Happiness Research Paper Example | Topics and Well Written Essays - 1500 words

Happiness - Research Paper Example In addition, the modern world fills our heads full of numerous distractions, many of which claim happiness can only be achieved after one has accomplished this material good or that status in life. In America, for example, people learn that happiness is what occurs when we have finally managed to claim ownership of a luxury car, a fine house and a stunning wardrobe to show off the tremendous body we’ve maintained, perhaps with the help of a personal trainer or skilled plastic surgeon. â€Å"To fulfill their dreams, Americans claim they need an annual income of $102,000† (Myers, 2000). According to Bolt (2004) and others, almost three-quarters of college freshmen feel being ‘very well-off financially’ to be a ‘very important’ or ‘essential’ goal in life (Bolt, 2004: 124). Other studies seem to indicate that our concept of happiness continues to change through life, so that what might have made us happy in the past will likely lose i ts ability to make us happy in the future (Diener & Diener, 2009). Although definitions of happiness and how to attain it may shift over time, research seems to link gaining happiness very strongly with the concept of adhering to a strongly identified sense of moral behavior. Within this discussion, it is important to understand that the concept of moral behavior as it is considered by philosophers does not merely constitute a choice between right and wrong behavior. The term â€Å"morality† is defined as a â€Å"moral quality or character; rightness or wrongness, as of an action† (Neufeldt & Goralnik, 1994: 882) and it is closely associated with the term â€Å"ethics† which is â€Å"the study of standards of conduct and moral judgment.† Even this much of an explanation is unclear, though, as terms such as â€Å"standards of conduct,† â€Å"moral judgment† and â€Å"moral character† have yet to be defined on a concrete level. These terms are potentially defined differently depending upon

The Problem of Studying Abroad Research Proposal

The Problem of Studying Abroad - Research Proposal Example The everyday living charges and some other education later funds may become known to the student only after he has experienced practical settlement into the foreign country. These hidden costs might inflate with the passage and it may not even be certain as to what their rate of inflation would be. The global uncertainty of economic conditions may be regarded as one of the pushing factors that result in this uncertainty of the situation. Incorporation The learning methods of the foreign country may be entirely different from those that have been followed by you in your educational system all your life. This might make incorporation into the foreign country’s learning setup difficult for the foreign students unless they are absolute geniuses. Diversity and Ethnicity Racial and ethnic discrimination may become a very grave issue for foreign students. If the ethnic background of the foreign student is targeted and is being mocked at by other students native to the foreign educational institution the learning environment becomes unbearable. Despite the understanding and open-mindedness of the twentieth century there have often been reported cases of ethnic discrimination against foreign students especially in areas like central London and Australia. Loneliness Staying away from home and family for months and often years is a very hard nut to crack. Students may be motivated enough to leave home for further studies but the hardships and settling compromises that they need to make in order to get adjusted into the new environment make them feel the worth of their native land and home. It is then that the foreign students feel really lonely and long for the helping hands that used to be always available for them back at their native homeland.

Compare 2 films Essay Example | Topics and Well Written Essays - 1000 words

Compare 2 films - Essay Example An analysis of several scenes will illustrate these points. Ozu’s â€Å"Tokyo Story† tells the journey of an elderly couple to the city of Tokyo where they reunite with their children and grandchildren. Their children, however, don’t have the time to spend with them. A few days later, the elderly couple goes back home. The mother falls ill and eventually dies. After the funeral, the children return to Tokyo leaving their father alone. Kurosawa’s â€Å"Rashomon†, meanwhile, recounts the stories of four different persons about a murder that transpired in the woods. A wife is allegedly raped by a bandit while her husband is murdered. In a dilapidated house that bears the name â€Å"Rashomon†, a priest and a woodcutter relay the story to a commoner. All four stories mutually contradict one another. In the end, an abandoned baby is found at the dilapidated house. 2. Themes Ozu explores the consequences of generational gap in families. Children, on ce grown, will live their own lives and leave their parents behind. Parents, on the other hand, will wish that their children achieve success and live happy lives. As time passes by, parents and children grow emotionally apart. The once warm and caring relationships become cold and neglectful. Neither parents nor children are to be blamed in this situation; it’s just the way things are. ... Kurosawa, meanwhile, explores the subjective nature of reality and the human tendency to embellish one’s positive characteristics and conceal those that are unattractive. Reality, as the film portrays, is a matter of interpretation. One event can be viewed and looked at from different perspectives creating a myriad of meanings out of it. The ultimate and absolute truth of something, therefore, can never be realized. This applies to human beings as well. People choose to believe what they please. Their perception is always influenced by motives both good and bad. 3. Stylistic Analysis Mise-en-scene. This refers to the composition of a scene which include the setting, lighting, costumes, and actor’s gestures, to name a few. Ozu’s mise-en-scene is constructed with utmost control and filled with telling details. The teapots, cups, or slippers are all there for a reason. Each tells a story of its own (eg. slippers lying at the elderly couple’s door at the spa). In â€Å"Rashomon†, the mise-en-scene gives emphasis on nature. Most of the time, the actors are shot beneath the shadows of trees and leaves revealing both their good and bad nature. The sometimes hysterical and animalistic acting of the wife and bandit show how strongly they held to their perception of the event. It seems like they’re trying hard to conceal their bad nature. Cinematography. This refers to the distance and movement of the camera, and the framing and duration of shots. Ozu often utilizes long and medium shots which show entire landscapes, actors in full body or waist up, and the space/background where the actors move around. Close-ups which emphasize facial features and emotions are never used. The camera moves only once

Teaching And Learning In The Digital Age Education Essay

Teaching And Learning In The Digital Age Education Essay Preparing learners for the demands of the 21st century requires committed, innovative teachers willing to push existing restrictions. It is also about effectively using the emerging technologies to enhance teaching and learning strategies. The unique and rapid changes happening in this field present various problems for teachers who are willing to experiment with their teaching and learning, roles and responsibilities, learning atmosphere and situations, patterns of interaction, strategies and theories, as well as, modes of assessment. Integrating technology in education can range from replicating existing educational practices through digital media with technology as tools, to transforming education to bring about new learning goals. Incorporating technology in the classroom can bring significant and positive changes in the teaching-learning process but it is not at all easy as we have strong conventional educational practices in our education system and integrating ICT will demand for the innovative role of the teacher as facilitator of the learning to the active role of the learner. The present paper focuses its attention on the problems and issues of the classroom and teaching-learning process in the digital age as it wont be easy to break existing pedagogical practices and adapt new ones. The paper further proposes the ways through which ICT can be effectively incorporated in the classroom. The paper also talks about the changing role of the teacher as well as of the learner in the world of technology and suggests the ways through which teachers can be motivated to use technological tools in their teaching-learning process. Key Terms: Teaching, Learning, Digital Age. INTRODUCTION: Integrating technology in education is a complex issue taking many forms that differ in purpose. This can range from replicating existing educational practices through digital media with technology as tools, to transforming education to bring about new learning goals. Education is at the core of powerful and rapidly shifting educational, technological and political forces that will shape the structure of educational systems across the globe for the rest of this century. Many countries are engaged in a number of efforts to achieve changes in the teaching-learning process to prepare students for information and technology based society. The UNESCO World Education Report (1998) notes that the new technologies challenge traditional conceptions of both teaching and learning and, by reconfiguring how teachers and learners gain access to knowledge, have the potential to transform teaching and learning processes. ICTs provide a range of powerful tools that may help in transforming the presen t isolated, teacher-centered and text-bound classrooms into rich, student-focused, interactive knowledge environments. The digital age means we now have interactive tools for the classroom to go alongside our more usual set of ideas and activities. Technology is both part of the problem and part of the solution. The information revolution itself has been fuelled by the growth of the Internet networked society but this revolution also offers alternative approaches to access, process and share knowledge, significantly reducing the importance of memory and the retention of a vast subject knowledge base (Burden, 2010). There is no longer the essential for teachers to retain a comprehensive body of subject knowledge which they are expected to be able to access and repeat with accuracy and speed. Subject knowledge is less likely to be perceived as placed in the individual teacher but rather as a shared effort in which the learner is capable of re-constructing new knowledge, both by themselves and as part of a collaborative effort (Ellis, 2007). The passive 3 Rs replaced by the more dynamic 3 Cs of collaboration, creativity and communication. These features challenge the traditional basis for teaching in schools. TEACHING LEARNING PROCESS: Schools today serve and shape a world in which there can be great opportunity to grow if people can learn to work creatively and collaboratively. Yet, instead of fostering creativity and uniqueness, more and more school systems have become preoccupied with traditional curriculum uniformity and pedagogical practices. Schools and teachers have been bound into the web of test scores and achievement targets. By and large, our schools are preparing young people neither to work nor to live well in this digital age. Twenty-first century teaching is no longer about the four walls of the classroom. Technology has enlarged the area of teaching-learning process as learners have the reach to vast store of information i.e. internet and they have lots of queries for this reason. So, pedagogical practices should necessarily be changed and capable enough to provide opportunities to the learners to discover the answers. It is also a fact that teaching has always adapted to its circumstances methodologically and physically, moving from lecture to pair work and from translation to communication, for example. Likewise, teachers have always tried to make the best use of any materials that they could get their hands on from slate to whiteboards, from hand-written postcards to authentic magazine articles, from radio recordings through to DVDs. Fig. 1, Teaching-Learning in the Digital Age The absolute degree of human knowledge, globalization and the accelerating rate of change due to technology necessitates a shift in our childrens education- from merely knowing to continuous cycle of learning, thus demanding the total change in the teaching learning process which is currently based on rote learning and memory. Digital age has opened up the new dimensions to the learning which are not visible in our existing traditional school system. Twenty first century learning is more complex than ever before as it includes various skills that must be acquired by the learner. Figure 2 presents these skills: Fig. 2, Skills of 21st Century Learner The days of only using chalkboards and books in the teaching learning process have gone. Nowadays, there is video or audioà ¢Ã¢â€š ¬Ã‚ video interaction in childrens classrooms. Using the same skills used for centuries-analysis, synthesis, and evaluation-teachers now must look at digital literacy as another realm within which to apply elements of critical thinking. TEACHER IN THE DIGITAL AGE: In the recent years school education sector has realized that the teacher is the ultimate key to educational change and school effectiveness. The teachers do not merely deliver the curriculum, but they also develop, define and reinterpret. It is the task of teachers to tackle with the technology and to grow their learners to acquire skills of the 21st century. In the current scenario, the voice of the innovative teacher in the country is barely audible. This voice is rich in practice and experience and can aid us in understanding best suited pedagogical practices for learners. ICT has given new roles and responsibilities to the teacher. ICT challenges the existing authoritarian role of the teachers as the sole source of knowledge and information and demands to be themselves learner first. Teachers themselves need to learn the new way of learning, and in addition to new ways of helping others learn. This also means a massive shift in the role of the teacher and in all structural aspects of the school system. It can be a highlight for most of the teachers when they suddenly realize that they learned something by and for themselves, not just for next class tomorrow. Teachers are hardly ever asked what they already know and can do, what experiences they bring, which problems they would like to tackle. Such low expectations are set in their teacher education courses in university and more traditional professional development settings. Fig. 3, Roles Responsibilities of the Teacher in the Digital Age The greatest teachers teach naturally. It flows from them like a gentle rain; they cant help but teach. ICT is just another tool in the toolbox of a good teacher. ICT expects teachers to give the students middle stage in the classroom, providing opportunities to explore and inquire for their learning. Teachers should act as guides, facilitators and advisors, building linkages between their students individual interests and understandings and the common skills and knowledge society expects them to acquire. Teachers hold personal theories, cognitive constructs and guiding principles that determine their instructional decisions and technology integration. Teachers are reflective by nature and use their own systems of beliefs to pursue solutions to problems as determined by their contexts. ICT has made it relevant for a teacher to be a subject specialist, in addition be able to utilize the amazing power that computers offer. The real facts remain the same. The good teachers love and passion for their subject, whether it be art, poetry or geography, can and do enrich the childs learning experience. ICT enhances this enrichment, but it will be difficult to break the existing boundaries and to convince the teachers to play their new role. LEARNER IN THE DIGITAL AGE: Students in a traditional classroom are passive. They listen and react to the teachers direct instruction. NCF, 2005 also articulates that childrens voices and experiences do not find expression in the class. It further says that children will learn only in an atmosphere where they feel they are valued and our schools still do not convey this to all children. But ICT has changed the way students learn and the styles of learning they adopt. The learner today has multiple resources available to them. They are ahead of their teachers in using the technology and accessing information in various fields. They are less dependent on teachers and prescribed text books. They build upon their existing knowledge and derive their own meanings. It has provided them freedom and flexibility which was not available earlier. Learners have active, reflective role in this digital age. Todays children are growing up digital. Their view of the world is very different from that of adults, thanks to exceptional access to information, people, and ideas across highly interactive media. Todays children are the latest model of human being. Looking at the world of children is not looking backward at our own past-its looking ahead. They are our evolutionary future. But, it also proposes the biggest problem in the teaching-learning process in the present digital age. A common scenario today is a classroom filled with digitally literate students being taught by linearà ¢Ã¢â€š ¬Ã‚ thinking, technologically obstructed teachers. Students have been exposed to these technologies or similar ones early on during their formative years while their teachers have just been exposed to it only recently. As a result, the students are sometimes more capable with the technology. In spite of this teachers are rarely given the chance to learn how to use this technologyà ¢Ã¢â€š ¬Ã‚ Ãƒ ¢Ã¢â€š ¬Ã‚ teachers are given the tools, but not the knowledge. Teachers increasingly are learning the technology on their own time. Students on the other are confident enough to use these technological advancements effectively and they even prefer it more on traditional methods of teaching and learning. Learners now have freedom to explore, discover and inquire whatever they want. ROLE OF ICT IN EDUCATION: Contemporary beliefs regarding learning have moved away from knowledge transmission models of simply imparting information to constructive knowledge models where knowledge is constructed. In the process of meaning making, technology is roped in to support the communication and construction of new knowledge resulting in new learning. Teachers want their learners to make their own decisions in future, enabling them to learn for themselves. The role of ICT in education can be seen as learning about, learning with and learning through ICT. ICT is used to liberate learners from the limitations of their physical environments due to inadequate infrastructure or lack of resources. ICT can mainly help in three areas that are as follows: Fig. 4, How ICT can help in the process of Teaching-Learning? Today ICT is an essential life skill in the same way as literacy and numeracy are. ICT provides an opportunity for economic development and is a requirement for employability. ICT is a tool for educational management that can improve teaching and learning. Teachers should utilize these technological advancements according to the particular context, pedagogy and activities during the lesson. Teachers need to be flexible to enough to use ICT. Use of ICT can create an interest among students which will result in learning at better pace and with ample opportunities to explore the answers to their various queries. But, it is not at all possible without changing the current traditional practices and roles that teachers and students are playing. CONCLUSION: ICT or digital age is the truth of our lives today which is unavoidable if one want to live, learn and move ahead in 21st century world. This digital age is a potentially liberating process freeing teachers and students from the acquisition and retention of information and enabling them to focus more on the creative processes of making connections and creating new paths which have meaning and purpose for the present time (Anderson and Krathwohl, 2000). ICT or digital age resources today offer great opportunities in education sector and especially to our schools for the beneficiary role they provide in information, learning and research. It clearly states that teachers should be digitally literate in order to use these ICT resources and tools. Existing traditional practices and roles necessarily be changed by the use of technology in the classroom. Teachers must be a facilitator and direct the students towards the right direction where as students should be provided with the freedom t o explore, discover and inquire. Resources should be made available to the schools in order to fulfill this objective and teachers must be educated digitally. It means, curriculum of teacher education will eventually be transformed into ICT based curriculum and exploratory pedagogical practices. ICT can enhance the teaching learning process and can make it more interactive than today. It will provide new dimensions to the learning as it will lead to autonomous learning. Constructivism will emerge as the new theory and technology will follow it in practice as it emphasizes on collaborative learning, real-world projects with authentic assessments with students accepting responsibility for their own learning. But all this will require internal inspiration and support system from our education system as well as the readiness to change and learn from everyone even from the students. Teacher training curriculum also need to be redesigned as teachers should themselves be learner and digita lly educated to be capable of using these ICT tools. REFRENCES: Anderson, L. and Krathwohl, D. (2000): Taxonomy for Learning, Teaching, and Assessing: A Revision of Blooms Taxonomy of Educational Objectives. Allyn Bacon: New York. Burden, K. (2010): Conceptualizing teachers professional learning with Web 2.0, Campus-Wide Information Systems 27, no. 3: 148-161.    Churchill, D. (2006): Teachers private theories and their design of technology-based learning; British Journal of Educational Technology, 37(4): p. 559-576. Dey, B., Saxena, K.M. Gihar, S. (2005), Information and Communication Technology and teacher Education : An empirical study : The Journal of Education, Vol. 1(2), pp.60-63 Ellis, V. (2007): Taking Subject Knowledge Seriously: From Professional Knowledge Recipes to Complex Conceptualizations of Teacher Development, The Curriculum Journal 18, 3: 447 462 Gardner, H. (1983): Frames of mind: A theory of multiple intelligences; Basic Books: New York. Glaserfeld, V. (1989): Constructivism in education; Pergamon Press: England. Jonesà ¢Ã¢â€š ¬Ã‚ Kavalier, B., Flannigan, S. (2006): Connecting the Digital Dots: Literacy of the 21st Century; Educause Quarterly, 29(2), 1à ¢Ã¢â€š ¬Ã‚ 3. Leask, M. Paschler, N.(2003), learning to teach using ICT in the secondary schools, Routledge: London. National Curriculum Framework (2005): National Council of Educational Research and Training: New Delhi. UNESCO World Education Report (1998): United Nation.

Sudden Infant Death Syndrome (SIDS) Essay -- Crib Death SIDS

Sudden Infant Death Syndrome (SIDS) Sudden Infant Death Syndrome (SIDS) or "crib death" is an abrupt and inexplicable death of an apparently healthy infant. Most of the cases involve infants from ages 1-12 months, and the event occurs during the night. Various theories have been postulated from research results but without consistency of the etiology. Since the death is sudden, prior diagnostic criteria or patterns are not available for correlation, although some near-miss infants have been followed. A number of possibilities have been documented in current literature, to include beta-endorphin changes, abnormal temperature regulation, pineal abnormalities, carotid body irregularities, lead poisoning, elevated fetal hemoglobin, brainstem immaturity, and cerebral hypoperfusion. The following is an overview of these pathologies in their relation to Sudden Infant Death Syndrome. As with most physiological processes, several intermediate steps can lead to a certain event, thus making the mechanism more controlled. However, as more steps that are required, there arises a greater number of possible problems. SIDS is no exception. Most literature supports the view that victims of SIDS suffer a failure of the automatic control of respiration, producing periodic apnea and eventually death. Neural control of respiration involves three anatomical structures (Armstrong et al., 1982~. The first is the motor system, which contains the neurons which initiate and maintain respiration. These include the dorsal motor nucleus of the vague, the nucleus tractus solitarius, the nucleus ambiguous, the nucleus retro-ambiguous, the reticulo-spinal tracts in the anterior and lateral columns and the anterior horn cells of the cervical and thora... ...16:1122-1126, 1978. Koceard-Varo, G. The physiological role of the pineal gland as the masterswitch of life, turning on at birth breathing and geared to it the function of the autonomic nervous system. The cause of SIDS examined in this context. Medical Hypothesis, 34:122-126, 1991. Myer, E., Morris, D., et. al. Increased cerebrospinal fluid beta-endorphin immunoreactivity in infants with apnea and in siblings of victims of Sudden Infant Death Syndrome. J. Pedia., 111:660-666, 1987. Quattrochi, J., McBride, P., and Yates, A. Brainstem immaturity in Sudden Infant Death Syndrome: A quantitative rapid Golgi study of dendritic spines in 95 infants. Brain Research, 325:39-48, 1985. Takashima, S., Armstrong, D., Becker, L., et. al. Cerebral hypoperfusion in the Sudden Infant Death Syndrome? Brainstem gliosis and vasculature. Ann. Neurol., 4:257-262, 1978.

The Flynn Effecct

Coupled with the given assumption, I do agree that human being is getting smarter. The reason of the growth in humans intelligent is affected by several factor. The factor that took Into consideration is shown as below: – 1. 1. 1 Technology: The conveniences that technology brought to this society, not only bringing conveniences to our daily. It also shift the human Intelligent paradigm to towards the right. Therefore the Intelligence Quotient (IQ) score are rising at the rate of 3 IQ points Increased per decade. 1. 1.Right to education: In the olden days, education could only affordable for the royalty and the rich. However, civil revolution has brought the awareness of the Importance of education. After World War II (1945), education system has embark the education system across some national(s). At the global level, Article 13 of the United Nations (1966), under the department of International Covenant on Economic, Social and Cultural Rights recognizes the right of everyone to an education. This recognition has strengthen the right for everyone to learn, having the opportunity for education, human intelligent end to continually increase as well. . 1. 3 Individual Psychology Behavior towards Media Influence (Media Psychology): Media psychology studies how media as a factor influence how people perceive, interpret, respond and interact in this cutting-edge century. To be able to perform as a media user, language abilities and reading is important. The increase of this awareness, indirectly influence human eager to learn and speak for their voice. Having this unaware awareness, it also helped in the human intelligent paradigm shift. This factor may not appear as an obvious factor UT it is a grey area to be studied further. 1. Which of the factors explaining the Flynn effect do you accept? Drawing upon the understanding towards the given case, the Education factor and Test-taking as'. N. Y factor are the main drives towards the growth in human intelligent . 1. 2. 1 Education: Students today are better educated than their ancestors, and education leads to higher test scores. 1. 2. 2 Test-taking save,y: Today's children have been tested so often that they are test-savvy. They know how to take tests and how to do well on them. 1. 3 If the Flynn effect is true, does this undermine the theory that IQ is most inherited?Why or why not? Based on the background study and understanding towards IQ, human intelligence Is not only difficult to measure; it is also difficult to define. Intelligence Is a combination of what we know (Knowledge), skills and ability to understand and reason – that Is the cognitive abilities continue to grow throughout our lives, rather than being set at birth. To answer this question In precise, IQ has only small percentage Is Inherited, biology Is only part of the Intelligence package; other factors Including our dally bobtail, what we eat to where we live, can also affect our Intelligence.

Ethical Delima

This case presents an ethical dilemma, a situation which arises when one must choose between mutually exclusive alternatives (Beauchamp& Walters, 2003). Decisions may have results that are desirable in some respects and undesirable in others. In Juana's case, her decision to refuse the blood transfusion had the desired outcome of allowing her to remain true to her religious beliefs. However, her choice also resulted in her death. If she had followed the recommendation of the physicians and the team, the desirable outcome would have been possible survival but would have had the undesired effect of violating her religious principles.The major ethical dilemma was that by honoring the patient's autonomy and religious beliefs, the physicians and interdisciplinary team were faced with compromising their moral duty to administer professional care in accordance with established standards (Chua & Tham, 2006). A brief review of the literature of Nursing Collection II: Lippincott Nursing Journa ls (from Ovid) and CINAHL databases for the past 5 years found no evidence to support best practice for a Jehovah's Witness who is pregnant and has experienced blunt trauma.Healthcare providers faced with this situation have sometimes attempted to obtain court orders that would overrule the patient's decision and result in her submitting to recommended medical treatment. For example, the Illinois Supreme Court (Illinois v. Brown, 1996) upheld a mother's decision to refuse blood transfusions even though they were vital for both the mother's and fetus' survival. The Patient's Bill of Rights states that the healthcare providers' responsibility is to give patients accurate information and that patients must consent to treatment (New York State Department of Health, 2008).This is consistent with the Federal government's recommendations to create guidelines that assure healthcare quality and to reaffirm the critical role consumers play in safeguarding their own health, (United States Depa rtment of Health and Human Services, 1999). Nursing practice is governed by the patient's right to autonomy rather than her religious beliefs (Levy, 1999). The first item in the American Nurses Association (ANA) Code for Nurses with Interpretative Statements (2001) addresses respect for human dignity:â€Å"Truth telling and the process of reaching informed choice underlie the exercise of self-determination, which is basic to respect for person †¦ Clients have the moral right to determine what will be done with their own person; to be given accurate information, and all the information necessary for making informed judgments; to be assisted with weighing the benefits and burdens of options in their treatment; to accept, refuse, or terminate treatment without coercion; and to be given necessary emotional support† (p. 1).However, it is difficult to witness death based on a person's decision to forgo care when medical options to sustain life are available. Treating this type of patient becomes particularly challenging when it involves two lives. Virtue ethics To analyze this ethical dilemma, the principles of Western medicine and the religious beliefs of Jehovah's Witnesses were examined. The questions that surfaced were (a) how would the application of virtue ethics provide insight into Juana's situation, (b) what were the ethical principles in conflict, and (c) why was it an issue to administer a blood transfusion to Juana in an emergency situation.Volbrecht's framework for ethical analysis was utilized to address the clinical dilemma and the questions listed above. Virtue ethics was the primary theory employed prior to the 17th century. This theory centers on shared familial and cultural histories and religious traditions and acknowledges the community's ability to identify, interpret, prioritize, and adjust to moral considerations within a particular context (Volbrecht, 2002). The following is an exposition of this case according to virtue ethics. Virtue ethics focuses on what is morally correct from the patient's viewpoint and centers on the patient's autonomy.Actions and character are intertwined, and the ability to act morally is contingent on one's moral character and integrity. Virtue ethics focuses on the context of the situation (Volbrecht, 2002). Ethical analysis of virtue ethics entails (a) identifying the problem, (b) analyzing context, (c) exploring options, (d) applying the decision process, and (e) implementing the plan and evaluating results (Volbrecht, 2002). Identifying the problem Juana, a 20-year-old Hispanic woman, 32 weeks pregnant, was involved in a car accident. Internal bleeding to the thoracic or abdominal cavity was suspected.The stakeholders were the woman, her husband, the fetus, and the interdisciplinary healthcare team. The team thought the best method of treatment for this patient was to administer a blood transfusion and perform an emergency cesarean section. Both the patient and her husband ref used this option because of their religious beliefs and provided written documentation indicating that the patient would not accept blood or blood products. The value issues were the physical survival of the woman and her fetus versus the woman's religious integrity. Analyzing contextTo understand the decision-making process in this case, one must consider the ethical principles of autonomy, beneficence, nonmaleficence, justice, compassion, and respect. The patient's religious beliefs and how they influenced her decision must also be taken into consideration. Gardiner (2003) confirms that the ethical principles mentioned above influence one's choices. In Juana's case, the healthcare team suspected she was experiencing internal bleeding and that she and the fetus were in physiological distress. Juana's decision to reject the proposed treatment was based on her stated religious beliefs.The contextual factors of this case centered on the patient's religious beliefs. The patient stated she would â€Å"rather be embraced in the hollow bosom of Jehovah than to be condemned for all eternity,† if she should receive a blood transfusion. Nurses draw from the code of ethics to reflect upon and understand the person's perspective, and to honor her wishes. â€Å"The nurse provides services with respect for human dignity and the uniqueness of the client, unrestricted by considerations of social or economic status, personal attributes or the nature of the health problem† (ANA, 2001, p.1). To respect the patient's decision and honor her dignity, supportive care was provided to the patient in an effort to save her life, while at the same time respecting her wishes. The ANA Code of Ethics supports the point of view that healthcare providers should respect patients' wishes and decisions despite their own personal beliefs (ANA, 2001). Applying an ethical decision process Looking through the lens of virtue ethics, the caregivers focused on Juana's autonomy and her ri ght to choose what she perceived best in spite of the possible outcomes.Juana was a competent, pregnant woman who made informed decisions not to receive blood transfusions or a caesarean section. Based on virtue ethics, the healthcare providers respected the patient's autonomy by reflecting on and honoring the decision of the patient and her husband based on her religious values and beliefs. The healthcare providers also drew on the principle of beneficence, which centers on promoting the well-being of others. In this case, the well-being was not physiological but spiritually oriented.The principle of nonmaleficence was also employed by not intentionally inflicting harm on the patient and honoring her wishes. Violation of a client's deeply held beliefs is a form of doing harm. (Leonard & Plotnikoff, 2000). They also drew from the principles of veracity and respect, which entail being truthful to the patient and allowing her to make an informed decision (Volbrecht, 2002). The nursing virtues of compassion, moral courage, and self-reliance also contribute to an understanding of this situation. Evaluating resultsAt the time this clinical situation presented itself there were no specific guidelines in the institution for dealing with the dilemma presented by this case. However, there are guidelines for Jehovah's Witnesses specifically geared to early identification and management of gynecological patients. For example, in Australasia, there are specific guidelines for treating pregnant women that focus on stabilizing the patient by using traditional and new treatment modalities to meet patient needs, particularly for Jehovah's Witnesses or other patients who decline blood transfusions (Women's Hospitals Australasia, 2005).For antepartum patients, the guidelines focus on early identification of Jehovah's Witnesses during prenatal visits, as well as placing these patients on a high risk protocol, including maintenance of high hemoglobin and hematocrit levels, having advance directives completed, and establishing affiliations with other hospitals that are well-equipped and staffed to meet these patients' needs (Women's Hospitals Australasia, 2005). The Hartford Hospital in Connecticut has a similar program and also performs bloodless procedures on patients who are Jehovah's Witnesses (Miller, 1996).As a result of Juana's case being reviewed by the ethics committee post-mortem, a risk-management protocol was developed requiring patients who refuse blood transfusions to sign a waiver that removes the legal responsibility for the decision from the hospital and caregivers. To support this type of protocol, the Society for the Advancement of Blood Management maintains a database of hospitals that provide blood-conserving services in the United States as well as in Canada, Chile, Korea, and South Africa (Society for the Advancement of Blood Management, 2008).The problem, however, in an emergency situation is that it may not be possible to get the pat ient to a participating hospital. The Watchtower Bible and Tract Society (2004) recommends that advance directives and other legal papers be in place should an emergency arise. These documents should be easily accessible so that healthcare providers can honor the patient's directives. In so doing, they will be applying the theory of virtue ethics and, therefore, respect the patient's wishes (Macklin, 2003).Healthcare providers should practice beneficence and non-maleficence without imposing their beliefs as to the right thing to do. More explicit and universal guidelines would benefit both patients and providers when faced with similar ethical dilemmas. Conclusion In nursing practice, cases of patients refusing blood transfusions or other interventions are becoming more common. Therefore, content regarding ethical issues, such as Juana's case, needs to be integrated into nursing curricula and the clinical arena.Nursing educators who incorporate bioethics into critical thinking in cl inical decision making situations can prepare novice and experienced nurses to handle complex ethical dilemmas, such as described in this paper. The learning process may be facilitated through integrating lectures with case studies and utilizing patient simulators to further enhance the learning process (Larew et al. , 2006).These teaching approaches would provide the opportunity to expose nurses to scenarios of acute patients where they can intervene in a safe environment, which in turn would decrease their anxiety and promote learning. Nurse educators can further facilitate the learning process by providing clinical experiences with diverse patient populations in a variety of settings followed by discussion of actual clinical experiences, ethical issues, and debriefing (Larew et al. , 2006).Nursing faculty have an ethical responsibility to prepare competent nurses and facilitate continuing education that will help nurses recognize ethical dilemmas in practice and apply ethical pri nciples in trying to resolve them. The focus in practice, education, and research must be on providing care that respects patients' cultural beliefs and autonomy. Nursing educators should place equal emphasis on ethics in order to provide the best holistic care possible. To do anything else is a disservice both to the profession and to our patients.