HIV- Infected Surgeon and a Duty to Disclose Essay Example for Free

HIV- Infected Surgeon and a Duty to Disclose Essay In Case 12 a doctor, Dr. M, has learned he is infected with HIV, should he disclose to his patients that he has HIV or even discontinue his practice of performing surgery on patients? In a study that was taken 2.5 times for every one hundred surgeries performed about one-third of those procedures the patient is touched with the surgeons’ blood. In the same study they have found that for every one hundred surgeries that a surgeon performs with HIV only three patients will contract HIV from the surgeon. Dr. M does not have an obligation to refrain from performing surgery due to the low risk of contracting HIV from him and with any surgery there are risks, such as death that have to be taken into consideration. While Dr. M doesn’t have the obligation to terminate his profession of a surgeon he does hold the obligation to disclose to his patents he is HIV positive. If he discloses this to them this allows for the patent to decide whether or not to continue the procedure with him. When he discloses this information to them he will also need to provide the facts and information to them of the low risk they have of contracting the virus from him. Just as Dr. M is obligated to disclose his information of the virus he carries to his patients so does this patents hold the same responsibility to provide that information to him. The patient providing this information to their surgeon is more critical then the surgeon providing it to them for the simply fact a surgeon has more exposure to blood than a patient does. For most patients the fear of the unknown is the worst disease of all but at times information is hard to attain. As a health care provider you should never allow the fear of not knowing what disease you have that could be passed along to your patients be in their minds. With the chosen profession of being a physician imposes a set of duties and obligations, which raise additional questions and concerns. As a physician you have accepted the obligation of do no avoidable harm, be as skilled and knowledgeable as possible, recommend and do what is best for the patient, and be honest with them. Along with these duties they also assume the responsibility and challenge of providing the facts that the patient needs in order to give a voluntary informed consent for the surgeon to perform surgery on them. As a surgeon they need to know whether it will impair their ability to perform their tasks safely and competently. They also need to know if it will pose any significant risk to their patients now or in the future. If the surgeon is or will become impaired they need to resolve the impairment. If this is not possible they may need to limit or change the kind of surgery they perform. The risk of HIV acquisition from an infected surgeon appears much lower than the risk bacterial infections, even those with deadly potential. These rates vary by surgeon and institution. It is not in the practice for surgeons to disclose their personal health information to potential patients. Similarly, most surgeons don’t openly disclose the number of similar cases they do annually, another factor associated with complication rates. Given this practice, it seems inappropriate to require disclosure of a lower-risk condition. That may change as risk-adjusted institutional and even surgeon-specific data become publicly available. Until then disclosure of HIV status seems inappropriate. It may arouse anxiety unnecessarily and have no practical effect on risk reduction. It may be that some patients would be more fearful of a low risk of HIV infection than of a serious adverse drug reaction, postoperative hemorrhage, or sepsis, but that is not a strong argument for routine disclosure. It is a reason to answer a direct question truthfully. While there may be an understandable hesitation to answer a patient’s pointed question about their surgeon’s HIV status, medical ethics and respect for persons demand an honest answer, just as they would to a question about training, experience, or complication rates. Therefore, surgeons should pose to patients the risks real and potential in a generic way and how they should be managed. Obtaining fully informed consent is morally necessary in order to acknowledge and respect an individual patients autonomy. Truth disclosure is an integral part of this acknowledgement. Accusations of paternalism may arise from decisions to restrict information to patients. The caring professions require patients trust in order to deliver care effectively. Being seen to care for a culture of openness may enhance patients trust in the professions while the appearance of concealment would certainly diminish it. In a society with an increasing culture of openness, and where the right to information from governments and official bodies is receiving attention, it would seem desirable to provide comprehensive information about risks. Patients have a right not to be harmed by their medical practitioner. This right is cherished in the concept of non-maleficence. While it is the duty of a doctor to do good to patients (benevolence), a particular treatment may not help all individuals. Thus, the least that a doctor should do is to do no harm. By not informing patients of their exposure, transmission might not be recognized, thus patients would be harmed by the denial of appropriate treatment. Moreover, if patients are infected, they constitute a transmission risk to those around them. Health care providers should not adopt the paternalistic approach of deciding for their patients what level of risk is acceptable, but should consider patients views. Autonomy and truth disclosure are important influences on this decision. In deciding whether to inform patients, a balance must be struck between their desires to know of past exposure to risks, and the professional view that when risks are negligible, patients need not be informed. It is strongly suggested that patients needs should be given greater weight.

The Relationship Between Science and Reality Essay -- Science Scientif

The Relationship Between Science and Reality The relationship between science and reality has more to do with coexistence rather than one idea being superior to the other. I shall first define what each means and then give examplester's of how I arrive a t this coexistence theory. According to Random House Webster's Unabridged Dictionary, 1 ed., science is defined as follows: 1. a branch of knowledge or study dealing with a body of facts or truths systematically arranged and showing the operation of general laws: the mathematical sciences. 2. systematic knowledge of the physical or material world gained through observation and experimentation. 3. systematized knowledge in general. The same dictionary defines reality as: 1. the state or quality of being real. 2. Philos. a. something that exists independently of ideas concerning it. b. something that exists independently of all other things and from which all other things derive. I have a 5-year-old nephew who is alive because he received a heart transplant a few weeks after his birth. His parents very public request for organ donors received a lot of attention at the time, including a local radio talk show that discussed the organ donor program in general and whether this particular baby should be given a new heart. The replies were astonishing to me in both their intensity and their divisiveness. That some people could publicly say, "let the baby die†¦it’s God’s way," left me with my jaw hanging open. Some callers talked about how it was unnatural for science to be used in such a manner while others praised the fact that we now had the technology to allow a child, who might otherwise die, live. Today, that medical miracle of science wil... ...dual, not social preferences†¦[which] is why in almost every country in the world, the automobile has triumphed†¦"(p308). He concludes that cars make California more enjoyable. Our group all agreed. As I stated earlier, The Relationship between Science and Reality, is about co-existence. We need both science and reality to not only coexist, but also to continue to improve our lives. Works Cited Random House Webster’s Unabridged Dictionary, Second Edition. 1999 ed. Bishop, Michael J, "Enemies of Promise." Lunsford, Andrea and John Ruszkiewicz, The Presence of Others: Voices and Images That Call for Response 3rd ed. New York: St. Martin’s 2000. 237-242. Wilson, James Q, "Cars and Their Enemies." Lunsford, Andrea and John Ruszkiewicz, The Presence of Others: Voices and Images That Call for Response 3rd ed. New York: St. Martin’s 2000. 303-313.

Federalist Argument for Ratification of the Constitution

Federalist Argument for Ratification of the Constitution November 18, 2010 Americans, prior to and shortly after the Revolutionary War, were strongly united under one opinion. The common belief that America ought to be an independent state, with its own system of government can be found in the literature of each and every colony. However, after the failure of the first governing document, the Articles of Confederation, delegates met in Philadelphia in order to draft a better functioning constitution. In this debate, the opinion of America soon became divided.On one side were the supporters of the proposed constitution (Federalists) and on the other the opponents (Anti-Federalists). The Federalists urged their fellow delegates and the nation for the establishment of a consolidated federal government that gets its power from an energetic constitution. The reason behind this position was none other than the failure of the Articles of Confederation. Although the two sides disagreed over the role and authority of the federal government, they did hold one thing in common: the Articles of Confederation were inadequate and threatened the preservation of the union.The Anti-Federalists believed that the flaws of the Articles of Confederation could be fixed by amendments while the Federalists combated that claim by suggesting that the â€Å"material defects† that exist in the articles cannot be repaired and thus a new, more energetic, constitution must be drafted. Additionally, the Anti-Federalists sought to support the Articles of Confederation because they believed that there are more problems introduced by the newly proposed constitution.They argued that the document would establish an untested form of government and they maintained that the Framers of the Constitution were an elitist group that had met in secrecy in order to empower â€Å"moneyed few. † The Federalists refuted the claims of their opponents in a series of essays that underlined the follow ing central ideas: the benefit of the union to the colonies; defense of republicanism in the newly proposed constitution; and the necessity of an energetic, proficient federal government. As previously stated, both sides agreed that the Articles of Confederation ere incapable of preserving the union. However, the Anti-Federalists believed in confederated government made up of small republics (as it existed prior to the ratification of the Constitution). â€Å"If the people are to give their assent to the laws, by persons chosen and appointed by them, the manner of the choice and the number chosen, must be such, as to possess, be disposed, and consequently qualified to declare the sentiments of the people; for if they do not know, or are not disposed to speak the sentiments of the people, the people do not govern, but the sovereignty is in a few.Now, in a large extended country, it is impossible to have a representation, possessing the sentiments, and of integrity, to declare the mi nds of the people, without having it so numerous and unwieldly, as to be subject in great measure to the inconveniency of a democratic government† (Hammond, Hardwick, & Lubert, 2007, p. 538). According to their argument, small republics preserve liberty best because citizens of small republics know the elected officials on a personal level and it is this intimate connection that assures obedience of the law.A confederation of states allows for the existence of states that reflect their constituents. In a large republic there will be many opinions and laws will be diluted by the number of opinions. This can create conflict and threaten the union. In Federalist 10, James Madison disproves this claim by stating the Federalist belief that large republics produce better candidates and a majority that is more inclusive to existing minorities. In the next place, as each representative will be chosen by a greater number of citizens in the large than in the small republic, it will be more difficult for unworthy candidates to practice with success the vicious arts by which elections are too often carried; and the suffrages of the people being more free, will be more likely to centre in men who possess the most attractive merit and the most diffusive and established characters† (Hammond, Hardwick, & Lubert, 2007, p. 465).Madison reasons that in a large state the number of voters and candidates is greater therefore the probability of electing a qualified representative is also greater. In a small republic candidates running in election can fool voters easier than in a large republic. Thus, Madison, in contrast to the Anti-Federalists, saw the large size of the United States as a help rather than a hindrance to the cause of liberty. Due to these qualities of large republics the salvation of the union would be facilitated.Federal inability to enforce laws on the states leads the Federalists to desire an energetic constitution that gave the government mor e authority and the apparatuses necessary to enforce its sovereignty. Under the Articles of Confederation, states were left to enforce federal law. Alexander Hamilton, in Federalist 15, argues that this practice â€Å"†¦in theory their resolutions concerning those objects are laws, constitutionally binding on the members of the Union, yet in practice they are mere recommendations which the States observe or disregard at their option† (Hammond, Hardwick, & Lubert, 2007, p. 472).Furthermore, he expands on federal powers and tools needed for enforcement in Federalist 23. In defense of the â€Å"necessary and proper† clause of the Constitution, Hamilton states that â€Å"†¦because it is impossible to foresee or define the extent and variety of national exigencies, or the correspondent extent and variety of the means which may be necessary to satisfy them† (Hammond, Hardwick, & Lubert, 2007, p. 478). The new constitution would enable to federal gove rnment to implement its authority over members of the union. In a federalist view this is a necessary improvement for the security of the union.If the national government is given responsibilities then it ought to also have the tools needed to carry out those responsibilities. The lack of clear and complete separation between the executive, legislative and judicial bodies was viewed by the Anti-Federalist as a reintroduction of a monarchial and tyrannical regime. James Madison, on the other hand, reasoned that the best government of the time, as it existed in Britain, and all of the colonies already practiced the same overlapping of powers that was found in the proposed constitution.In Federalist 48, Madison argues that it is this very overlapping of authority that preserves the separation of powers; â€Å"The conclusion which I am warranted in drawing from these observations is, that a mere demarcation on parchment of the constitutional limits of the several departments, is not a sufficient guard against those encroachments which lead to a tyrannical concentration of all the powers of government in the same hands† (Hammond, Hardwick, & Lubert, 2007, p. 494).He believed that his opponents had read Montesquieu but had not understood his notion of separation of powers clearly. According to Montesquieu, tyranny results when one branch of government simultaneously holds the powers of another branch. However, Madison argues that Montesquieu â€Å"did not mean that these departments ought to have no partial agency in, or no control over, the acts of each other† (Hammond, Hardwick, & Lubert, 2007, p. 490). Thus, the above claim enabled the Federalists to sufficiently settle the argument on this issue.As brilliant as the Federalist Papers were they were not the sole reason that the proposed constitution was ratified. Nevertheless, they aided the constitution's cause by giving the constitution's adherents ideas with which to counter their oppositi on. The Anti-Federalist outcry was not without its effects. With the ratification of the Constitution state legislatures voted for the addition of the first ten amendments. The Bill of Rights, as it came to be known, became an essential part of the document and its legacy of liberty.The ratification of the Constitution not only changed the political culture but also the social. Soon after its approval, American experienced a social shift as well. Citizens no longer saw themselves as only Virginians or New Yorkers; instead they became something larger than that, they became American first and the rest as they say is history.Works Cited Hammond, S. , Hardwick, K. , & Lubert, H. (2007). Classics of american political & constitutional thought. Indianapolis: Hackett Publishing Company, Inc.

What Is Distillation Principles and Uses

Distillation is an important separation process in chemistry, industry, and food science. Here is the definition of distillation and a look at the types of distillation and its uses. Key Takeaways: Distillation Distillation is the process of separating components of a mixture based on different boiling points.Examples of uses of distillation include purification of alcohol, desalination, crude oil refining, and making liquefied gases from air.Humans have been using distillation since at least 3000 BC in the Indus valley. Distillation Definition Distillation is a widely used method for separating mixtures based on differences in the conditions required to change the phase of components of the mixture. To separate a mixture of liquids, the liquid can be heated to force components, which have different boiling points, into the gas phase. The gas is then condensed back into liquid form and collected. Repeating the process on the collected liquid to improve the purity of the product is called double distillation. Although the term is most commonly applied to liquids, the reverse process can be used to separate gases by liquefying components using changes in temperature and/or pressure. A plant that performs distillation is called a distillery. The apparatus used to perform distillation is called a still. History The earliest known evidence of distillation comes from a terracotta distillation apparatus dating to 3000 BC in the Indus valley of Pakistan. Distillation was known to be used by the Babylonians of Mesopotamia. Initially, distillation is believed to have been used to make perfumes. Distillation of beverages occurred much later. The Arab chemist Al-Kindi distilled alcohol in 9th century Irag. Distillation of alcoholic beverages appears common in Italy and China starting in the 12th century. Uses of Distillation Distillation is used for many commercial processes, such as the  production of gasoline, distilled water, xylene, alcohol, paraffin, kerosene, and many other liquids. Gas may be liquefied and separate. For example: nitrogen, oxygen, and argon are distilled from air. Types of Distillation Types of distillation include simple distillation, fractional distillation (different volatile fractions are collected as they are produced), and destructive distillation (usually, a material is heated so that it decomposes into compounds for collection). Simple Distillation Simple distillation may be used when the boiling points of two liquids are significantly different from each other or to separate liquids from solids or nonvolatile components. In simple distillation, a mixture is heated to change the most volatile component from a liquid into vapor. The vapor rises and passes into a condenser. Usually, the condenser is cooled (e.g., by running cold water around it) to promote condensation of the vapor, which is collected. Steam Distillation Steam distillation is used to separate heat-sensitive components. Steam is added to the mixture, causing some of it to vaporize. This vapor is cooled and condensed into two liquid fractions. Sometimes the fractions are collected separately, or they may have different density values, so they separate on their own. An example is steam distillation of flowers to yield essential oil and a water-based distillate. Fractional Distillation Fractional distillation is used when the boiling points of the components of a mixture are close to each other, as determined using Raoults law. A fractionating column is used to separate the components used a series of distillations called rectification. In fractional distillation, a mixture is heated so vapor rises and enters the fractionating column. As the vapor cools, it condenses on the packing material of the column. The heat of rising vapor causes this liquid to vaporize again, moving it along the column and eventually yielding a higher purity sample of the more volatile component of the mixture. Vacuum Distillation Vacuum distillation is used to separate components that have high boiling points. Lowering the pressure of the apparatus also lowers boiling points. Otherwise, the process is similar to other forms of distillation. Vacuum distillation is particularly useful when the normal boiling point exceeds the decomposition temperature of a compound. Sources Allchin, F. R. (1979). India: The Ancient Home of Distillation?. Man. 14 (1): 55–63. doi:10.2307/2801640Forbes, R. J. (1970). A Short History of the Art of Distillation from the Beginnings up to the Death of Cellier Blumenthal. BRILL. ISBN 978-90-04-00617-1.Harwood, Laurence M.; Moody, Christopher J. (1989). Experimental organic chemistry: Principles and Practice (Illustrated ed.). Oxford: Blackwell Scientific Publications. ISBN 978-0-632-02017-1.