blood vessels are able to supply oxygen, energy, and nutrients to muscles particularly during prolonged exercise. An example could be swimming or running and it can improve heart health. Muscular strength is measured by how much a muscle can â€Å"handle†. The most force a muscle or group of muscles can handle, this aspect is used during weight training or other forms of resistance exercise. It is important because it improves muscle health and durability. The