Community Learning Disability Nursing Essay Example | Topics and Well Written Essays - 2750 words

Community Learning Disability Nursing - Essay Example This discussion highlights that aside from the physical and psychological punches are the psychosocial dilemmas of inequality in access not only to health care services but also in other resources. It then stipulates that learning disability nurses work to dismantle this barrier for the persons with learning disability to pass through to take up a gratifying life.This paper declares that  community nurses provide support on issues regarding their physical care needs, aging, and sexuality. Particularly the main responsibility of community learning disability nurse involves consultancy, assessment, treatment, training, care planning, health promotion, and promoting access to services. In addition to direct clinical and therapeutic role, nurses are involved with activities in delivering healthcare such as health promotion, health facilitation, teaching, and service development. It involves formulation and implementation of a written care plan, utilizing a structured approach with cont inuous evaluation and re-examination taking into consideration the collaboration with the family members and health team and the concept of person-centered planning.  As with any nursing health care delivery, utilization of a care plan is indispensable. Comprehensive assessment must be done in order to identify specific problems and sub-problems occurring which may not be ready recognized by the person with learning disability.... In addition Hall (2004) estimated it to be 25–30 per 1000 with mild and 3–4 per 1000 with severe learning disability in the UK. This number, though not alarming as it seem, deemed the necessity of learning disability nursing’s genesis in the clinical place and community. Gates and Barr (2009) provided a clear definition of learning disability nursing as they stated: â€Å"Learning disability nursing is a person-centered profession with the primary aim of supporting the well being and social inclusion of people with learning disabilities through improving or maintaining physical and mental health.† They comprehensively delineated the purpose of this profession to include the assessment of the health care needs of this population in order to aid them on their optimum level of independence. This task is achieved by the nurse by enhancing skills and competence required to meet the evolving needs of these people from birth to death and through collaboration wit h other agencies and associates. This branch of nursing does not focus only on clinical manifestations of physical health nor specific on mental health, but rather encompass the total well-being of a person in all aspects – physical, psychological, social, spiritual, and emotional (Gates and Barr 2009). Department of Health (2007) in UK reported that the incidence of wide range physical and mental health conditions among people with learning disabilities ceaselessly escalated. These are true to those in the population requiring special attention from biomedicine. Aside from the physical and psychological punches are the psychosocial dilemmas of inequality in access not

Understanding Human Behaviour Assignment Example | Topics and Well Written Essays - 2500 words

Understanding Human Behaviour - Assignment Example y ponders over the areas on which the service users need to work on in order to avoid misdiagnoses and also focuses on the ways that should be adopted by psychiatrists in order to understand the disability and mental health of the individuals. Also it discusses the problems that are faced by the health departments in the introduction of certain programmes because of the criticism of the service users. In this research essay I would focus on the notion that the massive power of the psychiatrists in the process of the diagnosis is something that has implications on the patients and this is something that should be given more importance. For the purpose of my research I have used many literature reviews. Psychiatric diagnosis refers to the process whereby the psychiatrist (or psychologist) is responsible for the identification and the labelling of a particular disease. One of the main purposes of this diagnosis is to help people and guide them through the entire treatment procedure. Lately, it has been felt that the diagnosis has had many different implications on the individuals concerned. According to Reich (1981) psychiatric diagnosis is a very important process because it can have varied effects on the patients. While some may be happy with the results of the diagnosis, others might not feel the same way. One implication of the procedure of the diagnosis is that the people who are diagnosed may have to suffer from unintended implications. For instance, the perceptions of the others might change towards the patient if he/she is labelled with a mental disorder. People may not want to interact with such patients. Reich (1981) argues that the main reason for this behaviour is the re sult of the institutionalized attitudes of the people and the society as a whole towards people who suffer from mental disorders and learning disabilities. The above mentioned effects may occur due to the attitudes of the people and the society to the mental people. There are, however,

Does America Have a Foreign Policy by Mark Funkhouser Article

Does America Have a Foreign Policy by Mark Funkhouser - Article Example The fact that the governor intervened with a new solution that was appealing to the people was commendable, though it did not go down well with the Ferguson police department. However, it does point out that governance has to be approached from an open-minded perspective as Governor Jay Nixon did. Working solutions have to be implemented in the short-term period then seek long-term solutions later. Similarly, Feather O’Connor Houston believes that governance has to be approached with transparency and commitment to bring about the much-needed changes. She uses the example of the veteran’s healthcare issues that had not been addressed for a long time. She is right to insist that reforms in the public sector has to be approached with competence so that the results can be timely, convenient and of good high quality. In what appears to be a summary assessment on leadership, Michael Brenner explores the loop side of the Obama administration and ponders to ask whether America does have a foreign policy. The author argues that since Obama took over as the president, there has been no tangible evidence of American foreign policy. The author is right to observe that indecisiveness by the Obama administration on such matters are responsible for the rise of IS and Moscow’s interference on Kiev. Brenner is also right to observe that political advisors should be people with experience, not political campaigners as Obama may have done. Brenner, Michael (2014, October 13).

Narrative report Essay Example | Topics and Well Written Essays - 750 words

Narrative report - Essay Example Mark Henderson had been informed by his daughter, Selena Henderson’s school that she had been posting on obscene items on the social media. Mark warned her and asked her to desist from doing so. His admonition had no effect upon Selena, and the school once again reported similar behavior on her part to Mark. The infuriated Mark accosted her and gave her a sound thrashing. While doing so, he became enraged to the extent that he commenced to strangle her. This was being witnessed by his wife and his son. However, his wife stopped him from strangling her. Daniel T Satterberg, the Prosecuting Attorney for King County had accused Mark Henderson of the crimes of assault in the second degree – domestic violence, and assault in the third degree – domestic violence. These were based on the same sequence of acts or conduct that were interrelated or forming the components of a common plan. These were assault in the second degree – domestic violence, and assault in the third degree – domestic violence. He further stated that the defendant Mark Henderson, in King County, Washington, on 23 January 2014 had assaulted Yvonne Henderson by choking her. This was contrary to RCW 9A36.021(1)(9), and against the dignity and peace of the State of Washington. In the courtroom, the pressing judge, Timothy A Bradshaw, exhibited adequate control. He ensured that the proceedings continued without any interruptions. His speech was distinct, precise and clear. As a result, he was unmistakably audible to all the people present in the courtroom. This impressive judge did not mince matters and endeavored to have meticulous procedure in place. He was intolerant of even the slightest deviation from established procedure. As a result, the attorneys, prosecutors, court clerks, and other concerned individuals had to function in an optimal manner. The defendant Henderson pleaded guilty with respect to the charges framed against him. Specifically, he conceded in writing that the he

Should Stem Cell Research be Unbound Proposal Example | Topics and Well Written Essays - 4250 words

Should Stem Cell be Unbound - Research Proposal Example Spinal cord injuries and Parkinson's disease are two examples that have been championed by high-profile media personalities (for instance, Christopher Reeve and Michael J. Fox). The Coalition for the Advancement of Medical Research estimates that stem cell research shows promise to develop cures and/or new treatments for 100 million Americans who currently suffer from a wide variety of diseases and disorders. There are several types of issues to consider as we reflect upon stem cell research. ... Many frame the debate about stem cell research around the question of "when life begins," although the issue is not when life begins, but when personhood begins and ends. Human life began millions of years ago when our ancestors reached a stage of evolutionary development that permitted the separate species, Homo sapiens to arise. Human life will end when our species becomes extinct. Stem cell research is a controversial issue in America as, with the present state of technology, the creation of a human embryonic stem cell line requires the destruction of a human embryo. Stem cell debates have motivated and reinvigorated the pro-life movement. There has been a deep and bitter dispute over the conduct of this research; many pro-lifers, for instance, Roman Catholics and conservative Protestants, have opposed this research. According to them, the embryos from which these stem cells are extracted are actually individual entities and have a soul to them. Since the embryos are killed when the stem cells are removed, or stored for long periods of time, long past their viable storage life, pro-lifers view the extraction procedure as murder. In the United States alone, there have been estimates of at least 400,000 such embryos. However, not everyone is opposed to stem cell research. Many groups that even protest it are comfortable with certain forms of cell research. Plent y of experiments and tests have been carried out to determine improved and more efficient ways of saving lives and replacing organs, without having to kill â€Å"pre-embryos.†

Naval academy Essay topic Essay Example for Free

Naval academy Essay topic Essay With? my? career? and? academic? goals? coming? to? a? nearing? sight.? I? am? honored? to? write? about? why? I? want? to? take? the? steps? into? attending? a? military? academy? ? From? first? learning? about? the? military? academies? through? a? close? friend? that? moved? from? florida? to? vandenberg? air? force? base? and? later? became? friends? through? lompoc? high? school.? I? realized? that? key? terms? such? as? leadership,? academics,? and? diversity all? things? that? the? academies? are? looking? for? in? students,? apply? to? me. ? From? a? young? age? my? teachers? have?  always? characterised? me? as? a? leader.? The? most? memorizable? quote? I? can? remember? during? a? parent? teacher? conference? with? my? 6th? grade? teacher? is? her? sasying? how? amazed? she? is? that? I? could? mingle? with? many? different? groups? with? many? interest? and? still? maintain? a? high? academic? academic? statue.? This? has? been? true all? through? high? school? with? being? part? of? many? sports? teams? such? as? basketball,? baseball,? wrestling,? and? the? captain? of? the? football? team. socially? I? have? been? part? of? chess? tournaments? with? the? chess?club,? treasure? of? my? class,? nominated? for? student? of? the? quarter,? admitted? into? youth? leadership? of? lompoc? valley,? youth? cfo? of? colas? kids? non? profit? organization,? and? the? list? goes? on.? ? ? Many? ask? why? a? military? academy,? why? not? a? college? or? university? not? related? to? the? military.? One? of? my? reasons? definitely? not? my? biggest? is? financially? I? wouldnt? be? able? to? pay? for? college.? Living? with? my? mother,? living? with? my? grandparents,? living? with? the? my? dad? in? government? housing,? living? alone,? and? currently? living? in?section? 8? housing? with? father? and? step? mother.? Financially? college? is? a? goal? achievable? through? academics? and? diversity? ,? but? will? always? have? the? restrain? financially? to? pay? for? tuition.? ? Being? admitted? and? attending? an? academy? will? not? only? help? me? along? with? my? family? financially? but? u? will? have? a? chance? to? serve? my? country? with? the? utmost? gratitude.? My? parents? have? never? pushed? me? to? apply? at? a? military? academy,? the? goal? of? admission? has? solely? been? through? self? motivation.? With? my? career? goals? being? in?the? field? of? engineering? (mechanical? in? preference)? I? have? researched? the? naval? academy? and? earning bachelors? in? science? at? the? academy? would? kick? start? my? future? with? opportunities? that? other? universities? cant? offer.? Knowing? that? you? must? complete? a? term? in? the? military? after? the? academy? has? no? change? to? my? decision.? From? meeting? first? srgt.? Eric? simon? on? the? Air? Force? base,? he? has? became? an? inspiration? to? become? a? man? of? respect.? I? first? met? him? through? my? best? friend,? srgt.? Simon? being? his? father.? When? I? first? met? him? my? first? impression? was? this? man? is? someone? to? respect? and? honor? with? gratitude? for? protecting? and? serving? our? country.? I? later? learned? through? experience? that? srgt.? Simon? is? a? great? father? and? man? all? around.? Coming? from? an? unhealthy? family? in? Maryland? I? have? been? able? to? relate? and? look? up? to? him? as? a? father? figure.? The? experience? of? meeting? srgt.? Simon? has? made? me? more? than? ready? to? serve? in? the? armed? services.? I? want? to? show? my? four? younger? brothers? that? If? I? can? do? it? they? can? do?it? ,? while? establishing? a? role? model? position? for? them.? ? Being? admitted? to? the? naval? academy? or? another? military? academy? has? been? my? goal? from? the? beginning? of? high? school.? Aiming? everything? I? do.? And? pushing? myself? to? be? a? stand? out? candidate.? I? am? more? than? willing? to? serve? my? term? of? service? with? the? utmost? gratitude? and? respect? for? my? country.? The? reason? I? feel? that? i? standout? among? the? other? candidates? is? how? diverse? I? am? in? all? the? aspects? the? academies? are? looking? for.? Being? a? leader? in? sports?activities,? through? team? voting? I? became? the? football? captain,? having? four? little? brothers? I? lead? them? everyday? as? a? role? model.? Academically? I? strive? in? the? classroom? ,? recieving? scholar? awards? throughout? high? school? ,? and? achieving? top? 20? percent? of? my? class.? through? the? community? of? school? ,? being? involved? in? many? groups? and? organizations.? Also? outside? of? school? in? my? community? of? Santa? Barbara? county? through? community? service? and? helping? organizations? such? as? the? American? G. I.? Forum? along? with? many? others.?

Euthanasia (Mercy Killing) Essay Example for Free

Euthanasia (Mercy Killing) Essay The topic I chose is Euthanasia (mercy killing) should be permitted in cases of terminally ill patients. Euthanasia is from the Greek word to die well. In other words, a good death. Some people call it the act of killing a person who suffers from a mental or physician condition. Mercy Killing, is another name for it. Euthanasia (mercy killing) or physician-assisted suicide/PAS, is a confusing and heart-wrenching issue for many. We are all likely to face difficult end-of-life choices at some point, whether for ourselves or for a loved one. I know for me that this is a very hard decision, as much as I would like to be support Euthanasia or physician-assisted suicide/PAS, I could not allow this to be done because of the moral issues and it’s against what GOD stands for. One shot is all it takes to kill a loved adored family member. But is an injection of death a good way to die? With lack of judgment and a bad day someone could be killed. Euthanasia or physician-assisted suicide/PAS is putting people to sleep just like you would put to sleep your dog when he gets too old. Where do we draw the line between murder and helping patients? Is a doctor putting patience to sleep considered murder? Who makes that decision? I watched my sister suffer with pancreatic cancer from the time that she was diagnosed until she passed away. Every time she went for her chemotherapy treatments and returned home, she was sick to the point that she just stopped going places and doing things with the family. I can remember the call that I received from my niece, when they had left the doctor’s office and he had inform them, that there was nothing else that they could do. The cancer has spread through the stomach lining. At that point my sister made the decision to stop the chemotherapy and the doctor put her and family in touch with Hospice. I can still remember the comment that was made by the nurse, â€Å"we are here to make her comfortable living with cancer not to help her die†. By legalizing assisted suicide could send us down a road from which there is no return. We can do far more to aid suffering patients by improving pain management and mental health care through legislative reform than we can by legalizing their self-destruction. I did not expect to get the results that I did receive on Euthanasia (mercy killings) or physician-assisted suicide/PAS. I would like to say that the split was 30/70, which was very surprising to me because I was thinking that the split would have been 50/50. After taking the survey, I found out that most people are against Euthanasia (mercy killings). Based on the comments that I received from my survey, regarding mercy killings and how it was against GOD’s commandments, while others stated that people should not have to suffer and be in pain all their life if there is n o cure for their disease. But just think is an injection of death a good way to die? With lack of judgment and a bad day someone could be killed and how do you bring them back or even live with it. As much as we do not want to see our love ones suffer and be in pain, I just don’t believe I could go through Euthanasia with any of my family members. As much as I may love them I can’t have their death on my hands. Euthanasia (mercy killings) or physician-assisted suicide/PAS, is a decision that you will have to live for the rest of your life. Even though that love one may be suffering and in pain, can you really honestly say that you could be responsible for helping them to die and is this something that you will be able to live with yourself for the rest of your life. Its important to understand the distinction between the terms assisted suicide and euthanasia. The former describes a situation where the doctor (or some other agent) provides the means for a patient to commit suicide, but the patient follows through on the final act himself. Euthanasia, on the other hand, is carried out from beginning to end by a doctor on the patients behalf. In the wake of the Schiavo case, there was much debate over the question of care for the severely handicapped or terminally ill, and what exactly those appropriate levels of care were. At the base level is ordinary care—generally speaking, that which any prudent person would administer in similar circumstances. It could include keeping the room at a comfortable temperature, providing attentive human contact, and ensuring that the patient has enough to eat and drink. Ordinary care is considered mandatory by the Catholic Church. Proportionate treatment (or proportionate means), which is also mandatory, is any medical action that meets all of the following three criteria: (1) It has a reasonable chance of curing the patient or assisting with the cure; (2) it does not carry a significant risk of death; and (3) it does not, in and of itself, present an excessive burden. For example, a sterile blood transfusion during surgery would be considered proportionate treatment, as the risk and burden involved are relatively low compared with its curative potential. Disproportionate means, on the other hand, are not mandatory. If any treatment would present an excessive burden—in terms of finances, emotions, religious beliefs, or the pain of the procedure—or fail to offer a reasonable chance of curing the patient, it is optional. Withdrawing disproportionate treatment is an act that, according to Dr. Kathleen Foley, former chief of pain service at Memorial Sloan-Kettering Cancer Center, respects [the] patie nts autonomous decision not to be battered by medical technology (Competent Care for the Dying Instead of Physician-Assisted Suicide, New England Journal of Medicine). There comes a time when continued attempts to cure are neither compassionate, wise, nor medically sound. Palliative care refers to the alleviation of pain or other symptoms, though some expand the definition to include the provision of mental, emotional, and spiritual support. A caregiver is required to offer palliative care—or at least pain management—as far as he is able, but it is not mandatory for a patient to accept. In fact, as Pope John Paul II said in The Gospel of Life, it is even licit to relieve pain by narcotics, even when the result isa shortening of life, if no other means exist. The issue of artificial nutrition and hydration is not fully defined; the question is currently being examined by the Magisterium, but the most recent pronouncement came from John Paul II himself in March 2004, when he stated that it is immoral to remove a feeding tube from anyone in a persistent vegetative state, calling it euthanasia by omission. Outside of a vegetative state, however, there are situations where a feeding tube would become burdensome and thus constitute disproportionate care—as in the case of a person dying from advanced stomach cancer—so these decisions must be made prudently on a case-by-case basis. For more information on this issue, visit www.euthanasia.com. For frequent updates on current court cases and legislation, checkwww.internationaltaskforce.org, and www.lifenews.com/bioethics.html. Once youve been armed with the latest facts and information, youre ready to begin the discussion. Strategy No. 1: Oppose the Status Quo of End-of-Life Pain Management First, we must recognize a basic truth: Patients in our medical system often have insufficient access to pain relief. Therefore, its vital to support increased patients rights, including access to health insurance, a choice in doctors, the latitude to see an independent specialist, open access to all of ones personal medical records, and the right to use palliative treatments. Its equally important to support the right of doctors to manage their patients pain properly without fear of government interference and prosecution. The issue of pain is an emotionally striking one, so its comforting to know that pain can be controlled. According to a report by the New York State Task Force on Life and the Law titled When Death Is Sought: Assisted Suicide and Euthanasia in the Medical Context, Modern pain relief techniques can alleviate pain in all but extremely rare cases. In fact, according to Dr. Eric M. Chevlen, the director of palliative care at St. Elizabeth Health Center in Youngstown, Ohio, 90 [percent] of cancer patients in pain can have dramatic relief with relatively simple oral therapies. Dr. Chevlen is also the author of the book Power Over Pain: How to Get the Pain Control You Need (International Task Force, 2002), a useful resource for those suffering due to a lack of proper palliative care. The American Pain Foundation estimates that with todays technology, close to 98 [percent] of all pain problems can be relieved or reduced. But most doctors have never actually studied pain in any detail. According toPain Net Inc., Of all pain practitioners, fewer than 10 [percent] are proficient in more than eight out of 130+ diagnostic or therapeutic procedures relative to pain. For this reason, its important to advocate a greater focus on pain in medical schools and continuing-education courses in pain management for all medical doctors, especially those frequently involved in end-of-life situations. We can also urge recognition for patients rights to see pain-therapy specialists (which some health-care plans are trying to restrict). What cannot be accepted is the notion that assisted suicide is a form of comfort care. Dr. Gregory Hamilton, the chair of Physicians for Compassionate Care, put it bluntly in an article in the Oregonian: Comfort care results in a comfortable patient; assisted suicide results in a corpse. Emphasize the Need to Diagnose and Treat Depression One of the chief arguments for PAS appeals to the American ideal of autonomy. The desire for self-determination resonates strongly with many Democrats, and they believe that the denial of these rights is un-American. Of course, a love of personal freedom is not unique to Democrats, and its easy for anyone to agree that we should have the freedom to live our lives as we see fit. But that freedom must come with restrictions. For example, child pornography is illegal in America—even in the privacy of ones home—and no judicious person would consider it a permissible use of our freedom. Clearly, Americans acknowledge the need to limit certain behaviors. The question is, what actions should be permitted or restricted? The issue of autonomy assumes that the person attempting to exercise his personal freedom can make decisions in a rational manner. But in fact, when it comes to requests for PAS, rational decision-making is rarely in play. Suicidal feelings in a person who has been diagnosed with a terminal illness are no different from those experienced by someone who isnt terminally ill. Depression, family conflict, hopelessness, feelings of abandonment—these are the conditions that lead to suicidal thoughts, regardless of ones physical state. According to the British Journal of Psychiatry and the New York State Task Force, between 93 and 95 percent of those contemplating suicide have a diagnosable mental disorder, most commonly severe depression. Is mental disorder also in play for the terminally ill who request suicide? One study in the American Journal of Psychiatry reported, All of the patients who had either desired premature death or contemplated suicide were judged to be suffering from clinical depressive illness; that is, none of those patients who did not have clinical depression had thoughts of suicide or wished that death would come early. The New York State Task Force report states that depression accompanied by feelings of hopelessness is the strongest predictor of suicide for both individuals who are terminally ill and for those who are not. It is depression or other mental illness, not ones physical condition, that makes a person suicidal. Pain plays an obvious part in this—diagnosable anxiety and depression, for example, are higher in cancer patients with pain. Not only is uncontrolled pain an important risk factor for suicide, in that it contributes to hopelessness and depression, but depression and anxiety can often augment the patients experience of pain. This brings us back to the need for pain therapy. The New York State Task Force report notes that the notion of competence to make treatment decisions, or the capacity to make a particular decisionpresumes that the patient is not clinically depressed. In the presence of clinical depression, there can be no true autonomy, no ability to make a rational decision or a clear, objective request for death. The good news is that mental illness, once diagnosed, is treatable. In a 1992 article for American Medical News suicidologist Dr. David C. Clark observed that depressive episodes in the seriously ill are not less responsive to medication than episodes in those who are not. The same opinion is held by Dr. Joseph Richman, former president of the American Association of Suicidology, who wrote in a letter to the editor of the Journal of Suicide and Life-Threatening Behaviour, Effective psychotherapeutic treatment is possible with the terminally ill. And in testimony to the New York State Task Force in 1992, Dr. William Breitbart of the Memorial Sloan-Kettering Cancer Center agreed, reporting that more than 80 percent of their patients diagnosed with major depression can be treated effectively. The New York State Task Force report puts the number even higher, saying treatment for depression resulted in the cessation of suicidal ideation for 90 percent of patients. Finally, its important to remember that the desire for suicide is often transient. In a study published in the Journal of the American Medical Association, the cases of 886 people who were rescued from attempted suicides were followed over a five-year period. At the end of those five years, only 34 had since taken their own lives. Where there is depression, there is no true autonomy. Treating patients for pain and depression, as well as other mental illnesses, can eliminate suicidal desires by giving the patient more control. In that way, we can help them achieve self-determination instead of self-destruction. Strategy No. 3: Oppose Discrimination Against the Disabled and the Poor If any one element has stopped PAS bills and ballot measures from becoming the law of the land, it has been the public efforts of activist groups for the disabled such as Not Dead Yet. While groups like the former Hemlock Society (now named Compassion and Choices) were founded on the belief that some lives were not worth living and that they were doing a service to the disabled by expanding their autonomy to include a right to die, this kind of attitude actually betrays a prejudice against the disabled—one that would inevitably make the right to die a duty to die. This sort of prejudice is already seen on the opposite end of the spectrum in the abortion debate. Dr. Anthony Vintzileos, a board member of the American Institute of Ultrasound Medicine, estimated in a May 2005 article for the New Jersey Record that 90 percent of women who receive a prenatal diagnosis of Down syndrome for their children choose to abort. People with disabilities are considered to have no real quality of life, nothing to contribute, and nothing to live for. The poor are also potential targets. Already receiving substandard medical care, the impoverished will be the last to ask for a second opinion, the first to see themselves as worthless, and the most likely to be dismissed as having nothing to contribute to society. If an authority figure were to counsel a poor person to ease the financial burden of medical care on his family through PAS, it would be difficult to say no. Democrats largely identify themselves as friends of the underdog and protectors of the weak. What better way to open their eyes to the injustice of PAS than by pointing out the potential for victimization of the disabled and poor at the hands of an often profit-driven health-care industry? Strategy No. 4: Examine Data from Europe At this point, your interlocutor will likely argue that Doctors would never do that, or that there should be guidelines to make sure that this victimization could never take place. The best response is simply to have a look at euthanasia in Europe (including its legal form in the Netherlands). Many familiar with the history of euthanasia recognize that the idea was a natural outgrowth of social Darwinism, where the strong survive and the weak are left behind. According to the New York State Task Force report, The practice of mass murder in Nazi Germanybegan with the active killing of the severely ill, and built upon earlier proposals advanced by leading German physicians and academics of the 1920s. Like policies currently advocated in the United States, these proposals were limited to the incurably ill, and mandated safeguards such as review panels. R. J. Lifton, author of The Nazi Doctors: Medical Killing and the Psychology of Genocide, is quoted in the report as saying that the phrases life unworthy of life and killing as a therapeutic imperative were vital in soothing the publics conscience when it came to the Nazi program of genocide: The medicalization of killing—the imagery of killing in the name of healing—was crucial to that terrible step. Its ironic that the Netherlands—whose doctors once refused the Nazis genocidal agenda—is now the site of the most extensive assisted suicide and euthanasia program in the world. Though euthanasia was not legalized in the Netherlands until 2002, it was commonly practiced well before then, with almost no danger of prosecution for the doctors performing it. The International Task Force on Euthanasia and Assisted Suicide reports that, according to the Dutch government–sponsored Remmelink Report examining death rates in Holland from 1990: †¢ 2,300 people died through voluntary euthanasia †¢ 400 died through assisted suicide †¢ 1,040 died through involuntary euthanasia—euthanasia was performed without the patients knowledge or consent, even though 72 percent of those patients had never indicated any desire for it †¢ 8,100 died from a deliberate overdose of pain medication to hasten the patients death, though in 61 percent of these cases the patient gave no consent. Of the estimated 130,000 deaths in Holland in 1990, 9.1 percent were the direct result of assisted suicide or euthanasia. And given that these numbers were voluntarily provided by doctors at a time when euthanasia was still technically illegal, its likely that the actual number of deaths through euthanasia was even higher. According to a February 1999 article in the Journal of Medical Ethics, almost 59 percent of euthanasia cases in Holland in 1995 went unreported, in clear violation of the guidelines in place. However, not a single Dutch doctor was prosecuted under the criminal charges of euthanasia, assisted suicide, or anything related. Euthanasia was technically illegal but not prosecuted in the Netherlands for more than a decade. Today, those over 16 can be euthanized for any reason; in certain circumstances, those as young as twelve can opt for euthanasia. Currently, the Netherlands is considering allowing euthanasia for infants, though some Dutch doctors have openly admitted to euthanizing infants already. Those who believe there is no slippery slope need to take another look. And while some may argue that the situation in the Netherlands at least offers patients more options when faced with end-of-life decisions, the reality is just the opposite. Hospice care—palliative centers that make up an important component of end-of-life treatment—is practically nonexistent in Holland. England, for example, had 183 hospices in 1999. The Netherlands, with a quarter of Englands population, had only three. Clearly, with such easy access to euthanasia, little effort is expended to offer alternatives to end-of-life pain management when its not as cost-effective as a quick death. What does this have to do with the United States? Dr. Herbert Hendin, executive director of the American Suicide Foundation, made the connection clear in his 1996 testimony before Congress, wherein he declared that Dutch patients and doctorssee assisted suicide and euthanasia, intended as an unfortunate necessity in exceptional cases, as almost a routine way of dealing with serious or terminal illness. The [American] public has the illusion that legalizing assisted suicide and euthanasia will give them greater autonomy. If the Dutch experience teaches us anything, it is that euthanasia enhances the power and control of doctors who can suggest it, not give patients obvious alternatives, ignore patients ambivalence, and even put to death patients who have not requested it. This is the safety that guidelines provide, as both history and current events have borne out. If we were to open the doors to PAS in the United States, a brave new world of involuntary euthanasia would be inevitable. Strategy No. 5: Oppose Profiteering by Managed-Care Providers If assisted suicide were legalized, managed-care providers would inevitably embrace it as a money-saving technique. The New York State Task Force report states that under anysystem of health care deliveryit will be far less costly to give a lethal injection than to care for a patient throughout the dying process. A 1998 study conducted by Dr. Daniel P. Sulmasy in the Archives of Internal Medicine found that doctors who are cost-conscious and practice resource-conserving medicine were six times more likely to write illegal, lethal prescriptions for their terminally ill patients. Dr. Diane Meier, a former advocate of assisted suicide, said in a 1998 New York Times article, Legalizing assisted suicide would become a cheap and easy way to avoid the costly and time-intensive care needed by the terminally ill. Substantiating this claim is the fact that Oregons Medical Assistance Program (OMAP) for the poor moved to provide physician-assisted suicide to its recipients as soon as the Death with Dignity Act was passed in 1997. Only 18 months later, the OMAP announced plans to cut back on pain medication coverage for the same population. Hospice care has also suffered—the International Task Force reports that one Oregon insurance company has a paltry $1,000 cap on in-home hospice care. With the cost of a lethal overdose running about $35, there would be little motivation to pay any more for palliative treatment. If this is how a liberal, Democratically controlled state government behaves, is there any doubt how profit-minded managed-care providers would react if assisted suicide were legalized throughout the United States? We would begin to see a new stratification of society, where the under-insured would be advised to settle for assisted suicide, while those with better insurance could get the medical assistance they needed. According to the International Task Force, If policies or laws permitting assisted suicide are approved, assisted suicide could become the only type of medical treatment to which certain people—those who are members of minority groups, those who are poor, or those who have disabilities—would have access. The last to receive health care would be the first to receive assisted suicide. The Dead End of Assisted Suicide Legalizing assisted suicide could send us down a road from which there is no return. We can do far more to aid suffering patients by improving pain management and mental health care through legislative reform than we can by legalizing their self-destruction. Euthanasia, in practice, almost inevitably becomes eugenic in nature, which is an affront to the disabled and a serious threat to the lives of the poor and unwanted. Further, the decriminalization of assisted suicide and euthanasia in Europe has produced horrific results that no sane nation would want to imitate. Its a noble impulse that drives Americans to help those struggling through illness and decline, but we cant let the desire to ease anothers suffering lead us to believe that there are quick fixes or easy answers in euthanasia. Instead, we must respond with love, prayer, and compassion—not with murder. As John Paul II wrote in Evangelium Vitae, True compassion leads to sharing another persons pain; it does not kill the person whose suffering we cannot bear.