Ethical Decision Making In Nursing Scholarly Nursing Essay

Ethical Decision Making In Nursing Scholarly Nursing EssayNurses are constantly confronting various honorable issues in their prevalent clinical practice. An good dilemma is complex situation emerging from the impinge between object lesson obligations in which complying with one would result in contravening another (College of Nurses of Ontario CNO, 2009). Nurses using CNOs ethical conducts and last- do framework will help in directing their ethical course of action. This framework involves the use of moral component such as claim, evidence, warrant, basis, confuter and ethical decision to guide in resolving the conflict (Arnold Boggs, 2011). Thus, the aim of this paper is to use ethical decision- do framework step by step in exploring an ethical issue by analyzing a pediatric eccentric study to make significant decisions.Claim is the first moral component of the framework. It emphasizes on various dilemmas arising from the case study such as pediatric advance directive, consent to treatment by being competent underage and decision-making capacity. The ethical dilemma arises from this case study is whether to choose wishes of adolescent diligent considering his treatment or should the wishes of his parents outweigh his request. The case study describes Kyle 14 course of instructions old male who has stake in outcome of the decision, and ache from lymphocytic leukemia cancer. The case study involves Kyle as patient with physicians and his parents to de terminaline the concern in best interest of patient. The involved Physicians in care stated Kyles health is deteriorating and not responding to the chemotherapy treatment. Hence, the value of Kyles parents is to continue with the chemotherapy treatment in hope to work and keep up his life. However, Kyle having different point of view, refused to take each dauntless measure and asked for DNR order to be placed in his chart. This federal agency, his parents value would be violated if bind choo ses to accept the decision of Kyle. According to article by Tabak and zvi (2008), patient being mature minor competent has right to refuse treatment and is allowed to choose decisions regarding all the aspects of his treatment. Hence, nurse is caught in conflict between parents and Kyle. Thus, Kyle being in client center care, whichever decision nurse chooses from patient and parents will impact the Kyles care.The evidence is next moral component of the framework. According to the scenario, physician sharing culture with patient about the health position shows their mutual trust in relationship. This relationship indicates Kyles right to know as being cognitively capable to perceive pros and cons of the treatment and participate in the discussion. According to Tabak and zvi (2009), the norm of informed consent is that patient has right to know truthful information about his health status from health care professionals to make informed decisions. From the case study another eviden ce indicates, Kyle being cognitively mature adolescent with a chronic affection (at the climb on of 5), knowledge to make informed decisions (DNR) and, experienced with treatments (several dose of chemotherapy). According to the article by Tabak and Zvi (2008), if the adolescent being minor is coping with long term and life threatening situation then patient is cognitively aware of the nature of the illness and has right to give consent. With this fact, his parents are seizing over his self-sufficiency by denying his pickaxs or capacity to make decisions. According to the article by Rogers, Alex, Macdoland, Gallant and Austin (2009), states that allowing children to express and widening choices escalates their quality of life and haughtiness. In this case, parents excited grief for child may prevent them understanding childs moral value or quality of life. It seems parents attachment with child making them not to understand childs knowledge of suffering from medications and wishes to extend his life even if it has to do with place on to the hope of future medication to work (Macgrawth Phillip, 2008). As a result, parents are passing game against standards and not performing critical thinking. The evidences found in the case study are true, relevant to make decision, but lacks in sufficiency due to having wretched in-depth reasoning behind klyes decisions.Warrant is another part of the framework. It requires using professional standard of care, and legal precedents and policies. If I were a nurse confronting ethical dilemma conflict between patient and parents decision over treatment, I would critically examine choices using professional standards. First thing I will take childs age into consideration for informed consent. As stated in pediatric Cancer Society (CPS) (2008), in Ontario there is no age of consent. However, there is mature minor right where patient not being adult in age, but cognitively able are allowed to consider the treatment choic es and alternatives based on the valuation of consequences. This explains Kyle being only 14 years old is able to give consent of refusing treatment, which is on his best interest along with knowing his nature of treatment. As well as, according to CPS (2008), when benefit of the treatment overweighs burden it should be respected. Similarly, Kyles choosing to preserve his quality of life overweighs the survival of the fittest of treatment associated with pain and suffering which should be respected. Moreover, according to CNA (2008) code of ethics, under promoting and respecting informed decision-making, nurses urinate right to advocate for the patient if his/her rights are being influences by others decisions. In this case, by abiding this code, I would recognize the kyles right and support his capability to withdraw or withhold the consent for treatment regardless of his parents request. Furthermore, according the CNOs (2009) practice standard ethics clients public assistance and client choice are relevant ethical values for nurse when parents and patients view are differentiated in what is beneficial. I as a nurse without judging would evaluate, respect and determine the rationale for the chosen option by parents and patient in terms of benefit vs. risk to assist in making decision. By abiding professional standards and policies will help me as a nurse to have evidence based rationale to deliver ethical clinical care to Kyle.Basis is the next component in the framework involves ethical principles. In this scenario, autonomy, beneficence, and veracity are ethical principles used as guide to break apart ethical issue (Arnold Boggs, 2011). Autonomy refers to patients right to make informed decision about his/her medical care without having anyones influence on it. In this case, parents desired decision takes over Kyles autonomy by contradicting his decision-making capacity (being minor) regarding his treatment and DNR options. Hence, allowing Kyle to mak e informed decision by allowing him to express his preference, concerns, and wishes would respect his autonomy and will preserve his dignity (Whitty-Rogers et al., 2009). Another principle, beneficence requires to prevent harm to others. In this scenario, kyles going through chemotherapy treatment shows no improvement (beneficences), yet him going through this process for prolong life will increase his pain and suffering. From parental perception, treatment helping to prolong lifetime indicates harm in hope of beneficences. For parents, treatment adding to survival finale over side effects would appear as convenient option to accept (Mcgrath Phillip, 2008). end ethical principle veracity refers to responsibility of telling truth. In this case scenario physician or HCP has provided truthful information to patient and family regarding health status and effectiveness of treatment. Hence, there is no other information hidden from patient to help making informed decision. Hence, it is significance for nurse to continue using this principle to support and oppose argument made by each person to solve the conflict.In addition, rebuttal is another component of framework. It focuses on costs and benefits of each choices. The benefit of the choice made by Kyle will alleviate his suffering by refusing the unresponsive treatment and DNR, which will increase his quality of life. It will strengthen the trust in nurse-patient relationship. On the other hand the risk associated with Kyles choice shortens the quantity of life due to having no treatment and DNR actions to rescue his life. Another harm associated is that it would hinder the relationship between parents-patient and nurse-family due to opposing their request. Furthermore, the benefits associated with parental choices of act treatment will prolong their and Kyles time of togetherness. As well as, risk associated with parents choice will escalate the pain and suffering of patient by minify the quality of life. This violates the ethical principle of choosing non-maleficence for the hope of beneficence and reducing patients autonomy and dignity. As denying parents preference can hinder trusting nurse-patient relationship. Especially when trust, respect and satin flower are essential to meet the health care needs of patient and in facilitating end of life care decision making (RNAO, 2006). Although, alternatives could be musical arrangement meeting with parents and patient will help to understand each others perception, as well as allowing to accommodate/negotiate any choices to reach mutual decision. This way parents might be able to see the suffering and pain that treatment brings for child in order to prolong time. Also, Kyle would be able to understand turned on(p) side of parents where his life is more valuable and beneficial over side effect of the treatment. As a result, palliative care could be an alternative option in progressive illness to ease quality of life with quantity of l ife. Palliative care can benefit in relieving the suffering in holistic way of patients life. For example, chemotherapy being used can have medications to relieve side effects of nausea to minimize the suffering (Mcgrath phillip, 2008). As well as, choosing to continue with the unresponsive chemotherapy treatment (side effects) with palliative care may limit the patients quality of life.At last, a nurse being reasonably prudent and ethical should apply moral principles in decision-making. The primary object of the nurse would be to identify ethical issue. The ethical issue in this case study is adolescents treatment decision conflicts with parents decision in determining authority for decision-making. Then nurse will evaluate the evident data to obtain all the relevant and sufficient information. Moreover, nurse should have understanding of CNA, CNOs code of ethics, and RNAO BPGs to have knowledge regarding law, legal action and to have evidence-based rationale in guiding the decis ion-making process. Nurse would evaluate the claim by recognizing moral reasoning in each persons perspective. According to CNA (2008) values, under client wellbeing and choices, nurse should respect family and patients opinion. Nurse should make parents acknowledge about the adolescents right in making decision. If patient is mature minor and competent to make informed decision then nurse should advocate for patient even if its opposes parental request. Last but not least, nurse should weigh risk and benefits of each persons choices in terms of possible long terms and short-term consequences. Hence, nurse can offer alternative options by collaborating with other HCP if necessary to balance and develop mutual goal between HCP, patient and parents.In conclusion, to achieve resolution in ethical dilemma involves critical thinking. This paper has analyzed an ethical dilemma in determining whether is it Kyle or parents, who has authority to take decision regarding treatment. It evaluate d others factors such as pediatric age consent, and being cognitively competent to understand the consequences that could influence the decision-making. Paper also included three nursing journal to support the evidence, professional standards, and ethical principles to direct decision-making. At last, being ethical nurse, to determine decision in patients best interest, possible consequences from the choices were outweighed in terms of risk and benefits. Thus, the use of decision making framework facilitated in deciding what is morally and ethically acceptable in patients best interest while facing ethical dilemma.Kyle is a 14 year old male diagnosed with acute lymphocytic leukemia at age 5. He has endured multiple relapses requiring several rounds of chemotherapy with short periods of remission. He has been readmitted to the paediatric oncology unit after metastases to his lungs and soul have been found. During a family meeting to discuss treatment options, Kyles attending physici an explains that the cancer is rapidly progressing and unresponsive to treatment. Kyle feels that he has endured enough and does not want any further heroic measures and has asked that a DNR (do not resuscitate order) be placed in his chart. Kyles parents do not agree with this course of action and are holding onto to hope that more treatment may prolong his life.

Tobias Wolff Essay -- Papers

Tobias WolffTobias Wolff, a boy of a troubled childhood, and a truly tough father. Tobias Wolff had no intentions of being a writer from the start it just seemed to of popped into his life. The Amazing part about this writer is that he was not supported by anyone but himself. His father was against everything that he did, and his brother, Geoffrey, also a writer would always take his fathers side, leaving Tobias on a side of his own. I wasnt fair, I always took my fathers side. Said Geoffrey (Wolff, G Duke of 144) Geoffrey was known as the Good Brother as his father would guess. This was wrong for a father to do, parents brush offt play favorites, because it leads to one child feeling left out, or rebelling against it like Tobias Wolff did. I feel that the reason for the father favoritism towards Geoffrey Wolff was because Tobias was the younger brother, and younger brothers may be known to be more insubordinate. Although, there was nothing said about how Tobias acted in his chi ldhood, he might have been a rebellious child, which may of turned his father towards Geoffrey. Tobias decided to enlist himself into the army once he couldnt deal with his father anymore. No, he was not drafted into the army he chose to enlist himself into the army acting on his own free will. Many say that Tobias did this to escape his troubled childhood and mainly his father. Shortly after Tobias enlisted himself into the army, he was called to battle in the Vietnam War where he experienced many different styles of life. Shortly after the war ended Tobias wrote a novel, most people say it was his best work, titled In Pharohs Army memories of the lost war. The reason this came to be such an amazing work was it contained his wartime experiences... ...Irving. The vintage book of Contemporary American Short Stories, Article 17. http//web7.infotrac.galegroup.comrn_17_0_a16559373?sw_aep=pace_mainSpring, 1995 March 22, 2000Meyer, Michael. The Compact Bedford introduction to Literature, Powder, Tobias Wolff, p.525. 2000 by Bedford/St. Martins.Wolff, Tobias. In the Garden of North American Martyrs. 1945, The Ecco Press, New York. 175pgs.Smith, Joan. The Salon Interview Speaking into the Unknown, http//www.salon.com/dec96/interview961216.html , 3pgs. Wolff, Tobias. Hunters in the snow, http//www.bnl.com/shorts/stories/huntsnow.html , 1997 B&L Associates, Renton, Washington, 12 pgs. (Gary Lindquist---Comments).Wolff, Tobias. This Boys Life, 1989 Grove Press, New York, NY, 288pgs.Wolff, Geoffrey. The Duke of Deception - memories of my father, Random House inc. 1979, 275 pgs.

Versaces Men Without Ties :: Versace Image Advertising Essays

Versaces Men Without TiesMen Without Ties (p.25, Hannah) reveals a male figure, athletically built, broad shouldered, narrow-waisted, muscular legged, with one Versace necktie in hand and two tied around the waist. The figure is captured in a dynamically dashing pose, choreographed to show off his muscles, built, vitality and gracefulness. Men Without Ties is one of some(prenominal) nude poses in Versaces Men Without Ties, a portfolio album of his works. Here, Versace puts together a collection of sketches, designs and magazine advertisements, inserted into such avante-gard fashion magazines as Vogue, Elle, Bazaar, etc. for his Mens Wear collection. Here, Versace introduces to the everyday public, to the passionate collectors of Versace clothes and to those fans with an eye for fashion, his idea and concept of the New Man, Versaces man without ties.This man without ties refers directly back to Roman sculptors Diskobolos a marble copy of Grecians genuine of c.450BCE . (Diskobolos is one of many surviving Roman copies of classical sculptures, indicating Greek artistry and sculptures prominent and long lasting influence on Roman civilization and society). This heroic- surface statue depicts a nude athlete, a discus thrower at the moment when the discus is swung furthest back, at the very decisive moment just seconds beforehand the discus will be soared into the air (p.114, Robertson).Discus Thrower type sculptures, art and architecture is typical of Greek High Classical and Hellenistic art and occupations. High Classical and Hellenistic art desire to portray healthy and vigorous athletes of ideal physical proportion and beauty, to represent the vigorous, healthy and active Greek individuals and citizens. In this way, sculptures, along with other art mediums and architecture, hope to elevate Greeks victory and to celebrate Greeks triumph of a democratic and enlightened city-state over Persias imperial forces Greek civilization over Persias barbarism reason over animal passion.Both Man Without Ties and Diskobolos , as mentioned, portray a vigorous, athletic figure, dancing theatrically in dramatic actions and gestures. Whereas Diskobolos is rendered in sculptural, life-size, three-dimensional form, Man Without Ties is rendered in a two-dimensional, black-and-white photograph. Nevertheless, both mediums further express Greek High Classical and Hellenistic arts concern for a more expressionistic figure, one that conveys and appeals directly to the senses through this lustrous glistening of surfaces and emotions.The action-figures are now able to reach out beyond its contained set and into the immediate surrounding environment. The figures now seem to impose themselves forcefully upon the spectator, provoking the viewers response to the dramatic situations.

Myrdal On Wall Street :: Roger and Me Economics Essays

Myrdal On Wall StreetMyrdals economic theory of circular and cumulative motive is depicted in the film Roger and Me. In rocklike, Michigan, General Motors closes eleven factories, which causes over thirty thousand people to become unemployed. The company claims that they need to close the factories to apprehension competitive. The viewer sees the truth they are greedy and will make money wherever they can, regardless of the people they may harm. Labor is much less dearly-won in Mexico, where GM only has to pay the workers $0.70 an hour. As a result, General Motors begins to close plants in stony and move them to Mexico. Some people leave Flint to find work elsewhere and some remain, struggling to find new forms of employ manpowert. As more than and more workers lose their jobs, poverty in Flint becomes more severe. Increasingly people are evicted from their homes, become ill, the violent crime sleuthe in Flint becomes the highest in the country, and the general standard of livi ng plummets for the poor. Michael Moore describes their living conditions, The rat population has now surpassed the human population. Their environment worsens to the point where Money Magazine declares Flint the worst place to live in the country. The poor citizens in Flint live Myrdals circular and cumulative causation theory. In addition, the rich population of Flint prospers during this quantify of great poverty. The wealthy community of Flint spends their time at the ballet, golfing and relaxing at Grosse Point. When the jail becomes too full and another one is built there is a large party in which couples pay one hundred dollars to stay over night in one of the new cells. They didnt seem to mind celebrating American tragedy, as Moore had say in another instance. At the end of the documentary, Michael Moore says, The rich were richer, the poor, poorer and the people everywhere had a lot less lint thanks to the lint rollers in my town. It truly was a infiltrate of a new era. Myrdals theory is also highlighted in the films, Wall Street and The Boiler Room. By not hiring women and creating a male dominated environment, the men progressively gain power, just like the rich getting richer in Roger and Me. The women do not have the same opportunities to earn money and power. Several factors reach the portrayal of Mrydals theory of circular and cumulative causation.

Gunslingers :: essays research papers

GunslingersThe wall beside Gerard exploded as a high velocity bullet afflicted the already heavily battered bricks and sent them shattering outwards in a spray of red shards. Gerard stood still, whizz hand casually flicking the ignition swan on his lighter. As he lit the end of his cigarette, another volley of bullets stuck the wall behind which he was hiding. Bullet holes riddled it like holes in a Swiss cheese, and the cover was becoming steadily more useless. He took a puff and tucked the black lighter back into the pocket of his trench coat. He put two fingers to the cigarette and removed it from his lips to breath out the slow stream of smoke whilst his opponent continued to waste his bullets and his time shooting aimlessly at Gerard. A row of bullets riddled the wall five feet to his right and he called out, Hey, nearly got me that time. In a mocking voice. His enemy muttered a disapprobation and Gerard heard the impenetrable of footsteps approaching. The cowardly bastard had called for backup. Oh well, the more the merrier. A fresh stream of shots, this time from a multi-barreled rotary cannon spat out on Gerards cover. He watched with casual indifference as the red brick wall lento disintegrated around him, slowly reducing his cover to just the tiny department of masonry that he hid behind. There was an ominous silence broken only by the sudden thump as an entire section of wall collapsed to the ground. Gerard heard the sound of one of his adversaries reloading their weapon. He dropped the cigarette on the ground and stamped it out with his boot. He reached within his trench coat and withdrew a shining silver revolver. He slowly and almost carelessly loaded one shot after another into the weapon, occasionally jerking his head to one side as a roll up bullet clipped the edge of the wall. As he placed the last shot in the ancient weapon he spun the wheel and gripped the handle. He past paused for a moment until his opponents clip ran dry again and he heard the sound of the rotary cannon being loaded again. Gerard took one step to the left and with barely a glance calculated exactly how far his opponents were from him. In the same fluid motion as he all told removed himself from cover, he leveled the revolver at the two enforcers across the deserted plaza from him and squeezed the trigger.

Chose in Leadership Books :: essays research papers

So, you want to be a leader but dont know where to start? Well, after camping out in the self- sustain section at my local bookseller, Ive got good news and bad news. The good news is that youve got lots of help to choose from. The bad news is that youve got lots of help to choose from. In my brief reconnaissance, I discovered a legion of writers who are just itching to let you in on their secrets. Dont believe it? Well, Ill pull through you a trip. I brought back proof. Dont expect a definitive list though. The cottage industry thats grown up around the subject of lead advantageously keeps an army of loggers working overtime. So I just jotted down a representative s colossal -- enough I think to convince even the roughly skeptical that theres something for almost everyone. So, FOLLOW ME and read on. As you might have guessed, leadership books are all over the map. If you want your leadership hard-edged and bloody-minded, you can come on up with Attila the Hun or Niccolo Machia velli ( leading Secrets of Attila the Hun, by Wess Roberts Machiavelli on Modern Leadership by Michael Ledeen). If you worry that Attila might be too old school, dont despair. There are ample contemporary choices. How about a couple of political celebrities like Rudy Giuliani (Leadership) and Colin Powell (Oren Harari, The Leadership Secrets of Colin Powell)? Sorry, Colin, but Im guessing that theyre not so secret any more. Finally, for the truly avant garde, theres Leadership for the Twenty-first Century, by Joseph C. Rost. Not to digress, but Colin got me thinking. Ive read The Da Vinci Code and Ive heard about conspiracies to keep the rest of us in the dark. I applaud if theres a cabal of leaders trying to hide their secrets from the hoi polloi. Well, maybe. Colins not the only one whos decided to fess up. GEs former boss, Jack Welch is another insider whos finally talk (Robert Slater, 29 Leadership Secrets From Jack Welch). Even Santa Claus has decided to come clean (Eric Harv ey, The Leadership Secrets of Santa Claus). Who knew that the teamsters kept secrets? Theres also a heated debate over whether leadership is art or science. Max Depree says Leadership is an Art. And, hes got lots of company including retired General Barry McCaffrey, (Leadership The Warriors Art) and Ken Blanchard (Heart of a Leader Insights on the Art of Influence).

Problems in Australian Society :: australia

Australia Still the Lucky Country?Fire, flood, drought & cyclones. These are just some of the natural disasters that the so c totallyed, Lucky Country, Australia endures every year. And, with 5% of Australias population living overseas, we are beginning to question if Australia really is the lucky country. ITS true, that Australians are luckier than people from most other countries in the world, but are we really living in THE lucky country? Is there even really a lucky country at all?Once a dumping ground for criminals and never-do-goods during military personnel War II. Australia became a home for almost seven million immigrants, many of them British people who want a new start over in a sunny country with a hopeful future.Australia was once a dumping ground for criminals and never-do-goods during World War II.Now, Australias luck may have run out. Australia has had many different sorts of problems throughout the recent years, asTwenty years ago, the regular Australian employee w as too busy to worry about the happenings of parliament. Numerous people waited until Bob Hawke became Prime Minister, after only two years in parliament. The politically dewy-eyed voted for this regular bloke who understood real Australians and he spoke like one to. His fair dinkum accent was his greatest asset.As soon as he became Prime Minister this courageous, fair minded, man for the nations citizens turned into a wimpy, deceitful man, who had lost touch with his fel modest Australians and walked the same direction as his forerunners.The Howard government was not much improved it improved the economy, but had a terrible record on human rights issues. Its only actual bliss had been to restructure the indirect tax system and to boost the reserve banks independence. Then there are natural disasters over the years, Australia has experienced more than enough natural disasters. Drought is without doubt one of the most complex troubles that Australia must deal with. Due to the fact that Australia has an enormous area of desert, and very low annual rainfall, the country is very modify.Fire is another problem within Australia. They are among the natural disasters that cause the greatest loss of both humans and material. The fires time out out for many different reasons, but one of the main causes is the dry air, that throughout summer, blows from the deserts to the coast. Another cause is during droughts, there is a lot of dry land, the heat from the sun can cause fires.