Elements of Evaluation Assignment Example | Topics and Well Written Essays - 250 words

Elements of Evaluation - Assignment Example They are reach, adoption, efficacy, maintenance and adoption. Reach is used to measure the depth in which the intervention is exposed to a specific group of people or a community (McKenzie, Neiger & Thackeray, 2012). Adoption is an analysis of the effectiveness of the way in which intervention strategies have been implemented in a certain community setting. The creation of an intervention program should be based on its ability to be adopted to solve a specific problem (McKenzie, Neiger & Thackeray, 2012). The efficacy of an intervention refers to its ability to address the health problem described. An intervention program should also be maintained. Maintenance of an intervention reflects heavily on the evaluation results of the intervention which reflects the durability of an intervention and its ability to maintained and remain relevance in addressing the health problem stated (McKenzie, Neiger & Thackeray, 2012). After obtaining of the results an intervention can be moved forward by using validity, reliability and sensitivity to change. Validity increases the durability of intervention and helps it maintain relevance in addressing the stated health problem (McKenzie, Neiger & Thackeray, 2012). Reliability is the ability to increase the level at which a health issue is dependable on an intervention program to be solved. Additionally, an intervention can be enhanced by increasing its adaptability feature which increases its sensitivity to adapt to incorporate changes (McKenzie, Neiger & Thackeray,

Japanese fiction works are better than Western ones Essay Example for Free

Japanese fiction works are better than Western ones Essay Q:What kind of Japanese fiction works? A:This presentation is mostly about comics and animation produced in Japan, but it covers also TV Shows and movies Topic: Japanese fiction General Purpose: To persuade Specific Purpose: To persuade you that Japanese fiction is better than western fiction regarding comics, animation, movies and TV shows Thesis statement: Although Western people see Japan as a calculating land with brutally efficient workers, they are in fact individualistic, expressive and sentimental if we can judge them from their works of fiction who surpass our own in various aspects Introduction: I. How other countries think of Japan II. Thesis statement III. Reminding the meaning of the terms manga and anime Body: I. First argument: Japans tendency to mix various influences from all over the world A.Japan borrows various foreign things and merges them with other elements B.Example regarding religion of Japan C.This tendency in regards to fiction II.Second Argument: How Japanese portray life, human relations, nature and the world in their fiction works A.Human nature is portrayed as it is B.Japans popular culture has a tight closeness to the ordinary, everyday lives of its audience C.Manga on any theme imaginable and toward any age range D.How human relations are portrayed III.Third Argument: Heroes fate after their struggle, death and the morality of the universe in Japanese fiction A.What defines a hero in Japan B.Death in japanese fiction C.View of the universe as amoral IV.Opposition/Refutation A1. Pornographic themes in manga and anime A2. Refutation B1. Japans cultural insularity robs it of relevance for other societies B2. Refutation Conclusion: I. Quote from Antonia Levi If someone will say that Japanese people are imaginative, sentimental, expressive and individualistic might earn him strange glances in most countries of the world. Many Westerners see Japan as a cold, calculating land of ant-like workers with brutal efficiency. Students are seen as oppressed slaves to their studies, pounded down like nails until their imaginations and individuality are crushed, or until they are driven to suicide. Japanese social culture is often seen as blanketed under stifling layers of politeness and formality, characterized by endless bowing. However, underneath all these there is the hidden Japanese soul. Almost all of the Japanese escape from reality through fiction works. These domestically created fiction works be it comics, animation, movies or TV shows enjoy great popularity not only in Japan but also in many countries of the world. Therefore, because these specific works are strikingly different from what were used to here in the Western world, it is inevitable to compare these two: the Western fiction works and the Japanese ones. Hello, everybody, my name is I will talk to you about Japanese fiction works and I will compare them to Western ones so as to enforce my opinion and persuade you of course, that Japanese fiction is better than Western fiction. Before starting, I want to make you acquainted with two terms. Manga, which is used to refer to the Japanese comics and anime, which refers to the Japanese animation. As a first argument, I have to inform you that Japan has the tendency to borrow various foreign things and to tinker with them, merging them with native or other elements so that they become something new and often quite distinct from the original. As an example, regarding religion, Taoism was the original religion of Japan but this didnt stop Japanese people from accepting Buddhism as well, and even acquiring some aspects of other religions in addition, like Christianity. In works of fiction this tendency of the Japanese means new and non-static entertainment through mixing different influences from around the world without having to suffice only to the myths and the influences of their own country. For my second argument supporting Japanese fiction, I want to inform you about the way Japanese portray life, human relations, nature and the world in their fiction works. The world and human nature in Japans pop culture can be portrayed as they are, not as they should be. This allows Son Goku, Dragonballs raised in the wild, central character, to be drawn naked, without the private parts-covering fig leaf that had to be added for American TV. It allows as well, the darker side of life to be portrayed. In an episode of Naniwa Kin Yudo, which is an anime TV series, the protagonist Haibara encourages the girlfriend of a customer, who cannot repay his loan, to work as a prostitute to cover her boyfriends debt. Scenes such as this can be disturbing but they are part of life and are neither denied nor hidden. Kazuhiko Torishima, editor of Japans best-selling comic magazine Shonen Jump states: I feel sorry for U.S. kids, who live in an adult-filtered Disney world. Moreover, Japans popular culture has a tight closeness to the ordinary, everyday lives of its audience. American comic artist Brian Stelfreeze has said: Comics in the U.S. have become such a caricature. You have to have incredible people doing incredible things, but in Japan it seems like the most popular comics are the ones of normal people doing normal things. Part of the normalcy is that the characters that populate Japans manga, anime and TV dramas display plenty of character flaws and weaknesses along with their strengths and good points. Furthermore, as Ian Reader, a scholar of Japanese religions and popular culture, has noted: Manga are simply too fascinating, colorful and rich a literary medium to be left solely to children. In Japan one can find manga on any theme imaginable and toward any age range. which is certainly not the case with American comic books. In addition, Timothy Craig which is an author, writes in his book entitled Japan Pop! that, human relations are a pervasive topic in Japanese pop culture, as one would expect from a society that places great importance on the group, harmony, and the smooth management of conflict. Human relations are also portrayed with a sophistication that does justice to the complexity of human affairs. Issues are many-sided, emotions are mixed, solutions are neither easy nor obvious, and outcomes are often ambiguous not unlike real life. He continues by saying that, in Japanese fiction the human characters are more real. They  exhibit a fuller range of human emotions and are put into more realistic situations, sometimes with unpleasant outcomes, than allowed by Disneys perfectly preserved, stiflingly safe fairytale-based storylines. For my last argument I will talk about heroes fate after their struggle, about death and the morality of the universe and therefore god, in Japanese fiction. We here in the Western world, are used to good being only good and be rewarded in the end and evil being only evil and be punished in most of the cases. This is not the case in Japanese culture. Its not unknown in Japan for heroes to become villains and vice versa. Moreover, the Japanese hero is defined by motivation than in the West where heroism is more dependent on result. The ideal Japanese hero is not only self-sacrificing, but also unconcerned with personal gain or survival. The heros willingness to give his or her all to it is what counts. Winning doesnt matter either. Losing and gaining nothing confirms the heros altruism and renders his or her sacrifice all the more tragic. Many characters also, meet meaningless, undeserved ends. And fans love that aspect, the fact that bad things, even death, can happen to any characte r at any time. It doesnt matter how brave, how good, or even how popular they are. According to my opinion, this fact is absolutely in accordance to how our own world works. Death and bad things generally, can be around the corner for any person, no matter how kind or good-willed he or she is. According to a book by author Antonia Levi titled Understanding Japanese Animation that doesnt happen on American TV where virtue is rewarded and evil is punished. Thats mainly because America is a Christian culture that believes that the universe is, or it should be, a moral place. The Japanese peoples take on this is that universe is amoral. Shinto as well, has no moral code at all! It simply celebrates life. Heroism and self-sacrifice may define a japanese character as a hero, but they will not save him or her. The universe simply doesnt care. On the opposing side now and regarding manga and anime specifically, some of you may have noticed and may say that a lot of these works have pornographic themes. Wrong. According to the author of the book Understanding Japanese Animation these works are actually a very small portion of the total production of Japan in manga and anime that is disproportionately exported  to the Western world. Another opposition stated by quite a few people, expresses that Japan is a one-dimensional economic power marked by a cultural insularity that robs it of relevance for other societies. Wrong again. The success and presence of Japans cultural exports in countries apart from Asian ones such as U.S.A, Canada and most of the European countries is strong evidence that Japans culture does have relevance for other societies. To conclude, and quote author Antonia Levi, its not just that Japans pop culture deals with dilemmas in a more realistic fashion, or that it raises issues considered taboo in other countries. Its willingness to show death and other bad stuff restores a kind of tension, a genuine dramatic emotionality that Hollywood and TV seem to have forgotten about. Bibliography: Clements, Jonathan and Helen McCarthy. The Anime Encyclopedia: A Guide to Japanese Animation Since 1917 Stone Bridge Press, 2001. Craig, Timothy. Japan Pop: Inside the World of Japanese Popular Culture East Gate, 2000. Levi, Antonia. Samurai from Outer Space: Understanding Japanese Animation Carus Publishing, 1998. Patten, Fred. Anime Stereotypes. Newtype, Issue Dec.2003 A.D.Vision Publications. For my third argument supporting my opinion, I will talk about the presence of female heroes in Japanese fiction. In the Western world apart from such exceptions as Wonder Woman, She-ra and Xena the role of superhero has traditionally been reserved for males, and targeted a predominantly male audience especially in comic books. This is not the case with Japanese  fiction. Japanese dont neglect females be it on the starring roles of their fiction works or as a target group audience. In manga specifically, there exists a separate genre called shoujo manga with many sub-genres itself, which raises issues and has stories related and devoted to women. The presence of females as featured heroes in manga, animation and TV shows has been much stronger in Japan than in the western world. As the book Japan Pop specifically reports: in Japan girl heroes are now as common and popular as boy heroes. The reasons for this are complex and, while hardly due to a greater feminist consciousness in Japanese society, are clearly linked to the increase in recent years of female artists.

Long Term Conditions Principles Of Care Nursing Essay

Long Term Conditions Principles Of Care Nursing Essay When you leave the clinic, you still have a long term condition. When the visiting nurse leaves your home, you still have a long term condition. In the middle of the night, you fight the pain alone. At the weekend, you manage without your home help. Living with a long term condition is a great deal more than medical or professional assistance. Harry Cayton, (DH, 2005a) This essay will provide a critical account of the health requirements of a patient suffering from a long term condition. It will concentrate on the experience of caring for a patient with type 2 diabetes, within the community. It will consider government policies and guidelines which relate to the management of diabetes, and the role of the district nurse. The Nursing and Midwifery Council (NMC, 2008) Code of Professional Conduct Guidance has been maintained throughout this essay and therefore, all names have been altered for the purpose of confidentiality and anonymity. Currently in the UK there are over fifteen million people in England reported to be living with a long term condition. (DH 2009), of these it is reported that 2.6 million people are diagnosed with diabetes. This has increased since 1996 from 1.4 million (Diabetes UK 2010), and over 500,000 more whom are unaware that they have it. It is also predicted that by 2025 over four million people will have diabetes, with the majority having type 2 diabetes. According to Clinical Knowledge Summaries (CKS) (2009) the risk of developing type 2 diabetes increases with age, possibly because as people age they become less active, gain weight, and this affects their mobility and weakening their circulatory system. However this notion is relatively weak as whilst white people over the age of 40 are prone to developing the illness, ethnic minority groups are affected from age 25 years upwards (Diabetes UK 2006). This distinction suggests that diabetes may relate to dietary choices. Another possible ex planation for the development of type 2 diabetes is a genetic link, where people are more likely to develop diabetes when a close relative already has it. Mary is a 61 year old afro-Caribbean lady whom had recently been diagnosed with type 2 diabetes. She lives alone since her husband died 10 years ago. She has no family in this country, and does not have many friends, more acquaintances. Mary had recently sustained a fall, fortunately nothing was broken, but she had suffered with severe bruising and loss of confidence. Her G.P. had been concerned about her and had asked the district nurses to monitor her blood sugars and blood pressure due to already diagnosed hypertension which she takes medication for. On assessment it was identified that Mary has been finding it hard to accept her diagnosis; she was hoping that her G.P had made an error. Hicks (2007) explains that it is not unusual to see denial in a hearing a diagnosis. Dunning (2009) goes on to say it can be appropriate in the early stages so that it enables people to keep a positive attitude and as a coping mechanism. However prolonged denial can cause future problems and possible neglect of warning signs that the condition is worsening. Marys knowledge of diabetes is very poor and her perception is that eventually everyone that has it will have to have injections, go blind, have something amputated and then die. She also stated that the only dietary advice she had been given was to stop eating sweets and food with sugar in. She had been finding it difficult to stick this as she found that most of the food she enjoyed had sugar in, she had also been told to eliminate fruit from her diet as someone told her that it was also high in sugar. Mary reported that she has started to feel low in mood and that she was feeling anxious about her bleak future. Lloyd (2008) states people with diabetes are twice as likely to have depression as those who dont. She goes on to say recent research has shown that this can have a detrimental effect on glycemic control, on self-management of diabetes and on overall quality of life. Evidently Mary has very limited knowledge of her diabetes this in turn has had a negative impact on her psychological well being. The integral place of psychological care, within a holistic approach to diabetes care, is recognised in the National Service Framework (NSF) for Diabetes (2001) where it states that The provision of information, education and psychological support that facilitates self-management is therefore the cornerstone of diabetes care'(p22). Similarly the National Institute of Health and Clinical Excellence (NICE) (2003) reports that diabetes professionals should have appropriate management and detection skills of non-severe psychological disorders, whilst being able to identify and arrange prompt referrals of people with significant psychological difficulties that can interfere with their well-being or diabetes self-management. From Marys assessment it was established that she was not in need of an urgent psychological referral, and that possibly an appropriate edu cation programme would facilitate Mary with the information to be able to understand and manage her diabetes. As acknowledged by the DH (2005b) patient education is designed to improve knowledge, skills and confidence, enabling people to take more control of their condition and assimilate self-management. Siminerio (2008) continues to say that due to the complexity of managing diabetes the patient will require health professionals to support with the appropriate amount of time and long term support to ensure self-management is achieved. Due to the interpersonal nature of their duty, district nurses play a crucial role in the primary care of those suffering from long term illnesses. Cook cited by DH (2005b) states Caring for people with long term conditions is a key part of community nurses (p5). Their home visits and interaction with patients, provides emotional support by developing close trusting relationships, and quickly identify health problems. Nevertheless, recent government policies implemented aim to improve the quality of patient care, reduce the number of hospital patients and deliver more health care to patients at home. However, due to the aging population and the demand for community care is increasing thus putting extra strain on the already full caseloads, resulting in a breakdown of strong patient-nurse relationships. Instead continuity of care may operate primarily through partnerships, shared nursing roles and the involvement of social services, voluntary agencies and NHS organisations. Even before we can really consideration of how Mary receives health promotion advice, there should be consideration for her receptiveness and readiness to receive that advice. Prochaska and DiClementes model of change (1984) (Budd and Rollnick 1996) (appendix 1) is a good example of this. Mary is in denial. It is hard to imagine that she could ignore the severity of diabetes along with the associated risks. However, this could have been to do with possible poor advice from the onset of her diagnosis or through fear (or possibly other reasons) but she has been in denial. This particular episode care following her fall and meeting with the district nurse may well be the catalyst that Prochaska and DiClemente refer to in generating a perceived need to change. Realisation of this fact should be a useful tool for any healthcare professional to capitalise on when endeavouring to manage the change process (Nickols 2004). Colin- Thome (2010) states Delivering improvements for people with long term conditions isnt just about treating illness, its about delivering personalised, responsive, holistic care in the full context of how people live their lives. In 2000 the Labour government introduced a strategy to reform the NHS. The National Health Service Improvement Plan, aimed to modernise services, raise standards, tackle under funding and make a shift towards patient centred care (DH, 2000). A key strategy to emerge was the introduction of the National Service Frameworks in 2001. Â   The NSFs were designed to bring health care in all areas to an acceptable national standard (NSF 2001). They aimed and put a stop to discrimination, offer provide person centred care, and access to fair and prompt services appropriate to peoples needs (Dimond 2008). Â   They also intend to respond to the experience and concerns of service users, use resources efficiently to achieve the greatest possible benefits and promote peoples health and independence. Standard One of The NSF for Long Term Conditions (2005c) requires healthcare professionals to deliver person centred care. Person centred care is seen as a key objective in healthcare. It lies at the heart of a number of policies and government strategies aimed at providing and improving personalised care, such as High Quality Care for All (DH, 2008) and Our Health, Our Care, Our Say, (DH, 2006). The Royal College of Nursing (RCN) (2007) describes person centred care as care which is safe, effective, promotes health and wellbeing and helps to integrate patients into todays society and community. Person centred care also informs, empowers, is timely and convenient (McCabe and Timmins, 2006). It is an approach which integrates patient ideas, expectations, beliefs, values, culture, emotional needs and social perspectives whilst ensuring mutual participation in a shared decision making partnership (Antai-Otong, 2006). The strategy of empowering and educating the patient is thought to be amongst the most useful (Peile 2004). Mary is far more likely to comply with a treatment regime if she understands the regime, the reasoning behind it and is given the tools to achieve it. (McDonald et al 1999). Empowerment and education is an important concept in patient management and has been widely used over a huge range of clinical issues (Kelly 2002). It will be particularly useful for Mary, not only with regard of accepting she has diabetes, but with the whole question of her diabetic control as well (Gadsby 2005). Mary will almost certainly have a large number of questions and concerns that she should be encouraged to raise, as understanding is a vital ingredient of compliance (Marinker 1997). District Nurses must act as teachers and counsellors, helping patients regain independence by showing patients or carers how to confidently perform care-giving duties in the absence of the nurse. Therefore play an indirect but crucial role in keeping hospital admissions and readmissions to a minimum. When educating a patient with diabetes, care must be taken to ensure that they recognise that diabetes is a progressive condition, and that their requirements will probably change during their life. Expert Patient Programmes (EPP) (DH 2007) are a valuable opportunity for individuals living with diabetes to learn more about how they can manage their condition, better themselves and not rely so heavily on healthcare services. They have been proven to be beneficial and involve lay members who nurse patients. Reports suggest they have been considerably successful at regaining patients independence (DH, 2007). It has been suggested that accident and emergency attendances could be reduced through the use of expert patient programmes, along with individuals accessing out of hours general practitioner services (EPP 2009). However, The Healthcare Commission found, following a study that in two thirds of Primary Care Trusts (PCT) 20% of people or less had been offered courses, even though there were structures of education and training in place. In half of the trusts, 10% of people reported to going to a course. Overall the reporting of attendance varied from 1% to 53%. There was also no consistency of the length, content and style of educational. Some were unstructured, not evaluated and were delivered by insufficiently trained staff. If the correct education programme is enforced then Mary would be able to manage her own care with support from the community team. Self management is seen as an integral, even central part of the system of care provided to people with long term conditions and can be instigated through the implementation of expert patient programmes (Davidhizar, 1998). The British Diabetic Association (BDA) (2005) also suggests that the overall aim of diabetes management is to enable people with diabetes to achieve a quality of life and life expectancy similar to that of the general population (p5), ensuring high quality equal care to ensure the provision of appropriate information and education to enable people with this condition to maximise their wellbeing. Kozier et al continue to explain that supported self care management refers to the individuals ability to manage their symptoms, treatment, physical and psychological consequences and lifestyle changes inherent in living with a long term condit ion (2008). Also through working in a multidisciplinary approach, different professionals can collaborate with each other in order to benefit the patient and deliver person centred care (Lethard, 1994). Nevertheless, education alone is frequently not enough. Merely providing information often does not lead to a change in behaviour. If there is a continuation of motivational struggles and unwillingness to change Prochaska and DiClemente suggest using motivational interviewing to try and over overcome this (Nickols 2004). This looks at encouraging and supporting people in adopting new behaviours. The district nurse would support the Mary whom is struggling with ambivalence about change. Encouragement is used so that there is recognition and action to move to the action stage, this where they can start to understand and feel able to change (Gallagher and Scott 2006). However, Bundy (2004) does go on to say this can be seen as quite challenging and can have elements of being confrontational. This process needs to be executed wisely, and there needs to be a relationship with trust for it to be beneficial. This can take time and as recognised previously there may not be continuity of care with the same nurse. Furthermore, care planning is also a key part of managing long-term conditions, and its importance has been stated in a number of major policy documents. The final report of Lord Darzis, High Quality Care for All, NHS Next Stage Review, (2008), stressed that over the following two years, everyone with a long-term condition should be offered a personalised care plan. In February 2008 the National Diabetes Support Team (2008) produced its guide to implementing care planning in diabetes Partners in Care and is also working with Diabetes UK and other key partners to determine ways to support the NHS in embedding the principles of care planning into the delivery of diabetes services (NSF 2008). It has been reported that Primary care is getting better at managing diabetes and one of the outstanding achievements of the Quality and Outcomes Framework is the rising numbers of diabetics receiving essential tests and measurements (for example, blood pressure and cholesterol). The results of those tests have also indicated health improvements, however an important fact is the 2005/6 National Diabetes Audit (Healthcare Commission 2007) found that not everyone is receiving every care process that they need thus indicating that there is still gaps in care. The theme of the final report of the NHS Next Stage Review acknowledged that too few people have access to information about their own care (NSF 2008). It is imperative that the person with diabetes has as much information as possible to allow for maximum utilisation of their time with the healthcare professional. The Department of Health recommend that measures can be taken to improve the lives of diabetics. Although diabetes currently cannot be immediately cured, by using medication and other therapies it can be controlled (2005a). Mary will have to be closely monitored to ensure that she is compliant with her management of diabetes. As has been demonstrated there are many interventions which district nurses can undertake. However, for Mary to have the best possible care a collaboration of multi disciplined professionals need to par-take in a proactive role in the holistic treatment of diabetes. The governments aims are to support people with long-term conditions by delivering recommend changes that will help people. This is particularly vital as the long term compliance of the person with diabetes is essential to prevent and delay complications, as diabetes is estimated to account for at least 5% of UK healthcare expenditure (DH 2008). In conclusion, it is clear that the key role of all health professionals requires knowledge and understanding of issues and policies to support patients. Furthermore, this role requires a detailed knowledge of inter-professional and multidisciplinary working. Â   It requires high levels of communication skills, diplomacy and assertiveness. Health professionals also need to have knowledge of service delivery systems to enable them to carry out their role and to provide their patients with an efficient and seamless service

Tarasoff v. Regents of University of California

Tarasoff v. Regents of University of California An ethical dilemma alludes to the mental conflict that emerges from differing moral goals. Confidentiality and the safeguarding all private information is essential in healthcare especially about the treatment of mental illness. Because of the privatization of mental health treatment coupled with the closing of many state institutions, emergency department doctors and nurses are often faced with patients who are a danger to themselves, family members.   A breach in privacy can negate the trust between the provider and the patient and lead to negative outcomes and legal issues however, concern for public safety must also be considered. The duty to warn others of the potential commitment of violent acts came to the forefront of healthcare in 1974(amended in 1976) in the case of Tarasoff v. Regents of University of California (Henderson, 2015). Details of the case Tarasoff v. Regents of the University of California, was a landmark case that dealt with the duty of mental health providers to notify those individuals who are threatened with harm. The Supreme Court in California heard The Tarasoff cased, which dealt with a complex area of tort law regarding duty owed of a medical provider to an individual to whom a threat of harm has been made. In 1969, while attending the University of California, Berkeley as an exchange student, Prosenjit Poddar met Tatiana Tarasoff.  Ã‚   After the demise of the relationship, Poddar became increasingly despondent and obsessed with Tarasoff. During this time, Poddar began outpatient treatment and was subsequently diagnosed with paranoid schizophrenia by a psychologist at Berkley, Dr. Lawrence Moore. It was during one of the treatment sessions, Poddar that discussed his intention to harm an unidentified female. Although the intended victim was not named directly, Tarasoff was easily identified.   Dr. Moore, concerned for the safety of Tarasoff, requested to have Poddar detained by campus police. Dr. Moore then requested to have Poddar involuntarily committed, believing that he was suffering from an acute episode of paranoid schizophrenia. Poddar was detained by campus security but was released after a brief interview during which time he answered questions rationally. Poddar was warned to stay away from Tarasoff with no further action taken. After the release, Dr. Harvey Powelson, medical ordered the destruction of all notes taken by Dr. Moore as well as the returns of all letters from the police.   Tarasoff nor her parents were not notified of the threat. On October 27, 1969 Poddar viciously attacked Tarasoff, causing her death. Tarasoffs parents filed a lawsuit against Dr. Moore and employees at the University alleging that Poddar had confided his intention to kill Tarasoff, Additionally Dr.   Moore nor his associates failed to warn the Tarasoff family of the imminent threat against Tatiana. At trial, Poddar was convicted of second-degree murder.   The wide-ranging implications of the case focus on the health care provider-patient relationship. Because of this landmark case, health care providers have the duty to protect potential victims from harm caused by the patients under their care. As of 2014, thirty-three states have instituted a duty to warn law (Henderson, 2015). Defendants Argument Dr. Moore argues mental health providers cannot with certainty predict the likelihood that a patient with act on threats of violence. Dr. Moore and the medical team further state that a breach in confidentiality will have detrimental effects on treatment. Further, the act of warning by revelation of confidential information would constitute a breach of trust. Plaintiffs Argument Tarasoffs parents argued that Dr. Moore violated the professional standards by neither warning them of a patient considered to be dangerous, nor detaining a patient considered to be dangerous. The defendants also asserted that Dr. Moore and others abandoned a patient deemed dangerous by ordering the destruction of all therapeutic notes. The plaintiffs further argued that Dr. Moore failed to provide adequate follow up care with Poddar to ensure he was not a danger to himself nor the public. Summary of the ruling The ruling by the Supreme Courts required a balance between the need to protect privileged medical communication between a mental health provider and the patient to protect against potential threats.   The special relationship in this case is the one that is established between a patient and his mental health provider. Such a relationship may increase obligations of protection. A duty of care may arise from the establishment of a special relationship between the health care provider and patient which imposes a duty upon the clinician   to control the patients conduct, or a special relation between the provider and the other individual, which gives to the other a right of protection (Bersoff, 2014).   This relationship was crucial to the ruling regarding the circumstances of the Tarasoff case. When a health care provider has direct or indirect knowledge of information that a reasonable individual may determine that a patient may harm himself or others, this provider must exercis e reasonable and prudent judgement to prevent harm. The court in California ruled that mental health professionals have an obligation to both the patient and individuals who are threatened by a patient. Justice Mathew Tobriner ruled that protective privilege ends about public safety and further states that mental health providers should notify the authorities as they are charged with public safety. Lastly, about the liability of the officers who failed to detain Poddar, the court held that a public employee cannot be found liable for an injury resulting from a discretionary decision. Therefore, the police officers involved were granted immunity from prosecution. Summary argument The plaintiffs in this case presented the best legal argument. For example, the psychiatrist is found to violate the professional standards. Dr. Moore was to be held liable for the failing to protect and warn. Regardless of whether the plaintiffs interests are qualified for legitimate protection from the defendant under the law is relative to the establishment of a duty to care. Obligation of care is the aggregate of foreseeability, degree of certainty of harm to the individual, establishment of a special relationship. Once a health care provider, in this case psychotherapist, determines that a patient represents a genuine peril, he bears a lawful obligation to his patient, as well as to his patients intended victim. The pros and cons of the argument on each side By notifying the police, the provider tried to detain the defendant and protect the public after he became aware of an acute episode of paranoid schizophrenia. He did not warn nor protect the intended victim which eventually led to her death. Thus, the ruling was made in favor of the plaintiffs, the parents of Tatiana Tarasoff.   Despite the defendants argument that the more public good would be accomplished through the support of mental health treatment and complete protection of confidentiality of patients undergoing treatment. References Bersoff, D. N. (2014). Protecting victims of violent patients while protecting confidentiality. American Psychologist, 69(5), 461-467. http://dx.doi.org/10.1037/a0037198 Henderson, E. (2014).   Potentially dangerous patients: A review of the duty to warn.   Journal of emergency nursing, 41(3), 193-200. http://dx.doi.org/10.1016/j.jen.2014.08.012 Tarasoff v. Regents of University of California. (2009). Scocal.stanford.edu. Retrieved 11 February 2017, from http://scocal.stanford.edu/opinion/tarasoff-v-regents-university-california-30278

Struggle in The River Between Essay -- River Between Essays

Struggle in The River Between  Ã‚   In the book "The River Between" we find traditional values of the tribe challenged by tribal members who had converted to Christianity. The novel focuses on the struggle between two conflicting interests: First there was the interest to convert Africans to Christianity, and the second was the tribe trying to keep their traditional values in the midst of Christianity. The most contrasting characters in the story were Waiyaki and Joshua. Waiyaki was a strong influence on the people of the land, and his father, Chege, was a man who had powerful visions of his son's future: "Salvation shall come from the hills ... Arise. Heed the prophecy" (Pg. 20). Waiyaki’s father put the burden of this prophecy on his son's shoulders. The realization of his role in this prophecy happened to Waiyaki in the end of the novel: " ... the journey with his father, the ancient prophecy and his bewilderment at its meaning" (Pg. 138). "Now he knew what he would preach if he ever got another chance: Education for unity. Unity for political freedom" (Pg. 143). Chege told Waiyaki to learn from the white people, but not to become involved in their vices: "Learn all the wisdom and all the secrets of the white man. But do not follow his vices" (Pg. 20). Waiyaki began to learn that knowledge and learning was important in order for his people to become victorious over the invasion of the white man. Waiyaki also understood that the traditions o f the tribe is what kept their people together, it was their roots: "Circumcision was an important ritual to the tribe. It kept people together, bound the tribe ... End the custom and the spiritual basis of the tribes cohesion and integration would be no more" (Pg. 68). And even tho... ...ormed, so the Western revolutions in both religion and government were gladly accepted by the Western cultures. But the Western invaders never realized how old these civilizations were that they were intruding upon, and they never realized that African, Chinese, or American Indian's cultures were thousands of years old. Western cultures have impacted many countries, such as India, for when the ancient invaders came to the land, such as the Aryans, eastern Indians accepted some of their beliefs, and they were even integrated into Indian society. But when modern Western cultures came into contact with India, particularly the British, they eventually took over the government and made the Indians second rate citizens. And until the 20th century India was under their control. So Western cultures have definitely had an influencing impact on other cultures.       Struggle in The River Between Essay -- River Between Essays Struggle in The River Between  Ã‚   In the book "The River Between" we find traditional values of the tribe challenged by tribal members who had converted to Christianity. The novel focuses on the struggle between two conflicting interests: First there was the interest to convert Africans to Christianity, and the second was the tribe trying to keep their traditional values in the midst of Christianity. The most contrasting characters in the story were Waiyaki and Joshua. Waiyaki was a strong influence on the people of the land, and his father, Chege, was a man who had powerful visions of his son's future: "Salvation shall come from the hills ... Arise. Heed the prophecy" (Pg. 20). Waiyaki’s father put the burden of this prophecy on his son's shoulders. The realization of his role in this prophecy happened to Waiyaki in the end of the novel: " ... the journey with his father, the ancient prophecy and his bewilderment at its meaning" (Pg. 138). "Now he knew what he would preach if he ever got another chance: Education for unity. Unity for political freedom" (Pg. 143). Chege told Waiyaki to learn from the white people, but not to become involved in their vices: "Learn all the wisdom and all the secrets of the white man. But do not follow his vices" (Pg. 20). Waiyaki began to learn that knowledge and learning was important in order for his people to become victorious over the invasion of the white man. Waiyaki also understood that the traditions o f the tribe is what kept their people together, it was their roots: "Circumcision was an important ritual to the tribe. It kept people together, bound the tribe ... End the custom and the spiritual basis of the tribes cohesion and integration would be no more" (Pg. 68). And even tho... ...ormed, so the Western revolutions in both religion and government were gladly accepted by the Western cultures. But the Western invaders never realized how old these civilizations were that they were intruding upon, and they never realized that African, Chinese, or American Indian's cultures were thousands of years old. Western cultures have impacted many countries, such as India, for when the ancient invaders came to the land, such as the Aryans, eastern Indians accepted some of their beliefs, and they were even integrated into Indian society. But when modern Western cultures came into contact with India, particularly the British, they eventually took over the government and made the Indians second rate citizens. And until the 20th century India was under their control. So Western cultures have definitely had an influencing impact on other cultures.      

The Diary of Anne Frank Essay examples -- English Literature

The Diary of Anne Frank In this project, I will be comparing the life of Anne Frank to mine. Firstly, I will give a brief timeline of the main events that took place in her lifetime. Then I will begin to compare the various aspects of her life to mine. Finally, I will draw up a conclusion. Annelies Marie Frank was born in Frankfurt, Germany, just 60 years before I was, 1929. During the first three years of her life, The Great Depression happened. The National Socialist Party began to gain support. In 1933, Hitler was made Chancellor. This was the same year that Otto Frank and his family moved to Holland. A year later Anne began school and in 1935 â€Å"Juden Verboten† (â€Å"No Jews†) appeared on signs in restaurants and shops all over Germany. Later that year, the Nuremburg Laws were introduced. I can’t imagine what it would be like to know that I wasn’t wanted in my home country. This was only the first hurdle for Anne, many were yet to come. Before Anne was thirteen, she had been sent to a special school because of her religion and World War II had started. When Anne’s thirteenth birthday came, she received a diary that changed the way millions of people now think. A month later, her sister, Margot was called to report to a transit camp. It was then that Otto Frank saw the sign he needed to take the family into hiding. They were in a secret annexe above the Opekta-Works in Amsterdam. Altogether with the Van Daan family and Mr Dussel the dentist there was eleven people. Through the two years they were in hiding, millions of Jews were being taken to concentration camps to be killed. Anne lived in constant fear. August 1944, the group in hiding are betrayed and split up into various concentration camps, ... ...could come down and have hour long conversations with people I’ve never met before. Hearing what Anne went through though makes me wonder how a seemingly insignificant book kept her sane and positive for that amount of time. August 4th, 1944. Just sixty years ago this year, the eleven were betrayed. Nazi soldiers came storming up and took away everyone in the room. They all went to concentration camps like Auschwitz. After a month they were all separated, after a year ten were dead. This makes me angry, the fact that they managed to stay alive for so long to be killed anyway, because of one man. Hitler. The story of Anne Frank shows to me that the authority Hitler had made a fourteen yr old girl physically break down. The story shows just how oppression is converted into depression. The pressure in her mind was released by conferring with her diary.

Sin Taxes

Principles and Processes of Government Budgeting| Sin Taxes, Good or Bad? | An Examination of the Use of Sin Taxes in the United States| By: Stacy Madden4/27/2012 | Executive Summary Historically sin taxes have been an effective and efficient way for the government to raise revenue. The federal government used tariffs and consumption taxes to generate almost all of its revenue in the early years of our nation. The tax structure and philosophy has evolved and changed since the beginning of our nation, however the use of sin taxes has remained a good way for governments to raise revenues.Sin taxes no longer provide a significant portion of federal or state governments; however they do provide a consistent stream of revenue. This paper examines the use of sin taxes in the United States. First, the paper provides a basic understanding of sin taxes, current definition, and history. Next, the paper outlines the goods and services most commonly targeted by sin taxes and provides information about the effectiveness of these taxes to raise revenue and accomplish policy outcomes.Common goods and services targeted by sin taxes include; tobacco, alcohol, fuel, hazardous chemicals, gambling, prostitution, pornography, and unhealthy foods. Lastly, the paper will examine the ethical and moral implications of sin taxes from the perspective of those who support and oppose the use of sin taxes in the United States. Introduction Ben Franklin adequately stated the importance of taxes with his famous quote, â€Å"but in the world nothing can be said to be certain except death and taxes. Citizens have vested governments with the power to tax in order to provide services for the common good. There are many different ways for a government to tax its citizens in order to raise revenues, ranging from taxes on income, wealth, and property, to taxes on goods and services. The United States uses many of these taxes in varying levels to raise the needed funds to carry out government busine ss. Some taxes are generally accepted and uncontested, while others are highly politicized and hard for Americans to accept.Presently, the federal government relies on income taxes for the bulk of its revenue whereas states and localities rely more heavily on other forms of taxes to raise money for their functions. The primary function of taxes is to raise revenue for the government, however governments have used taxes to help spark social change, punish those who partake of certain goods and services, or regulate the consumption of specific goods and services. In these instances, taxes move from matters of revenue to issues of social policy, acting as mechanisms to force certain behaviors from citizens.More specifically, sin taxes have been used in the United States to help change behavior or regulate the consumption of goods and services deemed as sinful. In this paper, I will define sin taxes and outline the political meaning of â€Å"sin,† provide a brief history of sin t axes and their use, examine the most common forms of sin taxes in the United States, and lastly discuss the ethical and moral implication of utilizing sin taxes as a mechanism of social change. Sin Tax, a DefinitionBefore considering the implications of sin taxes and their influence on the behavior of Americans, it is important to define the term. Taxes, most generally, are levied by governments to raise revenue in order to conduct business in the public interest. The United States, utilizing a progressive income tax to raise the bulk of its revenue, possess a culture where citizens pay most of their taxes on time. (Mikesell 493) This system is not one that commonly uses taxes as a punishment, instead encouraging its citizens to pay their taxes for the common good and success of the nation as a whole.Noncompliance is low, and the government has even employed strategies to enhance payment, such as instruction and assistance. (Mikesell 494) Sin taxes, however, do not take this positiv e approach to raise revenue, instead, governments use their powers of taxation to punish behaviors when utilizing sin taxes. Most commonly, sin taxes are excise or consumption taxes that charge fees for guilty pleasures or human indulgence. Lorenzi, Sin Taxes 60) Sin taxes, therefore, are intended to encourage citizens to consume or use taxed items responsibly or discourage behavior associated with the consumption of taxed items. Goods or services generally taxed through sin tax policy have some common characteristics including inelastic demand, promote behavior that is harmful to the individual, and promote behavior that is harmful to others.Goods or services targeted by sin taxes have an inelastic demand because they are generally habitual, addictive, or highly pleasurable. Lorenzi, Sin Taxes 60) Further, these goods or services are targeted by sin tax legislation because consuming or utilizing the good or services can lead to self-destructive behavior, negative consequences for c ommunities, and generally are considered socially undesirable. Thus, sin taxes are not prohibitive; citizens are allowed to consume targeted goods and services as long as the tax is not steep enough to make consumption of the good or service impossible. Viscusi 556) Further, the voluntary nature of sin taxes is generally more tolerable than involuntary nature of income taxes. (Schmidt, Barr and Swanson 1677) The most confusing and controversial element when considering sin taxes is the definition of sin.This word can be highly political and misleading, automatically making most think of sin in religious terms. However, sin, in the context of sin taxes, refers to addictive, self-destructive, and socially undesirable, behavior from the consumption of goods and services without crossing into religious doctrine. Lorenzi, Sin Taxes 60) In this context, then, sin is behavior that is undesirable enough to be targeted by taxes as a form of regulation or determent, but not so socially unacce ptable to be illegal to the public. (Lorenzi, Sin Taxes 60) Therefore, sin taxes should not be considered as forms of punishment for poor consumption choices, but instead be a catalyst to foster sounder and safer decisions. (Viscusi 547) However, this can be a slippery slope, the limited use of taxes on goods and services deemed as sinful could grow and encompass others outside the scope of sin.Sin Tax History Sin taxes have a long history, originating with religious doctrine and the power of organized religions to collect fees. Popes levied the earliest forms of sin taxes on prostitutes, brothels, and the sale of indulgence to raise money for religious projects. (Lorenzi, Sin Taxes 59) Laws required prostitutes to designate half of her property and fortune to convents, and brothels were taxed continuing through the 16th century. Lorenzi, Sin Taxes 59) Further, Russian Czar Peter the Great imposed fees on the length of beards to tax vanity, and the Puritans used sin taxes to curb ex travagance. (Lorenzi, Sin Taxes 59)The United States has a long history of utilizing taxes on socially undesirable goods and services to fund the government. In the early years of our democracy, the federal Government derived almost all its revenue from consumption taxes in the form of duties on imports and excise taxes on liquors and tobacco. American Economic Association 50) This tradition was set early when Congress enacted excise taxes on tobacco and snuff, refined sugar, distilled spirits, carriages, and property sold at auctions in order to finance the debts incurred during the Revolutionary War. (Hines 51) However, these taxes were not well received by a public that was over taxed by the British government and violent protests, in what was later coined the Whiskey Rebellion, resulted in the abolition of many unpopular excise taxes during the Jefferson Administration. Hines 52)The War of 1812 and the Civil War both required the federal Government to raise revenue and as a resu lt old excise taxes were reinstated as well as taxes on gold, jewelry, silverware, watches, playing cards, feathers, patent medicines, billiard tables, leather, telegrams, yachts, and many other luxuries, however these taxes were quickly repealed once the wars were over. (Hines 62) The federal Government was permitted to levy a personal income tax with the 16th Amendment, which became the main source of revenue in 1913. Hines) Federal excise taxes did not completely disappear during this time; however prohibition severely limited the possible revenue of excise taxes before the Depression.The repeal of Prohibition and expansion of excise taxes on luxuries during the Depression helped to finance the increased federal spending of the New Deal Programs totaling more than 15 percent of the federal revenue in 1933. Hines 52) The expansion of programming during and following World War II required higher income taxes, fully transferring the bulk of government revenue away from excise and co nsumption taxes to the system we employ today. (Hines) The federal government still utilized some consumption and excise taxes, however these were limited to those goods and services mostly deemed socially undesirable, or sin taxes. Popular Goods and Services Taxed as â€Å"Sin† Tobacco and Alcohol The scope of goods and services targeted by sin taxes is limited in American society.The two oldest and most widely targeted goods are tobacco and alcohol. As evidenced in the history of sin taxes, alcohol and tobacco have been taxed to finance federal and state governments, particularly in slow fiscal times or to raise money for major legislation or wars. These goods have been targeted by sin tax legislation because they have the potential to raise money rather quickly, have been relatively accepted as sinful, and have direct casual relationships with health or social problems. Hines 63) Further, it is easier for governments to justify taxes on tobacco and alcohol to the public si nce both goods tend to have negative consequences for the public at large. Legislators can disguise taxes on tobacco and alcohol as regulations to help protect society from the health and social consequences resulting from overconsumption of these goods while requiring those who consume tobacco and alcohol to finance the consequences of their consumption choices. (Boyd and Seldon 365) Thus, in times of increasing taxes it is easier and more popular to increase taxes on goods instead of taxes on income.Cigarettes have been a major target of sin taxes in most recent history as the health risks have been widely publicized. In order to combat cigarette consumption, the federal government and many states have levied taxes on the production and/or sale of cigarettes. The rationale behind this tax is quite simple, those who partake in the pleasure of smoking should help pay for the health care required resulting from their choice. (Gruber 203) Today, all states and the federal government i mpose an excise tax on cigarettes, and these taxes are increasing as governments try to balance their budgets. American Medical Association 1909)Cigarette excise taxes are widely accepted in public opinion, the hazards of smoking have demonized the industry and those who choose to purchase the products. (Gruber 194) Utilizing sin taxation to regulate consumption of tobacco has been highly effective, according to the CDC, â€Å"A 10% increase in the price of cigarettes can reduce consumption by nearly 4% among adults and can have an even greater effect among youths and other price-sensitive groups. (American Medical Association 1909) Sin taxation on alcohol, while a widely targeted good, seems to be less popular and publicized in popular media. Taxes on alcohol tend to be lower than those on tobacco, and many states handle the sale of alcohol differently (alcohol license tax, state operated liquor stores, etc. ), making the tax less visible to the public. (Johnson and Meier 580) Fur ther, it is harder to gauge the effect specific liquor, beer, and wine taxes have on consumption.For example, higher taxes increasing the price on one might cause consumers to substitute to another, more affordable alternative, such as substituting wine with beer. (Johnson and Meier 591) However, studies show increased prices on alcohol as a result of taxation have affected alcohol consumption rates to an extent even if it is minimal. (Boyd and Seldon 365) Sin taxation on both tobacco and alcohol have seemed to decrease the consumption of these goods while raising revenues for state and federal governments, however little attention is given to other factors affecting decreasing consumption rates.The American public has been flooded with messages about the dangers of smoking and national campaigns have worked to warn Americans to stop smoking, helping to decrease cigarette consumption in the United States along with the steep sin taxes increasing the prices. Further, many cities and states are adopting smoking bans in public places, limiting the accessibility of facilities for smokers. Also, there are very few substitutes for tobacco products, forcing smokers to either pay the tax or consume less.Political movements and tougher legislation against behavior resulting from alcohol consumption might be affecting consumption rates just as easily as increased prices resulting from sin taxes. Taxes on alcohol and tobacco can also increase production costs, causing producers to utilize their resources to raise other commodities that are not as heavily taxed, decreasing the overall production of tobacco and alcohol products. Boyd and Seldon 370) Further, lower consumption rates may not mean that consumption is actually dropping if consumers are turning to affordable black market substitutes. (Johnson and Meier 591) Environmental Americans have become increasingly accustomed to sin taxes that will help promote safer environmental practices and sustainability. Increased understanding of environmental factors surrounding pollution has increased the need for governmental regulation of emissions. As a result, the federal government has levied taxes on goods and services that contribute to pollution.The most common of these taxes is that on fuel; gasoline and diesel. Sin taxes levied on gasoline are intended to discourage driving and reduce pollution as well as traffic congestion in the process. (Hines 52) This tax is easy for government to justify since the majority of funds raised from the tax are spent on highway maintenance and construction. (Hines 52) While this tax may not have been enacted with â€Å"sin† regulation in mind, environmental regulation helps to justify it now, putting it in the â€Å"sin† category.Environmental sin taxes are not limited to fuel; they are also levied on gas-guzzler cars, heavy road vehicles, highway-type tires, and all forms of air transportation. (Hines 53) Ozone depleting chemicals also present an op portunity to tax environmental sin. Not only does the federal government limit the use of these hazardous chemicals, they are also taxed. (Hines 53) The strict regulation and higher taxes on these chemicals has severely reduced their production and use, almost making the usage limits irrelevant. Hines 53) In the future, scaled taxes on specific chemicals could help further reduce their use and potential harm to the ozone, however the federal government has not utilized sin taxes thoroughly enough to enact further environmental regulation. Gambling, Prostitution, and Pornography Gambling is a service that has been a target of sin taxes since the early years of our nation, easily defined as a sin but harder to single out and tax since it is not a good. The federal government has not taxed gambling with the same enthusiasm as tobacco, alcohol, or fuel taxes.Taxing gambling in the United States is tricky, Native American and state sponsored gambling is tax free, and setting gambling tax es too high can cause taxpayers to turn to alternatives, such as illegal gaming establishments. (Schmidt, Barr and Swanson 1682) Further, it is harder for consumers to feel the effects of gambling taxes since most tax costs are not directly funded by service prices. Instead, most sin taxes are levied on the gaming establishments in the form of license agreements for specific games or total revenue. Schmidt, Barr and Swanson 1687) Thus, gambling taxes do not technically raise the cost of the service and encourage citizens to make better decisions, instead gambling establishments bear the majority of the burden of the tax cost. While gambling sin taxes are hard to levy on individuals for regulation, they can be a tool to monitor and stop organized crime through IRS oversight. (Schmidt, Barr and Swanson 1681) Prostitution and pornography are equally difficult to tax, each for their own, separate reasons.Prostitution, while generally considered immoral, is legal in some states and on pa per is considered victimless since it is a consensual act between two adults. (Lorenzi, Taxing Antisocial Behavior for the Common Good 331) Further, taxes in this industry generally are levied on the establishment, much like gambling, and if the tax becomes too high, consumers will look for substitutes, generally illegal. Pornography is equally as difficult to tax, since so much of this product is available online.States are still trying to figure out how to charge a sales tax on online purchases, rather unsuccessfully, and pornography is no exception. Thus, taxes on this industry are limited to taxes on producers and networks, not individual consumers. (Lorenzi, Taxing Antisocial Behavior for the Common Good 331) In the end, taxes on prostitution and pornography are not as readily apparent to the consumer as with tobacco, alcohol or fuel, reducing the individual deterrent qualities of a sin tax on these goods and services. Fat TaxesObesity rates in the United States have been risin g, and as a result so have health issues and healthcare costs. (Chaufan, Hong and Fox 87) In recent years, state and federal governments have debated utilizing sin taxes to raise the cost of purchasing calorie dense foods with no nutritional value in order to deter consumption. However, these â€Å"fat taxes† are not new and have been present since the 1920’s. (Creighton 127) They are gaining in popularity as the obesity epidemic continues to cause widespread health issues.These unhealthy goods are particularly targeted by health officials because they are most commonly marketed to kids, and children who develop poor eating habits when they are young and more likely to become obese as adults. (Fletcher, Frisvold and Tefft 968) Thus, with evidence from the tobacco industry, sin taxes on unhealthy goods would seem to be a good method to encourage healthier food purchases. Further, taxing these goods could provide huge revenue increases for federal and state governments s ince the unhealthy food industry profits are similar to those of the alcohol industry. Fletcher, Frisvold and Tefft 968) Utilizing taxes as a mechanism to change behavior has not been as successful for curbing obesity. Taxing soft drinks has proved to discourage consumption, particularly for children and groups with limited spending capability. (Fletcher, Frisvold and Tefft 972) However, changing behaviors that lead to obesity takes more than just cutting specific foods out of a diet. For example, diets high in caloric intake can cause obesity regardless of where the calories are coming from if a person does not get enough exercise.Curbing obesity almost requires a personalized plan for each individual, focusing not only on their diet, but also exercise habits, genetic makeup, and lifestyle. (Chaufan, Hong and Fox 88) Simply targeting one factor does not help fix problems with the other factors. Further, there are too many substitutes for unhealthy junk food, allowing citizens to co ntinue to make poor health choices, even if we target certain goods. (O'Donoghue and Rabin 1841) Ethical and Moral Considerations of Sin TaxesSin taxes can be a valuable tool for government to raise revenue and help shape social policy. However, adding morals and values to a tax requires ethical and moral considerations above those of most other forms of taxes. These taxes are levied with a specific policy outcome in mind, yet sometimes it may be difficult to separate the government’s interest in raising revenue with the government’s overarching policy goal. Since these taxes generally have some sort of stigma attached with the goods or services taxed, it is also important to ensure these tax policies are enacted for the common good.Sin taxes have been the target of moral and ethical discussions mainly because it is hard to decide what exactly constitutes a sin. Disputes arise as legislators decide what goods and services need to be regulated for the public wellbeing. While many of the goods and services taxed as sin have historically been deemed evil, immoral, seedy, or bad; discourse about who decides these products deserve to be regulated and taxed above and beyond other goods and services must be evaluated. This seems to be the central moral question surrounding sin taxes.Should a minority of the population have to pay an extra tax to support the government simply because they partake or utilize a specific good or service? Taking this question a step further, sin taxes have the potential to raise large revenues, so is it ethical to make a few pay for government services for all? Who gets to decide how these funds will be spent, and who or what will this spending affect? (Green 70) The last overarching question surrounding the sin taxes focuses on the government’s power to tax, namely, can the government use its power to tax to shape and enforce social policies?Those in favor of sin taxes would argue there are many reasons why it is mor al and ethical to require consumers who purchase these particular goods and services to pay more than the average taxpayer. Namely, sin taxes target goods and services that cause negative consequences for the public at large. (Green 68) These could be increased health care costs or higher demand for social services. It is logical, then, to require these consumers to pay more since they are directly contributing to higher government costs for all.Not only is it logical and moral to require these consumers to pay more for the added costs as a result of their consumption, higher taxes can help them make better, healthier choices. Sin taxes have been proven to reduce the consumption of specific goods and services, helping to create sustainable, prosocial behaviors for the future. (Lorenzi, Taxing Antisocial Behavior for the Common Good 328) Sin tax policies can help deter and regulate antisocial behaviors as a result of consumption of sin goods and services while simultaneously raising revenues to pay for the programming needed to help those affected by this behavior.Further, sin taxes raising money on the backs of those partaking in antisocial behavior reduce the need to tax prosocial behaviors. For example, revenue generated from sin taxes can be used to fund government business, reducing income tax costs for the larger population. (Lorenzi, Sin Taxes) Targeting these immoral behaviors and using them to fund governmental operations ensures those engaged in prosocial behavior are not bearing a larger share of the cost of government. This is an attractive and easy sale to the public since higher taxes make all citizens unhappy.Sin taxes on paper are extremely regressive, and as a result unfavorable to many. However, lifetime incidence studies prove the effects of these taxes on lower income taxpayers is about equal to those in middle or higher income households. (Poterba 327) Those who oppose sin taxes see the value they bring to both government revenues as well a s the common good; however these positives do not outweigh the negative ethical and moral implications. First and foremost, opponents of sin taxes believe it is immoral for the government to rely on funding from the very behaviors it has deemed sinful and therefore is trying to regulate or change. Lorenzi, The Moral Grounds of Sin Taxes 68) Opponents see sin taxes as a stepping stone to banning certain goods and services, which should be a social policy decision supported by the public, not forced on them through prohibitive taxes. (Viscusi 547) Opponents therefore do not believe taxes should be used as a mechanism to enforce social policies or enact social change. (Creighton 135) In essence, the government is taking away the individual’s autonomy, legislating they should not purchase certain goods and products. (Green 72) This is a difficult issue to balance, Americans value independence and the freedom to choose.Further, sin taxes are regressive, putting the large burden of payment on those with the least ability to pay. (Hines 65) In slow economic times, when governments tend to raise sin taxes to help close the revenue and expenditure gap, sin taxes could actually hurt the economy, pushing these citizens to the end of their economic resources. (Johnson and Meier 582) In the end, the same population the government is targeting to raise the revenue would be the same population in need of government services once their resources were depleted.Further, utilizing sin taxes as a form of punishment or regulation directly competes with the message of the general tax code, namely, every citizen has the obligation to pay their taxes and support the government. The United States evolved their tax system from one based on consumption and tariffs to one based on taxing income based on the ability to pay. Sin taxes do not fit fairly into this carefully crafted tax structure we use today, sending the public mixed messages about citizen’s role in the taxatio n process. Lastly, opponents of sin taxes are skeptical if they are actually reaching the policy outcomes intended.Studies show increased prices on certain goods and services reduces consumption, however there could be many other factors contributing to the decline in usage. For example, reduced consumption might be a result of heightened public awareness about the health risks, greater access to prevention and rehabilitation, harsher criminal legislation surrounding a specific behavior, or any number of other factors. Further, sin taxes on some goods, like unhealthy foods, really do not work at all since there are so many additional factors that might be contributing to the issue. Chaufan, Hong and Fox 87) Opponents also are skeptical sin taxes even reduce consumption since the presence of similar or equal substitutes might encourage consumers to find these goods and services elsewhere, such as illegal gambling establishments or black market cigarettes. (Johnson and Meier 591) The availability of substitutes could in turn create greater antisocial behavior and costs to the government in the form of criminal investigation, prevention, and added health risks from unsafe goods and services. ConclusionTaxes are an inevitable fee all must pay to support the government. Citizens vest the power to tax with governments in return for government services. Governments take the power to tax a step further with sin taxes, not only raising revenue but also enacting or enforcing social policy. Sin taxes have been used successfully throughout history, particularly when citizens unanimously agree a sin exists. Sin taxes have also been successful in regulating or curbing consumption resulting in antisocial behavior as well as generating revenue.On the surface, it would seem as if sin taxes are a great way to raise revenues and influence or enforce social policy. However, there are many ethical and moral implications surrounding sin taxes. Digging deeper into the positive and n egative consequences of these taxes sheds light on the inherent problematic nature of the tax, and leads to questions about its place in the American tax structure. Legislators must be cognizant of these moral and ethical questions before deciding to enact taxes that could potentially be discriminatory to some members of society.These taxes should be evaluated on a case by case basis, with clear and measureable policy outcomes included in the evaluation. Policy outcomes that are not easily measured may not be the best use of sin tax influence for social change. In the end, taxes on goods or services labeled as sinful have great potential to raise revenue, and as a result these taxes are popular to help close revenue and expenditure gaps. Perhaps sin taxes are a great case study for tax structures based on consumption instead of income. Hines 69) Sin taxes target consumption, and this seems to work well to raise revenue for the government. Many of the ethical and moral questions surr ounding the use of sin taxes to influence social change could be eliminated within a tax structure based on consumption; however this shift would be a major tax reform in the United States. This may not be the answer we are looking for, yet sin taxes provide a window in which to examine tax policy, and possibly change the way our tax structures work in the future.Works Cited American Economic Association. Consumption and Other Indirect Taxes. † American Economic Review 9 (1919): 49-62. American Medical Association. â€Å"State Cigarette Excise Taxes-United States, 2009. † MMWR: Morbidity and Mortality Weekly Report. 2010. Boyd, Roy and Barry J. Seldon. â€Å"Revenue and Land-Use Effects of Proposed Changes in Sin Taxes: A General Equilibrium Perspective. † Land Economics 67. 3 (1991): 365-374. Chaufan, Claudia, Gee Hee Hong and Patrick Fox. â€Å"†Sin-Food† Taxes and Sugar-Sweetened Beverages–The Right Policy For the Wrong Reasons? † Ame rican Journal of Health Promotion 25. (2010): 87-90. Creighton, Robert. â€Å"Fat Taxes: The Newest Manifestation of the Age-Old Excise Tax. † Journal of Legal Medicine 31 (2010): 123-136. Fletcher, Jason M. , David E. Frisvold and Nathan Tefft. â€Å"The Effects of Soft Drink Taxes on Child and Adolescent Consumption and Weight Outcomes. † Journal of Public Economics 94 (2010): 967-974. Green, Rebecca. â€Å"The Ethics of Sin Taxes. † Public Health Nursing 28. 1 (2010): 68-77. Gruber, Jonathan. â€Å"Tobacco At the Crossroads: The Past and Future of Smoking Regulation in the United States. † Journal of Economic Perspectives 15. (2001): 193-212. Hines, James R. Jr. â€Å"Taxing Consumption and Other Sins. † Journal of Economic Perspectives 21. 1 (2007): 49-68. Johnson, Cathy M. and Kenneth J. Meier. â€Å"The Wages of Sin: Taxing America's Legal Vices. † The Western Political Quarterly 43. 3 (1990): 577-595. Lorenzi, Peter. â€Å"Sin Taxes. † Social Science and Public Policy 41. 3 (2004): 59-65. —. â€Å"Taxing Antisocial Behavior for the Common Good. † Society 47. 4 (2010): 328-332. —. â€Å"The Moral Grounds of Sin Taxes. † Society 44. 1 (2006): 67-71. Mikesell, John L. Fiscal Administration. Belmont, CA: Thompson Wadsworth, 2007. O'Donoghue, Ted and Matthew Rabin. â€Å"Optimal Sin Taxes. † Journal of Public Economics 90 (2006): 1825-1849. Poterba, James M. â€Å"Lifetime INcidence and the Diatributional Burden of Excise Taxes. † American Economic Review 79. 2 (1989): 325-330. Schmidt, Robert, Charles F. Barr and David A. Swanson. â€Å"Socioeconomic Impacts of the Proposed Federal Gaming Tax. † International Journal of Public Administration 20. 8-9 (1997): 1675-1698. Viscusi, W. Kip. â€Å"Promoting Smokers' Welfare With Responsible Taxation. † National Tax Journal 47. 3 (1994): 547-558.