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Physician Assisted Suicide Response

Physician Assisted Suicide Response

Introduction

The term physician assisted suicide (PAS) as applied to medial world refers to the practice carried by physicians on terminally ill patients by prescribing them medications to them with the sole purpose of terminating their own life. In the year 2009, my grandmother the praiseworthy Clare Daniels was dying. This American battle heroine had made a call to pass on with dignity. She was dealing with a hypertension, failed kidney, a broken hip, dementia, MRSA foot infection, pneumonia, and worst of all a horrible living conditions at a nursing house. All these complications and problems left her extremely frail and physically reliant on others. For fatally ill patients similar to my grandmother, where demise was unavoidable and would have arguably been less agonizing than alive, euthanasia should be an alternative or thought. Euthanasia is a means of relieving severely or fatally ill people’s hurting and save them from the misery of their sickness (Steinbock 2004).

Physician assisted suicide when though in a wider general view is not about health practioners or rather physicians becoming murderers or being seen as killers by the outside world. This act is on the subject of patients whose pain and torment we can’t ease and on not turn a blind eye on them when they request for help out. On this issue will there be medical doctors who believe they cannot carry out this? Of course they are there, and they shouldn’t be gratified to. However if additional doctors deem it compassionate to assist such patients by simply writing a recommendation, it is irrational to put them in danger of criminal trial, loss of certificate, or further punishment for doing so (CBCNEWS 2012).

Numerous opinions are put further for keeping the ban in opposition to physician-assisted suicide; nevertheless I strongly suppose they are outweighed by two primary philosophies that support ending the prohibition: the doctor’s obligation to ease anguish and the patient sovereignty that is the right to be in command of one’s personal body.

Humanity distinguishes the proficient patient’s right to sovereignty which is definitely to make a decision what will be done or will not be executed to her or his body. There is approximately general conformity that a capable grown-up he or she has the total right to self-rule and determination, which include the autonomy to have life-supporting medication suspended or inhibited. Suicide, a long time ago termed as unlawful all through the United States, is no more against the law in any region of the nation. Nonetheless supporting someone to take his or her personal life is forbidden in each state except Oregon. If patients request for such aid, it is extremely unkind and against mankind ethics to run off and go away leaving them to fend on their  own, weighing choices that are together indecisive and distressing, when humanitarian help and support may possibly be made obtainable (Emanuel (n.d.)

The medical doctor’s responsibilities are numerous however; when treatment is unattainable and palliation has at large futile to attain its purpose, there is at all times a remaining compulsion or rather duty to alleviate pain. At the end of the day, if the doctor has finished every one of rational analgesic procedures, it is the person ill furthermore merely him or her who be able to decide whether passing away is detrimental or a fine to be wanted. Marcia Angell, who is the previous supervisory editor of the New England Journal of Medicine, has argued the issue this way:

“The highest ethical imperative of doctors should be to provide care in whatever way best serves patients’ interests, in accord with each patient’s wishes, not with a theoretical commitment to preserve life no matter what the cost in suffering. . . . The greatest harm we can do is to consign a desperate patient to unbearable Suffering – or force the patient to seek out a stranger like Dr. Kevorkian” (Massachusetts medical society, 1997).

Subsequent arguments are always put across that wishes for aided suicide appear for the most part from sick persons who have not given sufficient ache control or those who are medically miserable and have not been correctly treated or analyzed. There isn’t inquiry that appropriate administration of such situations would considerably lessen the amount of sick people who think about suicide; whichever sanctioning of help ought to be dependent on previous administration of misery and ache (Emanuel n.d.).

On the other hand, treatable hurting isn’t the solitary cause, or still the mainly ordinary basis, why sick people inquire about ending their life. Harsh body wasting, immobility, bladder and urinary incontinence, entirety reliance, and stubborn nausea are renowned more additionally significant than hurting in the wish for speedier demise. There is a rising alertness that breakdown of decorum and of those qualities that we relate predominantly through having humanity are the aspects that mainly normally lessen the ill people to a condition of desperation and unmitigated depression (Kirkland 2010).

Moreover, a number of patients apologetically have taken away their personal life at a comparatively premature phase of life-threatening sickness specifically for the reason that they dreaded that increasingly rising disability, with no any person to help them, would deprive them of this choice at a later on instance at which they were really desperate. A sick person contemplating to take her/his owns life would be greatly less probable to get such like step if she or he were in no doubt of getting help in the forthcoming times if so preferred.

Life is the mainly valuable present ever, and no rational human being wishes to take that away, although there are several situations where living has nearly lost its worth. A proficient individual who has considerately well thought-out her or his own condition and discovers that unmitigated anguish overweighs the importance of sustained life sincerely arguing shouldn’t have to go hungry to passing away or locate other aggressive and extreme solutions when remarkably more compassionate ways present. Those doctors who desire to accomplish what they distinguish to be wholly their humanitarian tasks to their sick persons definitely shouldn’t be strained by legislative ban into secret actions.

There isn’t safe resolution to these incredibly receptive troubles. Nonetheless, I strongly deem that rational safeguard can be set in position that will lessen the jeopardy of misuse and also that the compassionate importance of legalizing doctor or rather the commonly called physician assisted suicide overweighs that danger. All medial practioners are bind by the sanction to carry out no hurt, however we have to identify that hurt may come about not just from the order of a unlawful act but it can also emanate from the exception of an deed of compassion. Whilst not each doctor will consider contented giving aid in these dreadful conditions, many deem it is true to carry out the act and our people shouldn’t term such deeds as criminal since they are acts of compassionate. Therefore it is my ultimate plea to request the government to legalize physician assisted suicide as its explained above permitting this act is highly helpful to the patient and the family affected as a whole (Singer (n.d.).

This one is due on 7/7/2013

References

Steinbock, B. (2004, February 29). The case for physician assisted suicide: not (yet) proven — Steinbock 31 (4): 235 — Journal of Medical Ethics. Journal of Medical Ethics – BMJ Journals . Retrieved July 7, 2013, from http://jme.bmj.com/content/31/4/235.full

Singer, P. (n.d.). Decisions about Death, by Peter Singer. Utilitarian Philosophers. Retrieved July 7, 2013 from http://www.utilitarian.net/singer/by/200508–.htm

Emanuel, E. J. (n.d.). Whose Right to Die? – Ezekiel J. Emanuel – The Atlantic. The Atlantic — News and analysis on politics, business, culture, technology, national, international, and life – TheAtlantic.com. Retrieved July78, 2013, from http://www.theatlantic.com/magazine/archive/1997/03/whose-right-to-die/304641/

The fight for the right to die. (2012, June 15). CBCNEWS. Retrieved July 7, 2013, from www.cbc.ca/news/canada/story/2012/06/15/f-assisted-suicide.html

Kirkland, M. (2010). The right to die vs. the value of life. Retrieved July 7, 2013, from UPI Top News (US) http://www.upi.com/Top_News/US/2010/03/21/US-Supreme-Court-The-right-to-die-vs-the-value-of-life/UPI-43371269156600/

Massachusetts medical society, (2nd January, 1997). The supreme court and physician-assisted suicide – the ultimate right. The new England journal of medicine. Retrieved from www.learner.org/series/ethics2/pdf/related_medical4_angell.pdf

 

Organ Donation and Transplantation Save Lives

Organ donation is the process in which a willing donor realizes the opportunity he/she has in helping others and therefore they register into a state or federal donor registry. Organ donations in the U.S. saves lots of lives bearing in mind that in fact one organ giver can save close to eight Americans. These donors produce one or even more organs to be transplanted to the needy people but nonetheless, 1118,733 Americans are still waiting to be offered organs and this translates to 18 people dying daily while waiting for organs.

Analyze the difficulties of kidney allocation

The location and allocation of organ for transplant, for instance like kidney come with loads of challenges. Some of the difficulties are gotten from feedbacks given by the donor family members, patients, transplant professionals and the general state/nation concerning the limitations of the existing allocation system. Some of these limitations include: numerous viable and kidneys which have an elongated potential prolonged existence being allotted to those budding candidates who apparently have shorter probable longevity. Also, the inconsistency in the admittance to transplantation by a candidate’s geographic location as well as blood group and more so the higher than needed reject rates of viable kidneys which probably could have benefited some of the candidates who are on the list of waiting.

There are several advantages which come up with having a national/federal registry which handles all the organ donors and also those candidates who need which type of organ. The patient is able to access a well detailed registry which contains the donors available and therefore the patient can make an informed decision whether to continue having hope of getting a transplant or not. People who apparently are underprivileged are able to access transplantation opportunities while the government is able to keep track of the whole donor – transplant records. A national registry got disadvantages in that some donors may provide the wrong information can even data can be distorted in the process of registering it. Moreover, people in need of transplant organs who is less informed is unable to know the operations of the national registry and in the course fail to get organs.

The donor registry system works under the directives of the Organ Procurement and Transplantation Network (OPTN) and this body oversees the recovery and allocation of solid organs. The current system is not fair since it promotes the giving of short potential survival organs to those candidates who seemingly have an elongated expected survival. This causes repeated transplantation which is usually risky to the patient since it may take a long time to get another organ. For instance, the system allocates about 80% of the kidneys to candidates who are within the 15 year bracket of the donor.

The process most of the times when it comes to kidney transplants follows the patient’s medical history and in the event that some of these candidates have the ability to pay so as to get an organ makes the process unfair since those patients without will be left out without organs. I would recommend that fairness within the process should be advocated at all times and make use of the candidate’s medical history

This one is due on 7/11

 

 

Ethics Compliance Plan

Importance of Code of Ethics

A code of conduct commonly refers to in the organization setting and its formulated with the sole aim of intending to act as the central reference and guide for all the users who supported the daily process of decision making. More so, the code of ethics is intended to explain a particular organization’s principles, values, and mission while connecting them with all the standards surrounding professional conduct. This document is quite vital to any organization ranging from healthcare setting to business companies and its breach can land the healthcare facility into serious dilemma with the government authorities, other organizations, and also patients. Formulating a code of ethics usually makes the aspect of decision making to be easier at each and every level of a healthcare facility by reducing tremendously vagueness and considerations of personal perspectives in moral standards (Employment Law Guide – Occupational Safety and Health).

This documented set of guiding principles are issued both to the management and all the human resources including the recruits so as to assist them in conducting their activities with respect to the foresaid primary values as well as ethical standards.  this open disclosure has many significance  which include: serving as a vital communication vehicle which generally reflects pledge a healthcare facility has made so as to sustain its most imperative values, compacting with such issues like its correlation with the entire community, standards for undertaking business/healthcare and obligation to the human resources. Code of conduct usually steers all the managerial decisions, thus forming a common structure upon which each and every decision is founded. More so, it helps in protecting a healthcare organization’s legal standing and reputation if it’s a well communicated and reserved code of ethics in the incident of flouting the ethics by a personnel (Employment Law Guide – Occupational Safety and Health).

Codes of ethics are able to cover any range, from the business level even to the workforce level. Business level ethics principles speak in impressive, optimistic terms, passing the whole ethical apparition of the healthcare facility in a distinct document. Seemingly, codes of ethics on the branch level regularly deal with extremely explicit issues, and these are often associated to trends and experiences in the department. Moreover, code of ethics is a device to promote deliberations of ethics plus to develop how the human resources react to gray areas, prejudices, and ethical dilemmas which are met in daily work. A particular code is predestined to harmonize relevant rules, policies, and standards not to replace them. Nevertheless, code of ethics present an important chance for the accountable organizations to form a positive community distinctiveness for themselves and this can direct to a further compassionate political as well as regulatory surroundings and overall an improved rank of public assurance and trust amongst important stakeholders and constituencies.

Explain the importance of the American Medical Association’s Principles of Medical Ethics

The American Medical Association (AMA) is the body which is responsible for coming up with the renown “Codes of Medical Ethics” and this document has apparently been the commanding ethics guides to all the practicing physicians in the whole American nation. More so, this document is quite essential in the medical profession as it articulates the continuing principles of medicine like a profession and as a proclamation of the standards to which all physicians entrust themselves personally and together, the Code of Medical Ethics is a benchmark for medicine as a specialized community. This Code defines the entire medicine’s truthfulness and it is the basis of the medical profession’s power to self-regulate. Furthermore, the Code is actually an existing document, which evolves as modifications in medicine along with healthcare delivery lift new questions on how the entire profession’s central values are relevant in a medical doctor’s day to day medical performance. The Code of Medical Ethics connects theory with practice, moral principles with real world problems in the caring of patients (AMA CODE OF MEDICAL ETHICS).

Summarize the three forms of advanced directives. Which office policies might you develop regarding the implementation of advanced directives? 

Advance directives basically are official documents which grant instructions regarding who ought to supervise a patient’s medical treatment along with what their end-of-life desires are, in the event that they are unable to talk for themselves. The three forms of advanced directives include: Health care Power of Attorney, Do Not Resuscitate (DNR) Order, and Tissue/Organ Donor Registry Enlistment Form. The Health care Power of Attorney permits the patient to select a faithful person so as to make every healthcare decision in the happening that they are terminally ill or permanently/temporary unable to make their own sound decisions. On the other hand, the Do Not Resuscitate (DNR) Order informs the physician that the said patient doesn’t want to get cardiopulmonary resuscitation (CPR) when their breathing or heart stops. The Tissue/Organ Donor Registry Enlistment Form ensures that the patient’s desires concerning tissue and organ donation are honored. These advanced directives have to be affirmed by the doctor in charge with the help of the hospital lawyer (Advance Directives).

This one is due on 7/14

 

References

Employment Law Guide – Occupational Safety and Health. (n.d.). United States Department of Labor. Retrieved July 7, 2013, from http://www.dol.gov/compliance/guide/osha.htm

AMA CODE OF MEDICAL ETHICS. (n.d.). Hepatitis, AIDS, Research Trust. Retrieved July 7, 2013, from http://www.heart-intl.net/HEART/030106/AMAcode.htm

Why Have a Code of Conduct | Ethics Resource Center. (2009, May 29). Ethics Resource Center | Ethics Resource Center. Retrieved July 7, 2013, from http://www.ethics.org/resource/why-have-code-conduct

Advance Directives. (n.d.). Missinglink Notice. Retrieved July 7, 2013, from http://missinglink.ucsf.edu/lm/ethics/content%20pages/fast_fact_advance%20_directive.htm

 

 

 

 

 

 

 

 

 

 What process could you use to ensure that all employees know the ethical standards? 

Ethical standards within the healthcare facility have to be observed at all times but since they keep on changing and more so medical transformations occur throughout, the employees would have to undergo seminars and aptitude tests once in a while so as to measure their grip of the existing ethical standards. Also, the new recruits would have to undertake trainings so as to make them accustomed with the organization’s code of ethics.

 

Present a situation in which the code of ethics of a medical professional is tested. Describe the situation and the possible consequences for the medical professional if they violate the office code of ethics. 

Physicians directly interact with patients and they also handle their medical health records. This puts them in a peculiar situation and therefore they have to always observe the code of medical ethics which advocates for confidentiality at all times and also for the respect of the dignity and rights of the patient. For instance, a doctor went forth to discuss the health records of a patient to her friends who went further to report it to the doctor in charge. This was a breach of the code of conduct and more so professional misconduct and the physician was suspended for three months without pay as the case was being investigated. Later, she was forced to compensate the patient for casing him stigma and emotional pain.

 

This one is due on 7/17

Write a Procedural Document

Name of Student

Name of Professor

Course Code

Date of Submission

Write a Procedural Document

This procedure describes the direction to the cotton farms. Cotton farms are the main source of income for the residents who live around the farms.  The people who work are kind, as you can immediately notice in your first encounter with them. Because there are no passenger buses going down the cotton plantations and the distance to the plantations if you live on the neighborhood when using the only country road is approximately a kilometer, you will need to go there at dawn so that you give yourself ample time to get there and interact with the workers in the plantation. It is very chilly hence warm garments may be needed.

  1. Access the only country road leading to all the cotton plantations. Walk straight down the road.
  2. Find along the road and ahead of you a tent with a darkened roof, approximately two thirds of the journey from the point the journey began.
  3. Identify a fire place beside the tent. If there is fire, you will notice it as an orange fire which seems to seep out of the stove which appears to be old and rusty.
  4. Meet a young woman with a baby beside the stove a soon as you draw closer to the tent. Walk straight to the woman, who may be nursing a baby.
  5. Warm yourself over the stove as you exchange greetings.  Impress your host with a smile so as to feel secure to entertain you around her house. Introduce yourself by your names and your mission to visit the cotton plantation.
  6. Request the woman to introduce you to the men she lives with assume that they are percent. Exchange greetings with the men and restate your mission in this new place.
  7. Learn how the woman hair is kept while serving handling food and the manner in which she sets the table for breakfast.
  8. Respond negatively incase they inquire if you had your breakfast since I believe sharing a meal with strangers is one way of creating a good rapport.
  9. Accept the invitation of the men to join them as they leave for the cotton plantations.
  10. Wind up you visit to the cotton plantations after making all the necessary observations on the actual distance covered from your residence, the magnitude of the work done on the cotton plantations and the lifestyle of the people who work in them.

(Kennedy, N.p)

 

 

 

 

 

 

 

 

 

 

 

 

Works Cited

Kennedy, Marie . “Organization Monkey » how to write a procedural document.” Organization Monkey. N.p., 27 Feb. 2009. Web. 10 July 2013. <http://acemyhw.com>.

 

DNA BIO 101

For Questions 1 and 2, circle, highlight or bold the alternative a, b, c, or d that best answers the question.

 

1. 20% of all bases in a strand of DNA are guanine. From this you would expect the percentage of adenine to be:

 

(a) 10%

 

(b) 20%

 

(c) 30%

 

(d) 40%.

 

2. Part of a strand of DNA has the following sequence of bases. The base sequence of the complementary DNA strand would be:

 

A A T C C G G T A

 

(a) AAT CCG GTA

 

(b) CCG AAT TGC

 

(c) TTA GGC CAT

 

(d) TTA CCG GAT.

 

3. Meiosis is the name of the nuclear division that occurs during the production of gametes.

 

(a) Draw a series of six diagrams to illustrate the stages involved in meiotic division occurring in a cell containing two pairs of homologous chromosomes. Colour code the chromosomes using blue for the paternal chromosome and red for the maternal chromosomes.

 

 

 

Stage 1—diploid cell

 

 

 

 

 

 

Stage 2

 

 

 

 

 

 

 

Stage 3

 

 

 

 

Stage 4

 

 

 

Stage 5

 

 

 

 

 

Stage 5—gametes

 

 

(b) The gametes you have drawn at step 6 are not the only possible gametes that can be formed. Name the two processes that could result in different gametes being produced in stage 6 and draw a diagram to illustrate the gametes that would result.

 

Process of meiosis producing these gametes -Spermatogenenis

Process of meiosis producing these gametes –Oogenesis

 

4. What led Boveri and Sutton to independently make the link between chromosomes and the inheritance of genes?

They noticed a similarity between the behavior of chromosomes during cell division (meiosis) and the behavior of factors (genes) described by Mendel experiments. They carried out staining techniques which the chromosomes to be visible. Boveri used sea urchins to investigate inheritance patterns; while Sutton used grass hoppers to investigate meiosis.

 

5. The phenotype of an organism is determined by both the environment and genotype.

Outline two specific examples that you have studied that illustrate the effect of the environment on phenotype.

Development of diabetes type 2. The defect gene responsible for conversion of glucose to glycogen is inherited. The gene will express itself if factors in the environment become favorable such as lack of exercise and too many sugars.

The shoe size of an individual; if an individual never puts on shoes, the size is likely to be larger than an equal shoe size individual who puts on shoes continuously.

 

6. Below is a diagram depicting a short length of DNA.

 

 

(a) What three major components of DNA do the symbols A, B and C represent?

 

A.  Phosphate

B. Sugar

C. Bases

 

 

(b) Describe one modification that could be made to the diagram to make it a more accurate depiction.

 

In multi-compartmental methylationa of DNA, the methylation states of DNA are varied so as to significantly alter gene expression levels significantly

 

7. What part does each of the following play in protein synthesis?

(a) DNA

It ensures precise replication during protein synthesis

(b) Messenger RNA

It contains the information, the coding sequence, needed during the protein synthesis. They are transcripts. Also contains start and stop signals for translation.

 

(c) transfer RNA

The transfer RNA carry amino acids to the ribosomes during protein synthesis

 

(d) Ribosome

Ribosomes act as the sites for protein synthesis.

 

8. Mutations are a source of new alleles in organisms.

(a) Define a mutation.

 

Mutation is an irreversible, heritable change in the DNA sequence of a particular gene or chromosome.

 

(b) Outline evidence for the mutagenic nature of radiation.

 

  1. Hodgkin’s disease_
  2. Skin cancers in Australia where people are constantly exposed to UV rays from the sun
  3. Leukemia
  4. Deaths resulting from cancer after Hiroshima bomb.

 

(c) Given the original DNA and the mutated DNA form:

 

Original DNA

 

TCA CAG GCG AGT TCT CAT

 

Mutated DNA

 

TCA CAG CGCG AGT TCT CAT

 

Discuss the change that this type of mutation would have on the protein produced by the gene containing this base sequence.

 

This is insertion in gene mutation in which a nucleotide base is added to the gene sequence. The corresponding protein would amino acid residues. The function of the protein made from the sequence may or may not change.

 

9. Describe the concept of punctuated equilibria highlighting how it differs from the process proposed by Darwin.

Punctuated equilibrium is a theory on evolution of species that was first advanced by Niles Eldredge and Stephen Jay Gould who were American scientists. The theory proposes that most species have a relatively sudden origin which takes thousands and thousands of years and not millions and millions as traditional theories claim. The evolution of this species in the rest of their time on Earth is not significantly enough. This theory differs from Darwin’s theory of origin of species which proposes that gradual evolution of species is inevitable.

_____ http://science.jrank.org/pages/5591/Punctuated-Equilibrium.html __

 

10. Rosalind Franklin was not awarded the Nobel Prize along with Watson, Crick and Wilkins for discovering the structure of DNA. Do you think this was fair? Justify your answer with reference to their work and the importance of collaboration and communication in scientific research.

Her work on DNA remained largely unrecognized for along time until her colleagues, Watson, Crick and Wilkins, became recognized. However, some of her contributions were key to the study of DNA, for example, the famous “photograph 51” that illustrated the helical structure of DNA which she handed over in 1953 to Watson and Crick. It is therefore unfair not to have been nominated for the prize.  Probably she would have been next for the award had she not died of cancer soon after the awards of the colleagues. The rules of the Nobel Prize require that only the recipients of the prize must be alive.

11. Transgenic species are being produced more frequently and have caused a considerable amount of controversy.

 

(a) How are transgenic species produced?

Transgenic animals are produced by introduction of a foreign gene or genes (transgenes) into an animal whereby the transmission must be done through the germ line to ensure that all the cells in the animal, with the germ cells included, contain a duplicate of the genetic material.

 

(b) Give one example of transgenic species production to illustrate its use in:

Agriculture

Production of a new variety of cotton has been developed that uses a gene extracted from a bacterium known as Bacillus thuringiensis in the process of synthesizing a protein that is specifically toxic to insect pests such as bullworm

The control or treatment of disease

Transgenic cows that produce milk containing a natural protein that kills the bacteria responsible for animal mastitis. An example of such is illustrated below.

 

 

(c) Discuss one ethical concern that could be raised concerning the use of transgenic species.

 

One area of development involving use of transgenic species in GMO crops which are able to produce resistance and pesticides. The negative effects of this technology will lead to some weeds developing resistance to these herbicides and this is encouraged by cross pollination. Thus the potential benefit of the herbicide is negated.

 

12. For a named species, evaluate the potential impact of the use of reproduction technologies on its diversity.

Crops plants have been engineered which produce seeds that lose sterility before they actually become mature. Germination and growth of these plants is dependent on application of the same chemicals that cause the sterility.