Power and social movements Essay Example | Topics and Well Written Essays - 3000 words

Power and social movements - Essay Example Furthermore, crowd mechanisms cannot be used to achieve communication and coordination of activity over a wide area, such as a nation or continent (Social Movement, 2006). In this regard, Sidney Tarrow defines a social movement as collective challenges by people with common purposes and solidarity in sustained interactions with elites, opponents and authorities. He specifically distinguishes social movements from political parties and interest groups (Tarrow, 1994). From whatever perspective one views social movement, it is apparent that all definitions of social movement reflect the notion that they are intrinsically related to social change; an attempt by the perceived powerless and voiceless in the society to exert their voice and power with an eye towards achieving such change. They do not, however, encompass the activities of people as members of stable social groups with established, unquestioned structures, norms, and values (Social Movement, 2006). Over the past few decades, several factors such as education, which have encouraged wider dissemination of literature, the increased mobility of labour due to the industrialisation and urbanisation of 19th century societies, the freedom of expression, and relative economic independence prevalent in the modern western society have precipitated an explosion of social movements in countries across the globe (Schock, 2005; Giddens et al, 2003). The New Social Movement (NSM); a new term that has come to describe the several social movements that sprung up over time, ranges from the civil rights and feminist movements of the 1960s and 1970s to the antinuclear and ecological movements of the 1980s and the gay rights campaign of the 1990s. Increasingly, traditional political institutions are becoming unable to cope with these challenges facing them. Taking a look at the origin of social movements, Tilly (2004) argues that social movement was not in existence before the late eighteenth century. Although he concedes that several elements like campaigns, social movement repertoire and WUNC displays have a long history, he opined that they were only recently combined together into what could be seen properly as a social movement. Social movement first came into existence in England and North America during the first decades of the nineteenth century and has since then spread across the globe (Tilly, 2004) From several indications it is apparent that the early growth of social movements was connected to broad economic and political changes including parliamentarisation, capitalisation, etc. Political movements that evolved in late 18th century, like those connected to the French Revolution and Polish Constitution of May 3, 1791 are among the first documented social movements, although Tilly notes that the British abolitionist movement has "some claims" to being the first social movement (becoming one between the sugar boycott of 1791 and the second great petition drive of 1806). The labour movement and socialist movement of the late 19th century are seen as the prototypical social movements, leading to the formation of communist and social democratic parties and organisations. From 1815, Britain after victory in the Napoleonic Wars

Heroes and Heroines in American Education Essay Example | Topics and Well Written Essays - 500 words

Heroes and Heroines in American Education - Essay Example Today, the United States is still the land of opportunity for the common man. Hundreds of thousands of people all over the world still would like to come to America and live here, centuries after the first European settlers made it their New World. And yet for young Americans, the heroes and heroines have increasingly been limited to what they see on television, films and those who excel in sports. This is due to the pervasiveness of media that has even taken over the role of educating the minds and ways of the youth, away from that of the schools and even to a certain extent, the family. Young people watch television many hours a day and even babies are weaned on cartoons. Likewise, Hollywood news and the latest victory of a Tiger Woods or a Roger Federer take much of the time and attention of youngsters. The way that young America is idolizing or making heroes out of actors and sports stars should be taken into a certain perspective in as much as the positive influence of empowerment is more often a case of make-believe (in the case of film stars for there is no sure way to tell the spin from the actual or the real ) and rarely goes beyond individual achievement (in the case of sports heroes, except probably with Michael Jor dan who was recognized not only a superb individual player but an outstanding team player as well). Real heroes and heroines on the othe

Exploring the Issues behind Patient-Assisted Suicide Essay Example for Free

Exploring the Issues behind Patient-Assisted Suicide Essay Death is as much a part of human existence, of human growth and development, like birth. All humans need to undergo all these processes as they journey through life. However, death sets a limit on our time in this world, and life culminates in death. However, when we intervene with some of these natural processes, problems arise because it intrudes in life’s natural processes. This is why, suicide is not just perceived as a medical problem because it also involves legal, ethical, social, personal, and financial considerations. It is not just morally reprehensible for a physician, or any medical practitioner, to assist the patient to conduct this procedure because it negates their responsibility to preserve life, suicide also devalues the life of the patient as its fate is put entirely in the hands of a human being to intrude with the natural process of things. For this reason, the debate over euthanasia (or patient-assisted suicide) involves many professionals, as well as the patients and their families. The arguments now have to do with the dignity of the patients, the quality of their lives, their mental state, and sometimes their usefulness to society. For example, the patient who is in a vegetative state is considered dead by some but not by others, and this case presents substantial ethical and logistical problems. The Oxford Dictionary of English (2005) defines euthanasia as â€Å"the painless killing of a patient suffering from an incurable and painful disease or in an irreversible coma†. However, euthanasia means much more than a â€Å"painless death†, or the means of procuring it, or the action of inducing it. The definition specifies only the manner of death, and if this were all that was implied a murderer, careful to drug his victim, could claim that his act was an act of euthanasia. We find this ridiculous because we take it for granted that in euthanasia it is death itself, not just the manner of death. How can someone administer a medical â€Å"procedure† to the one who dies in the end? If a person requests the termination of his or her life, the action is called voluntary euthanasia (and often also assisted suicide). If the person is not mentally competent to make an informed request, the action is called non-voluntary euthanasia. Both forms should be distinguished from involuntary euthanasia, which involves a person capable of making an informed request, but who has not done so. Involuntary euthanasia is universally condemned and plays no role in current moral controversies. A final set of distinctions appeals to the active–passive distinction: passive euthanasia involves letting someone die from a disease or injury, whereas active euthanasia involves taking active steps to end a person’s life. All of these distinctions suffer from borderline cases and various forms of ambiguity. The focus of recent public and philosophical controversy has been over voluntary active euthanasia (VAE), especially physician-assisted suicide. Supporters of VAE argue that there are cases in which relief from suffering supersedes all other consequences and that respect for autonomy obligates society to respect the decisions of those who elect euthanasia. If competent patients have a legal and moral right to refuse treatment that brings about their deaths, there is a similar right to enlist the assistance of physicians or others to help patients cause their deaths by an active means. Usually, supporters of VAE primarily look to circumstances in which (1) a condition has become overwhelmingly burdensome for a patient, (2) pain management for the patient is inadequate, and (3) only a physician seems capable of bringing relief (Dworkin, Frey Bok, 1998). One well-known incident that VAE came into the headlines was when it was provided by the bizarre activities of Dr.  Jack Kevorkian in early 1990s (or â€Å"Dr Death† as the media have dubbed him) in the USA. Dr. Kevorkian, a retired pathologist, assisted over forty people to commit suicide in recent years in circumstances which were somewhat removed from regular medical practice. These people travelled to Kevorkian from all over the USA to seek his assistance in suicide. He assisted them, sometimes by attaching them, in the back of his rusting Volkswagen van, to his suicide machine, which injected them with lethal drugs when they activated it. Despite being prosecuted for assisted suicide on several occasions, Kevorkian escaped conviction and continued his personal campaign for relaxation of the law in his peculiar way. It was only when he moved from assistance in suicide to euthanasia that he was finally convicted. He filmed himself administering a lethal injection, and the film helped secure his conviction for murder (Keown 2002, p. 31). Of course, his actions provoked discussion of the thin line separating passive euthanasia, which is legal in this country, and active euthanasia. Opponents of Kevorkian’s actions state that he is practicing assisted suicide, which is illegal. Proponents of Kevorkian’s actions argue that the patient’s right to control his or her medical treatment is sufficient justification for assisted suicide. Euthanasia is Not Ethical According to Somerville (2006), there are two major reasons why people should not allow euthanasia to be legalized. One is based on principle: it is wrong for one human to intentionally kill another (except in justified self-defense, or in the defense of others). The other reason is utilitarian: the harms and risks of legalizing euthanasia, to individuals in general and to society, far outweigh any benefits. While Mak, Elwyn Finlay (2006) reasoned that â€Å"most studies of euthanasia have been quantitative, focusing primarily on attitudes of healthcare professionals, relatives, and the public†. Pain is usually identified as a major reason for requesting euthanasia; other influences included functional impairment, dependency, burden, social isolation, depression, hopelessness, and issues of control and autonomy. This is why, Mak, Elwyn Finlay (2006) thought that legalizing euthanasia is a â€Å"premature† move when research evidence from the perspectives of those who desire euthanasia is not yet proven to be necessary. They said â€Å"more qualitative patient based studies are needed to broaden our understanding of patients†. What needs to be done, they deemed, should be the â€Å"inclusion of medical humanities, experiential learning, and reflective practice into medical education should help ensure doctors have better communication skills and attitudes†. By examining ways to improve care at all levels, healthcare professionals can eliminate the side effects of poor end of life care, then euthanasia would not be needed anymore. In 1988, the Journal of the American Medical Association published a statement on its take about patient-assisted suicide when a gynecology resident agreed to conduct assisted suicide to a young woman, dying of cancer, whom he has never seen before. Horrified by her severe distress, and proceeding alone without consultation with anyone, the doctor gives her a lethal injection of morphine. The publishing of this gynecology resident’s letter caused media hype and was featured in the previous issue in JAMA, where it was titled as â€Å"It’s Over Debbie† (1988). This is how the JAMA took its position regarding the matter: 1. ) On his own admission, the resident appears to have committed a felony: premeditated murder. Direct intentional homicide is a felony in all American jurisdictions, for which the plea of merciful motive is no excuse. That the homicide was clearly intentional is confirmed by the residents act of unrepentant publication. Law aside, the physician behaved altogether in a scandalously unprofessional and unethical manner. He did not know the patient: he had never seen her before, he did not study her chart, he did not converse with her or her family. He never spoke to her physician. He took as an unambiguous command her only words to him, Lets get this over with: he did not bother finding out what precisely she meant or whether she meant it wholeheartedly. He did not consider alternative ways of bringing her relief or comfort; instead of comfort, he gave her death. This is no humane and thoughtful physician succumbing with fear and trembling to the pressures and well-considered wishes of a patient well known to him, for whom there was truly no other recourse. This is, by his own account, an impulsive yet cold technician, arrogantly masquerading as a knight of compassion and humanity. (Indeed, so cavalier is the report and so cold-blooded the behavior, it strains our credulity to think that the story is true. ) Law and professional manner both aside, the resident violated one of the first and most hallowed canons of the medical ethic: doctors must not kill. Generations of physicians and commentators on medical ethics have underscored and held fast to the distinction between ceasing useless treatments (or allowing to die) and active, willful taking of life; at least since the Oath of Hippocrates, Western medicine has regarded the killing of patients, even on request, as a profound violation of the deepest meaning of the medical vocation. The Judicial Council of the American Medical Association in 1986, in an opinion regarding treatment of dying patients, affirmed the principle that a physician â€Å"should not intentionally cause death. † Neither legal tolerance nor the best bedside manner can ever make medical killing medically ethical (Baird Rosenbaum 1989, p. 26). Indeed, the laws of most nations and the codes of medical and research ethics from the Hippocratic Oath to today’s major professional codes strictly prohibit VAE (and all forms of merciful hastened death), even if a patient has a good reason for wanting to die. Although courts have often defended the rights of patients in cases of passive euthanasia, courts have rarely allowed any form of what they judged to be VAE. Those who defend laws and medical traditions opposed to VAE often appeal to either (1) professional-role obligations that prohibit killing or (2) the social consequences that would result from changing these traditions. The first argument is straightforward: killing patients is inconsistent with the roles of nursing, care-giving, and healing. The second argument is more complex and has been at the center of many discussions. This argument is referred to as the wedge argument or the slippery slope argument, and proceeds roughly as follows: although particular acts of active termination of life are sometimes morally justified, the social consequences of sanctioning such practices of killing would run serious risks of abuse and misuse and, on balance, would cause more harm than benefit. The argument is not that these negative consequences will occur immediately, but that they will grow incrementally over time, with an ever-increasing risk of unjustified termination (Dworkin, Frey Bok, 1998). Refusal of Treatment When a patient refuses treatment, the physician is faced with a great dilemma. Doctors maintain that if the patient does not want treatment, physicians do not have a duty to start it. Once treatment is started, however, physicians have a duty to continue it if discontinuing it would lead to the patients death. They are not required to force a patient to go on a respirator if the patient refuses, but once the patient has gone on the respirator, doctors have a duty to keep him on it, even contrary to the patients wishes, if taking him off would result in his death. Suffice it here to point out one important limit: a doctor is not ethically bound to assist a refusal of treatment which is suicidal, that is, made not because the treatment is futile or excessively burdensome but in order to hasten death (Keown, 2002, p. 253). Actual suicide has been a felony in England in the past but today, suicide has been decriminalized in most part of the world. Attempting to take ones own life, however, remains criminal in some jurisdictions. In these as well as in those states where it is not a crime, the state has intervened in some cases to order life-sustaining treatment in the face of objection by a competent adult. The most widely cited case in which this was done is John F. Kennedy Memorial Hospital v. Heston (1971), where a twenty-two-year-old unmarried woman refused a blood transfusion because she was a Jehovah’s Witness. She was forced to have one anyway on the theory that there is no difference between passively submitting to death and actively seeking it. The state regards both as attempts at self-destruction and may prevent them. Since this case, however, the trend of cases has been away from this reasoning and toward subordinating the states interest in the prevention of suicide to the rights of patients to forgo or have withdrawn life-sustaining treatment (Berger 1995, p. 20). However, when the patient is terminal and death is imminent, no treatment is medically indicated, and the competent patient’s rightful refusal of treatment does not conflict with the health provider’s form of beneficence. There may be an emotional problem in admitting defeat, but there should be no ethical problem. It should be noted that, although the patient may not be competent at the end, refusal of treatment may be accomplished through a living will or a surrogate, especially through a surrogate who has durable power of attorney for health matters. In the case when the patient is terminal but death is not imminent, for example when the disease or injury progresses slowly, and granted the consent of the patient or surrogate, it appears ethical to omit treatment on the ground that nothing can be accomplished in thwarting the progress of the disease. But it is not ethical to omit care, since human dignity is to be respected. To solve this dilemma, the AMA Council on Ethical and Judicial Affairs (1996) takes a clear stand on the issue: E-2. 20 Even if the patient is not terminally ill or permanently unconscious, it is not unethical to discontinue all means of life-sustaining medical treatment in accordance with a proper substituted judgment or best interests analysis. The treatments include artificially supplied respiration, nutrition, or hydration. In its recent opposition to physician-assisted suicide, the AMA has strongly endorsed a program to educate physicians to the appropriateness of switching from therapeutic treatment to palliative care. The group has gone from a tentative, negative position (â€Å"not unethical†) to a much stronger positive stand (AMA, 1996). On the other hand, we should also consider the reasoning behind the ethical correctness of not beginning or of stopping treatment in the case of the consenting patient who is terminally ill. First, the health care provider has no obligation to prolong dying merely for the sake of prolonging it. That is, it makes no sense to prolong life when the true result is the prolongation of the dying process. Furthermore, when treatment is only prolonging the agony of the patient, its continuation is unethical as an insult to human dignity (Cahill, 1977). In such cases, the health care provider would be ethically justified in discontinuing treatment, except when the patient insists on treatment. Even in this case, however, there can be exceptions. When there is a severe shortage of medical resources, the physician might be justified in stopping nonindicated treatment even over the protests of the patient. We say â€Å"might be justified,† since justification would depend, among other things, on a new social consensus about the duties of health care professionals and on a reasonable certainty that a shortage exists. There are also problems in discontinuing treatment when the patient’s surrogate(s) objects. It should be noted that cessation of life-sustaining treatment does not always bring about a swift and painless death, even though it may speed up the process of dying. For example, if kidney dialysis is discontinued, the person remains conscious and suffers vomiting, internal hemorrhage, and convulsions. The removal of a respirator does not lead to death immediately, and the patient suffers the pain and panic of suffocation. The obligation to care for the patient demands that every ethical effort be made to alleviate these sufferings with drugs and other methods that will not prolong life. Much recent research suggests that physicians are particularly deficient in their willingness and ability to provide adequate pain palliation for dying patients (SUPPORT, 1995). This could be one of the main concerns that drive the interest in physician-assisted suicide. Beyond this, when such pain relief is not possible for the patient, or when the harm is not the pain, but the insult to dignity, there arises the difficult problem of actively cooperating in the suicide of the patient. Religious Issues Several religions have a negative take on any form of suicide. Those who oppose active euthanasia on religious grounds, the basic concern seems to be the view that our lives are not ours but gifts from God. In this view, humans hold their lives as a trust. If this is true, then we are bound to hold not only the lives of others inviolate but also our own, since to take our life is to destroy what belongs to God. For Christians, in Exodus 34:7 and Daniel 13:53, scriptures taken from the Old Testament, the doctrine of the sanctity of life principle is upheld, except in rare instances of self defense. Judeo-Christian precepts generally condemn active euthanasia in any form, but allow some forms of passive euthanasia. The difference is that of omission and commission: While the Judeo-Christian philosophy might tolerate the allowance of death, acts that permit death, it draws the line in regard to acts that cause death. For Buddhists, they perceive it as an involvement of the intentional taking of life. This is why euthanasia is contrary to basic Buddhist ethical teachings because it violates the first of the Five Precepts. It is also contrary to the more general moral principle of ahimsa. This conclusion applies to both the active and passive forms of the practice, even when accompanied by a compassionate motivation with the end of avoiding suffering. The term ‘euthanasia’ has no direct equivalent in canonical Buddhist languages. Euthanasia as an ethical issue is not explicitly discussed in canonical or commentarial sources, and no clear cases of euthanasia are reported. However, there are canonical cases of suicide and attempted suicide which have a bearing on the issue. One concerns the monastic precept against taking life, the third of the four parajika-dharmas, which was introduced by the Buddha when a group of monks became disenchanted with life and began to kill themselves, some dying by their own hand and others with the aid of an intermediary. The Buddha intervened to prevent this, thus apparently introducing a prohibition on voluntary euthanasia. In other situations where monks in great pain contemplated suicide they are encouraged to turn their thoughts away from this and to use their experience as a means to developing insight into the nature of suffering and impermanence (anitya) (Dictionary of Buddhism, 2003). Nonreligious arguments against active euthanasia usually follow a slippery slope or wedge line of reasoning. In some ways the arguments recall the parable of the camel who pleaded with his owner to be allowed to put his nose into the tent to keep it warm against the cold desert night. Once the nose was allowed, other adjustments were requested, and the owner found himself sleeping with his camel. Is there something so persuasive about putting others to death that, if allowed, would become gross and commonplace? The Nazi â€Å"final solution,† which brought about the death of millions of Jews, gypsies, and other eastern Europeans, could be traced to compulsory euthanasia legislation that, at the time of its enactment, included only mental cases, monstrosities, and incurables who were a burden of the state. Using the Nazi experience as a guide, critics of active euthanasia do see some seductiveness to killing that humans do not seem able to handle. Perhaps Sigmund Freud (1925) was right as he wrote: What no human soul desires there is no need to prohibit; it is automatically excluded. The very emphasis of the commandment â€Å"Thou shalt not kill† makes it certain that we spring from an endless ancestry of murderers, with whom the lust for killing was in the blood, as possibly it is to this day with ourselves. The religious take on euthanasia often focus on the sanctity/inviolability of life. In Western thought, the development of the principle has owed much to the Judaeo-Christian tradition. That tradition’s doctrine of the sanctity of life holds that human life is created in the image of God and is, therefore, possessed of an intrinsic dignity which entitles it to protection from unjust attack. With or without this theological underpinning, the doctrine that human life possesses an intrinsic dignity grounds the principle that one must never intentionally kill an innocent human being. The right to life is essentially a right not to be intentionally killed (Keown, 2002, p. 40).

CompInnova System Project Requirements

CompInnova System Project Requirements The CompInnova project is focused upon the development of an innovative inspection methodology, with automated and manual capabilities, for any type of composite and metallic aircraft structures. Within this report, project requirements and specifications related to structural integrity, damage repair and development of a vortex robot, are presented and discussed in the following order: A qualified Phased Array (PA) method related to the structural integrity approach, is an advanced non-destructive testing method used to detect component failures (i.e. cracks), and can be used to assess the component condition. It is presented in chapter 2. An Infrared Thermography (IRT) method, also related the structural integrity approach, is used to determine the presence of flaws by monitoring the flow of heat over a surface, and is presented in chapter 3. A Damage Tolerance (DT) structural integrity assessment technique is used to fracture load for a specified defect size, and predict the required length of time for a sub-critical defect to grow to the size that causes fracture at given load. The DT is presented in chapter 4. Following the structural integrity assessment, a preliminary assessment of the specifications of the repair module of the vortex robot is presented in chapter 5, with the repair module envisaged to perform scarfing or stepped lap repairs on composites as well as bonding repairs on metals. The repair module, as well as the structural integrity assessment systems, is a part of a vortex robot, for which a detailed overview of the existing state of the art in NDT robotic technology is presented in chapter 6. In addition, an overview of the determined project requirements and specifications related to the proposed NDT novel vortex robotic mechanism is presented as well. The project requirements for the CompInnova system has been drafted and agreed by all the participants in this document. Phase Array (PA) technique is an advanced non-destructive testing method used to detect component failures. PA is used for in service inspection and characterization of faults in metallic, as well as composite components. PA uses transducers made up of individual elements that can each be independently driven, by which it is able to decrease the complexity and the handling of an ultrasonic testing system. The PA probes are connected to specially adapted drive units with independent, simultaneous emission and reception along each channel. 2.1 Phased Array Transducer The PAUT transducer should be a linear array transducer with number of elements between 16 and 128 and the central frequency should be ranged between 2 and 5 MHz so that minimum ultrasonic inspection requirements are satisfied for a range of different material structures. The element pitch would be between 0.5 and 0.8 mm (high resolution probe) and it will be defined according to the minimum detectable defect, the properties of the scanned samples and the quality of the acquired ultrasonic images. Furthermore, the array aperture (coverage area rate parameter) and the element length would be finally determined according to the final array specifications. The moving velocity for the array would be approximately 20mm/sec and dependent on the characteristics of the scanned sample for flat or slightly curved surfaces. The transducer would be able to be connected with any PA system via an array interface (i.e. 128 element Hypertronics generic array interface) with cable length that will be defined by the needs of the outdoor inspections required (i.e. required manipulation region of the probe, especially on large structures) and the quality of ultrasonic data acquired. The array should have the capability to directly be integrated in any manipulator for automated operation however it would also be possible to be used in manual inspection procedures with encoded capability along the movement direction with the aid of special encoding configuration that will be continuously attached with the array. By marking the necessary inspection paths on the sample surface and performing several passes with the probe, large areas can be inspected manually. The wedge coupled with the array would have a thickness between 30 and 35 mm and with an angle that is always dependent on the inspection sample thickness (i. e. make sure that reference signals like front and back wall echoes are detectable and visible) and the type of incidence wave required (i.e. longitudinal or shear wave). Precautions will be taken in order to maintain the array at a proper contact arrangement with the testing surface. Water mist, gel or combination of both, are used as a couplant before scanning. The phased array probe would have potential to be interconnected with PA instruments and effectively all the necessary functions for ultrasonic inspection procedure can be performed by the integrated system, which are: automatic recognition of the installed ultrasonic transducer by the PA instrument, ultrasonic array element configuration, system calibration for reliable inspections, gathering of acquired ultrasonic data, A-scan, B-scan and C-scan imaging of data, real time or post processing of acquired data, interconnection with manipulators for acquisition of probe X-Y-Z position, mapping software development for the acquired ultrasonic data, and editing, storing and loading of array configurations. 2.2 Ultrasonic Data Acquisition Mapping Software Ultrasonic data acquisition mapping software would be developed with the aid of installed software environment (i.e. Labview environment) on the PA instrument and therefore processing and visualization of the acquired ultrasonic data can be obtained. All the element firing and probe-wedge configurations can be modified within the software environment. More specifically the user determines the scanning method (linear, half step or FMC) and the number of active elements. This is a procedure that allows the user to adjust all the involved parameters of the ultrasonic hardware by carefully interfacing with the software. Figure 2.1: Representation of an Ultrasonic Data Acquisition Mapping Software The parameters of array and wedge operation can be adjusted. Operating frequency, active aperture elements, beam step, acquire elements and wedge geometry can be set according to the inspection requirements. Array and wedge geometries can be saved or loaded. After the setting of the array-wedge configuration and all the data from PAUT and manipulator are available the scanning can commence. When operating, any type of acquisition display (A scan, B scan or C scan) would be available and so watch the progress of the inspection. Sizing of defects or regions of interest can take place using different image processing techniques or by simply implementing the typical 6db method. 2.3 Conclusion The PA technique will be employed within the advanced defect detection software for detecting very small size flaws in aircraft structures, while achieving a high POD without increasing the scanning time dramatically. This is achievable with the PA technique, since it is able to reduce the amount of sensors as well as the overall complexity of the system applied, while enabling independent and simultaneous emission and reception along each channel.

Stevensons Use of Literary Techniques in The Strange Case of Dr. Jekyl

Stevenson's Use of Literary Techniques in The Strange Case of Dr. Jekyll and Mr. Hyde In his novella "Dr Jekyll and Mr Hyde", Robert Louis Stevenson explores the dual nature of Victorian man, and his link with an age of hypocrisy. Whilst writing the story he obviously wanted to show the people of the time what happened behind closed doors. In Jekyll's suicide note he makes the following observation " I have observed that when I wore the semblance of Edward Hyde, none could come near to me at first without a visible misgiving of the flesh. This, as I take it, was because all human beings, as we meet them, are commingled out of good and evil: and Edward Hyde, alone in the ranks of mankind, was pure evil." I believe that the underlying moral of this novella is that we are all comprised of good and evil, and that we should possess the ability to control and acknowledge the darker side of ourselves. Dr Jekyll is described as "a large, well made, smooth-faced man of fifty, with something of a slyish cast perhaps, but every mark of capacity and kindness". However, when angered "The large handsome face of Dr Jekyll grew pale to the very lips, and there came a blackness about his eyes". He is a very strong-minded man, as he argues about his will with Mr Utterson, however he does become addicted to Hyde, and too weak to oppose him. Mr Utterson after meeting Hyde for the first time, starts to feel sorry for his friend, however he does suggest that Jekyll has a dark past "was wild when he was young; a long while ago to be sure". Mr Hyde is presented as a very dark and sinister character. Hyde " was small and very plainly dressed, and the look of him, even at a distance, went somehow against the watcher's incli... ...l's mind to kill them both. By Jekyll killing, himself he sets both him, and Hyde free, although it is Hyde who is found when the cabinet door is forced open. This is because when Jekyll dies, he is emotionally and physically venerable, and Hyde shines through. So theoretically, it is Mr Hyde continues to exist temporarily when Dr Jekyll is gone. Therefore, I conclude that Stevenson explores the duality, which lies within man very well and aptly describes this phenomena in Jekyll's suicide note when he writes, " all human beings, as we meet them, are commingled out of good and evil". However, I feel that he has not truly exploited the capabilities that could have been developed when sculpting Hyde's character. Jekyll's original experiment was to try to create a purely good man, however, he just ends up destroying his experiment and eventually himself.

Accounting Ethics Essay -- essays research papers

paper will discuss the public perception of CPAs in today's society, pitfalls that they may encounter, methods to prevent some of these negative behaviors and consequences they may face should they fall short. Most "Who Do You Trust?" surveys rank politicians, lawyers and used car salesmen at the bottom and certified public accountants at the top. That is because the CPA profession has a squeaky clean image--anal-retentive little wimps who wear thick glasses and cannot get a date. CPAs are known and respected for their honesty. The profession that goes out of its way to project that image, and there is a certain amount of truth to it. Not all accountants are anal-retentive little wimps who cannot get a date. Many of them are quite articulate. Some are quite lovely, in some schools, more than half of the accounting majors are women. Also, not all CPAs are squeaky clean and respected for their honesty. Some are quite dishonest and are putting a black mark on the image of the entire profession. There is one area where the CPA profession has fallen short of protecting the public interest. The general duty that accountants owe to their clients and the other persons who are affected by their actions is to "exercise the skill and care of the ordinarily prudent accountant" in the same circumstances. Two elements compose the general duty of performance: skill and care. Another element and responsibility is owed to clients and other persons, that is that accountants should observe a standard of ethical or social responsibility. One set of difficulties concerns ethics education's ability to instill the chosen values and to make them stick after the educational process is completed. Instru ction in accounting ethics is directed at people whose character-or lack there-of-has largely been formed by the time the instruction occurs. Although such instruction should increase the moral awareness of those who are already predisposed to listen, its effect on the basically self-interested, indifferent, or unethical is questionable. Even those who are positively influenced by ethics instruction, moreover, may still behave irresponsibly if their careers or their livelihoods require them to act in their client's financial interest. Recent pressure to include more ethics instruction in the accounting classroom has placed an emphasis on individuals who have a sen... ... the trust instilled in me very seriously. I hope that this paper has enlightened you to the pitfalls many certified public accountants face today, both with ethical standards and with impending educational requirements. Reference Page Fulmer, W.E. and B.R. Cargile: 1987, "Ethical Perceptions of Accounting Students: Does Exposure to a Code of Professional Ethics Help?" Issues in Accounting Education 2, 207-219. Loeb, S.E.: 1988, "Teaching Students Accounting Ethics: Some Crucial Issues', Issues in Accounting Education 3, 316-329. Metzger, J.D.: 1992. "Business Law and the Regulatory Environment: Consepts and Cases 8th Edition. 1061. McGee, Robert W., "CPAs vs. the Public Interest". Dumont Institute, Ethic Information Center. 1. Whiteck, C: 1992, 'The Trouble with Dilemmas: Rethinking Applied Ethic', Professional Ethics 1, 119-142. er, J.D.: 1992. "Business Law and the Regulatory Environment: Consepts and Cases 8th Edition. 1061. McGee, Robert W., "CPAs vs. the Public Interest". Dumont Institute, Ethic Information Center. 1. Whiteck, C: 1992, 'The Trouble with Dilemmas: Rethinking Applied Ethic', Professional Ethics 1, 119-142.

Developing Communication and Interpersonal Skills: Continuing Professional Development ?

Introduction The Nursing and Midwifery Council (NMC) has set out at least four domains of competencies for entry to the register in Adult Nursing. In this brief, I will focus on the second domain of communication and interpersonal skills. Communication plays a crucial role in addressing the needs of the patients. Adult nurses are expected to communicate effectively, listen with empathy and advocate for their patients (Department of Health, 2012a, 2012b). Specifically, the Department of Health (Commissioning Board Chief Nursing Officer and DH Chief Nursing Adviser, 2012) has introduced the 6 Cs of nursing, which encompasses compassion in nursing practice. Compassion in care is only possible when patients feel that their nurses understand their feelings and show empathy (Chambers and Ryder, 2009). Communication is essential in helping patients articulate their needs (Hall, 2005). Similarly, poor communication could result to misunderstanding, anxiety for the patients and poor quality of care (Chamb ers and Ryder, 2009). In this brief I will focus on the domain of communication and interpersonal skills since these form the foundation of my relationships with my patients. Developing my competency in this domain would help me identify both verbal and non-verbal messages of the patients and address their needs accordingly. Meanwhile, effective communication is needed when I communicate with my colleagues and other healthcare practitioners. A focus on my communication skills with my patients will be made in this reflective brief. Communicating effectively with my patients and other health and social care professionals would help improve the care received by my patients. Benner’s (1984) stages of clinical competence would be used to underpin my development from novice to competent. Gibb’s (1988) reflective model will be utilised to reflect on my experiences in the last three years from novice to competent. Professional Development from Novice to Competent Level Reflective practice (Gibbs, 1988) allows healthcare practitioners to improve current practice by learning from incidents and one’s own experiences. Pearson et al. (2009) explains that one’s own experiences are another form of evidence in healthcare. With the focus on patient-centred care, the NHS (Department of Health, 2012b) has encouraged evidence-based care when addressing the needs of the patients. I will use Gibbs (1988) model in reflecting on my communication experiences in years 1 to 3. This model starts with a description of an incident followed by analysis, evaluation, conclusion and action plan. An incident during my year 1 exemplifies how I developed my communication and interpersonal skills as a novice. I was assigned to the mental health ward and assisted an elderly patient with dementia who was admitted for pneumonia. During his first day in the hospital, my senior nurse performed a nutritional assessment and informed me that I should assist the patient during feeding time. This was consistent with the Patient Mealtime Initiative (PMI) (NHS, 2007) implemented in our ward. As a student nurse, I would be assist the patient to self-feed and make his environment comfortable and uncluttered. During mealtime, I talked to the patient and informed him that I would assist him in eating his food. He stared at the wall and did not respond. I gently asked him if he was ready to eat. When he turned to me, I informed him that he could now start eating. He only stared at his food and did not seem to understand my instructions. I placed the utensils near his hand so he could grab it and eat. When he did not respond, I asked him if he wanted me to help him eat. After a few minutes, he got his spoon and held it for a few minutes. I began to realise that he did not seem to understand my instructions so I started to place the spoon with food in his mouth and gently touched his chin to remind him to chew his food. My senior nurse passed by and informed that I have to put some pressure on the patient’s chin and make some chewing motions to help remind him that he needs to chew his food. It took me an hour to feed my patient. On reflection, communicating with older patients with dementia could be a challenge. Most of these patients suffer from cognitive impairments, which make it difficult for them to communicate their feelings and concerns (NICE, 2006). A significant number of older patients with dementia who are admitted in hospital wards are underweight (World Health Organization, 2014). Jensen et al. (2010) explain that many of these patients have forgotten how to eat and chew their food while others lack cognitive abilities in understanding instructions on feeding. Hence, the National Institute for Health and Clinical Excellence (NICE, 2006) guideline on nutrition for older patients highlights the importance of assisting the patients during feeding. For patients in the advanced stages of dementia, the main aim of nutrition is to maintain hydration and comfort feeding. Meanwhile, some patients could also suffer from swallowing problems, making it more difficult to ingest food (Lin et al., 2010). The hospital ward environment is also new to older patients with dementia and might trigger anxiety and fear (Lin et al., 2010). Since patients are in unfamiliar surroundings with unfamiliar people, they might express their fears and anxieties through aversive behaviours (NICE, 2006). It is shown that nurses react negatively to aversive behaviours of older patients with dementia (Jensen et al., 2010). On reflection, the incident taught me to be more patient and to understand both verbal and non-verbal messages. It took some time for me to realise that I have to feed the patient since he appeared confused. I was also unprepared on how to communicate with an older patient with dementia. As a novice nurse, my feelings and apprehensions are normal and are also shared by other nurses (Cole, 2012; Murray, 2006). Best and Evans (2013) have shown that nurses feel unprepared to communicate and care for older patients with dementia. On reflection, I should continue with my professional develop ment by joining training and seminar on how to communicate with older patients with dementia and address their nutritional needs. When faced with a similar situation in the future, I am better prepared and would not need more supervision from senior nurses on how to communicate with older patients with dementia and address their needs. For instance, I am now aware that these patients have difficulty verbalising their needs and I have to be sensitive of non-verbal cues and interpret aversive behaviour as possible signs of distress, anxiety or fear (Best and Evans, 2013). The second incident occurred during year 2 in my placement in the Urology Department. At this stage, I already considered myself as an advanced beginner (Benner, 1984). I was assigned to care for a 45-year old male patient who was admitted due to testicular pain. I introduced myself to the patient and informed him that I was part of a team that would be caring for him during his hospital admission. I noticed that he was uncomfortable communicating with a student nurse and asked for a more senior nurse. I gently informed him that my senior nurse was supervising other student nurses and he was left to my care. I tried to communicate and noticed that he had difficulty with the English language. I asked him if he needed a language interpreter. Once an interpreter was identified and assisted me with communicating with my patient, I noticed a change in his behaviour. He began to open up and was willing to take his prescribed medications. I slowly understood that he was anxious about his co ndition and wanted a male nurse with the same ethnic background to be his nurse. When he realised that most of the nursing staff are composed of female nurses, he began to accept me as his nurse. On reflection, this incident illustrates the importance of taking into account individual differences and using communication strategies to understand the patient’s needs. Specifically, I became aware that he had difficulty with the English language. The act of getting an interpreter greatly improved our communication. One of the competencies stated under communication states that nurses should be able to use different communication strategies in order to identify and address the patient’s needs (Nursing and Midwifery Council, 2010; National Patient Safety Association, 2009). It was apparent that the patient was self-conscious that a female nurse was addressing his needs. It is shown that a patient’s perception about his condition is also influenced by their cultural beliefs and ethnicity (Department of Health, 2012b). He was uncomfortable that a female nurse was providing care when he was suffering from testicular pain. However, the patient shares similar ethnic background as the interpreter and only became comfortable when the interpreter assured him that he could trust me. I realised that patients with different cultural background could be anxious about their treatment and might have difficulty communicating. On evaluation, I felt that I was able to address the immediate language barrier gap by getting an interpreter to help me communicate with the patient. My experiences during my first year in placement with patients who have different ethnic backgrounds and have difficulty expressing themselves in English helped me prepare for this situation. As Benner (1984) stated, nurses develop competency through experiences. I felt that I have improved on my communication skills and have achieved the advanced beginner level during year 2. Being sensitive to the communication needs of my patient is also consistent with the 6 Cs of nursing (Commissioning Board Chief Nursing Officer and DH Chief Nursing Adviser). In this policy paper, nurses are encouraged to show compassion in caring through effective communication. On analysis, I could have improved my communication skills by learning how to communicate with patients with different cultural beliefs about human sexuality. The patient was shy that a female nurse is part of the healthcare team managing his testicular pain. As part of my professional development and action plan, I will participate in training and seminars on how to communicate about health issues, such as testicular pain, that are considered sensitive and may carry some cultural taboo. The third incident happened during year 3, in my placement in the surgical ward for orthopaedic patients. At this stage, my previous experiences in communicating with patients during year 1 and 2 have helped me develop important communication skills. These included recognising non-verbal messages, understanding how culture influences my patients’ perceptions of nurses and the care they receive. Culture plays a crucial role in how patients place meanings on the words and symbols I use when communicating (Funnell et al., 2009). Apart from culture, I realised that the patient’s own perceptions of the illness and pain they are experiencing could also influence the quality of our communication. In the incident, I was assigned to assess the level of post-operative pain of a patient after surgical operation. He was a 32-year old male and was unable to communicate even after four hours of surgery. I tried to communicate with him to help assess his level of pain. Since he could not verbalise his level of pain, I used the visual analogue scale (VAS) to identify the level of pain. On analysis, I felt that I have done the right thing and have fulfilled one of the competencies under the domain of communication. Specifically, the NMC (2010) states that nurses should be able to use different communication strategies to support patient-centred care. The use of the VAS helped the patient articulate his level of pain. The VAS is often used as a tool in healthcare practice when assessing the patient’s level of pain. This tool is reliable and has been validated in different settings (Fadaizadeh et al., 2009). On analysis, my personal experiences in the last three years helped me be come acquainted with current guidelines on pain assessment. It also helped me identify a simple but valid and reliable tool in assessing patient’s level of pain. Pain perception in post-operative patients is highly subjective and could be influenced by several factors (Gagliese and Katz, 2003). These include age, gender, prior pain experience, medications and culture (Lavernia et al., 2011; Grinstein-Cohen et al., 2009; Gagliese and Katz, 2003). Regardless of the factors that influence pain, nurses should be able to assess the patient’s pain accurately and communicate with the patient strategies on how to control pain (Clancy et al., 2005). Hence, communication is crucial in ensuring quality post-operative care. On reflection, I was aware that the patient has difficulty communicating. Hence, choosing a more complex tool in assessing pain could add to more distress and anxiety for the patient (Gagliese and Katz, 2003). I realised that choosing a simple assessment tool helped calm down the patient since I was able to deliver care appropriately. On reflection, I would follow similar procedures in the future. However, I would improve my knowledge on pain assessment by participating in pain education nursing classes in university or in the hospital where I am assigned. This would form part of my continuing professional development and action plan. Abdalrahim et al. (2011) argue that nurses with high knowledge on patient education are more likely to accurately assess patient pain, leading to earlier relief and management of the patient’s pain. However, Francis and Fitzpatrick (2013) express that despite high levels of knowledge on pain management, there are some nurses who have difficulty translating this knowledge into actual practice. One of my roles as a nurse in an orthopaedic surgical ward is to manage post-operative pain of my patients. Failing to manage pain could lead to chronic pain, longer hospital stays and poorer health outcomes (Grinstein-Cohen et al., 2009). I also realised that effective communication with patients is needed to ensure that the patient’s needs are addressed. Conclusion In conclusion, the three incidents portrayed in this reflective brief demonstrate how I evolved as a nurse practitioner from novice to competent. Specifically, my communication skills have developed from year 1 until Year 3. In the first incident, I had difficulty communicating with older patients with dementia. Beginner nurse practitioners have no experience in the situations they find themselves in. This was true in my experience with the older patient with dementia. It was my first time at communicating with a patient with cognitive impairment and feeding him. I lacked confidence in carrying out the task and only improved after several meetings with the client. However, in year 2, my communication skills improved. For instance, I was able to immediately identify the needs of the patients by depending on verbal cues and non-verbal messages of the client. I was able to get an interpreter and communicate with him. However, I also realised that I still need to improve by participating in classes and training on how to communicate effectively with patients with different ethnic background. Finally, in year 3, I was now more competent in communicating with patients. Even when the patient in post-operative care could not communicate, I was aware that he was in pain. I was also able to use an appropriate assessment tool that is consistent with the guidelines in our hospital. I realised that I possess more confidence in communicating with the patient and identifying his needs. My previous experiences in communicating with different groups of patients helped me become competent in identifying the needs of the patients. Importantly, care was delivered promptly since I was able to appropriately assess the level of pain of the patient. All these three experiences show that I could hone my skills in communication. My communication experiences in nursing will help me become more competent and ready as a future nurse registrant. References Abdalrahim, M., Majali, S., Stomberg, M. & Bergbom, I. (2011) ‘The effect of postoperative pain management program on improving nurses’ knowledge and attitudes toward pain’, Nurse Education in Practice, 11(4), pp. 250-255. Benner, P. (1984) From Novice to Expert: Excellence and power in clinical nursing practice, Menlo Park: Addison-Wesley. Best, C. & Evans, L. (2013) ‘Identification and management of patients’ nutritional needs’, Nursing Older People, 25(3), pp. 303-6. Chambers, C. & Ryder, E. (2009) Compassion and caring in nursing, London: Radcliffe Publishing. Clancy, C., Farquhar, M. & Sharp, B. (2005) ‘Patient safety in nursing practice’, Journal of Nursing Care Quality, 20(3), pp. 193-197. Cole, D. (2012) ‘Optimising nutrition for older people with dementia’, Nursing Standard, 26(20), pp. 41-48. Commissioning Board Chief Nursing Officer and DH Chief Nursing Adviser (2012) Compassion in Practice, London: Department of Health. Department of Health (2012a) The Power of Information, London: Department of Health. Department of Health (2012b) Bringing clarity to quality in care and support, London: Department of Health. Fadaizadeh, L., Emami, H. & Samii, K. (2009) ‘Comparison of visual analogue scale and faces rating in measuring acute postoperative pain’, Archives of Iranian Medicine, 12(1), pp. 73-75. Francis, L. and Fitzpatrick, J. (2013) ‘Postoperative pain: Nurses’ knowledge and patients’ experiences’, Pain Management Nursing, 14(4), pp. 351-357. Funnell, R., Koutoukidis, G., and Lawrence, K. (2009) Tabbner’s nursing care: Theory and practice, 5th Edition, Chatswood, London: Elsevier. Gagliese, L. and Katz, J. (2003) ‘Age differences in postoperative pain are scale dependent: a comparison of measures of pain intensity and quality in younger and older surgical patients’, Pain, 103(1-2), pp.11-20. Gibbs, G. (1988) Learning by doing: A guide to teaching and learning methods, Oxford: Further Educational Unit, Oxford Polytechnic. Grinstein-Cohen, O., Sarid, O., Attar, D., Pilpel, D. and Elhayany, E. (2009) ‘Improvements and Difficulties in Postoperative Pain Management’, Orthopaedic Nursing, 28(5), pp. 232-239. Hall, L. (2005) Quality work environments for nurse and patient safety, London: Jones & Bartlett Learning. Jensen, G., Mirtallo, J., Compher, C., Dhaliwal, R., Forbes, A., Grijalba, R., Hardy, G., Kondrup, J., Labadarios, D., Nyulasi, I., Castillo Pineda, J. & Waitzberg, D. 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