Terminating the Patient-Provider Relationship Essay Example for Free

Terminating the Patient-Provider Relationship Essay Introduction Problem Overview With the advent of 21st century medical technology, health care procedures, ethical and legal considerations and scopes of practice among health care providers have become greatly complex. According to Servellen (1997), one of the most confronting issues of the modern provider-patient relationship is the often misunderstanding of accountability, responsibility and liability of care measures towards the patient (p.334). Legal considerations of providing care and duty of obligation of the provider towards the patients start when the health care professional enters into a relationship with a patient. However, the agreement of care relationship does not only require role of the provider. According to Scott, Ed and Scott (2005), compliance of the patient throughout the care procedures rendered by the provider is another significant component of caring process (p.162). In fact, providers include initial assessments on patient’s level of compliance prior to the start of care process, and more importantly, health professionals inform the patient about the written policy imposing the responsibility of the patient to comply with the process of health care interventions. As considered by American Academy of Nurses, if the patient becomes noncompliant or initiates actions violating professional rights of provider or the patient’s rights, the provider possesses the benefit of terminating the working relationships as considered by the appropriate grounds (Scott, Ed and Scott, 2005 p.162). On the other hand, if the provider terminates the relationship, such professional decision now confronts the issue on breaching the pledged role of devoted care and legal duty of service. Termination of patient-provider relationships is confronted by question whether or not conflicts between the professional role of the provider and the legal duty to provide care (Servellen, 1997 p.334). The current implementations of patient care disengagement largely depend on the institutional policy. According to Scott, Ed and Scott (2005), â€Å"termination of the provider-patient relationship is justified when the patient makes a knowing, voluntary election to end the relationship, either unilaterally or jointly with the provider† (p.162). Upon signing the consent of care, both participants of the care process obtain their own roles in the entire procedure of care. Mason (2004) emphasizes that the professional relationship with the patient can just be terminated due to personal or other inappropriate grounds (p.307). Termination of care is only considered ethical and appropriate when (1) the patient has already reached the maximum benefit of the procedure as supported by clinician’s judgment, or (2) when the patient has already achieved cure from the procedure. However, termination of patient-care relationship on the ground of patient non-compliance imposes a conflict issue between duty of care and patient’s participatory role in the process of care delivery. As supported by Servellen (1997), the provider’s duties to the patient, involving a breach of duty, relates to the standards of practice for all health care professionals (p.334). According to Mason (2004), termination of patient care may result to a legal accusation of abandonment, which â€Å"is the discontinuation of an established patient-provider relationship† (p.307). According to AMA, a non-compliant patient is considered as a â€Å"difficult patient† and candidate for the reconsideration of patient-provider termination of care. However, termination of care must follow appropriate procedures without interfering the continuity of patient care. Terminating the patient care somehow conflicts with the element of maintaining the continuity of care. As explained by Carter, Levetown and Foley 2004), noncompliant patients under reconsideration of patient-care termination still possess the rights of continuous care until another health care reliever has been reassigned (p.120). Moscow (2004) points out that terminating patient care without proper reliever of care is automatically considered a liability against the established patient-provider relationship contract (p.120). According to Servellen (1997), despite the protective and patient-focused approaches of the provider, inevitable times wherein a provider is confronted with situations (e.g. DNR requests can sometimes impede to patient’s right of autonomy, etc.) that can possibly or actually impinge patient’s rights can still occur (p.335). According to American Hospital Association (AHA), the four basic consumer rights state that the (1) patient has the right to safety, (2) right to be informed, (3) right to choose, and (4) right to be heard (Servellen, 1997 p.335). Considering these components as part of the reconsiderations in the ethical discussion of patient-provider care termination, it is indeed inappropriate to terminate the relationship set prior to the start of the process. As mentioned by AMA, provision of care towards non-compliant patients is still under the governance of the elements of (1) health care provider’s duty to provide continuous care, (2) fulfilling the expectations of care for the patient, and (3) carrying out the obligations of care (Mason, 2004 p.307). Terminating the care relationship set during the formal contract establishment between the provider and patient is automatically considered a breach in the legal nature of such relationship. Such action is a considerable ground for the legal liability of abandonment. Despite the issue on termination of care, there are still possible grounds wherein a health care’s refusal to care can be considered appropriate. According to Servellen (1997), provider’s may terminate or refuse care process when (1) the procedure caries physical risks to either the provider or the patient, (2) rendered care violates patient’s rights to autonomy and self-determinations, and (3) religious or moral issues followed by either of the two parties (p.335).   According to Carter, Levetown and Foley (2004), the actual patient-provider relationship is founded on trust and relationship, and not merely on legal holds or set contracts (p.120). Considering this as a form of assertion to the later supporting principles of patient-provider relationship termination, the issue on role fidelity arises as another essential consideration aside from autonomy and the contractual-based patient-provider relationship. Carter, Levetown and Foley (2004) emphasize the value of adhering to the moral and professional role of the nurse, and not solely limiting the care provision on to the patient’s level of compliance (p.120). Guided by the principle of â€Å"patient’s best interest† and fidelity, Mezey and Berkman (2000) support the idea pointing out on the idealistic elements of nursing practice wherein professionals should consider their importance in administering care under holistic and universal perspective regardless of potentially solvable conflicts (p.502). Despite of the relationship established after the setting of contact, the provider needs to consider the nature of non-equalitarian partnership and not the coequal partnership; rather, leading, establishment of rapport and serving the best interests to as the patient as the care provider must all be considered.   As supported by Shamus and Stern (2003), patient-provider relationship imposes a duty of unauthorized disclosure of contract care process without appropriate grounds (p.74). The 1996 Health Insurance Portability and Accountability Act (HIPAA) indeed protect the patients from such decisions brought by health care providers. However, compliance and sets of patient’s participatory obligations throughout the procedure count significantly on the entire health care delivery process (Shamus and Stern, 2003 p.74). Insurance of care does not only direct the obligations and tasks towards the provider but also from the patient. According to Earp, French and Gilkey (2007), patient-provider relationship is expected to work as an enhancing strategy for patient’s trust towards their health care provider. Furthermore, such relationship supports a therapeutic alliance and patient care processes involving high levels of trusts, rapport and patient satisfaction (p.195). By this principle, patients are indeed subjected to participate and cooperate in the process of health care delivery. However, in case the patient declines to participate, health care providers must not immediately terminate the procedure since they are no coequals of the patients and resistance towards care measures are sometimes inevitable. According to Rothestein, Brody and McCullough et al. (2001), health care providers must continuously administer care and interventions necessary for the well-being of the patient despite of the non-compliant behavior (p.620). In case the patient becomes notoriously incompliant to either selective or general procedures scheduled for administration, AMA suggests a series of assessment for the noncompliant behavior without involving one’s professional role outside the scope of care provision (Mason, 2004 p.307). Furthermore, the patient’s decision to not comply entirely depends on himself or herself; although, it is an important protocol consideration to check institutional policy for the proper consent documentation of such patient’s behavior. Most public institutions implement waiver signing when the patient refuses to take medications for example. According to Earp, French and Gilkey (2007), this is done for the purpose of formality and protection from possible accusations of abandonment or care quality infringements (p.195). On the other hand, when provider-patient relationship is not anymore pursuing its beneficial state or health care alliance status, AMA suggests the termination of health care management. As supported by Rubenfield and Scheffer (2006), the duty of the provider in relation to the physician-patient relationship includes (1) fulfilling the patient’s expected care, (2) carrying out the health care roles of the provider towards the patient, and (3) delivering care guided by the principles of fidelity and nonmalificence (p.96). If the provider has been determined to satisfy all these criteria, the duty to treat or provide care to the patient is indeed not violated. However, if the patient pursues his or her state of noncompliance despite of the standards of care being administered and the potential of further causing harm to one’s self, terminating the set provider-patient relationship is indeed justified. Nonetheless, as supported by the AMA Code of Ethics in 1998 Doc #1, p.5, â€Å"physicians cannot withdraw from a case without giving notice to the patient, the relatives, or responsible friends sufficiently long in advance of withdrawal to permit another medical attendant to be secured† (cited at Rothestein, Brody and McCullough et al., 2001 p.621). The health care provider is still tasked to service the patient until the reliever of care becomes available. Meanwhile, despite the legal recognitions in terminating the provider-patient relationship, the question still lies if whether or not the provider breaches his or her professional role as the higher component of the alliance considering the noncompliant state of the patient. Statement of the Problem The participation of both parties in the patient-provider relationship is an important consideration to the entire success of the health care delivery process. Once the provider accepts the task pf providing care to the patient, it is lawfully and professionally understood that the provider agrees to setup a transactional bond with the patient. According to AMA code of ethics, the setting of contract between the provider and the patient includes participatory roles from the two parties, and compliance to the higher participant of the alliance, the health care provider, must take the lead of health care management (Rothestein, Brody and McCullough et al., 2001 p.621). Added by Earp, French and Gilkey (2007), â€Å"patient-provider relationship is even ideally characterized by high levels of provider informativeness, interpersonal sensitivity and partnership building† (p.189). However, in some instances, patient may pose as the incompliant participant of the body system, which can greatly compromise the delivery of care as well as the role function of the provider. As emphasized by Servellen (1997), if the patient manifests a noncompliant behavior towards the care being provided by the assigned health care professional, the code of ethics should rather consider the termination of the bonded agreement than forcing the two participants to maintain their relationship since this can actually be detrimental to both patient’s health and provider’s role (p.336). Hence, termination of patient-provider relationship in relation to patient’s incompliant behavior can be possibly done via appropriate process of separation mandated by the institutional policies. It is important however to consider the validation of the provider’s claims followed by the written acknowledgement signed by the patient. After establishing an agreement of termination, the provider is expected to maintain the level of care being provided to the patient until the endorsement of the patient’s care to the assigned reliever. AMA has imposed significant abandonment liabilities once the provider terminates the established relationship without properly engaging to the set institutional policies. According to Rothestein, Brody and McCullough et al. (2001), terminating the established relationship between the provider and the patient without properly notifying, validating and documenting the said action will immediately resort to legal liabilities (p.621). Termination of patient-provider relationship must be laid down to the patient for recognition and prevention of legal accusation of abandonment. Despite the valid points and supporting rationales in terminating the patient-provider relationship, the issue still lies questioning the appropriateness of termination in relation to the ideal practice of role fidelity and duty of care. Due to this very reason, we have proposed a descriptive and non-experimental study analyzing the legal, ethical and moral nature of terminating the set patient-provider relationship. The objectives of the study proposed are as follows: To determine the ethical stand point of terminating patient-provider relationship in relation to the ideal principles of (a) duty of care and (b) role fidelity To determine the perceptions of the patients on the potential effects of terminating patient-provider relationship towards the level of trust and health care satisfaction Scopes and Limitations Due to the continuously evolving policies of health care system, changes in the patient-provider relationship have also evolved progressively. Despite the idealistic principles of fidelity and duty of care, health care providers still encounter inevitable instances wherein the client becomes non-compliant towards selective or general interventions implemented as part of the care process. According to Servellen (1997), instead compromising the care delivered to these patients, code of ethics have now reconsidered the procedure-based termination of patient-provider relationship to prevent the delivery of reluctant or incompetent care management due to patient’s incompliance (p.327). However, Carter, Levetown and Foley (2004) and Mezey and Berkman (2000) assert that terminating patient-provider relationship violate the principles of duty of care and role fidelity since it is always the task of the provider to carry-out the needs of the patient as guided by the principle of â€Å"patient’s best-interests† regardless of the patient’s response to health care. In this proposed study, the primary goal is to determine whether or not the ideal principles of health care (role fidelity and duty of care) are breached once the provider terminates the established relationship with the patient. At the end of the study, the following questions must be answered: What are the supported grounds for terminating patient-provider relations approved by AMA and AAN? Cite the legal, ethical and moral comparisons between the two policies. Does the health care provider breach the established relationship once he/she requested for termination due to incompliant behavior? Significance of the Study Despite the defined institutional policies supporting the process of termination, the issue on breached principles of health care still remains questionable. Federal health care organizations, such as AMA and AAN, have clarified the issue and process involving the termination of patient-provider relationship on the grounds of non-compliance and failure to adhere to the provider’s instructions. According to Servellen (1997), during the times of the HIV epidemic, termination of care is considered professionally inappropriate; hence, care provided towards these HIV patients became detrimental to the patient’s health due to the reluctance and exaggerated care measures implemented by these providers (p.327). The issue involving the termination of such established relationship covers both ethical and legal principles (e.g. role fidelity, duty of care, etc.) governing the pledged role of the provider and the assigned participatory role (e.g. patient’s rights, patient’s task of compliance, etc.) of the patient. Clarifying the care issues on the termination of patient-provider relationship is significant due to the following reasons: By understanding the limitations and defined grounds of terminating the patient-provider relationships, the study can aid in identifying the relationships of ethical principles that shall answer the confronting issue of patient-provider relationship By understanding the legal and ethical considerations on patient-provider relationship termination, the study can help in defining policy proposals on the proper procedures for implementing the termination of patient-provider relationship   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The conceptual framework of the study illustrates the proposed program of implementation addressing the issue on termination of patient-provider relationship. The conceptual framework is based from the primary goal of the study – to determine the standpoint of the termination of patient-provider relationship. By determining the subjective responses from two types of samples, patients and nurses (selected â€Å"provider† population), the procedure should be able to reveal the ethical justifications and oppositions on the subject of terminating patient-provider relationship due to noncompliance. After determining the collation of responses, the procedure analyzes the data in order to obtain significant relationships pertaining to the issue on breaching the principles of role fidelity and duty of care upon termination of such care contracts. Program Proposal f.1. Research Design   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The study proposes a non-experimental and descriptively designed survey methodology as the program for analyzing the issue on termination of patient-provider relationship. Using the perception-based methodology, the study explores the different insights of the two parties involved – patients and nurses/ providers – in the issue targeted by the study. The proposed program utilizes open-ended questions depicting the different possible perspectives of the samples – approval, opposition, suggestive– towards the issue imposed. The design of the study relates to the patterns illustrated on the conceptual framework. The emphasis of the survey questions is derived from the primary goal of the study – to determine if whether or not the termination of patient-provider breaches the concept of role fidelity and duty of care.   The collated responses obtained from the survey are compared to the ethics analysis condu cted in the literary reviews. f.2. Samples and Sampling Technique Used   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The study aims to achieve the total target population of 100 patients and 100 nurses proportionately divided into two different sample hospital locales. Using a simple random sampling method, selection of patient respondents is guided by the following criteria: (1) 18 and above, (2) patients must be admitted within the hospital premises for at least two days, and (3) must be conscious and coherent. On the other hand, sampling criteria among nurses are as follows: (1) must be licensed professional, (2) must be employed and working within the hospital premises, (3) must have at least 2 years of nursing experience from the surveyed hospital locale or other institution. f.2. Data Gathering Procedure   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Data gathering procedures shall be composed of two different methodologies: (a) ethics analysis conducted in the literary reviews and (2) survey methodology implemented on two groups of samples. Ethics analysis from the literature reviews comprise of the different ideas answering the ethical disputes on termination of patient-provider relationship. In the process of ethics analysis, the principles of role fidelity and duty of care involved in the issue are the emphasis of the analysis. The main objective of this procedure is to answer the ethical standpoints of the issue based on whether the termination violates the principles of role fidelity and duty of care. On the other hand, the second methodology deals with the perceptions answering the issue on breached principles of role fidelity and duty of care through the termination of patient-provider relationship. After gathering the results of the two data sources, the integration of data is conducted aiming to answer the primary goal of then proposed study. f.3. Instrumentation   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Survey questionnaires are the primary instrument used for the gathering of data and responses from the qualified samples. The questions used have been derived from three categories inclined to the different possible responses of the respondents. Categories used include (1) approval, (2) opposition, and (3) suggestive. Using open ended-questions according to the four categories, the respondent must select their preferred side among the four categories. Approval selection depicts their positive response over the termination of patient-provider relationship, opposition is the reverse,   and suggestive implicates the possible changes they want. The results of the survey are collated for the purpose of analysis and implications of data. f.4. Program Implementations   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In the process of implementing the proposed program for evaluation and assessment of the issue, methodologies shall comprise (a) ethics analysis via records review and (b) the qualitatively designed survey of the chosen sample population. Implementation process shall begin with the gathering of records and reviews on issues and bioethical discussions on termination of patient-provider relationship. In the process of analyzing the obtained data, the study shall document (a) the ethical principles associated to the termination issue, (b) the conflicting ethical principles, and (c) the violated ethical principles upon implementation of the issue. After gathering these three components, the data shall be analyzed drawing appropriate implications from the documentation acquired. With the acquired results from ethics analysis, we shall now relate these to the two principles – role fidelity and duty of care that are hypothetically breache d upon terminating patient-provider relationship.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   After the application of the second procedure, the survey methodology shall now begin its pilot study with a smaller sample population of at least 10 qualified respondents from the chosen research locales. During the process of pilot testing, the research processes involving the survey questions, respondent interaction, collation of data, analysis and interpretation of data shall be tested for validation and revision in case necessary. After the pilot study, the actual survey procedure shall commence targeting a population of 100 qualified respondents from each of the two hospitals chosen. Furthermore, 100 target samples from each institution shall be divided into two comprising of 50 qualified nurses and another 50 qualified patient respondents. The total sample population shall therefore be 200 qualified respondents.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   After gathering the survey results using open-ended questions and simple random sampling technique, the results shall be collated according to the three categories of the questions used -(1) approval, (2) opposition, and (3) suggestive. The results shall be analyzed according to the data obtained from the records review. Implications associated to the ethical issue proposed (termination of patient-provider relationship) shall be drawn from the results of the interview. With the implications and analysis of the survey results, the next procedure integrates the study results from the records review and survey results to draw the general relationship between the perceptive study and theoretical ethical discussion on the issue proposed. Finally, the results drawn from the integration should answer the primary goal of the study.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   1.5. PICO Analysis Table 1: P.I.C.O Analysis Population The main subjects concerning the research topic are the patients and associated providers, such as nurses and physicians. Program implementations involve similar sample groups as well (patients and nurses). Intervention Ethics analysis on patient-provider relationship utilizes the general overview of nursing and clinical care procedures (e.g. medication administration, wound care, etc.). On the other hand, the program implementation utilizes two interventions, specifically (a) Survey with corresponding questionnaires and (b) records analysis. Comparison Variable comparisons involve (a) patient perception versus (b) nurses perception on whether or not termination of patient-provider relationship violates the principles of duty to care and role fidelity. Outcomes Expected results of the study differentiate among the two parties involved. Nurses perceive the termination an ethical consideration under the basis of noncompliance and breach in the contract of relationship set prior to care delivery. Meanwhile, patients perceive the termination as an ethical breach since the tasks of the nurses must always comply with the duty to care and role fidelity. Conclusion In summary of this research proposal, we aim to determine the ethical standpoint of terminating patient-provider relationship on the grounds of patient incompliance despite the set agreement and principles governing the role of the health care provider. Since termination of patient-provider relationship has already been acknowledged by federal organizations (e.g. AMA, AAN, etc.), we determine if such termination of accounts on the basis of patient’s incompliance breaches the ethical principles of role fidelity and duty of care. In order to strengthen the ethics analysis of the issue, we have incorporated a descriptively designed survey method to obtain the perceptive response of both patients and nurses towards the imposed issue. After collating the results of the survey, the next step is to integrate the results obtained from the records review and from the survey conducted. References Carter, B. S., Levetown, M., Foley, K. M. (2004). Palliative Care for Infants, Children, and Adolescents: A Practical Handbook. London, New York: JHU Press. Earp, J., French, E. A., Gilkey, M. B. (2007). Patient Advocacy for Health Care Quality: Strategies for Achieving Patient-centered Care. New York, U.S.A: Jones Bartlett Publishers. Mason, J. (2004). Concepts in Dental Public Health. New York, U.S.A: Lippincott Williams Wilkin. Mezey, M., Berkman, B. J. (2000). The Encyclopedia of Elder Care: The Comprehensive Resource on Geriatric and Social Care. London, New York: Springer Publishing Company. Rothstein, M. A., Brody, B. A., McCullough et al., L. B. (2001). Medical Ethics: Analysis of the Issues Raised by the Codes, Opinions, and Statements. London, New York: BNA Books. Rubenfield, M., Scheffer, B. K. (2006). Critical Thinking Tactics for Nurses: Tracking, Assessing, and Cultivating Thinking to Improve Competency-based Strategies. New York, U.S.A: Jones Bartlett Publishers. Scott, R. W., Ed, N., Scott, W. (2005). Legal Aspects of Documenting Patient Care for Rehabilitation Professionals. New York, U.S.A: Jones Bartlett Publishers. Servellen, G. (1997). Communication Skills for the Health Care Professional: Concepts and Techniques. New York, U.S.A: Jones Bartlett Publishers. Shamus, E., Stern, D. (2003). Effective Documentation for Physical Therapy Professionals. New York, U.S.A: McGraw-Hill Professional.

binge drinking Essay -- essays research papers fc

What Causes Binge Drinking   Ã‚  Ã‚  Ã‚  Ã‚  Binge Drinking is an intriguing phenomenon that many college students take part in all across the country. The issue of binge drinking has been a problem on college campuses for decades. Binge drinking has many horrible effects, but the problem starts with the causes for it. If the causes could be controlled then the issue would not get out of hand. Many college students give different causes for their drinking problems, and experts on the subject have their explanations as well. The problem is, while growing through adolescence anything can become an excuse for drinking, such as  ¡Ã‚ §its Thursday the day before Friday, we need to drink ¡Ã‚ ¨ or,  ¡Ã‚ §it ¡Ã‚ ¦s the last Wednesday of the semester, lets get some beer. ¡Ã‚ ¨   Ã‚  Ã‚  Ã‚  Ã‚  Binge drinking has different definitions but many would agree that  ¡Ã‚ §Binge drinking has been defined as drinking more than 4-5 drinks in a row in one sitting. A drink is defined as a 12 ounce can or bottle of beer, a wine cooler, a four ounce glass of wine, or a shot of liquor ¡Ã‚ ¨ (Rhodes 1). Others believe that men who consume 5-6 drinks and women who consume 4-5 drinks are also considered Binge Drinkers. Personally I do not think that sex matters, if someone is consuming multiple drinks to become highly intoxicated they should be considered a Binge Drinker.   Ã‚  Ã‚  Ã‚  Ã‚  One article that covers the results of a national survey states that  ¡Ã‚ §Adolescents ¡Ã‚ ¦ levels of alcohol and drug use have been found to be strongly associated with peers ¡Ã‚ ¦ use. However, other studies have shown that a student ¡Ã‚ ¦s drinking was more strongly influenced by how much he or she thought close friends drank than by perceptions of the extent of use by students in general ¡Ã‚ ¨(Results 2). This is a statement that I can agree with because growing up I have watched many young people become greatly influenced by their friends. Now a days the phrase  ¡Ã‚ §peer pressure ¡Ã‚ ¨ concentrates on pressure from a direct group of friends rather than a students peers as a whole. Another reason the article gives for the cause of Binge Drinking is that  ¡Ã‚ §Students who perceive that more drinking occurs than actually does provide themselves with an excuse for drinking more because  ¡Ã‚ ¥everyone is doing it ¡Ã‚ ¦Ã‚ ¡Ã‚ ¨ (Results 2). E veryone knows that most youngsters want what every other kid has, this idea relates in the... ...nge drinking. Almost anything can become a cause for binge drinking. There are things that directly lead to drinking problems such as depression but most of the causes for it are just any old excuse. If I had to decide on main causes for binge drinking they would be depression and simple excuses that give students a reason to drink. People that are depressed usually have thoughts of giving up on life, so by drinking they are just easing their pain. Most of the binge drinking that goes on in college is because students feel that they are supposed to drink, its a college tradition in a way. This is why students will use any excuse they can to drink. Works Cited Anxiety and Binge Drinking. 30 Oct. 2000. Houser, Regan. Message in a Bottle. 30 Oct. 2000. Prevention Primer: Binge Drinking. 30 Oct.2000. Wechsler, Henry and Kuo, Meichun. College Students Define Binge Drinking and Estimate Its Prevalence: Results of a National Survey. EBSCO Publishing 29 Oct. 2000

Nazi Germany’s discrimination against the Jews throughout World War II Essay

As a result of anti-Semitism in Nazi Germany, a system of violent suppression and control emerged that ultimately took the lives of an estimated 6 million Jewish people Anti-Semitism is an opposition to, prejudice against, or intolerance of Semitic people, most commonly Jews. Anti-Semitism has existed throughout history, since Israel’s dispersion in 70 AD. In every land in which the Jews have lived, they have been threatened, violated and murdered, century after century. After Germany’s defeat in World War I, many Germans found it hard to accept their defeat. These Germans connived a theory that the citizens at home had betrayed them, â€Å"especially laying blame on Jews and Marxists in Germany for undermining the war effort† (http://www. historyplace. com/worldwar2/riseofhitler/ends. htm). This is the main reason that led to the extreme discrimination and removal of basic rights of Jewish people in Germany during the 1930’s and 1940’s, however, there were many other reasons including Christianity’s general hatred for Jewry. Jews were often the victims of Nazism. The first Jewish victims of the Nazi era were 8 innocent people who were killed in the streets on 1 January 1930 by Brownshirts. Soon after that, violence against Jews in the streets became common. Violence was an integral part of the Nazi programme†¦ Jews were molested in cafes and theatres, synagogue services were disrupted and anti-Jewish slogans became the daily calling card of Nazi thugs. (Gilbert,2001:31) One particular night of violence, known as Kristallnacht, is remembered with fear. During the night of November 9-10, 1938 thousands of windows were smashed out of Jewish businesses and homes, hundreds of synagogues were burnt to the ground, and more than ninety Jews were murdered. On March 9, 1933 the first Nazi concentration camp was opened at Dachau. On April 1, a boycott of all Jewish shops was put in place. It only lasted a day, because of threats of a counter-boycott in the USA of all German made goods. However, the expulsion of all Jewish people from Germany’s Universities and then the ‘Burning of the Books’ quickly followed the one-day boycott. The ‘Burning of the Books’ consisted of 20 000 books burned in a massive bonfire in front of the Berlin Opera House, and opposite the University of Berlin. The books that were destroyed were judged to be ‘degenerate’ and ‘intellectual filth’ by the Nazis, many being written by Jewish authors. Also during this time, Jewish scientists and intellectuals were dismissed from their positions, and Hitler was quoted as saying â€Å"If the dismissal of Jewish scientists means the annihilation of contemporary German science, we shall do without science for a few years†. In late 1939, the first ghettos were created in Poland. All Jews were forced to move into a designated area of a city or town, which was surrounded by brick walls topped with barbed wire, and guarded by armed men. SS General Heydrich ordered that the ghettos were to be located on railway junctions, or along a railway ‘so that future measures may be accomplished more easily’. Large numbers of people had to share small living quarters, and medical supplies and food were limited. The Jews could only bring into the ghettos what they could carry, and their luggage was searched and pillaged on their arrival. Life in the ghettos was hard, and death rates were high. Most of the deaths in the ghettos were by starvation or disease. In the two largest ghettos in Poland, Warsaw and Lodz, the death toll from starvation alone in the first twelve months after the creation of the ghettos reached approximately 42 000. In most of Western Poland, there were no ghettos. This was because General Heydrich had ordered Western Poland to be ‘cleared completely of the Jews’. Immediately after the Germans invaded a town, they rounded up all the Jewish people, made them dig large pits, then shot and buried them just outside the town. The ghettos were also referred to as concentration camps and slave labour camps. This was because while the Jews resided in the ghettos, they could be forced to work up to fourteen hours a day in some circumstances. Some were deported to separate concentration camps where they would work on farms in the country to maintain a food supply for the German war machine. Others who stayed in the ghettos worked for the Nazis in munitions factories making armaments, or for local businessmen who paid the government for the use of slave labour to work their factories. These Jews were mostly considered totally expendable, and were subject to minimal food rations, a lack of medical attention, and violent beatings. At least half a million Jews died as slave labourers. The extermination camps, or death camps were the sites for hundreds of mass murders. Men, women and children were deported from ghettos and concentration camps to these death camps and usually taken straight from the train to a gas chamber where they were gassed to death. A few hundred people were kept alive as slave labour to sort through the clothing and luggage of the victims. A small part of this labour force was known as the Death Jews. These Jews performed the task of removing bodies from the gas chambers and stripping them of anything of value. They then dragged the corpses to a crematorium where the naked bodies were burnt. Most of the labour forces were killed and replaced whenever a new group of deportees arrived. The most infamous death camp was Auschwitz, where mostly deportees from Western Europe and southwest Poland were taken. Lilli Kopecky, a deportee from Slovakia recalls arriving at Auschwitz: When we came to Auschwitz, we smelt the sweet smell. They said to us: ‘There the people are gassed, three kilometers over there. ‘ We didn’t believe it. (Gilbert,2001:77) More than a million Jews were murdered at Auschwitz alone. The Holocaust is probably the most infamous instance of anti-Semitism in History. The oppressive tactics of Nazi Germany took away all the rights of the Jews, and wiped out almost the entire race of Jewish people in Europe. If the Nazis had succeeded in what they came so close to doing, there would not be a trace of Jewry remaining in Europe today.

Wolves Keeping Nature in Balance Essay - 1057 Words

Everyone knows of the apocryphal evil that is wolves, hunting our children, killing our livestock, taking the best deer. Having a wolf hunting season seems like a no brainer, right? But what if that’s not how wolves are, what if they are innocent, so to say. Should they be hunted? The short answer is no. There should not be a wolf hunting season because many of the thoughts on wolves are incorrect; hunting would compromise wolf studies, and the population is already suffering. We have all heard of the Big Bad Wolf, stalking children and spreading fear and chaos. It commits heinous crimes and deserves to be destroyed. This is a misdemeanor. Wolves hunt deer, rabbits, moose, and other animals (â€Å"Wolf†). Because most of the animals they hunt†¦show more content†¦This happens because baying dogs appear as an attacker to wolves, causing them to go on the defense. The best solution would be not to use hunting dogs, but this option is exceedingly undesirable. Mult iple decades and thousands of dollars have been invested into the research of wolves and their behavior. One of the most successful ongoing studies takes place every winter on Isle Royale. They collar and track the wolves, studying their hunting habits and interactions with other packs. While visiting Isle Royale this summer, one of the Park Rangers said to me, â€Å"Wolves make great family members, but awful neighbors. Kind of like the Mafia.† While this may seem strange, what she meant was this; wolves are especially munificent towards their pack mates. They are loyal and some of the best parents, especially the fathers. However, they have been known to assassinate neighboring pack members at times (â€Å"All About Wolves†). Isle Royale is a prime example of this; limited space and resources cause constant fighting between the packs. While on the mainland wolves don’t fight over territory as much due to more space. Researchers can use this to their advantage. How? By creating a fake wolf pack. How it works is if a pack is attacking livestock, they can usually eliminate the one or two problem wolves and not have to worry. This doesnt always work, which then results in exterminating the pack. There is another solution they are trying. Instead,Show MoreRelatedBenefits of Keeping Endangered Species Around1234 Words   |  5 Pageshunted to extinction. The calvria tree depended on the dodo to digest its seeds for new trees to grow. Once the dodos were gone, the trees had no way to reproduce. Only a few very old trees survive today (Primack 35). One of the benefits of keeping endangered species around is to help the economy. This can be seen in industries such as fishing and agriculture. Food crops depend on pollinators in order to grow. About $10 billion worth of crops in the U.S. are pollinated by honeybees, whichRead MoreHada Gwaii Case Study905 Words   |  4 Pagesitself. 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This occurs when the companions do battle with giant venomous spiders in Mirkwood forest. Bilbo finds depth and strength in his nature that he was surprised was there and smote these villainous creatures all on his own, saving his friends and adding to his stature among those in the group. Somehow the killing of the giant spider, all alone by himself in the dark without the helpRead MoreThe Novel The Zookeeper s Wife 2010 Words   |  9 Pagessoldiers threaten to murder all the people living in the villa. The soldiers ordered everyone to stand and a straight line, as they pointed their guns at them. At the time, Antonia was pregnant with her second child and she could barley keep her balance. The soldiers took the Fox Man’s fifteen-year-old helper behind the shed and a shot was fired. The soldiers then ca me back and indicated that RyÅ› was next. RyÅ› followed the Nazi behind the shed and another shot was heard. Antonina was in completeRead MoreNegative Effects Of Poaching1806 Words   |  8 Pagesorganizations to become involved as well. Beth Allgood proclaims that,â€Å"rebel and militia groups, criminal syndicates, and even terrorist organizations are using the lucrative black market for animal parts to finance their operations.† In her article,â€Å"Criminal Nature – the dangerous links between poaching and organized crime†, Allgood reports that organized crime groups find wildlife trafficking attractive due to high profits, low risks, and weak penalties. Of course, the dangers of the illegal activities associated