The Mayor of Casterbridge Essay Example for Free

The Mayor of Casterbridge Essay This essay will demonstrate and analyse how Thomas Hardy uses the first two chapters of this book as a prologue to the rest of the novel. To establish this, this essay will include Hardys style and use of language. This sort of style is quite unique, which is probably why he used it. Other important elements are the setting and how they are linked to Hardy himself, the themes and the way he exemplifies characters. The main character, Michael Henchard, is said to be of fine figure and swarthy. He wore a short, brown corduroy jacket, a fustian waistcoat, tanned leggings, white horn buttons and white breeches. Also, he wore a straw hat. At the beginning of the narrative, Michael is holding a tool-bag. This shows that Michael is a man of the trade. This flows with what Hardy says about Henchard being a skilled countryman. Michaels entrance to the story is palpable, but until later on in the novel, we dont actually know his name. Until the 6th page, 3rd paragraph, Michael is referred to as, amongst other things, the man. This gives a bit of suspense as the reader wishes to read further to find out who this person is and what his name. The reader discovers that he is indeed the husband of Susan; the woman he is accompanying. He doesnt play the role of a husband or a father at all (we also find out that he and Susan have a baby called Elizabeth-Jane. He remains using similar behaviour until chapter two. The first time he actually opened his mouth to talk, was, when addressing a worker around Weydon-Priors. The second time, one page later, was when he briefly replied to Susan in pg 4/5, when Susan is telling him to go to the Good Furmity Sold Here tent at the fair, instead of the Good Home-brewed Beer, Ale and Cyder tent. His disinclination to go to the furmity tent is shown when he says, Ive never tasted it. At this point, he finally shows some responsibility as he gave way to he representations ; the her being Susan. His carelessness is again shown on page six, where he gets drunk from the excessive rum in his furmity. He then goes on further, when he states how he got married too young. Michael puts himself and Susan in great shame when he auctions her. At this point, we dont know whether its the drink talking, or if he really feels this way. We are persuaded that Michael really wants to rid of his wife, when, on pages 8/9/10, he pursues his selling, until finally a bidder puts the money on the table and the exchange is made. Hardy shows that Henchard really is a malicious man, without any thought to his responsibility. We know this by the language used; he talks badly of Susan; I married at 18, like the fool that I was; and this is the consequence ot. We finally see the back of Susan, telling us that the exchange was true and complete. Overall, we see that Michael is a man who doesnt see his responsibilities and likes to live a single persons life. He is careless in most of actions and is easily taken under the influence of drink; the reason why he auctioned his wife. In Chapter Two, however, we discover, that Michael didnt have the slightest clue of what he did the previous night. This is shown as he thinks back of what he had done, and showed great regret. We know this as he travels around the fair in search of his wife and later takes a serious oath, for such an alcoholic as Henchard especially. Michael then travels around the Fair in search of Susan. Later, around page 17, we discover Henchard to be making a vow as to not drink spirits for 21 years, as spirit was the reason why he lost his ex-wife; I, Michael Henchard, on this morning of the 16th of September, do take an oath before God here in this solemn place that I will avoid all strong liquors for the space of 21 years. His pledge is significant to the play because it changes his outlook; he becomes a less rowdy person; a Mayor. This also allows him to find Susan, as his perspective is broadened; he can sort out his priorities. Susan is first introduced at the same time as Michael. Shes described as being pretty and having a half-apathetic expression. Michael and Susan have a declining relationship. Susan doesnt converse with Michael and just saunters along with him silently. As with Michael, we dont discover Susans name at first. This is probably because Thomas wants to set the scene first, then the characters, etc. Although we dont know that Susan and Michael are in wedlock, we o know that Susan is the mother of young Elizabeth-Jane. She and Michael dont converse until the dialogue where Susan encourages Michael to go the furmity rent, instead of the alcoholic tent; page 4. This proves that Susan is the most sensible out of the two. Although Susan may have made the most sensible choice, she still didnt escape shame and pain. She discovers Michaels bad side, as he has too much rum in his furmity. We know that this isnt the first time, Henchard has behaved this way previously, as Hardy writes, The young woman his wife, who seemed accustomed to such remarks She isnt mentioned much, until the auction scene, when she tells Michael how his behaviours is inappropriate and irresponsible and is just making a fool of himself. Later on in page eight, Susan gets more serious, realising the great significance of Michaels actions; Come, come, it is getting dark, and this nonsense wont do. If you dont come along, I shall go without you. Come! The repetition shows her concern and desperation to avoid the situation. Susan tries to maintain her dignity and pride by agreeing to all of the selling, probably to rid herself of such humiliation and torture. We know instantly that Susan regrets the whole ordeal as she went out of the tent sobbing bitterly. Although the furmity lady, only has a brief part to play in the story, she is still quite important. She is first mentioned in page five. She is described as haggish and is said to be of fifty years of age. She was wearing a white apron, reaching almost all the way around her waist. Her only actions were to stir the large pot of furmity, which consists of grain, flour, milk, raisins, currants, etc. She seems to be just a furmity lady, but Hardys crone-like description of her fits nicely with her slyness as she laces the furmity with quite a lot of rum. She appears again at the bottom of the page when she served Michael and Susan a bowl of furmity. She has a quite a persuasive character as she convinces Michael to have some rum. This meant more profit for her. Apart from the above, her last appearance was when the auction was maturing; she told Susan that it was the drink talking and that Michael didnt mean what he was saying. The furmity lady represents the working-class of Weydon-Priors. Especially as she is part of the fair, she seems to have a nomadic life; always moving around to different locations. As she is reacquainted with Susan later on, Hardy skilfully relates the furmity lady to the downfall of rural life, The turnip-hoer first had an appearance on page 3. He told Michael about the type of work available in Weydon-Priors. The turnip-hoer had a very brief appearance in the novel indeed. He did have quite a significant part, as the reader discovers that there was a lack of work for the working-class and that Weydon-Priors was a changing area, good for some, bad for most. He represents the economic state of the village and is a typical countryman. The mention of the Fair almost automatically implies that it has some connotation in the anecdote. He had a hoe on one shoulder and a dinner-bag suspended from it as well. Hardy describes the turnip-hoer as being a pessimist. This shows that he just saw things from the bad side and didnt really look for any good in anything. He probably used that word as he replied negatively to anything Henchard asked. Then, he mentions the Fair Day; the only way of getting any money in most cases. We learn quite a lot about Wessex and the way of life there in the first few pages of Chapter One. This is due mainly to the turnip-hoer. From him, we learn that there is a shortage of jobs. Due to the time setting, it is quite obvious to those with knowledge of history, that it is the time of the Industrial Revolution. The chronicle fits in efficiently with the time setting, before the nineteenth century had reached one-third of its span ; this was during the pinnacle of the Industrial Revolution 1709 to 1853. We then discover that homes are being knocked down to make way for the industrial buildings. Therefore, life must be quite hard for the working-class. This is shown by the turnip-hoer saying how there is a lack of employment; lack of money. We know this because, Weydon-Priors is at the threshold of being an industrial city. The only way of making money outside the industrial side, it seems, is to work in the Fair or sell horses. The Fair is packed with people and full of life. Different activities and different fairs to visit, for example, toy-stands, waxworks, medicine men, and so forth. Hardy uses a varied form of vocabulary in this text, but most of the book uses a sophisticated range of vocabulary. Examples of sophisticated choices include: Hardy uses this wide range of lexis effectively to make an effective description of an object or person. By using efficient language, Hardy creates a good picture in the mind of the reader. He does this by describing something with great detail. For example, when he first introduced Michael, he used great detail in order to produce sufficient imagery. The man was of fine figure, swarthy, and stern in aspect; and he showed in profile a facial angle so slightly inclined as to be almost perpendicular. He goes on to use analogous detail in describing his attire. It is quite obvious that Hardy likes to use detail in his descriptions. This is required to produce a vivid image for the reader. The result of this is a strong and almost exact picture of the object or person in question created in the mind. This can help the reader understand further things mentioned in the story and the relevance and significance of things mentioned. The structure of Hardy sentences varies occasionally, but the overall lengths of the sentences are long. This is typical of the time period; early 1900s This provides a neutral atmosphere, as shorter sentences or pauses give a tenser ambience. A good example of the use of shorter sentences, is during the auctioning of Susan, The sailor hesitated a moment, looked anew at the woman, came in, unfolded five crisp pieces of paper The lengths of the paragraphs also vary, but most of them are long, which is typical of the time period. When a more important scene is written in The Mayor Of Casterbridge, Hardy uses very long paragraphs to create a significant flow in the action. Apart from the narrators language, there is the language used by the characters. The characters language varies from their class, but is quite similar. They use northern dialect and they dont pronounce all of the letters; this emphasises the setting of the novel. This presents the way northerners speak. An example of this vernacular is, and this is the consequence ot. There isnt much dialogue until the auction scene. This creates quite a tense atmosphere with some suspense. A very significant factor of language, is the relationship between Michael and Susan. They dont speak habitually at all. They converse a small amount at the Fair, only to talk about things like lodging. This is imperative as it clearly depicts the relationship between the two Henchards; they dont have a close affiliation and only communicate when necessary. Most of the early chapters are based on the theme of marriage. This is because, Michael and Susan were married and Michael sold Susan because he was saying how fed up he was with marriage. The further actions made by Henchard were reflections to what he had done; he swore to give up spirits for twenty-one years, he went in search for Susan due to marriage and possibly love. At the scene of the auction, the only people who seem to have some reverence for the sacred bond of matrimony, are Susan and the furmity lady. Susan is the only person who tries to put the whole state of affairs to a halt, Mike, Mike, this is getting serious. O! too serious! The repetition shows her concern. The furmity tries to reassure Susan that Michael is just under the influence of drink, Others just encourage Michael, Theres them that would do that, this shows that they find such an offer common. For the rest of the customers in the tent, it appeared to be a sort of entertainment. The economy plays quite an important part in the tale as well. This is because Michael and Susan first went towards Weydon-Priors, because Henchard was in search of employment. Change is evident in the area of Weydon-Priors as the turnip-hoer told Michael of the knocking down of the houses, lack of vocation. The quality and style of life will obviously be changed by this new revolution. By mentioning or hinting the industrial revolution, Hardy sets the time and setting of the anecdote well, making it more realistic. Hardy uses the theme of nature in The Mayor Of Casterbridge, but only occasionally in the first two chapters. An example of Hardy doing this, is on page two, half-apathetic expression of on who deems anything possible at the hands of Time and Chance except, perhaps, fair play. The first phase was that work of Nature As you may notice, Hardy used capital letters for the beginning of the three words Time, Chance and Nature. He might have done this to make the three words stand out and allow the reader to see their significance. Time and Chance seem to control occurrences. Time; things are going to happen, its just a matter of time when. Chance; sometimes. People can be lucky and have chance on their side. Nature; the contrasts between man and nature. Fate seems to play a small, but quite important role in the anecdote. Hardy uses this element skilfully. It assists the auction scene with the entrance of the sailor. It would have been quite hard for the sailor to hear the auctioneers voice from outside; he was destined to meet and purchase Susan and Elizabeth-Jane. Hardy shows how Henchard develops quite quickly in the prologue. He begins as a man who seems to be oblivious of his duties to his wife and infant. The main event which convinces Michael he has to revolutionize his conduct. After getting under the influence of spirits, he humiliates his wife and then puts her on the market. When he becomes abstemious, he realises his faux pas and falls in to a state of remorse. The next day, he starts to search for his spouse. After failing to locate Susan in the Fair, he makes an oath to avoid all strong liquors for the space of twenty-one years This shows that he has realised that the main cause of the whole dilemma was the alcohol. Another example of him following a new route, is the narrators text, seemed relieved at having made a start in a new direction. This is a sort of quest for Michael; to give up alcohol and to find his lost partner. The type of narration used is third person narrative. The reader is only given limited information as to whats happening. The conscious narrator decides what and how information is revealed. An example of this is the concealing of Henchards name. We dont have full knowledge that Susan and Henchard are married; their relationship together. This makes the reader want to continue reading to discover the role and significance of the character. Hardy uses language effectively to get the appropriate mood and atmosphere. He uses sufficient imagery when he wants to give the reader a detailed description of the scene. He uses symbolism to assist this, e. g. at the Fair, Hardy refers to the horses to represent Susan, as the horses are also being sold. He uses varied sentence structure to achieve tension. Although most other writers would use shorter sentences to create anxiety, Thomas uses commas as well. An example of this, is at the end of CH 1. Hardy uses prolonged sentences, but with commas to create a depressing atmosphere. The whole of the story after the auctioning of Susan, is founded on that very act. The main outline of the first two chapters is quite simple. Firstly, the couple enter Weydon-Priors. Then, they visit the Fair and go to a furmity tent. Michael gets drunk and offers to sell his wife, Susan. After much pondering, a sailor approaches Henchard and purchases Susan, who is accompanied by Elizabeth-Jane. Michael, the next morning, realises what he did in his drunken rage. He makes a vow to never touch any spirits for 21 years. Michael finds that he has lost Susan forever, or so he thinks After the selling of Susan, all of Michaels actions were based on that event. Before CH. 3 continues, a lot time passes; Hardy likes to use time in his writing. As you can see in the brief plot of the story above, all of the actions made reverberated the auction. Michael made a vow due to the auction, he went in search of Susan because of the sale, etc. Hardy cleverly makes an impression in the readers mind at the beginning of the story. This makes the reader want to read further to discover the following events. From this essay, I have learnt about Hardys style, his use of things like Nature, Time and so on. I have learnt of Thomas lexis and structure. The overall language he uses is different to other authors in the sense that he uses very sophisticated expression and refers to seemingly irrelevant things to achieve sufficient effects; symbolising. Also, we learn how Hardy develops characters and their identity, e. g. Michael. His description also fluctuates to other publishments, as he refers to things like nature, chance and time; he uses elements that might be relevant to him. Hes a unique author.

Relevance of Psychology in Primary Health Care Delivery

Relevance of Psychology in Primary Health Care Delivery Critically discuss how an understanding of psychology can enhance the delivery of primary health care. (District Nursing) Essay The concept of psychology as relevant to district nursing and the primary healthcare team can be examined on a number of different levels. An understanding of psychology is clearly important to the nurse when she interprets a patient’s reaction to events in their personal illness trajectory. (Yura H et al. 1998). It is equally important as she considers her professional approach to the patient and the understanding of how a patient will react to the delivery and impact of healthcare, particularly in her considerations of how to achieve maximum patient compliance in any given therapeutic regimen. (Dean A. 2002).There are other, arguably less immediately obvious, ramifications of the impact of psychological implications in the delivery of primary health care when one considers the interactions and dynamics of the primary healthcare team and the interplay between various members of the team. In this essay we shall consider all of these implications. We start with the general plan that the topic of psychology in this context is potentially vast and for this reason we shall consider individual illustrative episodes in some detail in order to demonstrate an overall understanding of the area. The perception of any given situation and indeed, the evaluation of the probabilities that arise from it, are generally dependent on its presentation. This in turn gives rise to differences and variations in the number and scope of the possible outcomes from that situation. This is the so called Theory of Rational Choice (De Martino B et al. 2006). The perception of a situation is dependent on its â€Å"framing†. It therefore follows that the outcome is also dependent on the same concept of framing of the presentation. This has great relevance to our question, as the District Nurse can make decisions that are influenced by the â€Å"framing† of the presentation by the patient, but more significantly, she can seek to modify the decisions that a patient ultimately makes by framing her presentation of the situation in a number of different ways. There is a substantial evidence base in the literature which cites examples of how decisions can be changed or even reversed if t hey are presented with different emphasis on different factors in the presentation (van Osch S M C et al. 2006). A full consideration of the implications of this statement will suggest that these psychological concepts will have a direct bearing on other professional considerations such as autonomy and other ethical issues. (Hendrick, J. 2000). How can a patient be considered to be making a truly autonomous decision if that decision is being influenced by the abilities of a nurse to â€Å"frame† the presentation of the relevant factors in order to suggest that one outcome is better than another? (Green J et al. 1998). How can a patient be considered to be â€Å"empowered and educated† about a course of treatment if the nurse has been selective in the way that treatment has been explained to the patient? (Sugarman J Sulmasy 2001). We do not presume to suggest that such concepts are necessarily wrong. It may be entirely reasonable for a nurse to use her professional skill and judgement to suggest to a patient that one particular course of action is preferable to another by framing the presentation in such a way that the patient is guided towards a certain decision. In a commonly experienced clinical situation such as a frightened patient with an extensive skin wound to the leg which clearly requires suturing and who is saying that they don‘t want anything to be done, we could probably all agree that it would be quite appropriate for a nurse to suggest that the procedure of suturing is not very painful and will give a good cosmetic result whereas to leave the wound open will give rise to infection and other difficulties. From an analytical viewpoint, this approach could be viewed as detracting from the patient’s autonomy and ability to make their own valid consent. (Gillon. R. 1997). A pragmatist mi ght equally suggest that the nurse is employing valid psychological principles in her professional desire to achieve what is probably the best outcome for the patient (Coulter A. 2002) One of the major areas that we shall consider in this appreciation of the significance of psychology in the delivery of healthcare, is that of attitude of those delivering the particular intervention to the patients concerned. This area is examined in commendable detail by the paper by Johansson (K et al. 2002) which specifically considered the effectiveness of the delivery of alcohol awareness programmes in a group of problem drinkers. The reason that we have selected this paper for an initial consideration is that, unusually for a research paper, it does not simply consider the efficacy of a particular healthcare package, but it reviews and critically analyses the attitudes of the healthcare professionals on the overall outcomes with specific focus on their readiness to participate in such a venture. This is seminal to the major thrust of this essay and therefore merits a detailed examination. In essence, the entry cohort to this study was a collection of about 150 primary healthcare team workers who could potentially be involved in the delivery of an alcohol awareness programme. Each was asked to fill in a questionnaire which was designed to evaluate a personal profile of the respondent and covered areas such as: experiences with patients with alcohol-related health problems, knowledge and perceived capacity concerning early identification and intervention, attitudes towards the role of primary care staff in early identification and intervention and current intervention methods in use at the health centre. The results are interesting insofar as there was general agreement that the likelihood of a patient generating or triggering an enquiry into their alcohol usage was most likely to be when issues relating to the alcohol-related health-risks were perceived by the healthcare professionals. The relevance of the psychological aspects of such an enquiry became clear when it was found that nurses were more likely to enquire than the doctors in the sample and that on average, nurses tended to drink less alcohol than doctors. (Dihn-Zarr, T et al. 1999) Those who drank the least were more likely to be concerned about the health risks than those who drank more. Clearly the effects of alcohol in any individual patient are specific, but the willingness of a healthcare professional to instigate healthcare measures to minimise the health-related effects of alcohol appears to be dependent on their own attitudes towards alcohol and this may be reflected in their own levels of consumption. There is an old adage that the definition of an alcoholic is a patient who drinks more than their doctor. (Fleming, M et al. 1999). In the light of this study, this comment may not be as flippant as it initially appears. In alcohol-related problems, there is frequently an element of denial, both in terms of alcohol intake and its effects. (Herbert, C et al. 1997). If the healthcare professional involved has a degree of denial of their own intake, clearly this will have repercussions on their presentation of the problem to the patient and their subsequent evaluation and willingness to invoke therapeutic or interventional measures for that patient. (Kaner, E. F. S et al. 1999) Other significant factors that contributed to the likelihood of a healthcare professional instigating therapeutic measures were found to be their individual perception of their own degree of knowledge on the subject, both in terms of the effects of alcohol on the body and also in terms of the interventions that were available. (Aalto, M. et al. 2001) Many nurses expressed the fact that they were concerned that patients might react negatively to such enquiries and that this would affect the degree of patient empathy. Doctors appeared to be generally more confident about handling the possibility of a negative reaction. The same study pointed to the fact that it appears that such fears were unfounded in reality, as the same proportion of patients reacted in a negative way in both groups. >From this brief overview, it can be seen that psychology plays a role at many different levels in what is basically a fairly straightforward healthcare professional / patient interchange, and the attitudes of both patient and healthcare professional can have a profound impact on the eventual outcome of the care package for the individual patient. The paper itself makes the comment that: Nurses appear to be an unexploited resource, in need of training and support. Nurses may need to be convinced that an active role does not interfere with the nurse–patient relationship. Building teams of GPs and nurses in primary care might enhance the dissemination of alcohol prevention into regular practice. A further psychological input that is relevant in this area is the perception of the healthcare professional of just how effective the intervention that is proposed is likely to be. A previous paper on the same subject (Andrà ©asson S et al. 2000), concluded that healthcare professionals were much more likely to recommend a healthcare intervention that they had personally experienced or witnessed as successful, with greater frequency than one which had been shown to have a secure evidence base in published literature. The paper concludes with the suggestion that specific training in the subject needs to be implemented and this training not only needs to address the knowledge gap that has been identified, but also the belief systems and attitudes of the healthcare professionals in the primary healthcare team in order that it can reach its maximum potential. Although this paper was targeted and written in relation to a specific alcohol related intervention, it is reasonable to assume that the selected comments cited in this essay are sufficiently general to apply to most specific health related interventions and we will consider and explore other psychological rationales in specific relation to Health Promotion initiatives together with the inferences that can be drawn in relation to team building issues at greater length later in this essay. One of the major areas where psychology is relevant to the success (or otherwise) of a particular treatment is encapsulated in the concept of empowerment and education. (Howe and Anderson 2003). The patient who is both empowered and educated by the nurse will approach their illness trajectory in a completely different psychological frame of mind than one who is not. Time spent in explanation to a patient of the parameters and reasons for their treatment is rarely wasted. (Holzemer W et al. 1994). Marinker’s concept of the differentiation of compliance and concordance. (Marinker M.1997) is particularly useful in this respect. Although his original paper was written with specific regard to the taking of medication, the principles that it expounds are sufficiently general that they are now commonly extrapolated to cover most aspects of the interaction between the healthcare professionals and the patient. The patient who understands why he is being asked to undergo a particular th erapeutic regimen is far more likely to complete is successfully than one who is simply told what to do. This can be encapsulated in the professional advice on the subject from the RCN Patients are as fully involved as practicable in the formulation and delivery of their care (e.g. through the use of self-care plans) Where appropriate, patients are offered treatments other than medication Treatment plans are individually tailored for each patient Patients are involved, unless impracticable, in any decisions about referral Where practicable, patients are informed of the reasons for referral to specialists or other professionals (cited in CSAG 1999) This element of compliance is frequently cited in many of the tools of quality indication that are used in formal studies in this area. The degree to which a patient complies (or concords) with instructions can be viewed as a measure of success of the presentation of that treatment directly to the patient. (Campbell S M et al. 2000) As we have intimated in the introduction, the title of this essay can be interpreted at several different levels. In this segment we shall consider the impact of formal psychology services in primary health care. The rationale for our consideration of this topic specifically lies in the fact that an understanding of basic psychological principles is fundamental in allowing the nurse to appreciate the elements of treatment commonly undertaken in a psychology clinic. The excellent and informative article by Sobel (A B et al. 2001) provides a good starting point for this consideration. In practical terms, the average attendance at a psychology clinic is about five outpatient attendances. (Arndorfer, R. E et al. 1999). This means that the contact of a patient with the primary healthcare team is likely to outnumber the attendances at the clinic over a period of time. To give a specific example, it is clearly important for the nurse, who may come into contact with (for example) an anorexic adolescent, to understand the issues revolving around body dysmorphia, self-image enhancement and self-esteem (Lavigne, J. V. et al. 1999) if they have been undergoing treatment, if the nurse is to consider giving any degree of holistic consideration to whatever problems are being presented to her at the time. It is clearly of little value, if requested to give advice on the subject of weight loss (which is a common enquiry at nurse-run clinics), (Hogston, R et al. 2002) . to attempt to give such advice without a background knowledge of the psychological principles that have been employed in trying to restore the patient’s eating habits to a more normal pattern. (La Greca, A. M. 1997). Equally the parents of a child who is undergoing treatment for enuresis may have questions that they have not felt able to ask at a busy clinic and these may be presented to the practice nurse. A background knowledge of current treatment (both interventional and behavioural) is clearly vital t o being able to answer the questions with a degree of professional confidence. Another area where the nurse’s knowledge of psychological issues may be important is that, given the fact that a comparatively high number of patients default from follow up before being formally discharged, the nurse should know that psychological treatment is rarely successful if the â€Å"less than optimum† course of treatment is completed. (Sobel, A. B et al. 2001). Encouragement to return to complete the full course may be a useful remit for the nurse confronted by a patient in this situation. It follows that a sensitive exploration of the reasons for default my also be helpful and a knowledge of the subject is clearly helpful here as well. The patient who has defaulted from follow up through apathy needs completely different handling from the patient who has defaulted because of a resurgence of painful or difficult memories during a course of cognitive behavioural therapy. (Street, L. L.et al. 2000). In the latter case, empathetic handling is of great importance a s the issues involved may have a deep significance for the patient and completion of the course may be fundamental to a complete resolution of the issues involved. (Mitchell M C et al. 2004). When dealing with the patient who has specific emotional or psychological issues, the professional nurse would commonly have to employ a degree of psychological understanding which may be deeper than in many other cases for both of the reasons set out above. Let us now consider a different aspect of psychology and its relevance to nursing practice in primary care. A large proportion of the work of the district nurses can be taken up with the care of the dying patient. The dying, or terminally ill patient typically has a psychological profile that is quite different to the â€Å"average† patient. This was explored in the fascinating and very well written paper by The (The et al. 2000) who considered the elements of denial and cognitive distortion exhibited by a patient when being given news that they do not want to hear. The diversity of psychology shown by these patients is virtually unique to this group and a firm grasp of the essential elements is vital if the district nurse is going to handle the situation both professionally and well. The concept of â€Å"a good death† (Seale C et al. 2003) is one that is frequently cited in the modern literature and a fundamental prerequisite to a good death is that the patient is surr ounded and treated by healthcare professionals who have broad understanding of the psychological issues that are relevant to this spectrum of patient. (Wilkerson, S. A et al. 1996) There are many patients who confront the inevitability of death with a stoical inevitability that makes their management a relatively straightforward matter (Wadensten et al. 2003). The patients that we shall specifically consider in this segment however, are those who have a positive diagnosis of a life threatening condition but employ a number of coping mechanisms so that they do not have to directly confront the possibility of imminent death. These mechanisms can range from false optimism right through to frank and abject denial (Weeks et al 1998). We have already considered some of the ethical implications of autonomy and consent earlier in this essay, but they also are of great relevance in this section. It follows that if a patient is to have any degree of meaningful input into their treatment plans and consideration of the various options that are open to them, they must be both fully aware of, and quite prepared to confront, the implications of the situation that they find themselves in. If they chose to distort some or any of the relevant facts of the case, it equally follows that they cannot make a reasoned and rational decision about the options and choices that they have in front of them. Once again we return to the issue and concept of framing the presentation, the only difference here is that it is generally the patient who deliberately distorts the frame rather than it being distorted or manipulated by the healthcare professionals. This specifically is the issue that The and his colleagues considered in their paper (The et al. 2000). We should start a consideration of this issue however, with a reference to an earlier paper by Jennings (1997) who described the â€Å"emotional roller coaster† experienced by patients who deal with a malignant diagnosis and that this â€Å"evolution of emotional landscapes† can be predicted with a degree of certainty. This can be best examined with a verbatim extract from the The paper which refers to patients with small cell carcinoma of the lung: â€Å"False optimism about recovery is usually developed during the (first) course of chemotherapy and was most prevalent when the cancer could no longer be seen in the x ray pictures. This optimism tended to vanish when the tumour recurred, but it could develop again, though to a lesser extent, during further courses of chemotherapy. Patients gradually found out the facts about their poor prognosis, partly because of physical deterioration and partly through contact with fellow patients who were in a more advanced stage of the illness and were dying. False optimism about recovery was the result an association between doctors activism and patients adherence to the treatment calendar and to the recovery plot, which allowed them not to acknowledge explicitly what they should and could know. The doctor did and did not want to pronounce a death sentence and the patient did and did not want to hear it. Clearly an understanding of the psychology of what colours the patient’s reactions is vital to the district nurse if she is to handle this type of situation both professionally and empathetically. If we take a completely detached and dispassionate consideration of this situation the healthcare professional can say with almost complete certainty, that the patient with a positive diagnosis of small cell carcinoma of the lung is going to die. Statistically we know that over 90% of patients are dead within two years of diagnosis and the overall five year survival figures are nil. (Seale C et al. 2003) The practicality of the situation is therefore that it clearly makes sense to discuss options in terms of treatment, palliation and support as soon as a positive diagnosis is made. In real terms, this is rarely done because healthcare professionals frequently find it difficult to effectively pronounce a â€Å"death sentence† on patients. In this respect the psychology of the situation is as much a reflection of the attitudes and feelings of the healthcare professionals as it is of the patient. On a fictional level one can cite the classic literary example of A J Cronin’s Dr Findlay (Cronin A J 1934) who disagreed with his partner Dr Cameron. Dr Findlay felt strongly that the eponymous Mrs McIver should be told of her hopeless prognosis on the grounds of being completely truthful with the patient and this was against the advice of the older, more experienced partner, Dr Cameron who had been hitherto managing the situation by keeping the lady’s spirits high by telling her how well she was looking at each occasion he had contact with her. Dr Findlay confronts the situation by telling Mrs McIver the truth and within a few days she has died. The relevance of the story is seen at the end where Dr Findlay is depicted talking to the dead lady’s husband and Dr Findlay expresses his shock at the speed at which the old lady died and the husband concludes the episode by observing that: â€Å"She was doing really well until you took away from her the one thing that she had left – and that was hope†. In short, this episode highlights some of the difficulties and dilemmas that are frequently faced by healthcare professionals in general and district nurses in particular. The practicality of the situation could have been handled better with a more thorough understanding of the thought processes and psychological mechanisms employed by Mrs McIver in her last few weeks. One can see the point of view of Dr Findlay who took the view that the lady would not have been in any realistic position to make appropriate arrangements to confront her own death if she had never faced the possibility in the management plan that Dr Cameron had adopted. Dr Findlay’s approach could be argued to have allowed her to consider a number of timely treatment options if the truth was confronted. The fact of the matter was that she chose to actively collude with the optimistic approach of Dr Cameron and she derived strength and the ability to cope from the transparent belief (a cognitive distortion) that her prognosis was not hopeless. Dr Cameron was clearly of the opinion that this was of greater benefit to her than confronting her imminent death. What the story does not tell us (and we can only surmise) is that Dr Cameron, in common with many other real healthcare professionals, also has psychological difficulties in dealing with the subject himself. A number of different mechanisms may be active in this situation. It is possible that, by telling a patient that they are soon to die, it may challenge the notion that medical science can cure everything and that healthcare professionals are infallible (sadly, a still all to common belief). Equally it could be that the healthcare professionals involved do not like to be vicariously reminded of their own mortality and therefore collude willingly with the patient’s false optimism. Others again may take a rational view that â€Å"if the patient wants to know the truth then they will ask, if they don’t want to know then they won’t ask† and thereby actively avoid confronting the situation (Curtis J R. 2000) The The paper examines this issue in considerable depth with a commendable degree of scientific scrutiny. In the words of the paper, the authors suggest that: The problem of patient / doctor collusion does actually require an â€Å"active, patient orientated approach from the doctor†. A practical and novel solution to this problem is suggested in the form of the use of a â€Å"treatment broker† who is defined as: â€Å"a person who is trusted by both patient and doctor and who can help both parties to clarify and communicate their (otherwise implicit) assumptions and expectations†. The’s analysis suggested that the majority of patients in the study did actively want to know if the illness that they had was terminal with over 85% stating that they would wish to be told the truth rather than be given false optimism in an unrealistic fashion. This is contrasted with the finding that, in the study, when a patient was given a terminal diagnosis, the next question was almost invariably a variation of â€Å"what are the chances of a cure?† (Meredith et al 1996). It is also the case that other studies on the psychology of this type of situation have shown that when patients ask about their condition (and this applies not specifically to terminal conditions) they do not want to hear anything other than good news (Costain et al 1999). This argument is extrapolated even further in a study by Leydon and his co-workers (Leydon et al 2000) who provide an excellent qualitative study into patient’s reactions and they cite examples of patients who were interviewed directly after a recorded conversation with a healthcare professional and who overtly denied that they had been given a terminal diagnosis even though this was demonstrably not true. An interesting twist in these discussions of the psychology of the situation is provided by Dean (Dean 2002), who offers a specific insight into the way patients perceive the differences between nurses and other healthcare professionals. He takes the arguments of false optimism and overt denial and examines them further. Again, this paper is specifically concerned with the patient with a terminal diagnosis, and it looked at the differences in the content and tone of the conversations that patients had with both doctors and nurses. A significant finding from this paper was that a patient may choose to overtly collude with the doctor during discussions of â€Å"a cure† but within a very short space of time may choose to talk in a much more open way with a nurse when pretences of a cure are actively dropped. Dean suggests that â€Å"such a dichotomy of approach is not unusual†. He suggests that: Patients may well feel a need for a theatrical faà §ade to bolster their own psychological states as well as to collude with the doctor and indicate that they are remaining positive and confident in the doctor’s ability to try to achieve a cure. And this suggestion is echoed and expanded in the Curtis paper (Curtis 2000) with the observation that, in their more candid moments patients may well wish to get a more â€Å"down to earthâ€Å" response, which they perceive that they will get from the nurse, who they think may not require a faà §ade or even indulge in the sophisticated game play of the doctor. Lynn (Lynn 2001) adds a counter-intuitive note of caution for the nurse with the thought that this situation requires a great deal of careful handling by the nurse, as the psychological mechanism that underlies the nursing approach is that the patient may actually be looking for reassurance and (possibly unexpected) reinforcement of their own false optimism. This is an exemplification of the constant calls in the literature for a holistic and patient centred approach to patient care rather than a blanket approach to this type of clinical problem. The rest of The’s paper is concerned with the psychological theory behind the explanations of just why it is that patients do adopt these defensive positions and just why it is that healthcare professionals frequently collude with them on this issue. It is not particularly relevant to explore this in any further detail as the point is clearly made that a basic understanding of the mechanisms by which patients cope with their adversity and the psychological constructs that are frequently presented in these circumstances is of great importance to the nurse who has to deal with, interpret and empathise with the patient’s particular needs at any given time in their illness trajectory. Nurses are often involved, both overtly and in their everyday work, in the business of Health Promotion. Psychology plays a very important part in the overall success and implementation of health promotion strategies on a both a population and an individual level. The theoretical basis of much recent work in the field of Health Promotion is in the concept of the Attitude-Behaviour theory (A-B theory) (Rise J 2000). This theory suggests that the optimum change in behaviour patterns (at least in the field of health and self-interest) is achieved with the optimum change in attitude (or â€Å"realignment† in the jargon). We opened this essay with a reference to the Theory of Rational Choice. An offshoot of this theory (the Theory of Reasoned Action) modifies the A-B Theory to the extent that it provides a model framework by which one can assess the many divergent processes by which attitudes guide behaviour. The hypothesis states that if people can become highly motivated to make a correct decision and are in a position (because they have been given relevant information), then they are likely to spontaneously engage in a â€Å"deliberate and thoughtful process in deciding how to behave† (Rise J 2000). In the context of Health Education (which was the field that the theories were originally developed in) the theory suggests that if people are given sufficient and persuasive information in relation to their health, then a significant proportion will spontaneously indulge in lifestyle changing activity which can be consistent with healthier living. The significance of these theories is that, if t he nurse has a remit to promote a healthier lifestyle (which is arguably part of a professional remit), she is most likely to have the greatest success in providing significant amounts of information to patients rather than simply dictating to them how they should alter their lifestyle without any significant explanation. This comment effectively brings us full circle to the concept of compliance and conformance as postulated by Marinker. Another issue that has deep seated psychological implications, is the current trend towards teambuilding in primary health care. The ramifications of this concept are huge, and therefore we intend to only discuss the issue by considering a number of the most relevant points. To a large extent, team building overlaps with the concept of multidisciplinary team working. This move has required a redistribution of both power and authority (and thereby a redistribution of responsibility) within the team. (Shortell S M et al. 1998).The psychological implications of this are that if one considers the NHS of more than about twenty years ago its structure was more isolationist and based on individual practice (DHSS 1988). Individual speciality teams and individuals worked in a degree of comparative isolation and this also implied a greater degree of individual responsibility than they have at present. This change has brought about a number of major changes in areas such as ethics and work prac tices which are not particularly relevant to our topic in this essay (and therefore will not be discussed further), and also the psychology of working, which clearly is. The first consideration is the psychology behind the concept of leadership. Leadership is clearly important if one is to have an effective team. In psychological terms styles of leadership can be divided into several categories. The two most prominent being congruent leadership and transformational leadership. A full discus

The Food Security Of India

The Food Security Of India Food Security as described in World Food Summit, Rome 1996, Food Security exists, when all people, at all time have physical and economic access to sufficient safe and nutritious food to meet their dietary needs and food preference for an active and healthy life. India uptill now has faced 14 famines in its history and among them the Bengal Famine of 1943 was the worst. Food availability and agriculture in India has been largely related to the vagaries of monsoon. In the past concentrated efforts were made to achieve food security by increasing food grain production. The Green Revolution was a step towards attaining Food Security. For maintaining a satisfactory level of operational and buffer stock of food grains and to ensure national food security, The Food Corporation of India (FCI henceforth) was set up under the Food Corporation Act 1964. It ensured effective price support operation for safeguarding the interest of the farmers. Another important work that FCI does is managing the Public Distribution System. FCI maintains food security in the country through its four Zonal Offices- North Zone, South Zone, East Zone and West Zone and their respective regional offices. FCI has also established a comprehensive and a structured training mechanism in accordance with its organisational goals known as the Institute of Food Security. The flagship activity of the institute has been to conduct short-term training programmes on various subjects related to Food Security, Managerial Skills, Computer skills and on operations of FCI. Food Security as we have mentioned above exists when all people have access to have food and there is a minimum level of nutrition that is maintained. There are four main dimensions of food security that can be identified: PTO Physical Availability of food- It is determined by the level of food production, stock levels and net trade or in short we refer to the supply side of food availability. Economic and Physical access to food- Access to food depends on income, expenditure, market and prevailing prices in the market. Availability of food grains in the country does not ensure availability to every individual. Food utilization- Sufficient energy and nutrient intake by individuals along with good biological utilization of food consumed determines the nutritional status of individuals. Stability of other three dimensions over time Adverse weather conditions, political conditions and economic factors have an impact over food security. In spite of constant efforts by the government and FCIs repeated efforts India has failed to feed the teeming millions. Food availability in the country is poor and there still remain a huge amount people who strive to get two squares of meal a day. Innovative strategic interventions are the needs of the hour and they have to be implemented to ensure food availability, food access and utilization. Freedom from hunger is not only a basic right but it is also essential for the enjoyment of all other rights. There has to be much stress on community farming. Through research and development it has to be aimed to reduce cost of production. New technology has to be introduced so as to achieve high production and better yield. It has been rightly mentioned in our five year plans that the time has come to introduce a Second Green Revolution. A revolution of such a great intensity is required to overcome these ailments. Expanding utilization of food facilities and encouraging private sector i nvestments can be another possibility towards achieving this goal. Over the years India has miserably failed to achieve food security. The number of people without enough food to eat on a regular basis remains stubbornly high through the ages. In India about 29 % of the 872.9 million people are malnourished. There have been various reasons contributing to this. One of major reasons is that Indian agriculture has been highly dependent on the vagaries of monsoon. Rainfall has been constantly irregular in India and moreover the recent changes in the climatic conditions all over the world have contributed to the problem of unavailability of food. In spite of Governments repeated efforts to maintain Food Security and availability, it has been highly subject to the irregularities of agricultural production. It is said that India attained national food self-sufficiency 35 years ago yet about 35% of its population remains food insecure. We look into the close interlink between food security and agriculture. In the past three decades the South Asian countries have made considerable advancement in food production which was elicited by the Green Revolution. Green Revolution was introduced in 1960s and they brought in the use of High Yielding Variety (HYV) of seeds. It brought about a revolutionary boost in production. Now there was a huge expansion in the crop yield which contributed to the countrys growth. But agriculture was highly decelerated in the country and more focus was laid on industrialisation. Thus the wave of green revolution did not reach all parts of the country and it full effect was not realised. It remained regional and only affected the rich farmers. Also in the 1960s India experienced two major droughts and there was a severe food shortage. There was not sufficient food for all. Also we can say that green revolution was successful to some extent but the aim of self sufficiency and food security still seem like a distant dream. In India climate plays a major role in agriculture. Agriculture even to this day is highly dependent on the vagaries of monsoon. Climatic change will affect food security through its impacts on all components of national and local food production system. There has been a rising trend in the temperatures all over the world. This has contributed to a fall in rainfall drastically. Another aspect of climatic change is that of extreme weather events like cyclone which has made agriculture losses higher and has affected total production. Climatic changes as seawater incursion and unusual flooding are effecting greatly as well. Changes in temperature and precipitation influence water run-off and erosion affecting soil organic carbon and nitrogen content and salinity in the soil. Thus the changing weather condition all over the world has had its toll on agriculture. The new climatic conditions are more likely to have negative impacts such as a rise in the spread of diseases and pests, which will reduce yields. Rainfall trends have changed and decrease in rainfall has lead to a fall in production. Rising temperature, changing precipitation patterns and an increasing frequency of extreme weather events are expected to be the reasons for reducing regional water availability. In a country like India where there is lack of irrigation facilities and agriculture is completely dependent on rainfall, irregular rainfall directly affect the total crop production. Unavailability of sufficient water is also another reason for crop failure. Grain output has been stagnating for over a decade and there is a growing gap between supply and demand. A decrease in production leads to poor availability and thus food security of the country is poor. The crisis has been building up for some time. The food grains yields of Indian farmers are not going up. Thus we come to the conclusion that climate change will reduce crop yield in the tropical country like India. The regional inequality in foo d production resulting from climate change will have a very great implication on the food security of the country. Another problem is that of lack of proper mechanization in agriculture. Indian farmers are mostly too poor to implement the modern techniques or machinery in their farms. The small and marginal farmers generally sell their produce. Now transporting and storage of food grains too holds huge importance in a country like India where the condition of infrastructure is very poor. The Food Corporation of India has been entrusted with the job of maintaining a buffer stock. A buffer stock is necessary so as to ensure food security during bad agricultural years or crop failures. But due to lack of infrastructure every year there is a considerable amount of food grains that is wasted. Quantity of food grains damaged in India : YEAR QUANTITY(lakh MTs) 2004-2005 0.97 2005-2006 0.95 2006-2007 0.25 2007-2008 0.34 2008-2009 0.03 2009-2010 0.03 AVERAGE 0.58 Source: Rajya Sabha Unstarred Question No. 2779, dated 27.04.2007. Lok Sabha Unstarred Question No. 3065, dated 08.12.2009 The above table shows the amount of food which is wasted from 2004-2010. In a country like India where agricultural production is not enough and people do not get two squares of meal a day, these datas are shocking. This has lead to a fall in food security because there has been a deficiency of food grains. Another important factor in this context is that of land use. Due to rapid industrialisation in building roads, houses and factories, private entrepreneurs are taking away the fertile lands for non-agricultural purposes. The supply of land in nature is fixed and as more and more land is used for non-agricultural practises it has been seen that the land for agricultural purpose is decreasing. People look at the comparative advantage of industrialisation over agriculture. But they fail to realise that in a way they are decreasing their food-grain production. This has lead to a disparity between the demand and supply of food grains and thus instability in food security. The food policy of India took up two objectives one is to create a food surplus economy and next is to provide food grains at subsidised rates. Our Prime Minister Indira Gandhi had implemented a seed-water-fertilizer policy commonly called the Green Revolution in order to attain self-sufficiency and to attain food security. It is time we had a revolution of such an intensity to revive our strategies to attain food security. In a country as huge as India where population grows at about 8 % and where a large chunk of the population is malnourished and under-weight it becomes necessary to attain food security. The supply chain between the farmers and the consumers should be shortened. Farmer friendly marketing processes should be introduced. And most important a second revolution is necessary to bring about stability in the Food Security in the country. **************************

Aspergers Syndrome Essay -- Disease/Disorders

Hans Asperger, a pediatrician from Austria, began to study a group of children at his clinic in 1944. He noticed that the young boys he was studying were clumsy, lacked social skills, and did not understand nonverbal communication. Asperger’s syndrome (AS), named after Doctor Hans Asperger, is a developmental disorder. Research by Woodbury-Smith and Volkmar (2009), claim that AS was originally thought of as a less severe form of Autism, in which the individual has higher linguistic ability but still lacks social skills. Many researches now consider AS an Autism Spectrum Disorder (ASD). However, it is disputed amongst researchers as to whether it is explicit from High Functioning Autism (HFA). Many characteristics of AS and HFA are overlapped, making it difficult to distinguish between one and the other (Woodbury-Smith and Volkmar, 20089, p. 2). In this paper, Asperger’s syndrome, as depicted in the film, â€Å"Adam†, will be evaluated. Asperger’s syndrome is defined as an ever-present neurodevelopmental disorder, in which social communication is affected and discernment and attentiveness may be bounded (Woodbury-Smith and Volkmar, 2009, p. 2). According to Baron-Cohen, Wheelwright, Robinson, & Woodbury-Smith (2005), Asperger’s syndrome can be characterized by various behavioral and social symptoms: lacking the ability to understand social cues; preoccupation with one or few interests; disliking change in routines; repetitive behavior; failure to understand emotional tones in speech; and a seeming lack of empathy. The title character in the film â€Å"Adam†, Adam Raki, is a 29-year-old man who has AS. At the beginning of the film, Adam is left alone for the first time after the death of his father. When Adam meets his new upstairs neig... ...Cited Baron-Cohen, S., Wheelwright, S., Robinson, J., & Woodbury-Smith, M. (2005). The Adult Asperger Assessment (AAA): A Diagnostic Method. Journal Of Autism & Developmental Disorders, 35(6), 807-819. Hurlbutt, K., & Chalmers, L. (2004). Employment and Adults with Asperger Syndrome. Focus On Autism & Other Developmental Disabilities, 19(4), 215-222. O'Connor, K. (2007). Brief Report: Impaired Identification of Discrepancies Between Expressive Faces and Voices in Adults with Asperger’s Syndrome. Journal Of Autism & Developmental Disorders, 37(10), 2008-2013. Rogers, K., Dziobek, I., Hassenstab, J., Wolf, O. T., & Convit, A. (2007). Who Cares? Revisiting Empathy in Asperger Syndrome. Journal Of Autism & Developmental Disorders, 37(4), 709-715. Woodbury-Smith, M. R., & Volkmar, F. R. (2009). Asperger syndrome. European Child & Adolescent Psychiatry,18(1), 2-11.

Free Essays - The Adventures of Huckleberry Finn :: Adventures Huckleberry Huck Finn Essays

Free Essay on The Adventures of Huckleberry Finn    In the novel The Adventures of Huckleberry Finn by Mark Twain the main character, Huck Finn, grows and learns many lessons. Throughout my life I have learned many similar lessons. In addition, I have discovered that there is a relationship between Huck's life lessons and my life lessons. Also I have learned many different lessons that Huck was dispossessed from learning. Twain's character, Huckleberry Finn, and I can be compared and contrasted through lessons we both have learned and lessons that only I have learned. During my life I have learned that lessons are hard, complex, and above all else are universal. One lesson that Huck and I have shared in learning is that a person can choose to escape an unfair situation. Huck escaped his abusive father and was taken in by the Widow Douglas and Miss Watson. I too escaped an abusive father. When I was six years old my mother divorced my father and I decided to live with her. Another lesson that Huck learns is to be his own pe rson. He learns this when he left Tom Sawyer and his gang for his own adventures. I learned this same lesson when some friends wanted to go to a concert on a night that I had school and a project due the next day. I did not go with them and even though my friends had fun, I was proud to be an individual. Additionally, Huck learns that friends are very important because they are always there for you. He and Jim become very close over their long trip down the river. They do things for each other that shows that they are friends. Tom helps Huck rescue their friend Jim from slavery. Huck and Tom free Jim because he is a good friend to them. I have also learned that friends are a tremendous part of my life. On various occasions, friends have helped me study for important tests. Consequently, Huck and I have learned similar important life lessons though the experiences were different. On the contrary, there are also a few lessons that I have learned that Huck has not learned. I have learned that you must deal with your problems instead of running away 12/19/98 from them.

Health Risk Assessment Bnt’s Story Essay

To die with dignity should be a given. Death will present itself to everyone eventually and presumably no one in their right mind would choose not to die with dignity. That being said why is it that so many people who would choose to die a good death are no allowed to. For some people no death is a good death, but that is silly because as everyone knows death is inevitable. No one can escape this fact. The controversy herein lies within the circumstances people who are suffering or lingering with a terminal illness that debilitates them such that they have no quality of life are not afforded the comfort of dying with dignity. It seems that this high merit is available to our beloved pets, but not our beloved family members. Aunt Bessie is forced to endure unrelenting pain from here incurable pancreatic cancer. No amount of pain medication is available to treat her pain and allow her to maintain consciousness. She knows her time is limited and she does not feel she should have to wait out the inevitable in such a terrible state. At the same time the family pet Bassett hound is found to have a mass in her intestines. She cannot eat and barely moves as she is in so much pain. The veterinarian has given the option of putting her to sleep or euthanizing her to put her out of her misery as she is suffering so. This sits well with most people. Aunt Bessie requesting euthanization though is out of the question. Why is the question that this paper will attempt to answer and why this is wrong will also be addressed? Euthanasia Defined Euthanasia can bring about different feelings to people depending on the context in which it is used. Mention that good old dog and it is good as they no longer suffering. Change the identity to a person and it is not so easily swallowed. No matter how it is interpreted the true meaning of the act is the same in either circumstance. â€Å"Originating from the Greek terms â€Å"eu† (happy or good) and â€Å"thanatos† (death), euthanasia means literally â€Å"happy death† or â€Å"good death. † (Le Baron Jr. , 1999). Breaking that definition down even further is subdivisions in the definition are voluntary/involuntary and active/passive: â€Å"Voluntary euthanasia is a death performed by another with the consent of the person being killed. Non-voluntary euthanasia is the provision of euthanasia to an incompetent person according to a surrogate’s decision. Involuntary euthanasia is euthanasia performed without a competent person’s consent. Passive euthanasia involves allowing a patient to die by removing her from artificial life support systems such as respirators and feeding tubes or simply discontinuing medical treatments necessary to sustain life. Active euthanasia, by contrast, involves positive steps to end the life of a patient, typically by lethal injection† [ (Le Baron Jr. 1999) ] Euthanasia brings tranquility to death. In euthanasia the suffering prior to death is limited and death is entered more peacefully as opposed to lingering with pain and suffering. Presumably most people would want to end their journey in life without pain and suffering. A more compassionate death is a more desirable death. However to know what euthanasia actually means requires more exploration into the depth of this term. Practical Problems Euthanasia can bring about bad feeling to some people. After all when the term is used it is in relationship to death. In our culture and to numerous people death or speaking about death is taboo. This is an unfortunate fact. What is most unfortunate is that death is inevitable and therefore discussion regarding it should be more open. Essentially the problem with euthanasia is this taboo associated with it. Ethically euthanasia is an appropriate and well warranted act of kindness and consideration. Support of euthanasia will be provided within the context of this paper, and the potential negative issues will also be brought up. Ethics Argument For The ethical principles that can justify euthanasia are many. This is because the premise of euthanasia is based upon the idea of caring. This idea of caring is inherent to most care givers and is the key principle in euthanasia. Such acts of caring resonates through theses ethical principles and frameworks: Respect of persons, Virtue ethics, Utilitarian, Rights based ethics and ethics of caring. These frameworks or principles although many will all show supportive qualities for euthanasia. Respect of Persons In respect of persons the support of euthanasia is found in that the principle here is that individuals are afforded autonomy and able to make their own decisions. When a person chooses not to suffer at the end of their life this is an autonomous decision. â€Å"Respect for persons generally means respecting a client’s autonomy† (Ethical Principles, 2011). That person in the eyes of this principle is just in making that call. The respect of person principle sustains this in its foundation. â€Å"The principle of respect for persons affirms the primary importance of allowing individuals to exercise their moral right of self determination. To violate their ability to be self-determining is to treat them as less than persons. (Bennette-Woods, 2001). Therefore, this principle is then supportive of euthanasia when decided upon by an individual. Virtue Ethics With the act of euthanasia people are seeking the good by allowing a good death. Suffering is not permitted to go on until death. Rather death is allowed to happen prior to a lengthy battle with pain and suffering. Virtue ethics is doing good and for the right reason. Forcing peop le to live with pain and suffering would not be characterized as good. So presumably then allowing for euthanization is good. Because it is done in response to alleviate further pain or suffering it satisfies the right reason aspect. In another view the dying patient is taking a virtuous stance. â€Å"Some dying patients consider it virtuous to spare friends and family the ordeal of witnessing a slow process of degeneration† (van Zyl, 2002, p. 19). This again satisfies the criteria for virtue ethics. Utilitarian In encompassing the utilitarian ethical frame work consideration must be made for the balance of the greatest good. Allowing a person to die a â€Å"good death† will promote the greatest happiness for both the person and for those remaining behind. Sure there will be unhappiness in that there is a loss with the person dying, but the greatest happiness will be in knowing that the person is no longer suffering and that the pain of their disease is not torturing them any longer. This satisfies part of the balance. The other part is on behalf of the individual who is suffering. There is much good in ending a life from pain and suffering. A â€Å"good death† is much more desirable then a death of unrelenting pain and suffering. Therefore the balance of the greater good is established here and the utilitarian frame work is established. Right Based Ethics The right to die is an inevitable right. â€Å"Advocates of euthanasia argue that people have a right to make their own decisions regarding death, and that euthanasia is intended to alleviate pain and suffering†. (Nargus, 2012) It is of the belief of many that all people hold this one true right. Dying is ultimate natural right. â€Å"The patient has the right to make the decision about when and how they should die, based on the principles of autonomy and self-determination† (Nargus, 2012). This alone substantiates the use of rights based ethics and upholds this as an ethical point for euthanasia. Ethics of Caring This is the final ethical stance that will be used to persuade the positive perspective of euthanasia. To care is the essence of this ethical principle. To care would be to not allow suffering with pain at the end of life. Compassion is a must in the ethics of caring and allowing pain and suffering to continue cannot be construed as compassionate. â€Å"The ethic of care demands that we maintain conditions under which caring can flourish†. (Bennette-Woods, 2001) How better to show a sense of caring then by stopping suffering, stopping pain and allowing for a good death. Ethics of caring is the basis for most nursing philosophies and can be equated to most nursing principles. Care is not just in the physical sense, but the emotional sense as well. Care is delivered when euthanasia is allowed. Ethics Argument Against The arguments proposing that euthanasia be allowed were provided and supported. Now a few counterarguments will be analyzed and provided. Kant’s original ethical framework intent was clearly against the use of euthanasia, but a newer vision of Kantian ethics could also be supportive of the act. However, the argument against it in this framework will be what is focused on. Nonmaleficence framework can also be argued against euthanasia. This theory bases itself on doing no harm and depending what is perceived as harm is how this argument can be made. Kantian Ethics â€Å"A moral action is one that is performed solely for the purpose of meeting a moral obligation, and the action itself can only be judged moral in light of the intention behind it†. If the intention produces death it cannot be a good intention. Death although now relieved of suffering is the outcome. With Kantian ethics the end result is not at question. The person no longer suffering perspective is not of any value. The point is euthanizing a person is morally wrong and the outcome (alleviating pain and suffering) has no bearing in the matter. This is why this argument was not used in the pros. The outcome has to matter. Nonmaleficence Ethics â€Å"The principle of Nonmaleficence states that we should act in ways that do not inflict evil or cause harm to others. In particular, we should not cause avoidable or intentional harm. (Bennette-Woods, 2001) While some people feel that causing an earlier death as with euthanasia is harmful not everyone shares this view. â€Å"Professional organizations have invoked professional obligations as an argument against support and participation in assisted suicide and euthanasia†. [ (Ersek, 2004) ]. For those that do this could certainly be understood as argument against euthanasia. However, for others the harm is noted in the continuance of a life of suffering. Catholic Moral Tradition Each human life is considered sacred and deserving of a right to life. This is the position that the Catholic moral tradition stands behind. According to the Roman Catholic perspective, we are not obliged to ward off death at all costs, but we should not deliberately intervene to bring death about (Euthanasia a Catholic Perspective, 1987)†. The church goes on to say that† the end of human life is not subject to a person’s free judgment† (Euthanasia a Catholic Perspective, 1987). This theory protests that as in birth; death can only be implemented by God. However, even the church has come to make exceptions or loop holes that allows for euthanasia to happen. In the double effect principle medication can be given in large doses to relieve pain. The patient will succumb to death as a result of this medication, and that is ok. As long as the intention is to relieve pain, not cause death the Catholic moral traditions is receptive to this. It seems as if the church has struggle d with this issue in the past and the best that they can deliver is this double effect doctrine. (This was actually developed in the 15th century). . Final Justification â€Å"A slow, painful, undignified death is a fate that most of us would not wish on our worst enemies† (Dyer, 1999) yet this fate are often offered to people, loved ones and family members. This categorically should not be. Euthanasia theories have been presented and supported both for and against the act. What it comes down to is how individuals understand things. Some religious factions are adamant that this act is strictly forbidden. This author does not share these views. There is no argument that it is wrong to kill someone. However, there has to be availabilities for exceptions. When an act is done for all the right reason it then becomes a just act. When a person is deemed terminal and is some way suffering then this would create such an â€Å"except†. This is only one of an infinite number of â€Å"except† possibilities. Each case presenting itself must be evaluated for its ethical morality. Evaluation can be accomplished by using the previous theories presented in favor of euthanasia. Should the case lend itself to these proposed theories then it is indeed a just act. Pets are not made to suffer a miserable final existence (associated with the love of them) neither should people. Loved ones, family, friend or foe no one deserves to die suffering when a good death is an option.

Digital Fortress Chapter 36

â€Å"Manual abort?† Susan stared at her screen, mystified. She knew she hadn't typed any manual abort command-at least not intentionally. She wondered if maybe she'd hit the wrong sequence of keys by mistake. â€Å"Impossible,† she muttered. According to the headers, the abort command had been sent less than twenty minutes ago. Susan knew the only thing she'd typed in the last twenty minutes washer privacy code when she'd stepped out to talk to the commander. It was absurd to think the privacy code could have been misinterpreted as an abort command. Knowing it was a waste of time, Susan pulled up her ScreenLock log and double-checked that her privacy code had been entered properly. Sure enough, it had. â€Å"Then where,† she demanded angrily, â€Å"where did it get a manual abort?† Susan scowled and closed the ScreenLock window. Unexpectedly, however, in the split second as the window blipped away, something caught her eye. She reopened the window and studied the data. It made no sense. There was a proper â€Å"locking† entry when she'd left Node 3, but the timing of the subsequent â€Å"unlock† entry seemed strange. The two entries were less than one minute apart. Susan was certain she'd been outside with the commander for more than one minute. Susan scrolled down the page. What she saw left her aghast. Registering three minutes later, a second set of lock-unlock entries appeared. According to the log, someone had unlocked her terminal while she was gone. â€Å"Not possible!† she choked. The only candidate was Greg Hale, and Susan was quite certain she'd never given Hale her privacy code. Following good cryptographic procedure, Susan had chosen her code at random and never written it down; Hale's guessing the correct five-character alphanumeric was out of the question-it was thirty-six to the fifth power, over sixty million possibilities. But the ScreenLock entries were as clear as day. Susan stared at them in wonder. Hale had somehow been on her terminal while she was gone. He had sent her tracer a manual abort command. The questions of how quickly gave way to questions of why? Hale had no motive to break into her terminal. He didn't even know Susan was running a tracer. Even if he did know, Susan thought, why would he object to her tracking some guy named North Dakota? The unanswered questions seemed to be multiplying in her head. â€Å"First things first,† she said aloud. She would deal with Hale in a moment. Focusing on the matter at hand, Susan reloaded her tracer and hit the enter key. Her terminal beeped once. TRACER SENT Susan knew the tracer would take hours to return. She cursed Hale, wondering how in the world he'd gotten her privacy code, wondering what interest he had in her tracer. Susan stood up and strode immediately for Hale's terminal. The screen was black, but she could tell it was not locked-the monitor was glowing faintly around the edges. Cryptographers seldom locked their terminals except when they left Node 3 for the night. Instead, they simply dimmed the brightness on their monitors-a universal, honor-code indication that no one should disturb the terminal. Susan reached for Hale's terminal. â€Å"Screw the honor code,† she said. â€Å"What the hell are you up to?† Throwing a quick glance out at the deserted Crypto floor, Susan turned up Hale's brightness controls. The monitor came into focus, but the screen was entirely empty. Susan frowned at the blank screen. Uncertain how to proceed, she called up a search engine and typed: SEARCH FOR: â€Å"TRACER† It was a long shot, but if there were any references to Susan's tracer in Hale's computer, this search would find them. It might shed some light on why Hale had manually aborted her program. Seconds later the screen refreshed. NO MATCHES FOUND Susan sat a moment, unsure what she was even looking for. She tried again. SEARCH FOR: â€Å"SCREENLOCK† The monitor refreshed and provided a handful of innocuous references-no hint that Hale had any copies of Susan's privacy code on his computer. Susan sighed loudly. So what programs has he been using today? She went to Hale's â€Å"recent applications† menu to find the last program he had used. It was his E-mail server. Susan searched his hard drive and eventually found his E-mail folder hidden discreetly inside some other directories. She opened the folder, and additional folders appeared; it seemed Hale had numerous E-mail identities and accounts. One of them, Susan noticed with little surprise, was an anonymous account. She opened the folder, clicked one of the old, inbound messages, and read it. She instantly stopped breathing. The message read: TO: [email protected] FROM: [email protected] GREAT PROGRESS! DIGITAL FORTRESS IS ALMOST DONE. THIS THING WILL SET THE NSA BACK DECADES! As if in a dream, Susan read the message over and over. Then, trembling, she opened another. TO: [email protected] FROM: [email protected] ROTATING CLEARTEXT WORKS! MUTATION STRINGS ARE THE TRICK! It was unthinkable, and yet there it was. E-mail from Ensei Tankado. He had been writing to Greg Hale. They were working together. Susan went numb as the impossible truth stared up at her from the terminal. Greg Hale is NDAKOTA? Susan's eyes locked on the screen. Her mind searched desperately for some other explanation, but there was none. It was proof-sudden and inescapable: Tankado had used mutation strings to create a rotating cleartext function, and Hale had conspired with him to bring down the NSA. â€Å"It's†¦Ã¢â‚¬  Susan stammered. â€Å"It's†¦ not possible.† As if to disagree, Hale's voice echoed from the past: Tankado wrote me a few times†¦ Strathmore took a gamble hiring me†¦ I'm getting out of here someday. Still, Susan could not accept what she was seeing. True, Greg Hale was obnoxious and arrogant-but he wasn't a traitor. He knew what Digital Fortress would do to the NSA; there was no way he was involved in a plot to release it! And yet, Susan realized, there was nothing to stop him-nothing except honor and decency. She thought of the Skipjack algorithm. Greg Hale had ruined the NSA's plans once before. What would prevent him from trying again? â€Å"But Tankado†¦Ã¢â‚¬  Susan puzzled. Why would someone as paranoid as Tankado trust someone as unreliable as Hale? She knew that none of it mattered now. All that mattered was getting to Strathmore. By some ironic stroke of fate, Tankado's partner was right there under their noses. She wondered if Hale knew yet that Ensei Tankado was dead. She quickly began closing Hale's E-mail files in order to leave the terminal exactly as she had found it. Hale could suspect nothing-not yet. The Digital Fortress pass-key, she realized in amazement, was probably hidden somewhere inside that very computer. But as Susan closed the last of the files, a shadow passed outside the Node 3 window. Her gaze shot up, and she saw Greg Hale approaching. Her adrenaline surged. He was almost to the doors. â€Å"Damn!† she cursed, eyeing the distance back to her seat. She knew she'd never make it. Hale was almost there. She wheeled desperately, searching Node 3 for options. The doors behind her clicked. Then they engaged. Susan felt instinct takeover. Digging her shoes into the carpet, she accelerated in long, reaching strides toward the pantry. As the doors hissed open, Susan slid to a stop in front of the refrigerator and yanked open the door. A glass pitcher on top tipped precariously and then rocked to a stop. â€Å"Hungry?† Hale asked, entering Node 3 and walking toward her. His voice was calm and flirtatious. â€Å"Want to share some tofu?† Susan exhaled and turned to face him. â€Å"No thanks,† she offered. â€Å"I think I'll just-† But the words got caught in her throat. She went white. Hale eyed her oddly. â€Å"What's wrong?† Susan bit her lip and locked eyes with him. â€Å"Nothing, â€Å"she managed. But it was a lie. Across the room, Hale's terminal glowed brightly. She'd forgotten to dim it.