Combating The Local Drug Distribution In Missouri Essay Sample For College

In times of the raging opioid epidemic and increased recreational drug use, the local police departments need more money and manpower to address the rising challenge. Although young people in Missouri tend to avoid binge drinking, cigarette, and alcohol use, the illicit drug abuse of marijuana, cocaine, inhalants, and meth has increased between 2009 and 2017 (Harris House, 2019). Missourians successfully passed Amendment 2, making the medical use of cannabis legal back in 2018. As Lofton (2019) points out, easily available marijuana without proper law enforcement in place may lead to skyrocketing use of more dangerous narcotics and high financial costs for the state. Drug legalization provided offenders with additional loopholes, while officers are currently outnumbered and possess limited tools to eliminate the street drug market.

Thus, the Jefferson County Sheriff’s Department should apply for a Federally Funded Grant, for the funds to be used towards eliminating the street drug markets in the local community. This will significantly benefit the local community by providing safer neighborhoods and decreasing the local crime rate within the community. It will also give the sheriff’s department the funding needed to create a surveillance and take-down task force team to gather information on the community’s drug markets. Doing this will provide the information and evidence required by the Jefferson County Sheriff’s Department to eliminate the drug markets in the area and ultimately decrease the crime rate due to drug addiction within the community.

To start with, the Jefferson County Sheriff’s Department lacks officers and needed resources. For that reason, the funding opportunities offered by the Department of Justice should be seized by the agency to enhance the public safety experience. An application for a Federally Funded Grant for the comprehensive deterrence program seems to be the most viable solution at the moment. It would be beneficial for the state, local authority, and the whole community. The investment incurred in local law enforcement is expected to provide safer neighborhoods by decreasing the crime rate associated with drug abuse. A new drug deterrence approach will decrease local numbers of larceny theft, violent crimes, property crimes, and driving under the influence. Today police are struggling to deal with the consequences of marijuana legalization and the opioid crisis. Still, a Federally Funded Grant will make it possible to target the reason behind it (illegal drug markets).

In terms of the local police department, the funding is necessary to establish a take-down task force team and surveillance system to monitor and gather intel on the local drug markets. This comprehensive approach must incorporate both soft and hard power to ensure local citizens’ collaboration and involvement. As James Deater highlights, most overdose victims buy drugs, overdose, go to an emergency room, and then again buy medications from the same dealer (Stelter, 2018). The victim’s cell phone data (messages, photos, calls) can be downloaded and analyzed. Although it is not a popular tactic, putting surveillance on such victims usually cuts investigation time, identifies dealers, and even prevents consecutive overdose. Instead of putting physical surveillance, electronic options can also be applied by tracking the victim’s phone. Thus, funding is needed both to expand the department’s staff and acquire the required technology.

Intervention is needed as medical drug legalization brought several challenges to the forefront. Lofton (2019) notes that the main issues are “doctor shopping,” lack of funding and police officers to conduct surveillance, illegal growing at home, and the Amendment itself (the Plain View Doctrine). Cannabis is a gateway drug that sees drug abusers gradually progressing to more dangerous and hard substances like fentanyl, heroin, and meth. The recreational use of easily accessible prescription marijuana often results in robberies, violent crimes, and other unlawful acts. Without proper law enforcement, Missouri’s financial costs will likely exceed the anticipated state revenue from medical cannabis circulation due to inhaled criminal rates and illegal street markets (Lofton, 2019). Monitoring of prescriptions and the seed-to-sale program of licensing are among practical solutions.

To be effective, the deterrence strategy should be comprehensive and well-designed. Frabutt, Shelton, Di Luca, Harvey, and Hefner (2009) proved that focused deterrence is a promising approach that combats drug-dealing in open-air markets. The outcomes of drug market interventions (DMIs) conducted in three cities in North Carolina and Tennessee highlighted the effectiveness of a deterrence-based, pulling-levers framework. For instance, High Point DMI resulted in an 8% drop in violence among treatment groups, whereas the compared census groups saw an increase in violence (National Institute of Justice, 2014). The Nashville DMI caused the narcotic offenses rate to drop by 56% during the next 26 months (Braga, Weisburd, & Turchan, 2019). The rate of most serious crimes (UCR Part 1) has also decreased by 4% in the targeted group, 20% in the adjoining area, and 3% in the entire city. Although the reduction in violent crimes is not significant, similar interventions usually lead to positive outcomes and are worth the effort.

The DMI should be a multidimensional and partnership-based project that balances enforcement powers (prosecution, arrests) and soft power. The latter measures include informing on possible law enforcement sanctions (notification), informal social control, support, and help to those who want to change their behavior. Deep and transparent collaboration is needed between the department and the entire community to enhance social control. Family members and community figures are expected to encourage drug dealers to stop their illegal and socially detrimental activities. In their turn, the entire department conducts an in-depth undercover investigation, puts surveillance on victims, and contacts such individuals’ families. Frabutt et al. (2009) found that stakeholders were encouraged to join the project because of the task force’s considerable contribution to the violence reduction in the community. Focus group participants revealed that such projects contribute to decreased drug dealing, quality of life offenses, and violent crime rates. The collaboration between police and community deters potential criminal behavior and simultaneously eases intel gathering. The Jefferson County Sheriff’s Department can successfully implement a similar structure with some adjustments.

On the contrary, some modern researchers criticize the deterrence approach based on hard power. For instance, Hoss (2020) insists that decriminalization is the best strategy to reduce the crime rates associated with substance use disorder. The current criminal law framework is not sufficient because it fails to address the grassroots reasons, leading to excessive imprisonment that raises federal costs. The high state drug imprisonment rate does not significantly deter drug use and crime, whereas many lower-level offenders behind bars could be rehabilitated instead. As Hoss (2020) explains, criminalization (high incarceration) leads to intergenerational trauma that causes the next generation to repeat their parents’ mistakes. Nevertheless, decriminalization is proved to increase the number of people who consider drug use normal.

To conclude, the legalization of medical marijuana is a challenging step for the state and its citizens. A special program that requires a task force and surveillance staff can be a great solution to the possible drug-related problems. Although well-defined and comprehensive strategies to combat the local drug distribution are effective, they require significant funding and workforce, including the community’s involvement. The Jefferson County Sheriff’s Department should receive a Federally Funded Grant to organize a DMI similar to that held in Nashville or High Point. This drug elimination strategy will help provide safer neighborhoods and decrease the local crime rate within the community.

References

Braga, A. A., Weisburd, D., & Turchan, B. (2019). Focused deterrence strategies effects on crime: A systematic review. Campbell Systematic Reviews, 15(3), 1-65. Web.

Frabutt, J. M., Shelton, T. L., Di Luca, K. L., Harvey, L. K., & Hefner, M. K. (2009). A collaborative approach to eliminating street drug markets through focused deterrence. 

Harris House. (2019). Missouri drug statistics point to increased use by college-aged people.

Hoss, A. (2020). Decriminalization as substance use disorder prevention. University of Toledo Law Review, 51(3), 477–490.

Lofton, J. (2019). Law enforcement problems associated with medical marijuana legalization: A Missouri perspective. Missouri Medicine, 116(4), 265–269.

National Institute of Justice. (2014). Program Profile: High Point drug market intervention. Web.

Stelter, L. (2018). Three surveillance tactics to find and stop opioid dealers. Police1. 

Healthcare Rationing During A Pandemic

Introduction

With limited resources to allocate, healthcare providers often have to make decisions about patients’ life and death. Especially with the covid pandemic, which places a significant burden on the healthcare system, it is essential to correctly assess the patient’s chances of recovery and the outcome of the decision. Thus, it is necessary to consider a set of ethical principles, identify ethical issues and their participants, and follow standards and guidelines to deal with ethical dilemmas effectively.

Ethical Principles, Issues, and Stakeholders

Solving the presented ethical dilemma, it is first necessary to define the ethical principles on which it is based. Healthcare professionals’ ethical behavior includes aspects both in terms of the moral values ​​and principles of professional conduct (1 p. 643). To make ethical decisions, healthcare providers need to use critical and logical thinking skills gathering and evaluating key factors. Ethical principles vary depending on the situation; however, in terms of morality, they include consideration of ‘equality, honesty, diversity, fairness, individual rights, and dignity (1 p. 643). In terms of ethical behavior, in turn, adherence to the responsible authorities’ guidelines is implied. Ethical principles aim to improve the patient’s condition and regulate relations between members of the healthcare system. The emergence of dilemmas can be associated with the rationalization of limited resources allocation, which is illustrated in the presented case.

In the presented case, healthcare professionals need to decide which patient is in a deteriorating condition to provide a ventilator. First of all, the basic beneficence principle is relevant, implying preventing or removing harm, promoting well-being, as well as maximizing good. The principle of dignity is also relevant in the situation since doctors and nurses need to consider the moral values involved. The principle of equality is also essential, which implies the exclusion of discrimination of any kind. The utility principle in the situation aims at maximizing the possible benefit to the patient. Finally, the principle of transparency is important, as health professionals must clearly explain the decision-making process and the factors considered. Although the principle of confidentiality is fundamental to healthcare, during a pandemic, this duty ‘can be superseded by a duty to protect other members of society known to be at risk’ (2 p. 115). Thus, it is necessary to consider a spectrum of basic health principles based on morality and others’ benefit.

To make a decision, it is also necessary to determine ethical issues and the range of stakeholders. The ethical dilemma presented in the case presents the issue of allocating limited medical resources and triage decisions. Therefore, the decision-making process involves primarily health workers (physicians and nurses), patients in need of assistance, and their relatives. Therefore, the decision should be made based on consideration of the ethical principles, the presented issue, and the stakeholders’ interests.

College Practice Standards or Guidelines

Different standards and guidelines often regulate medical workers’ activities, but in the context of a pandemic of a virus new to humanity, their development is challenging. However, access to ventilators in a pandemic is a matter of life and death, which is why many countries offer guidelines for resource allocation (3). These standards aim to facilitate the decision-making process and remove the moral burden of healthcare providers. The prescriptions vary slightly from country to country and are based on criteria of justice and benefit maximization. Existing guidelines shift focus from ‘an individualistic approach to a triage decision-making in the context of the pandemic’ (3 p. 7). All but Canadian standards prescribe a medical criterion consideration in triage decisions (3). However, all guidelines involve considering the patient’s current condition and predictions of short-term and long-term survival, which are difficult to determine in the case of covid.

Age is also a criterion for consideration, but it can be a basis for a decision only in combination with other factors and comorbidities. Thus, age is considered in ‘Australia/New Zealand, South Africa, and Canada in cases of similar ranking, as a tiebreaker’ (3 p. 8). The principle of transparency is indicated in all standards as an integral part of decision-making: the patient and family members must be informed about all key factors. Moreover, the patient’s will and the preferences of his family should be considered when evaluating the situation (3). Thus, in conditions of limited resource allocation during the pandemic, the guidelines narrow the range of principles under consideration to benefit maximization and justice. Moreover, they offer different criteria for assessing the patient’s current condition and making predictions about the beneficial effect of treatment for him.

In a pandemic, resource allocation decisions must follow specific protocols and guidelines based. Thus, if the physician made a decision not to provide the ventilator to the patient by the triage principles, then he will not bear criminal liability (4). Moreover, a medical worker cannot be held liable for failure to provide equipment that does not exist, for example, in conditions of shortage (4). Thus, from a legal perspective, the physician is ordered to make a decision only based on ethical principles.

Steps to Solve the Case

  1. Identify the Facts.
  2. Determine the Relevant Ethical Principles.
  3. Explore the Options.
  4. Act.

The first patient is 82 years old and has no diseases, while the second patient, at the age of 41, has several comorbidities: obesity, type II diabetes. The first patient has no relatives interested in his treatment; the second patient has two children. In addition, the first patient does not have negative habits, while the second patient is a smoker and also has poor diabetes control. Therefore, the ethical issue is to evaluate the effectiveness of providing a ventilator to one of the patients, the prognosis of the chances of recovery, and the negative consequences in case of failure.

In the case of the first patient, the stakeholders are the patient himself, the physician, and the second patient. In the case of the first patient, the stakeholders are the patient himself, the physician, the first patient, and the patient’s family. Relevant ethical principles are justice and benefit maximization, from the physician’s perspective, since other relevant participants’ opinions have not been sought.

Option one: providing a ventilator to the first patient may be justified because he is healthy and can tolerate treatment well; however, his age raises concerns regarding the result. Option two: providing a ventilator to a second patient may be justified due to the younger age and more stakeholders. However, the presence of complicating diseases and smoking raises concerns regarding the effectiveness of treatment. Therefore, the most ethically justified option is the choice of a second patient, since, with a successful outcome of treatment, the physician will help more people, including the patient himself and his family.

Conclusion

It is necessary to document or communicate the decision taken at this stage, including the criteria considered in the decision-making process. Then the physician should develop a plan for the implementation of appropriate measures and carefully evaluate it. It is also essential to involve a colleague who can review the final solution and elicit agreement and disagreement with it. Finally, it is important to understand whether the physician feels comfortable with the decision and whether all the relevant factors were considered.

References

  1. Ahmed A, Ali H, Mahmoud MA. Prioritizing well-being of patients through consideration of ethical principles in healthcare settings: concepts and practices. Sys Rev Pharm. 2020. Web.
  2. Kramer JB, Douglas BE, Piroska KK. Ethics in the time of coronavirus: recommendations in the COVID-19 pandemic. J Am Coll Surg. 2020. Web.
  3. Jöbges S, Vinay R, Luyckx V, Biller-Andorno N. Recommendations on COVID-19 triage: international comparison and ethical analysis. Bioethics. 2020. Web.
  4. Cohen G, Crespo AM, White DB. Potential legal liability for withdrawing or withholding ventilators during COVID-19: assessing the risks and identifying needed reforms. JAMA. 2020. Web.

Dependency And Structuralism Vs Liberal And Neoliberal

Introduction

The dependency theory belongs to radical school of thoughts in international relations meaning departing from conventional acceptable approaches. It is referred to as structural because it analyzes the structure of society, economic structure. The theory assumes that the society is economically determined. The type of economy, its organization and the mode of production influences all forms of behavior. It further assumes that every economy has classes and is capitalistic in nature. Capitalism brings about class divisions, a class is a position occupied by people in the production process. The theory presumes that the state is the committee of a dominant class and it pursues class interest not national interests. This essay compares the tenets of liberalism with those of dependency theory.

Dependency Theory

The theory is utilized in international relations to predict dependency in third world countries. Dependency has been defined as a condition in which the growth and expansion of an economy is conditioned or determined by growth and expansion of another economy. This means that a dependent state cannot experience a self-sustaining development that is; it cannot be self-reliant because its economy is a reflection of the developed state’s economy. The process of dependency is sustained by foreign aid including technical assistance and military aid. The aid does not enhance the economy but it strengthens dependency relations.

The aid further marginalizes the dependent countries since they create permanent debts. Marxists argue that neither mercantilism nor liberalism guarantee human happiness this is because the owners of the means of production control the markets whereas the state is the property of the elite. It therefore postulates that people should determine their own destiny through collectivization of interests (Allen & Thomas, 2000).

Dependency v Liberalism

  1. Liberalism argues that politics and economics have no relationship whatsoever. The market according to liberalists is self-regulating because it operates on its internal logics. It claims that the market offers a diversity of options where consumers whether rich or poor will be accommodated. Dependency on the other hand postulates that the market is the property of the rich, which is used to perpetuate the poor.
  2. Liberalism suggests that consumers and producers require each other to the extent that producers will only make available those goods and services that consumers require from time to time. Consumers and producers check each to arrive at a win-win situation. Dependency is against this market logic because of monopolization. The rich exploit the poor because they produce goods cheaply and make their prices unaffordable by the poor. Workers produce things that they cannot afford.
  3. Liberal thinkers do emphasize that economic activities that are left to the market will spur growth and development because a market environment nurtures competition through enhanced quality. Those that are unable to keep up with the pace are eased out, as stronger providers will replace them. This guarantees mass happiness due to flexibility while at the same time it offers an opportunity for societies to realize rapid economic development. Dependency has a separate opinion. It argues that competition is fair since the owners of the means of production develop some mechanisms that make it hard for the poor to compete in the market. The poor are left with no option but to provide cheap labor.

In conclusion, liberalism remains the only solution to handling market challenges. Many countries, even the communistic ones have capitalistic orientation to the economy. Liberalism is flexible as compared to mercantilism and dependency theories. Liberalism facilitates peace because countries/people that trade together will relate and co-exist very harmoniously. This is because their interests are tied progressively through transactions. According to liberalists, politics is a perpetual struggle characterized by conflicts, intrigues and largely influenced by zero-sum game. One’s gain is another’s loss. Bringing politics to economics is disastrous, it is better if economic activities are left free of political interventions so that their own logic could be the framework of operations (Szirmai, 2005).

In cases where the market experiences some turmoil, the state should only come in if it persists for too long because such instabilities are usually temporary and the market will soon overcome because it is self-checking and regulating. The state therefore comes in only to correct the environment that causes instability. As soon as that is done, the government should withdraw to allow market fundamentals to regain their independence.

References

Allen, T. & Thomas, A. (2000) Poverty and Development. London, UK: Oxford University Press.

Burnell, P. & Randall, V. (2008) Politics in the Developing World. London, UK: Oxford University Press.

Szirmai, A. (2005) The Dynamics of Socio-Economic Development: An Introduction, Cambridge: Cambridge University Press.

Todaro, M.P. & Smith, S.C. (2009) Economic Development. Boston: Addison Wesley

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