Business Ethics Essay Example | Topics and Well Written Essays - 500 words - 37

Business Ethics - Essay Example For example, the level of pollution may vary but that does not mean that pollution is not experienced by either of the States. Differences in ethics are mainly based on professional cultures, laws, organizational culture, and human resource systems. In the United States, for instance, bribery to acquire a business is forbidden. In other countries, no business transaction can be conducted without bribery. In others, money obtained from bribery is tax deductible. In Asia giving business, gifts imply value for business relationships and convey respect. In the United States, such moves may not be necessary. Some might even consider it as a bribe to influence judgement. A code of ethics can be established for the global market through research. This will be achieved by gathering information about cultural requirements on different countries. These requirements can then be modified so that they are applicable to different business circumstances. Similarity with American code of business ethics will be professionalism such as proper communication channels. The difference will incorporate different cultural expectations. The first measure that should be taken in case an organization offends a foreign culture is to establish the nature of conflict by understanding the history of cultures. Expectations of different cultures greatly affect transactions. It is, therefore, important to understand cultural bases that define ethical behaviour. The second step requires conducting research about foreign ethical guidelines prior to getting into business. This knowledge acquired combined with good managerial skills can rectify an organization’s reputation. Finally, the offended party can be given the fundamental right to choose, and other advantages over the organization hence maintain integrity (Kent, 2014). Ethical frameworks greatly differ in the global business market hence making it difficult to distinguish practices

MGT 647 Individual Project 5 Assignment Example | Topics and Well Written Essays - 750 words

MGT 647 Individual Project 5 - Assignment Example he departments so that there could be a streamline of work flow and accountability ensured to both the project leaders and management of project done in an efficient manner that conforms to organization requirement. By undertaking the activities, Advance Corporation was achieved and improve in many ways. By training the labors, there was employment of highly qualified workers who could articulate major issues in the company hence there was a smooth flow work and reduced burden on behalf of the managers since quality was guaranteed (Russell, 2007). The departments who were understaffed before could improve work since more workers were allocated to them. Through the adoption of the videoconferencing facility, management of the project and coordination became easier since there was sharing of information at all levels of the project cycle reducing chances of not spreading information from one department to another. Movement was also made easier since the geographical barriers were greatly minimized since the facility enabled the managers to take control and coordinate work at any place without interference as they either travel, away on other company duties or get meeting information at any place (Gido & Clements, 2012). By structuring the duties of the departmental heads, especially the research and development,t and that of sales reduced the problems that had emanated previously caused by either the confusions in responsibilities and disagreements to a more continuous flow of work with distinctive work procedures leading to a more efficient and faster work. Differences in opinions acts as the generation of ideas as to how to articulate issues as alternatives to the best solutions. After a thorough discussion with the two managers, it was easier for them to understand one another and acts with flexibility which provided a good environment to the work process in the organization. By implementing the actions and deeds the company was able to achieve its objectives

Crisis Intervention Plan For School Shootings Social Work Essay

Crisis Intervention Plan For School Shootings Social Work Essay School shootings are one of the common events that achieved a level of cultural symbolism and make fear within students, their relatives, and school personnel. It is not shocking that these shootings are still happening, since the source of the problem is sophisticated. School shootings promote depression and anxiety within schools and encourage the idea that schools are unsafe for many students; in this paper I will discuss the course of action in Virginia Tech and my role as a school psychologist during the crisis. On April 16, 2007, Virginia Tech experienced a terrible and unforgettable event in the American university history. An Asian student shot and took the lives of 32 students and faculty, staff. He left behind injured individuals and people with psychological problems, and then he killed himself. Moreover, victims families, friends and the university community have suffered horribly. As a school psychologist in Virginia Tech, I think it is very crucial to collect the data about the student who killed the victims in order to know more about the real causes that led him to shoot people and kill himself after. This will help to deal with students behavior to avoid and stop real causes before they get more complicated. The student murderer was skinny and looked younger than his age. He did not participate in class and did not want to speak. The professors reported that he was mentally ill and he asked him to seek counseling. I believed that it is important to work with students who have same symptoms like this person who needed an early diagnosis. I believe that mental health clinics receive a big number of antisocial behaviors which is the most common disorder in our daily life. I think that early diagnosis of serious aggression that can be Conduct Disorder which begins as aggression in the early childhood and developed during adolescence and adulthood, it is very vital to know about these cases in order to help those individuals since they were diagnosed with Oppositional Defiant Disorder (ODD). Conduct is a disorder that refers to people who deal with specific behavioral and emotional problems during the childhood. People diagnoses with this disorder cannot focus and they have a hard time to follow rules. They are often referred as bad people or delinquent, ignoring that they mentally ill. Course of action Schools must be protected and safe places for children to study, however after this shooting event, a number of students and their families still feel threatened and their lives in danger by armed and dangerous classmates. As a member of school community we need to discuss our plan and how to deal with current students, families, professors and the other members who experienced the incident and help them to overcome and continue benefit from school. I believe that it is very interesting to work with survived students to trust us and discuss our plans to offer a safe place to learn. As school staff, we need to work with parents and public safety providers (local police and fire departments, emergency responders, hospitals, etc.) (National Association of School Psychologists, 2006) The school community needs also to enhance, and renew the school procedures to keep school building safe. Work with students to be able to discuss and talk aloud if something happened that makes them feel un comfortable, worried or scared. Teach the students that everybody play a big role to maintain the school safety. School community needs also to offer crisis training and professional development for all staff based upon needs assessment. (NASP, 2006) Anger and violence are progressively more significant issues to school psychologists and other professionals today. Those educators faced the effects of learning problems and social adjustment issues. It is very significant to provide monthly workshops for all students to identify their feelings and help them to know how to manage their feelings of anger, especially if they are taking drugs or having mental illness will be helpful. It is very important to teach and make students stay away from drugs and alcohol. Added to this, being away from guns and other weapons will be helpful as well. Teach students in early age that violence is not a solution to handle problems. Therefore, provide counseling sessions to all students, especially those who are struggling with anxiety, depression, or other emotional concerns that they cannot handle. William Pollack, a Harvard Medical School psychologist, stated in the incident of the Columbine shooters needed help, and what they got day after day was no one noticing. They were left alone. Adolescents, even though they say they want to be alonethey really want some kind of connection with an adult who understands and cares. (USA today, 2009) As a school staff, we need to work on our safety programs as well. We will need to lock doors, provide security cameras and call systems. We need to encourage and build up the respect between staff and students, students and students. Respect the students potential and performance is very vital also. The interaction between counselors or professors and students is very important to be able to recognize students feelings and alert any serious emotional issues or mental health problems. Check and connect is a good strategy to provide to school staffs in the workshops. In this approach, every day, one professor or more should talk about a specific students case. As the initial responsibility we have as school staff, we should help people experience the event in an appropriate context. We need to provide counseling and psychological treatments and we have to work with them to be able to continue their studies and help them to achieve their goals as they came for the first time and may be better. We have to work with those people who were in the event on the traumatic that may happened and they will think about all the time. We need to be able to help them to forget it and start a new personal and educational safe life. It is obvious that people who commit this kind of things and shooting usually have mental disorders such as severe depression or other emotional problems. Those individuals usually feel unwanted and badly treated by others, they are dissatisfied in their academic performance and goals, and therefore they go for suicide and shooting in order to do revenge. Moreover, these students always prepared for their plans previously and they talked about their purposes in advance. Hopefully, we will have time to know about their plans and help them recognize their feelings to be able to intervene early. That is why I believe that we need to build up confidence and communication with students and promote them to ask for help whenever they feel that they need it. As people working in schools, the event is hard to experience, but we may be able to better control the school and in preventing more shootings. Moreover, students who are under medications for anxiety, depression or other concerns and are currently in university, they need to be in contact with their doctor, therapist as well as their family. It may be also appropriate for students who have faced a prior traumatic event as well. I believed that school shooting is one of the biggest issues that need more than a single solution; poor parenting and early identification are big terms to think about dealing with such incidents. Most shootings in schools occurred primarily because of revenge against society. Specific people such as parents, friends, and roommates know how to help professionals to diminish specific psychological outcomes of a traumatic incident by using observation as a method to watch students who are at greater jeopardy and assist directly. Awareness of the issues that can lead to cruel psychological distress may assist adults to differentiate those students who need mental health assistance. As school community, we should plan cooperatively to invent a safety within schools to decrease violence by utilizing various approaches in order to meet each schools needs. For an effective result, it is helpful to include the following components such as making school-community safety partnerships, establishing comprehensive school crisis response plans (NASP, 2006) As a course of action, schools should adopted new laws and strategies to cope with this new style of showing such brutal aggression in instructional establishments, such as forbidding violent behaviors by issuing a disciplinary rules and punishments against individuals who are attempting to be involved in aggressive behaviors in schools settings. Besides, schools need also to offer a proper and effective counseling therapy for people who still under the shock of a shooting incident and help them to overcome the crisis time. As far as community is concerned, it should be a priority to protect students who experience aggr essive events and make them regain confidence to pursue their academic and emotional life. Improving classroom environment is also presented in our school plan by endorsing such a positive school discipline School climate is a relatively enduring quality of the entire school that is experienced by members, describes their collective perceptions of routine behavior, and affects their attitudes and behavior in the school (Camilla Sandra, 2007). Our program fights racism and intolerance and implements strategies to accept people from different cultures; in school program, the community promotes consultation, appropriate social skills, rising security in schools, and use disciplinary method to punish individuals who did not respect the school policy. Utilizing prevention programs for all students is one of the vital strategies we have in our program like talking about the federal law. Basically, we also implement some specific interventions in order to support students positive emotiona l development and educate them to utilize non-violent methods to decipher their personal concerns. Support students who show early signs of violation behaviors at schools and encouraging peer relationship by utilizing communication and mediation programs to resolve conflicts. School-based mental health services are very wanted recently. As school community, collaborating with parents and policy makers we should scrutinize issues that can account for events in which a massacre happened in the establishment setting in order to assist students to accomplish their aims in schools and help them to identify their personal and social issues. During the crisis, as member of school community, we were looking for manners in order to stop these events to re-happen. School Psychologists national association (NASP) team stated that, Crisis has been frequently recognized as a time of potential danger as well as potential opportunity.à ¢Ã¢â€š ¬Ã‚ ¦ If our profession is able to manage the danger that is, manage the immediate crisis and quickly return the system to normal functioning then there exists a tremendous opportunity to stimulate long-term systemic change. Once seen as effective and credible, the psychologist has infinitely more opportunity to move the system in the direction of prevention (Kathy, 2008). School psychologists can be a terrific source to the institutional community in the improvement of efficient mental health services to discuss students and families needs. It is also fundamental that school psychologists become very important and positive individuals in endorsing their task as mental health service providers and programs in schools. My role as a school psychologist As a school psychologist, I need to be able to identify student in need for extra help and aid in recognizing proper referral sources in the community. I would also use the psychological triage as a technique to establish the crisis intervention cure. The use of this approach is particularly significant when the psychological trauma victim surpasses the number of available people who can intervene. According to National Association of School Psychologists (NASP), there are various things that we can do as people working in schools that may insure that schools are secure places for students and enhance the comfort level of individuals such as inform parents by the school safety policies and calamity avoidance efforts. As a school psychologist, I need to be active within schools, communicate with students and their parents. I need also to visit classrooms frequently. Work on students behavior and help school community to teach students the appropriate and expected behaviors, provide interventions and supports. Talk and make a link with community colleagues to evaluate emergency response plans and discuss the needs that may be noticeable to the current crisis. Highlight violence prevention programs and curriculum currently being taught in schools and emphasize the efforts of the school to teach students alternatives to violence including peaceful conflict resolution and positive i nterpersonal relationship skills. Cite specific examples such as Second Step Violence Prevention, bully proofing, or other positive interventions and behavioral supports (NASP, 2006). My role as school psychologist as well is to prevent those individuals who homicide others and suicide. An article by NASP stated that society needs to ease closer relations as a replacement of watching television and using computers in the rest of the evenings, visit friends, classmates, and neighbors, walk you dog or go for picnic will help to stop murders to realize their plans and crimes. As a course of action, we should work on the relationship between students, their professors, and other school workers (NASP, 2006) My role as a school psychologist also is to examine the psychological disorders of students who appeared to be at risk such as those individuals who may have post traumatic stress syndrome, depression, Schizophrenia, and other mental health problems. It is very significant to early diagnosis those people with the previous disorders in order to be able to intervene and help them to live normal people and act responsively. My job as a member of the community is to be aware of some people who refuse to talk about their experience in the past and hide their traumatic events. In this point, I need to be able to help survivors of this horrible crisis to talk about it and assist them to be able to identify and discuss their feelings from it. I need to be able to aid those people by using psychotherapy sessions and advanced techniques. As a school psychologist, I can be trusted to help with delicate personal and family situations that interfere with schooling. I can also help prevent future problems when I intervene with learning problems early on, and I can also recognize that changes in the school environment and at home can improve the quality of life for children and their families.   For most victims, cognitive-behavioral therapy is the best treatment that I can use in order to change distorted and possibly harmful perceptions of post-traumatic stress, severe anxiety, depression, pleasant mental image ry, and relaxation techniques. Other counseling and therapy techniques may help those people achieve a good perceptive of the illness and the factors that protect against it. There are also stress inoculation training and visualization techniques that can be used as treatment to help those victims in our school setting. All these treatments need to be taught to survivors in order to practice it on their own. I need also to share with them my feelings, experience, and signs to help decreasing feelings of fear and helplessness. In terms of intervention, as a school psychologist I should work and consult with teachers in order to choose, implement, and evaluate interventions that best work for the different needs of different students.   As expert I need to be able to teach students, teachers, parents, and other professionals problem-solving strategies to address issues related to students academic, behavioral, and psychological problems after the incident. I need also to be able to assist teachers, parents, and other professionals use data-based decision making to improve student and systemic outcomes. Besides, I have to help teachers understand the unique needs of students, especially those diagnosis with mental health problems. It is very important to consult with those individuals doctors and counselor as well in order to keep in truck, know more about their current situations, and help them to release their pains. NASP promotes that school psychologists to take a leadership role in developing comprehe nsive approaches to violence reduction and crisis response in schools (NASP, 2006). Since school psychologists are capable to involve in the whole school personals in enhancing and applying positive behavioral interventions that support social-emotional development of students. School psychologists are also important members who are skilled by using and implementing different intervention strategies that may decrease violent behaviors within school settings and with different students. As a school psychologist, I can discuss with other school members the implementation of social skills activities and other techniques used in order to educate students how to solve their personal issues. My other role is to offer consultation process to promote schools form calamity planning teams. As part of the evaluation program, I need to reduce aggression activities among students and help those who were presenting during the incident physically, psychologically, and social seclusion. As far as m y role, I will help school to response to this emergency case. As a school psychology, my role also is to be well aware of the advantage of the early intervention and prevention efforts. Traditional crisis caregivers include emergency response professionals, mental health providers, medical professionals, victim assistance counselors, and faith leaders (NASP, 2003) those professionals are all well skilled to handle different cases and to help sufferers to manage their life and handle their problems. Teachers and administrators are the most people who interact with our students; however some of them did not get any training to offer mental health services and intervention. As a school psychologist, I think that will be very helpful to provide trainings and help those professionals to be able to intervene. These roles of school psychologists are very vital elements as plans of school safety. To guarantee that school psychologists are well trained to offer leadership in school violence prevention. NASP helped school psychologists to get the necessary comprehension and skills to apply aggression prevention and the crisis in schools during their programs and through their life experiences. Summary Very serious violent problems occur in school settings and have sophisticated causes, unknown sources and valuable consequences. Besides, fights, sexual harassment, and bullying that occur every day in all school establishments in the world. We started to experience shootings people at schools and suicide. These affected the schools environments, safety, and made many students, relatives and school staffs to undergo horribly. Thus, the efforts to decrease aggression at school settings need to be multi-faceted. School settings are trusted to protect children and keep them secure during the school day. Teachers, principals, and all school staff do big efforts to keep students safe and away from any danger. Many students trust schools and they feel happy and comfort in the school staffs who save them from harms and protect them. There are various cases and huge number of shoots and suicide in school settings, therefore schools and professionals community need to prepared in order to have a minimum damages and handle crises, in order to keep students and staff out of harm and able to learn and teach. In my opinion, I think that a successful and effective program will guarantee the safety of all students and school staff. It is crucial to create programs that lead to stop and reduce aggression and responding rapidly and efficiently whenever violence happens. Aggression decrease plans have to also affect on all student approaches to violence, educate them and school workers to be able to solve their skills in an effective away, and help the school to make an environment that encourages acceptance and tolerance between students and staff. School safety programs are very efficient when we involved other groups of violence prevention efforts such as local law enforcement, juvenile probation, public health personnel, and other parent and community groups (NASP, 2006) This will help to reduce aggression and anger among students in order to ensure life of all children and youth and improved their performance to achieve their goal. I believe that all families, friends, and school staff have the responsibility in this massacre, by ignoring the murder mental health history and let him lived in the campus as a normal student. The safety group of the campus has also a big responsibility and failed to intervene in the appropriate time to stop the killing show was happening. The uncontrolled guns are big issues as well that led to kill those innocent students easily. All school psychologists have the responsibility to give hands to educational institutions and involve in the methodical group structure and problem solving process. They have the responsibility to analysis the data and identify students problems. All these plans should be discussed in objective data of school databases. Typically my role as a school psychologist is that I cannot make diagnosis, but I can provide data by using various number of assessments tools like doing observations, interviews, and consulting with parents and other professionals. There are very big numbers of interventions that can be used by school psychologists to assist those individuals in order to comprehend their goals and try be able to deal with it.

Sophocles Antigone - Antigone Must Challenge Creon Essay -- Antigone

Antigone Must Challenge Creon in Antigone    In his "Funeral Oration" Pericles, Athens's leader in their war with other city-states, rallies the patriotism of his people by reminding them of the things they value. He encourages a sense of duty to Athens even to the point of self-sacrifice. He glorifies the free and democratic Athenian way of life and extravagantly praises those willing to die for it. In Antigone, Creon, Thebes's leader in their recent civil war, also must rally the patriotism of his people. While he, too, praises the loyalty of his people, he does two other things to rally the citizens: he emphasizes his own qualifications for leadership, and he reminds them what happens to traitors.   Ã‚  Ã‚   Creon speaks to his people at the beginning of Antigone because he is now the only ruler of Thebes, and he wants them to be loyal to him. He knows there's a chance they might not have faith in him because in Oedipus the King he claimed to be content to leave the active leadership to others. Also, he's not next in line to be the king after Laius, the late, beloved king. Even more important is the fact that Laius's grandchildren, Oedipus's sons Eteocles and Polynices, ended up on opposite sides of a war over Thebes. Some Thebans were probably loyal to Eteocles, but others may have been sympathetic to Polynices, who tried to take the throne away from his brother. Now Creon, the new leader, will have the best chance for success if he gets the people to forget about Oedipus and the terrible time of his rule, and about Oedipus's sons and the rebellion that divided their country. Although he does praise the Thebans for respecting the royal house of Laius, saying, "your loyalty was unshakable" (line 187), he wants them to reali... ...ells trouble for the city's future and for his own success. Sometimes he sounds harsher and more threatening than Pericles did, but the problem of unifying people after a war between brothers is more difficult than unifying people to fight outsiders (which is what Pericles had to do). After all, Pericles can praise all the Athenians who died for their city's sake in the Peloponnesian War, but Creon can't praise all the Thebans who died in this battle. His idea for unifying Theban citizens behind him is to focus attention on himself as an example of everything they admire, and to show them the terrible consequences for disloyalty. Given the situation, I see this as an admirable goal, but I can also see why it's inevitable that Antigone, the strong-minded daughter of Oedipus and the sister of Polynices, will see Creon as arrogant and will challenge his rule.      

Force Practice Questions

A hockey stick exerts an average force of 39N on a 0. 2kg hockey puck over a displacement of 0. 22m. if the hockey puck started from rest, what is the final velocity of the puck? Assume no friction. Your physics teacher walking with the aid of a cane approaches a skateboard of 3. 5 kg lying on the side walk. Pushing with an angle of 60 degree down from the horizontal with his cane, he applies a force of 115N, which is enough to toll the skateboard out of his way. Calculate the initial accelerationA solo arctic adventurer pulls a string of two toboggans of supplies across level, snowy ground. The toboggans have masses of 95kg and 55kg. Appling a force of 165N causes the toboggans to accelerate at 0. 61m/s2. Find the tension in the rope attached to the second toboggan. A 75kg man is standing on a scale in an elevator when the elevator begins to descend with an acceleration of0. 66 m/s2. What is the reading on the scale while elevator is accelerating? A 32 kg baby is practising climbing skills on a climbing wall, while being belayed by her parent.The child loses her grip and dangles from the rope. When the parent starts lowing the child, the tension in the rope is 253N. Find the acceleration of the child when she is first being lowered. The lighter person on an Atwood machine is 45kg. If the tension in the rope is 512N, what is the mass of the second person? What is the acceleration of the two people? A 40g glider on an air track is connected to a suspended 25g mass by a string passing over a frictionless pulley. When the mass is released, how long will it take the glider to travel the 0. 5 m to the other end of the track. Starting from rest, Grace bikes down the starting ramp at a professional biking track. If the ramp has the minimum legal dimensions (1. 5m high and 12m long), find the acceleration when coefficient of friction is 0. 11 Lyn flick a 5. 5g coin up a smooth board propped at an angle of 25 degree to the floor. If the initial velocity of the coin is 2 . 3m/s up the board and the coefficient of kinetic friction between the coin and the board is 0. 4, how far does the coin travel before stopping?

Physician-Assisted Suicide (PAS)

Why would anyone consider Physician-Assisted Suicide (PAS)? It’s a scenario that’s seen all too often—a chronically ill woman is suffering in severe excruciating pain daily and feels like she’s become a burden to her family, a lonely man is suffering with a life-limiting illness and has no family to offer any care or support to him. These individuals have lost their independence and feel like they have no quality of life left to live. Great strides have been made to improve end-of-life care through palliative care and hospice programs, but sometimes that’s just not enough. In America, the care that is offered to the elderly and the chronically ill is less than ideal. Statistics show that an estimated 40-70% of patients die in pain and another 50-60% die feeling shortness of breath. Ninety percent of the nursing homes where patients go to receive 24-hour nursing care are seriously understaffed. Patients who are home and have care provided by family o ften feel like they are a burden on their caregivers. The cost of hiring in-home caregivers support is not covered by Medicare or state and federal Medicaid systems. Caregivers often suffer from physical, emotional, financial, psychological and social strain. A person may feel as if they have lost all control of their life when they suffer from chronic and life-limiting illnesses. The body isn’t doing what it should and there is no way to stop it.Therefore, a person my feel like they can regain some control through Physician-Assisted Suicide (PAS). If they can’t control the illness, they can at least control the way they die. Suffering has always been a part of human existence. Since the beginning of medicine there have been requests made to end this suffering by means of physician-assisted suicide.Physician-assisted suicide is when a patient voluntarily choses to terminate their own life by the administration of a legal substance with the assistance of a physician eit her directly or indirectly. The patient is provided a medical means and/or knowledge to commit suicide by a physician. The life-ending act is performed by the patient and not the physician. Recent studies show that approximately 57% of physicians practicing today have received a request for physician-assisted suicide in some form or  another.There are many alternatives to PAS that exist. Unrelieved physical suffering may have been greater in the past, but now modern medicine has more knowledge and skills to relieve suffering than ever before. If all patients had access to careful assessment and optimal symptom control and supportive care, palliative care specialists believe that most patients with life-threatening illnesses suffering could be sufficiently reduced to eliminate their desire for a quick death. When the patient’s desire prevails, there are other available avenues to relieve the suffering and avoid prolonging life against their wishes. The driving force behind p atients seeking physician-assisted suicide is quality of life.In October 1997, physician-assisted suicide became legal in the state of Oregon. By the end of the year 2000, approximately 70 people had utilized the physician-assisted suicide law to end their lives. One hundred percent of these cases reported that individuals were not able to take care for themselves and make their own decisions and loss of autonomy. Eighty-six percent of these cases reported that individuals were suffering from loss of dignity and the ability to participate in enjoyable activities.Currently, physician-assisted suicide is legal in Oregon, Washington, Vermont and Montana. Oregon was the first to pass the Death with Dignity Act in 1997. The requirements for attending/prescribing or consulting with a physician to write a prescription are listed in the following table. Washington followed suit passing the Death with Dignity Act in 2008, and Montana passed the Rights of Terminally III Act in 2009.Table 1. S afeguards and Guidelines in the Oregon Act1. Requires the patient give a fully informed, voluntary decision. 2. Applies only to the last 6 months of the patient’s life. 3. Makes it mandatory that a second opinion by a qualified physician be given that the patient has fewer than 6 months to live. 4. Requires two oral requests by the patient.5. Requires a written request by the patient. 6. Allows cancellation of the request at any time. 7. Makes it mandatory that a 15-day waiting period occurs after the first oral request. 8. Makes it mandatory that 48-hours (2 days) elapse after the patient makes a written request to receive the medication. 9. Punishes anyone who uses coercion on a patient to use the Act. 10. Provides for psychological counseling if either of the patient’s physicians thinks the patient needs counseling. 11. Recommends the patient inform his/her next of kin.12. Excludes nonresidents of Oregon from taking part. 13. Mandates participating physicians are li censed in Oregon. 14. Mandates Health Division Review. 15. Does not authorize mercy killing or active euthanasia. Source: Compassion & Choices of Oregon, 2009b.Physician-assisted suicide is illegal in Canada. In the Netherlands, it is legal under certain circumstances, and the right to choose physician-assisted suicide remains highly favored. Physician-assisted suicide is also illegal in the United Kingdom. They currently focus on palliative care. Under strictly defined regulations, physician-assisted suicide is legal in the following countries: Australia, Columbia, and Japan. The legalization of physician-assisted suicide remains controversial.The topic periodically comes up for intense attention. Organized medicine agrees on two principles: 1. Physicians have an obligation to relieve pain and suffering and to promote the dignity of dying patients in their care. 2. The principle of patient bodily integrity requires that physicians must respect patients’ competent decisions t o forgo life-sustaining treatment. There are four main points argued against the acceptance and legalization of physician-assisted suicide along with their counter argument. Improved Access to Hospice and Palliative CareWith quality end-of-life care being made available through hospice and palliative care programs, there is no reason for anyone to seek physician-assisted suicide. In the United States, there are over 4,500 hospice agencies. Millions of people don’t have access to the hospice agencies because of the restrictions on funding and the inflexibility of the Medicare Hospice Benefit requiring patients to have a life expectancy of six  months or less. Counter argument: Rare cases of persistent and untreatable suffering will still exist even with improved access to quality end-of-life care. Hospice and palliative care aren’t always sufficient to treat severe suffering. Limits on Patient AutonomyPhysician-assisted suicide requires the assistance of another perso n. In the opinion of Bouvia vs. Superior Court, â€Å"the right to dies is an integral part of our right to control our own destinies so long as the rights of others are not affected,† was determined. Our society threatens physician-assisted suicide by worsening the value of human life. The sanctity of life is the responsibility of society to preserve it. Counter argument: Physicians who are requested to help to end a patients’ life have the right to decline on the basis of conscientious objection. The â€Å"Slippery Slope† to Social DepravityThere is concern to the opposition to physician-assisted suicide being allowed with euthanasia not too far behind. Without the consent of individuals in physical handicap, the elderly, the demented, the individuals with mental illness, and the homeless, there is a slippery slope toward euthanasia without the consent of the individuals is deemed â€Å"useless† by society. Counter argument: The â€Å"slippery slopeâ⠂¬  would not be allowed to happen within our highly cultured societies. Violation of the Hippocratic OathThe Hippocratic Oath states that a physician’s obligation is primum non nocere, â€Å"first, do no harm.† The direct contrast to that is physician-assisted suicide, where killing a patient is deliberately regarded as harm. Counter argument: According to an individual patient’s needs, the Hippocratic Oath should not be interpreted. Alternatives to Physician-Assisted SuicideThose opposing to physician-assisted suicide argue that there are legal and morally ethical alternatives to assisted death. Patients have the right to refuse any further medical treatments that may prolong the death, including the medications. Counter argument: Life-sustaining measures to live and  still suffer are not relied on by some patients. Withholding life-sustaining treatments would only prolong suffering for these patients. Another argument is that patients can, and often do, de cide to stop eating and drinking to speed up their death. Within one to three weeks afterwards, the death will usually occur, and it would be reported as a â€Å"good death.†Counter argument: One to three weeks of intense suffering is too much for any one person to have to put up with. This debate has yet to see any final resolution. Physician-assisted suicide may become more of a reality in our society because of the undercurrent of public support. The United States Supreme Court handed down two cases central to physician-assisted suicide in 1997: Vacco vs. Quill and Gregoire vs. Glucksberg. In both case, it was determined that there was no constitutional right on the grounds of equal protection or personal liberty to the physician-assisted suicide. Both constitutional history and the Western Civilization trends were argued by the court and generally worked against reading the Constitution that way.The court was sensitive in its decision to the prospect of unintended and unw anted consequences that might follow the recognition of a Constitutional right to physician-assisted suicide. However, it was never said that physician-assisted suicide would ever be legitimate. It was concluded that the states of the Union could decide the matter for themselves. Requests for physician-assisted suicide should be taken very seriously. Responses to these requests should be compassionate and immediate. There are six steps that should physicians should take when responding to requests for physician-assisted suicides: Step 1: Clarify the RequestStep 2: Determine the Root Causes Step 3: Affirm Your Commitment to Care for the Patient Step 4: Address the Root Causes of the Request Step 5: Educate the Patient About Legal Alternatives for Comfort and Control Step 6: Seek Counseling from Trusted Colleagues and AdvisorsStep 1: Clarify the RequestThe physician should talk to the patient about what suffering means to them. Determine if their point of view can be defined. Listen c arefully to their request paying specific attention to the nature of the request. Calmly ask questions to extract the specifics of their request and why they’re  requesting such help. Ask directed and detailed questions to learn whether the patient is imagining an unlikely or preventable future. Listen to the patient’s answers with sympathy but not as if you’re endorsing their request to their perception of what they consider to be a worthless life. The physician must be fully aware of his or her own biases in order to effectively respond to the patient’s needs. If the idea of suicide is offensive to the physician, the patient may feel his or her disapprobation and worry about abandonment.Step 2: Determine the Root CausesThe physician needs to assess the patient’s underlying causes for requesting physician-assisted suicide. The patient’s request may be a failure of the physician in addressing the needs of the patient. The attributes of suf fering should be focused on: physical, psychological, social, spiritual, and practical concerns. The physician should evaluate to see if the patient is having some type of clinical depression or common fear about their future outlook. The patient may be worrying about suffering with pain or other symptoms, loss of control or independence, a sense of abandonment, loneliness, indignity, a loss of their self-image, or being a burden to someone.Step 3: Affirm Your Commitment to Care for the PatientThe fear of abandonment is often felt in patients as they face the end-of-life. They want to be assured that someone will be with them at this time in their life. The physician should listen to and acknowledge the feelings and fears that the patient may express. They should commit to helping the patient find answers to their concerns. The physician should commit to the patient as well as the patient’s family and anyone who is close to the patient that they will continue to be the patien t’s physician until their life has ended.Step 4: Address the Root Causes of the RequestA patient’s request for a quick death is caused by some type of suffering on their behalf. They physician should discuss with the patient their health care preferences and goals. Alternative approaches or services should be discussed at this time with the patient. The physician should be able to determine if supportive counseling is needed for the patient.Step 5: Educate the Patient about Legal Alternatives for Control and ComfortPatients often have misconceptions about the benefits of requesting physician-assisted suicide. They may not be aware of the emotional effort that goes into planning for physician-assisted suicide. They also may not be aware of the emotional strain on family and friends. The physician should discuss the legal alternatives to physician-assisted suicide.The legal alternatives include refusal of treatment, withdrawal of treatment, declining oral intake, and end -of-life sedation. The patient should be made aware that they have a right to decline or consent to any treatment or hospitalization, but that their declining of treatment will not affect their ability to receive high quality end-of-life care. The patient should also be made aware that they have the right to stop any treatment at any time including the stopping of any fluids or nutrition.Patients suffering with unbearable and unmanageable pain may be approaching their last days or hours of life, and the only option available to them is end-of-life sedation. Before the end-of-life sedation should be considered for a patient, the attending physician and members of the health care team should know that all available therapies were tried. This option has to be agreed upon with the patient and their families with the patient have the final say so if they are capable of making the decision for themselves.Step 6: Consult with ColleaguesPhysician-assisted suicide requests are the most chall enging situations that physicians have to face in their practice of medicine. The physicians often hesitate to involve others in these situations for reasons about personal issues being raised, convictions about the inappropriateness of talking about death and concerns about the legal implications of the situation. The personal, ethical and legal ramifications for physician-assisted suicides should be supported by a trusted colleague or advisor of the physician. The trusted colleague could be a mentor, peer, religious advisor, or ethics consultants.Support may also come from nurses, social workers, chaplains, or other members involved in the care of the patient. Physician-assisted suicide requests should be a sign to the physician that a patient’s needs are not being met and that further evaluation is needed to identify the elements contributing to the patient’s suffering. Unfortunately, there is no easy answer to the question of physician-assisted suicide. Patients ha ve  the right to withhold and withdraw life-sustaining procedures. Patients also have the right to receive powerful medication for pain relief and sedation. Physicians who oppose physician-assisted suicide do not always have to prescribe lethal medication.