Is virtue ethics able to provide concrete ethical guidance to doctors Essay

Is virtue ethics able to provide concrete ethical guidance to doctors Why or why not - Essay Example This raises the question of the sort of person one should be rather than what they should do. Due to the assumption, virtue ethics is not considered as a normative rival in relation to utilitarian and deontological ethics. However, its revival serves as a reminder to moral philosophers that a full account of our moral life may not be given due to the normative theory elaboration. The grounds one might have for believing that a choice of action cannot be given by virtue ethics is based on the claim that it is concerned with character rather than action, meaning it is not able to provide concrete ethical guidance (Mukherjee, 223). The above claim highlights the contrast that is there between virtue ethics and the other two approaches. While virtue ethics is agent-centered the other two are said to be act-centered. The conflict problem comes about with supporting the general claim that virtue ethics does not give a course of action. Different virtues have different requirements and it is said that these different requirements can point us in different directions. This goes to support the idea that virtue ethics is not able to provide concrete ethical guidance to doctors (Hursthouse, 651). The Emperor of All Maladies gives a history of cancer. It is an ancient disease that was not talked about much but its effects brought about the need for it to be looked into. This was in an attempt to learn more about its personality and behavior. It traces back the origin of the disease, the triumphs and deaths encountered. It brings out the start, the progressiveness and the war waged against it by people who were determined to see that it comes to an end or find ways of preventing and curing the disease (Mukherjee, 224). A thirty year old kindergarten teacher named Carla Reed and a mother of three woke up one morning with a headache. As she later found out, it was not an ordinary headache. She was a very active

The Business Environment essay Example | Topics and Well Written Essays - 2000 words

The Business Environment - Essay Example Legislative authority is restored in the chambers of congress, the Senate and the House of Representatives. The Judiciary which includes the Supreme Court and the federal courts is vested with the judicial power. Their job includes interpreting the constitution of the US and federal laws and regulations. This comprises of settling disputes between the legislative and the executive branches of the government. The federal government was created by the constitution. The most distinctive feature of the US politics are the Senate powers as the upper house of the legislative branch, large scope of the Supreme Court power and the separation of powers between the executive and the legislature as well as the of two major political parties. The British political system on the other hand takes a different shape. It takes the framework of a constitutional monarchy, where the head of the state is the Monarch, currently Queen Elizabeth II, who is also the nominal source of judicial, executive and the legislative authority in England while the Prime Minister is the government head. The British government is vested with the most executive powers while the legislative power is exercised by both the government and the two parliament chambers which comprises of the House of Commons and the House of Lords. There is independency of the judiciary from the other arms of the government despite some judge being members of the House of the Lords, the highest court of the United Kingdom. Britain is a multi party state since the year 1920 with two biggest political parties; the Conservative Party and the Labour party. Mainly the parliamentary politics have been dictated by coalitions and minority governments. The Prime minister is veste d with the powers of appointing the ministers who creates the government and performs as political heads of different government sections. Most of the senior government officials are in

Health Care Case Discussion Term Paper Example | Topics and Well Written Essays - 1750 words

Health Care Case Discussion - Term Paper Example gh the doctor may ne incapacitated to save the life of some patients, such patients expect the medical practitioners to employ their professional aptitude wholly in their endeavor to safeguard the wellbeing of patients. As such, it is in the interest of the physician to settle on resolving the challenges of the patient. Legal and professional code of conduct mandates the physician to settle on medication to administer to his or patients. Additionally, it is upon such physicians to administer the medication to patients, in their ultimate endeavor to alleviate the sufferings of such patients (Cohen, 2013). However, the professional and the legal codes of conducts allows for the patient’s autonomy. Patients have an entitlement to decide on their treatment modes and communicate with the physician, based on their physical and mental soundness. This ought to be in line with the health practitioners’ professional mode of treatment administration while following the preset professional and legal aspects of such treatments. This should be in response to the best interests of the patients. As such, the physicians ought to investigate carefully the health challenges that the patient may be going through, and endeavor to alleviate the patients’ challenges. Ethical and professional misconduct in the medical field has serious devastating impacts to the subsistence of the patients, as well as the professional development of such physicians (Cohen, 2013). The physicians may also be compelled to undergo through numerous unwarranted legal challenges. In the case involving Dr. Contadina and Joe, the physician appeared to have neglected the professional objectives by failing to examine carefully the health predicament that Joe was going through. It was evident that Joe had his total reliance on the doctor, and could not envisage any malice from Dr. Contadina. As such, Joe followed the instructions of the physician fully without questioning her procedure. In this case,

Career Management System Essay Example | Topics and Well Written Essays - 500 words

Career Management System - Essay Example The various common elements of the career management system are examined for planning and shaping the career path of employees. The organizational growth chart is important incentive for the employees to work hard to achieve higher professional status within an organization (Gutteridge & Leibowitz, 1993). The possible career options and avenues of personal and professional growth within the firm help employees to plan their future growth. Thus, organizations need to develop clear career ladders for the workers that they might seek to advance their career. The organizational policies and procedures are critical paradigms that help create an environment of constant motivation for the employees to work with high commitment. The internal job search and facilities provided within organizational to the employees need to be constantly communicated across the workforce. Compensation, career moves, eligibility for new job or promotion etc. are important issues for workers who strive for growth to achieve their ambitions and career related objectives. Thus, strategies and policies must include the changing nature of the society that is increasingly becoming multicultural and focus more training and development of human resource to meet the challenges of the global competition. Organizations need to create facilitating environment of constant learning. It not only helps to nurture high standard of ethics and quality work but it also helps employees to acquire new skills that would add value to their core competencies leading to higher performance. Most importantly, improving skills and gaining knowledge provide workers with cutting edge competition that helps them to meet the challenges with new vigor and motivation. The networking across the community helps to create new job opportunities for not only new job aspirants but also for the

Current concern Essay Example for Free

Current concern Essay Current concern with interdependence is particularly indebted to the earlier attempt of integration theorists to explain political unification among states. Certainly, integration theory has played an important role in the development of liberal international theory in the main, and traces of it echo evidently in neoliberalism and its cognate approaches. As Donald Puchala puts it: â€Å"integration studies were precursors to transnational and transgovernmental relations, to interdependence studies, and to the revitalization of the study of international organization presently so apparent† (Puchala 1981, 150). Once more, however, neoliberalism is a corruption of the functionalist, neofunctionalist and world federalist streams that together constitute integration theory. Neoliberalism holds the integrative convictions and logic of the latter approach however before the recent speeding up of integrative forces in Europe at least, has stressed less theatrical and politically ambitious forms of interstate cooperation. Although neoliberalism, as the term proposes, has become the chief, self-declared authority on interdependence and further matters liberal in contemporary IR theory, in spite of resting on the tenuous conviction that the idealist convictions of both the classical economists as well as the integrationists-that conflicts of interest between states are likely to be reduced by greater levels of interaction-can be gainfully combined with essentially Realist constructs. The feasibility of this project requires to be explored.

Evolution of Whales Essay Example for Free

Evolution of Whales Essay Since historical time’s organisms gradually undergo change in all body aspects for example body size, shape, complexity of organs and slight changes in genetic material. The changes are minor in a generation; accumulate with the continuity of generations with the overall differences producing major changes. In most cases a group of organisms arise from a common ancestor for example whales, dolphins and porpoises evolved from mammals that lived on land for instance pakicetids and mesonychids. Whales are also thought to have a common ancestor with hippopotamus, deer and camels. Whale ancestors were terrestrial which as a result of modification in the body parts and organs gave rise to the present day whales. There are many theories that explain the evolution of whales and the most embraced is that of whales evolving from small aquatic animals. The rule of natural selection by Charles Darwin dictates that only the fit organisms survive. This rule has applied to the evolution of whales since those that were unable to cope with competition became extinct. Most of the ancestors of whales were obtained through fossil study (paleontological evidence) of both terrestrial and aquatic organisms’ remnants excavated from Australia and Pakistan. Some of the examples of whale ancestors are sinonyx, pakicetids, ambulocetids, rhodocetids, basilosaurus, dorudon, squalodon, mammalodon colliveri, janjucetus hunderi and Harrison’s whale. Statement on whales Whales are the largest living mammals that inhabit aquatic environment. Whales can dive to depths of about 3000 meters and have to go back to the surface to breath. Like most terrestrial mammals whales give birth, suckle and nurse their young ones for around six months. They do not have skin glands, tear glands and olfactory senses. They receive signals through vibrations to the periodic and auditory bullae formed by fusion of skull bones. The blue whale; one of the whale species is the largest creatures that has ever lived on earth. The whale is subdivided into several species namely; sperm whale, blue whale (mentioned above), orcas (killer whales), and pilot whales. Some of these whale species have become extinct through natural selection as postulated by Charles Darwin in his theory â€Å"the origin of species by means of natural selection†. The blue whale is in the sub- order baleen whale and has long slender body shaded blue at some parts of the body. They feed on krill and only hunt in areas with concentration of krill. They mostly mate during autumn. Blue whales give birth to young whales in water weighing about two tones. The blue whales suckle their young ones till they are six months old. These whales are sexually mature at the age of around ten years. They are known to attain the age of about eighty years and their only predator is the orca or the killer whale. The population of whales has been decreasing in the recent years because of large scale whale hunting. Blue whales communicate to other whales especially during courtship, locating prey, maintenance of individual territory and maintenance of social organization by making some sounds about 165 decibels.

Principles of Motivational Interviewing

Principles of Motivational Interviewing Motivational Interviewing Assignment Introduction: For the purpose of this assignement this student will identify 4 principles of Motivational Interviewing (MI) based on Miller and Rollnick’s (2002a) skilful clinical method of communication, comparing and contrasting these principles with the Digial Recording from my Laboratory work, concluding with the contribution that MI has made to the provision of nursing practice. What is Motivational Interviewing: The World Health Organisation (WHO) clearly identified Health Promotion as â€Å"†¦ the process of enabling people to increase control over, and to improve, their health†¦Ã¢â‚¬  (WHO 1986), however, there have been â€Å"feelings of frustration† recorded from primary health care workers (HCW) when interacting with patients in relation to making healthy lifestyle changes. This has been attributed in part, due to a lack of motivation in patients and therefore the patient may be adverse to change (Percival, 2013). Miller Rollnick (2002b) hope that HCW by using a collaboration of MI techniques may bring about positive change within a patient, by promoting their hopes and aspirations for the future, drawing on their tangible strengths and using motivation as the mechanism to achieve this change. Indeed, Miller and Rollnick (2002c) defined MI as: â€Å"It is a collaborative, not a prescriptive, approach, in which the counsellor evokes the person’s own intrinsic motivation and resources for change.† Principles of Motivational Interviewing: Miller Rollnick in 2002 identified a number of guiding principles for MI; expressing empathy, develop discrepancy, roll with resistance and support self-efficacy, further reviewed by Rollnick et al. (2008) and expressed using the acronym RULE: Resist the righting reflex, Understanding person’s motivation, Listen with empathy and Empower the person. To achieve success in MI using these principles, there are certain skills that must be utilised in a positive and effective outcome, for instance asking open questions, affirming the strengths of the patient and reflecting back or summing up what you have heard. Assess and critique of digital recording using identified principles: Resist the Righting Reflex: A natural and automatic reaction of the HCP is to make things â€Å"right† by fixing a problem, this stems from their training and experience in healthcare. Through the role play I feel that I spent too long trying to redirect the patient back to the topic of smoking, wanted to right the situation and I wouldn’t take verbal and nonverbal cues that the patient did not want to talk about smoking at that given time, it seemed to me that she had a greater desire to vent her feelings about her current marital situation including the recent infidelity, from a biopsychosocial perspective this was central to her recovery, and yet I returned on a number of occasions to the question of smoking albeit in a covert manner. The patient was in a state of pre-contemplation (Prochaska and DiClemente 1986), whereby she didn’t want to engage in any confrontational situation, believing that she did not need to change her habits regarding smoking, upon reflection the patient appeared pressured to into accepting change which further exacerbated her lack of desire to change. It appears that there was an increase in persistent resistance from the patient, which was as a direct outcome of me reverting back to the issue of smoking, therefore it is probable to say that in this scenario as a result of my desire to â€Å"right† the situation, I in fact made it worse, creating an underlying tension which was not beneficial for the patient’s recovery. I feel that a better approach would have been to gently broach the subject, with an understanding and acceptance that this was not the right time to discuss smoking cessation as the patient had other ongoing stressors. If by looking at and talking with the patient about her current biopsychosocial and socioecological stressors, I may have developed greater insight into what exactly may motivate this patient, therefore giving me clearer collateral to help develop my objective of discussing smoking cessation. Exploring and understanding the individual’s motivation: The patients own motives for change are more often than not prone to initiating change, however, in this scenario there was no indication that the patient was voicing any indicators that they wanted to change their smoking habbit, yes, she had mentioned that she had given up in the past and though I tried to develop that area it was met with resistence. Instead of trying to reason why this person isn’t motivated, I should have looked at what it is exactly that motivates her, irrespective of her current situation. There was scope to develop this as the patient showed great concern for her children, a key discrepancy in her concerns and her current smoking habit, this is a focal point that I should and could have developed further. In her current situation the patients confidence appeared to be extremely low, however I could have measured a true subjective rating in her confidence level by asking her a simple rating question â€Å"to rate from 0-10 how ready are you†¦Ã¢â‚¬ . This would have given me a springboard on which to probe for further motivational factors. Again by asking simple open ended questions such as: â€Å"what do you want to achieve? or how important is this for you?† it would have given greater insight into what motivates the patient by denoting what their goals are. As such, my focus was to talk about smoking cessation and unfortunately I didn’t pay much attention to signals; identifying what interests and concerns the patient was currently experiencing. There were small marked areas of ambivalence, which some (Mill Red 2008) regard as normal in MI and it was apparent at this time that the cons to giving up smoking outweighed the pros thus the patient appears to be somewhat unmotivated. Listening with empathy Empathy entails the HCP to listen to and engage with the patient in a non-judgmental manner. I expressed an understanding of how personal this experience was for the patient asking them to focus on their own issues and recovery, it could have been very easy for me to have been blasà © about the circumstances leading up to the admission, accepting what the patient was telling me in a non judgmental way. Giving a summary reflection, I paraphrased what the patient had told be asking for affirmation that I had an understanding of the current situation, which helped me to contextualise and use the patients own frame of reference. I listened for ‘change talk†, but couldn’t identify any desire, ability, reasons, need, commitment or taking steps towards instigating change, therefore the patient may not have been ready to engage in MI, however, it was a brief encounter of 5 minutes, giving me good insight into the patients current situation. The patient may not have been able to articulate their true convictions because of fear, lack of cognizance or increased anx iety due to her physical ill health and also the far reaching impact of her partner’s infidelity. Upon reflection my opening of â€Å"tell me about your problem† was poor and should have been more open and empathetic could have been more, I should have used â€Å"tell me about it† I felt that I displayed some very good attributes to listening empathetically; my body language and posture were open, engaging and receptive. I was non-confrontational or judgemental and verbally exhibited this through an appropriate use of tone and pitch, however, as mentioned earlier, I missed some important cues and felt that I didn’t ‘roll with resistance’, though it must be noted that working in a psychiatric environment there are less time constraints and more opportunities to develop an augmented MI working relationship with a patient. Empower the patient: Erickson et al. (2005) deemed that a person can increase their belief in the probability of change based on their ‘past successes’, so by focusing on the patient’s strengths and allowing them to achieve their own goal(s) the HCP can give the responsibility, ownership and control of choices back to the patient. It is within this stage that the HCP has to be a facilitator and motivator to the patient. Again the use of ‘scale questions’ can be very beneficial to the patient allowing them to rate how they perceive their situation allowing them to focus on their skills and strengths. As with all interventions in nursing, the skillset is with the clinician and MI can only work effectively if used correctly. Throughout the role play there were a number of positive example of where I was empowering the patient, starting with â€Å"I am not hear to lecture or preach to you, just to talk to you†¦Ã¢â‚¬  this I felt set expectations with the patient though it could have been more specific to smoking cessation. Focusing on strengths and positives; I asked â€Å"what did you do before to give†¦Ã¢â‚¬  showing the patient that they have succeeded in stopping smoking in the past. The patient expressed concerns about intrinsic family issues, though acknowledging that these are important, I advised the patient to focus and ‘concentrate on themselves in the here and now’. There were a number of pitfalls that I should have avoided such as using technical terms ‘psychosocial/biopsychosocial’ as the patient may not have understood what I meant, I should have kept it short and simple, mirroring the language used by the patient. Another area that should have been avoided was when I asked â€Å"when did you start smoking again? I know you don’t want to talk about it but..† as I feel that this reaffirmed a negative with the patient, contrasting strongly with the strengths and positives previously identified. Patients’ own arguments for change can be more persuasive than any arguments that an HCP may put forward, but it must be noted. Concentrate on the here and now†¦ It is fundamental that the HCP engages with the client in an open, non-confrontational manner with the HCP not falling into the trap of being the expert trying to assess the patient, apportioning blame or having preconceived ideas/beliefs regarding the patient. Conclusion: The Contribution that MI has mad to Nursing Practice. MI by the virtue of its patient centredness, MI affords itself to be used in a wide array of clinical settings through the use of interpersonal relationship (Rollnick and Miller 1995) allowing healthcare providers to be at one with the patient (Sobell Sobell 1993). There have been, in excess of 200 Randomised clinical trials validating the efficacy of MI in a wider cohort of nursing interventions (REF). It appears from the research that there are more studies needed to validate the true clinical efficacy of MI, however, MI has been used successfully in a multiplicity of settings from from smoking/alcohol cessation, improved efficacy in medication adherence, clients with Cancer (Thomas et al. 2012) HIV, weight management, indeed MI could and should be used all encounters between HCP and patients. The UK’s National Health Servce is rolling out a programme through all sectors about making every encounter count† which has its basis in MI. The WHO actively encourages the use of MI for those working on a quit lines when used in combination with theoretical approaches (WHO, 2014). Talking therapies have been complimented by the symbiotic use of MI in the promotion of health and as such must be embraced across all segments of the health sector, affording self-efficacy in positive outcomes for the patient. References: Mill Red 2008) Erickson, S. J.,Gerstle, M., Feldstein, S.W. (2005). Brief interventions and motivational interviewing with children, adolescents and their parents in paediatric health care settings. Archives of Paediatric and Adolescent Medicine, 159, 1173–1180 Miller, W. R. (1983). Motivational interviewing with problem drinkers. Behavioural Psychotherapy, 11, 147–172. Miller W.R. (1995) Motivational Enhancement Therapy with Drug Abusers http://motivationalinterview.org/Documents/METDrugAbuse.PDF(Accessed 13/10/2014) Miller W, Rollnick S (2010) What’s New Since MI-2, 2’nd International Conference on Motivational Interviewing, Stockholm, Sweden. (Last accessed: 14/10/2014) http://www.motivationalinterview.org/Documents/Miller-and-Rollnick-june6-pre-conference-workshop.pdf Miller, W. Rollnick S. (2002a pg. 41) Motivational Interviewing: Preparing People for Change, 2nd edn. Guilford Press, New York Miller, W. and Rollnick, S. (2002b) Motivational Interviewing: Preparing People for Change, 2nd edn. Pg 22 New York; The Guilford Press Miller, W. and Rollnick, S. (2002c pg.41) Motivational Interviewing: Preparing People for Change, 2nd edn. New York; The Guilford Press. Moyers, T. Rollnick S. (2002) A motivational interviewing perspective on resistance in psychotherapy. Psychotherapy in Practice 58, 185–193. Percival, J. (2013) Healthy lifestyle changes – getting beyond the ‘difficult’ conversationNovember 2013 | Volume 23 | Number 9 RCN London Prochaska J.O, DiClemente C.C (1986) Towards a comprehensive model of change. In Miller WR, Heather N (Eds) Treating Addictive Behaviors: Processes of Change. Plenum Press, New York NY, 3-27. Rogers C. (1951) Client-Centered Therapy. Houghton-Mifflin, Boston, MA. Rollnick, S. Miller, W. and Butler, C. (2008) Motivational Interviewing in Health Care. London; The Guilford Press. Sobell M.B. Sobell L.C. (1993) ProblemDrinkers. Guilford Press, New York. Thomas, M.L. (2012), Elliott, J.L., Rao, S.M. Fahey, K.F. Paul, S.P Miaskowski, C. A Randomized, Clinical Trial of Education or Motivational-Interviewing–Based Coaching Compared to Usual Care to Improve Cancer Pain Management: Vol. 39, No. 1, January 2012 Oncology Nursing Forum White, W.L. Miller, W.R. (2007) The use of confrontation in addiction treatment: history, sciences and time for change. Counsellor 8, 12–30. WHO (2009) Milestones in Health Promotion, Statements from Global Conferences. Accessed 17/10/2014 /http://www.who.int/healthpromotion/Milestones_Health_Promotion_05022010.pdf?ua=1 WHO (2014) Training for tobacco quit line counsellors: telephone counselling. WHO, Geneva. 1