The presented case study indicates that George has amyotrophic lateral sclerosis (ALS). This condition progresses gradually and eventually results in motor neuron deterioration and complete loss of coordination and muscle control. Terminal conditions such as ALS call for appropriate care delivery from competent health professionals. That being the case, healthcare specialists should exhibit culturally competent and sensitive dexterities whenever providing medical attention to patients with such conditions (Hasheesh, AboZeid, El-Said, & Alhujaili, 2013). Cultural competence is a concept that guides nurses and medical practitioners to provide unbiased and quality services to their clients. The case of George is quite complicated thereby requiring him to consider a number of options such as euthanasia. Using Christianity and Buddhism as two diverse religious perspectives, this discussion explores how George’s health demands can be met by healthcare practitioners.
Christians believe in a Supreme God. According to them, He is the prime reality. God also created the universe and the world in an orderly manner. This explains why the world is autonomous. Human beings (or Christians) were created by God and should, therefore, be ready to live harmoniously with the world. Humans are complex in nature since they were created in the image of a Supreme Being. In death, a process of transformation takes place whereby humans acquire a higher state (Theofanidis & Mecek, 2016). Christians are guided to live a holy life in order to see God who dwells in heaven. Human beings are also endowed with great abilities. This is the reason why they are able to understand the world and everything around them. They are also capable of differentiating between what ought to be wrong or right. People must do what is righteous and pleasing if their ultimate goal is to be part of God’s kingdom. The purpose and meaning of history are for humans to be able to understand why God created them and the universe in the first place (Hasheesh et al., 2013). With this kind of understanding, human beings can lead a better life and eventually enter His kingdom.
Detailed Ethical Analysis
Christian ethics dictates that human beings should support, love, and take care of each other. This kind of maxim can be used to analyze the unique issues arising from the presented case study. According to Christians, God allows heartaches and diseases in order to prepare men for a better life after death. As a Christian, George will understand that his disease is not the end of life. He should acknowledge that God allows similar conditions so that men can remember their creator, repent, and transform their ways (Monteverde, 2017). Additionally, his friends and family members can pray for him in order to be healed. This is a clear indication that the cultural belief can guide George to strengthen his faith and eventually lead a better life.
From a Christian point of view, the health condition can be a wakeup call to guide George and those around him to strengthen their religious foundations. They will also be willing to guide him to reexamine and analyze his role on earth. Although the disease might be a major obstacle, George can focus on the best practices to make his life meaningful. The people around him will also be willing to support and take good care of him (Nunes & Rego, 2016).
Christianity teaches its followers to be mindful of others including the sick and troubled. Although George’s life might be doomed, Christians will go a step further to encourage him to remain prayerful and always thank God for his good doings. Christians will fast and pray in order to be healed. Additionally, believers will support and offer exemplary services to him (Monteverde, 2017). They will respect his condition and provide adequate care. Caregivers providing medical support should consider this religious perspective in order to ensure quality and culturally sensitive care is available to George.
As indicated earlier, euthanasia is one of the options under consideration in George’s case. It is acknowledgeable that euthanasia remains a widely publicized and controversial subject in the world of medicine. Consequently, a wide range of viewpoints and ethical issues have emerged from the subject. Christians have gone further to explain why human life is worth respecting (Theofanidis & Mecek, 2016). This is the case because life is not given by man but by God. Christian values such as dignity, respect for the autonomous nature of life, love, and care guide Christians to take good care of their fellow believers even when they are sick. Since God gives life, Christians will not be willing to embrace the practice. Consequently, Christianity will encourage George to remain prayerful and empower his relatives to take good care of him. This is the true sign of faith and respect for God’s creation.
From this analysis, it is quite clear that George should not be allowed to think of euthanasia. He should be ready to take good care of himself, pray, and thank God for everything (Monteverde, 2017). His relatives and family members should be on the frontline to support and take good care of him until he dies peacefully.
Buddhism is one of the religious groups that encourage their followers to treat all things as supreme in nature. According to the faith, God is usually impersonal. He is like a force that is ubiquitous in nature. Believers in this faith argue that the surrounding world is fantastical or nonexistent (Watts & Tomatsu, 2014). This means that it is more or less unreal. They go further to indicate that God is everywhere and unites all people. As a result, the reality of humans on earth is meaningful. People, according to this faith, will never die. The believers acknowledge that death is a process characterized by reincarnation. This is a process characterized by a number of stages. The process eventually results in something known as nirvana or oneness (Watts & Tomatsu, 2014).
The forces within the human body are eternal and live forever. In order to know whatever happens around them, humans must detach themselves from their physical bodies and world. By so doing, they can be able to understand the kind of divinity residing in them. A sense of enlightenment is what is usually needed in order to differentiate the wrong from the good or right. Another requirement is that people should overcome ignorance. Such kind of practice will make them good and demystify the meaning of what ought to be right or unacceptable. Buddhists believe that human history does not have any relevance since they are all caught up in a constant process characterized by re-embodiment (Watts & Tomatsu, 2014).
The uniqueness of this religious faith explains why George’s condition will definitely be treated differently. The presence of a degrading health condition in the body is something normal according to Buddhists. George will be required to consider a new kind of enlightenment in an attempt to overcome the disease. According to members of the faith, diseases can arise when people ignore the true nature or meaning of what is believed to be the reality (Monteverde, 2017). Although the disease is causing a lot of suffering, Buddhists will encourage George to reexamine his situation in order to realize the needed enlightenment. This approach will eventually present new strategies that can be used to deal with the condition.
Despite the presence of ALS in his body, the religion will indicate clearly that George is capable of leading a normal life and eventually achieve his objectives. In order to do this, religious faith encourages him to refocus on the idea of enlightenment. This idea can guide the sick to re-pattern their lives and experiences. This ultimate goal should be to create a new meaning characterized by something known as true unity (Theofanidis & Mecek, 2016).
The worldview presented by this religion can offer a number of considerations when focusing on the issue of euthanasia. To begin with, the idea of enlightenment can be used to address the issue because Buddhists are allowed to embrace the most appropriate or preferable goals. This happens to be the case because human beings are integral parts of the universe. Additionally, Buddhism indicates clearly that humans are immortal and live eternally. They can interpret the surrounding world the way they want in order to understand it clearly. Every person will have his or her unique experiences. The past should be ignored since it can offer very little to support the present (Watts & Tomatsu, 2014). With such values, it is agreeable that George will be in a position to embrace the idea of euthanasia. Although the process results in death, Buddhism teaches its followers that death is nothing but a form of rebirth. The ultimate goal is for people to consider what can bring them closer to happiness, enlightenment, and contentment.
The Buddhism perspective indicates that people can overcome sin by considering keenly the nature of reality (Watts & Tomatsu, 2014). This consideration can be applied by followers who want to take good care of their lives. George, therefore, can be empowered by this kind of faith to take control of his life and make the most desirable decisions. Opting for euthanasia will result in some kind of enlightenment. The approach will make it easier for him to withdraw from the physical world and connect with the divinity residing in his soul. The decision will make it possible for George to control his life and attain nirvana.
Hasheesh, M., AboZeid, A., El-Said, S., & Alhujaili, A. (2013). Nurses’ characteristics and their attitudes toward death and caring for dying patients in a public hospital in Jordan. Health Science Journal, 7(1), 384-394. Web.
Monteverde, S. (2017). Nursing and assisted dying: Understanding the sounds of silence. Nursing Ethics, 24(1), 1-14.
Nunes, R., & Rego, G. (2016). Euthanasia: A challenge to medical ethics. Journal of Clinical Research and Bioethics, 7(4), 1-5.
Theofanidis, D., & Mecek, F. (2016). Euthanasia: A healthcare debate for a Greek-Turkish perspective. International Journal of Caring Sciences, 9(1), 321-329.
Watts, J., & Tomatsu, Y. (2014). Buddhist care for the dying and bereaved. New York, NY: Simon and Schuster.
Diabetic Ketoacidosis Disease
Diabetic ketoacidosis (DKA) is a condition that can appear in patients suffering from diabetes mellitus (both type 1 and type 2) and, in most severe cases, may turn out to be fatal if not addressed in due time. Although this type of a hyperglycaemic crisis is rather infrequent, its incidence has increased recently, which raises concerns about the impact of DKA on patients’ state, associated morbidity, and economic aspects related to its treatment. In order to prevent adverse consequences, it is crucial to develop protocols or guidelines that would allow making the appropriate, timely diagnosis and preventing further development of the disease (Skitch & Valani, 2015).
Established clinical criteria are necessary to ensure patient monitoring as well as controlling insulin therapy, fluid resuscitation, and electrolyte replacement. Furthermore, DKA treatment is fraught with a number of side effects and complications that require effective strategies to be addressed. Since the condition is also associated with a high cost of stay (app. $2.5 billion per year for both direct and indirect expenses), profound research is needed to ensure that proper preventive measures are taken, and the treatment is administered successfully at an early stage (Gosmanov, Gosmanova, & Dillard-Cannon, 2014).
In order to be able to assess the success of DKA protocols implementation in different countries, two articles were chosen for the review, one of which analyzes guidelines from Canadian pediatric emergency departments while the other assesses the effectiveness of protocols developed by the Joint British Diabetes Society (JBDS).
The authors of the first study, Skitch and Valani (2015), review DKA protocols across Canada with the purpose of finding their similarities and differences. They hypothesize that all protocols should be consistent with best practices, non-contradictory, and evidence-based. The researchers used the following methodology: They obtained copies of DKA treatment protocols from pediatric teriary centers across the country and performed a comparative analysis, for which information about the initial amount of fluid bolus, insulin infusion rate, maintenance fluid rate, administration of bicarbonate, potassium replacement, etc. was collected and critically evaluated.
Documents from 13 hospitals were analyzed and compared. As a result, the researchers proved that all the collected guidelines were chiefly similar and consistent in the recommendations provided for the identified interventions, although there were some variations in the volume of initial fluid bolus and maintenance of fluid rates. Thus, it was concluded that Canadian pediatric DKA protocols were non-contradictory and ensured the implementation of best practices. Yet, existing variations indicated that further research is required (Skitch & Valani, 2015).
The major strength of the study is its well-structured design and profound statistical analysis. The researchers clearly indicated the parameters used for the comparison and provided a thorough investigation of all the hospitals included in the sample using the selected framework. The results are presented in tables (demonstrative and precise) and are discussed at length. However, there are also certain weaknesses: The number of units under analysis is rather small, and they are all of the same type, which implies that the situation could be different in other Canadian hospitals. Furthermore, nothing is mentioned about treatment practices (Skitch & Valani, 2015). Thus, it is impossible to estimate whether the described protocols are successfully transferred into practice.
The second study, performed by Crasto, Htike, Turner, and Higgins (2015), investigates the implementation of the guidelines developed by JBDS and hypothesizes that they provide a framework for successful management of DKA in adults in the UK. The method used is a retrospective analysis of 50 cases of DKA. The researchers found out that in 46 percent of patients, who developed DKA, potassium supplementation was not administered (as it should be according to the protocol), and only 10 percent received dextrose. However, no cases of complications or deaths were reported despite the violation of the protocols. The authors concluded that in spite of good adherence to the guidelines at the early stages of treatment, there were still lots of areas of concern, such as inadequate fluid management, metabolic monitoring, and iatrogenic hypoglycemia (Crasto et al., 2015).
Unlike previous research, this study is practice-oriented, which is its major strength. Researchers perform a deep analysis of the implementation of DKA in real clinical settings. They use a large number of variables in order to establish the connection between the patients’ condition and their age, sex, duration of diabetes, number of hospital admissions, and the length of hospital stay (Crasto et al., 2015). This makes the audit more accurate and demonstrative. However, the main weakness is that the authors fail to provide detailed recommendations to improve the adherence to DKA guidelines, although some options are enumerated. Furthermore, they do not discuss any possible flaws in the protocols that may account for the fact that they are not followed in practice.
Since DKA is a complex condition that requires immediate management within the first 24-48 hours of admission, it is essential for health care units to have clear and well-defined protocols to address the problem timely and efficiently. The incidence of DKA is growing worldwide, and its morbidity and mortality rates are high (Gosmanov et al., 2014). The major bulk of research is devoted to the investigation of either theoretical implications of the protocols of treatment or the ability of hospitals to implement them in practice. As a result, researchers fail to provide recommendations on how these protocols must be improved to be able to fit real clinical settings, as well as how hospital units should prepare to ensure that all the measures indicated in the protocols are taken. This could be one of the future directions of research.
Crasto, W., Htike, Z. Z., Turner, L., & Higgins, K. (2015). Management of diabetic ketoacidosis following implementation of the JBDS guidelines: Where are we and where should we go? British Journal of Diabetes, 15(1), 11-16.
Gosmanov, A. R., Gosmanova, E. O., & Dillard-Cannon, E. (2014). Management of adult diabetic ketoacidosis. Diabetes, Metabolic Syndrome and Obesity, 7(1), 255-264.
Skitch, S. A., & Valani, R. (2015). Treatment of pediatric diabetic ketoacidosis in Canada: A review of treatment protocols from Canadian pediatric emergency departments. CJEM, 17(06), 656-661.
Asthma Management In Children And Education
Asthma is a common condition in children. Except for medication, treatment should involve other methods to manage the disease. Asthma management is important to maintain a high quality of life. However, the effectiveness of such control depends on the education of patients. The main goals of this paper are to discuss asthma in detail and formulate a PICOT question to guide further research.
Asthma is a chronic medical condition in which the airways in the lungs are always inflamed. Through these airways, air moves in and out of the body (“Asthma,” n.d.). They are called bronchial tubes. Certain things can trigger the symptoms that make these tubes swollen and lead to difficulty in breathing. Usually, such a condition occurs during physical activities. Therefore, people with this type of asthma should avoid exercising. Also, various allergies often accompany the disease.
The prevalence of asthma depends on the region. There are many factors that increase the risk of the development of the disease. Some of them are the environment, genes, and working conditions. However, the disease is more common among middle-income communities. Therefore, the quality of life has a direct impact on the prevalence of asthma. According to statistics, there are approximately 334 million patients who suffer from asthma, and this condition causes 250,000 deaths annually (Smith, 2016). In addition, the prevalence of asthma is still growing.
There are several general manifestations of the disease. One of the most common symptoms is breathing with a whistling sound in the chest. In mild cases, “wheezing is only end expiratory” (Morris, 2017, para. 4). However, if the disease is in the advanced stage, this sound can also occur when inhaling. In addition, asthma might develop without such a symptom. In exercise-induced asthma, wheezing is present after exercising. Also, cough is often a symptom of the disease. Another common sign is chest tightness or pain in the chest.
Asthma can cause complications of different severity. That is why it is necessary to control the disease. Asthma might lead to fatigue, poor work performance, and some psychological problems such as depression or stress. It is very important to get professional health care if the disease affects the quality of life. In most severe cases, asthma can result in pneumonia, a collapse of the lung, or respiratory failure (“Asthma,” n.d.). Some of these conditions may threaten the life of a patient and thus should be immediately treated.
First, a doctor collects information about the family history and lifestyle of a patient. It is necessary to know about the environment in which the patient lives and works. Second, during a physical exam, a doctor looks at eyes, ears, throat, skin, chest, and lungs (“Asthma,” n.d.). Also, the exam might require a lung function test and X-ray of lungs. Finally, it might be necessary to carry out some other tests to rule out differential diagnoses.
Conclusion with PICOT Question
Asthma can be successfully managed so that it will not lead to any serious complications. However, it is necessary to increase medical literacy among patients. It is especially relevant for African American children as many of them live in poor conditions, which increase chances for the development of the disease. However, educational programs should be designed, taking into consideration certain cultural factors that might hinder educational processes. There are various programs that are aimed at teaching patients with asthma to control the disease, but not all of them might be effectively applied to minority communities. Therefore, the following PICOT question might be formulated to guide further research in this area: In African American children (P), will proper education on asthma management (I) compare to no education (C), help to reduce disruption of daily lives (O), over a one year period (T)?
Morris, M. (2017). Asthma clinical presentation.
Smith, Y. (2016). Asthma epidemiology.