Patient Refusal Of Treatment Nursing Essay

Patient Refusal Of Treatment Nursing Essay I dont want to be treated, Alice Nuvo said in the scenario 6. She is a woman who was diagnosed with pancreatic cancer and that has a very low percentage of survival for another year, even with the best treatment. Just give me something to control the pain and let me go home- she said. In this scenario we will talk about autonomy, which is typically defined as self-determination and refers to the ability of competent individuals to make decisions over their own lives. In order for autonomy to be meaningful, a competent individuals decisions should be respected even when those decisions conflict with what others believe to be reasonable. Over the last few decades, respect for autonomy has come to be recognized as a fundamental principle of Bioethics. In general, a patients autonomy should be respected even if the patient decides not to follow a doctors or health care teams advice. Respect for autonomy has helped to redefine the physician-patient relationship as patients have become more active participants in making health care decisions. Traditionally, the physician played a more paternalistic role in that he/she would largely decide for the patient what the best course of action would be. But now days the patient should not be coerced into making a health care decision, meaning that the patient should not be forced against his/her wishes into making a choice. The patients decision must be voluntary. The basic starting point for ethical analysis in health care, is the encounter between the patient and the health care professional. This relationship is shaped by the goals of that encounter, both the goals that health care professional has and the goals that the patient has. The goals of medicine, which guide the goals of all health care professionals, are: to prevent, cure, slow down or arrest the development of an illness; to stabilize a satisfactory condition; or to relieve the distressing symptoms of illness. It is important to note that these goals are more than simply seeking a cure, and are certainly not focused on seeking to preserve or prolong life at all costs. It is also important to recognize that it is not necessarily possible to meet all of these goals all of the time. The other person in the encounter is the patient, who also has her or his own goals, both health and broader goals in life, as well as values and preferences. Each person forms her or his own conception of what is a good life. This means each person has the freedom to act to put the choices that arise from that conception into effect. Everyone else must respect the space a person needs in which to do this. This is the basis of autonomy. However, autonomy is not an end in itself, but a means whereby a person takes responsibility for her or his own life. In health care, autonomy can be expressed in this way: the patient is the source of the health care professionals right to treat her or him. More specifically the patient has the right to choose to accept or refuse treatment that is offered or choose between different options. The important thing to remember is that the patient will consider her or his goals in life, will act upon her or his values and preferences as well as the medical facts in making such a decision, and all of these must be respected. In many situations the patients decision is not questioned. Decisions have been challenged when the choice does not seem reasonabl e to the health care professionals or others, generally it is challenged by questioning the competence of the patient, which we are not going to question in this particular case of Alice Nuvo. A patients decision to accept or refuse life-sustaining treatment needs to come out of a reflection on the usefulness and reasonableness of such treatment. Treatment has to be reasonable, this means that it has to be effective and that the benefits need to be in proportion to the burden for the patient of undergoing the treatment. There are two aspects of the refusal of life-sustaining treatment. The goals of medicine establish the purposes of treatment. It is not always possible to meet all of the goals, and at times may only be possible to relieve the distressing symptoms of illness. It is not a goal of medicine to prolong the dying process. The second aspect of any decision to forgo treatment is the patients right to choose whether or not to accept such treatment, even if the treatment has a reasonable chance of being effective. A person who is terminally ill is someone for whom there is no further curative treatment, like Alice Nuvo has no further CURATIVE treatment. Therefore, the only goal that it may be possible to meet is that of relieving symptoms. However, the point at which treatment is ceased and the decision made to forgo resuscitation varies with each patient. One person may wish to remain alive long enough to see a grandchild married. Another person may wish to spend the last weeks of life with close family members without suffering the debilitating side effects of chemotherapy. Id rather spend the remaining time with my husband and two daughters then die in the peace, instead of puking up my guts in some hospital Alice Nuvo said. After all this being said, the fact that refusal of any life-sustaining treatment is not to be equated with a slow, passive suicide, the person is not choosing to die. Rather she or he is choosing other goals, in line with her or his conception of a good life. In each case death is accepted as a foreseen, possible side effect of such a choice, but it is not directly chosen. Decisions regarding life-sustaining treatment are complex. Such decisions made by patients are based on a balancing of the benefits and burden of any such treatment and will include the goals, values and preferences that the patient has. But sometimes doctor thinks patient is making the wrong decision, how far should he go to try to persuade her or him to accept the treatment? Patient autonomy does not allow the health care provider to make the decision for the patient, but it does allow providers to educate the patient. It requires of health care providers that they respect patients by providing accurate and complete information that gives patient understanding of positive and negative sides of treatment.

Advantages and Disadvantages of Modern Lifestyle Essay

Technology has taken unimaginable strides over the past couple of decades, affording people all around the world possibility, flexibility and, above all things, convenience in their everyday communication and overall lifestyle. It is ever-changing. Whether you’re sending a love letter, making a purchase, running a business, researching a paper, financing a house, getting in touch with your old college roommate or booking a flight to Fiji, it all comes down to one simple thing: the click of a mouse. Social Networking It’s possible in today’s world to reconnect with high school and college friends in a matter of minutes. Before the Internet came to be, it was nearly impossible to stay in touch. Unless you ran into them at your 10-year reunion, you had no idea where they were. Nowadays, in this growing culture of social networking, it’s nearly impossible not to know what they’ve had for dinner, not to mention where life has taken them. No matter how many miles stand between you, social networking has allowed both old and new friends to keep in touch from moment to moment. Opportunities to Work From Home The flexibility of working from home in your pajamas or from the beach in your bathing suit may be one of the most attractive advantages modern technology offers for some. Not only does it save you a long commute to the office, a ton of gas money and the inevitable stress of hitting rush hour traffic, but it buys you more time in the day to spend on more important matters like family and friends. Convenience in Education Getting an education is as simple these days as turning on your laptop and taking classes online. Although it’s not your traditional classroom, the kind housed with a roomful of students seated in wooden desks and a professor lecturing in the front of the room, it is nonetheless an effective alternative to a good education. Even though you may be curled up on your couch in the middle of the night with a hot mug of tea and your cat on your lap, you are, in fact, in the modern learning environment, earning your degree from home. Even high school classes are being offered online for students seeking summer school and degree programs.

Administrative Law – Paper

Administrative law simply means that the branch of public law which deals with the organization and powers of administrative and quasi administrative agencies and prescribes the principles and rules by which an official action is reached and reviewed in relation to individual liberty and freedom. Technically, from the definition it is clear to state that administrative law is bound and founded to determine the legality of the government action, the nature and scope of the powers conferred to the government official through checking abuse of administrative power.Meanwhile, the study of administrative law can be explained in broader after pondering the red light and green light theories, in which the red light theory views primarily that objective of administrative law is to consider the law and control the state power and desires to minimize the encroachments of the state on the rights of individual whereby this is monitored and controlled by judiciary.In connection to that, Green the ory relies much in operation of the state in the sense that it allows the intervention of the state in larger public interest ensuring right of citizen and well being of society as whole and this can be achieved through freedom of information, active involvement, positive deliberation, effective consultation and other similar action at the level of administration. In the same vein, the issue raised, if the means are not trustworthy, how the end could be?Just or unjust. In the light of the control mechanism discussion hereunder is considering intensively how far the means which are not trustworthy could result to unjust end. POLITICAL PARTIES; as per the political parties Act ,is defined as any organized group formed for the purpose of forming a government or local government authority within the united republic through election or for putting up or supporting candidate to such election .Now, the modern political thoughts tends to accept the notion that political parties are absolute essential to democracy so far the political parties try to crystallize many shades of opinion into one coherent policy unify many diverse element into one manageable unit. The political parties are manifested from the right of freedom of assembly as stipulated in the constitution .The political parties are mechanism to perform an important function of interest articulation, whereby an individual finds out the open channels to express their interest and needs, and also performing function of interest aggregation ,where peoples demands converted into general policy alternatives. Therefore in modern democracy ,it has always been necessary to guarantee and protect the freedom of assembly ,in that line it is one of the platform for attainment of social development and nurturing of democratic advancement in a given society.But the situation contrary to our country today, the right is restricted and its enjoyment subjected to the laws of the land, the problem comes in the course of interp retation and ,implementing the realization of this right. Experience can be drawn respectively from Tanzania, that the state limits the occupation of political parties so as to enhance the sustainability of state powers, there various laws and aspect which curtails the freedom of association for political parties and its operation . Starting with:- Cumbersome procedures for the registration of Political parties. t is a requirement of the law under political parties Act that any political party upon the request for registration must have at least 200 members from ten different region in the country. this number is too large and unrealistic especially in Tanzania where democracy is at infant stage. this provision denies the nourishment of democracy. Forinstance the denial of CCJ(chama cha jamii). Also under the same act it is provided that any political party ,by its constitution advocates the break up of union between Tanganyika and Zanzibar shall be disqualified and denied registrat ion. gain this provision limits the scope for scope discussion and will of the people towards union. The system of permanent national voters registration under the national election Act where without being registered the constitutional right to vote and being voted is vanished. in 2010,some irregularities in the system contributed good number of citizen not to vote due to typographic errors, double entry, false inclusion of alive in the list of deceased. Mere technicalities defeated the rights of citizens.Denial of independent candidate; one should not be compelled to join a political party in order to enjoy political right. the right to participate in governance of state includes right to vote and be voted. Also the practices shows that the ruling party during election used the government resources in the campaign. forinstance using of government vehicles and converting the government plans to political promises. this act are against free and fair election which is fundamental aspe ct of democracy.The role of police force; basically the police force does not guarantee the right to freedom of assembly but merely regulates the enjoyment of the right. on the ground of national security or public safety the police have the power to prohibit the assembly , however ,Lugakingira J,viewed that the law does not operate to take away the right to hold assembly or procession ‘it only empowers the police and magistrate to step in far the preservation of peace and order. but the police used such discretion power contrary even where is not necessary and sometimes used in favour of ruling party.To underscore this, refer the case of Mabere N yaucho Marando&another Vs Attorney General where it was held that ‘’in order to maintain public order and security during political rallies ,it was important for permit to be issued. however that discretionary power to issue permit had to be exercised judicially which required that all political parties get same and equa l treatment†¦ Therefore, the above means seems to be not trustworthy ,hence bars the growth of democracy which is the spirit of our constitution, and participation of people in a matter and due political process fear to face the iron bar of law enforcers.Hence this will defeat the interest of change and justice in community. ACCESS TO JUSTICE; this emanates from the cardinal principle of law that every person is equal before the law. Regardless of political stands ,religious affiliation, all should be treated alike without affording unnecessary privileges and exemption. Right to access justice is fundamental principle of rule of law. As in the case of Mwl. Paul john mhozya Vs Attorney General held that everyone and every institution or organization in this country is enjoined to pay respect to the principle of supremacy of the law.Access to justice should be devoid of undue technicalities which defeats the end of justice, the procedure of taking government to court is very cumb ersome . this is supported by the case of Peter Ng’omango Vs Gerson Mwangwa and Attorney General held that the right of an individual to have free access to the court is well recognized by constitution. the requirement of the consent of the minister before one can sue the government as imposed in section 6 of government proceeding Act infringes constitution â€Å"therefore this law is arbitrary and oppressive since it does not subjected to any control, therefore offends proportionality test.Also access to justice goes further to the speedy in dispensation of justice. As in the case of Hussanaira Kharton Vs Home Secretary State of Bihar held that delay in trial by itself constitutes denial of justice. In some circumstances citizens are denied the right o be heard ,while one has to be heard so as to access justice, failure to heard a party constitutes the violation of natural justice which is the spirit of the law. As in the case of Judge in charge of Arusha &Attorney General Vs Munuo that ‘’no one should be condemned unheard’’.On the other hand, independence of judiciary and impartiality of it determine highly the proper access and attainment of justice. But number of means such as judicial appointment, poor remuneration, and judicial infrastructures denies a number of people not to meet justice. also some enactments such as civil procedure code on the issue of security for cost and election Act on requisite for money so as to launch an appeal of election. , denies the access of justice . refer Francis ndyanabo Julius ishengoma Vs Attorney general. Therefore, justice should not be commercialized ,but should be done though heaven falls.Through easy entry to judicial system, availability of legal representation, equality before the law, our means will be trustworthy and end will be just. HIGHER ADMINISTRATIVE AUTHORITIES; These include president, ministers ,civil service, higher institutions, and boards, these bodies ought to co mply with the principle of natural justice in the course of discharging their duties. the principle are to give reason(s) for any decision made, to hear both sides. And should not be dominated with the personal interest but public interest.The failure of decision maker to take into account a relevant consideration in making administrative decision is one of the instance of abuse of power and discretion, this would entitle a party with sufficient stand to seek for judicial review of ultravires administrative actions. Now, proper procedures must be followed and decision maker not be biased. In supporting the above arguments ,the following cases are material. in the case of Mohamed Jawad Mrouch Vs Minister for home affair held that discretionary power must be exercised fairly, and this requires adherence of the rules of natural justice .Also the case of Said juma muslim shekimweri Vs Attorney General held that I this country,civil servant are dismissed for misconduct only and not pleas ure of president. and when civil servant dismissed cause must be assigned. Therefore, in the light of the case of James Gwagilo Vs Attorney General where Mwalusanya J(as he then was)held that ‘’there is no doubt that the absence of reasons would render the constitutional right of appeal and judicial review ineffective and illusionary† I have come in the view that the administrative authority must omply with legality and proportionality test. ORDINARY JURISDICTION; The matter of jurisdiction is not a mere technicality but fundamental. And independence of judiciary is the spirit of the jurisdiction of the court. by the virtue of Article 107 of constitution, the court is conferred jurisdiction to provide justice. Independence of judiciary rely on the basis of condition of service and tenure, manner of appointment of judges and discharge of their duties, and degree of stability and logistical protection against outside pressure and harassment . ut judges are appointee s of President from another pillar, remunerations comes from executive, this is ridiculous. Also application of law must be of retroactively, and each case must be adjudicated objectively and on merit and not self interest of judges, and impartiality is paramount important. Refer the case of James Bita Vs Iddi kambi held that the judiciary is an instrument of state set up to adjudicate impartiality disputes between subjects and subjects or subjects and government. Judicial officer at any level should not flinch from performing this sacred duty.Therefore ,the court should not be subjected to the means which are not trustworthy and unreliable so as to enable this temple of justice to be free and dispense justice and justice only without fear. WRIT JURISDICTION;This includes writ of mandamus,prohibition,certiorari,and habeas corpus. , as stipulated under the law reform (fatal accident and miscellaneous provision)Act . The citizen may be aggrieved with the actions and decisions of admin istrative authorities and request upon the high court to make review and issue an order which is prayed.However, the court writ jurisdiction is oustered by other laws and cause the court to remain dumb in case of the abuse of of power by public authorities. Article 41(7) enshrines that there shall be no challenge from any person and no any court shall have the power to investigate or entertain the issue of legality of president who announced by National electoral commission. The court of law is jealous of its jurisdiction ,as held in Mtenga Vs UDSM that it is trite to observe that the court is and has to be for the protection of public ,jealous of its jurisdiction and will not lightly finds its jurisdiction oustered.Also presence of undue technicalities such as one can not ask for the judicial review unless he/she has obtained leave. This mean leave could defeat the interest of justice; frankly this is not proper approach to justice. in the case of Timothy Mwakilasa Vs Principal sec retary held that it is an admitted fact that applicant has not obtained any leave from this court to make his application. That being so, the purported application is incompetent in law and this court ca not entertain it. Court of law is guardian of citizen rights and it is a temple of justice in which everyone is free to access and attain justice.The means to reach it should not be complex but smooth and trustworthy so as to arrive at the peak of justice. PUBLIC OPINION AND MASS MEDIA; This two aspects are underscored under the article 18 , and constitutes a primary element of democratic society . It cannot be conceivable without free debate and freedom of media. However the freedom of collecting and publishing newspapers,magazines,books,bulletins are hampered by the government through the laws which are not trustworthy. Minister ,in his opinion on the ground of public interest may decide to bann any newspaper in the land .Forinstance banning of Mwanahalisi newspaper. this law oust ers the jurisdiction of the court ,in which the court is jealous on it. Also according to Africa media barometer report, Tanzania communication regulatory authority(TCRA) is not entirely independent since both board chairman and director general are presidential appointees. This situation can compromise impartiality of media. Harassment and killings of the journalists;wherejournalist tend to shock the higher authority by publishing some news ,entered in hostility with the power.On February 2010,journalist Asraj mvungi and others were arrested by police officer following the order from district officials that they instigate land conflict. in connection to that ,killing of one Daud Mwangosi (journalist)draws a road towards the killing of freedom of media. And another challenge is that media is owned by politicians, tycoons and religious institution, hence editorial freedom demises. Therefore ,the laws that regulates enhancement and betterment of the media is subjected to the absolute discretion of government authorities.This is ridiculous and peril towards transparency and accountability of the government of the day. Hence,with this path the end shall not be just. As I arrive to the conclusion ,I am of the view that trustworthy means and procedures are cornerstone towards a good end, and always an end justifies the means. therefore,it is high time for us to look back on our laws making bodies and interest of justice for the purpose of modifying them. it is my humble opinion that citizen and government has to respect and adhere constitutionalism and democracy.

Green Card Program for Rich Foreigners is Fraud Risk, GAO Says

A federal government program that helps wealthy foreigners get temporary U.S citizenship â€Å"green cards† is a bit too easy to trick, says the U.S. Government Accountability Office (GAO). The program is called the EB-5 immigrant investor program. The U.S. Congress created it in 1990 as an economic stimulus measure, but legislation funding the program is due to expire on December 11, 2015, leaving lawmakers scrambling to revise and revive it. One proposal would raise the minimum required investment to as much as $1.2 million, while retaining same the job creation requirements. To qualify for the EB-5 program, immigrant applicants must agree to invest either $1 million in a U.S. business that is to create at least 10 jobs, or $500,000 in a business located in an area that is considered rural or has an unemployment rate at least 150% of the national average rate. Once they qualify, the immigrant investors are eligible for conditional citizenship status allowing them to live and work in the United States. After 2 years of living in the United States, they can apply to have the conditions for legal permanent residency removed. In addition, they can apply for full U.S. citizenship after 5 years of living in the United States. So, What Are the EB-5 Problems? In a report requested by Congress, the GAO found that efforts by the Department of Homeland Security (DHS) detect and prevent fraud in the EB-5 visa program have been lacking, thus making it hard to determine program’s actual positive impact on the economy, if any. Fraud in the EB-5 program ranges from participants overstating job creation figures to applicants using illegally gained funds to make their initial investments. In one example reported to the GAO by the U.S. Fraud Detection and National Security Directorate, an EB-5 applicant concealed his financial interests in a number of brothels in China. The application was ultimately denied. Drug trade is one of the most common sources of illicit investment funds used by potential EB-5 program participants. While the GAO gave no details for reasons of national security, there is also a possibility that some applicants for the EB-5 program may have ties to terrorist groups. However, GAO reported that U.S. Citizenship and Immigration Services, a DHS component, relies too heavily on outdated, paper-based information, thus creating â€Å"significant challenges† to its ability to detecting EB-5 program fraud. The GAO noted that the U.S. Securities and Exchange Commission reported getting more than 100 tips, complaints, and referrals related to possible securities fraud violations and the EB-5 Program from January 2013 through January 2015. Overstated Success? When interviewed by the GAO, U.S. Citizenship and Immigration Services (USCIS) reported that from 1990 to 2014, the EB-5 program had generated more than 73,730 jobs while contributing at least $11 billion to the U.S. Economy. But the GAO had a major problem with those figures. Specifically, the GAO stated that â€Å"limitations† in the methods Citizenship and Immigration Services uses to calculate the program’s economic benefit may cause the agency to â€Å"overstate some economic benefits derived from the EB-5 Program.† For example, the GAO found that the USCIS’s methodology assumes that all immigrant investors approved for the EB-5 program will invest all the money required and that that money will be spent totally on the business or businesses in which they claim to be investing. However, GAO’s analysis of actual EB-5 program data revealed that fewer immigrant investors successfully and fully completed the program than were approved in the first place. In addition, â€Å"the actual amount invested and spent in these circumstances is unknown, noted the GAO.