Breach of contract †contract law Essay

Spanish Contract Law provides a broad notion of breach of contract for any behavior that departs from the specified behavior in the contract in any way (time, quality, substance, etc.) or is not specially justified on legal grounds (actions forbidden by the government are not breaches since they are justified on a legal ground). The general benchmark to determine breach is the contract agreed by the parties themselves, and not external notions. However, external notions are used in important situation such as the consumer’s market where the consumer’s expectations are the primary benchmarks to assess quality and performance since there is not an explicit contract. External notions are also important in other market, where a third party may have some duty or responsibility over the contract, and therefore, is responsible (at least in part) for any potential breach. The reason for breach does not exclude the breach. What matters is the breach. The analysis of breach takes place in objective terms. Subjective factors generally do not exclude breach, although they may affect remedies. In certain contractual areas, breach of duty and fault are generally required (professional contracts, management contracts: breach requires violation of a duty of care or a duty of loyalty). In professional contracts, the fault may be of a professional who was in contract with the firm, and in management contracts, it may be the fault of the manager. 2) Remedies: Spanish Contract Law provides a wide range of general remedies for breach of contract: †¢ Specific performance: the court forces the breacher to act as it was established in the contract. If for example, the contract stipulated that the promiser had to give the promisee a product of quality 2 and he delivers a good of quality 1, then as remedy the court force the promiser to deliver a good of quality 2. †¢ Damages: the court force the breacher to pay a certain amount of money  (damages) to the other party as compensation. It is a monetary remedy. The court calculate the amount to be paid. †¢ Liquidated damages: these are also monetary compensation, but with the difference that they are not calculated by the court, but they are instead specified in the contract itself. One example are the soccer players’ contracts, or sale contracts that specifies the amount to be paid for each day of delay. Other general remedies that we can find are: †¢ Termination: if a party suffers a breach, it can contract with another party and abandon its contractual obligation. If the breacher does not agree with this, court is necessary. †¢ Reduction of prices: in case of breach of a party, a general remedy is to reduce the price to equilibrate the contract. Generally, it is the aggrieved party who chooses the remedy to be imposed. 3) Specific performance: Specific performance is a remedy for breach characterized by the fact that a failed performance or departure from required action by the contract will be imposed upon breaching party. It is also characterized by several material variants of the remedy such as: forced delivery, forced action, injunction not to do, repair defective performance and replace non-conforming good. In the case of the injunction not to do, the court oblige the breacher not to do something, such as obliging a CEO to work for the competition if in the contract it was stipulated that he cannot. Specific performance conceptually includes repair and replacement of consumer goods. The main issue with specific performance, when it is feasible, is the issue of the balance of benefits and costs of the remedy. Specific performance implies that the breacher perform as the contract establishes. However, sometimes, the cost of this performance may be higher than the benefit in social welfare terms. Take the example of the mining firm, which has a contract with the owner of the land to mine for 10 years and then clean the land. When the 10 year pass, the firms breaches the contract and refuse to clean. The cost of cleaning the land is 20 millions, and the benefit for the  owner is 1 million. So if the court imposes a specific performance to firm, society will loose 19 millions. A good alternative would be to impose damages to the firm, which would be preferred by the owner, since an agreement between the firm and the owner will be reached that maximize the social welfare. In these cases, performance may be more costly than its value for promisee: performance may be ex post inefficient. There are both positive and negative features of specific performance as a remedy. As positive features, we can distinguish low informational requirements to apply remedy (avoids cost of error linked to estimating damages) and the party aggrieved by breach appears to be satisfied in its promissory expectation. As negative features, we find performance may be more costly than its value for promisee (performance may be ex post inefficient), requires a court order and takes time, for complex performances requires costly and difficult supervision by court and performance by a party forced to comply with contract may be perfunctory (lowest effort) at best. 4) Damages: Damages are understood as general remedies that can be applied to all types of contracts and breaches of contracts. It is a remedy defined in very broad terms: amount of money to compensate any harm suffered by the injured party as a consequence of any breach of contract. We can differentiate between two kinds of damages: expectation and reliance damages. This is why it is a remedy with a variable extension. Expectation damages: Expectation damages is the sum of money that will give the party damaged the same amount of welfare and utility than if the contract would not have been breached and the final result would have been attained. Therefore, the breach party would have to pay the aggrieved party an amount of money that would compensate for the harm caused and in addition an amount of money equal to the value of the performance for this party. There are however some problems with expectation damages since they are difficult to compute and some instances of moral hazard may appear. Those who seek for damages have to provide evidence of both the existence and amount of damages. This requirement has some exceptions in case of harm in re ipsa: illegitimate use of a productive good, deprivation of a productive good, and few other examples. Expectation damages is the general rule in Spanish Law for breach of contract. It is the damage measure that accompanies termination for breach and the replacement measure of specific performance. It is awarded when there is a breach of representations and warranties, advertising and promotional communications and in cases of pre-contractual fraud that are equivalent to breach of contracts. How can we compute expectation damages? When goods or services admit substitutes or cover transactions to avoid the negative consequences of the other party’s breach of contract, the price of these transactions is relevant. If the seller breaches the contract and the buyer has bought a good, generally fungible, then the expectation damages will be equal to the difference between the price of the substitute and the price established in the contract: Psub-Pc. If the buyer breaches the contract and the seller celebrates a cover sale the expectation damages would be equal to the difference between the price established in the contract and the price of the new sale: Pc-Psub. Other ways of computing expectation damages are the following: Market damages: (for fungible good with market price) buyer will receive expectation damages consisting of the difference between the market price when the breach of contract took place (Pm) and the contract price (Pc). Seller will receive the opposite difference. Expectation damages present some limitations that reduce it scope and amount. One of this limitations is the foreseeability rule. This rule state that the breacher should only be liable for the things that are foreseen or could have foreseen at the time of contracting and that are necessary  consequence of his failure to perform. For instance, if the foreseeable harm of a breach is 100 and the aggrieved party end up suffering a loss of 1000, the foreseeability rule states that damages will amount only to 100. The foreseeability rule gives incentives to give information in the time of contracting. Those who suffer from harm must declare the value of the performance. In tort law, there is no foreseeability rule, you pay the actual damage. Another limitation is the duty to mitigate damages: the aggrieved party is under the duty to mitigate damages that the other contracting party has caused with her / his breach of contract. Reliance damages: Reliance damages: sum of money that will give the party damaged the same amount of welfare and utility than if the contract would not have taken place (the initial situation). This is why reliance damages are generally lower than expectation damages. Reliance damages cover expenses for the injured party derived from concluding the contract, specific investments that the injured party has made in reliance of performance of the contract by the other party and opportunity costs. Limited assets: Damages do not always work well. Sometimes, individuals can bear the payment of these damages, and therefore, they will have incentives to reduce them. However, this is not always the case. When the breacher has not enough assets to pay damages up to the point of optimal care, damages do not work well, because people will not pay for the consequences of their acts, and therefore, their level of care will be the optimal according to what they can pay, and not what they should pay. This is known as judgement proof problem. Damages for pain and suffering: The traditional position of the Spanish Supreme Court and Spanish Courts is: †¢ To accept damages for pain and suffering for breach of contract †¢ To award damages for pain and suffering with a relative amplitude and generosity. †¢ To award damages for pain and suffering with several functions: †¢ To avoid the problems of calculating and justifying the amount of the damage award †¢ To compensate harm in personality rights (right to life, liberty, honor, etc.). †¢ To compensate non-patrimonial values joined to economic goods and rights (discomfort, inconvenience, disappointment, frustration) †¢ To punish intolerable or egregious behaviors of breach of contract. When an individual suffer harm, her utility decreases (she goes form point A to point B, but her utility function for money will not change). If this harm is economic, we can compensate this harm with money, which will leave her at point A again. However, the harm that an individual can suffer may be non-economic, and for the same amount of money her utility decreases (her utility function changes). Money cannot restore the initial utility (a huge amount would be needed). This is the case of pain and suffering (accident and death of a relative, discomfort, etc). This is why it is useless to take insurance for death, since it would not compensate the harm. The hairy hand example: What is the difference between expectation and reliance damage? Let’s look at an example. An individual was injured in his hand and lost 50% of his use. He entered in a contract with a doctor who promised to reestablish the hand to a 100% of use in exchange for quantity of money. Before the contract was made, the individual was situated in an indifference curve that related all the  combination of hand use and money that let the individual indifferent. We assume that the individual is willing to give up hand use for money. After the contract and operation, the individual was worse off, with 25% of use. What should the doctor pay as damage? If expectation damages are used, the doctor should pay the individual a quantity of money that together with the 25% of hand use leave him with the same utiity as if the contract had succeded and he had 100% of use (situate him in a higher indifference curve). If reliance damages are imposed, the doctor should pay the individual a quantit y of money that, together with the 25% of hand use, leave him with the same utility as if the contract did not take place, with 50% of hand use (situate him in the initial indifference curve). 5) Liquidated damages: Liquidated damages are damages for breach that are not determined ex post breach by a Court or arbitration panel, but ex ante by the contract parties themselves into the contract. Such possibility of â€Å"privately stipulated† remedies for breach is acknowledged by most legal systems, typically in the form of payment of money, although other possibilities may exist. They typically replace Court damages and they can be agreed as added penalty for breach. The most important issue is whether Courts are forced to enforce liquidated damages, or they may disregard, or reduce, the amount of the liquidated damages award. The reasons why Courts allow liquidated damages are: †¢ Freedom of contract †¢ A large liquidated damages clause may be necessary to induce promisee to find promise credible and the contract sustainable. †¢ Parties are in a better position than Courts to assess benefits and costs of determining a given amount. †¢ Liquidated damages compensate systematic underestimation of damages by Courts. If liquidated damages are higher than the expectation damages, then the court will apply the second ones. There are however some economic arguments that may lead to reduce or at least control the level of liquidated damages clauses: †¢ â€Å"Excessive† damages clauses resulting from incorrect predictions or forecasts about future outcomes. †¢ External shocks unforeseen by parties that produce an unexpected increase in the damages payment. †¢ True â€Å"uncertainty† about future costs for one party. †¢ Behavioral biases that lead party to underestimate the true adverse impact of a damages clause (the â€Å"deferred cost problem†): †¢ Over-optimism concerning future performance and costs (the example of the gym) †¢ Hyperbolic discounting of future outcomes We can see the liquidated damages as barriers to entry. An excessive amount of LD is beneficial for the parties to the detriment of a third party who  may bid for the services of breaching party. Promisor agrees to pay an amount larger than ED, in exchange of higher price. Promisee uses high liquidated damages to extract larger payment from a third party interested in performance by promisor: larger payment from third party increases the surplus to the contract parties, that is shared between them. Also, excessive payment of third party are made possible by excessive damages clauses, which reduce efficient entry by third parties, and prevents them from successfully bidding for promisor’s performance. That is why the goal of reducing â€Å"excessive† liquidated damages is not to protect the breaching party, but third-parties. Sometimes, excessive LD for signaling are unwanted, since an unforeseeable contingency may appear that will cause a breach in the contract. A pooling equilibrium may be more desirable than a separating one when the distortion caused by the penalty on the â€Å"good type† is large enough. 6) Termination: Among the general remedies for breach, the last one is termination (or rescission, or cancellation, as it may also be called in Common Law jurisdictions). This remedy entitles the aggrieved party to cancel the contractual relationship with the breaching party, eliminating the obligations arising from the terminated contract. Once the contract is terminated the parties should give back what was received under the contract, unless the goods are now in lawful possession of a third party. In this case, the value of the goods would replace the goods themselves. The elimination of the effects of the contract is retroactive: it is considered that the contract did not exist. Spanish courts have established that termination does not require a lawsuit. However, if the other party disputes the termination or its conditions, restitution would require a lawsuit. Courts do not determine termination, but declare whether termination was or not properly effected by the party. The most contested issue about termination is when is termination available as a remedy. It is clear that not every breach or non-performance allows the  aggrieved party to terminate, but a qualified breach (material or fundamental breach) is required. We can define it as follow: †¢ Relevance: the breach must affect the central obligations or duties under the contract and not merely ancillary or incidental duties. †¢ Duration: the breach should not be merely sporadic or transitory, but likely to be repeated or continuing. †¢ Importance: the breach must substantially affect the interests of the non-defaulting party. Termination does not go alone, it does not exclude damages, and in fact it is naturally accompanied by damages payment.

Patient Advocacy Analysis Essay

Introduction A patient advocate may be present for healthcare appointments and alert the healthcare provider about patient compliance issues. He or she may separately assist the healthcare provider and support staff with potential issues and communication challenges. The patient advocate is also responsible for maintaining communication with the patient and healthcare provider to ensure that patients understand the procedures. By reducing fear and increasing patient compliance, this can result in higher successful treatments. Generally, a patient advocacy contract that includes a release of medical information must be placed with each healthcare facility (Ad Hoc Committee on Advocacy, 1969). Some institutions may require a power of attorney for healthcare for a patient advocate to exchange confidential information. The patient advocate may provide medical literature and research services to the patient, family, or healthcare provider. The patient advocate may also assist with family communication on issues arising from illnesses and injuries . This may include further referral for care and support for both patients and families. The patient advocate has a responsibility for awareness of compliance, appropriateness, and coordination of care for the patient, such as oversight for potentially conflicting treatment modalities and medications. The patient advocate can ensure that questions about the appropriateness of treatment are promptly discussed with the patient’s care provider, and that all treatments and concerns are promptly entered into the patient’s healthcare record. The patient advocate is also responsible for reviewing the patient’s healthcare record for correctness and for explaining it to the patient. Another responsibility of the patient advocate is to create and maintain an electronic log for the patient that is available on disk to healthcare providers i This log may be of great benefit in subsequent urgent situations. The patient advocate can also assist in resolving disputes between patients and their healthcare provider, as well as engaging in communications on behalf of the patient in case of employment issues by approaching the employer to achieve a mutually beneficial solution for the employer and the individual employee. Where applicable compliance standards are not met, the patient advocate may conduct liaison with corporate oversight, government agencies, or legal professionals to further negotiate such issues on behalf of the patient and family. It is the duty of a patient advocate to maintain patient privacy according to local and national laws, treating all patient and family information as privileged and protected. This includes ensuring that healthcare providers’ communications are treated as highly confidential and privileged, whether or not those communications are specific to the patient, and that permissions to disclose information are negotiated carefully. It is also the duty of the patient advocate to follow any referrals for medical, financial, legal, administrative or other personnel to assure that the patient is always kept safe and well informed, never abandoned or misled during the process (Carlton, 1984) SWOT Analysis When developing a SWOT analysis for the Patient Advocate Organization, three primary purposes emerged: 1. Inspire continued trust and confidence in the nursing profession among patients, their families, and the American people; 2. Leverage nurses, the single largest health care workforce, together with patients, partners in their care, in accelerating performance improvement; and 3. Stimulate reform through shared perspectives, knowledge, and values among nurses and patients, their families, and consumer stakeholders. A SWOT analysis focuses on internal strengths and weaknesses and external opportunities and threats. In this instance, these concepts have been applied to a proposed alliance that serves these three proposed purposes. Typically, SWOT analyses are presented in tabular formats and entries are listed in one of four quadrants in the table (i.e., strengths, weaknesses, opportunities, threats). The SWOT analysis is presented in Table 1. Strengths Purpose 1. Inspire continued trust and confidence. a. Existing nurse workforce is the largest segment of the healthcare workforce b. Living up to nursing’s promise to represent the patient voice c. Expanding consumer recognized success (e.g., number of hospitals, evidence-based link to quality/safety). d. Expanding and maturing evidence-based that establishes nursing-quality-value linkages. e. Operating consumer advocacy groups is a well-known skill for several of the major groups with which we could partner f. Convener organizations have a proven track record in working together (e.g., areas of education, competency development, leadership) Purpose 2. Accelerate performance improvement a. Expanding and maturing evidence-based that establishes nursing-quality-value linkages b. Partnering to expand and accelerate current and future measurement sets (examples follow): b.1. Experience with, and advancement of, measure development and data collection (i.e. NDNQI, AWHONN EDGETM Database, etc) b. 2. Existing national, regional, and state nursing performance measures databases (e.g., NDNQI, CalNOC, Maine and Massachusetts) b.3 Existing national quality measurement and reporting infrastructure (e.g., Compare websites) Purpose 3. Stimulate reform a. Existing nurse leaders with strong organizational skills and credible backgrounds b. Threats by existing nursing and nurse faculty shortages are widely recognized by policy makers and health care stakeholders. c. Patients and nurses, each individually,†¨make strong advocates; together, their combined effectiveness will likely be transformative d. Reviewing the evidence suggests that nurses make effective policy advocates Weaknesses Purpose 1. Inspire continued trust and confidence. a. Existing, numerous professional nursing organizations and specialty groups result in fragmentation and diffusion of the expertise and resources among nursing as a whole. May be confusing/distracting to consumer groups who join an alliance b. Creating a new â€Å"fancy† alliance may not change nursing’s image from that of a profession that â€Å"takes orders.† We may remain unable to gain access to high levels of policy making and policy makers c. Funding source for sustained support is unknown d. Participation would be voluntary (e.g., What incentive†¨would organizations have to provide technical time and support for NPQA?) Purpose 2. Accelerate performance improvement a. Representation of VANOD, CalNOC, MilNOD is lacking in the convener group gathering under the planning grant b. Lacking sufficient nursing-sensitive outcome measures and resulting data to address all patients in all settings across an episode of care limits how comprehensively nursing care quality can be portrayed and might limit partnerships with certain consumer groups c. Developing standard language may be necessary prior to creating additional standard measures (e.g., birth date or date of birth) d. Adding/changing billing codes (e.g., G-codes, E-codes) to document nursing care is not in the realm of influence for nurses or consumers but together we may have more success. Purpose 3. Stimulate reform a. Nursing is not typically a ‘target’ of federal policies because of employee-employer relationship (rather than direct contractors with payers for services) b. Existing consumer and nursing organizations approach policy makers with multiple requests: lack of unity c. Nursing inclusion within existing alliances may be viewed as duplicative Opportunities Purpose 1. Inspire continued trust and confidence a. Build upon nursing social capital with consumers as the most trusted among health care professions b. Identify (empirically, anecdotally) and enhance the value-added of nursing with consumer participation and support c. Improve consumer understanding about the quality of nursing care d. Improve nursing’s knowledge of consumers’ experience of professional nursing Purpose 2. Accelerate performance improvement a. Continue quid pro quo to various alliances (i.e. HQA, KCA, QASC) providing entry into these policy discussions b. Dedicates significant, shared resources to improving quality, safety and value c. NPQA could serve as a neutral reporting entity to achieve economies of scale and scope by moving performance measurement reporting from various nursing organizations to a central source. d. NPQA sets agenda for measure adoption and collection Purpose 3. Stimulate reform a. Disseminate practice-based questions/issues to policy makers and thought leaders to guide funding of research or studies b. Recognize evidence that suggests that nurses, APRNs and consumer groups have opportunities to strengthen their policy voice c. Vision for proactive, toward thinking policy agenda that can push (e.g. What so we want decision makers know about nursing performance?), pull(e.g. What do decision makers already know about nursing performance ?) and/or Partner (e.g. What do decision makers want/need to know about nursing performance ?) Threats Purpose 1. Inspire continued trust and confidence a. Consumer partners may overwhelm nursing. Nursing may be subordinate to consumer leadership. b. Potential to be barraged or criticized by special†¨patient advocacy groups and specialty nursing groups who are not included in membership c. Partnership adds complexity to operational aspects of an alliance such as leadership, governance, membership dues, etc Purpose 2. Accelerate performance improvement a. Current national practice specialty organizations (AORN, AANA, ONS, AWOHNN, AACN, ACNM) have limited resources and will have to decide where to invest (e.g., choices will need to be made that could result in weakening NPQA) b. Data may portray low quality nursing performance with subsequent unintended consequences for nursing c. Established boards of both large nursing organizations and consumer organizations may refuse to support or may change support as leadership and resources fluctuate d. Alliances with whom nursing has a quid pro quo relationships have not universally welcomed nursing participation and have rationed our involvement (e.g., don’t recognize different nursing groups) e. Consumer group(s) may not recognize a need to measure nurse performance in the same manner in which nurses do. Conflict may result (e.g. consumers may think, â€Å"Did the nurse carry out the order?†) Purpose 3. Stimulate reform a. Absence and inattention to nursing issues/strengths in health care reform proposals b. Presence of a strong medical lobby and physician advocacy groups linked with consumers c. Established alliance landscape and inconsistent/ ‘unwelcoming’ nature among existing alliances to nursing d. Lack of awareness by policymakers of the necessity to engage nursing to realize dramatic and sustainable improvements in quality and safety Customer analysis Before implementing this process in South Florida, it is necessary to conduct the market research to check whether this process has market relevance to this area. In other words, it is important to find out whether customers want to use patient advocacy and then analyze if it is available for implementing it in this area via the drives of value. Basically, there are three interdependent drivers of value, including population health, patient experience and total cost per capital, to promote the development of patient advocacy. The data published by U.S. census government shows that the population in Florida is experiencing a huge change during recently year, no matter the change is characteristic by age or race. First, as illustrated in Figure 2, we can see that from 1960 to 2040, the actual and projected census population will rapidly grow from around 50,000 to over 25,000,000 in Florida. There are two main factors causing this phenomenon. On the one hand, there are the baby boomers. This accounts for the natural population increase. While births exceeded deaths during each of the two decades, less than half a million persons were added to Florida’s population each decade due to the natural increase. On average, 118 more Floridians were born than died each day during the decade of the nineties (Census Report, 2000). On the other hand, individuals’ life expectancy is rapidly extended. As populations of modern societies have begun to age, the older age cohorts have become disproportionately represented. Figure 3 show that the age group over 65 and up holds the largest percentage during 2010 to 2030. For example, in the area of Southeast Florida, its population of 6.2 million, is larger than 34 of the 50 states in 2008. About one in every three (31.2%) South Florida resident was born in the state of Florida. Meantime, in South Florida, the elderly are projected to reach almost one million (20.7% of the total) in 2030, up from 14.4% in 2010 (Ogburn, 2010). Compared to the Treasure Coast, the change is becoming more obviously as it is shown in Figure 4. The data described above figures out that even though the population growth slowed down in recent days, South Florida continue s to grow at a speed that is faster than the nation as a whole, with higher rates in the northern region. Apparently, the change population characteristic provides a huge market for the patient advocacy. A demographic trend often overlooked in discussions of healthcare is the changing structure of American families and households. There has been a decline in the proportion of the population that is married and a proportionate increase in the size of the single, divorced, and widowed population. The average household size has declined, and there has been a large increase in the proportion of the population that lives alone. Therefore, more and more households are involved in the health industry to some extent. This means that Floridians’ expectations for acquiring healthcare knowledge and learning about diseases is increasing. This will help them know how to make decisions when they face the healthcare problem and know whether the plan recommended by physicians and nurses are available to them. Secondly, as illustrated in Figure 5, it can be shown that the race/ethnic composition o f Southeast Florida was made up of 37% Hispanic or Latino. In 2000, the non-Hispanic White population represented 47% of the regional total, down from 57% in 1990. In other words, the non-Hispanic White population of Southeast Florida ceased to be the majority sometime in the 1990s, due mostly to the growth of the Hispanic population in Miami-Dade Country (Ogburn, 2010). Hence, it is very important to take the Spanish language into account when patient advocacy is established. Thirty-three percent of the South Florida population is over age 65, so for those elderly who do not know how to speak English, patient advocacy could help them understand what the medical staff tell them about their diseases or how to take those pills. It also helps to reduce the potential abuse error when patient advocacy staffs teach those patients via their own language. Thirdly, as acute illness has declined as the pervasive type of disorder, chronic conditions have emerged as the dominant type of health problem in developed countries. Chronic conditions generally do not contribute directly to mortality, but are often cited as underlying causes of death. They are more likely to interfere with the quality of life, since they often result in some form of disability. Chronic diseases always result in more cost and more time for recovery. Some maybe even cannot be treated. Thus, patients find themselves confused about the advantages and disadvantages of the treatment. Patient advocacy members listen to confused patients and help them collaborate with physicians and insurance companies. Patient advocacy will offer medical assistance, insurance assistance, home health assistance, elder and geriatric assistance and legal assistance. Those types of assistance will help patients with chronic illnesses to understand their healthcare conditions in detail. The Four Ps The four marketing Ps (product, price, place and promotion) are important in developing the entire marketing process for every company or organization. In other words, the heart of a marketing strategy is the development of a response to the marketplace. For every business, all they need to do first is to identify the customers’ needs, and then determine the price customers are willing to pay. Then, they need to identify what place is most convenient for customers to purchase the product or access the service and, finally, they need to promote the product to customers to let them know it is available (Berkowitz, 2011). Hence, when conducting the Four Ps analysis, there are some questions we need to figure out. Those questions are shown on Figure 6.1 (â€Å"4Ps Marketing,† n.d.): Product The important thing to remember when offering the service of patient advocacy to customers is that they have a choice. For example, for health care providers, they can rely on the customer service center in their own organization to deal with patients’ complains; for patients, they might turn to their doctors or friends who have those treatment experience for help when they need. Therefore, patient advocacy organizations should considerable emphasis on developing a list of help service which customers really want. For example, in South Florida, as we also mentioned earlier in this paper, a large proportion of people speak Spanish as their first language, so Spanish speaking can become a selling point and add into the service list in this area; especially in a situation of establishing commutation between a Hispanic or Latino patient and an English-speaking physician. What is more, for those existing services, the organization should also pay attention to the product life cycle as well. For example, with the implementation of Obama Care, the American healthcare system has become a complex system, and it has become increasingly difficult for patients to understand and adapt, so patients’ fears and frustrations have continued to grow since they may get confused by the new policies and become worried about how to get their reimbursements after the treatment. In other words, customers’ requirements change over time. What is important and useful today may be discarded tomorrow. Therefore, marketing should continuously monitor the external environment and other factors to modify the services in order to meet the customer’s need. Price Price focuses on what customers are willing to pay for a service (Berkowitz, 2011). And the customer’s perception of value is an important determinant of the price charged. Customers draw their own mental picture of what a service is worth. So the pricing decision is a major aspect of marketing strategy. In the healthcare industry, the issue of price is less likely to be a concern since pricing was based on predetermined reimbursement formulas. However, in order to sustain and develop and organization, whether public, non-profit organization, private, or for-profit, patient advocacy organizations still need to pay attention on how they establish the price. 1. The Types of Services and Complexity of Service. As customers’ needs are varied, there are perhaps dozens of services health advocates can provide, ranging from explaining treatment options to reviewing hospital bills, from uncovering clinical trials appropriate to customer’s need, to getting their insurance company to pay a claim they think should be covered. Each service should cost differently according to the time it takes to accomplish it. 2. The Background and Expertise of the Employee Just as would be true in any service business, the more credentials an advocate has achieved, the more it will cost. Further, some advocates have developed specific niches to their work that becomes a benefit to customers, who may be worth a higher salary. So obviously, a higher price should be made for these employees in order to sustain the organization. 3. Geographic Location. Just as there are variations in cost for almost anything we buy based on where we live, the same is true for health advocacy services. As shown in Figure A7 (â€Å"Miami Household,† 2011), in Florida, take Miami as an example, households with income under 15,000 reached 25% in 2010, which was twice as many household of the entire United States. Considering the low-income rate in this area, the price should not be too high when providing services. However, the danger of using low price as a marketing tool is that the customer may feel that quality is being compromised. It is important when deciding on price to be fully aware of the brand and its integrity. A further consequence of price reduction is that competitors match prices resulting in no extra demand. This means the profit margin has been reduced without increasing sales. Place All businesses must decide how many other organizations are needed to distribute their product or service, so does the patient advocacy organization (Berkowitz, 2011). In fact, the purpose of getting any intermediary organizations involved is to provide service to customers in a more accessible way. Therefore, not only big general hospital, but also small primary care clinic should be considered when providing services. Besides, â€Å"place’ in the marketing mix, is not just about the physical location or distribution points for services. Especially in the healthcare industry, it encompasses the management of a range of processes involved in bringing patient advocacy to the end consumer. Promotions Promotion is more than just advertising (O’Malley, 2001). The promotions aspect of the marketing mix covers all types of marketing communications such as advertising, personal selling, publicity, and sales promotion. However, advertising is an important part of promotion. Generally, advertising is conducted on TV, radio, cinema, online, poster sites and via the printed press (e.g., newspapers, magazines). Different advertising channels can be used to maximize the effectiveness of advertising. For example, TV advertising makes people aware of a help service and press advertising provides more detail. This may be supported by in clinic or hospital recommendation to get people to try the service. It is imperative that the messages communicated support each other and do not confuse customers. A thorough understanding of what the brand represents is the key to a consistent message. The purpose of most marketing communications is to move the target audience to some type of action. This may include purchasing the service, visiting or calling the organization, and recommending the choice to a friend or purchasing another service that he or she may also need. The key objectives of advertising are to make people aware of the service offered by the organization, which they cannot get from anywhere else, and to feel positive about it and remember it. Therefore, when promoting, messages should gain the customers’ attention and keep their interest. The next stage is to get them to want what is offered. Showing the benefits that they will obtain by taking action is usually sufficient. The right messages must be targeted at the right audience, using the right media. Take South Florida as an example, 33% of the population in this area is over age 65, so it is important to find an advertising channel to reaches this group of people. In this case, Internet advertising may not be such a good idea while newspaper and television may bring more customers to the organiza tion instead. Conclusion After analyzing the market in South Florida, we can easily reach the conclusion that there are great needs to have patient advocacy in South Florida. In fact, patient advocacy is an emerging practice, and it deserves more recognition when developing healthcare business. Whether you are in private practice, serve as a hospital patient advocate or are developing an advocacy program in a managed care company, having a clear marketing plan of patient advocacy in your business region is a key factor to successfully grow your practice in the future. References Agency for Healthcare Research and Quality. Healthcare costs and financing. Research Activities. 2011. Accessed at heep://www.ahrq.gov/research/jun11/0611RA11.htm. Ad Hoc Committee on Advocacy. (1969). The social worker as advocate: Champion of social victims. Social Work, April, 16–20. Berkowitz, E. N. (2011). Essentials of Health Care Marketing. 3rd Edition. Jones & Bartlett Learning, LLC. Carlton, T. O. (1984). Clinical social work in health settings. New York: Springer Publishing Company. Florida Population: Census Summary 1990 and 2000. Make a difference as a patient advocate. Retrieved from: http://allhealthcare.monster.com/benefits/articles/3210-make-a-difference-as-a-patient-advocate?page=2 Miami Household Income Statistics (2011). CLR Search.Retrieved from: http://www.clrsearch.com/Miami-Demographics/FL/Household-Income Ogburn R. F., 2010. Demographics and population growth in southeast Florida. South Florida Regional Planning Council. Retrieved from http://www.sfrpc.com/region/demographics.htm O’Malley, J. F. (2001). Healthcare marketing, sales, and service: An executive companion. Chicago: Health Administration Press, p. 101 4Ps Marketing Mix Example (n.d.). SmartDraw. Retrieved from http://www.smartdraw.com/examples/view/4ps+marketing+mix/

Employment and Personal Values

What do you do if your personal values are in conflict with organizational/interpersonal business protocols? | Reaction Paper – Week 2| Professional Development MBA-525-MBOL5| Kelly M. Mistretta| 7/15/2012| | Values are a part of each of us. Our value system is influenced from birth by family members. As we grow, our values continue to be shaped by our family, in addition to outside influences such as teachers, friends and other mentors. In our professional life, we will most likely be faced at some point in time, with a conflict between our personal values and a professional situation.It is important to handle the conflict with dignity and to find a solution to the conflict in which your individual values are maintained, as well as your professional integrity. Personal values act as motivators and impact priorities. Examples of motivating values are achievement, happiness, advancement/promotion, and family. â€Å"To gain a better understanding of how your values motivate you to set priorities, try looking at your personal activities. (Values, 8) When making a decision based on your personal values and the activities that influence these values, it is important to realize that the priority that you place on these values will potentially have both positive and negative consequences. When choosing a career at a company, you should recognize the potential consequences and conflicts that you may be faced with. It is important to distinguish carefully between your personal values and organizational values. When faced with a situation that you feel uncomfortable with in a professional situation, you should first consult with your company’s Code of Conduct.It is possible that the situation also is in conflict with the Code of Conduct. Although the law does not require a Code of Conduct, â€Å"company leaders see the benefit of having their ethical policies formalized. † (Pace, 28) Codes of Conduct are beneficial to employers, because it lets empl oyees know what is expected of them. It is important for an employer to uphold their Code of Conduct, because if they don’t, the code becomes useless. All employees should have a copy of the Code of Conduct to refer to so that they know what is considered acceptable conduct, how to handle and report misconduct and the potential penalties for misconduct.Relationships with employees, peers and bosses can cause conflict for management. â€Å"The dilemma is further complicated by the fact that these critical people may have contrary goals and competing needs. A misstep in handling an ethical issue may well affect a relationship, or linger on the conscience, for years to come. † (Maddux, 7) As an employee, when faced with a situation that goes against your personal beliefs, you must make sure that regardless of the outcome, you have a clear conscience and feel comfortable with your decisions and actions.An example of personal values conflicting with business values for me o ccurs on an almost daily basis with a co-worker. This person plays Christian music loudly at her cubicle throughout the day. Personally, I do not have a problem with the Christian music. In fact, I listen to a Christian radio station in my vehicle constantly. However, I do not agree that the workplace is the best place to play this music. We see a variety of customers throughout the day who have different beliefs and values than we do.Furthermore, we work in a government office and have to be very careful not to cross over an imaginary line. I personally would be offended if I visited a government office and had rap music or heavy metal music played to me while conducting business. I think that she could offend a customer who would rather not hear about religion while obtaining a building permit. A better option for this co-worker would be to listen to her music when there are no customers and then mute or stop the music when there is someone at her desk.Professionalism is a trait t hat we should maintain at all times. It can be hard to maintain your composure when a situation conflicts with your personal beliefs. An individual needs to consider how the ramifications and the severity of these ramifications when analyzing a situation that offends them personally. If the situation involves a co-worker, you should discuss the situation with them and let them know why you find their actions offensive to you. Hopefully your co-worker will respect your values and you can find common ground on the situation. REFERENCESFrederick, William C. (1995). Values, Nature, and Culture in the American Corporation. Cary, NC:Oxford University Press. Maddux, Dorothy, Maddux, Robert B. , Sanders, Marian. (1989). Ethics in Business: A Guide for Managers. Boston:Course Technology Crisp. Pace, J. (2006). The Workplace: Interpersonal Strengths and Leadership. Boston:McGraw Hill. Values, Motivation, and Priorities. (2007). Setting Priorities: Personal Values, Organizational Results, 8-11 . Trade-offs and Consequences. (2007). Setting Priorities: Personal Values, Organizational Results, 16-17.

Legal Advice Essay Example | Topics and Well Written Essays - 1750 words

Legal Advice - Essay Example Apparently, Heather had complied with her duties as a commercial agent. The law mandates these agents to look after the interest of the principle and action in utmost good faith; put efforts in making negotiations and where possible concludes sales; comply with the principles instructions; and communicate with the principle on necessary information. On the other hand, the principle has the duties of informing the agents within an appropriate period on the refusal or acceptance of the procured transactions of their agents. The remunerations regulations of commercial agents stipulate that an agent is entitled to commissions accrued on transactions concluded within the confines of the period of the contract. Moreover, the agent is also entitled to transactional commissions within the period of contract of the agency especially where the agent has exclusive right to a geographical setting or particular specific clients. This above entitlement is only viable if the transaction entered int o is within the geographical area in question or the group highlighted above . The regulations on commercial agency also stipulate that the agents to commercial firms are entitled to commissions on concluded transactions even after the contract has been terminated. This regulation is conscious to the agent’s effort during the contract period and the transaction ought to have been entered into within a period that is reasonable by incorporating the terminated contract . What complicates Heather’s case is that their agreement with the company.

Comprehension Critique Essay Example | Topics and Well Written Essays - 750 words

Comprehension Critique - Essay Example In their findings, they noted that all students in the first two cohorts who had graduated were absorbed in the teaching jobs. Furthermore, since the deployments of the two batches, the number of nurses had increased, owing to the fact that now the faculty could afford to enroll more students as a result of availability of teachers. Thus, they concluded that the shortage in the number of nurse could be addressed by increasing the number of faculties since there was going to be a steady supply of lecturers. A lesson to the authorities in charge was to ensure there was to be an increase in the faculties of nursing if the shortage of nurses was to be solved. Their research was reasonably reliable but is not the lasting solution. This is because the funded students in the accelerated doctorate program may decide to down their tools after three years of service. If this will be so, then what will be the fate of the students already admitted into the nursing faculties? I bet they will lack tutors to foresee their academic needs. Furthermore, what will happen if the fund were pulled out? I guess that the doctorate students will pull out. Thus, this solution only applies if the said factors will not happen. Gerolamo, Angela, Roemer & Grace (2011), decided to establish if the key issues behind the shortages of nurse was connected to work load within the faculty. Using qualitative secondary literature review, they worked out on three main objectives namely: to establish the meaning of shortage in the faculty, evidence that shortage is affecting the work process, and analyze policies affecting the process of nurse activities. In their study, they compared the literature concerning work load and nursing and other faculties. In their findings, they noted that all literature concerning nursing shortages pointed to work load as the main cause. Furthermore, they established that

The Value of Work Essay Example | Topics and Well Written Essays - 1000 words

The Value of Work - Essay Example I view hard work as a means to an end and it could be the only means available to everybody, rich or poor, young or old, educated or not. Coming from a Chinese descent, I had my own share of the difficulties in life. I have seen how my parents worked hard only to make sure that I will be able to go to college and finish my studies. They dreamed of keeping us out from poverty so that they did not just share their beliefs about working hard but they also worked hard to show the meaning of their words. China is known to be a country that has survived many difficulties through hard work and this somehow molded the perspective of the Chinese people regarding work and wealth. Wealth and success is always directly proportionate to hard work, that is, if we are speaking of honest gain alone. The Chinese are well-known for their thriftiness, that most are able to succeed financially, slowly but surely. Therefore, although it has not always been directly taught to us the value of money, it see med to have always been in our blood, our culture. The thriftiness of the Chinese is not a picture of stinginess rather of value, and the appreciation of its value and source. Money is not supposed to be wasted easily because it is not earned easily. It takes a lot of hard work to gain money so every drop of sweat is to be remembered when spending time comes. I may not understand fully well the reaction of the man being shocked by his stepson handing him some coins simply â€Å"because he did not like them jangling in his pocket† (Updike) but I guess I have a glimpse of the difficulties he has been through that he valued every cent as we, Chinese do. Cultural background largely affects my beliefs about work and is compounded by my observations, religion and educational background, both formal and informal. In our country, a lot of people work in the fields and farming is indeed difficult according to my observance because farmers usually work under the sun and even under the rain. Their jobs are not like those of low-paid employees like janitors, waiters, plumbers or carpenters who also have difficult jobs but are always under the protection of a roof when the sun is up or the rain is pouring hard. I can just imagine the sacrifice farmers spend in doing their responsibilities in order to live a decent life even if the financial value of their hard work is not much. Still, I respect them. I do not just equate work with financial success but I also look at its qualitative value. Some people may look down on people who earn low salaries but for me, I look up to them because they earn their bread decently. It is said that learning starts at home and family members are the first teachers. This is very true. I had my first education on work when my parents taught me to save in a piggy bank. Since both my parents are working, they did not have much time to spend with me. Therefore, in their little time that they are able to talk with me, they always tell me to save money because it is difficult to earn it. They also encouraged me to always behave and obey their instructions and as long as I do so, they give me extra coins to put in my bank. This developed me to discipline myself to obey and behave. I believe this has a very strong effect on my perspectives now about work. Although I did not earn money by sweeping the floor, wiping the table or washing the dishes, I was able to earn because of discipline. I consider it a

Football League alls for Safe-Standing Areas in Championship Research Paper

Football League alls for Safe-Standing Areas in Championship - Research Paper Example Considering the intrinsic factors associated with the game, the government has also approved standing in the stadium by introducing new legislation on safe standing. Today, British football is on the verge of reintroducing the standing facilities because of the desire of the fan groups to stand and watch football once again. The completion of this project would not have been possible without the cooperation of the sporting industry and its fans who kindly responded to my survey requests. A special thanks to you to the Newcastle United Football Club Fan forum that completed and promoted my survey Furthermore my family and friends, who have supported me during this project. Overcrowding in football stadiums has always been a common phenomenon in England and the long history of the game shows that the event has faced deadly accidents many a time. The safe game is always a prime matter of concern in the English Premier League (Slater, 2013). Earlier, standing facilities were allowed in the stadiums which results in serious overcrowding, especially during big matches. Although a large number of spectators can give significant profit figure to the stadium authority, and often can act as a catalyst to the home team, it is generally considered unsafe. English football is an event of collective hooliganism and indiscipline and it often results in serious fatalities (Finnegan and Rookwood, 2008). To combat this problem, all- seating facility was introduced and it was a mandatory legislation to be followed by all the stadium authorities. It is generally assumed that all seating provides better safety and better comfort compared to standing facilities.

Sex Crime Essay Example | Topics and Well Written Essays - 1500 words

Sex Crime - Essay Example "After a three-year period of consultation with those dealing with crimes and sexual offences, the Sexual Offences Act 2003 came into force on 1 May 2004" (The Office for Criminal Justice Reform, 2006, p.12). The sexual offences act, 2003 has revealed a detailed discussion as regards consent in regard to rape. The Law Lords overturned this common law idea that marriage means a man has a 'continual' consent from his wife for sexual activity at any time (R v. R [1992]). Thomas (2005) describes as "[t]his was later brought into statute in 1994, now in Sexual offences Act 2003" (p.11). The present paper is intended to justify whether the guidance of consent as provided in the said enactment is proper or warrants further explanation and amendment. The Sexual Offences Act, 2003 has been designed to make the process easier and convenient for prosecuting people who use physical force to others for having sex despite the unwillingness of the other party. The legislation provides that a person would not be charged with the offence if he or she intends to protect a child from sexually transmitted infection, from physical safety of the child or from becoming pregnant. The Sexual Offences Act 2003 has made a greater legal protection for victims by clarifying the law on consent. Section 1 of the Act states, a person commits an offence of rape if he intentionally penetrates to the vagina, anus or mouth of another person despite her reluctance. The phraseology "reasonable belief" as enunciated in section 1 is determined in regard to the particular context of a given circumstance. Section 74 of the Act defines consent as stating that a person is presumed to give consent if he agrees by choice, and has the freedom and capacity to make tha t choice. Section 75 provides a list of circumstances where it may be considered that the victim or complainant did not consent to the said sexual interaction. From a perusal of section 76, it is clear that if (a) the defendant intentionally deceive the complainant as to the nature or purpose of the relevant act; or (b) the defendant intentionally induce the complainant to consent to the relevant act, it is presumed that the victim did not give his or her consent. As per the provisions of section 79(2) penetration is a continuing act from entry to withdrawal and if the victim consents to penetration but withdraws consent after penetration, the accused must withdraw his penis immediately.Consent in the sexual offences ActConsent must be obtained peacefully and without the use of force or violence. If it is obtained by force, threat or inducement or any other unlawful means, said consent would be declared as void and illegal. The meaning of the term "consent" as given in the Sexual offence act, 2003 is an aiding tool for the juries in deciding whether the victim was able to give or did actually give his or her consent to the said sexual transaction. In this connection, the defendant must show that his belief in consent was reasonable and obtained in due manner and a jury must consider all the circumstances including any step which he has taken to ascertain in determining whether the vi

The New Synagogue, Berlin, Germany Essay Example | Topics and Well Written Essays - 3000 words

The New Synagogue, Berlin, Germany - Essay Example The building has defied time, having been constructed in early 20th century, following its demolition in the Second World War. Otto Von Bismark, the Prime Minister of Prussia by then, opened the building in 1866. It is one of the few synagogues that survived Kristallnatch-a revenge attack that involved the Nazi youths. The current building is a reconstruction of the former building. Its street frontage was ruined and the current building is a renovated version of the older building. The entrance has a new outlook; the domes and the towers have been repainted and redesigned, perhaps using the newest architectural designs, this time round blending modern designs and architecture with the mediaeval Roman architecture used before the demolition (Simms 43). Only some few rooms were left behind. The synagogue was meant to serve the growing Jewish population in Germany, especially the immigrants who came from the East. The building had a capacity to house 3000 worshipers in one sitting. The building was also used for public concerts; the most notable being the violin concert featuring Albert Eistein in 1930. The religious services included organ and choir, reflecting liberal developments among the Jewish community then. The building was set ablaze in the infamous Kristallnatch on November, 1938, in the e vent that saw the Torah scrolls debased, furniture destroyed, and combustible property within the building set ablaze (Simms 98). A brave police officer, Lieutenant Otto Bellgardt, arrived on 10th Nov, the following day and ordered the Nazi mob to disperse, arguing that the building was a historical landmark that was protected. He upheld the law to protect the synagogue from further damage by the Nazi youths. Therefore, the fire was distinguished before it could spread to other parts of the buildings. The New Synagogue remained intact and was rebuilt by the congregation who used the building up until 1940. Apart from prayers, the

The Man in the Iron Mask Movie Review Example | Topics and Well Written Essays - 750 words

The Man in the Iron Mask - Movie Review Example Both the book and the film have many points of similarity but there are also various scenes in the movie which are completely in contrast to how they are presented in the book. One of the differences between the book and the film is the heavy fictionalization of the characters in the film as compared to the book. However, in the book, the characters are presented as real people, not fictional characters. Even if they are fictional, their lives are based on real life therefore the reader feels like he is experiencing something that might actually have happened. In the film however, one cannot really feel what the characters are supposed to be feeling because they are all over-fictionalized. Another inconsistent with Duma’s books pertains to the death of d’Artagnan. In the Book Vicomte de Bragelonne, d’Artagnan dies some ten years later after the events presented in The Man in the Iron Mask. His death was actually caused by wounds he suffered while at battle in Maa stricht. In the movie however, d’Artagnan dies as he tries to stop King Louis from Killing Philippe. The film also implies that d’Artagnan had been the father of King Louis and Philippe through his association with Anne of Austria. Duma’s work does not indicate anywhere that D’Artagnan and Anne had any relations whatsoever. ... es made in the movie are also necessary as they help the viewer to understand more of King Louis’ character and his role in the conspiracy against his own twin brother. The changes have therefore enabled the audience to relate to the chatcater sand story line much easier. Leonardo DiCaprio plays as The Man in the iron Mask, Philippe and King Louis, the man’s twin bother. The role of the Captain of the Musketeers, d’Artagnan is played by Ganriel Byrne. John Malkovich, Gerard Depardieu and Jeremy irons star as the three Musketeers: Athos, Porthos and Aramis respectively. When Dumas was writing the story, he wanted to reflect a situation that was real then. That is, he wanted to present a situation that was relevant during his own time. The historical aspect of the book is therefore critical to the understanding of the events that occur in the story. The movie does not really dwell much into the historical aspect of its story line. It seems that the main aim of the producers is to use the characters to stir up emotions that the audience can identify with. For the sake of the audience, the producer does well in changing some aspects of the film. At this point in time, most people already know the history if 17th century France during which time the book was written. Therefore the changes did nothing to change how people perceive that history, however, the changes did have an impact in the way people related to the film. A new ending gave a new meaning to the whole story. D’Artagnan comes out as the tragic hero at the end of the movie, while in the book, it is not so clear what his role was. It is thorugh the changes made by the producers that the audience gets to know who really is behind the iron mask and his relation to the King and d’Artagnan. The various

Financial Statements Essay Example | Topics and Well Written Essays - 2000 words

Financial Statements - Essay Example d of the companies are for the year 2008.The areas covered are profitability, liquidity, financial risks, investments attractions and overall growth of the companies. The ratios employed to assess the profitability of two competitive airlines are Operating profit margin, Net Profit Margin, ROCE, and earnings per share. Gross profit margin cannot be employed as the airline business is not a goods trading business. Operating Profit Margin â€Å"measures the percentage of each sales dollar remaining after all costs and expenses other than interest and taxes are deducted. It represents the pure profits earned on each sales dollar.†(Lawrence J. Gitman, page 144)i Easyjet operating profit margins are mere 3.85% as compared to massive 19.78% of Ryanair. The reason for such difference is the efficiency employed by Ryanair in operating expenses to reach a turnover of $27138222000. On the other hand the turnover of $2362.8m has been achieved by Easyjet at huge operating cost of $2271.8m. Net profit margins take into consideration all expenses including depreciation and finance expenses before taxes. It will be noted that Easyjet has shown improvement in net profits margin of 4.66% when compared to its own operating profit margins of 3.85. The reason is that Easyjet has net finance income and not the expenditure. It is because of this reason Ryanair/s net profit margin of 16.17% is lower than its operating profit margin of 19.79 as it has finance expenses are higher than finance income. But Ryanair’s net profit margin is certainly higher than Easyjet because of its efficiency shown in controlling the expenses. Return on capital employed (ROCE) is more realistic ratio of profitability â€Å"if the assets are stated at current value rather than at historical cost; that is, there is a revaluation reserve included in the capital employed.† (Philip Ramsden, page 42)ii Taking this limitation into account, Easyjet has a very poor ROCE of 3.81% as compared to 8.19% of Ryanair.

Peter Singer’s Solution to World Poverty Essay Example for Free

Peter Singer’s Solution to World Poverty Essay How can we help people in need, and become better human beings? How can it be that we have money for new cars, houses and vacations, but when UNICEF or some other kind of healthcare organization ask us for just 2 dollars, we turn them down right away? In the article â€Å"Solution to world poverty† Peter Singer gives some of his suggestions on how to help others, and become better persons. Singer tells a story about a man named Bob. Bob just bought himself a new car. The car he bought is one of the most expensive cars you can get. A classic Volkswagen Bugatti. He then has to make a choice. He either has to let his car get destroyed and save the life of a child or save the car and let the child get killed. He chose to save the car. The other story comes from a Brazilian film, a woman called Dora, all she has to leave a homeless nine years old boy to a family that will adopt him in order to make a thousand dollars. Dora delivers the boy into his new family, but she is told that the boy was too old for adoption and he would be killed for organs used in transplantation. To save the boy, Dora decides to take the boy back. In fact Dora would like to save the boy because she has the direct contact with him, but for Bob, he never ever see this kid before, they have no relationship or any contact at all. But what is luxury? Money can be divided into two categories. â€Å"Need to have† and â€Å"Nice to have†. Food is something you need to have, clothes is something you need to have, but a vacation is just nice to have. â€Å"Nice to have â€Å" is just a luxury. I have just used 300 dollars on a new Xbox, but instead of using 300 dollars on this machine, I could have donated the money to the research of cancer. I would not mind giving the 300 dollars to some kind of healthcare organization, but now when I have the Xbox at my home, I say to myself that â€Å"it’s too late†, but in reality it’s not. All I have to do is return the Xbox, and give the money to the organization, but I know I won’t. Singer uses the stories to let himself into the conscience of his readers. Singer says: â€Å"If you think that is was very wrong of Bob not to throw the switch that would have diverted the train and saved the child’s life, then it is hard to see how you could deny that it is also very wrong not to send money to one of the organizations listed above.† Singer â€Å"blames me† for delaying the cure of cancer, when I bought that Xbox, instead of donating the money. I’m sure that the most of people, who have read this article, would think about the subject â€Å"donating† without doing anything more than think about it. Singers article is provoking, and you feel bad after you have read it, and maybe that’s the thing we need. What about people, how would it affect them? Most people might become more humane. The concept of donating would be difficult for the first couple of years, but slowly the public would start to get use to donating. After a few generations, it would be a part of the everyday life, around the world. Singer writes: â€Å"But he was not unlucky at all. We are all in that situation.† Singer is referring to the choice Bob had to make. Singer means that we all have to choose between life or death. Luxury or healthcare. If Peter Singers plan were to actually work, the amount of lives saved would be enormous. By donating the money that would otherwise would go to luxuries, organizations such as UNICEF would send the money overseas to the people who need it. With that money, they could buy food, water, and get roofs above their heads and many other products that are considered to be necessary . There is one problem, however: how much of the money donated would actually reach the people it was intended for? Some organizations take a percentage of the donated money to cover administrative costs. I have talked to a member of Green Peace, and he could not tell me how much of the money that was donated, actually goes to the area that needs it. If only one third of the donated money goes to the troubled area, it’s no wonder why the results is in so slow progress.

Defining Reflective Practice And Identifying Advantages And Implications Nursing Essay

Defining Reflective Practice And Identifying Advantages And Implications Nursing Essay The ability to become reflective in practice has become a necessary skill for health professionals. The implementation of reflective practice is now found in many of the other allied health care disciplines including the Radiography profession. UK health practitioners are expected to meet a continuing professional development standard (CPD), and reflection is a strategy that facilitates meeting this standard for registration (Driscoll and Teh, 2001). This is to ensure that health professionals are continuing with their daily learning and improving their practice. Reflective practice plays a big part in healthcare today and is becoming increasingly noticed. This assignment aims to address the definition of reflective practice, advantages and disadvantages associated, implications of reflective practice and how to improve reflection within healthcare. What is reflective practice? Reflective practice is advocated in healthcare as a learning process that encourages self evaluation with subsequent professional development planning (Zuzelo, 2009). Reflective practice has been identified as one of the key ways in which we can learn from our experiences. Reflective practice can mean taking our experiences as an initial point for our learning and developing practice (Jasper, 2003). Jasper (2003) summarises reflective practice as having the following three components: à ¢Ã¢â€š ¬Ã‚ ¢ Things (experiences) that happened to the person. à ¢Ã¢â€š ¬Ã‚ ¢ The reflective processes that enable to person to learn to learn from those experiences. à ¢Ã¢â€š ¬Ã‚ ¢ The actions that result from the new perspectives that are taken. Reflection is part of reflective practice and is a skill that is developed. It can be seen as a way of adjusting to life as a qualified healthcare professional and enhancing the development of a professional identity (Atwal Jones, 2009). Reflection re-examines the individual experiences or feelings, and the outcome of this is allowing the practitioner to develop a new perception and an appreciation of how the experiences encountered in practice can add to professional knowledge (Boud et al, 1985). Reflective practice permits the review of everyday practice to develop the additional knowledge, skills and competencies required to enhance care delivery. Reflection can be described as a process of reasoned thinking. It helps the practitioner to critically assess self, and their approach to practice (Fleming, 2006). There are different interpretations of reflection and reflective practice documented. However, there are two well known basic forms of reflection. Schà ¶n (1987) identifies two types of reflection that can be applied in healthcare, Reflection-in-action and Reflection-on-action. Reflection-in-action means examining your own behaviour and that of others while in a situation (Schon, 1995; Schon, 1987).   It can be termed as coming across situations and problems which may require thought and problem solving in the midst of practice. It can also be described as thinking whilst doing (Millinkovic and Field, 2005). Reflection-on-action is possibly the most common form of reflection. It involves revisiting experiences and critically analysing them to help improve skills and to improve future practice. The aim of reflection is to value strengths and to develop diverse, more effective ways of acting in the future (Somerville and Keeling, 2004). Reflective practice is seen as more than just a thoughtful process. It has the potential to be turned into a learning situation where future practices can be changed as a result of the process (Jarvis, 1992). Advantages of reflection Reflective practice is an essential component of continuing professional development (CPD) and is required by all regulatory bodies of healthcare professionals in order to maintain registration (Atwal Jones, 2009). However, Driscoll (2006) notes that reflective practice is regularly represented as a choice for health professionals, whether to be reflective or not to be reflective, about their clinical practice. Driscoll (2006) also notes that if there is such a commitment to reflection, it can help improve practice and transform healthcare. It has been argued that reflection on clinical work may be essential to the development of our clinical knowledge (Benner, 2001). Atwal and Jones (2009) suggest reflective practice can build up better levels of self-awareness about themselves as practitioners and as individuals, leading to opportunities for professional and personal development. There are benefits and barriers of incorporating reflection into the NHS and imaging professional prac tice. The benefits of reflective practice are: Reflection enables health professionals to share knowledge with others, to help practice and assists practitioners in making sense of challenging and complex situations (Chapman et al, 2008). This helps to optimise work practice and improve interprofessional relationships. Reflection allows an objective to look at our practice in order to improve the quality of our performance at work. It also allows practice to be critiqued, enabling enhancement in the development of areas needed to be improved, identifying learning needs (Stewart et al, 2000) and taking responsibility for continuing professional development (Griffin 2003). Reflection helps practitioners develop a questioning attitude and the skills needed to constantly update knowledge and skills (Westberg and Hilliard, 2001). Reflective practice helps recognise the strengths and weaknesses, enhancing development and helps apply the skill of reflection to CPD cycle. Reflection can assist the practitioner to observe the aspects of their practice, encourage professional development, personal growth and evaluation of skills ( Chapman et al,2008) Reflection helps practitioners make sense of challenging and complicated practice, and acts as a reminder that there is no end to learning (Zuzelo, 2009) Disadvantages of reflection There are known barriers which prevent practitioners being able to reflect effectively. Smythe (2004) questions whether there is any time to think and be reflective because of the busy work environment that practitioners are involved in. Barriers to reflection are: Lack of motivation to partake in reflection or reflective practices from staff or fellow colleagues. The culture of organisation. Some organisations may not promote reflective practice because it may not highly be favoured in the department, or there may not be any interest in reflection (Workforce Support, 2010). Some staff may not know how to undertake reflective practice because they may have not been taught how to undertake it and how to reflect in such a manner, and may be apprehensive about documenting experiences and emotions (Workforce Support, 2010). Some practitioners are rooted in the preconception that reflection is too difficult and that reflection is a taught skill (White, 2003). There is lack of time to undertake reflective practice as imaging departments today have an increase in workload and if the department is relatively busy, there is a lack of time to undertake reflection, as reflection does require some quality time (Johns and Freshwater, 2005). Radiography is largely scientific and technical therefore reflection does not need to play a role in the profession (Hall and Davis, 1999). However Radiography has evolved through the years and the work is becoming increasingly more patient centered. Reflection may be seen as something often used in response to a negative outcome (White, 2003). Implication of reflective practice in regards to service delivery and management. Service delivery is a vital component on improvement of health services. The World Health Organisation (2010) summarises that effective service delivery depends on key resources such as motivated staff, information and equipment, and these have to be well managed. Imaging departments need to make sure that these key components are in place, in order to deliver the best possible care, and making sure they exceed the requirements of the patient. It can be suggested that reflective practice is identified as an important strategy for enhanced care delivery and continuing professional development.The Health Professions Council standards of proficiency for Radiographers (HPC 2007/09) state that CPD contributes to the quality of practice and service delivery and stresses the value of reflection on practice and the need to record the outcome of such reflection. It is suggested that by supporting reflective practice in healthcare departments, issues of the quality of own service delivery can be raised. Reflection will also help develop service delivery and provide a service in the best possible way, and will allow the department to think about actions that are being undertaken that should not be, and actions that are not being taken that should be (E-training resources, 2010). Reflective practice may become an opportunity for innovation and change within the department. If reflective practice is to be supported in departments, the department would need to make sure that all staff are participating in reflective practice and making sure that staff are benefiting from this, and learning from their practice. Some staff members may find it difficult to engage in reflective practices, therefore it is essential that the department help assist with the reflective processes to make sure all staff are actively participating (Workforce Support, 2010).The service head would have to make sure that the staff in the department are undertaking some form of reflection and can build way s to help implement some reflective practice activities within the department for all staff to engage in. Implementing these practices will help shape the management of the department. Examples of reflection documented Many journals have been written that propose the use of reflective assignments and journaling as tools to improve reflection and thinking skills in healthcare (Chapman et al, 2008). Forms of reflection can be very useful in understanding how practitioners can improve both their professional practice and the organisation in which they work in (Workforce Support, 2010). Reflective practice can be made formal through such processes and underpins the process of continuing professional development (CPD) (White, 2003). Pee et al (2003) states that journal writing is a technique for individuals to express their experiences and to use the reflective and analytical, or critical thinking process for learning. Reflective journals are an ideal way to be actively involved in learning (Millinkovic Field, 2005) and can be implemented to allow practitioners to write down events in practice and their thoughts and actions on daily situations, and how this may impinge on their future practice (William s Wessel, 2004). Reflective clinical journals also present a method in which health care professionals may write about clinical learning experiences and reflect on them (Millinkovic and Field, 2005). Practitioners can progress their skills in reflective thinking and writing, which will allow the practitioners to become self- directed in their learning (Chapman et al, 2008). This is also in agreement with Kennison and Misselwitz (2002) as they state that reflective journals can be considered a helpful tool of reflection, as it can help develop the health care professionals writing skills, reflect on their practice, discover reactions and bring new meanings to past experiences. Reflective workplace diaries can also be used to promote reflective practice. Workplace diaries can be used to note down events that occurred within a clinical setting for example a critical incident or a patient interaction (Chapman et al, 2008). It is a daily record of day by day personal experiences and obs ervations and from these thoughts, ideas and feelings can be expressed. From this, questions such as what happened and why? How do I feel about it? What can I learn from it? Can be asked, and this will allow the practitioner to reflect on their topic in a deeper more thought processed structure. Chapman et al (2008) stresses that it is also important that when using the reflective diary, the health practitioner has to be able to reflect, are willing to reflect and to make changes from this reflection. A review of the diary will help practitioners progression of reflective writing, and more levels of critical reflection can be undertaken. Ways to improve reflection Reflection can be improved in a number of ways to help benefit the practitioner. Appraisals can be implemented within the department, for all health practitioners to take part in. The appraisals will encompass the practitioner to talk about their practice and how they are using their skills, and to reflect on the work that they are undertaking, taking note of any improvements that can be made to better the practice. An increase in knowledge can be demonstrated through reflective practice with the focus of reflective reports including involvement in audits and research (Snaith and Hardy, 2007). Snaith and Hardy (2007) also write that reviewing local practice initiatives among many other possible activities may help improve reflection. Continuing professional Development (CPD) essential to the enhancement of clinical skills (Chapman et al, 2008) and is mandatory to the HPC in order to retain registration. Imaging departments can implement ways for practitioners to engage in CPD activit ies that are accessible to all practitioners. CPD will help keep professionals up to date and will also help practitioners engage in ways in which they can reflect in the activity undertaken, which will enhance their reflective and thinking skills. This will benefit to lifelong learning (Chapman et al, 2008). Reflection can be incorporated into a CPD as a means to enhance and maintain reflective practice in a clinical setting. The Society and College of Radiographers CPD tool offers some direction to practitioners that want to present reflective evidence of their increasing knowledge base and a framework of how it may be planned (Kelly, 2005). Tutorials can be implemented in the department for practitioners that want to become involved in reflective practice, the different ways to reflect, and some frame works that are used for reflecting. Not many practitioners are aware of how to reflect on practice (Workforce Support, 2010). There are different ways of reflecting and by making th ese ways become known to practitioners, it can help decide which framework is best suited for their learning, and can undertake better reflection on their work. Conclusion Although experience is at the centre of learning in imaging departments, reflection is fundamental to deeper learning from experience. Reflective practice is becoming an essential skill that is incorporated into clinical practice and continuing professional development (CPD) and it is therefore important that the imaging department understand the role and the potential of reflection. The adoption of a reflective approach to clinical work is important since it is an effective means of highlighting best practice, whilst furthering professional development. Different ways to reflect in practice can be approached and adopted that will benefit future practice of the professional and how it implements their daily work lives; however, there are evident barriers to reflection within an imaging department. This includes time because of the busy environment a hospital encompasses and lack of motivation if the vast majority of health care practitioners are not undertaking it. Imaging department s have to implement ways in which the practitioners can reflect in their practice to enhance patient care and promote effective service delivery. Reflection can be a powerful mover in the process of learning, which can lead to change and the development on a professional and personal level and various measures have to be taken into account to achieve this.

The Electron Transport Chain

The Electron Transport Chain In the electron transport chain, electrons flow downward in energy from coenzyme NADH and flavoprotein FADH2 to the terminal electron acceptor, molecular oxygen, O2. Electrons move spontaneously from carriers of lower reduction potential (Eo) to carriers of higher reduction potential. Molecules involved in the ETC have reduction potentials between the values for NAD+/NADH couples and oxygen/H2O couples. Energy extracted from the transfer of electrons is most efficiently conserved when it is released in a step wise fashion, and is accomplished with four distinct protein complexes in the mitochondrial membrane: Complex I = NADH-coenzyme Q reductase (NADH dedhydrogenase) Complex II = succinate-conenzyme Q reductase (succinate dehydrogenase) Complex III = coenzyme Q-cytochrome c reductase Complex IV = cytochrome c oxidase Complex I oxidizes NADH and reduces coenzyme Q (UQ), transferring a pair of electrons from NADH to UQ. The oxidation of one NADH and reduction of UQ results in a net transport of protons from the matrix side to the intermembrane space. Complex II oxidizes succinate and reduces UQ, yielding a net reduction potential of +0.029 V, which does not contribute to the transport of protons across the inner mitochondrial membrane. Complex III facilitates the transfer of electrons from UQ to cytochrome c (cyto c) via the Q cycle, which oxidizes UQH2 and reduces cyto c, releasing four protons into the intermembrane space for every two electrons that pass through the Q cycle. Complex IV accepts electrons from cyto c and reduces oxygen to form H2O, driving proton transport across the inner mitochondrial membrane into the intermembrance space. For every four electrons used to reduce oxygen, four protons are released into the intermembrance space. Components of the ETC are arranged in line with the flow of electrons from donors with lower affinity for electrons toward acceptors with higher affinity for electrons. Affinity for electrons is measured by the reduction potential. The transfer of electrons does not occur in a simple linear sequence. Electrons can enter the ETC at different entry points, either through Complex I or Complex II, and then the pathways converge at Complex III. As Fig. 1 shows, electrons move from more negative to more positive reduction potentials on the energy scale. Table 13-7 presents the following reduction potentials for reactions that occur in the ETC: NAD+ + 2H+ 2e- Æ’Â   NADH + H+ ΔEo = -0.320 V FAD + 2H+ +2e- Æ’Â   FADH2 ΔEo = -0.219 V Fumarate + 2H+ + 2e- Æ’Â   Succinate ΔEo = +0.031 V Q + 2H+ + 2e- Æ’Â   QH2 ΔEo = +0.045 V cyt c1(Fe3+) + e- Æ’Â   cyt c1(Fe2+) ΔEo = +0.220 V cyt c(Fe3+) + e- Æ’Â   cyt c(Fe2+) ΔEo = +0.254 V Â ½ O2 + 2H+ + 2e- Æ’Â   H2O ΔEo = +0.816 V As mentioned, molecules involved in the ETC have reduction potentials between the values for NAD+/NADH couples and oxygen/H2O couples. Electrons move from more negative to more positive reductions potentials in the following order: NADH Æ’Â   Q Æ’Â   cytochrome c1 Æ’Â   cytochrome c Æ’Â   O2 Reactions that have positive reduction potentials have negative free energy and are energetically favorable. Complex III has a more positive reduction potential than Complex I and II, and Complex IV has a more positive reduction potential than Complex III. The reduction potential for each complex can be estimated with the half reactions and reduction potentials provided in Table 13-7. Below are the net equations for each complex: Complex I NADH + 5H+N + Q ↔ NAD+ + QH2 + 4H+P Complex II Succinate + Q ↔ fumarate + QH2 Complex III QH2 + 2 cyt c1 + 2H+N ↔ Q + 2 cyt c1 + 4 H+P Complex IV 4 cyt c + 8 H+N + O2 ↔ 4 cyt c + 4 H+P + 2 H2O For example: Complex I NADH + 5H+N + Q ↔ NAD+ + QH2 + 4H+P NAD+ + 2H+ 2e- Æ’Â   NADH + H+ ΔEo = -0.320 V Q + 2H+ + 2e- Æ’Â   QH2 ΔEo = +0.045 V ΔEo = Eoacceptor Eodonor ΔEo = 0.045 (-0.320) = +0.365 V Complex III QH2 + 2 cyt c1 + 2H+N ↔ Q + 2 cyt c1 + 4 H+P Q + 2H+ + 2e- Æ’Â   QH2 ΔEo = +0.045 V cyt c1(Fe3+) + e- Æ’Â   cyt c1(Fe2+) ΔEo = +0.220 V ΔEo = [2 x 0.220] 0.045 = +0.395 V The reduction potential for Complex III is greater than that of Complex I, correlating to flow of electrons in the ETC. Electrons move from more negative to more positive reductions potentials. In addition, both overall reactions for NADH/FADH2 to O2 are positive values, another indication that electrons moving from Complex I/II to Complex IV is energetically favorable. The calculations are provided below. This is the overall reaction for electrons that travel from NADH to O2 NADH + H+ + Â ½ O2 Æ’Â   NAD+ + H2O NAD+ + 2H+ 2e- Æ’Â   NADH + H+ ΔEo = -0.320 V Â ½ O2 + 2H+ + 2e- Æ’Â   H2O ΔEo = + 0.816 V ΔEo = 0.816 (-0.320) = +1.136 V This is the overall reaction for electrons that travel from FADH2 to O2 FADH2 + Â ½ O2 Æ’Â   FAD + H2O FAD + 2H+ +2e- Æ’Â   FADH2 ΔEo = 0.219 V Â ½ O2 + 2H+ + 2e- Æ’Â   H2O ΔEo = + 0.816 V ΔEo = 0.816 (-0.219) = +1.035 V As a result of the ETC, the net reaction for the transfer of two electrons from NADH through the respiratory chain to molecular oxygen is highly exergonic (positive reduction potentials and negative free energy). For each pair of electrons transferred to O2, four protons are pumped out of the matrix into the intermembrane space by Complex I, four by Complex III and two by Complex IV, producing a proton gradient that drives ATP synthesis (Fig.2).

volleyball college essay :: essays research papers

Have you ever struggled mightily for something and succeeded? What made you successful?   Ã‚  Ã‚  Ã‚  Ã‚  I looked in their faces and knew mine mirrored theirs. I didn’t want it to, but it did. Just ten minutes ago, we all were so jubilant. We were so sure we were going to win. We had all wanted it for so long, but we finally felt is as our destiny just a few moments ago. But as our opponent threw the ball in the air, I knew she was just about to serve another ace. However, when the ball landed three feet in front of our best passer, something snapped inside of me.   Ã‚  Ã‚  Ã‚  Ã‚  We were going to win the game. That was the end of it. I knew it. We were the winners of that game. I stood up and yelled in a voice that even frightened me. I didn’t scream about moving our feet, or calling the ball, I screamed about how big of winners we were. I was done with moping. For seven minutes of my life, I had forgotten that I could do anything I set my mind to, and I had given up. The worst seven minutes of my volleyball career were those seven minutes in the third game of the final match at Brighton Volleyball Tournament. I had put my determination down to wallow in my disappointment. Disappointment needs to build determination. I had decided a long time ago that there were certain things in life that I could do better than other people. Those were my gifts. I use my gifts to my full potential.   Ã‚  Ã‚  Ã‚  Ã‚  The server on the other team once again threw the ball into the air. This time, my teammate sprawled for the ball, and made a perfect pass to me, allowing me to set the ball and have my co-captain smash it to the ground. I looked once again at the faces of my teammates. Things were different now. I knew at once that they knew what I knew. We were the winners of that game. We remembered that at that point, and were assured of it when the referee blew the final whistle after I served an ace on game point.

Differences and Similarities of Short Stories :: The Withered Arm The Red Room Essays

Differences and Similarities of Short Stories In this essay I will be comparing the differences and similarities of four short stories I have read, , 'The Signalman', The Red Room', 'The Man with the Twisted Lip' and 'The Withered Arm' also I will be looking at how the writers have created an atmosphere. The four stories are all of mystery and try to keep the reader gripped until the end, all have areas in which there is suspense. In 'The Signalman' Charles Dickens keeps the reader in suspense because when the ghost visits the signal man you don't really know who the haunting warning is for. In 'The Red Room' H.G. Wells keeps the reader in suspense because when the ghost is sighted it is never really described. In 'The Man with the Twisted Lip' Arthur Conan Doyle keeps the reader in suspense by not actually telling if it is a murder on just disappearance. Also in 'The Withered Arm' Thomas Hardy keeps the reader in suspense because you find out who Gertrude catches the rash from. Each writer had a setting and different historical background 'The Signal Man' was written in 1866 by Charles Dickens, the surroundings for his story was an old railway station with old steam trains. The Man with the Twisted Lip' written by Sir Arthur Conan Doyle was written in 1860. This story was one of many Sherlock Holmes tales which display aspects of life in the last decade of Victorians reign. 'The Red Room' by H.G Wells was a Gothic horror story, which had traditional scenery at a castle (Loraine castle). 'The Red Room' was written in 1894, H.G Wells makes it obvious how ancient and old fashioned everything in the castle was. 'The Withered Arm' by Thomas Hardy was written in 1865 and located in Wessex, around Dorchester which Thomas Hardy calls Caster bridge the county town of Dorset where most of his stories were set. 'The Signalman' by Charles Dickens was set at an old rail way station, with steam trains. The idea of a signal box in the countryside and being manually operated, gives a sense of historical background for today's readers. 'The Man with the Twisted Lip' by Sir Arthur Conan Doyle was set in the streets of East London. A few years before the story was written a famous sequential killer 'Jack the Ripper' murdered people on the very same streets where the story was based on in the story it said "An endless succession of sombre and deserted streets. This gives the effect that the streets are frightening and vicious. 'The Red Room' by H.G Wells is a Gothic Horror story set in a

Freedom and Determinism

â€Å"Freedom, Determinism, and the Case for Moral Responsibility: A Look Back at the Murder of Jamie Bulger† begins by telling of the heinous crime that is the centerpiece of this paper. On February 12th 1993, British toddler Jamie Bulger abducted at a local shopping mall in Liverpool, England. Evidence that the two year old was beaten, sexually molested, and clubbed to death with bricks and an iron bar before discarding his body on train tracks. The age of his two assailants, Jon Venables and Robert Thompson, ten years old.Then they begin to explain the difference of opinions on the responsibility of the murderers. One side labels the boys as savages and criminals, while the other argues that they are â€Å"victims of broader social, economic, and cultural processes. † Sparking the question, are we truly responsible for how we act in society? The essay then moves on to the defense of determinism and how it relates to this specific event, stating that, â€Å"From a de terminist point of view, Jon Venables’s and Robert Thompson’s fate was set even before their birth.Born to ill-educated, working class parents, the details of the boys’ lives constitute a veritable catalogue of social ills. † The paper enlightens us on the rough and negative environments that both Jon Venables and Robert Thompson were raised in. Jon’s parents were â€Å"unstable and depressed,† and his dad eventually abandoned his abusive mother, himself and his â€Å"developmentally challenged† siblings. Thompson was the second youngest of â€Å"seven violent and aggressive boys†¦ one of whom was an arsonist and another who was a master thief. His parents were drunks and he witnessed his mother being beaten by his father in many alcoholic driven violent outbursts. The question is raised if Venables and Thompson are morally responsible for the actions leading to the murder of little Jamie. Here is where the paper really dives int o the determinist philosphy, stating â€Å"the Determinist argument holds that a person’s heredity and environment fix the choice before it is made. † Using legitimate sources such as â€Å"The Delusion of Free Will† by Robert Blatchford and â€Å"What Means This Freedom† by John Hospers, the essay presents sound reasoning to the determinist view.Taking from Blatchford, the point â€Å"that teaching is part of our environment and that we act as we have been taught that we ought to act. Thus, though we may act as we choose, we will choose as heredity and environment cause us to choose† John Hospers suggests that one holds no responsible for any of ones actions because actions â€Å"grow out of his character, which is shaped and molded and made what it is by influences . . . that were not of his own making or choosing† The paper also presents some arguments against the deterministic view from the free will perspective.Another essay, â€Å"A B rief Defense of Free Will† by Tibor Macha, and his opinion â€Å"the fact that some people with bad childhoods turn out to be crooks while others are decent would seem to indicate that people can cause and are responsible for at least some of what they do,† is examined. In â€Å"The Problem of Free Will,† W. T. Stace states, â€Å"In the case of Jamie Bulger’s murderers, young as they were at the time, the drive to inflict unimaginable pain on the toddler, at the moment they did it, does not seem to have been externally caused. They desired to do it. They were not motivated by any external factor, such as the proverbial gun to the head.They were morally responsible for their action and thus deserved to be punished. † While this paper makes a reasonable and knowledgeable argument for us to try to look at crimes like this from a more deterministic view, I have a hard time converting. Being that I am a criminal justice major, I am aware that there are many different theories on why crimes are committed, and not only what should be done to help prevent them from happening again, but what kind of treatment or punishment the perpetrator(s) should receive to more effectively rehabilitate them.I am one that stands with firm justice on brutal acts like this, regardless of age. Although in a violent and criminalistic environment, the kids were not directly forced to commit such a gruesome act, nor did they ever witness it from their parents. Therefore, in my opinion, the responsibility lies within the kids for their desire to not only torture, but kill.