Is there a Real Choice in Where Patients with Cancer Wish to Die or is this a Myth - Free Essay Example

Sample details Pages: 12 Words: 3559 Downloads: 7 Date added: 2017/06/26 Category Medicine Essay Type Research paper Level High school Did you like this example? Introduction Recently, the concept of patient autonomy has become more prevalent within the healthcare field with the government and the NHS promoting patient choice and providing assurance that individuals will have full control over their care and patient journey. However, a recent publication from Macmillan Cancer Care (MCC) (2013a, pp. 1-27), suggests that there is very little choice available for individuals suffering from terminal cancer with regards to where they spend the end of their lives. Don’t waste time! Our writers will create an original "Is there a Real Choice in Where Patients with Cancer Wish to Die or is this a Myth?" essay for you Create order Figures provided within the MCC (2013a, p. 8) report suggest that 81% of cancer sufferers would prefer to die at home whilst in reality, 48% of these die in a hospital with only 23% of patients dying within the comfort of their own homes. For individuals who are approaching the end of their lives, the option of being cared for and dying within their own home with the familiarity and comfort that this brings, is often very important. The National Bereavement Survey (NBS) (Office for National Statistics, 2012, np) showed that that the loved ones of those who had died in hospital often considered the standard of care as being poor when compared to those who died at home, in a care home or within a hospice. Indeed, the NBS (ONS, 2012, np) showed that 53% of loved ones whose friend or family member had died at home and 58% of those who had died in a hospice, rated the standard of care as outstanding or excellent compared to just 34% for those who had died within a hospital. This ess ay will consider the barriers that cancer patients are presented with when making their end of life choices and will make recommendations for improvement of service to ensure that these individuals are allowed to make and receive their final choice. However, the essay will begin with a brief overview of the benefits that end of life patient choice can bring to both the individual and to the wider society. The Benefits of End of Life Patient Choice According to the National End of Life Intelligence Network (2012, p.7) 89% of patients who die in hospital are brought in as emergency admissions. However, a large number of these individuals have already expressed their desire to die at home, therefore representing a poor patient outcome and negative experiences. In addition, these unnecessary emergency admissions place a costly strain on accident and emergency departments and the patients take up hospital beds that could be used for other cases. When one considers that the number of people in this country is increasing with the elderly becoming the most prevalent age group, it is not unfeasible to believe that the number of individuals dying from terminal cancer over the next few decades is also going to increase. This increase in numbers is likely to cause the current model of care to become unsustainable. However, promoting choice and delivering end of life care choices can actually save money by reducing the number of emergenc y admissions. According to MCC (2013a, p.9), there is a net saving of just under  £1000 for every individual who dies in the community rather than in a hospital bed. Barriers to End of Life Care Choices Evidence suggests that there are multiple barriers that prevent individuals from being cared for and ending their lives in their chosen place. The first barrier is the identification of people approaching the end of their lives. According to MCC (2013a, p.10), 38% of cancer patients approaching their end of life were unaware that they were dying, whilst figures from Marie Curie Cancer Care (2013, p.7) show that only 26% of individuals with a palliative care need are placed on the palliative care register. One of the main reasons for this appears to be a lack of confidence in the health professionals over instigating conversations with individuals over their end of life journey. A study carried out by Revill (2010, p.11) found that 60% of GPs were not confident about discussing death or dying with their patients. This lack of identification and lack of professional confidence therefore prevents many people from being able to make their end of life choice in a timely fashion, therefo re increasing the number of emergency admissions that have previously been discussed. However, another issue that has been raised is that of poor planning and coordination between services. When one considers the needs of a terminally ill cancer patient, it is clear that there is a requirement for multiple health and social care providers to work together to provide a joined up service delivery. Unfortunately, the MCC (2013a, p.11) report suggests that this joined up service is not occurring with 45% of respondents thinking that community services worked well together and only 33% stating that GP and other services outside of the hospital worked well together. The reason for this poor service is considered to be a lack of coordination and communication between the different care entities. Indeed, the MCC (2013a, p.11) report suggests that it is often a requirement of the close family and friends of the dying loved one or the actual patient to coordinate care between health and so cial care departments. The report suggested that information needed to be repeated to the different professionals suggesting that there is a lack of communication between the different departments and that patient information is not being recorded or shared in an appropriate manner. Nevertheless, there is evidence to suggest that Advance Care Plans (ACP) are a successful way in which a persons end of life choices can be successfully achieved. Abel et al (2013, pp.168-173) followed 969 terminally ill patients, 550 of whom had made an ACP. 75% of these individuals successfully achieved their dying wishes with regards to the location that they had chosen. In addition, a study published by the NHS (2012, pp.3-4) suggests that the Electronic Palliative Care Coordination Systems (EPaCCS) where patient information, including their end of life choices, can be stored and shared, is an effective way of achieving pro choice for the patient with up to 80% of individuals living in areas where the EPaCCS system is implemented achieving their preferred choice of location to die. In addition, the NHS (2012, p.12) report shows that the implementation of this system has resulted in savings of  £133,200 where it is implemented. Another positive study has been published by Gao et al (2013, np) who found that the number of individuals being able to die either at home or in a hospice has increased since 2005 when the National End of Life Care Programme was first launched. However, the percentage change was only marginal (0.8%) therefore suggesting that more needs to be done to ensure patient autonomy is at the top of the list for terminally ill patients. Another barrier that is likely to prevent an individual from dying within their own home is lack of skills and resources within the community workforce. In these cases, the role of the community nurse is vital, however, the number of community nurses is steadily declining (Royal College of Nursing, 2013, np). This redu ction of the workforce further dilutes the available skill mix, therefore having a detrimental impact on the quality of care provided to those who choose to die at home. According to the MCC (2013a, p.13) report, only 19% of individuals who chose to die at home received adequate pain relief during their last 3 months of life. Indeed, the lack of 24/7 access to community services forced a large number of these individuals to contact emergency services resulting in admittance to hospital. In 2010, nearly half of the UKs primary care trusts did not provide 24/7 community nursing services for end of life patients with little progress being made following the subsequent change to Clinical Commissioning Groups (MCC, 2013a, p. 13). Another report published by MCC (2013b, pp. 1-15) suggests that a lack of access to social care services also restricts the ability of an individual to make end of life care choices. Whilst it is obvious that the right amount of social support is needed in or der for a terminally ill individual to be able to remain at home during their last stages of life, this support is often not provided. The MCC (2013b, p. 3) report suggests that this is not always due to the service not being available, but more often being the result of the complex assessment process and the lack of coordination between health and social services. Indeed, 97% of healthcare professionals stated that the complexity of the social care needs assessment is a substantial barrier to gaining the right amount of home care for terminally ill patients. As such, the care for these terminally ill individuals is often left to family members as informal carers. However, only 5% of these individuals actually receive a carers allowance despite them taking on the majority of the personal care responsibilities of these terminally ill patients. Thomas et al (2002, p.531) asserted that the needs of cancer patient carers were greatest as the cancer progressed to end stage; however, a di stinct lack of support for these informal carers is prevalent throughout the UK (Soothill et al, 2001, p.468). MCC (2013b, p.6) found that 47% of these informal carers felt that they needed support but were unable to get any. Therefore it is not surprising that this lack of carer support is resulting in many cancer patients being admitted to hospital in the days or hours before death despite it being their wish to die at home. Recommendations for Improvement As studies have shown that the local implementation of the EPaCCS has been successful, there should be a renewed commitment by the Department of Health and the NHS to ensure the national implementation of this scheme. Indeed the National End of Life Care Strategy (DOH, 2008, np) made a commitment to pilot and establish end of life care registers that would ensure the coordinated care of terminally ill patients and also ensure that every organisation involved in the care of that individual were aware of their end of life choices. As such, it is asserted that NHS England need to prioritise the roll out of these systems. When this system is implemented on a national basis, EPaCCS will not only coordinate care but will also provide considerable data that can be used to compare outcomes for end of life patients throughout the UK. In addition to this system, it is vital that health care professionals involved with terminally ill cancer patients encourage them to fill out an ACP as a rout ine part of the care package. A randomised control trial carried out by Detering et al (2010, np) followed 309 terminally ill patients for a period of six month, 154 of whom had completed an advanced care plan. Of the 56 patients who died during the study period, 29 of them had made an ACP with 86% of these achieving their end of life choices compared to just 30% of those who had not made an ACP. This shows that it is vital to document end of life choices to ensure that they are followed by all those involved in the final days of the patients care. Another recommendation is to make end of life care training mandatory for all health professionals who are likely to be involved in palliative care. This includes making a timely identification of individuals who are approaching the end of their lives and providing these professionals, including GPs, with the right training to boost their confidence in instigating end of life discussions with terminally ill patients. This will enable t hese terminally ill individuals and their families to come to terms with their disease progression and make appropriate plans for their end of life care. It is also recommended that all terminally ill individuals have a named professional who is responsible for the coordination of their care and who will ensure that their end of life choices are met whenever possible. This was a key recommendation of the UK Governments (2013, pp. 1-62) review of the Liverpool care pathway, which stated that a named consultant or GP should take overall responsibility for a patients end of life care, whilst a named registered nurse would have day to day responsibility for the care of that individual and for the communication of information between the patient, family members and other members of the care team. The UK Governments (2013, p. 57) review also recommends improving access to community services by increasing funding to ensure that there is a consistent 24/7 access to all social care servic es throughout the UK. This is considered to be a priority, as without access to 24/7 care, a large number of individuals are not having their pain managed adequately, forcing them to take further action by attending an emergency department. In addition, the government needs to commit to implementing free social care to terminally ill patients and to simplifying the social care assessment to ensure that all those who need social support are able to access this service in a timely fashion. Whilst the UK government has recognised that there is much merit in the proposal of free end of life social care (MCC, 2013a, p. 19), they are yet to offer a firm commitment to this proposal. The continued complexity of the social care assessment and the confusion over who is able to receive social care needs to change if patients wishes to die at home are to be honoured. Indeed, Taylor (2012, p.1297) asserts that there is a need to change the way in which all health and social care is provided to e lderly patients and suggests a combined health and social care assessment to ensure a proper joined up and coordinated service for these vulnerable patients. It is also recommended that improved support for carers is instigated to ensure that all those who are caring for a terminally ill patient are recognised as informal carers and are in receipt of a carers allowance. In addition, it is vital that these carers a given the right level of support by health professionals; this support should include having 24/7 access to help and advice, being given regular respite and having adequate information with regards to the progression of their loved ones disease to enable them to encourage the patient to make end of life care plans. Joyce et al (2014, p.1150) found that out of 120 caregivers who were responsible for delivery of medications to their terminally ill relative, only 27 (22.5%) of them received any formal support. This often led to confusion over dose rate and fear that the pa tient was receiving too much or too little of the medication provided. This issue is compounded by the fact that many of these informal carers are elderly themselves and often have their own health problems (Jack et al, 2015, p.131). Finally, it is considered that delivering choice for end of life care should be focused on giving that patient a good death, regardless of where they chose to die. As such, it seems logical that there is a need to understand the experiences of terminally ill patients towards the end of their lives in order to deliver adequate care. As such, it is considered vital to explore how the experiences, concerns, fears and feelings of people approaching the end of their lives can be recorded and used to improve future patient outcomes. Whilst it is accepted that the National Bereavement Survey (ONS, 2012, np) provided a large volume of useful information, the current lack of nationally collected information from end of life patients needs to be addressed. As such, it is recommended that future study be directed in this way. Conclusion In conclusion, it is clear that whilst having a genuine choice over where to spend the last few days and hours of your life is hugely important to terminally ill patients, there are significant barriers to achieving these choices. Current figures suggest that nearly three quarters of cancer patients chose to die at home but less than 29% of them actually do so. The MCC (2013a, p. 3) report estimate that this amounts to 36,000 patients dying in hospital when they had chosen to die at home. A number of barriers exist that are currently preventing the individual from achieving personal choice at the end of their lives; these include poor identification of individuals entering the end of life stage, poor communication from health professionals, poor planning and coordination between health and social services, lack of skills and resources in community nursing and lack of universal access to social care resources. Nevertheless, despite these current barriers, none are insurmountable if current services are simplified and organised in a way that sees the needs of the individuals and their families and carers brought to the forefront. Whilst the government has funded reports and strategies to improve end of life care, it is clear that not enough is being done to change the way in which end of life care is provided. Significant change is required in order to move care and resources out of hospitals and into the community so that peoples preferences can be delivered. However, this can only happen if there is a clear commitment given by all the players involved in end of life care to share the same ambition, that being to deliver a coordinated and integrated care package that meets the needs, wishes and preferences of end of life patients and their carers. A number of recommendations on how this can be achieved have been included in this essay. These recommendations include simplify the social care assessment, providing free social care to end of life patients, improvi ng support for informal carers and ensuring that these carers are recognised, improving the training of health professionals in recognising the transition to end of life stages and encouraging them to instigate discussions over end of life choices, improving access to social services by ensuring a 24/7 service across the UK and implementing the roll out of the EPaCCS across the whole of the UK to ensure that end of life choices are recorded and shared between all the relevant care providers. As it stands at present, whilst end of life patients do have a choice over where they die, these preferences are often not honoured. They do not have full control or autonomy over their end of life care. However, the choice of place to die is not a myth as it is a very achievable option that requires coordination between services and a commitment from the government to improve community health services. References Abel, J., Pring, A., Rich, A., Malik, T., Verne, J. (2013). The impact of advance care planning of place of death, a hospice retrospective cohort study. BMJ Supportive Palliative Care, 3(2), 168-173. Department of Health. (2008). End of life care strategy. Available online at https://www.gov.uk/government/publications/end-of-life-care-strategy-promoting-high-quality-care-for-adults-at-the-end-of-their-life accessed 21 June 2015. Detering, K. M., Hancock, A. D., Reade, M. C., Silvester, W. (2010). The impact of advance care planning on end of life care in elderly patients: randomised controlled trial. British Medical Journal, 340. 1345-1353 Gao, W., Ho, Y. K., Verne, J., Glickman, M., Higginson, I. J., GUIDE_Care Project. (2013). Changing patterns in place of cancer death in England: a population-based study. PLoS Med, 10(3), e1001410. Jack, B. A., OBrien, M. R., Scrutton, J., Baldry, C. R., Groves, K. E. (2015). Supporting family carers providing endà ¢Ã¢â€š ¬?ofà ƒ ¢Ã¢â€š ¬?life home care: a qualitative study on the impact of a hospice at home service. Journal of Clinical Nursing, 24(1-2), 131-140. Joyce, B. T., Berman, R., Lau, D. T. (2014). Formal and informal support of family caregivers managing medications for patients who receive end-of-life care at home: A cross-sectional survey of caregivers. Palliative Medicine, 28(9), 1146-1155. Macmillan Cancer Care. (2013a). A time to choose. Available online at https://www.macmillan.org.uk/Documents/GetInvolved/Campaigns/Endoflife/TimeToChoose.pdf accessed 21 June 2015. Macmillan Cancer Care. (2013b), Theres no place like home. Available online at https://www.macmillan.org.uk/Documents/GetInvolved/Campaigns/SocialCare/Making-the-case-for-free-social-care-at-the-end-of-life.pdf accessed 21 June 2015. Marie Curie Cancer Care. (2013). Death and dying. Available online at https://www.mariecurie.org.uk/globalassets/media/documents/policy/policy-publications/february-2013/death-and-dying- understanding-the-data.pdf accessed 21 June 2015. National End of Life Intelligence Network. (2012). What do we know now that we didnt know a year ago? New intelligence on end of life care in England. Available online at https://www.endoflifecare-intelligence.org.uk/view?rid=464 accessed 21 June 2015. NHS. (2012). Making the case for change: Electronic palliative care coordination systems. Available online at www.nhsiq.nhs.uk/download.ashx?mid=4423nid=4424 accessed 21 June 2015. Office for National Statistics. (2012). National Bereavement Survey 2012. Available online at https://www.ons.gov.uk/ons/rel/subnational-health1/national-bereavement-surveyvoices-/2012/index.html accessed 21 June 2015. Revill, S. (2010). GP Pilot Project Evaluation. Available online at https://www.dyingmatters.org/sites/default/files/user/documents/Resources/Dying_Matters_GP_Pilot_Evaluation_-_final.pdf accessed 21 June 2015. Royal College of Nursing. (2013). Frontline First: Nursing on Red Al ert. Available online at https://www.rcn.org.uk/__data/assets/pdf_file/0003/518376/004446.pdf accessed 21 June 2015. Soothill, K., Morris, S. M., Harman, J. C., Francis, B., Thomas, C., McIllmurray, M. B. (2001). Informal carers of cancer patients: what are their unmet psychosocial needs? Health Social Care in the Community, 9(6), 464-475. Taylor, B. J. (2012). Developing an integrated assessment tool for the health and social care of older people. British Journal of Social Work, 42(7), 1293-1314. Thomas, C., Morris, S. M., Harman, J. C. (2002). Companions through cancer: the care given by informal carers in cancer contexts. Social Science Medicine, 54(4), 529-544. UK Government (2013). More Care, Less Pathway, A review of the Liverpool Care Pathway. Available online at https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/212450/Liverpool_Care_Pathway.pdf accessed 21 June 2015.

Neumann Surname Meaning and Family History

The Neumann surname originated as a descriptive surname or nickname  for a new man, settler, or newcomer, from the German prefix neu, meaning new, and mann, meaning man. NEWMAN is an English version of this surname. Neumann is the 18th most common German surname. Surname Origin: German, Danish, Jewish Alternate Surname Spellings:  NEUMAN, NAUMANN, NEWMAN, NEUMANNS, NEUMANS, VON NEUMANN, NUMAN, NAUMAN, NAWMAN, NEIMAN, PNEUMAN Famous People with the Neumann Surname Balthasar Neumann  - 18th-century German architectJohn von Neumann - famous Hungarian  mathematicianElsa Neumann - German physicistGerhard Neumann - German-American aviation engineer Where the Neumann Surname Is Most Common According to surname distribution from Forebears, the Neumann surname is most common in Germany, where it is the 16th most common last name. Its also fairly common in Austria, ranking 120th.  According to WorldNames PublicProfiler, the Neumann surname is found throughout Germany, but especially in the northeastern part of the country in the states of Brandenburg, Mecklenburg-Vorpommern, and Sachsen. The Newman surname, on the other hand, is most frequent in southern England, in the South West, South East, and East Anglia regions. Surname maps at Verwandt.de indicate the Neumann surname is found in the greatest numbers in Berlin, followed by the cities and counties of Hamburg, Region Hannover, Recklinghausen, Mà ¼nchen, Essen, Kà ¶ln,  Là ¶bau-Zittau, Dortmund, and Bremen. Genealogy Resources for the Surname Neumann Meanings of Common German Surnames: Uncover the meaning of your German last name with this article on how various types of German surnames originated, and a list of the 50 most common last names in Germany.Neumann  Family Crest - Its Not What You Think: Contrary to what you may hear, there is no such thing as a Neumann  family crest or coat of arms for the Neumann surname.  Coats of arms are granted to individuals, not families, and may rightfully be used only by the uninterrupted male-line descendants of the person to whom the coat of arms was originally granted.Newman Family  DNA  Surname Project: Individuals with the Newman  surname, and variations including Neumann, Neuman, Nauman, Naumann, Nawman, Newnam, Newnom, Neaman, Neiman, Numan, Pneuman, and von Neumann, are invited to participate in this group DNA project in an attempt to learn more about Newman family origins. The website includes information on the project, the research done to date, and instructions on how to participate.Neumann Family Genealogy Forum: This free message board is focused on descendants of Neumann  ancestors around the world.FamilySearch Neumann Genealogy: Explore over 3.2  million results from digitized  historical records and lineage-linked family trees related to the Neumann surname on this free website hosted by the Church of Jesus Christ of Latter-day Saints.Neumann Surname Mailing List: Free mailing list for researchers of the Neumann  surname and its variations includes subscription details and a searchable archives of past messages.DistantCousin.com - NEUMANN  Genealogy Family History: Explore free databases and genealogy links for the last name Neumann.GeneaNet - Neumann Records: GeneaNet includes archival records, family trees, and other resources for individuals with the Neumann  surname, with a concentration on records and families from France and other European countries.The Neumann  Genealogy and Family Tree Page: Browse genealogy records a nd links to genealogical and historical records for individuals with the Neumann  surname from the website of Genealogy Today.

The 1930s Essays - 2163 Words

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The Copperplate typeface is a typeface that all designers...

The Copperplate typeface is a typeface that all designers in the industry should learn and know about. At first glance the Copperplate typeface seems very common but if you look at it in depth you can see its many interesting characteristics. Back in the day this typeface was not so used as it is today, now we can see it representing many businesses and people are using it more and more. For various reasons some people like or dislike the Copperplate typeface. With more detailed information about this typeface that will be discussed in this essay you will be able to make your own decision and determine whether you like it or dislike it. The Copperplate typeface was given this name because in that time period (from 1530 to the 19th century)†¦show more content†¦A Linotype is a machine that was used back in the day to produce lines of words as single strips of metal and it was mainly used for newspapers. The Copperplate typeface has many elements from different sources. For ex ample, the typeface has a resemblance to stone carvings, lapidary engravings and classic roman typefaces. Frederic W. Goudy named this typeface Copperplate because from 1530 up to the 19th century copperplate engraving was a very popular technique to create illustrated material. Copperplate engraving consists of engraving or etching some type of design into a plate made of copper. He meant this typeface to be used by Linotype machines for the production of newspapers and many other types of printing and so it has AB and BC designations to help distinguish the difference between the capital letters and the small caps. It also has a numbering system that tells us the difference in weight and width of the typeface. The Copperplate typeface was first released by Goudy as a font family which contained many weights and variations. It was designed in all caps and small caps because it was meant to be used for headlines and header design, also for stationary and society printing. Copperplat e typeface imitates lapidary inscriptions, this is why it is categorized as a glyphic typeface. Another characteristic of glyphic typefaces is that the contrast of the stroke weight in a character is minimum and we can observe this in all the

Social Responsiblity free essay sample

Corporate social responsibility is defined in Chapter 5 as the corporate duty to create wealth by using means that avoid harm to, protect, or enhance societal assets. Did GE in the Welch era fulfill this duty? Could it have been done better? What should it have done? Jack Welch did make GE the most valuable company in the world. He was described as â€Å"the most important and influential business leaders of the 20th Century† by some Wall Street analyst. Nevertheless, Jack Welch as the CEO did not fulfill the duty of social responsibility. He did not avoid harm or protect societal assets. Under Welch’s leadership the GE Company contributed to environmental damages in areas of the country which manufactured GE products. One instants is GE heavily polluted the Hudson River with PCBs, one of the most toxic and persistent man-made substances that can cause cancer in people. From 1947-1977 GE dumped as many as 1. 3 million pounds of PCBs into the Hudson River. It has turned 197-mile stretch of the river into the nation’s superfund site. Since then there has been a struggle for GE to clean up the mess. In 1980 Congress passed the Superfund law which has created a tax on the chemical and petroleum industries and provided broad Federal authority to respond directly to releases or threatened releases of hazardous substances that may endanger public health or the environment. GE has failed to comply with this law. They are fighting the development of clean-up plan with every tool it can buy by lobbying congress, attacking the Superfund law in court, and launching a media bitz to spread disinformation about the usefulness of cleanup, claiming that dredging the river would actually stir up PCBs which was false claimed by EPA and outside experts. If they do not clean up the mess it could cost tax payer $350 to 400 million dollars. This is showing that GE is not protecting society and is actually harming people. When Welch was CEO he could have just cleaned up the mess and it would have reduces the health risk it cased to people. Instead he choose to fight the clean up process which cost him millions while he could have just spent to money and cleaned it up to avoid harm, and protect society. Another way he harmed, and did not enhance society is the number of people he laid off in the company. With is five years of him taking over 1 and 4 people would leave GE payroll. The book states, union leaders estimate that in his last 15 years GE eliminated 150,000 jobs in the United States through layoffs, subcontracting, and out sourcing to foreign countries. With the extensive about of layoffs and outsourcing jobs it hurts the United States economy by increasing the unemployment rate and the American debit ratio. Welch has added the economy of outsourcing which is leaving American’s with out jobs here and unable to find jobs. This is not enhancing are society when the unemployment rate is increasing due to layoff employees and outsourcing jobs over seas. The only way Jack Welch fulfills its primary economic responsibility in paying taxes. They paid 5. 7 billion dollars in taxes in 2000. Taxes do help in society in many ways though. The taxes paid to state and local jurisdictions help pay for police and fire protection. Federal income taxes help pay for defense for the country. They also pay for capital facilities such as highways and other transportation services and for help for those who are poor or ill. Jack Welch believed that he fulfilled his social responsibility by paying taxes because how that helps society. He said, â€Å"I think a company’s social responsibility is first and foremost to winning because winning companies are the only companies that can give back. Winning companies pay taxes. † However, GE pressured cities, countries, and states to lower taxes by threatening to move operations elsewhere. This impacted schools and the infrastructure by lowering the budgets. He believes in paying taxes is his social responsibility but will do anything to lower the taxes which showing his lack of social responsibility and do anything to lower cost to increase profits. Paying taxes is wonderful and all but it is not the only social responsibility that a corporation should have. Jack Welch should have been proactive in his cleaned up the PCBs in the Hudson River, to help prevent the harm of the fish and the citizens who live near and on this American water source. He should have considered the layoffs and what effect outsourcing had on the US economy. It would have been more socially responsibly to have looked for ways to enhance American work force thru innovative ideas and partnering with other businesses in the world. In his defense, he did fulfill the economic responsibility of paying taxes to elp society; he would have done anything in his power to lower the taxes though. He could have done more! 2. Does GE under Welch illustrate a narrower view of corporate social responsibility closer to Friedman’s view that the only social responsibility is to increase profits while obeying the law? Welch does illustrate a narrow view of the corporate social responsibility closer to Friedman’s view. Jack Welch did believe the only social responsibility is to increase profits while obeying the law. Welch said a â€Å"CEO’s primary social responsibility is to assure the financial success of the company. It is all about hitting the numbers with Jack Welch. He did this by doing anything to lower the cost and he delivered the growth figures that could only be dreamed by lesser companies. He improved the company’s market value from twelve billion dollars in 1981 to approximately 280 billion dollars in 2001. He achieved this by closing, selling, or fixing manufactures within GE, and by outsourcing jobs to cut cost in Mexico. Welch’s vision was that every GE business would be the number one or number two competitor in its industry. If the business was not able to hit its numbers he would fix it, sell it, or close it down. He closed 73 plants, sold 232 businesses and eliminated 132,000 workers from GE payroll all to increase profits. Another way he increased profits was outsourcing jobs. It cut cost by moving facilities jobs to Mexico’s low wage labor markets. Ed Fire, the union’s president, estimated that two-thirds of the 30,000 lost jobs were simply transferred to low-wage countries. He would find the lowest wages, lowest benefit levels, and most intolerant working conditions to help boost revenue. GE has eliminated additional jobs in the United States by pressuring its suppliers as while to migrate along with it to Mexico. By this they have eliminated a large number of jobs in the US. This is not helping protect society with job security. It is only helping the company increase profits which show that GE only believes its social responsibility is to increase profits and not help the society. GE did increase profit by obey the law. However they are such a powerful company with too much political power and usually the laws are written in their favor. This makes it easier for them to obey the laws since Welch used his influences to get rulings in GE’s favor. An example of Welch influential powers is a court case in 2004. In the case, Judge S. R. Underhill ruled in favor of GE in a tax case involving events that took place from 1993-1998. The main issue is whether a corporation can ethically exploit features of the tax law. In this case, GE shifted 98 percent of the taxable income to two non-taxable Dutch Banks, but did not shift 98 percent of the benefits. Also, the GE tax process resulted in fully depreciated airplanes being depreciated a second tome. The courts ruled in his favor (Bierman). Jack Welch did have a narrow prospective to corporate social responsibility. He sole thought that increase profits was it. He should this by saying the only good company is a â€Å"winning† company. . How well did GE comply with the â€Å"General Principles of Corporate Social Responsibility† set forth in the section of the title in the chapter? The general principles stated in the book are and how Jack Welch complied to the principles are: †¢Corporations are economic intuitions run for profit. This principle is about the greatest responsibility is to provide economic benefits. Jack Welch manly ran his corporation by this principle alone. In this principle it believes that they should be judged primarily on economic criteria and cannot be expected to meet purely social objectives without financial incentives. All firms must follow multiple bodies of laws. This principle includes obeying corporation laws and chartering provisions, the civil and criminal laws of nations and bodies of regulation that protect stakeholders, and international laws. GE does obey the laws and regulations stowed abound them. However, the company is too politically powerful and regulations are written in favor of GE some critics state. †¢Corporations have a duty to correct the adverse social impact they cause. It states that they should try to internalize external cost, or cost of production borne by society. GE has not fulfilled its duty with this principle. GE in 1977, as stated in question on, dumped 1. 3 million pounds of PCBs into the Hudson River which impact the society around the area and the fish in the river. The harmful toxins have been linked to cancer. GE has refused to clean up the mess. They are fighting the clean up with every means necessary. They are not trying to help society with the damage it has caused. It will probably in the end cause tax payers money to clean up the mess. †¢Managers should try to meet legitimate needs of stakeholders. In this principle, manager’s primary responsibility is to customers, stockholders and employees. GE did care about its stockholders. For instance, an example from the text book stated that if you invested $100 in GE stock in 1981 and held it there for 20 years it would have been worth $6,749. This shows that he had a great deal of interest in the money that the stockholders make. Shareholders were enriched with Jack Welch as CEO. Earnings per share rose from $0. 46 in 1981 to a rising to $1. 07 in 2000. He said he had a great deal of interest in his employees; however he laid off one and four employees. Corporations should accept a measure of accountability toward stakeholders and publicly report on their market, mandated and voluntary actions. GE did report this action which made is confirmable to parties outside the firm. The voluntary actions that was reported for its philanthropic foundation, was that they donated forty million in grants to colleges, universities, and nonp rofit groups in the United States. Also, former GE employees volunteered one million hours community services. In market actions it creates several hundreds of jobs, pays 5. 7 billion dollars in taxes, and makes valuable products for society. In mandated actions, GE follows government regulations and agreements negotiated with stakeholders apparent to the public. After evaluating the general principles of social responsibilities Jack Welch didn’t apply himself to the principles. They one only he applied his company to was the institution is run for profits. He also cared a lot about making the money for the shareholders. Nevertheless, he lacked the responsibility to his employees and environmental society. 4. What are the pros and cons of ranking shareholders over employees and other stakeholders? Is it wrong to see employees as costs of production? Should GE have rebalanced its priorities? A United States survey states, â€Å"8 out of 10 directors rank shareholders ahead of all stakeholders including employees (2). They are doing all they can to enhance shareholders value. The shareholders collectively own that company. And there interests are solely in the profit and performance and the direction the organization is in. The shareholders play an important role in raising finance of the organization. By ranking the shareholder ahead of the other stakeholder they are maximizing profits and shares. Shareholders give the organization continuous pressure to deliver results. They want a return on there investment. They want a management style where the need is only to increase profits which results in excessive pressure on the employees. The best interest of the company finances is not always in the best interest on the employees, the shareholders believe. When focusing on what the shareholders what the organization gets lost in the business environment focusing on profits instead of the people, the employees and other stakeholders. What they forget is that the stakeholders and employees are the business and the ones making the profits. The employees are the business greatest assets. If the focus just stays on the shareholders which are profit generated, over their employees, they will soon loss their only profit generating resource. As a result, corporations need to ensure the stakeholders are satisfied first to produce a profit. Growing the business and ensuring employees are fairly treated should the up most importance by managers and directors. Employees are part of cost of production. Costs are defined as those expenses faced by a business in the process of supplying goods and services to consumers. There is fixed and variable cost in production. Employees are apart of fixed cost by the salary of wages they receive. The variable cost for employees includes the wages of part-time staff or employees paid by the hour. Employees are huge part of production cost. GE should rebalance some of its responsibilities. Jack Welch should have taken more interest in his employees well being and the environment. Like now under the supervision of Jeffery Immelt, is in the process of rebalancing a culture shift of involvement in the environment. He has â€Å"Ecomagination† campaign featuring a loveable dancing rain-forest elephant that projects a friendly corporate face. They are now also marketing environmentally friendlier technologies such as wind power. He is trying to shift the focus from the shareholder to the stakeholders which Welch should have done. There is no doubt that Jack Welch is one of the most admired CEO’s of the 20th century. He turned one of America’s oldest companies into one of its largest income producing mega organization in the world but at a cost to society and individuals. In our new business models we should take the best of Jack Welch’s era and mix it with the new Ecomagination Societal accountability trends to create a business environment that looks at the entire picture to create profit and

My First Driving Experience Essay Sample free essay sample

â€Å"Sitting in the driver’s place. perspiration dribbling down my brow. my heavy external respiration joined with the thundering buffeting in my thorax. † a feeling all excessively existent. yet one that was necessary to carry through my turning experience. As you mature. these memorable â€Å"First clip experiences† come your manner go forthing lasting pes prints in your life. As for me. the first clip larning how to drive was a one clip experience that had much more in shop for me than had of all time anticipated. It was a beautiful Saturday forenoon. and I had woken up in an cheerful temper dying to get down off my twenty-four hours as freshly aged 16 twelvemonth old. As I am acquiring up. I see my ma standing in my room access with a smile stretching stat mis across her face from ear to ear. â€Å"Honey. I believe you are decidedly old plenty to get down your first driving lesson! What do you state? † As if she had profoundly offended me I annoyingly reply. We will write a custom essay sample on My First Driving Experience Essay Sample or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page â€Å"Mom do you cognize how unsafe it is to drive around the streets filled with brainsick drivers ready to do devastation in every corner they turn in? its a war zone out at that place! † â€Å"Honey. danger is inevitable. and it’s ever skulking in anything new you try. but I believe in you sweetie. merely give it a attempt. † Surprisingly. my ma ends up converting me. and before I know it I am in the drivers place of her new cherry ruddy Mustang. After a few proceedingss of seeking to convert myself I have made the right determination. I put on my place belt. look into my mirrors. and I place the key in the ignition. On my moms way. I nervously turn on the auto. at this point my bosom is a bomb clicking off at every second that passes. â€Å"Now easy start pressing on the gas pedal. † is all I hear when â€Å"Bam! † I slam my pes and into the auto I go parked right in forepart of me. The silence that followed spoke a million words. â€Å"I am done† is all I hear myself say as I get out of the auto. banging the door behind me. The following forenoon I stay in my room for most of the twenty-four hours. and I see a familiar silhouette standing in my door manner. â€Å"Today is a new twenty-four hours. and completing what you start will do you a stronger single. retrieve giving up will non acquire you anyplace. I believe in you honey. but most significantly you need to believe in yourself. † These soothing words of encouragement were all I needed at that minute. non merely did it do me recognize that I was capable of accomplishing this and more. but it was a encouragement of assurance like no other. â€Å"Mom I want to give it another shooting. I know I am ready. † with a smilings she nods. â€Å"Now that’s what I call assurance. † So. there I am. the ruddy visible radiation glowering at me. the engine boom. teasing me to get down. the paved route pressing me to sit its charcoal-like surface. I take a deep breath. and I go for it. easy this clip. but with more reassurance. As the p roceedingss tick off. I can experience myself doing advancement. â€Å"There you go you’re making it! † my ma says excitedly. and this is all I need to hike my assurance to its soap. Before I know it I am driving around as swimmingly and every bit fleetly as an ice skater effortlessly skating on thin ice. A bosom warming smiling from my ma was plenty for me. and the joy I felt that twenty-four hours was wholly overpowering. This peculiar first clip experience on larning how to drive greatly impacted me. It made me recognize that giving up should neer be an option. good at least for me I know it neer will be. I have learned to endeavor. and push through any obstruction that may traverse my way to success. Get the better ofing this obstruction has shown me that holding finding is the cardinal factor in being able to accomplish something you deemed impossible. Just retrieve to neer allow your fear overcome your finding. allow your finding overcome your fright. and you will win in what you set your head to.