Neanderthals and Human Evolution Essay Example for Free

Neanderthals and Human Evolution Essay The Neanderthals are an extinct species in the homo genus. They lived during the Pleistocene age. The Neanderthals are believed to have lived in most of Eurasia from 120,000 years ago to about 30,000 years ago. They were a more advanced pre-modern variation of the homo genus. The reason they are viewed as more advanced than other Pre-modern hominids is because they made tools, buried their dead they also lived to around forty years of age. This is quite long compared to their contemporaries. Their tools and artifacts characterize what is known as the Mousterian. To be precise the Neanderthals created flake tools. Tools made by the breakage of flakes of stone off of a larger rock. One example of these are the hand axes and smaller tools with a sharp cutting edge. They were large game hunters who were specially adapted to thrive in the frigid conditions of the middle Pleistocene in Europe. They seem to have originally evolved in Europe at around 250,000 years ago, but latter expanded into southwest Asia. The Neanderthals appear to have been the first hominids who deliberately buried their dead. The graves sometimes included flowers, tools, and food. This could possibly signify a belief in an afterlife. There is also some evidence that they would as a group care for injured or deficient members of their community showing that they had likely had the capacity for compassion. The first Neanderthal remains were discovered in the Neander valley in Germany. The remains show that the Neanderthals were about five feet tall with a stocky and powerful build. While they did have prominent brow ridges and an occipital bun their brain size is comparable to modern day human size. Their population went in to decline and eventually became extinct when the Homo sapiens began to move in to their territory. There are a couple theories on what occurred at this point. One theory is that Homo sapiens either killed off the Neanderthals or took over so much of the land that the Neanderthals couldn’t survive on what was left to them.

Social Impact of Cybercrime

Social Impact of Cybercrime Cyber criminals take full advantage of the anonymity, secrecy and interconnectedness provided by the Internet, therefore attacking the very foundations of our modern information society. Cyber crime can involve botnets, computer viruses, cyber bullying, cyber stalking, cyber terrorism, cyber pornography, Denial of Service attacks, hacktivism, identity theft, malware and spam. Law enforcement officials have struggled to keep pace with cyber criminals, who cost the global economy billions annually. Police are attempting to use the same tools cyber criminals use to perpetrate crimes in an effort to prevent those crimes and bring the guilty parties to justice. This essay begins by defining cyber crime, and then moves to a discussion of its economic and social impacts. It continues with detailed excursions into cyber bullying and cyber pornography, two especially representative examples of cyber crime today, and concludes with a discussion of ways to curtail the spread of cyber crime. Computer-related misdeed designated days back to the sources of computing itself, though the larger connectivity between computers through the Internet has conveyed the notion of cyber misdeed into the public consciousness of our data humanity, where it continues at the start of the 21st century. In 1995, when the World Wide Web was in its very early phases of development, futurist Gene Stephens composed about the present and future truth of cyber misdeed then made some predictions: Billions of dollars in deficiency have currently been discovered. Billions more have gone undetected. Trillions will be thieved, most without detection, by the appearing expert lawless individual of the twenty-first 100 years the cyberspace offender (Stephens, 1995, p. 24). Reflecting on his propositions in a 2008 item, Stephens documented that he and other ones foresaw much of the cyber misdeed to come: I rightly outlook an blast of mobile telephone time robbery and telephone fraud; expanded cyber attacks and deception contrary to government and business; huge borrowing business card robbery and fraud; interior robbery of clients persona by financially laboring and/or hungry economic service employees; more cyber porn, cyber stalking, cyber harassment, and cyber vengeance; and the use of biometrics and encryption as procedures of defending facts and numbers in cyberspace (Stephens, 2008, p. 33). Media accounts since the 1990s have documented the numerous procedures by which lawless individuals have utilized the Internet to consign crimes. Cyber thieves have become accomplished at utilizing the anonymity and secrecy of the Internet to defraud their victims of their cash, their calm of brain and really even their lives. When victims let their guard down by muting a wholesome skepticism and caution, cyber misdeed takes place. As one FBI representative documented, The scammer endeavors to prey on victims who are kind of in melody with whats going on in the world. The con alterations, but finally theyre preying on the good will of people (quoted in Simmons, 2008). The Extent of Cyber Crime Law enforcement agents have labored to recognize, apprehend, and prosecute these tech-savvy lawbreakers, even as sociologists have searched to get to the origin of cyber crime. The U.S. Federal Bureau of Investigation (FBI) has dedicated cyber squads at each of its 56 area agencies over the US [that] support 70 cyber task forces nationwide, endorsed up by international understanding accumulating by its Internet Crime Complaint Centre (Heath, 2008). The area of cyber misdeed has generated the area of cyber criminology, characterized as the study of causation of misdeeds that happen in the cyberspace and its influence in the personal space (Jaishankar, 2007, p. 1). The scope of cyber misdeed continues really staggering, and it extends to grow. In 2007 solely, the U.S. finances lost $240 million to cyber misdeed (2007 Internet Crime Report, p. 1), up $40 million from 2006, though the genuine dollar allowance might be substantially higher because the report only followed situations described to regulation enforcement. According to one Internet security business, cyber misdeed is $200 billion commerce, rivaling the illegal markets for pharmaceutical trafficking and cash laundering (Swartz, 2008, par. 2). In Europe, almost one quarter of computer users in the European Union described that they had been victims of cyber misdeed (National Economies, 2008). As more and more persons have utilized the Internet to manage their buying, broadcasting, banking and account giving, they have become goals for cyber criminals. There are common-sense steps that can avert or decrease having ones borrowing business card data thieved online, as well as to bypass other scams and risks, but cyber misdeed in these localities perseveres mostly due to a need of buyer education. Some diversity of cyber misdeed, for example hacktivism, is ostensibly inspired by noble aims, for example dispute contrary to seen misuses by authorities and corporations. Often these attacks engage posting remarks on authorized government websites and are not inspired by a yearn for monetary gain. However, other types of cyber misdeed have a much more brutal intent. These encompass cyber stalking, cyber bullying and cyber terrorism. Cyber Crime the Society While the financial influence of cyber misdeed is after argument, rather less vigilance has been granted to the communal significances of cyber crime. Psychologists and psychiatrists can assist victims contend with the fallout from persona robbery, sexy misuse or economic wreck, while sociologists are well-positioned to gaze at the broader communal influences and interpretations of cyber crime. Cyber misdeed attacks the very bases of up to date, technological societies, compelled up as they are with the fast flow of computer facts and numbers helped by the Internet. At the most rudimentary grade, cyber lawless individuals often take benefit of technologically unsophisticated persons who nonetheless find themselves in a world where the Internet performances an progressively centered function in both groups and in personal lives. Cyber misdeed counts, at this grade, on the proficiency of those who are more technologically complicated to use that information to knack other ones into submitting crucial data, for example their bank account data or Social Security number. While it is likely in some positions for the casualty of cyber misdeed to refurbish thieved cash or even their individual online persona, the happening often departs the casualty traumatized and profoundly doubtful of the Internet and other trappings of up to date life. In this way the cyber lawless individual d eprives his or her casualty of numerous of the conveniences of todays data economy. Experts in cyber misdeed have documented that its influence happens on multiple levels. First, on a solely financial grade, cyber misdeed engages the robbery of millions, possibly even billions, of dollars every year. In supplement, cyber misdeed needs persons and organizations to take on the supplemented cost of security programs and other entails by which to block the cyber criminals. Cyber-bullying Cyber-bullying can best be recounted as the elongation of personal bullying in cyberspace. However, the one-by-one often is not bodily assaulted, but rather psychologically harassed. Perhaps not amazingly, cyber bullying most often takes location inside assemblies most probable to be attached to internet, in specific teenagers and other juvenile adults. According to a 2007 review by the Pew Internet American Life Project, 32 per hundred of American teens described being victims of cyber bullying (Lenhart, 2007). Cyber bullying is characterized as the undertaking by which an one-by-one or assembly of persons is aimed at for abusing, attack or intimidating notes dispatched through wireless telephones and other Web-connected devices. According to cyberspace professional Parry Aftab, Cyber-bullying is when one progeny or teen goals another for humiliation, humiliation, worry, blackmail. Something conceived to injure the other utilizing an interactive technology. Thats made a large-scale distinction because children have wise that they can use the internet as a weapon (quoted in Battling the online bullies, 2008). Sometimes cyber bullying extends and expands a battle or contradiction that takes location at school, a party or in some other communal situation. In the attitude of numerous victims and professionals, cyber bullying is poorer than in-person bullying because the perpetrators can conceal behind a cloak of anonymity supplied by the Internet. Two victims of cyber bullying expressed the harshness of the tactic: Its rougher over the internet because they dont have to glimpse your answer when they state those signify phrases to your face. So over the internet youre more probable to state the meanest likely things you can state, and then you dont even lament it, said cyber-bully casualty Abby. I would get notes on IM [Instant Messenger] and they would be youre actually mean or youre ugly, until I just couldnt take it any more, states Ralph who was furthermore a casualty of cyber-bullying (quoted in Battling the online bullies, 2008). A distracting elongation of cyber bullying happens when personal assaults, for example rapes, and are dispatched online. The aim is to display the power and command of the perpetrators over the casualty or victims, as well as to disgrace and humiliate them. A associated perform is announcing photographs, telephone figures and other individual data about the cyber bullying casualty on certain websites. The trauma sensed by victims of cyber bullying is very genuine, and it often exacerbates preexisting insecurities sensed by juvenile persons going through adolescence. There has been not less than one described example of a cyber bullying casualty committing suicide after pain unrelenting attacks (Pokin, 2007). Given the expansion of Web-enabled apparatus, parents, progeny supports, political leaders and regulation enforcement agents are unsure about how to decrease examples of cyber bullying. Some suggested answers encompass more parental engagement in their childs online undertakings, for example texting and instant messaging, while other ones propose that affirmative gaze force is the best long-run procedure for decreasing cyber bullying. Cyber-pornography Cyber-pornography mentions expressly to progeny pornography on the internet, usually engaging those less than 18 years of age. While enclosures in the United States and Europe have discovered mature individual pornography on the internet to drop inside lawful boundaries, there is a effectively agreed lawful, lesson, psychological and communal agreement that young children are not to be engaged in the international sex industry. Just as the increase of the internet helped a new and expansive kind of bullying, so too it has directed to a expansion of progeny pornography. Various websites have become repositories of related to sex explicit images of young children, where the pictures are acquired and traded (simons, 1998). There are clues that the increase of cyber pornography has directed to expanded examples of progeny misuse in the world (internet porn, 2004). Countries like Great Britain have been especially impacted: Childrens benevolent humanity nch previously nationwide childrens dwellings said there was clues that the 1,500% increase in progeny pornography situations since 1988 would be echoed in more young children being misused to make the pictures. the scale of the difficulty has altered after acknowledgement in just over a decade, said nchs internet advisor john Carr. The expanded demand has made progeny pornography into large-scale enterprise and the penalties for young children in all components of the world are horrifying (internet porn, 2004, par. 1-3). A newer pattern of cyber pornography on the internet engages online groups for example second life, where avatars, or three-dimensional representations of computer users, combine with one another in very shrewd online environments. Prosecutors have conveyed allegations contrary to persons in second life who acquired virtual sex with other second life users comprised as children. In some nations, for example Germany, virtual progeny pornography is illicit, while the regulation is much less clear in another location (johnston, 2007). Putting an End to Cyber Crime In his 1995 term paper, Gene Stephens suggested what one might call a conventionally libertarian way to battle cyber misdeed that aligns well with the open ethos of cyberspace: the only genuine assist isà ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ãƒâ€šÃ‚ ¦ conscience and individual standards, the conviction that robbery, fraud, and attack of privacy are easily unacceptable (quoted in Stephens, 2008, p. 2). Given the huge expansion of cyber misdeed even in the years since 1995, Stephens now sees things differently. Today he contends that halting cyber misdeed will count mostly on two factors: a more protected Internet infrastructure, redesigned with security foremost in mind; and coordinated, international policing of cyberspace to back up other security procedures for example biometrics. One proposition Stephens makes is for a more protected, second lifetime Internet: The Defense Advanced Research Projects Agency (DARPA) set up the Internet and fostered its early development, but DARPA will probable overhaul its creation in the 2010s. Not only will the conclusion be much quicker and bigger capability usage, but furthermore, by effectively beginning over with the security facets in brain, the future Internet will be safer and tougher to strike and disable (Stephens, 2008, p. 3). Stephens furthermore contends that battling cyber misdeed engages undertaking a bigger and more basic issue: How can one policeman an locality, for example cyberspace, that very conspicuously no one individual owns and has jurisdiction over? The response, he contends, is voluntary, multinational policing, with the cost of malfunction being too large to ignore: The exponentially advancing capabilities of appearing Web technologies spotlights the long-ignored matters of who owns the World Wide Web, who organizes it, and who has jurisdiction over it. The response now is: Nobody! Can the worlds most mighty socio-politico-economic mesh extend to function nearly at random, open to all, and therefore be excessively susceptible to cyber criminals and terrorists alike? Yet any try to constraint or policeman internet can be anticipated to be contacted by farthest opposition from a plethora of users for a kind of causes, numerous contradictory. à ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ãƒâ€šÃ‚ ¦ Biometrics and more-advanced schemes of ID will require to be finalized to defend users and the network. In supplement, multinational cyber crime flats will be needed to apprehend those preying on users worldwide, as Web board riders in Arlington, Virginia, and Victoria, British Columbia, may be victims of cyber scams perpetrated in Cairo or Budapest. Coordination and collaboration will be keys to producing the Internet a safer location to journey and perform enterprise (Stephens, 2008, p. 3). There still appears to be work left to do. For demonstration, Interpol, which battles misdeed over nationwide boundaries, only has $102 million allowed for each year to battle cyber crime (Swartz, 2008). Can one be hopeful about the containment of cyber crime? If annals are any referee, the identical Internet expertise that empowers lawless individuals to flout the regulation can endow regulation enforcement to fight back the law. In the case of the telegraph, instanced previous, it was utilized to good result shortly after it was invented: After killing his mistress [in 1845] and escaping to London by train, [John] Tawells recount was telegraphed ahead by the policeman and he was apprehended upon his appearance (Standage, 1998: 51) (Wall, 2007, p. 2).

Attitudes Towards Euthanasia | Literature Review

Attitudes Towards Euthanasia | Literature Review Introduction This literature review is based upon peoples attitudes towards Euthanasia, which comes from the Greek meaning good death and in English means the killing of one person by another to relieve the suffering of that person and Physician Assisted Suicide (PAS), which is described as; a medical professional aiding a person who is incapable of the act themselves to commit suicide, (NHS, 2010). For this literature review, a literature search was performed using the Cochrane library, Science Direct, EBSCOhost and Sage using the key words: Assisted suicide Euthanasia Opinions Attitude United Kingdom Public Right to Die Assisted Dying Most of these words (with the exception of Assisted Suicide and Assisted Dying) were used in each of the search engines individually and also used to form sentences, however, the only electronic databases that gave this search the information it required was Sage. This provided a substantial amount of journals, a lot of the others used were subscription based or a fee was required, but from the free to use information two of the most relevant to the subject I wished to perform the review on were chosen. The two papers were chosen from surveys and studies performed in the United Kingdom, because it was decided to research what the thoughts and feelings of medical professionals were in a place where this practice was presently illegal. Use in the literature search, but this was difficult to come by. The titles of the three journals are: Legalisation of Euthanasia or Physician Assisted Suicide: Survey of Doctors Attitudes, and Opinions of the Legalised of Physician Assisted Suicide. Des pite not inputting the word physician into the search engine, a lot of the searches came up with types of journals which mention this anyway. This review will critically evaluate the information in the journals and will be compared with each other, discussing the disadvantages of the surveys and the advantages. The review will also include the various research methods used in the research. The Literature Review The first paper reviewed is in English by Clive Seale, PhD, from the Centre for Health Sciences, Barts and The London School of Medicine and Dentistry, London and is called The legalisation of Euthanasia or Physician-Assisted Suicide: Survey of Doctors Attitudes. The protocol was to determine what doctors opinions about the legalisation of medically assisted dying (which includes the terms, euthanasia and physician-assisted suicide (PAS)) were and this was done in comparison with the opinions of the general public of the UK. The methodology was to send out structured questionnaires with a series of questions using qualitative methods and then analyse the results in a quantitative manner. In 2007, Binleys database (http://www.binleys.com) was used to send questionnaires to 8857 currently working medical practitioners all over the UK, this was broken down into 2829 (7%) GPs, 443 (43%) neurologists, 836 (21% of these were doctors) specialists in the care of the elderly, 462 (54% of thes e were also doctors) specialists in palliative medicine and 4287 workers in other hospital based specialities. This is quite a large sample to use and covers a wide range of specialities. It is not clear in what month in 2007 these questionnaires were sent out but follow-up letters were sent to non-respondents between November 2007 and April 2008 to enquire as to why they did not respond, in which 66 doctors in all responded with the most common reason being lack of time to complete the survey. Overall the response rate was 42.1% with specialists in palliative medicine being the most responsive with 67.3% of people returning their questionnaire, along with specialists in the care of the elderly (48.1%) neurologists (42.9%) other hospital specialties (40.1%) and GPs (39.3%). Despite the large sample of people, 42.1% of replies are quite disappointing, although it is a very emotive subject. The questions consisted of personal questions such as age, gender, grade, ethnic origin, and speciality of the respondent and, on average, the number of deaths attended. They were all asked four questions about their attitude towards euthanasia and assisted suicide, in order to obtain the questionnaire in full the author of the survey invited people to contact him. An email was sent: Appendix (a) and a reply was received the next day: Appendix (b). Previous surveys regarding this subject were performed in the Netherlands, Oregon (USA) and Belgium majority support from the medical profession has been important in passing permissive legislation in these countries. The keywords used in this study were assisted dying; euthanasia; physician-assisted suicide; right to die and terminal care. The distribution of questionnaires meant that the methodology used was right as it was discreet and reached a lot of people in a short amount of time, the only danger with this method was that the medical professionals did not have to respond which was shown in the return response of 42.1% there was no financial or other incentive as this would go against all ethical considerations. Ethical approval for this study was granted by the South East Research Ethics Committee. The results showed that those who were specialists in palliative medicine were more opposed to euthanasia or PAS being legalised than the other specialities, although this could be down to the higher response rate in this area. Those that expressed their religious beliefs were more opposed to the legalisation also. The study showed that the most widely held view was that British doctors do not s upport legalising assisted dying in either euthanasia or PAS; this differs from the British Social Attitudes (BSA) survey which has tracked changes in public opinion since 1984, and is the most consistent source of data (http://www.britsocat.com). The second paper reviewed is Survey of doctors opinions of the legalisation of physician assisted suicide by William Lee, Annabel Price, Lauren Rayner and Matthew Hotopf from the Institute of Psychiatry. Kings College, London. The protocol is similar to the first paper in that they were looking at practitioners opinions on euthanasia and PAS. The article begins by saying that there is wide support among the general public for assisted dying but not so much for those who care for the dying. The methodology was to send out a postal survey of a 1000 senior consultants and medical practitioners were selected randomly from the commercially available Informa Healthcare Medical Directory (2005/2006), retired doctors were excluded from the survey. Questionnaire were sent firstly in February 2007, 12 weeks later, in May, non-respondents were contacted and then six weeks later they were telephoned, it was discovered that that some of the possible contributors had moved, died or retired. This i nformation was adjusted to take this into account. The authors completed separate univariable (a single variable) and multivariable (containing more than one variable) predicting the outcomes using polytomous methods which would allow two outcomes to be predicted together. The response rate to the survey was 50% once the exclusions were accounted for, which is higher than the first paper and still gave a lot of date to work with. Included in the survey the authors included a brief outline of the Assisted Dying for the Terminally Ill Bill (2006) 32% of the doctors who responded had read some of the Bill. Gender, speciality and years in post had no effect on opposition or support for a new law. An interesting point noted is that the views of doctors who do not care for the dying tally with the general publics view, so there is some correlation there with 66% of those who never cared for the dying supporting a change in the law. The outcome of interest for the authors was to what level practitioners agreed with the statement: The law should not be changed to allow assisted suicide. A second outcome of interest was the level of agreement with the statement I would be prepared to prescribe a fatal drug to a terminally ill patient who was suffering unbearably, were that course of action to become legal. (Hotopf, et. al. 2007:3). The findings of this questionnaire can be found in Appendix (c). Both of these questions were determined using five-point Likert-type scales, used commonly in questionnaires, following this were converted into three-point scales comprising of agree, neither agree nor disagree and disagree with a change in law. The survey shows that senior doctors are split abut their views regarding a change in the law; fewer are in favour than the general public in the United Kingdom. These findings have been noted in the US, as well as Canada, Finland and the Netherlands as well as the UK. Ethical permission was gained from the Institute of Psychiatry, Kings College London Research Ethics Committee. Comparisons and Conclusions There are many comparisons between the two papers, for example, both sent out questionnaires to their target group, who were specialists in certain fields. However, the first paper surveyed over double the amount of people the second paper did but got less replies. Both studies were done in the same year but it is difficult to tell who started theirs first as the date for first paper is unknown other than it was performed in 2007. The second survey is far more in depth that the first one, and it suggests that qualitative research is needed to understand doctors views better whereas the first paper did not state which the preferred method was. The second paper suggests that doctors who oppose a change in the law comes from an over-optimistic credence in their ability to relieve the suffering of the dying. (Hotopf, et.al. 2007). It is possible to argue against this though and the knowledge and experience of patients who are dying influences views about PAS. Both compare the attitudes b etween the general public and the specialist doctors and note a big difference between them. On the whole both papers conducted a thorough and precise survey but there is room for further research and investigation. References Hotopf, L, Lee, W, Price, A, and Rayner, L. (2009) Survey of Doctors Opinions of the Legalisation of Physician-Assisted Suicide, Bio-Med Central, [Online], Available from: http://www.biomedcentral.com/content/pdf/1472-6939-10-2.pdf [Accessed: 22nd April 2010]. NHS (2010) Euthanasia and assisted suicide [Online], London. Available from: http://www.nhs.uk/Conditions/Euthanasiaandassistedsuicide/Pages/Definition.aspx [Accessed 22nd April 2010]. Seale, C. (2009) Legalisation of Euthanasia or Physician-Assisted Suicide: Survey of Doctors Attitudes, Palliative Medicine, [Online], Available from: http://pmj.sagepub.com/cgi/content/abstract/23/3/205 [Accessed 22nd April 2010]. Papers used in Literature Search: Hotopf, L, Lee, W, Price, A, and Rayner, L. Survey of Doctors Opinions of the Legalisation of Physician-Assisted Suicide. Seale, C Legalisation of euthanasia or physician-assisted suicide: survey of doctors attitudes. Appendix (a) Original Message From: Katy Marsland (08111890) [mailto:[emailprotected]] Sent: 26 April 2010 19:25 To: [emailprotected] Subject: A Questionnaire request. Dear Sir, I am at the University of Lincoln and am doing a literature review for my degree in Health and Social care involving your survey on the Legalisation of Euthanasia or Physician-Assisted Suicide: Survey of Doctors Attitudes, and was wondering if it were possible for you to forward me a copy of the questions in order to aid my review? Many thanks in advance Katy Marsland Reply: Here is the questionnaire. Clive (b) END OF LIFE DECISIONS IN MEDICAL PRACTICE: CONFIDENTIAL ENQUIRY PLEASE TICK THE BOXES TO INDICATE YOUR ANSWERS THANK YOU FOR YOUR ASSISTANCE à ¯Ã‚ Ã‚ ¯ General Background Questions Your age à ¯Ã‚ Ã‚ ¯ under 35 years of age à ¯Ã‚ Ã‚ ¯ 36 to 45 years of age à ¯Ã‚ Ã‚ ¯ 46 to 55 years of age à ¯Ã‚ Ã‚ ¯ 56 to 65 years of age à ¯Ã‚ Ã‚ ¯ over 65 years of age Your gender à ¯Ã‚ Ã‚ ¯ male à ¯Ã‚ Ã‚ ¯ female Your medical specialty à ¯Ã‚ Ã‚ ¯ General practice à ¯Ã‚ Ã‚ ¯ Palliative medicine à ¯Ã‚ Ã‚ ¯ Neurology à ¯Ã‚ Ã‚ ¯ Elderly Care à ¯Ã‚ Ã‚ ¯ Other, please specify Grading of your post à ¯Ã‚ Ã‚ ¯ Consultant à ¯Ã‚ Ã‚ ¯ Specialist registrar à ¯Ã‚ Ã‚ ¯ Associate specialist / staff grade à ¯Ã‚ Ã‚ ¯ SHO / HO / F1 / F2 à ¯Ã‚ Ã‚ ¯ GP principal à ¯Ã‚ Ã‚ ¯ GP registrar Please indicate the number of deaths, on average, for which you would be the treating or attendant doctor in the normal course of your duties Answer only one of (a), (b) or (c). (Please give the most accurate estimate you can) (a)_______________per week (b)_______________per month (c)_______________per year Have you been the treating or attendant doctor in the case of a death in the last 12 months? à ¯Ã‚ Ã‚ ¯ yes à ¯Ã‚ Ã‚ ¯ no Please go to question 30, on page 7 SPACE FOR COMMENTS ONCE YOU HAVE FINISHED THIS QUESTIONNAIRE Once you have completed this questionnaire, you can use this space to provide any clarifications to your answers or make other points PLEASE TRY TO RECALL AS CAREFULLY AS POSSIBLE THE MOST RECENT DEATH WITHIN THE LAST 12 MONTHS FOR WHICH YOU WERE ACTING AS THE TREATING OR ATTENDANT DOCTOR, AND ANSWER ALL OF THE QUESTIONS 1 TO 29 FOR THAT PARTICULAR DEATH It is, of course, impossible to do justice to all the finer nuances of decisions concerning the end of life in a short questionnaire. But please indicate those answers which approach the actual circumstances of this death as closely as possible. 1 Sex of the deceased à ¯Ã‚ Ã‚ ¯ male à ¯Ã‚ Ã‚ ¯ female 2 Age of the deceased (please estimate if unsure) à ¯Ã‚ Ã‚ ¯ under 1 year à ¯Ã‚ Ã‚ ¯ 1-9 years à ¯Ã‚ Ã‚ ¯ 10-19 years à ¯Ã‚ Ã‚ ¯ 20-29 years à ¯Ã‚ Ã‚ ¯ 30-39 years à ¯Ã‚ Ã‚ ¯ 40-49 years à ¯Ã‚ Ã‚ ¯ 50-59 years à ¯Ã‚ Ã‚ ¯ 60-69 years à ¯Ã‚ Ã‚ ¯ 70-79 years à ¯Ã‚ Ã‚ ¯ 80-89 years à ¯Ã‚ Ã‚ ¯ 90 years and over 3 Place of death à ¯Ã‚ Ã‚ ¯ hospital à ¯Ã‚ Ã‚ ¯ hospice à ¯Ã‚ Ã‚ ¯ care home à ¯Ã‚ Ã‚ ¯ deceaseds own home à ¯Ã‚ Ã‚ ¯ other (please specify) 4 Cause of death *This does not mean the mode of dying, such as heart failure, asphyxia, asthenia, etc: it means the disease, injury, or complication which caused death 1a Disease or condition directly leading to death* 1b Other disease or condition, if any, leading to 1 (a) 1c Other disease or condition, if any, leading to 1 (b) 2 Other significant conditions contributing to the death but not related to the disease or condition causing it 5 With respect to this death, when was your first contact with the patient? à ¯Ã‚ Ã‚ ¯ before or at the time of death: go to Question 6 à ¯Ã‚ Ã‚ ¯ after death: go to question 30, on page 7 6 How long had you known this patient? à ¯Ã‚ Ã‚ ¯ more than six months à ¯Ã‚ Ã‚ ¯ one to six months à ¯Ã‚ Ã‚ ¯ one to four weeks à ¯Ã‚ Ã‚ ¯ between one day and one week à ¯Ã‚ Ã‚ ¯ less than 24 hours Medical actions 7a 7b 7c Concerning this death, did you or a colleague: withhold a treatment* (or ensure that this was done)? withdraw a treatment* (or ensure that this was done)? use any drug to alleviate pain and/or symptoms? (please tick as many answers as apply) * IN THIS STUDY TREATMENT INCLUDES CARDIO-PULMONARY RESUSCITATION (CPR), ARTIFICIAL FEEDING AND/OR HYDRATION à ¯Ã‚ Ã‚ ¯ no à ¯Ã‚ Ã‚ ¯ yes (please specify treatments withheld) à ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦. à ¯Ã‚ Ã‚ ¯ no à ¯Ã‚ Ã‚ ¯ yes (please specify treatments withdrawn) à ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦. à ¯Ã‚ Ã‚ ¯ no à ¯Ã‚ Ã‚ ¯ yes, morphine or another opioid à ¯Ã‚ Ã‚ ¯ yes, benzodiazepine à ¯Ã‚ Ã‚ ¯ yes, other drug 8a 8b In withholding a treatment, did you or your colleague consider it probable or certain that this action would hasten the end of the patients life? In withdrawing a treatment, did you or your colleague consider it probable or certain that this action would hasten the end of the patients life? à ¯Ã‚ Ã‚ ¯ no à ¯Ã‚ Ã‚ ¯ yes à ¯Ã‚ Ã‚ ¯ no treatment withheld à ¯Ã‚ Ã‚ ¯ no à ¯Ã‚ Ã‚ ¯ yes à ¯Ã‚ Ã‚ ¯ no treatment withdrawn 9a 9b Concerning the drugs used to alleviate symptoms, (Questions 7c), were these administered knowing this would probably or certainly hasten the end of life? partly intending to end life? à ¯Ã‚ Ã‚ ¯ no à ¯Ã‚ Ã‚ ¯ yes à ¯Ã‚ Ã‚ ¯ no drugs used to alleviate symptoms à ¯Ã‚ Ã‚ ¯ no à ¯Ã‚ Ã‚ ¯ yes à ¯Ã‚ Ã‚ ¯ no drugs used to alleviate symptoms 10a 10b In withholding a treatment, did you or your colleague have the explicit intention of hastening the end of life? In withdrawing a treatment, did you or your colleague have the explicit intention of hastening the end of life? à ¯Ã‚ Ã‚ ¯ no à ¯Ã‚ Ã‚ ¯ yes à ¯Ã‚ Ã‚ ¯ no treatment withheld à ¯Ã‚ Ã‚ ¯ no à ¯Ã‚ Ã‚ ¯ yes à ¯Ã‚ Ã‚ ¯ no treatment withdrawn 11a 11b Was death caused by the use of a drug prescribed, supplied or administered by you or a colleague with the explicit intention of hastening the end of life (or of enabling the patient to end his or her own life?) If yes, who administered this drug (i.e. introduced it into the body)? à ¯Ã‚ Ã‚ ¯ no à ¯Ã‚ Ã‚ ¯ yes à ¯Ã‚ Ã‚ ¯ the patient à ¯Ã‚ Ã‚ ¯ you or another health care colleague à ¯Ã‚ Ã‚ ¯ a relative à ¯Ã‚ Ã‚ ¯ someone else NOTE: IF YOU ANSWERED NO TO ALL THE QUESTIONS ON THIS PAGE, GO TO QUESTION 23 Decision making NOTE: QUESTIONS 12 TO 22 REFER THE LAST-MENTIONED ACT OR OMISSION, THAT IS, THE LAST YES THAT YOU TICKED ON THE PREVIOUS PAGE (QUESTIONS 7 TO 11) 12 Which were the most important reasons for the last-mentioned act or omission? (please tick all that apply_ à ¯Ã‚ Ã‚ ¯ patient had pain à ¯Ã‚ Ã‚ ¯ patient had other symptoms à ¯Ã‚ Ã‚ ¯ request or wish of the patient à ¯Ã‚ Ã‚ ¯ request or wish of relatives à ¯Ã‚ Ã‚ ¯ expected further suffering à ¯Ã‚ Ã‚ ¯ no chance of improvement à ¯Ã‚ Ã‚ ¯ treatment would have been futile à ¯Ã‚ Ã‚ ¯ further treatment would have increased suffering à ¯Ã‚ Ã‚ ¯ other (please specify below) à ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦. 13 In your estimation, how much was the patients life shortened by the last mentioned act or omission? à ¯Ã‚ Ã‚ ¯ more than six months à ¯Ã‚ Ã‚ ¯ one to six months à ¯Ã‚ Ã‚ ¯ one to four weeks à ¯Ã‚ Ã‚ ¯ between one day and one week à ¯Ã‚ Ã‚ ¯ less than 24 hours à ¯Ã‚ Ã‚ ¯ life was probably not shortened at all 14 Did you or a colleague discuss the last-mentioned act or omission with the patient? à ¯Ã‚ Ã‚ ¯ yes, at the time of performing the act/omission or shortly before: go to Question 15 à ¯Ã‚ Ã‚ ¯ yes, some time beforehand: go to Question 15 à ¯Ã‚ Ã‚ ¯ no, no discussion: go to Question 19 15 At the time of this discussion, did you consider the patient had the capacity to assess his/her situation and make a decision about it? à ¯Ã‚ Ã‚ ¯ yes à ¯Ã‚ Ã‚ ¯ no 16 Did this discussion include the (probable or certain) hastening of the end of the patients life by this last-mentioned act or omission? à ¯Ã‚ Ã‚ ¯ yes à ¯Ã‚ Ã‚ ¯ no 17 Was the decision concerning the last mentioned act or omission made in response to an explicit request from the patient? à ¯Ã‚ Ã‚ ¯ yes, upon an oral request à ¯Ã‚ Ã‚ ¯ yes, upon a written request à ¯Ã‚ Ã‚ ¯ yes, upon both an oral and a written request à ¯Ã‚ Ã‚ ¯ no: go to Question 21 18 At the time of this request, did you consider the patient had the capacity to assess his/her situation and make a decision about it? à ¯Ã‚ Ã‚ ¯ yes: go to Question 21 à ¯Ã‚ Ã‚ ¯ no: go to Question 21 ONLY ANSWER QUESTIONS 19 and 20 IF YOUR ANSWER TO QUESTION 14 WAS NO, NO DISCUSSION 19 Did you consider the patient had the capacity to assess his/her situation and make a decision about it? à ¯Ã‚ Ã‚ ¯ yes à ¯Ã‚ Ã‚ ¯ no 20 Why was the last mentioned act or omission not discussed with the patient? (Please fill in as many answers as apply) à ¯Ã‚ Ã‚ ¯ patient was too young à ¯Ã‚ Ã‚ ¯ the last mentioned act or omission was clearly the best one for the patient à ¯Ã‚ Ã‚ ¯ discussion would have done more harm than good à ¯Ã‚ Ã‚ ¯ patient was unconscious à ¯Ã‚ Ã‚ ¯ patient had significant cognitive impairment à ¯Ã‚ Ã‚ ¯ patient was suffering from a psychiatric disorder à ¯Ã‚ Ã‚ ¯ other, please elaborate at the end of the questionnaire 21 Did you or a colleague discuss with anybody else the (possible) hastening of the end of the patients life before it was decided to take the last mentioned act or omission? (Please fill in as many answers as apply) à ¯Ã‚ Ã‚ ¯ with one or more medical colleagues à ¯Ã‚ Ã‚ ¯ nursing staff /other caregivers à ¯Ã‚ Ã‚ ¯ by partner/relatives of the patient à ¯Ã‚ Ã‚ ¯ someone else à ¯Ã‚ Ã‚ ¯ nobody 22 Which were the most important reasons for the last-mentioned act or omission? (please tick all that apply) à ¯Ã‚ Ã‚ ¯ patient had pain à ¯Ã‚ Ã‚ ¯ patient had other symptoms à ¯Ã‚ Ã‚ ¯ request or wish of the patient à ¯Ã‚ Ã‚ ¯ request or wish of relatives à ¯Ã‚ Ã‚ ¯ expected further suffering à ¯Ã‚ Ã‚ ¯ no chance of improvement à ¯Ã‚ Ã‚ ¯ further treatment would have been futile à ¯Ã‚ Ã‚ ¯ further treatment would have increased suffering à ¯Ã‚ Ã‚ ¯ other (please specify below à ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦ NOTE: QUESTIONS FROM HERE ONWARDS SHOULD BE ANSWERED WHETHER OR NOT YOU ANSWERED YES TO ANY OF THE ACTS OR OMISSIONS MENTIONED ON PAGE 3 (QUESTIONS 7 TO 11) 23 Was an explicit request to hasten the end of the patients life made by any of the following? (Please tick all that apply) à ¯Ã‚ Ã‚ ¯ partners/relatives of the patient à ¯Ã‚ Ã‚ ¯ nursing or other care staff à ¯Ã‚ Ã‚ ¯ someone else à ¯Ã‚ Ã‚ ¯ no explicit request 24 As far as you know, did the patient ever express a wish for the end of his/her life to be hastened? à ¯Ã‚ Ã‚ ¯ yes, clearly: go to Question 25 à ¯Ã‚ Ã‚ ¯ yes, but not very clearly: go to Question 25 à ¯Ã‚ Ã‚ ¯ no: go to Question 26 25 Did the patients wish for this outcome reduce or disappear over time? à ¯Ã‚ Ã‚ ¯ no à ¯Ã‚ Ã‚ ¯ yes, in response to care provided à ¯Ã‚ Ã‚ ¯ yes, other reason 26 The treatment during the last week was mainly aimed at: à ¯Ã‚ Ã‚ ¯ recovery à ¯Ã‚ Ã‚ ¯ prolonging life à ¯Ã‚ Ã‚ ¯ support during the dying process 27 Which caregivers were involved in the care for the patient during the last month before death (beside yourself and as far as you know)? (please tick all that apply) Of those not involved, which ones might have helped? Involved Not involved and might have helped general practitioner à ¯Ã‚ Ã‚ ¯ à ¯Ã‚ Ã‚ ¯ specialist in pain relief à ¯Ã‚ Ã‚ ¯ à ¯Ã‚ Ã‚ ¯ palliative care team à ¯Ã‚ Ã‚ ¯ à ¯Ã‚ Ã‚ ¯ psychiatrist / psychologist à ¯Ã‚ Ã‚ ¯ à ¯Ã‚ Ã‚ ¯ nursing staff à ¯Ã‚ Ã‚ ¯ à ¯Ã‚ Ã‚ ¯ social care worker à ¯Ã‚ Ã‚ ¯ à ¯Ã‚ Ã‚ ¯ spiritual caregiver à ¯Ã‚ Ã‚ ¯ à ¯Ã‚ Ã‚ ¯ volunteer à ¯Ã‚ Ã‚ ¯ à ¯Ã‚ Ã‚ ¯ family member à ¯Ã‚ Ã‚ ¯ à ¯Ã‚ Ã‚ ¯ 28a 28b 28c 28d Was the patient continuously and deeply sedated or kept in a coma before death? Which medication was given for sedation? (please tick as many answers as apply) At what time before death was continuous sedation of the patient started? Which were the most important reasons for this sedation? (please tick all that apply) à ¯Ã‚ Ã‚ ¯ yes à ¯Ã‚ Ã‚ ¯ no: go to Question 29a à ¯Ã‚ Ã‚ ¯ midazolam à ¯Ã‚ Ã‚ ¯ other benzodiazepine à ¯Ã‚ Ã‚ ¯ morphine or another opioid à ¯Ã‚ Ã‚ ¯ other type of medication à ¯Ã‚ Ã‚ ¯Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦. hours before death à ¯Ã‚ Ã‚ ¯Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦. days before death à ¯Ã‚ Ã‚ ¯Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦. weeks before death à ¯Ã‚ Ã‚ ¯ patient had intractable pain à ¯Ã‚ Ã‚ ¯ patient had intractable psychological distress à ¯Ã‚ Ã‚ ¯ patient had other intractable symptoms à ¯Ã‚ Ã‚ ¯ request or wish of the patient à ¯Ã‚ Ã‚ ¯ request or wish of relatives à ¯Ã‚ Ã‚ ¯ other (please specify below à ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦ 29a 29b 29c Did the patient receive morphine or another opioid during the last 24 hours before death? How much time before death was the administration of morphine or another opioid started? Which figure best illustrates the dosage of morphine or another opioid during the last 3 days before the patients death? à ¯Ã‚ Ã‚ ¯ yes à ¯Ã‚ Ã‚ ¯ no go to Question 30 à ¯Ã‚ Ã‚ ¯Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦. hours before death à ¯Ã‚ Ã‚ ¯Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦. days before death à ¯Ã‚ Ã‚ ¯Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦. weeks before death à ¯Ã‚ Ã‚ ¯ No increase à ¯Ã‚ Ã‚ ¯ Gradual increase à ¯Ã‚ Ã‚ ¯ Strong increase last day Attitudes and beliefs Questions 30 and 31 are about voluntary euthanasia (that is, when someone ends the life of another person at their request), worded in the same way as those used in surveys of general public opinion. 30 30a 30b First, a person with an incurable and painful illness, from which they will die for example, someone dying of cancer. Do you think that, if they ask for it, a doctor should ever be allowed by law to end their life, or not? And do you think that, if this person asks for it, a doctor should ever be allowed by law to give them lethal medication that will allow the person to take their own life? à ¯Ã‚ Ã‚ ¯ Definitely should be allowed à ¯Ã‚ Ã‚ ¯ Probably should be allowed à ¯Ã‚ Ã‚ ¯ Probably should not be allowed à ¯Ã‚ Ã‚ ¯ Definitely should not be allowed à ¯Ã‚ Ã‚ ¯ Definitely should be allowed à ¯Ã‚ Ã‚ ¯ Probably should be allowed à ¯Ã‚ Ã‚ ¯ Probably should not be allowed à ¯Ã‚ Ã‚ ¯ Definitely should not be allowed 31 31a 31b Now, how about a person with an incurable and painful illness, from which they will not die. Do you think that, if they ask for it, a doctor should ever be allowed by law to end their life, or not? And do you think that, if this person asks for it, a doctor should ever be allowed by law to give them lethal medication that will allow the person to take their own life? à ¯Ã‚ Ã‚ ¯ Definitely should be allowed à ¯Ã‚ Ã‚ ¯ Probably should be allowed à ¯Ã‚ Ã‚ ¯ Probably should not be allowed à ¯Ã‚ Ã‚ ¯ Definitely should not be allowed à ¯Ã‚ Ã‚ ¯ Definitely should be allowed à ¯Ã‚ Ã‚ ¯ Probably should be allowed à ¯Ã‚ Ã‚ ¯ Probably should not be allowed à ¯Ã‚ Ã‚ ¯ Definitely should not be allowed 32 Religion: what is your religion? à ¯Ã‚ Ã‚ ¯ None à ¯Ã‚ Ã‚ ¯ Christian (including Church of England, Catholic, Protestant and all other Christian denominations) à ¯Ã‚ Ã‚ ¯ Buddhist à ¯Ã‚ Ã‚ ¯ Hindu à ¯Ã‚ Ã‚ ¯ Jewish à ¯Ã‚ Ã‚ ¯ Muslim à ¯Ã‚ Ã‚ ¯ Sikh Any other religion, please write in 33 Religion: would you describe yourself as: à ¯Ã‚ Ã‚ ¯ extremely religious à ¯Ã‚ Ã‚ ¯ very religious à ¯Ã‚ Ã‚ ¯ somewhat religious à ¯Ã‚ Ã‚ ¯ neither religious nor non-religious à ¯Ã‚ Ã‚ ¯ somewhat non-religious à ¯Ã‚ Ã‚ ¯ very non religious à ¯Ã‚ Ã‚ ¯ extremely non religious à ¯Ã‚ Ã‚ ¯ cant choose 34 What is your ethnic group? Choose ONE section from A to E, then tick the appropriate box to indicate your ethnic group A White à ¯Ã‚ Ã‚ ¯ any White background B Mixed à ¯Ã‚ Ã‚ ¯ White and Black Caribbean à ¯Ã‚ Ã‚ ¯ White and Black African à ¯Ã‚ Ã‚ ¯ White and Asian à ¯Ã‚ Ã‚ ¯ Any Other Mixed background, please write in C Asian or Asian British à ¯Ã‚ Ã‚ ¯ Indian à ¯Ã‚ Ã‚ ¯ Pakistani à ¯Ã‚ Ã‚ ¯ Bangladeshi à ¯Ã‚ Ã‚ ¯ Any Other Asian background, please write in D Black or Black British à ¯Ã‚ Ã‚ ¯ Caribbean à ¯Ã‚ Ã‚ ¯ African à ¯Ã‚ Ã‚ ¯ Any Other Black background, please write in E Chinese or other ethnic group à ¯Ã‚ Ã‚ ¯ Chinese à ¯Ã‚ Ã‚ ¯ Any Other, please write in To clarify any answers or to make further comments, please use the space on page 1. Thank you for your help with this important survey. Now that you have finished the questionnaire, to ensure the anonymity of your answers you will need to do two things. Place the completed questionnaire in the reply-paid envelope, seal it and post it as soon as possible Post the reply-paid response notification card with your name on it if you wish to avoid receiving follow-up reminders. These two items will be received by different people in different locations and kept separate. It will not be possible to link your questionnaire with your name. This questionnaire has been sent to a random sample of 10,000 doctors. It will not be possible for the researchers or anyone else to use your replies to discover your identity or the identity of the patient on whose care you have reported. We understand that recalling events of this nature can be a distressing experience. If you wish to talk to someone about your feelings concerning end-of-life care, the Confidential Counselling Helpline of the British Medical Association can assist you. Their number is: 0645 200 169 (c) Euthanasia and Assisted Suicide in the United Kingdom A Research Proposal Part B By Katy Marsland 08111890 University of Lincoln Hand in Date: 4th May 2010 (1,352 Words) Julie Burton NUR2002M-0910 research Methods 2009/2010 Table of Contents: Page Title 26 Research Questions 27 Aims of Project 28 Initial Literature Review 29-30 Methodology 31 Ethical Considerations and Practical Constraints 32 Timetable for Dissertation Research 33-34 References 35 A Research Proposal 1. Title: Euthanasia and Assisted Suicide in the United Kingdom. 2. Research Questions Should Euthanasia and Assisted Suicide be made legal? What are the arguments for and against policy change in the United Kingdom? Which section of society is most supportive of a change in the law? Which section is most opposed and why? 3. Aims of Project This research aims to investigate, using secondary data, whether a change in the law is needed to clarify the position of euthanasia and assisted suicide in the United Kingdom, and whether this should be made legal just for those who are terminally ill or for

Organization and Administration of Higher Education :: Education Essays

Organization and Administration of Higher Education General Objectives: The purpose of this course is to provide an overview of the administration of institutions of higher education. The course is concerned with providing basic information about major administrative units in institutions of higher education, philosophical and theoretical foundations of administration, and current issues faced by administrators. An important feature of this course is to explore issues of leadership and accountability in post secondary education. Specific Objectives: Following are the specific objectives of the course: 1. To orient and familiarize students with the philosophy and administrative organization of institutions of higher education. 2. To examine specific administrative units of institutions of higher education. 3. To identify leadership skills necessary for those who contemplate a career as an administrator in colleges or universities. 4. To examine current issues faced by college and university administrators. 5. To provide students with an opportunity to study one or more administrative units in detail. 6. To improve writing and reporting skills. Accommodations. Students in need of a specific accommodation under Section 504 of the Rehabilitation Act of 1973 or the Americans with Disabilities Act of 1990, please contact the instructor privately. Every attempt will be made to provide reasonable accommodations for such students. Readings will be assigned from Internet resources. Students must have access to the World Wide Web to be successful in this course. The WWW is available in the departmental computer lab, the college of education computer lab, and the Parks library. Sequence of Instruction Date Course Topic January 14 Organization of the Course January 21 Holiday January 28 Overview of Higher Education February 4 Institutional mission, Carnegie classification system, accreditation, HBCU’s. February 11 Strategic Planning February 18 Governing Boards and The Presidency--Abstracts due February 25 The Faculty March 4 Mid Term Examination March 11 The Curriculum March 18 Spring Break March 25 Managing Financial Resources April 1 Student Affairs April 8 Measuring Quality-- Papers due April 15 Student Reports April 22 Student Reports April 29 Student Reports May 6 Final Examination Evaluation 1. Each student will submit abstracts of 20 articles or chapters that pertain to the general subject matter on 4x6 cards. Please use no more than one card per abstract. The summary should include the title of the piece (APA Style Manual, either 4th or 5th edition), a brief summary of the purpose of the citation including its contents and conclusions, if any.

Compare and Contrast Judaism, Christianity, and Islam Essay examples --

Compare and Contrast Judaism, Christianity, and Islam Human beings have always been curious about the meaning and purpose of life. Religions try to answer the curiosity people have about there being a higher source, typically identifying this greater domination as God. Some beliefs teach that there is only one G-d this is defined as a monotheistic religion. Some examples of monotheistic religions are Judaism, Christianity and Islam. Although each sect has a different perspective on teachings and beliefs they have one common thread; the belief in a singular deity. Each religion has a different perspective but most important is where the religions generated from. Major religions started in various parts of the world. Judaism, Christianity and Islam share the same birthplace the Middle East. Jerusalem is not only the home to Judaism but Christian and Muslim Religions as well. Equally important is the expansion of religions. For example Judaism and Christianity are also practiced in Europe, North America, Russia and elsewhere. Islam can be found in Europe, Central Asia, North and West Africa and elsewhere. (30-41) Diverse religions spread throughout the countries allowing for the expansion of followers. The Birthplace of the religions is just as significant to the different sects; which, the religions are composed of. Each religion has different branches where each sect varies on beliefs. For instance, Judaism is broke into three major branches Orthodox, Conservative and Reform. This are consider the sects of today. One major argument between the groups is the interpretation and validation of the Torah. "The argument is rather the torah was written by G-d and given to mosses completely intact. The Second argument is the ... ... he was sent to earth to save human beings from sin and death. The teaching's of Jesus center around love. The way to salvation is do good works. Also too have faith in G-d and the Christ's resurrection. Last but not least is Islam. The basic beliefs of Islam are summed up in this statement of Faith. "I believe in Allah, his angels, his books and prophets and the Day of judgment". The Angel Gabriel brought Allah's message to Muhammad They believe the purpose of life is to submit to G-d, and obtain paradise after death. They way to achieve salvation is to follow the Qur'an, and Five Pillars of Islam. Although many religions have different sects; which, may share different ideas just like in Judaism, Christianity, and Islam. It is evident that these religions believe in one god. The teaching and traditions of each religion make each religion unique in its own way.

Budgeting

We are living on a single income in a world that requires two or more income sources to survive. This culminates into spending more than the earnings made, thus making saving, a prerequisite for investing an unachievable dream. However, a close look justifies that not all people are cramped up with single income sources. As discussed in this article, few lucky people have managed to utilize easy money saving tips that have enabled them to save money for investments that guarantee a financially stable future.One of the tips is budgeting, which acts as a guide in controlling what one spends. Outline what you spend on a monthly basis and correlate the spending with the income you earn. Outline a long term plan on what you want to save in a fixed time frame. This will help you determine the amount of money that you should spend or save on a monthly basis. Another tip is cutting one’s spending. To cut on unnecessary spending, you need to change you lifestyle. You can prepare food a nd eat at home instead of spending a lot of money eating in restaurants.Considering that replacing goods is more expensive, repair them in advance to avoid hefty costs. More so, ensure that you quit vices such as smoking and drinking among others that could incur hefty health costs and increased spending on a long-term or short-term basis. Limiting debts by going for loans with low and flexible interest rates is also another effective money saving tip. Compare different banks’ interest rates for loans and get the bank that offers the best rate. Supposing you have a business, you could try to haggle for the existing loans.For instance, threatening to relocate the business can make lending institutions quite flexible in terms of interest rates and flexibility. This can prevent you from taking unnecessary loans in a bid to repay another high interest loan when the business in not doing well. Besides the above tips, you should detect the slightest opportunities via which you can get what you want without having to spend or incur extra costs. For instance one can join reward programs that give spending point on the purchases made.With time, the spending points might help you get free stuff and save money that you would have incurred while purchasing the stuff. As we can see, money saving tips narrow down to proper budgeting, having long-term goals and a change of lifestyle. One needs to identify money saving opportunities and also opportunities for cutting down the spending. For people who find saving to be quite difficult, they can use financial advisor’s services. However, if you are well endowed with the above easiest saving tips, you can go ahead, save and transform your life.

Disney Park

Disney Theme Parks Case 1. What do you think motivated Disney to set up parks abroad, and what might be the pros and cons from the standpoint of the Walt Disney Company? The reason behind Disney's motivation to set up theme parks abroad were mostly because of business opportunities. Based on how successful the Disney Theme Park is in the United States and the attraction they are gaining from foreigners, the management probably realized that it is time to consider entering the global market. By doing this, it would mean an increase of sales for the company.This is somehow a form of advertisement for people to buy their products and even to attract more and more consumers. Opening another theme park in a different country would also contribute to the survival of the company should their theme park in the United States lower in sales. On the other hand, for the cons, one is concerning the cultural factors that may hinder the company from doing business in other countries. A good example would be the concerns in Paris. They feared that putting up a Disney Theme Park in their country might destroy their own culture. Another con would probably be the area where the park would be best put up.In other words, which area the theme park should be placed that would be profitable. Transportation is another factor as well as competition from other theme parks abroad. 2. Why do you suppose Disney made no financial investment in Japan, one of $140 million in France, and then one of over $300 million in Hong Kong? Disney made no financial investment in Japan because they were considering the risks of building one. They probably think that it might not be as profitable or that putting up a Disney Theme Park in Japan would outweigh the cons than the benefits.Paris, like what was mentioned in the case, is the most visited European City and the French are the largest European consumers of Disney Products. This is the reason why Disney invested in Paris. Also they were getting a lot of support from the country's government. And with their help, they would be able to get investors. According to the case, the reason why Disney invested only $140 million to take 49% of the ownership in a $5 billion worth of operation was due to the problems they have encountered before, which is the fear of France's culture to be destroyed.So what Disney did was to add attractions that would cater to French tastes and agreeing to make French the first language in the park. Aside from France, Disney also invested in Hong Kong. The case states that Disney is interested in Asia since it accounts for about half the world's population and is becoming affluent enough that more people can afford to take trips and pay for leisure activities. They chose Hong Kong not only for their infrastructure, but also because it is Asia's largest tourist destination.In addition, the families that live in Hong Kong are those with higher family incomes than mainland Chinese cities. Soon after, the two agreed to a joint venture that included 57% ownership by the Hong Kong government and the remaining by Disney. 3. What factors in the external environment have contributed to Disney's success, failure, and adjustments in foreign them park operations? There are many factors in the external environment that contributed both to Disney's success and failure.For the factors that contributed to the success, one would probably be Disney's already popular reputation, which helped them in entering the global market easily. Another is their strategy of focusing on countries that would ensure and give them better business opportunities. Another factor to be considered is the government support they are getting. As for the factors that contributed to their failure, one that is mentioned in the case is that they encounter problems concerning the culture of other countries.Another example would be the almost downfall of Euro Disney when their shares went down to 39% and the general public to 36%. This is probably due to the high prices and their no-alcohol policy. Another factor that contributed to their failure is the climate. Some countries were just too cold to attract visitors. 4. Should Disney set up a park in Shanghai? If so, what types of operating adjustments might it make there? It is not advisable for Disney to put up a theme park in Shanghai. One of the major reasons is competition.The case states that China has built more than 2000 amusement parks, ranging from lavish to shoddy. Although most of them have not done well, putting up a Disney Theme Park would not necessarily mean that it would eliminate its competitors. In addition, China's one child per family policy may hinder the success of Disney. The visitors of Disney Theme Parks are mostly children, and if the number is lacking, it would also probably mean lack of visitors. Another reason is that if Disney puts up a theme park in Shanghai, there would be few customers since there is also a Disney theme park in Hong Kong.