She walks in Beauty Essay Example | Topics and Well Written Essays - 500 words

She walks in Beauty - Essay Example An insatiable urge to know the full details of her beauty grips the reader. However, the comparison of her beauty to the night immediately casts doubts, because the conventional attitude in literature has been to compare beauty to something which is bright. This confusion is immediately lifted with words like â€Å"cloudless† and â€Å"stars†. The third and fourth lines of the poem, â€Å"And all thats best of dark and bright/ Meet in her aspect and her eyes† (Byron), give an excellent description of her superb beauty. Darkness helps the stars to project their glow to their best. Similarly, the dark dress the lady wears promotes the glow of her face. There is a heavenly grace, says the poet, in the glow of her face. The poet now tries to convey the personality of the lady which her external beauty reflects. â€Å"One shade the more, one ray the less† (Byron) would have made her beauty slightly imperfect. The word â€Å"grace† now replaces the word â€Å"beauty†, because the poet moves from describing the outer features to express her inner qualities. The poet says that â€Å"the nameless grace/ Which waves in every raven tress† only shows â€Å"how dear their dwelling-place† is (Byron). Her thoughts are â€Å"pure†, and they are â€Å"serenely and â€Å"sweetly† expressed through her face. Thus, the poet has succeeded in turning the attention of the readers from their initial impression. They now realize that the lady not only walks with her physical beauty, but also carries with her a graceful soul. In the last stanza, the poet devotes three lines to repeat the greatness of her physical beauty by using the word â€Å"glow†, in stead of â€Å"â€Å"beauty†, and then spends the last three lines to explain her moral nature. On â€Å"that cheek, and oer that brow/ So soft, so calm, yet eloquent† (Byron) sit the smiles and glow. They speak about her human nature, of her â€Å"days in goodness spent†. She has â€Å"A mind at peace with all

Music concord Essay Example | Topics and Well Written Essays - 500 words

Music concord - Essay Example The people were in an excited mood as the performance of the first song came to an end (Murph n.pag). The conductor stood still holding the baton, as he beckoned the band to start on the next song. â€Å"Autumn† by John Stevens was an upbeat standard of the original tune. A saxophone and piano alternately played the song’s melody like they were two lovers under the moon light. The melody was overwhelming and everybody in the hall seemed to be nodding to the tunes rhythmically. The second part of the concert featured songs written by Christian Gouinguene. The allegro format of the songs made them sound nothing like the original versions. This made the mood of the concert hall even more jubilant because everybody seemed to be enjoying the vibrant sounding new versions of the songs (Murph n.pag). One can actually say the presto, or fast tempo, was just the correct one for young people to enjoy this composer’s songs to the fullest. The rhythm, of the music was continuously getting steadier and faster like a heartbeat of an exhilarated individual, as the songs reached their climax. The dynamics of the song were increasingly getting louder until all instruments reached peak and then rhythmically changed to a moderate level till the series of songs ended. After the intermission, the people were quiet again ready to be taken for another exhilarating journey of tunes and harmonious melodies. â€Å"Naked as a Jaybird† by J.J. Johnson started the session. The inspiring melodies set an amorous mood at the start of the concert session (Murph n.pag). As the passion of the song got more elaborate and heated up, the feeling changed as the lead violinist and other instruments in the ensemble got into the musical accompaniment. However, there was no big change in the melodic feel of the piece and the 1, 2, 3 pattern was noticeable throughout the entire song. After just a short while, one could also hear

An Inconvenient Turth Essay Example for Free

An Inconvenient Turth Essay My reason for picking this topic is, because I would like to know more about global warming. What are the real danger`s that we are facing due to global warming? What can we do to stop the exceeding rapid rates of global warming? I would like to imform other about the new knowledge that I obtain on the subect of globle warming. Al Gore tell how people use to Think about global warming that the world was big enough and we would never have a problem. He also describes global warming as when the sun`s radiation comes in, in the form of light waves passing through earth atmosphere to heat the earth,and then it is re-radiated back into space in the form of infrared radiation, and some of the out going infrared radiation is trapped by the earth atmosphere and warms it. This thin layer of atmosphere is being thicken by all of the global warming pollution that`s being put up there. He speaks of Mr. Roger Revelle as the first person to propose measuring carbon dioxide in the earth`s atmosphere. After the first years of data he intuited what it meant for what was to come. He and a team of other designed the experiment in 1957 with the help of Mr. Charles David Keeling. they started sending these weather balloons up every day. The results of his measurements after only a few years it was startling. He drew the connections between the larger changes in our civilization, and this pattern that was now visible in the atmosphere of the entire plant, and then he projected into then future where this was headed unless we make some adjustments. Mount Kilimanjaro had icecaps 30 years ago. and now it has all melted. Mr. Lonnie Thompson, studies glaciers, and predicts there will be no more snows of Kilimanjaro within the next decade. Its also is happening in Glacier National Park, and all around the world the ice is now gone. He mentions about CO2 and temperature, when there is more carbon dioxide, the temperature gets warmer. He speak of this not so much as a political issue,but a moral issue. It is deeply unethical. He had a lots of faith in the democratic system that these finding would be compelling enough to cause a real change but they were n`t. He speak about when the oceans get warmer that cause stronger storms leading to a lots of big hurricanes and a all time record in the U.S. of tornado, and in Japan record set for typhoons. He contribute the changing of the season to global warming and changing nature plans. He also says that the burning of forests and brush fires causes more co2 to be pit into the air.what all of this means is our ability to a have a future to live in the earth. I really enjoy the movie The movie was very informing I got a better idea about what is happening around the world. I agree with Al Gore something must be done. It was amazing to me about how everything connect together like a domino effect. I picture in my mind how all these great mountains all around us is melting which is changing the temperature of the sea, which cause many of the world`s disaster by storms. Man is destroying himself. It makes me think can we go back where their was not a lots of invention that polluted our air. Can we truly find a solution to this mas, mass, mass, problem are have we went to far of no return. I think about the air we breathe and the water we drink. I remember only about 40 yrs.ago when I was ten years old, my grandmother showed me where I could drink out a spring it was so clean and beautiful and fresh tasting, I hate to think if I when back there to drink what kind of substance would be in that water now. Everything is being effected our food, the animal niches,and season is changing we can`t tell winter from fall or spring from summer and the insects can`t tell neither. If we have gone to far to stop all the problems, why not do, what we can do, to correct what we can, for the future of our life on the earth.

Fragrance Store Business Plan

Fragrance Store Business Plan Business Name: FRAGRANCES Company Summary Fragrances is a new natural and herbal cosmetics company proposing to set up a signature herbal cosmetics store in Central London. The store will deal in herbal cosmetics including perfumes. The company has been setup by a team of three members who have years of experience in understanding and managing cosmetics business, channel marketing and high-level sales. The promoters will initially fund the business themselves as they believe strongly in their product idea. Market research among over 1000 women in various age groups shows that there is a demand for such products. Sales projections for Fragrances are estimated be over  £1 million for the first year, with a decent net profit. The promoters feel that, by creating awareness of their products, many women will prefer to purchase their products for their own use, as will friends and family members. Objectives Create a niche market in herbal cosmetics industry Generate retail sales of over  £1,000,000 in year one. Maintain a gross margin of over 65%. Mission To give an unlimited opportunity to women of all ages to become beautiful naturally Keys to Success Fragrances will: Offer a unique line of herbal cosmetics that will take into account the differences in requirements of diverse age groups. Herbal cosmetic products are currently in demand today and are also available but there are no differences in cosmetics available for different age groups. Satisfy the demand of women who do not want to use cosmetics containing harmful chemicals Execute a targeted marketing campaign to generate awareness of the their products Fragrances will be a UK-based herbal cosmetics company offering its customers a series of unique herbal cosmetics including skincare products, hair care products and perfumes. There will a wide variety in these cosmetics and will take the differences in requirements of diverse age groups. The store will have two product experts who will help the customers choose the right products according to their ages and requirements. The company will reach out to customers through their own signature store as well as its website. In the future, the company will also explore the possibility of expanding to the entire UK by setting up a chain of such stores. Company Ownership Cosmetics industry in the UK is a growth industry dominated by a few key players. Fragrances needs to pool funding to be able to make its presence felt in the industry. It will be set up as a private limited company as the three promoters will pool in their funds and will form the core management team. As a private company it will be able to achieve its initial standing which would not have been possible as a sole proprietorship or partnership firm. Start-up Summary Start-up costs for Fragrances include legal costs, computer supplies, new product marketing, website design and regulatory costs for cosmetics[1]. Start-up assets are mostly dedicated to start-up stock. Start-up Expenses  £ Legal 1,000 Computer Supplies 1,250 Marketing 15,000 Web design 2,500 Regulatory 4,000 General Administration (including rent and salaries) 137,000 Total Start-up Expenses  £160,750 Start-up Assets Cash  £10,000 Start-up stock  £60,000 Other current assets 0 Fixed assets (Including fixtures)  £20000 Total assets  £90,000 Total Requirements for Expenses and assets 250,750 To start with, Fragrances will introduce its herbal range in skincare products perfumes. Skincare products These will include day creams, night creams, exfoliating creams, anti-wrinkle or anti-ageing creams. Within these there will be creams for specific age-groups and skin types. Perfumes Fragrances will start-off with a limited range of perfumes for the working women. In stage two, more variety will be introduced. Source: National Statistics, accessed from http://www.statistics.gov.uk/cci/nugget.asp?id=6 Market Segmentation The three main segments of the market who would buy herbal cosmetics are working executives, college and university students and ageing women. There will also be those who would shop for women, perhaps a husband, friend or a family member. Though the store will be in Central London it will cater to the needs of entire UK. Women living outside London will buy the cosmetics online through the company website. The absence of a store in small towns will not impact the sale as the product will be extremely effective and safe. The confidence will be based on additional expenditure on creating awareness about the products. As per the mid census estimates, the total women population in all age groups in UK is 30,730,300 (Source: NSO Statistics). In addition, statistics indicate that on an average 93% of total women in all age groups buy cosmetics. The potential market may be set at 28,579,179 (93% of total women). Based on the primary and secondary segments, the projected sales forecast is conservatively set at less then 1% of the total potential market (285,790), as highlighted in the following table and chart. Potential Customers Growth 2008 2009 2010 CAGR Working women 0% 142,895 142,895 142,895 0% Young girls 0% 107,171 107,171 107,171 0% Ageing women 0% 26,793 26,793 26,793 0% Others 0% 8,931 8,931 8,931 0% Total 0% 285,790 285,790 285,790 0% Product Elasticity: The product is a necessity and is not highly price elastic. Consumers are ready to pay a higher product if they become aware of the unique benefits from the product. Industry Analysis The UK cosmetics industry accounts for  £5 billion sales. (Source: Euromonitor – Consumer Europe 2002/3 – 18th Edition Pub. Euromonitor International Plc)) 93% of British women use cosmetics in some shape or form making us one of the highest users in Europe. (Source: Key Note Report – Cosmetics Fragrances A Market Sector Overview 10th Edition, Ed. By Eleanor Hughes) Convenience and benefits continue to be a key trend for British cosmetics consumers. Easy application and usage, as well as effectiveness, are the main requirements. Some of these products have a higher price positioning, but consumers appear willing to pay higher unit prices if products can offer genuine benefits in terms of saving time. Fragrances will be a small segment of the cosmetics industry. The market is dominated by major players. Significant shifts in overall value share in this sector have primarily been achieved through major mergers and acquisitions such as L’Orà ©al’s purchase of The Body Shop. Competition Analysis Natural and herbal cosmetic products is a growing sector with the presence of a few big players such as L’Orà ©al’, Bodyshop, Boots and Johnson and Johnson. It is becoming stronger in the UK and UK is now competing with other European countries for product launches. There has been a 170 per cent increase on launches from the comparable period in 2006. According to a recent Mintel report, the UK has seen the largest increase in herbal beauty products of any European country even in the first quarter of 2007. The country accounted for a mere five per cent of the 1600 organic cosmetics launched worldwide in 2006, which has now risen to 19 per cent of the 1053 products that have already been launched globally in 2007. In recent years there has been an explosion of activity as consumers have become more aware of the health benefits of using natural ingredients. Supermarkets have now begun to pick up on this trend, with leading chains such as Asda, Tesco and Waitrose all developing own brands to capitalise on the growing consumer demand for organic and ethical products. Our marketing strategy is to create product awareness among women using cosmetics by strategically placing Internet ads, using direct mailers and generating PR. Competitive Edge The present herbal cosmetic retailers carry a mainstream line of cosmetics that are appealing to the masses. Due to their mass distribution model, it would not be prudent for them to carry small amounts of specialty items for specific age groups. By positioning in the market as a specialty store, Fragrances is confident that word of mouth will help to create product awareness across UK. Fragrances unique selling proposition is that its products will be exclusive and customised for women in accordance with their age groups, skin types etc. Currently, no major cosmetic retailer and online stores offer such customised herbal cosmetics. The primary weakness of Fragrance will be to generate awareness about the cosmetics and highlight how these are different from the other products available in the market. To generate sales, there is a need to first create awareness about the existence of the product and make it easy for potential customers to locate the speciality store. However, it will not be difficult to establish its presence in the cosmetics industry. Marketing Strategy Fragrances marketing strategy is crucial to its success. The company will need to create awareness of its products through: Strategically-placed ads in women’s magazines and women related websites Direct mail and e-mail advertising to working women New product PR in publications for women Sales Strategy Sales are dependent upon creating awareness and generating excitement about the herbal cosmetics. The company will strategically place pop-up and banner ads on web-sites relevant to both women, use direct mail and e-mail lists and seek public relations coverage in relevant media sources. Fragrances will fulfil orders through its speciality store. It will also offer returning customers an option to place their orders on the company’s official website, or fax in orders to the company. E-orders: Customer can purchase online 24-hours a day, seven days a week. Fax orders: Customers can fax in an order 24-hours a day, seven days a week. Sales Forecast The sales forecast for First Year 2008 takes into account slower sales at the beginning as the company creates awareness of its product and website. Initially the company will be selling limited range of skincare products and perfumes. As the company grows, it will explore the demand for other types of customised products. The following table illustrates unit sales of 109,500 units for the first year. This would require the company to sell to less than 1% of its target market. FY 2008 FY 2009 FY 2010 Unit Sales Units Sold 109,500 115,000 121,000 Average unit price  £ 10  £10  £10 Sales Revenue  £ 1,095,000  £1,150,000  £1,210,000 Direct Unit Costs  £3  £3  £3 Direct Cost of Sales  £ 328500  £345000 363000 Initially the company will be managed by its promoters. They will oversee product development, the online store, speciality store and marketing efforts. Outsourcing will be used on some initial tasks, specifically the website design and maintenance. Personnel Plan As the company’s launch date approaches, two product experts will be hired to help with the speciality store sales. As the company grows, more personnel will be added as needed. Personnel Plan FY 2008 (in  £) FY 2009 (in  £) FY 2010 (in  £) Management team for 3 Members  £45,000  £45,000  £45,000 2 Employees  £20,000  £21,000  £22,050 Total People 5 5 5 Total Payroll  £65,000  £66,000  £67,050 Fragrances project the gross margin to be healthy percent (70%). Sales projections for 2008 are at over  £1 million. Refer appendix for a projected profit loss account, projected cash-flow statement and projected balance sheet for the period 2008-2010. Start-up Funding The promoters of the company will use personal funds to finance the start of this business. The primary start-up costs are as follows: Start-up Expenses  £ Start up Funding Start up Expenses to fund 160,750 Start up Assets to fund 90,000 Total Funding Required 250,750 Assets Non-cash assets from start-up 80,000 Cash 10,000 Additional cash Raised 0 Cash Balance on Starting Date 10,000 Total Assets 90,000 Liabilities and Capital Liabilities Current Borrowing 0 Fixed liabilities 0 Accounts payable 0 Other current liabilities 0 Total Liabilities 0 Capital Planned Investment Shareholders equity 250,750 Investor 0 Additional Investment Requirement 0 Total Planned Investment 250,750 Loss at Start-up (160,750) Total Capital 90,000 Total Liabilities and Capital 90,000 Break-even Analysis The following Break-even Analysis shows what is needed in monthly sales to break even. Break-even Analysis (Year 2008) Monthly units break-even 1,914 Monthly Revenue Break-even  £19,140 Assumptions: Average per-unit revenue  £10 Average per-unit variable cost  £3 Estimated monthly fixed cost  £13396 This Confidentiality Agreement (the â€Å"Agreement†) is by and between (hereinafter â€Å"Disclosing Party†) and the undersigned recipient of information. (hereinafter â€Å"Recipient†) Recipient and its Representatives shall not disclose any of the Confidential information in any manner whatsoever, except as provided under Permitted Disclosures. Recipient hereby agrees to indemnify Disclosing Party against any and all losses, damages, claims, expenses and legal fees incurred or suffered by Disclosing Party as a result of breach of this Agreement by Recipient or its Representatives Appendix A Projected Profit Loss 2008 ( £) 2009 ( £) 2010 ( £) Sales 1,095,000 1,150,000 1,210,000 Direct cost of goods 328,500 345,000 363,000 Other costs Cost of goods sold 328,500 345,000 363,000 Gross Margin 766,500 805,000 847,000 Gross Margin % 70% 70% 70% Total Operating Expenses 396,025 375,667 352,917 Profit Before Interest and Taxes 370,475 429,333 494,083 EBITDA 370,475 429,333 494,083 Interest Expense Taxes 148,190 171,733 197,633 Net Profit 222,285 257,600 296,450 Projected Cash Flow 2008 ( £) 2009 ( £) 2010 ( £) Cash Received Cash from Operations Cash sales 1,095,000 1,150,000 1,210,000 Subtotal cash from operations 1,095,000 1,150,000 1,210,000 Additional cash received VAT received 0 0 0 New current borrowing 0 0 0 New other liabilities 0 0 0 Sale of other current assets 0 0 0 Sale of fixed assets 0 0 0 New Investment received 0 0 0 Subtotal cash received 1,095,000 1,150,000 1,210,000 Expenditure Cash spending 58,000 86,000 95,000 Bills payment 652,232 691,342 727,276 Total spent on operations 710,232 777,342 822,276 VAT paid 0 0 0 Repayment of current borrowing 0 0 0 Purchase of other current assets 0 0 0 Purchase of fixed assets 0 0 0 Dividends 0 0 0 Subtotal Cash Spent 710,232 777,342 822,276 Net Cash Flow 384,768 372,658 387,724 Cash Balance 394,768 767,426 1,155,150 Projected Balance Sheet 2008 2009 2010 Assets Current assets Cash 394,768 767,426 1,155,150 Stock 60,000 60,000 60,000 Other Current Assets 0 0 0 Total Current Assets 454,768 827,426 1,215,150 Fixed Assets Fixed assets Accumulated 20,000 20,000 20,000 Depreciation 0 0 0 Total Assets 474,768 847,426 1,235,150 2008 2009 2010 Liabilities and Capital Current Liabilities Accounts payable 53,900 57,085 60,020 Current borrowing 0 0 0 Other current liabilities 108,583 220,456 308,795 Long term liabilities 0 Total liabilities 162,483 277,541 368,815 Capital including profits 312,285 569,885 866,335 Total liabilities and Capital 474,768 847,426 1,235,150 Bibliography Barrow Colin, Barrow Paul, Brown Robert, The Business Plan Workbook, (2001) Kogan Page Ltd Blackwell Edward, How to Prepare a Business Plan, (2004) Kogan Page Ltd Branson, Richard, The Best-Laid Business Plans: How to Write Them, How to Pitch Them (Virgin Business Guides), (2005) Virgin Books; New Ed edition Covello Joseph, Hazelgren Brian, The Complete Book of Business Plans (Jan 1993), Sourcebooks Eleanor Hughes, Key Note Report – Cosmetics Fragrances A Market Sector Overview 10th Edition Euromonitor – Consumer Europe 2002/3 – 18th Edition Pub. Euromonitor International Plc Finch Brian, How to Write a Business Plan, (2006), Kogan Page Ltd McKeever Mike P., How to Write a Business Plan,(1992) Nolo Press UK Population data accessed from http://www.statistics.gov.uk/glance/#population Footnotes [1] The UK cosmetics industry is regulated under the the Department of Trade and Industrys 1996 Cosmetic Products (Safety) Regulations.

Mark Twain/ Huck Finn Essay -- essays research papers

In Mark Twains’ books he relates himself to a characters by giving them some of his personal life and history. In the book The Adventures of Huck Finn, Mark Twain relates the most to the main character of Huck Finn. Mark Twain and the character Huck Finn have similarities in their lives, such as, Twain placing Huck on the river he grew up on, having Huck not be specific with his religious beliefs, and never staying in the same place for long.   Ã‚  Ã‚  Ã‚  Ã‚  The main thing that stood out in the book was that the story always happened around the river. Huck would go away from the river for a while but would always end up coming back to it a short time later. It was the same way with Mark Twain, whose real name is Samuel Langhorne Clemens. â€Å"Mark Twain† is a river man's term for water that was just barely safe for navigation (Kaplan). He was only four years old when his family moved to Hannibal, a small town in Marion County on the west bank of the Mississippi River. There Clemens spent his boyhood, amazed by the romance and shocked by the violence of the river life, with the steamboats, keelboats, and giant lumber rafts, as well as by the people who washed up by the river, the professional gamblers and confidence men. Near the river, the men were fierce and had little cares. It was no place for a young boy.   Ã‚  Ã‚  Ã‚  Ã‚  Further from the banks of the Mississippi was Hannibal. Hannibal was a fine place to raise children. There were many places to go with fun things for young boys to do. Twain let his imagination go when he went to places like Holliday’s Hill and the caves close to the summit, where he may have played pirates just like Huck. A close friend of Clemens was Tom Blankenship, the son of the village drunkard, who was to be immortalized years later as Huck’s friend Tom Sawyer (The Adventures of Tom Sawyer). Tom Sawyer is Huck Finn’s best friend in the book. Tom freely invents lies and loves adventure, just as Tom Blankenship did.   Ã‚  Ã‚  Ã‚  Ã‚  When Clemens was just a young boy he saw death on the river and in his owns home. One of his sisters died when he was four years old, and his brother died three years later when he was seven years old (Encyclopedia Britannica). After the death of Samuel Clemens’ father, it became necessary for him to contribute to supporting his family. He worked so hard that he bu... ...g. So Clemens rode the Mississippi for almost four years, and he remembered these years as the most carefree of his life.   Ã‚  Ã‚  Ã‚  Ã‚  The river is the main focus of the book. They never seem to stay away from it for very long. Even with all the bad stuff going on at the river, it seems to be the only place that Clemens and Huck can find peace. The river even takes his evil father away from him for good. Through spending so much time with Jim, and all the experiences on the river, Huck reveals a strong sense of humanity (â€Å"Huck Finn Notesâ€Å"). He showed this when he did everything he could to save the two murderers who fell off of the ship. Huck will always do everything that he can to help a person if they need it. Huck is a very clever character who always thinks his plans out, unlike Tom who just acts upon an idea.   Ã‚  Ã‚  Ã‚  Ã‚  Clemens seems to use his childhood experiences to write this book. To represent his self as a child he uses Huck and lets him live out all of his childhood adventures. Twain and Finn are similar because they both grew up on the river, have no specific religious beliefs, and they never stay in one place for a long time.

The Classic Period in Music :: essays research papers

Getting it's name from art history, the classic period in music extends from 1740 to 1810 and includes the music of Haydn, Mozart, the first period of Beethoven, and Bach's sons. The classical period of music coordinated harmony, melody, rhythm, and orchestration more effectively then earlier periods of music. During the classical era the social function of music began to change from earlier aristocratic and religious connections toward more public and secular activities associated with the middle class. The rise of public concerts, the spread of commercial opera houses, the growth of music publishing, the increased number of musical pieces composed and played were all direct effects of the changing musical times. Among the many musical types of the period, the classical period is best known for the symphony, a form of a large orchestral ensemble. The symphonic pieces generally had three movements, the sonata, the minuet, and the finale. Building of the achievements of earlier composers, Haydn, and Mozart brought the symphony to it's peak in the last 20 years of the 18th century. Haydn excelled in rhythmic drive and development of theme-based music. Mozart also added to the symphony by contrasting memorable lyric themes in very full sounding orchestral settings. To satisfy the middle-class amateur, classic composers supplied a ton of new chamber music for all imaginable combinations. The piano sonata became a very important form of chamber music, especially after being refined by Haydn, Mozart, and Beethoven. After 1765, the string quartet began to increasingly dominate the chamber music field. Unlike the concertos of the baroque period, the classic era mainly emphasized the solo concerto. The choice of solo instrument, however, was somewhat broader then in the baroque era. There was more of a trend during the classical period towards keyboard concertos. This style was originated in North Germany, by C.P.E. Bach, and gradually spread to other areas. Mozart took the concerto to its greatest heights. "His incomparable ability to weave the complex strands of the concerto fabric without entangling or obscuring either soloist or orchestra has never been surpassed.

Ethical Healthcare Issues Essay

Ethical dilemmas in health care are often the most difficult to navigate. Quite often the life of a person depends on the decision made when a challenge arises. This is certainly the case regarding patients in a permanent vegetative state. These cases have provoked very strong, opposing opinions throughout the medical community. Generating a definitive answer to how a facility handles these situations is extremely important to ensure appropriate ethical policy is followed throughout the care or termination of medical services for a person in a permanent vegetative state. Four ethical principles assist in guiding the ethical conversation: autonomy, nonmaleficence, beneficence, and justice. Autonomy Preserving a patient’s autonomy is a standard ethical policy for health care providers. Examples of how doctors and facilities protect a patient’s right to independence include Advance Directives, the Patient Self-Determination Act, and HIPAA. â€Å"The problem is that vegetative patients are not competent to refuse continued treatment, and there is concern about how best to protect them from treatment that they would probably refuse if they could† (Jennett, 2002, p. 356). A patient who has the unforeseen misfortune of entering into the permanent vegetative state may not have the chance to express their stance through an Advance Directive on how he or she wish to proceed medically, therefore stripping him or her of the right to autonomy. Some patients may have expressed their wishes informally to their family members and loved ones, such as the desire to donate organs when the time comes. If the decision were made to end medical care in a more direct and rapid way, organs would have a better chance of becoming used to help others, which would restore some of the patient’s autonomy (Wade, 2001). Most people would rather donate their organs for the benefit of others, rather than remain in an unconscious state, when given the choice. Unfortunately, these patients are not given a chance to voice that opinion. Nonmaleficence Nonmeleficence is the ethical principle to do no harm. It could be argued that a person in a permanent vegetative state feels nothing, and that poses the question regarding whether or not one can do harm to someone who does not feel anything emotionally or physically (Wade, 2001). In addition, continued treatment actually may be doing harm to the patient. â€Å"There have been many declarations that survival in a permanent vegetative state is not a benefit to the patient, some regarding it as a fate worse than death† (Jennett, 2002, p. 356). There are opposing viewpoints that believe patients in a vegetative state actually may be aware of their surroundings. According to Hope (2011) a study confirmed, â€Å"patients thought to be in a permanently ‘vegetative’ state may still be able to think and communicate† (para. 1). Although this may sound hopeful for loved ones, for some patients being aware of surroundings but not able to move or communicate is doing more harm to them. Would it be more nonmaleficent to end their suffering if they have poor quality of life? Beneficence The philosophical question beneficence raises is will an unknowing patient benefit from an act of good (Wade, 2001)? The patient is not aware of any kind or unkind act done to him or her in an unconscious state. Ongoing treatment could bring about a recovery, but a patient may not view this as beneficent. The state that their body and mind would be in and the quality of life they would have is questionable for whether or not keeping the patient alive was actually doing him or her any good. Beneficence can also relate to the survivors of the patient. In many cases, it is the willingness of the family to keep the patient alive in the hopes of a miracle even if it is against what the doctor’s recommend (Brody, 1988). Is it beneficent to the patient’s family to remain in a state of ongoing grief when there is no improvement in sight? Justice Justice is the most applied ethical principle for arguing for or against termination of treatment for patients in a permanent vegetative state. One argument that can be raised is whether or not it is fair to continue to allocate resources for a person in this state when it limits the care and resources other patients could be receiving (Wade, 2001). If a person is in a permanent unconscious state and doctors have determined that he or she will not regain consciousness or live a normal life, should the care and services he or she are using be given to a patient who has a greater chance of recovery. In addition, consider the cost to society for paying for the ongoing resources and care these patients will need (Brody, 1988). Is it fair to impose that cost on others? Instead, the funds could be used to save the lives of others. However, if the policy became to end patient’s care once they have reached a permanent vegetative state it could be said that attitudes may change toward other severely disabled people and the ongoing care they receive (Wade, 2001). Provider’s compassion may begin to be diminished over time through seeing the termination of care on these permanent vegetative patients, and it may desensitize them in a way that would make it difficult for them to provide any ongoing care to disabled people. Terminating an individual’s life whether it is physician-assisted or merely stopping food sources will always pose huge ethical concerns, even if the patient is in a permanent vegetative state and cannot express emotion or feel pain. Forming an opinion on the issue is not easy, and there are many parties who have interest in the outcome such as the patient, their family, the staff providing care, the facility providing care, and society. By applying the four ethical principles of autonomy, nonmaleficence, beneficence, and justice healthcare administrators can begin to form an ethical opinion to shape the way their facility approaches the many challenges permanent vegetative patients cause. References Brody, B. A. (1988). Ethical questions raised by the persistent vegitative patient. The Hastings Center Report, 18(1), 33-37. Hope, J. (2001, November 10). Vegitative patients ‘can still think and respond’. Daily Mail, 0(0), 28. Jennett, B. (2002). The vegitative state. Journal of Neurology, Neurosurgery and Psychiatry, 73(4), 355-357. Wade, D. T. (2001). Ethical issue in diagnosis and management of patients in the permanent vegetative state. BMJ: British Medical Journal, 322(7282), 352-354.