My Impressions From Death Of A Salesman - Free Essay Example

Sample details Pages: 7 Words: 2107 Downloads: 1 Date added: 2019/06/12 Category Literature Essay Level High school Tags: Death Of A Salesman Essay Did you like this example? Death of a Salesman: Play Report Death of a Salesman is a popular play that grapples with the idea of the American Dream by the famous author, Arthur Miller. The play is about Willy Loman and the events that lead to him killing himself. It has received many awards and is still very popular to this day. Don’t waste time! Our writers will create an original "My Impressions From Death Of A Salesman" essay for you Create order He was born on October 17, 1915 in New York during the Great Depression. The Great Depression was a worldwide economic depression that effected millions of people. His father struggled to earn money during the Great Depression, which he believes shaped him as a person. It showed him the insecurity of modern existence, (The Editors of Encyclopedia Britannica) at a young age which affected his entire life. He was married to the also famous, Marilyn Monroe, for five years and even wrote a play titled, The Misfits, in her name. Death of a Salesman was his second play written, after his Tony Award winning film titled Focus. He had been coming up with ideas for Death of a Salesman since he was a teenager, initially being about a Jewish Salesman. Other popular works of his includes The Crucible, After the Fall, and The Price. He sadly passed away on February 10, 2005, but his legacy lives on as a beloved playwriter. The play takes place in New York in a small home surrounded by apartments in every direction. It takes place in the 1900s, and money is hard to find with the population growing in their town. I believe the overshadowing of their home by the apartments surrounding them symbolized and foreshadowed major facts in the story. Willyrs yearnings to live the American dream overshadowed the importance of his family like apartments overshadowing his home. When Willyrs home slowly breaks from the weight of the apartments, it resembles his slow death leading to his death. The apartments are crowding his home or safe place, like how his dreams consume or crowd his thoughts and prevents him from working to accept things as they are. His home represents many aspects of Death of a Salesman and is great foreshadowing by the author. The set of the play is a small quaint home with a very minimal amount of furniture. On the first floor is the kitchen with the necessities, and behind there is a small liv ing room accompanied with a bedroom to the right. The boyrs bedroom is on the second floor and is not well lit. A portion of the stage represents their backyard next to the home and many scenes take place here. The storyrs setting plays a big role in the development of the story. The plays exposition starts with a traveling salesman named Willy Loman returning home from a business trip to his loving wife, Linda. He comes home to his two sons, Biff and Happy, visiting the family and their arrival becomes the initial incident of the story. The rising action begins when Willy is not happy and frustrated with Biff for not having a job at his age, although Linda tells him not to be too critical. Biff never graduated college which is one of the additional reasons his father is so frustrated. After Willy eats a snack, he starts to hallucinate about past experiences with his two sons. In his daydream, he reminisces about spending time with his sons while they were in high school and chatting with his wife. His daydream ends and soon after Willy is offered a job by his rich brother, Ben. Willy refuses the offer and begins to hallucinate about how his sons stole lumber a while back. His hallucination is over quickly, but his family begins to worry, and they discuss his condition. Willy becomes joyous to hear that his sons wish to go into business together, and Biff decides to go ask Bill Oliver whom is an old employer of Biffs for a loan to achieve their ambitions. Linda tells her sons about how she has found a pipe that showed Willy has tried to commit suicide, so she tells them to be nice to him at dinner. The next day, Willy goes to talk to his employer about staying local for business and no longer travelling, but his wish is declined, and he is fired. Willy has another hallucination, this time about Biffrs football game and he wishes his team to win. As Biff arrives to meet Bill, he realizes the man has no recognition of him, so he steals his fountain pen out of spite. All the boys meet up for dinner that night and ends up in a huge fight which ends up being the climax of the story. Willy reminisces his time with a woman that he was cheating on his wife with, and the stunned expressions on Biffrs face as he walked in on them together. After returning hom e, the boys apologize and Willy becomes once again angry with Biff, which causes him to sob in distress. Once the entire fight is over, everyone goes to bed, but Willy decides to go and commit suicide by driving off a cliff. The resolution of the story includes his funeral in which no one attended, and Linda repeating Were free, to her husbandrs grave. Willy Loman is the husband to Linda Loman and is the main character in this play. He is described to be stubborn, suicidal, short tempered, and in his opinion; well-liked by his peers. His character is completely infatuated with the idea of the American Dream for his family, this idea tends to stand in they way of his true happiness. This standard was a huge obstacle in his life that made it hard for him to accept his family for who they are. Willy tried to be more accepting of his sons, but sadly these tactics did not work. He ended up reverting to his old judgmental ways of life, instead of being accepting. His life ended by committing suicide and left many loose ends in the story. Even until his death, everything he did was for the American Dream in his life. This includes sacrificing himself to pass his inheritance on to his family, so they can be free. Willy was a static character because he cannot let go of the American Dream that his hindered him for so long. He was able to re sist change by sticking to his stubborn ways and not letting go of what he wants. Willy ended up going off the deep end, and it was his anger that led him to suicide. Biff Loman represented so many ideas in Death of a Salesman and stood out from the rest of his family. He is in his mid-thirties and still does not seem to have a stable job. He wanted to find himself and pursue a profession that he loves, unlike Willy and Happy who settled for money. His first job was working on a farm, but he was not content in that job position. Biff is constantly developing in this story because he always wanted to grow as a person and was open to new thoughts and ideas. An example of this, is he has a new goal to go into business with his younger brother. A huge obstacle in his life is his viewing of his fathers failures, specifically Willy cheating on his wife in front of his own eyes. He was the only character to know of his fatherrs cheating, and he disapproved immediately. This causes Biff to seem trapped in a web of lies his father strung; and consequently, leaves him vulnerable in the story. His main tactic to overcome this problem was following his instin cts, which told him to get away from his father and live his own life. Biff was a dynamic character in the story because he changes from an insecure boy living under his fatherrs shadow to a man who realizes the importance of taking care of himself. Happy Loman is also one of the main characters in the story and was important to the plays development. Happy is the youngest son of the Loman family and is in his mid-thirties. He is a successful young man and has many dreams, and who is similar to his father in many ways. His dreams tend to be unrealistic, like his fatherrs unrealistic want to live the American dream. He also is in a career not for enjoyment but for the money itself. Another way he is like his father is because he also is a people pleaser, and this is shown at the restaurant with the female staff. Since he is similar to his father, I think it is very likely he is also lonely inside but has learned to hide it. He is always being looked down on and never praised for being who he is. An obstacle in Happyrs life is like Biffs; trying to live up to his fathers standards. Happy tries to meet this standard by accepting his fathers wants and following them; without seeming to stand up for himself in the story. He does not overcome his obstacle out of fear of rejection from his father. Happy is a static character because he never developed into a new man. He was fixated on being who his family wanted him to be, and not being himself. As discussed, many times in this paper, the American Dream is a major theme in this story. It is shown multiple times in the story in many ways. This is showed when Willy does anything to be liked, even if it means living a lie. Willy always paraded the idea of having so many friends, but no one cared to come to his funeral. Another way he portrayed the want for living the American Dream is how Willy wants an ideal family that is perfect. A quote that supports this is, In the greatest country in the world a young man with such†personal attractiveness, gets lost, (Miller 8) which shows his judgment of his kids based on our countryrs success. Arthur Miller gives the basic question, Is striving for the American Dream worth it when you loose everything? I believe the author believed the author did not think it was worth it, and that is why he killed off the main character to portray his opinion. A very interesting part of the play is that Arthur never told the audience what Willy s old as a travelling salesman. He left this unsaid to leave readers in suspense, and to have us ask ourselves what we believed he sold. Personally, I think Willy sold his personality for popularity because he thought it led to success, when he was broken inside. A quote supporting this is, Hers liked, but hers not well liked, (Miller 21) which refers to Bernard when Willy asked if he was well liked. This basically is saying Bernard is not successful because the family relates popularity with other to success in life. Overall, this was not my favorite play I have read for many reasons. The first reason is I initially found it very confusing and I had to review the story before I was able to write my paper. Another reason is that it is not a happy story, and it does not help when you know someone will die at the end of the story. I also did not like Willy because he could not get over the idea of the American Dream because it seemed to prolong the story without having many happy moments. Although I did not enjoy the story overall, I did enjoy certain parts of it. One part I enjoyed was Biffrs character development even though he has had some troubles in life. My favorite part of the story was the foreshadowing with the setting of the play, including the house and apartments. The way that Arthur was able to foreshadow so many aspects of the play in a subtle way was very clever of him. I also enjoyed seeing Linda being so committed to her and Willyrs relationship, even though he did not deserve it. W illy did everything wrong as a father and husband, and yet his wife stays with him through it all. The play had many interesting scenes and although I did not enjoy all of it, I am glad I got to read it. Words Cited Britannica, The Editors of Encyclopaedia. Arthur Miller. Encyclopedia Britannica, Encyclopedia Britannica, Inc., 13 Oct. 2018, www.britannica.com/biography/Arthur- Miller-American-playwright. Death of a Salesman. SparkNotes, SparkNotes, 2018, www.sparknotes.com/lit/salesman/. Shmoop Editorial Team. Death of a Salesman. Shmoop, Shmoop University, 11 Nov. 2008, www.shmoop.com/death-of-a-salesman/.

Business plan Vapiano Restaurant - 5148 Words

BA (Hons) Hospitality Tourism Management Small Business Development and Entrepreneurship MODULE CODE: 6HO712 CW1 Business plan: Vapiano restaurant Student information: Student name: Oman Anja Student ID: 54151 Class: BA1 Module: Small Business Development and Entrepreneurship e-mail: anja.oman@ihtti-mail.ch Lecturers: Yuriy Barabentsev / Jaco von Wielligh Word count: 3,725 Date of Submission: 20.3.2015 TABLE OF CONTENTS 1 EXECUTIVE SUMMARY 3 1.1 Business Objectives 3 1.2 Mission Statement 4 1.3 Guiding Principles 4 1.4 Keys for success 4 2 INDUSTRY ANALYSIS 6 2.1 Industry rivalry 6 2.2 Threat of substitutes 7 2.3 Bargaining power of buyers 7 2.4 Bargaining power of suppliers 7 2.5 Barriers to entry 8 3†¦show more content†¦Differentiation strategy 4. Already a recognized brand 5. Good communication with Vapiano, which has a successful base model 6. Following the rules of franchiser 7. Excellent customer service 8. Team oriented leadership 9. Strong identification with Vapiano concept 10. Well established network with local suppliers 2 INDUSTRY ANALYSIS We will be using Porters five forces analysis by which we will evaluate what the industry is like based on: Industry rivalry Threat of substitutes Bargaining power of buyers Bargaining power of suppliers Barriers to entry - threat of new entrants Figure 1: Porters Five Forces Analysis adopted by author 2.1 Industry rivalry There are 13 existing businesses within the complex in which we are interested in, that may pose as a threat, since they offer food as well. There is however not a single restaurant in the whole country that offers a unique product like Vapiano, which differentiates itself from others by preparing fresh food as fast as a fast food business. The industry is very big, which enables a business like this to grow without taking market share from other similar businesses. In a longer period of time, that means that the impact of the industry on the firm is very likely to be positive. The industry however is not only big, but it is expanding at a fast pace. Industries that are growing fast in revenue are less likely to compete, making the growth positive for our franchise. The costs of storage

Impairment of Assets Longreach Limited

Question: Discuss about the Impairment of Assets for Longreach Limited. Answer: Impairment of assets is discussed in AASB 136. It states about a condition when an assets value diminishes to an extent that it is lesser than its carrying value. The standard details about the accounting entries when impairment of an asset takes place along with the conditions for impairment to happen. The Australian Accounting Standard on impairment is similar to the International Accounting Standard 36. The economic financial crisis of 2008 has made this standard important in the eyes of all the investors and the shareholders. Therefore Longreach Limited should also ensure to check its assets for impairment and if so do the necessary accounting entries. Indications of impairment is the first thing to check before impairment of an asset is done. But it is very crucial to understand that all the items present in the asset side of the balance sheet does not get impaired. Current assets like inventories, contracts for construction of an asset, deferred tax assets, employee retirement benefits, investments in properties held for sale, agricultural assets disclosed at fair value, contracts for insurance and the other non-current assets held for sale are not subject to impairment as they are dealt in other accounting standards (aasb.gov.au., (2007). The reasons for impairment can be internal as well as external. Assets may become out dated due to technological changes or there may be certain assets which have recently become saleable in nature are internal factors whereas factors such as political and economic instability, increase in the market rate of interest wherein it has a negative implication on the asset or such cash generating unit are considered to be factors external to the company. Once an asset passes the test for impairment then the amount that can be realised and the amount at which the asset is presently being carried is compared and if the recoverable amount is less than the carrying amount then the difference of the two is marked as impairment loss and accounted for in the income statement as an impairment loss in the expense side. The said amount is further deducted from the assets present carrying amount (Dagwell et.al.2012). However it is not necessary that once an asset impaired cannot be reversed. There may be indications wherein the carrying amount of the asset is less than its actual recoverable amount. In such a case, the impairment amount should be reversed. But there is a capping to the reversal. It can be reversed to the extent the carrying amount of the asset would have been had such an impairment not happened. Thus some of the major terms that Longreach Limited should know are as under: Recoverable amount: The fair value less cost of selling of the asset or the value-in-use whichever is greater is termed as the recoverable amount of the asset. Carrying Amount: The amount recorded in the balance sheet before impairment is said to be carrying amount. Cash Generating Unit: A group of assets which have the capacity of generating income for the company independently is construed as a cash generating unit. Value-in-use: The NPV of the cash flows that an asset can produce in future is known as the value-in-use (Albrecht et.al. 2011). But it is very important for the Longreach Limited to understand that impairment of goodwill is not same. Impairment of goodwill happens fully specially when an impairment of a CGU happens then the goodwill is impaired first and then the rest of the assets are impaired proportionately. But once a goodwill has been impaired then it cannot be reversed. Resaon behind the same is that AASB 138 does not realise the goodwill that is generated internal to the organization and hence not accounted for (Bond et.al. 2016). Thus if there is an increase in the goodwill after impairment it is said that the internally generated goodwill has increased hence not is not recorded. AASB 136 states that on impairment of an asset certain disclosures are required. They are as under: For each class of asset impaired, the amount of impairment loss recorded in the profit and loss accounted as well as in the line items of the comprehensive income. The amount of impairment loss reversed if any accounted for in the income statement as well as the line items of the comprehensive income. In case of segmental reporting, the impairment loss that is recorded in the income statement and in the equity. Any reversal of the said impairment accounted in the income statement and the equity. In case impairment of goodwill or a material CGU which has goodwill also impaired then the reason behind such an impairment, amount of impairment , if any reversal has happened then the amount of such reversal and in case the impairment or reversal of a CGU has happened then the amount of the same and how it has been allocate amongst the various assets which are a part of the CGU (Hamilton et.al. 2011). Therefore my recommendation to Longreach Limited would be to immediately apply the said standard in the preparation of the financials so that the balance sheet is not overstated or understated. The Company should ensure to value its goodwill carefully and also to check for the indications of impairment so that the true value of the assets are revealed to the investors of the Company. Disclosure requirements should be adhered to so that it is easy for the investors to interpret the various causes of impairment and the calculations thereof. Thus on a concluding note it is understood that impairment reveals the true realisable value of an asset in case of liquidation and also helps to determine whether all the liabilities can be met with the help of the existing assets successfully and sufficiently. As per AASB 136 on impairment of assets, inventory is not subject to impairment as the same is dealt with in AASB 102. The other assets such as goodwill, land and building, factory and plant and machinery will be impaired. Further the brand Crossbow will not be impaired as the companys brand value has not diminished thus it does not show any indication of impairment of the same. Land will be impaired separately as its realisable value is known separately and the balance amount, the goodwill will be impaired first to its full value and th balance after that will be allocated to the rest assets proportionately. Since the value of land is known separately therefore the same is to be impaired first. The impairment loss for land is $200000- $ 171000= $29000. The journal entry is as under: Profit and Loss Account (loss on impairment) Dr...............$29000 To accumulated impairment loss (Land)...............................................$29000 The total impairment is $1680000- $1420000 = $260000. Out of the same the impairment of land will be deducted i.e. $260000-$29000 =$231000. From the same goodwill will be impaired in totality and the balance of $231000-$40000= $191000 will be allocated to factory and machinery to in the proportion of 7:4. Therefore the impairment allocated to factory will be 7/11*191000= $121545 and that to machinery will be 4/11*191000 =$69455 The journal entry will be as under: Profit and Loss Account (loss on impairment) Dr.................$231000 To goodwill A/c.....................................................................................$40000 To accumulated impairment loss (Shoe Factory)A/c...........................$121545 To accumulated impairment loss (machinery) A/c................................$69455 References: aasb.gov.au., (2007), AASB 136- Impairment of Assets, Available at https://www.aasb.gov.au/admin/file/content105/c9/AASB136_07-04_COMPapr07_07-07.pdf (Accessed 19th January 2017) Albrecht, S., Stice, E., Stice, J., Swain, M. (2011).Accounting: Concepts and applications(11th ed.). Mason: South-Western Bond, D., Govendir, B., Wells, P., (2016), An evaluation of asset impairment by Australian Firms and whether they were impacted by AASB 136, Available at https://onlinelibrary.wiley.com/doi/10.1111/acfi.12194/full (Accessed 19th January 2017) Dagwell, R., Wines, G., Lambert, C., (2012), Corporate Accounting in Australia, Pearson: Australia Hamilton, K., Hyland, B., Dodd, J.L., (2011), Impairment : IASB-FASB Comparison, Drake Management Review, vol.1, no. 1, pp. 55-67

Law and Ethics Essay Example

Law and Ethics Essay Laws are a familiar concept, and provide a basic social framework of right and wrong to which the majority adhere. Ethical theories may also be applied to all issues of uncertainty, including those not covered by laws or professional guidelines. They create a mechanism within which issues of moral uncertainty may be questioned and resolved (Jones 1994). One such area of moral dilemma is that of informed consent. In it’s simplest terms, consent may be defined as giving permission: †¦ in current usage consent is defined as a voluntary compliance, or as a permission. I consent’ means I freely agree to your proposal’, which is an explicit statement that my consent to a certain course of action has been sought and granted without any element of coercion. (Faulder 1985:32) However, in recent years this definition of consent has been deemed inadequate. Consent may be regarded as invalid if the consenting individual does not know what they are consenting to. It is for this reason that the adjective informed’ has been used to clarify it’s meaning (Tschudin 1989).Faulder (1985) states that the medical profession is divided as to the exact meaning and purpose of informed consent. We will write a custom essay sample on Law and Ethics specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Law and Ethics specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Law and Ethics specifically for you FOR ONLY $16.38 $13.9/page Hire Writer This is particularly true in the field of midwifery and obstetrics where this has recently become a key issue, despite the existence of a number of professional guidelines such as the Code of Professional Conduct (United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) 1992). This is in part due to the reluctance of many in the medical profession to adopt this new ideology.The age of informed consent brings with it enormous changes to the previously paternalistic health service. The Changing Childbirth Report (Department of Health 1993) with it’s ethos of woman centred care emphasises the need to empower clients by providing them with adequate information to make their own decisions. It is the right to know, and the right to say no. (Tschudin 1989) Informed consent is about the right to control our own destinies and to determine our own ends as far as humanly possible; it is about the right to ake choices and the right to refuse consent; it is about the right of individuals to preserve their integrity and dignity whatever physical and mental deterioration they may suffer through ill health; it is about our duty always and in all circumstances to respect each other as fellow human beings and as persons. (Faulder 1985:2) This essay will examine the legal, professional and ethical issues that affect, and are affected by informed consent. The writer will explore the subject as it relates to midwifery, using examples from the field and with reference to pertinent laws and professional guidelines.LAW Consent has been an issue in English law since the middle ages, however the first legal action concerning consent was not raised until 1767 when a patient brought an action against his doctors alleging that he had not co nsented to a particular treatment (Faulder 1985). More recently at the beginning of the century, consent forms before surgical procedures became statutory (Faulder 1985). Informed consent however, was not raised as a legal issue until 1957 in the case Bolam v. Friern Hospital Management Committee (cited by Faulder 1985).The case centred round the hospitals alleged failure to disclose risk to the patient who subsequently suffered a fracture. Although the court found in favour of the hospital in this case, the need for more information was highlighted. The court found that the hospital had provided acceptable information based on current standards of practice, however at that time the current standard practice was not to provide fully informed choice, which is now thought to be best practice. From this case, the Bolam test was devised, which examines a consensus of current practice for comparison.As the law currently stands, a healthcare professional †¦ can be sued for battery (u nlawful touching) and for negligence (the failure to meet approved professional standards or care). (Faulder 1985:21-22). Treatment without consent may be regarded as battery, but legally this consent still does not have to be fully informed in the UK. The amount of information provided is at the discretion of the doctor, as demonstrated by the Sidaway v. the Board of Governors of Bethlhem Royal Hospital (1984, cited by Palmer 1993).Consent may be implied, verbal, or written, but accurate records must be kept by the professional as to the information given and the consent granted by the client (UKCC 1996). Rogers states two notable exceptions whereby a patient can be treated without their consent . If a person has a notifiable disease or is capable of causing one, or If a person has been detained under the provisions of the Mental Health Act (1983), the Mental Health Amendment Act (Scotland 1983) or the Mental Health Act (Northern Ireland 1961) (1989:259).The latter exception has b een utilised in a number of recent enforced caesarean section cases whereby the client has been deemed temporarily mentally incompetent due to her refusal to give consent to the operation. The most notable is that of Re MB [1997] CA (cited by Migdal 1999). The judge deemed that although the client was behaving irrationally due to a needle phobia, this did not imply she was not competent to make her own decisions. If she were competent to consent, then her refusal was also a competent one.The rights of the mother to autonomy as a priority even when risking the life of her unborn child have also been clarified by these recent cases. (Caulfield 1999:118) An unborn child does not have a separate legal status from its mother and the court cannot take the status of the unborn child into consideration when determining whether the mother has the legal capacity to consent or refuse treatment (Caulfield 1999:118) The competence of children under the age of 16 to give informed consent has also been examined by the court. The case of Gillick v.West Norfolk Wisbech area health authority in 1987 (cited by Rogers 1989) based on the hypothetical situation of a request for contraceptive pills by a child under 16, established a legal principle whereby a health professional could administer treatment against the wishes of the child’s parent. However, the parents approval must still be gained if the child is not deemed to be mentally competent to make their own decisions. PROFESSIONAL Many professional bodies and codes exist to dictate the behaviour of the medical staff that belong to their respective professions.Although many are not able to be used in a court of law, breaking these rules can lead to being struck off a professional register or any number of other sanctions that may be enforced that may result in legal action. A registered midwife is personally and professionally accountable for their practice. This accountability extends to adhering to the Code of Profes sional Conduct (UKCC 1992), with clauses 5 and 7 being especially pertinent to the topic of informed consent. Clause 5 states that a midwife should : †¦ work in an open and co-operative manner with patients, clients and their families, foster their independence and recognise and respect their involvement in the planning and delivery of care. (UKCC 1992:clause 5) A strong emphasis is placed on honesty, respect and client autonomy. The healthcare professional may be guilty of coercion by deceit if all options are not disclosed to the client. This is discussed further in the Guidelines for professional practice (UKCC 1996) and The Midwife’s Code of Practice (UKCC 1994) where the need for adequate information provision is further stressed.This has been demonstrated in the recent concern regarding vitamin K administration to new-born babies. At East Surrey hospital, written consent is now required, with all options including refusal clearly explained (Surrey and Sussex Healt hcare trust 1999). In the light of this information, very few parents decide to refuse vitamin K, and instead have a clear understanding of why it is offered after birth. Clause 7 in the Code of Professional Conduct also highlights the importance of autonomy, and respect in a medical relationship: [a midwife should] †¦ recognise and respect the uniqueness and dignity of each patient and client †¦(UKCC 1992).This demonstrates that the clients decisions should be respected, whether the outcome is to give or refuse consent. Although this may be ethically uncomfortable at times, it is the client’s ethics and morality that must be upheld rather than the professional’s. The general public has more rights, and is more aware of these rights than ever before. The Patients Charter states You have the right to have any proposed treatment, including any risks involved in that treatment and any alternatives, clearly explained to you before you decide whether to agree to i t (Department of Health 1999:4).The Changing Childbirth report (Department of Health 1993) also examines these rights from a specific pregnancy and childbirth perspective. It states that the client and her partner should be well informed, and involved in the planning of their care, and that their views and wishes should be respected by the professionals providing her care. ETHICS Informed consent was first introduced as an issue in medical ethics with the Nuremberg code (cited by Faulder 1985:131).This highlighted the need for voluntary consent with sufficient knowledge and comprehension to medical experimentation after the atrocities of medical experimentation in World War 2 concentration camps were discovered. Although this code was primarily concerned with the consent given before medical experimentation, the words that lie within it provide a foundation for informed consent in all areas, emphasising the need for freedom of choice based on knowledge sufficient to understand and d ecide.Previous to this, a paternalistic approach to medicine was adopted for those that could afford it, with high regard paid to the doctors opinion which was rarely if ever questioned. Faulder (1985) cites five moral principles or rights upon which much ethical theory is loosely based ; autonomy, veracity, justice, beneficence and nonmaleficence. There is a very strong relationship between the principle of autonomy and consent (Jones 1994). One cannot exist without the other and together they allow self-determination. The body we inhabit is ours and ours alone to decide about, which does not mean that in coming to our decisions we do not consider, and more often than not take, the advice given to us by doctors (Faulder 1985:24) Veracity (truthfulness) holds the key to mutual trust and respect vital within any medical relationship, and justice acknowledges the claim for patient autonomy by enabling it to be exercised (Faulder 1985:26) and is well demonstrated by the legal aspects o f consent. Nonmaleficence (To not do harm) is considered to be the positive opposite to beneficence.Beneficence (the duty to do good) is often cited by doctors as argument against informed consent, and it is often the medical profession who decide what is in the best interests’ for the client. This duty to do good’ explains why in British law, a doctor has the right to choose what information is provided before consent is given, as in the Sidaway case. When the consent of the patient or client is not sought for any treatment or intervention, that person’ life is devalued. A paternalistic stance is taken; truth telling or honesty is compromised; trust is lost, individual freedom cannot be exercised: in other words, harm is done. (Tschudin 1989:339) Two main schools of thought exist within modern medical ethics: Deontology, with an absolute duty to obey moral principles regardless of the consequences, and utilitarianism, which aims to do the greatest good for the greatest number of people (Jones 1994). Although on face value they appear similar, they work in direct opposition to one another. For example, in the instance of a client who refuses consent for antenatal testing, a deontologist will respect the clients autonomy and is be happy to continue with no testing as is becoming the norm in the midwifery profession.A utilitarian feels that the needs of the many outweigh the need of the individual, and as such would consider the possible effect on the fetus, the health service if the baby were to be born unwell, and society as a whole. They work on a balance between beneficence and nonmaleficence. This approach to medical ethics is favoured by many doctors (Faulder 1985). CONCLUSION Informed consent cannot be considered as a purely professional, legal, or ethical issue, and areas of uncertainty cannot be resolved by their independent use.However it is an extremely important issue in all three contexts. The midwifery profession has made advan ces in this field, but must continue to improve and extend this. Informed consent can no longer be selective or at the discretion of the paternalistic medical profession: †¦ informed consent is a matter of ethical principle, not a legal formula or a courtesy which the doctor may or may not extend to his patients as he thinks fit and only to those he deems capable of acting upon it (Faulder 1985:15)Informed consent brings with it enormous responsibility. The general public as well as medical staff must be well educated in order to utilise this right. While this idea of informed choice is being introduced and improved, it may be open to abuse by all involved, it must therefore be open to input from all involved parties. The system that sets the policies up that promote choice should not be left entirely to the medical profession. medicine, and in particular medical ethics, is too important to leave to the doctors (Faulder 1985:19) Word count 2,194 Law and Ethics Essay Example Law and Ethics Essay Laws are a familiar concept, and provide a basic social framework of right and wrong to which the majority adhere. Ethical theories may also be applied to all issues of uncertainty, including those not covered by laws or professional guidelines. They create a mechanism within which issues of moral uncertainty may be questioned and resolved (Jones 1994). One such area of moral dilemma is that of informed consent. In it’s simplest terms, consent may be defined as giving permission: â€Å"†¦ in current usage consent is defined as a voluntary compliance, or as a permission. I consent’ means ‘I freely agree to your proposal’, which is an explicit statement that my consent to a certain course of action has been sought and granted without any element of coercion. † (Faulder 1985:32) However, in recent years this definition of consent has been deemed inadequate. Consent may be regarded as invalid if the consenting individual does not know what they are consenting to. It is for this reason that the adjective ‘informed’ has been used to clarify it’s meaning (Tschudin 1989). Faulder (1985) states that the medical profession is divided as to the exact meaning and purpose of informed consent. This is particularly true in the field of midwifery and obstetrics where this has recently become a key issue, despite the existence of a number of professional guidelines such as the Code of Professional Conduct (United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) 1992). This is in part due to the reluctance of many in the medical profession to adopt this new ideology. The age of informed consent brings with it enormous changes to the previously paternalistic health service. The Changing Childbirth Report (Department of Health 1993) with it’s ethos of woman centred care emphasises the need to empower clients by providing them with adequate information to make their own decisions. It is the right to know, and the right to say no. (Tschudin 1989) â€Å"Informed consent is about the right to control our own destinies and to determine our own ends as far as humanly possible; it is about the right to ake choices and the right to refuse consent; it is about the right of individuals to preserve their integrity and dignity whatever physical and mental deterioration they may suffer through ill health; it is about our duty always and in all circumstances to respect each other as fellow human beings and as persons. † (Faulder 1985:2) This essay will examine the legal, professional and ethical issues that affect, and are affected by informed cons ent. The writer will explore the subject as it relates to midwifery, using examples from the field and with reference to pertinent laws and professional guidelines. We will write a custom essay sample on Law and Ethics specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Law and Ethics specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Law and Ethics specifically for you FOR ONLY $16.38 $13.9/page Hire Writer LAW Consent has been an issue in English law since the middle ages, however the first legal action concerning consent was not raised until 1767 when a patient brought an action against his doctors alleging that he had not consented to a particular treatment (Faulder 1985). More recently at the beginning of the century, consent forms before surgical procedures became statutory (Faulder 1985). Informed consent however, was not raised as a legal issue until 1957 in the case Bolam v. Friern Hospital Management Committee (cited by Faulder 1985). The case centred round the hospitals alleged failure to disclose risk to the patient who subsequently suffered a fracture. Although the court found in favour of the hospital in this case, the need for more information was highlighted. The court found that the hospital had provided acceptable information based on current standards of practice, however at that time the current standard practice was not to provide fully informed choice, which is now thought to be best practice. From this case, the Bolam test was devised, which examines a consensus of current practice for comparison. As the law currently stands, a healthcare professional â€Å"†¦ can be sued for battery (unlawful touching) and for negligence (the failure to meet approved professional standards or care). † (Faulder 1985:21-22). Treatment without consent may be regarded as battery, but legally this consent still does not have to be fully informed in the UK. The amount of information provided is at the discretion of the doctor, as demonstrated by the Sidaway v. the Board of Governors of Bethlhem Royal Hospital (1984, cited by Palmer 1993). Consent may be implied, verbal, or written, but accurate records must be kept by the professional as to the information given and the consent granted by the client (UKCC 1996). Rogers states two notable exceptions whereby a patient can be treated without their consent . â€Å"If a person has a notifiable disease or is capable of causing one, or If a person has been detained under the provisions of the Mental Health Act (1983), the Mental Health Amendment Act (Scotland 1983) or the Mental Health Act (Northern Ireland 1961)† (1989:259). The latter exception has been utilised in a number of recent enforced caesarean section cases whereby the client has been deemed temporarily mentally incompetent due to her refusal to give consent to the operation. The most notable is that of Re MB [1997] CA (cited by Migdal 1999). The judge deemed that although the client was behaving irrationally due to a needle phobia, this did not imply she was not competent to make her own decisions. If she were competent to consent, then her refusal was also a competent one. The rights of the mother to autonomy as a priority even when risking the life of her unborn child have also been clarified by these recent cases. (Caulfield 1999:118) â€Å"An unborn child does not have a separate legal status from its mother and the court cannot take the status of the unborn child into consideration when determining whether the mother has the legal capacity to consent or refuse treatment† (Caulfield 1999:118) The competence of children under the age of 16 to give informed consent has also been examined by the court. The case of Gillick v. West Norfolk Wisbech area health authority in 1987 (cited by Rogers 1989) based on the hypothetical situation of a request for contraceptive pills by a child under 16, established a legal principle whereby a health professional could administer treatment against the wishes of the child’s parent. However, the parents approval must still be gained if the child is not deemed to be mentally competent to make their own decisions. PROFESSIONAL Many professional bodies and codes exist to dictate the behaviour of the medical staff that belong to their respective professions. Although many are not able to be used in a court of law, breaking these rules can lead to being struck off a professional register or any number of other sanctions that may be enforced that may result in legal action. A registered midwife is personally and professionally accountable for their practice. This accountability extends to adhering to the Code of Professional Conduct (UKCC 1992), with clauses 5 and 7 being especially pertinent to the topic of informed consent. Clause 5 states that a midwife should : †¦ work in an open and co-operative manner with patients, clients and their families, foster their independence and recognise and respect their involvement in the planning and delivery of care. † (UKCC 1992:clause 5) A strong emphasis is placed on honesty, respect and client autonomy. The healthcare professional may be guilty of coercion by deceit if all options are not disclosed to the client. This is discussed further in the Guidelines for professional practice (UKC C 1996) and The Midwife’s Code of Practice (UKCC 1994) where the need for adequate information provision is further stressed. This has been demonstrated in the recent concern regarding vitamin K administration to new-born babies. At East Surrey hospital, written consent is now required, with all options including refusal clearly explained (Surrey and Sussex Healthcare trust 1999). In the light of this information, very few parents decide to refuse vitamin K, and instead have a clear understanding of why it is offered after birth. Clause 7 in the Code of Professional Conduct also highlights the importance of autonomy, and respect in a medical relationship: â€Å"[a midwife should] †¦ recognise and respect the uniqueness and dignity of each patient and client †¦Ã¢â‚¬ (UKCC 1992). This demonstrates that the clients decisions should be respected, whether the outcome is to give or refuse consent. Although this may be ethically uncomfortable at times, it is the client’s ethics and morality that must be upheld rather than the professional’s. The general public has more rights, and is more aware of these rights than ever before. The Patients Charter states â€Å"You have the right to have any proposed treatment, including any risks involved in that treatment and any alternatives, clearly explained to you before you decide whether to agree to it† (Department of Health 1999:4). The Changing Childbirth report (Department of Health 1993) also examines these rights from a specific pregnancy and childbirth perspective. It states that the client and her partner should be well informed, and involved in the planning of their care, and that their views and wishes should be respected by the professionals providing her care. ETHICS Informed consent was first introduced as an issue in medical ethics with the Nuremberg code (cited by Faulder 1985:131). This highlighted the need for voluntary consent with sufficient knowledge and comprehension to medical experimentation after the atrocities of medical experimentation in World War 2 concentration camps were discovered. Although this code was primarily concerned with the consent given before medical experimentation, the words that lie within it provide a foundation for informed consent in all areas, emphasising the need for freedom of choice based on knowledge sufficient to understand and decide. Previous to this, a paternalistic approach to medicine was adopted for those that could afford it, with high regard paid to the doctors opinion which was rarely if ever questioned. Faulder (1985) cites five moral principles or rights upon which much ethical theory is loosely based ; autonomy, veracity, justice, beneficence and nonmaleficence. There is a very strong relationship between the principle of autonomy and consent (Jones 1994). One cannot exist without the other and together they allow self-determination. The body we inhabit is ours and ours alone to decide about, which does not mean that in coming to our decisions we do not consider, and more often than not take, the advice given to us by doctors† (Faulder 1985:24) Veracity (truthfulness) holds the key to mutual trust and respect vital within any medical relationship, and justice â€Å"acknowledges the claim for patient autonomy by enabling it to be exercised† (Faulder 1985:26) and is well demonstrated by the l egal aspects of consent. Nonmaleficence (To not do harm) is considered to be the positive opposite to beneficence. Beneficence (the duty to do good) is often cited by doctors as argument against informed consent, and it is often the medical profession who decide what is ‘in the best interests’ for the client. This ‘duty to do good’ explains why in British law, a doctor has the right to choose what information is provided before consent is given, as in the Sidaway case. â€Å"When the consent of the patient or client is not sought for any treatment or intervention, that person’ life is devalued. A paternalistic stance is taken; truth telling or honesty is compromised; trust is lost, individual freedom cannot be exercised: in other words, harm is done. (Tschudin 1989:339) Two main schools of thought exist within modern medical ethics: Deontology, with an absolute duty to obey moral principles regardless of the consequences, and utilitarianism, which aims to do the greatest good for the greatest number of people (Jones 1994). Although on face value they appear simil ar, they work in direct opposition to one another. For example, in the instance of a client who refuses consent for antenatal testing, a deontologist will respect the clients autonomy and is be happy to continue with no testing as is becoming the norm in the midwifery profession. A utilitarian feels that the needs of the many outweigh the need of the individual, and as such would consider the possible effect on the fetus, the health service if the baby were to be born unwell, and society as a whole. They work on a balance between beneficence and nonmaleficence. This approach to medical ethics is favoured by many doctors (Faulder 1985). CONCLUSION Informed consent cannot be considered as a purely professional, legal, or ethical issue, and areas of uncertainty cannot be resolved by their independent use. However it is an extremely important issue in all three contexts. The midwifery profession has made advances in this field, but must continue to improve and extend this. Informed consent can no longer be selective or at the discretion of the paternalistic medical profession: â€Å"†¦ informed consent is a matter of ethical principle, not a legal formula or a courtesy which the doctor may or may not extend to his patients as he thinks fit and only to those he deems capable of acting upon it† (Faulder 1985:15) Informed consent brings with it enormous responsibility. The general public as well as medical staff must be well educated in order to utilise this right. While this idea of informed choice is being introduced and improved, it may be open to abuse by all involved, it must therefore be open to input from all involved parties. The system that sets the policies up that promote choice should not be left entirely to the medical profession. â€Å"medicine, and in particular medical ethics, is too important to leave to the doctors â€Å"(Faulder 1985:19) Word count 2,194