Ethical Issues for Community Treatment Orders

Ethical Issues for Community Treatment Orders Ekta Patel Community Treatment Orders refer to a legal order in which patients must accept medical care such as therapy, rehabilitations, management or coping classes, counselling or other health services while living in the public. The Community Treatment Order (CTO) accounts to serve patients with psychiatric treatment plans that are essentially established by the patients psychiatric health provider. The CTO requires patients to comply with all conditions and terms of the order, hence, if not followed, they would be directed to a psychiatric health facility where essential care and treatment would be initiated. CTO can be prepared for any time period for up to twelve months. This means that patients may have to comply with CTOs for more than just one sequential time. Section 7 on the Canadian Charter Rights of Freedom, under the Mental Health Legislation, it states that life, liberty and security of all citizens are fundamental principles of justice. Notwithstanding, ethical concerns arise because these rights of people are jeopardized with the forceful commitment and acceptance that psychiatric patients have to conform to when CTOs come to play. There have been ethical controversies associated with the implementation of CTOs along with other forms of outpatient treatment regulations. The debate on the suitable mandatory care in the community reflects the unstable political, philosophical, and medical concerns. With the involuntary Community Treatment Orders options, it is said to force treatment amongst individuals seeking care, hence taking away their rights of having a choice. In short, CTOs place patient autonomy at risk. The debate argues that this forceful treatment takes away the right of individuals to refuse treatment for a psychiatric illness. This argument of limiting freedom amongst individuals with disturbances is not recent; it has been a targeted issue since the 1960s through the 1970s. During the 1960s and 1970s the debate largely focused on the quarrel of involuntary inpatient treatment and care. However, at present, the debate focuses on community based treatment, arguing that CTOs serve to stop involuntary medical attention. With the implementation of CTOs, are several associated arguments. Firstly, CTO being involuntary, it breaks the norm of never forcing treatment amongst individuals. CTO aggravates forceful actions into the community. The implementation of CTO intensifies the struggle of defending patient rights within the community, thus neglecting other possible services that could be far more optimal in treating patients. Thirdly, we all know that the overflow of inpatients and wait-times in health care facilities have become a prime concern, and with the execution of CTOs, hospitals will be far more packed with non-adherent patients. Consequently, this reinforces long wait-times in Emergency Departments and causes in-patient beds to be occupied more frequently, therefore delaying and interrupting the quality of health services and care for other patients. From the perspective of psychic, Uri Geller, come people are deprived of their liberties in the attempt to give them psychiatric care. Occasionally, others are deprived of psychiatric care in the attempt to guard their liberties. Supporters of CTOs argue that when people with psychological disturbances are given liberty, they could potentially become marginalized from getting crucial treatment required to benefit their health. Though this idea to some extent is accurate, there is a much riskier adverse effect associated with it. This is because, when patients are involuntarily treated for the specified amount of time chosen by psychiatrics, patients are required to take regular doses of antipsychotic medications. As a result of this, it can lead to severe long-term or short-term harmful side effects. Community Treatment Orders have illustrated to reduce the number of victimized patients of abuse. CTO is a form of epistemic violence, because it involves ignoring individuals perspective, while declaring they are too sick to have a say. The implementation of CTOs is significantly increasing, but it is argued that the result of CTOs does not validate the constraints that are compiled on a patients autonomy. Reason being, although coerce CTOs make the public feel secure and safe, it violates those, who are suffering from psychiatric imbalances. This is because, they are not given the liberty and the right to choose what type of treatment and care they would like to seek and are discriminated against. According to a randomized controlled trial, it was found that the number of patients readmitted did not differ as much between patients. Hence, it can be concluded that compulsory orders do not reduce the rate of hospital re-admission of psychiatric consumers. There is limited evidence that proves that compulsory community treatments, including CTOs have achieved its medical goals, which was to decrease re-hospitalisation and increase attention towards medication and medical services.ÂÂ   Instead, to improve community-based psychiatric services, psychiatrics or other medical specialists could arrange for regular patient testing, for example, frequent urine, and blood. This can help specialists to have adequate patient information, allowing them to precisely determine optimal treatment plans. References Andrew, M., John, D., Julia, S., Jorun, R., Ksenija, Y., Maria, M., Merryn, V., Stefan, P., Tom, B. (2013). Community treatment orders for patients with psychosis (OCTET): a randomised controlled trial, Article, Volume 381, Page 1-7. Retrieved from http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(13)60107-5.pdf Brenda A. L.,ÂÂ   Geoffrey., R., Robert, M.ÂÂ   (Eds.). (2013).ÂÂ   Mad Matters. Toronto, Ontario: Candian Scholars Press Inc. Canadian Civil Liberties Association. (2015). Talking About Community Treatment Orders and Discrimination. Retrieved from https://ccla.org/talking-about-community-treatment-orders-and-discrimination/ Dreezer, S., Bay, M., Hoff, D., Microlog (2007). Dreezer Dreezer Inc., Ontario Ministry of Health and Long-Term Care Ebrary CEL York University, Report on the legislated review of community treatment orders, required under section 33.9 of the Mental Health Act. [Toronto, Ont.]: Ontario Ministry of Health and Long-Term Care. Hutt, L., La Forest, G. V., Lahey, W. (2013) Independent Panel to Review the Involuntary Psychiatric Treatment Act and Community Treatment Orders. Department of Health and Wellness, Canadian Electronic Library (Firm), Ebrary CEL York University. Report of the Independent Panel to Review the Involuntary Psychiatric Treatment Act and Community Treatment Orders. Department of Health and Wellness Office of the Chief Psychiatrist. (2001). Community Treatment Orders A Review (PDF File). Retrieved from http://www.health.wa.gov.au/mhareview/resources/documents/A_Review_of_CTOs_T_Rolfe.pdf R.A. Malatest Associates., Ontario. Ministry of Health and Long-Term Care., Canadian Electronic Library (Firm). (2012). The legislated review of community treatment orders: Final report. Victoria, B.C.: R.A. Malatest Associates Ltd.. Richard O. (2004). Why Are Community Treatment Orders Controversial. The Canadian Journal of Psychiatry- In Review, Volume 49 (9), Pages 1-6. https://ww1.cpa-apc.org/Publications/Archives/CJP/2004/september/oreilly.pdf Ronan, M. The Community Treatment Order: Clinical and Ethical Issues. (1998). Australian and New Zealand Journal of Psychiatry, Volume 32, Pages 223-228. http://journals.sagepub.com/doi/pdf/10.3109/00048679809062732 Steve, K., Katherine, H. (2014). An Updated Meta-Analysis of Randomized Controlled Evidence for the Effectiveness of Community Treatment Orders. The Canadian Journal of Psychiatry. Pages 1-4 http://journals.sagepub.com/doi/abs/10.1177/070674371405901010

Me Talk Pretty One Day Essay

Me Talk Pretty One Day. The title already starts questions and as you get through the essay, it makes perfect sense and creates a meaning to the title. Sedaris is the narrator throughout the essay and nearly at the beginning of the story you finds his tone throughout the essay is kind of a depressed tone, it sounds like he is depressed and put down by the instructor of his french course. Sedaris is passionate in leaning French. He moves to France and starts school there, so that he would learn the language better than he could in America. On his first day Sedaris watches his fellow students catch up with each other, discussing their summer vacations and the latest news about mutual friends. He has a number of first impressions: they appear much younger (he is now forty-one years old), they are definitely much more attractive, and they all appear to speak French flawlessly. Sedaris soon feels a little out of his element, until his French teacher arrives and makes him feel like a complete imbecile. However, Sedaris is not alone in being belittled by his instructor for she did not just pick on him but the rest of the class. However, he still went home every night and studied everything so that he could go to class the next day and know just a little more so the teacher wouldn’t pick on him as much. You find the depressed tone again during class, that everyone wanted to be there but at the same time didn’t want to be there. The teacher rode on a high horse because she didn’t speak only fluent French but 4 other languages too, including English, which she shows to Sedaris by saying in English â€Å"I hate you, I really hate you. (Found on page 3, last paragraph) Now why in her right mind does the teacher feel the need to put everyone down, and to say something of this nature stating that she hates him. Why is that, is it because she herself has troubles in her life and she feels in her time of power of being the professor of a French course and the only one that can speak it fluently, that she can emasculate everyone in the class. But through all of that all of the students including Sedaris, go home every night and study their French for hours on end, an example of it is stated on page 14, 1st paragraph. â€Å"I took to spending 4 hours a night on my homework, putting in even more time when we were assigned an essay. † Because of that the tone suddenly switches from a depressed tone to an upbeat tone right towards the end of the essay when Sedaris states, â€Å"Understanding doesn’t mean that you can suddenly speak the language. Far from it. It’s a small step, nothing more, yet it’s rewards are intoxicating and deceptive. The teacher continued her diatribe and I settled back, bathing in the subtle beauty of each new curse and insult. † From that moment, the professor goes on to belittle Sedaris but this time he isn’t hurt or insulted by it. He takes from it and with confidence replies to her insults with, â€Å"I know the thing that you speak exact now. Talk me more, you, plus, please, plus. Leaving you with a feeling of happiness and joy knowing that Sedaris gained his confidence back. From the tone of the essay, it makes everything feel a lot better in the end. The use of the â€Å"French† in the essay, gives meaning to the times where you dont understand what the counterpart is saying applying the use of words that doesn’t exist creates a confusion but also an understantment of how Sedaris feels when the teacher is talking to him. Here you can see the words meimslsxp; lgpdmurct; apzkiubjxow; palicmkrexis; fiuscrzsa; ticiwelmun; kfdtinvfm; vkkdyo; kdeynfulh. Understanding and speaking do not automatically go hand in hand, but it is better to understand rather than to speak. Which is the point the author is trying to make through the entire selection.. David Sedaris takes a stroll down memory lane in his anecdote about his experience learning to speak French in Paris, under the rule of a cruel dictator-like teacher. He describes certain moments of intense cruelty of the teacher, such as when one girl in his class doesn’t know the correct irregular past tense of the verb to defeat. The girl was poked in the eye with a freshly sharpened pencil, and the teacher, although remorseful, did not spend much time apologizing. The students in the class are not fluent in French, and their halting sentences, when translated, sound like â€Å"sometime me cry alone at night†¦that be common for I, also, but be more strong, you. † This is the exact way that a student of a foreign language would speak, and it illuminates the difference between speaking a language so that others could possibly understand you, and understanding the language.

Middle Eastern Views of Mental Illness

There are many countries that are considered to be countries of the Middle East. Some of these include Iraq, Iran, Turkey, Yemen, and Isreal, just to name a few. Many of these countries have things in common, such as belief in Islam, use of the Arabic language, connections through the Arab League, historical ties, etc. The different countries form a chain of countries that are linked by culture and religion on the one hand and yet vary greatly in terms of dialect and history on the other.The Arabic language is a large common denominator between these countries; however, dialects can be so different from each other to a point where a person from Syria can hardly communicate with a person from Algeria. (1) Most landscape in the Middle East is either occupied by harsh desert conditions or mountains. This has made its people very tough in terms of living conditions. Lebanon, parts of Syria, Turkey, Iran and Iraq have mountainous areas while most of the other countries are flat and extrem ely arid.Those living in the desert traditionally used to move around in a perennial search for water, which resulted in unique eating behaviors and homes. A typical Arab house in the desert is built out of mud and has little furniture. The food is basic with little processing. However, in the mountains of Lebanon, Syria or Turkey one will encounter strong homes with heavy stones and arches that can last for generations. In addition, food in these areas is usually produced during summertime and stored in cellars for use when nature does not allow them to go out and work their snow covered fields. 1) Religions play a big role in the dynamics of the Middle Eastern society. They are considered to be one of the main pillars of the society and individuals are stereotyped based on religion. Islam, Judaism, and Christianity are the main religions practiced in the middle-east and people who practice these faiths only surround themselves with people of the same faith. Daily life is practiced on the basis of ones religion and others are expected to respect that.1) The present day Middle East is a mixture of very old cultures and very young nations that were organized by European colonial powers after the defeat of the Central Powers which led to the end of World War One and fall of the Ottoman Empire. The culture of the Middle East is thus understood only by learning about the history of the region and the forces that have influenced the growth and demise of controlling powers. Since World War One, colonial countries such as France, Great Britain, and The United States have ignificantly influenced the Middle East. (1) Keeping in mind this very generalized description of the Middle Eastern culture we can now begin to look at the beliefs in terms of mental illness. In my research it is safe to say that most all opinions by middle easterners are based off of their religious beliefs. According to the SRA (Stigma Research and Action) people from non-Western cultures tend to attribute the cause of mental illness more frequently to the afflicted individual.It is possible that discrimination against the mentally ill differs in an Islamic culture where mental illnesses and other ailments are, to some extent, considered to be due to the will of God, rather than evil forces, bad behavior, or other personally devaluating factors. According to the holy Koran, people with a mental disorder should be treated with respect, and this might result in a less stigmatizing attitude.Such a perception of causality would also reasonably apply to the individual, and might be a factor that reduces self-blame. One must bear one’s predicament and wait for the mercy of God! A study was done by SRA researchers and participants were asked a series of open-ended questions. Responses indicated feelings of alienation, sharing stereotypes about the mentally ill, experiences of discrimination, social withdrawal, and resistance to being stigmatized and discriminated against.For example, responses included: Yes, they discriminate against us; They don’t count on us; Our society has no capacity for us; I mean there is no cultural understanding in our society; They ridicule, insult and harm us; I wish they could understand that psychiatric patients are like other patients, like patients with cancer or cardiac disease and that they can live their lives.A recurring theme was the idea of the mentally ill as dangerous and aggressive: They all believe a mentally ill patient is a natural born killer and that’s why I try to keep myself to myself and not even claim what I’m entitled to; When the police came they were acting as if I was a criminal, but they ought to know that I’m a patient, not a criminal. (2) The International Journal of Mental health Systems has thoroughly researched the country of Iraq in terms of their views on Mental illness.According to their research public attitudes towards mental illness in Iraq has shown that comm unity opinion about the aetiology of mental illness is broadly compatible with scientific evidence, but understanding of the nature of mental illness, its implications for social participation and management remains negative in general. (3) As nurses we have to remain unbiased, and educational towards our patients and their families.When faced with a patient with a mental illness whom is Middle eastern we need to stay mindful of the fact that they probably believe that they were afflicted by their God in some way, or in some way they deserved to be born with this illness. We need to simply educate them on the importance of medication Therapy and safety. We should treat all of our patients the same no matter what their cultural beliefs are and we should always treat each patient with respect.Active listening is an important skill to master as a nurse with all patients but with Middle Eastern patients especially it is a sign of respect to listen to them first, and allow them to finish completely prior to speaking. Giving this level of respect to all patients all the time will ensure that as nurses we never offend, and that we give the best quality care.

The Fires of Jubilee How Reliable is It Essay - 1462 Words

The Fires of Jubilee, by Stephen B. Oates, tells an account of Nat Turner’s rebellion. Beginning with Nat’s early life and finally ending with the legacy his execution left the world, Oates paints a historical rending of those fateful days. The Confessions of Nat Turner by Thomas R. Gray and approved by Nat himself is among Oates’ chief sources. Oates is known as a reputable historian through his other works, and has strong credentials however, in the case of The Fires of Jubilee there are some limitations. It is, therefore, worth analyzing Oates’ interpretation for reliability. In doing so one sees that The Fires of Jubilee, because of its weak use of citations, failure to alert the audience of assumed details and the way in which†¦show more content†¦Considering the limitations Oates may have run into with publishers, his use of citations is a decent attempt. However, his method is not the most effective way. First, there is not a footno te in sight. There is no rule demanding the utilization of footnotes; however, footnotes illuminate and confirm Oates’ sources. Not using footnotes, by contrast, make his sources difficult to comprehend, possibly temporarily, weakening his argument. Finally, there are some quotes with numbers and some without. Clearly, Oates has a system for his sources but it is not necessarily the best way. The reader should be able to follow the author’s mode of citations making the argument clear and convincing. Allowing confusion here affects the author’s ability to convey his or her view; combined with other weaknesses could mean considerable failure for the case. While reading the content one sees Oates as an extraordinary story-teller. His prose and drama allow the reader to see, hear, and feel the world of Southampton, VA. Oates calls this approach â€Å"the technique of dramatic narration.† However, this advance can affect accuracy. In the early stages of his account Oates writes, â€Å"By the time Nat was four or five years old, Nancy was extremely proud of him. Bright-eyed and quick to learn. . . . † This quote gives the audience some kind of understanding of the relationship between Nancy and her son and begins to illustrate NatShow MoreRelatedHistory of Michigan 7th test Chap 18 19 Essay1530 Words   |  7 PagesD) Aretha Franklin E) Ray Charles 4.What Michigan governor was a serious candidate for the Republican nomination for president in 1968 until he made a controversial statement accusing the U.S. government of brainwashing the American public about how the war was really going in Vietnam? A) John Engler B) William Milliken C) George W. Romney D) Gerald R. Ford 5.What innovative aircraft designer convinced Henry and Edsel Ford to become involved in commercial aviation? 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