Everyday in society, physical activity is pursued in many ways, ranging from informal daily tasks such as chores, walking to school, and propelling one’s wheelchair, across the spectrum to highly organized and/or competitive sport. Here in the School of Kinesiology and Health Studies, we study human movement in its many forms. We examine the role of physical activity in promoting physical, mental, and social health and well‐being from the level of the individual to society. With that in mind, please tell us why you are interested in being admitted to the Kinesiology offered by the University.

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Everyday in society, physical activity is pursued in many ways, ranging from informal daily tasks such as chores, walking to school, and propelling one’s wheelchair, across the spectrum to highly organized and/or competitive sport. Here in the School of Kinesiology and Health Studies, we study human movement in its many forms. We examine the role of physical activity in promoting physical, mental, and social health and well‐being from the level of the individual to society. With that in mind, please tell us why you are interested in being admitted to the Kinesiology offered by the University.

Operation, Technology, And Management Plan & Assignment 3 Part 2: Business Plan – Draft

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Part 1

Use the “NAB Company Portfolio”.

Write a three to six (3-6) page paper in which you provide the following information below.

Operations Plan (1 – 2 pages)

Note: Remember to assign a dollar amount to each operational cost you find, as you will need these figures for your income statement and cash flow in Week 8.

1. Create an operations plan for your NAB company using the template in the text as a guide (p. 214 | Operations Plan Preparation Form – Click here for help accessing a specific page number in your eBook ). Extract appropriate information from the NAB Company portfolio, where applicable. Other required items in the template should be filled in using your personal preferences.

2. Provide a rationale for the competitive advantages section using appropriate functional-level and business-level strategies to explain the competitive advantages.

· Note: Much of the research pertaining to the hints provided here can be found in the NAB company portfolio.

· Hints: Consider whether you will rent or buy your facilities or outsource production to an existing company.

· Hints: One of your biggest expenses as a startup non-alcoholic beverage company will be transitioning from a small batch prototype of your beverage to production on a large scale. Research the equipment you will need (vats, refrigerators, burners, ovens, bottling equipment, and so on), whether you will rent or buy, how you will maintain and clean it, and so forth. Consider how you will ensure quality control. What capacity do you intend to reach?

· Hints: Deliberate your inventory control. Where do your supplies come from and what is your turnaround time to produce your beverage once you have received an order?

· Hints: Consider your distribution method. Refer back to your notes for the SWOT analysis assignment in Week 2 of class.

· Hints: How will you stay abreast of new developments in your industry? What new products do you have in development now, in addition to your flagship product?

3. Describe your research and development activities and explain how they will contribute to the company.

Technology Plan (1 – 2 pages)

4. Create a technology plan for your NAB company using the template in the text as a guide (p. 227 | Technology Plan Preparation Form ). Extract appropriate information from the NAB Company portfolio, where applicable. Other required items in the template should be filled in using your personal preferences.

5. Provide a rationale for the personnel needs section by incorporating appropriate functional-level strategies.

· Hints: Consider the type of technology your company will use to conduct the following activities: manage personnel; take, fulfill, and track orders; manage inventory; communicate with customers and provide customer service; and produce your beverage.

Management & Organization (1 – 2 pages)

6. Create a management plan for your NAB company using the template in the text as a guide (p. 248 | Management Plan Preparation Form ). Extract appropriate information from the NAB Company portfolio, where applicable. Other required items in the template should be filled in using your personal preferences.

7. Using the flow charts on p. 242 as a guide, outline your company’s management hierarchy. Note: Charts or diagrams must be imported / included in the MS Word document.

8. Provide a rationale for the management structure and style section by incorporating appropriate functional-level strategies.

9. Format your assignment according to these formatting requirements:

a. Cite the resources you have used to complete this exercise. Note: There is no minimum requirement for the number of resources used in the exercise.

b. Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; references must follow APA or school-specific format. Check with your professor for any additional instructions.

c. Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required page length.

The specific course learning outcomes associated with this assignment are:

· Create a plan to implement a firm’s strategy and manage the change from current operations.

· Describe strategic planning techniques used to formulate alternative strategies designed to achieve stated business goals.

· Use technology and information resources to research issues in strategic management.

· Write clearly and concisely about strategic management using proper writing mechanics.

Part 2

This assignment consists of two (2) sections: a draft of your business plan and an income statement containing your business plan financials (i.e. Week 7 Discussion “The Financials”). Note: You must submit both sections as separate files for the completion of this assignment.

You must intend to raise money for your startup company. You can start with money from friends and family but at some point you will need funds from outside investors, either angels or venture capitalists, depending on how much money you project you will need to raise. Another possible angle is to develop money through crowdfunding, assuming your product meets the demand of such audiences.

Before you can raise money, you must develop a business plan that convinces an investor that your company will succeed.

Section 1: Business Plan (MS Word or equivalent)

Read Chapters 18 and 19 of the course text: Successful Business Plan. Use the Plan Preparation Forms at the end of each chapter of Successful Business Plan as a rough guide.

Write an approximately fifteen to twenty (15-20) page draft of your business plan in which you:

1. Revise the components of the following previously submitted sections based on the feedback you have received.

1.

a. Company Description (Assignment 1)

b. Industry Analysis and Trends (Assignment 1)

c. Strategic Position & Risk Assessment (Assignment 1)

d. Target Market (Assignment 2)

e. Competition (Assignment 2)

f. Marketing Plan & Sales Strategy (Assignment 2)

2. Create an Ethics & Social Responsibility Plan.

Note: The Ethics & Social Responsibility plan should account for approximately three to five (3-5) pages of the Business Plan Draft.

2.

a. Describe the ways in which your company is committed to being a good corporate citizen.

.

2. Hints: Consider the following areas:

1. Creating jobs

1. Following the laws of every jurisdiction in which your company operates

1. Fair and honest treatment of employees

1. Non-discrimination of employees and increasing diversity of your work force

2. Hints: If your company is designed as a social venture—in which you have a primary purpose of achieving a social or environmental goal—describe what that goal is and what aspects of your company are designed to reach that goal. Provide a rationale for why you have or why you have not chosen this to be a social venture.

3.

b. Discuss how your company’s activities will affect the environment and identify the steps you will take to mitigate any negative impacts.

·

· Hints: As a beverage company, consider such issues as your choice of packaging, disposal of bottles / packages by consumers, and your use of resources, such as water in areas where water may be scarce.

4.

c. Determine any health issues / claims related to the product you are making, whether negative or positive. Suggest the strategy your company will use to mitigate any negative issues, and to ensure any positive claims are true.

5.

d. Many beverage products have negative health impacts on certain segments of a population (e.g., children, pregnant mothers, etc.). Suggest your company’s plan, through advertising, distribution, and / or other methods, to target and reach only appropriate market segments.

3. Format your assignment according to these formatting requirements:

a. Cite the resources you have used to complete the exercise. Note: There is no minimum requirement for the number of resources used in the exercise.

b. Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; references must follow APA or school-specific format. Check with your professor for any additional instructions.

c. Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required page length.

Section 2: Business Plan Financials (MS Excel worksheets template)

4. For year one, revise and submit the Income Statement, Cash Flow Projections, and Balance Sheet sections from the “Business Plan Financials” MS Excel template (see: Course Required Files in Week 1).

The specific course learning outcomes associated with this assignment are:

· Describe strategic planning techniques used to formulate alternative strategies designed to achieve stated business goals.

· Create a plan to implement a firm’s strategy and manage the change from current operations.

· Analyze strategies for exerting the internal leadership needed to drive the implementation of strategic initiatives and improve operating excellence.

· Use technology and information resources to research issues in strategic management.

· Write clearly and concisely about strategic management using proper writing mechanics.

As security and IT change so rapidly, your article should be no older than 2007 (i.e. Less than 5 years old). Summarize the article using at least 500 words. 

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Assignment Instructions

Research via the internet and find an article in the news regarding wireless hacking, hardware hacking, or other security breach. As security and IT change so rapidly, your article should be no older than 2007 (i.e. Less than 5 years old). Summarize the article using at least 500 words.  The key to this assignment is to demonstrate your understanding of the topics, not to re-word the text or reference material.

Please complete the scenario below following these guidelines for your deliverable.

· The assignment must be a minimum of 2 pages double spaced, plus a title page and a reference page for a total of 4 pages.

· Make sure you are using at least two (2) academic references.

· This submission should be created following APA 6th edition guidelines.

leading factor of death in adults worldwide

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A heart attack or Myocardial infarction (MI) is the leading factor of death in adults worldwide (Nicolai et al., 2018).  MI occur in patients when the blood flow to the heart is blocked due to increased built of plaque within the walls of the blood vessels. Patients can experience sharp, sudden pain or heaviness in their chest as the first sign when experiencing an MI.  This pain can be in the chest and move up to the jaw and down the left arm. When blood flow is decreased to the heart, there is an insufficient amount of oxygen supplied to the heart, and the electrolyte become imbalanced specifically potassium, calcium, and magnesium.  The heart can only handle the blood, oxygen, and electrolyte imbalances for twenty minutes before tissue begins to die, at this point is the damage is irreversible (Huether & McCance, 2017). As an advanced practice nurse, an Electrocardiogram (ECG) would be first in diagnosing techniques. Depending on the results of the ECG will help determine how to treat the patient. If the ECG showed ST elevation, this means the patient needs to get to a cardiac catheterization lab urgently. If the ECG results within reasonable limits, treating the chest pain would be the next appropriate step.  Medication used to treat stable chest pain are called nitrates. The most common name is nitroglycerin. The medication is placed underneath the tongue where it dissolves and should relieve the pain within one to five minutes (Arcangelo, Peterson, Wilbur, & Reinhold, 2017).  When the ECG indicates a STEMI, a thrombolytic medication should be initiated to dissolve any blood clots in the arteries (Avoiding, 2005). A standard medication used in my patient care experience is heparin which is first based on weight for the first six hours of treatment. After six hours labs are drawn on the patient to determine whether the rate should be titrated up or down. After patient returns from cardiac catheterization lab, cardiology doctors can provide guidance on how to proceed with the proper medications for the patient.
Genetics and Ethnicity
If your parents have had an MI, does it mean you will have one? Likely the answer is no; research has shown necessarily doesn’t say you will but have found a link among ethnicity in Europeans, South Asians, Southeast Asians, and Arabs (Joseph et al., 2016). Specifically, there’s no genetic link to an MI but rather coronary artery disease (CAD) which can lead to MI.  However modifiable risk factors, such as a healthy lifestyle, prove to be the most significant way to decrease the risk of an MI.
Self-Care
After a patient experiences an MI, usually, they are set up to attend a Cardiac rehabilitation program. This program helps the patient get back to a healthy lifestyle while incorporating changes to prevent an MI in the future. Advanced practice providers should closely watch patients with hypertension, diabetes, and hyperlipidemia. Research has shown if a patient has two out three diagnoses they are at higher risk for a heart attack (Avoiding, 2005). Encouraging physical activity, a healthy diet, and smoking cessation are critical factors in patient education. Studies suggest educating patients on doing at least thirty minutes of activity a day such as walking, gardening, or housework also to cut out fast food that is high in fat and sugary drinks (Advance et al., 2005).
Reference
Arcangelo, V. P., Peterson, A. M., Wilbur, V. & Reinhold, J. A.  (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA:  Lippincott Williams & Wilkins.
Avoiding heart attacks and strokes. [electronic resource]: don’t be a victim – protect yourself. (2005). Geneva: World Health Organization, c2005.
Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.
Joseph, P. G., Pare, G., Asma, S., Engert, J. C., Yusuf, S., & Anand, S. S. (2016). Clinical Research: Impact of a Genetic Risk Score on Myocardial Infarction Risk Across Different Ethnic Populations. Canadian Journal Of Cardiology, 321440-1446. doi:10.1016/j.cjca.2016.05.014
Nicolai, J., Müller, N., Noest, S., Wilke, S., Schultz, J., Gleißner, C. A., & … Bieber, C. (2018). To change or not to change – That is the question: A qualitative study of lifestyle changes following acute myocardial infarction. Chronic Illness, 14(1), 25-41. doi:10.1177/1742395317694700
The post APA format for MSN degree 2 references from Walden University Library

Future Direction of Health Care

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Future Direction of Health Care

In a three- to five-page paper:

Describe a minimum of five challenges from the list below that are defining the future strategic direction of health care.

Proposed health care reform and legislation

Information technology advancements such as the electronic medical record (EMR)/ electronic health record (EHR)

Accreditation, quality of healthcare, and organizational compliance

Economics, including third party payers, future funding, rising costs, the Medicare and Medicaid programs

Access to health care including the uninsured and those in the poverty levels

Public entities in controlling the demand aspects of health service

Market shares and advancing age of population

Maintaining a skilled workforce

Pay for performance

Describe how an organization can adapt its direction and strategies to effectively address these challenges.

Your paper must be three to five double-spaced pages (excluding title and reference pages) and formatted according to APA style as outlined in the Ashford Writing Center. Utilize a minimum of two scholarly sources that were published within the last five years. One source must be obtained from the Ashford University Library.

Professional Coalition Project (Spring Term 2018

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NR 504 Week 7 Assignment – Professional Coalition Project (Spring Term 2018)

Involvement in interdisciplinary coalitions allows the healthcare leader to gain an understanding regarding navigating socio-political environments as well as providing macro leadership within a broader community setting. The purpose of this project is to build and provide leadership to a coalition that addresses a healthcare concern. Leadership skills at the macro-level will be applied.

Due: Week 7

Total Points: 125 Points

NR 504 Week 7 Discussion; Identifying & Associating With Professional Coalitions (Spring Term 2018)

Involvement in interdisciplinary professional coalition/organizations allows the healthcare professional to stay current in their field or specialty, gain an understanding and navigate socio-political environments, as well as contribute their ideas to their healthcare specialty.

• Research your state’s exemptions and differences within your state regarding laws requiring vaccinations for school-age children.

o Find the professional coalition/organization that supports the use of vaccines for school-age children.

o As a group, discuss the pros and cons of the above scenario and your stance of this controversial public health risk.

Critique an evaluation plan by sharing at least one strength and one area of improvement.

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Respond to the discussion #2 below by this approach:

Critique an evaluation plan by sharing at least one strength and one area of improvement.
Review and evaluate the uploaded powerpoint presentation below.
Reminder:

1 page only
Put APA citation and at least 1 reference dated 2011 to 2016.

Master Plan of Evaluation

The Northeast Group’s master plan of evaluation for Princeton University focuses on the following curriculum components; Princeton’s mission and values, individual courses of the BSN program and the institutional environment. We plan on implementing a cohesive evaluation approach including formative, benchmarking and summative evaluation strategies. The formative evaluation will allow us to measure achievement (Center for Disease Control, n.d.). We will achieve this through course evaluations, measuring student outcomes and surveying student and staff satisfaction. Evaluating through benchmarking will provide direct comparison with other programs on the same level as Princeton. Through benchmarking we can evaluate items such as cost, program content, passage rates, strengths and weaknesses of the nursing program; all which can help us continually improve the program (Keating, 2015). By using a summative evaluation, we can collect data to be used to judge the final outcomes of the educational program.

Strategies

Some strategies we will utilize to achieve our evaluation goals are observation, oral communication, and clinical simulation. Student’s performance can be evaluated using observation by utilizing clinical competency expectations. The benefit of observation is that it allows faculty to visually ensure students are meeting course program outcomes. Oral communication is extremely important in nursing. The benefits of evaluating through oral communication is to assess the student’s ability to verbalize ideas and thoughts clearly and to assess critical thinking skills. Clinical simulation can give students the opportunity to demonstrate competency with different types of patients as well as provide skill validation without potential harm to patients (Billings & Halstead, 2016).

Powerpoint Presentation

Please refer to slide # 14 on our power point presentation for the Master Plan of Evaluation Table.

References

Billings, D. M., & Halstead, J. A. (2016). Teaching in nursing: A guide for faculty (5th ed.). St. Louis, MO: Elsevier.

Center for Disease Control. (n.d.). Type of Evaluation. Retrieved from https://www.cdc.gov/std/Program/pupestd/Types%20of%20Evaluation.pdf

Keating, S. B. (2015). Program Evaluation. In K. S. B, Curriculum Development and Evaluation in Nursing (3rd ed.). New York: Springer Publishing Company, LLC.

provide a financial statement analysis report covering the following points

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BUSINESS FINANCE

Analyze Coca Cola.

Based on these financial statements, the company’s background, industry statistics, and other market and company information, provide a financial statement analysis report covering the following points:

a. Executive summary of the company and its industry.

b. Detailed evaluation of:

(1) Short-term liquidity (current debt-paying ability).

(2) Cash forecasting and pro forma analysis.

(3) Capital structure and solvency.

(4) Return on invested capital.

(5) Asset turnover (utilization).

(6) Profitability and equity analysis. Note: You are expected to use a variety of financial analysis tools in answering (b). Your analysis should yield inferences for each of these six areas.

c. Comment on the usefulness of the financial statements of this company for your analysis.

d. How did accounting principles used in the financial statements affect your analytical measures?

e. Provide a forecast of the income statement, balance sheet, and statement of cash flows for a five-year horizon and a terminal year in Year 6.

f. Estimate the value of your company’s common stock per share using the valuation analysis and procedures described in the Comprehensive Case.

Present your animal and your adaptation.

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his week in Practice and Reinforce” the focus was on succession, so the forum this week will focus on species interactions. You saw just a few examples of adaptations that plants and animals have developed to protect themselves from predators. Your task for this forum is to seek out your own example of an adaptation that benefits a species of your choosing and present it to your classmates. This could be any type of animal with any adaptation covered in the lecture and reading materials: Mimicry, chemical defense, camouflage, warning coloration (just to name a few).

Research your chosen animal and create a new discussion post, addressing the following aspects:

Use the name of your chosen animal as the post title.

Points will be deducted for duplicate entries (unless the time stamps on both posts are very close together, suggesting they were being written at the same time).

Present your animal and your adaptation.

Discuss native habitat, other species the animal typically interacts with including predators and competitors.

Think about community interactions and co-evolution as you explore your chosen species.

Discuss how the animal’s adaptation helps them survive, as well as how its predators/competitors have evolved in response to this adaptation.

Include a picture to in your post.

(or at the very least a link to a site that has an image).

To receive full credit, you must:

Write in complete sentences that are thoughtful, well written, and free of typos.

Address all parts of the forum topic.

Use vocabulary presented in the learning materials appropriately.

orum Grading and Feedback

All forums will be graded using the following criteria. You must create one discussion and reply to at least one other post by 8 pm on Saturday to receive any points.

Criteria

0 Points

1 Point

1.5 Points

2 Point

Total Possible Points

Initial Discussion

Posts information that is off-topic, incorrect, or irrelevant to forum topic

OR

there is evidence of plagiarism

OR

did not post by the deadline.

Posts adequate information with superficial thought and preparation; doesn’t address all aspects of the forum topic.

Posts well developed information that addresses all aspects of the assignment; lacks full development of concepts.

Posts well developed information that fully addresses and develops all aspects of the forum topic.

2

Criteria

0 Points

0.5 Points

0.75 Points

1 Point

Total Possible Points

Vocabulary and Concept Integration

Does not attempt to integrate appropriate vocabulary and concepts presented in the learning materials

OR

there is evidence of plagiarism

OR

Did not post by the deadline.

Attempts to integrates appropriate vocabulary and concepts presented in learning materials, but does not include personal experiences, additional references and images when appropriate

AND

demonstrates a misunderstanding of concepts.

Integrates appropriate vocabulary and concepts presented in learning materials, but does not include personal experiences, additional references and images when appropriate

OR

demonstrates a misunderstanding of concepts.

Integrates appropriate vocabulary and concepts presented in learning materials, includes personal experiences, additional references and images when appropriate.

1

Follow-Up Postings

Posts no follow-up responses to others.

Posts shallow contribution to discussion (e.g., agrees or disagrees); does not enrich discussion.

Elaborates on an existing posting with further comment or observation.

Demonstrates analysis of others’ posts; extends meaningful discussion by building on thoughts provided by others.

1

Uniqueness of Discussion Topic

(When Applicable)

Topic selected is identical to a discussion posted earlier in the forum.

Topic selected is very similar to a discussion posted earlier in the forum. (i.e. you post about Bengal tigers when someone else already posted about Siberian tigers)

N/A

Discussion 9

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As emphasized in this week’s media presentation, all nurses need to be familiar with the laws and regulations that govern their practice: their state’s Nurse Practice Act, ANA’s Nursing: Scope and Standards of Practice, specialty group standards of practice, etc. In addition, basic ethical principles guide nurses’ decision-making process every day. ANA’s Code of Ethics and ANA’s Social Policy Statement are two important documents that outline nurses’ ethical responsibilities to their patients, themselves, and their profession. This said, there is a dilemma: The laws are not always compatible with the ethical positions nurses sometimes take. This week’s Discussion focuses on such a dilemma.

To prepare:

Review this week’s Learning Resources, focusing on the information in the media presentation about the relationship between the law and ethics.
Consider the ethical responsibility of nurses in ensuring patient autonomy, beneficence, non-malfeasance, and justice.
Read the following scenario:

Lena is a community health care nurse who works exclusively with HIV-positive and AIDS patients. As a part of her job, she evaluates new cases and reviews confidential information about these patients. In the course of one of these reviews, Lena learns that her sister’s boyfriend has tested HIV positive. Lena would like to protect her sister from harm and begins to consider how her sister can find out about her boyfriend’s health status.
Consult at least two resources to help you establish Lena’s legal and ethical position. These resources might include your state’s Nurse Practice Act, the ANA’s Code of Ethics, ANA’s Nursing: Scope and Standards of Practice, and internal or external standards of care.
Consider what action you would take if you were Lena and why.
Determine whether the law and the ANA’s standards support or conflict with that action.
Post a description of the actions you would take in this situation, and why. Justify these actions by referencing appropriate laws, ethical standards, and professional guidelines.
Links:

https://www.nap.edu/read/11623/chapter/4
NURS 6050: Policy and Advocacy for Improving Population Health “Legal and Ethical Aspects of Healthcare Delivery”

Program Transcript

NARRATOR: Understanding the legal aspects of health care delivery.

JACK SCHWARTZ: There are some kinds of legal obligations that everybody needs to know.

NARRATOR: And the role of ethics in health care delivery.

NNEKA MOKWUNYE: No matter what culture you’re from, no matter what mortal belief system you have, what the laws of your land say, what values your family has taught you, the ethics still transcends these. And it’s those set of principles that we use to regulate health care.

NARRATOR: This week our experts share insights into the legal responsibilities of the nurse and health care professionals and the role of ethics in decision making and nursing practice.

JACK SCHWARTZ: There’s some kinds of legal obligations that everybody needs to know, anybody who works at a hospital or a nursing home, other care facility that gets confidential patient information needs to know they have a legal obligation not to disclose it improperly. That’s for everybody; everybody needs to know that law.

Let’s take somebody who’s an administrator and who’s in charge of say, medical informatics. Well, that person needs to know a lot more about the law that governs medical privacy and confidentiality because the nature of the job requires more detailed knowledge. Doing that job day-to-day requires knowing about HIPAA, the federal privacy law, and state law on medical records.

You have to know the day-to-day legal context for what you do. If you’re in the business of sending bills to the government, you need to know the laws and regulations that surround that activity.

You’re not going to have a lawyer perched on your shoulder all the time. And so, as part of your job, you need to have enough familiarity with those day-to-day basic legal requirements to do the job.

You also have though, to have the discernment to know when you’re encountering something that’s unexpected, that’s new, that’s complicated, where you need help.

© 2012 Laureate Education, Inc. 1

One characteristic of law is that it’s a command. It’s a directive from the sovereign, from the government, that tells people what to do or what not to do. And often there is a specified consequence to the failure to obey. So if you’re a health care professional for example, you have a license. You have certain requirements in the law, in regulation that you need to meet. If you don’t, you’re putting your license at risk.

If you’re a hospital, you’re a nursing home, you have a license too, that the state gives in expectation that you will conform to certain legal and ethical standards. If you don’t meet that, you put your licensing in jeopardy, the very existence of the organization in jeopardy. And of course, for some breaches of legal obligation, there’s the risk of paying out a lot of money.

NNEKA MOKWUNYE: At our hospital we have ethics as a mandate, and there’s over 400 cases a year that we do. And in our 400 cases, we still don’t even capture all the needs of our patients and our staff. We have to embed ethics into health care in order to make any patient visit to a hospital the best possible, in order to make our staff have a feeling of comfort and decrease of distress in working with sick patients, in order to have families feel like what could be done with the best things that should be done were actually done.

JACK SCHWARTZ: People sometimes wonder about the relationship between law and ethics. The cynical say, well, there’s no relationship. They fight with one another, like unruly siblings. And others say, well, there’s no real difference. If you act ethically, you’re acting legally. It’s somewhere between the two. But it’s actually closer to the two going together.

A Supreme Court Justice once said that “Law floats in the sea of ethics.” That the ethics comes first because of immorality in society gives rise to certain ways of behaving, which often get codified in the law.

FELICIA COHN: Ethics is the systematic study of morality. It’s asking the question, what should I do, and why should I do it?

What ethics is not is also as important as what ethics is. And you can define it almost in the negative. Ethics is not mere common sense. It’s not mere opinion. The difference is that ethics requires argumentation. You have to have good reasons for the decisions you make. You have to be able to justify what you do and explain why you did it. Mere common sense is usually a gut reaction.

An opinion, you’re entitled to hold opinions without rational reasons for them. In ethics, you’re required to provide those rational reasons.

Ethics is also not the law. Sometimes, and ideally, they will merge. They will reflect one another.

© 2012 Laureate Education, Inc. 2

Common situation is a decision to forgo life sustaining treatment. We have to decide if we should turn off a ventilator for a terminally ill or dying patient. So we ask, what should I do in this situation? Should I turn off the ventilator or not?

So if we make the decision to turn off the ventilator, we then have to figure out why, that’s the ethical question. Why should I turn it off? What principles or values justify turning off the ventilator? And why are those principles or values more important or prioritized over principles and values that would support not turning off the ventilator?

We like to think that our law is based in ethical expectations. But that’s certainly not always the case. A lot of our law is based in practicality. Speed limits, for example, have really nothing to do with ethics. Murder laws, however– we have a law of prohibition against killing, fraud– certainly do have a basis an ethics. But there are occasions when the ethical course of action in a particular situation will diverge from the law. That what I, as an ethics consultant, would recommend for treating a particular patient might be contrary to a particular law. And when that occurs, I have to work harder to justify the course of action I’m advising.

NNEKA MOKWUNYE: I don’t believe here we have a conflict with our legal department. When we decide to uphold the ethics and not uphold the law, there is this tension because our legal team has to be prepared for whatever backlash that has. But the only reason why I think that there is no conflict where they feel like they shut us out or we shut them out is because we are working partners.

They understand where we’re coming from. We understand where they’re coming from. They know that we will uphold the ethics and we know that they have to abide by the laws. So that clarity in our rules has been very helpful. The relationship between legal and ethics has to be very strong and very clear in order for it to work because there is the chance that there could be conflict between the two, and conflict will never allow an institution to grow the way it’s supposed to grow.

There are four ethical principles. The principle of autonomy is the principle for respecting of persons. One way I like to define that is to not only respect a person by giving them the options as an informed consent, but to also bring in respecting them by helping them making decisions. What respecting autonomy truly is, is saying, here are your options, this is what I think is important. And let’s join this partnership together to figure out how to do, what’s best for you.

You come to a physician for help and guidance, and I think it’s disrespectful to just have the physician say back to you, well, this is all the things I can do. Tell me which one it is. Part of the respect is to give them the guidance of, although I

© 2012 Laureate Education, Inc. 3

can do this, I don’t think that’s in your best interest. So that’s respecting autonomy.

The next principle is beneficence, which is the do good principle and avoid harm. Some argue that beneficence and nonmaleficence, which is the third principle, should be one, a combined do good and avoid harm. But I think that the two need to be separate because although you may be doing good and avoiding harm in one way, there’s a lot of times where you are causing harm in order to do good.

Surgery can technically be seen as a harm; the body wasn’t meant to be cut open. But you’re doing it for the sake of promoting a good by trying to help the person. That’s one of those situations where it’s the intention behind it and the consequence of the intention that allows the principle to standalone.

And the last one is justice, which is fair and equality for all, which is always the hardest one. In order to really truly be a center that values patient care and deliver optimum care, you have to have ethics involved. Because we do help to make the bad decisions easier. We help to make the transition from aggressive therapy to comfort therapy easier. We smooth a lot of the rough edges and we deal with a lot of the conflict. So the wholeness of medicine cannot be without ethics.

Even if the experience was a sad one and a loved one died, they still feel like this is a place that took care them, that cradled them through the process, and that all comes from having ethics as a strong presence in the hospital setting.

© 2012 Laureate Education, Inc. 4