Acute Respiratory Distress Syndrome Health And Social Care Essay

Acute Respiratory Distress Syndrome Health And Social Care Essay Acute Respiratory Distress Syndrome (ARDS) is a serious respiratory condition of diffuse alveolar injury seen frequently in intensive care patients. It was first identified in 1967 by Ashbaugh, Bigelow, Petty and Levine as the acute onset of broad respiratory symptoms. This improved the clinical and pathological understanding of the condition. Small changes to therapeutic practice have developed, however despite these developments the morbidity and mortality in patients of all ages with ARDS remains significantly high (Fan, Needham, Stewart, 2005). This topic has been chosen by the author as they have a personal interest in this type of patient after having recently cared for a critically ill ARDS patient in their ICU (Intensive Care Unit). The author has previously been involved in caring for ARDS patients at their place of work and over that period has observed changing practices and treatment. A further knowledge and understanding of this complex patient is their motivation for this topic. A case study relating to a case of ARDS is attached as Appendix 1 and will be referred to throughout this assignment. The pathophysiology of this disease leading up to the presenting signs and symptoms of ARDS will be presented. Current literature and treatment trends will be discussed in conjunction with the medical and nursing practice observed within the ICU workplace. Treatment trends and recommended best practices will be identified and critically analysed. Recommendations will then be presented to encourage best practice within the ICU workplace. First described in 1967 by Ashbaugh and colleagues as Adult Acute Respiratory Distress Syndrome, ARDS patients continue to have a high rate of mortality and morbidity (Fan, Needham, Stewart, 2005). A definition was implemented in 1988 (MORE DETAILS>>>) and then a new simplified definition was recommended in 1994 by the American-European Consensus Conference (AECC) (Harman 2009). It acknowledged that the severity of lung injury varies, and it was a definition that was easy to apply in the clinical setting (Ware Matthay, 2000). The new definition involved changing the name from adult to acute respiratory distress syndrome as it was observed that the syndrome occurs in adults and children. The AECC definition states that the patient must have an acute condition, characterised by bilateral pulmonary infiltrates and severe hypoxaemia in the absence of evidence of cardiogenic pulmonary oedema. Hypoxaemia is calculated as a ratio of PaO2/FiO2. In ARDS the ratio is less than 200. Cardiogen ic pulmonary oedema is excluded either clinically or by pulmonary wedge pressure of less than 18mm Hg in patients with a Swan-Ganz catheter. Despite this official and accepted definition there is still argument over the ability to accurately define ARDS when it is a syndrome and not an illness and because of this the presentation and pathway of the disease varies between patients (Zambon Vincent, 2008). There has also been criticism over the simplicity of the AECC definition as it does not identify the underlying cause, nor does it require other systems affected to be assessed (Ware Matthay, 2000). The major benefit of the universally accepted definition has been the ability for hospitals and investigators to begin the advancement of clinical trials into treatment of this syndrome (Ware Matthay, 2000). In patients diagnosed with ARDS 80% can have the cause related to either direct or indirect injuries. Direct injuries include pneumonia, aspiration, lung contusion, fat embolism, near-drowning, inhalation injury, and reperfusion injury. While indirect injuries include non-pulmonary sepsis, multiple trauma, massive transfusion, pancreatitis and cardiopulmonary bypass (Berten Soni 2009). This insult to the respiratory system is reflected in a variety of pathophysiological presentations leading to the patients presenting signs and symptoms. There are 3 identified stages of ARDS. The acute or exudative phase is seen in days 1-7. The sub-acute or proliferative stage is seen from around day 7, and the chronic or fibrotic phase is generally seen around 2-3 weeks after the initial onset (Marshall, Bellingan, Laurent, 1998, Griffiths 2007). The exudative phase leads to the disruption of the normal alveoli-capillary barrier which therefore disrupts ventilation and oxygenation. Inflammation occurs in the lungs and the body releases cytokines and inflammatory mediators from the epithelial and endothelial cells. Other cells (neutrophils and T-lymphocytes) move into the lungs and causing alveolar damage. The inflammation causes endothelial dysfunction, and increases the permeability of this barrier which allows fluid to escape from the capillaries and limits the draining of fluid out from the lungs. Small vessel thrombosis occurs as a result of pulmonary capillary and endothelial swelling Cell debris plugs the alveolus lumen leading to pulmonary oedema increasing the thickness in the alveolar-capillary space. Surfactant supply depletes and production becomes inactivated. The exudative phase is seen in the ICU patient as increased shortness of breath, higher respiratory rate, productive cough, wet sounding chest, decreased oxygenation. These symptoms were all seen with the patient in Appendix A. The Proliferative Phase is and involves the initial stimulus causing the stimulation of the cascade effect. All ARDS patients will experience this stage. It leads to an increase in the permeability of the alveolar-capillary barrier leads to a rush of fluid into the alveoli. This injury allows pulmonary oedema to occur in patients with no known cardiogenic failure. This protein rich fluid engulfs the alveoli drawing in activated neutrophils and macrophages. This initiates the inflammatory cascade which releases interleukins, tumour necrosis factor and inflammatory mediators. Neutrophils release oxidants, leukotrienes and various proteases. The effect of this process is cell damage, with cell debris blocking alveolus lumen and the inactivation of surfactant. As a result platelets combine, a procoagulant cascade may arise. Surfactant inactivation, alveolar filling, cellular debris all lead to an increase in respiration rate. Surfactant loss causes alveolar collapse due to increased surface tension and causes a decreased closing lung volume. This leads to less than normal functional residual capacity causing increased respiratory rate and reduced lung compliance. The alteration in the harmony between alveoli and vascular ************************************************** The proliferative stage is generally seen after day 7. It involves the proliferation of fibroblasts, hyperplasia of pneumocytes and ongoing inflammation. The Fibrotic phase is seen 3 weeks after presentation and the patient is seen to have lung fibrosis, honeycombing and bronchiectesis. This leads to long-term chronic lung conditions. Clinical management of ARDS is focused on promptly and appropriately treating the underlying cause, supporting lung function and preventing complications related to the medical treatment and the disease process. No treatment is definitive, but early anticipation of complications can reduce the length of stay. Treatment is supportive As previously noted mortality rates have barely reduced over the years. There has been much research into new ventilation strategies along with pharmacological and non-pharmacological techniques. So far few have improved survival. The most important and practice changing study was in 2000 when The Acute Respiratory Syndrome Network did a large (861 patients) multi-centred randomised trial comparing traditional tidal volumes with lower tidal volumes. At the time patients were being ventilated with tidal volumes (VT) of 10-15ml per kilogram of body weight with plateau pressures of 50, to achieve normocarbia and pH. The study was abandoned early as there was seen to be a 22% decrease in mortality of those patients with the lower range of TV. The high peak pressure and the high tidal volumes were found to be causing shearing injuries to the lungs and also causing a higher mortality. This study revolutionalised ventilation strategies of ARDS patients and demonstrated that lung protection techniques could improve survival (Levy, 2004). It is now common practice worldwide to ventilate patients on tidal volumes of around 6ml/kg and as low as 4ml/kg and to allow permissive hypercarbia. I There continues to be research in to the benefit of PEEP in ARDS. There have been several studies conducted looking at the benefits but few have had conclusive results. Ashbaugh et al. (1967) identified patients that were mechanically ventilated with ARDS and had no PEEP became immediately severely hypoxaemic. Research has continued since then as to identify the optimal amount of PEEP. PEEP is important as it assists the severe ARDS patient by minimising alveolar collapse and improving gas exchange and lung compliance. Traditionally PEEP is set at 5-12cmH2O (Briel et al., 2010) but it is yet to be established what is the optimal level of PEEP ( Gattiononi, Caironi, 2008, Dellinger, Levy, Carlet et al, 2008). recent studies have been trying to identify if higher PEEP is better than lower, or traditional PEEPS. The problem has been what is low and what is high PEEP? A recent analysis by Briel et al. (2010) and supporting commentary by Rubenfeld (2010) has identified that the it has also been found that PEEP can be dangerous in but it is not established how much is enough PEEP. The author has identified medical and treatment seen within their place of work and will discuss this further. Oxygenation is optimised as seen in appendix A by Treatment includes optimising gas exchange by maintaining oxygenation, adequate tissue perfusion. Strict fluid balance. Ensuring nutritional requirements are met Before 1990 ARDS was reported to have a mortality rate of 40-70% in the US (there were few studies outside the USA initially) (Harman, 2009). Since then several studies have been done around the world. New research has found the rate of mortality has deceased marginally in some studies, but still not significantly. A couple of studies in the US and the UK in the 1990s have found mortality rates much lower in the 30-40% range (Davidson, Caldwell Curtis, 1999, Davey-Quinn, Gedney Whitely 1999). A 2002 Australian study identified mortality at 34% (Bersten, Edibam, Hunt, Moran, and the ANNZCCSCTG). A 2008 systematic analysis of ARDS statistics identified mortality still in the range of 15-61% in studies published after 2000 (Zambon Vincent, 2008). It must be acknowledged that some of this data was from studies with very small groups of patients in the trials. Despite this it still identifies a high rate of mortality and very little improvement in survival over the years. Improvements have been developed in the care due to ventilation strategies, improved intensive care better understanding and treatment of sepsis, recent changes in the application mechanical ventilation, better overall supportive care of critically ill patients Medical and nursing management within the authors One of the biggest developments in the treatment of ARDS was a study done in 2000 which challenged the traditional ventilation of high Treatment is supportive with the aim of maintaining adequate oxygenation to the tissues via APPENDIX 1 Mrs X is a 51 year old female who is normally fit and well. She has no past medical history. She does not take any regular medicines. She has no known allergies. She lives with her husband and 3 adult children and works full time. She returned from Melbourne 10 days prior to her presenting symptoms appearing. Mrs X has been unwell for 7 days with lethargy, myalgia, and a slight cough. She presents to her GP with a 72 hour of worsening headache, myalgia, and now a productive cough. Her GP prescribes antibiotics (Amoxycillin) and advises her to commence them the following day. The following day Mrs X is taken to the local tertiary hospital (A) by her husband with further worsening symptoms and now respiratory distress. Her respiratory rate is 30; her SpO2 is 93% on room air. She is tachycardic (110), afebrile, normotensive and her chest x-ray shows right middle and right lower lobe pneumonia, early basal consolidation, and a small left pleural effusion. Mrs X is admitted to the medical ward on CPAP Presents at tertiary hospital (A) with worsening symptoms. Respiratory Rate 30. CXR shows RML + RLL pneumonia, early basal consolidation, and small L) pleural effusion. Admitted to medical ward with CPAP, tiring over the evening with increasing PEEP and FiO2 requirements. Transferred to ICU on CPAP. Intubated at 2130hrs due to worsening condition and tiring. Continues to deteriorate over the next 12 hours, now with a vasopressor requirement. Referred to tertiary hospital (B) for transfer. Swabs and cultures taken for multiple bacteria and to identify the source of pneumonia. Broad spectrum antibiotic cover commenced. (Screening included H1N1, mycoplasma serology, and urinary legonella-all eventually coming back as negative). Managed in tertiary hospital (A) overnight with high PEEP (20) and Fio2 (90%) requirements. Spo2 and PaO2 remain low (85%/55). Recruitment manoeuvres attempted by consultant and found to bed unsuccessful. Bloods show early coagulopathy, thrombocytopenia. Worsening CXR: RUL, RML, RLL, LML, LLL consolidation. Discussion with family regarding possibility of ECMO in tertiary hospital (C) if continued deterioration. Tertiary hospital (B) arrives the following afternoon. Pt being managed prone. Unproned and transferred to Tertiary Hospital (B). Arterial blood gas on arrival= Managed in hospital (B) with high respiratory support. Peaking with Fio2 1.0 PEEP of 24. Aiming for Pao2 >60, SpO2 >88%. Condition further deteriorates on day 3 in hospital (B). Ventilation and oxygenation proving difficult. Any movement causing severe desaturation. Increasing PEEP (18) and decreasing FiO2 (0.6-0.7) found to be beneficial in this patient. ABG over the day Time FiO2 pH pCO2 pO2 0908 0.6 7.35 53.5 59.7 1452 0.7 7.36 52.4 60.5 2001 0.6 7.35 53.6 62.6 2300 0.7 7.38 49.7 55.0 Initial arterial blood gas shows Sedated on morphine and midazolam and propofol. Strict fluid balance. Commenced on regular IV steroids. IV frusemide. IV erythromycin and imipenem. FASTHUG principle applied. Enteral feeding recommenced Remained febrile despite antibiotic and line changes. Chest drain insertion on day 3 in hospital (B) Tracheostomy on day 9 as not respiratory or cardiovascularly stable enough earlier. Remained on a FiO2 of an average of 0.60 and PEEP of 16-20 for the first 12 days. De-sedated and a slow respiratory wean commenced on day 10. Patient continues to be critically ill and have slow respiratory wean on day 18 when she is transferred back to her domicile hospital (Hospital A) to continue recovery and weaning

Responsibility of the Creator Essay

Responsibility of the Creator Elizabeth Shute May 11, 2011 Literature Mrs. O’Kelly I believe Victor Frankenstein was responsible for his creature’s actions. He had many chances to help but he was a too much of a coward. For example, Frankenstein could have helped Justine but he was too scared to speak up. It was his fault she was in jail and it was his fault she died. She was accused of killing William because Victor’s Monster put the necklace in her pocket. Frankenstein felt responsible for his younger brother’s death when he realized that the monster he created murdered William. Frankenstein started to feel as if he himself had committed the murder because of his role in the monster’s existence. Everything the monster did was Frankenstein‘s fault because he was the creator. Rather then he blaming the monster for his downfall, Frankenstein blamed himself because he created the monster’s life. Victor also felt as if he, himself, murdered Justine because she was executed for a crime the monster committed. Elizabeth was altered by the injustice of Justine’s death, and Frankenstein felt responsible for that alteration as well. The chain of events that the monster set off with William’s murder began not with the monster, but with Frankenstein’s desire to create life. He shows his obsession with creating life when he says, â€Å"†¦I paid no visit to Geneva, but was engaged, heart and soul, in the pursuit of some discoveries which I hoped to make. †1 When the creature was complete he rejected it. He could barely look at the disgusting face which he had brought to life. He even says, â€Å"†¦Breathless horror and disgust filled my heart. †2 The  weight  of remorse about his role in the deaths of William and Justine adversely affected Frankenstein’s mental and physical health. His responsibility for their deaths and whatever other destruction the monster may have wreaked on humanity overwhelmed him. When the monster came to Frankenstein to plead his case and tell his story, Frankenstein realized that he had some obligation to the monster because he created it, in the same way that he bore responsibility for the monster’s actions. Frankenstein was no  longer  simply responsible to humanity for the monster’s actions, but he was also responsible to the monster for his happiness. Being the creator of a life was more responsibility than Frankenstein planned for. The monster called upon Frankenstein to fulfill his obligation of providing for his happiness by creating a  female companion  to keep him company. Out of his  sense of  obligation to his creation and out of fear for his family, Frankenstein agreed to make the female monster. His responsibility to humanity carried greater  weight  than the idea of his responsibility to his creature for the actions of the original monster and the new one he agreed to create. He hadn’t yet realized the full  weight  of responsibility he would bear for the actions of both monsters. Before Frankenstein could marry  Elizabeth, he had to complete his obligation to the monster so that he could be completely rid of him and the responsibility for his actions. As a result, Frankenstein postponed the wedding and took a  trip to England to work without the danger of being discovered by his family. His obligation to the monster was not only to ensure the monster’s happiness, which Frankenstein felt obliged to do as the monster’s creator, but also as a way to protect his family from the monster’s vengeance. Before he completed the female monster, Frankenstein realized the  weight  of responsibility he would bear if together the two monsters destroyed any other  human life  or reproduced, and the thought was just too much to bear. Rather than  deal  with the responsibility for two hideous, superhuman creatures, Frankenstein would rather  deal  with the wrath of one, so he destroyed his work on the female monster. So began the battle between Frankenstein and the monster. Frankenstein was responsible for Henry’s death at the hands of the monster, and this grief rendered him ill for a long time. Frankenstein is once again in the position he found himself with William and Justine’s deaths. He didn’t murder Henry, but his friendship with Frankenstein made Henry susceptible to the monster’s wrath because he used Henry to get back at Frankenstein. Although the Irish magistrate acquitted him, Frankenstein knew that he was responsible for Henry’s death because he had defied the monster’s wishes and the monster repaid him by killing his friend. Frankenstein, feeling responsible for  Elizabeth’s death as well as his father’s, vowed vengeance. The only way to absolve his responsibility for the monster’s actions was to kill him, so that’s what Frankenstein set out to do. He was responsible for the monster’s creation and its actions, and he planned to be responsible for the monster’s destruction as well. Frankenstein never admitted to his family what he had done, never admitted or took responsibility for his actions. He might as well have killed Elizabeth, William, Justine, and Henry with his own hand. The so called â€Å"Monster† only wanted companionship; he did not want to murder those people. The circumstances forced him to commit murder. Frankenstein was the instigator of those circumstances. Victor certainly created something that caused destruction, not only in his own life but in others lives as well. Justine took the fall for Victor, dying for his secret. Elizabeth died because Victor chooses not to create another monster. The monster did not necessarily want another monster-like companion, he just wanted acceptance. Victor brought about his own destruction. Victor’s ability to deal with the real world was almost nonexistent. He had only one friend, Clerval. His choice for a wife was a person he called â€Å"cousin†, but in fact was his adopted sister. Did Victor create this so-called â€Å"monster† to have a friend, the one thing the monster wished for? Victor denied his friendship to the monster, but why? The joy of creating life, the monster, overruled his judgment. He was denying the fact he had committed such a vile act upon humanity. He even says, â€Å"A being whom myself had formed, and eluded with life, had met me at midnight among the precipices of an inaccessible mountain. †3 Victor may have admitted to creating the monster, but he denied that he had driven the monster to commit murder. He needed to admit, not only to himself, but to his family that he was the one responsible for William’s murder. By not admitting this, he allowed his friend Clerval and his wife Elizabeth to be murdered as well. His determination that his secret not be discovered became his downfall. Victor was responsible for every action of his own and for the actions of the monster. Frankenstein’s monster only wanted to be accepted for what he was. The monster needed a friend. Someone he could talk to, someone to love him, and someone to love back. Friendship was not possible. Unfortunately, the human race is very shallow. In the monster’s own words he says, â€Å"†¦they spurn and hate me. †4 We tend to judge the appearances of others, rather than getting to know the person inside. A person’s appearance is only the shell in which they live, it never reflects the person they are. Frankenstein’s monster wanted a friend, not judgment; but even his creator rejected him, not once but multiple times. The second time Victor rejected him he says, â€Å"Devil’, I exclaimed, ‘do you dare approach me? And do not you fear the fierce vengeance of my arm wreaked on your miserable head? Be gone, vile insect†¦Ã¢â‚¬ 5 In the end, Frankenstein didn’t care whether he lived or died. Victor wants the war to end. He has lost every battle he and the monster have fought. I only think that He wished death upon the monster so that the murders will stop. Even in the end Frankenstein was selfish. He did not want anything to stand in the way of science. Had he learned nothing? At least Walton had learned that maybe people should take responsibility for their actions. Walton did let the crew turn the boat around and not face the inevitable, death. Frankenstein made his bed, and now he’s lying in it. In the end, Frankenstein died while the monster survived. So in the end, Frankenstein lost everything. Frankenstein led himself down the path of destruction. He lost his friend, wife, and brother. He was loved by no one. All those whom he had cared about were dead. His experiment had turned him into a shell of hatred and despair. His focus on his creation, led him to a black hole, from which there was no escape. Frankenstein’s ambition did lead to disaster, but he was also the monster with no regard for human life. Now that Frankenstein was in the afterlife, the monster could now end his own life. His quest was over.

Ethics and Values and 2g Scam

Ethics and Value Management Project Report Table of Content 1. Abstract 1. 1 Introduction 2. Ethical Issues 3. Ethical Dilemma’s 3. 1. Dilemma faced by A. Raja 3. 1. 1. Role of A. Raja 3. 1. 2. Ethical Theories 3. 1. 3. Cost and Benefit analysis 3. 1. 4. Recommendation for resolving the Dilemma 3. 2. Dilemma faced by Corporates 3. 2. 1. Role of Corporates 3. 2. 2 Ethical Theories 3. 2. 3. Cost and Benefit analysis 3. 2. 4. Recommendation for resolving the Dilemma 3. 3. Dilemma faced by Government 3. 3. 1. Role of Government 3. 3. 2. Ethical Theories 3. 3. 3. Cost and Benefit analysis . 3. 4. Recommendation for resolving the Dilemma 3. 4 Dilemma faced by Media 3. 4. 1. Role of Media 3. 4. 2. Ethical Theories 3. 4. 3. Recommendation for resolving the Dilemma 4. Recommendations for avoiding recurrence of the issue 4. 1 Plan to avoid recurrence of such a scam 5. References 5. 1. Websites 5. 2. Books 1. Abstract 1. 1. Introduction: The  2G  spectrum  scam  involved politici ans and government officials in India illegally undercharging  mobile telephony  companies for  frequency allocation  licenses, which they would then use to create  2G  subscriptions for  cell phones.The shortfall between the money collected and the money that the law mandated to be collected is estimated to be  176,645  Crore  (US$32. 15 billion), as valued by the  Comptroller and Auditor General of India  based on  3G and BWA spectrum auction  prices in 2010. However, the exact loss is disputed. The Supreme Court declared allotment of spectrum as â€Å"unconstitutional and arbitrary† and quashed all the 122 licenses issued in 2008 during tenure of  A. Raja(then  minister for communications & IT) the main official accused in the 2G scam case.In 2011,  Time  magazine listed the scam at number two on their â€Å"Top 10 Abuses of Power† list. 2. Ethical Issues With the outbreak of the 2G spectrum scam, the following ethical issues on t he part of the Government, Regulatory bodies, media and industry came into the forefront. * Spirit of collective responsibility not conserved: An ethics of co-responsibility is required and can only be implemented through mechanisms well beyond the legal system. In the 2G scam, almost all of the entire media and nation has put the name of Mr A.Raja as the responsible person for the corruption but the actual decision of telecom policy was passed through the cabinet. * Too much power in hands of very few: This is what actually happened in case of 2G scam. The entire decision making power rested in the hands of selected bureaucrats. * Middle men used for access to those in power: Middlemen were used to by company officials and other illicit channels to reach the ministers. People in power were lured by money. Those who did not bend to the power of money were either transferred or were threatened. Neutrality of media questionable: In the  2G Spectrum Scam  Case, instead of providing valuable insights, the media is trying to become the judiciary. The media has targeted easy scapegoats, revolving their stories around a selected few because even they know that it is difficult for them to target certain big names like the Tatas, Ambanis and Ruias. * Personal greed puts business ethics at stake:  Raja was the mastermind of this whole scam and his personal greed made him do all the corrupt things. The 2 fundamentals of business i. e. air dealing and transparency was completely kept aside to enjoy the false fruits. * Wrong use of power leads to a great turmoil:  Raja being the Telecom minister, tried to influence the senior officials of DOT by all means. Those who didn’t get influenced were either transferred or removed from their posts. 3. Ethical Dilemma’s 3. 1. Dilemma Faced By A. Raja: Mr A. Raja was in a dilemma whether he should disclose the name of every main conspirator of the plot, or should he wait for his fellow mates having a reputed pos ition in the government and corporate world to help him get out . 1. 1. Role of A. Raja A Raja has received  3,000  crore  (US$546 million)  as bribe for bringing forward the cut-off date for applications for spectrum from the initial 1 October 2007 to 25 September 2007. At the time of taking decision he might have got influenced of the dilemma related to it but money made him blind and despite of knowing the risk associated and at the stake of his personal values, he took the decision of performing the 2G Scam. There was also a clear conflict of interest among promoters, shareholders and other stakeholders of company.The conflict of public shareholders and stakeholders put them in very interesting position. There was also a dilemma when the case uncovered which was more or less can be termed as the prisoners dilemma as should he tell the names of all the person associated or only few because it was a very high end case consisting of many renowned politicians and bureaucrats 3. 1. 2. Ethical Theories: Depending on the dilemma faced by different people in this case there are different ethical theories that can be applied.Mainly we can apply 2 theories: * Utilitarianism: Utilitarianism is a theory in normative ethics holding that the proper course of action is the one that maximizes utility, specifically defined as maximizing happiness and reducing suffering. In this theory person compares the benefits with its cost and take decision accordingly. * Hedonism: It is a school of thought that argues that pleasure is the only intrinsic good. In very simple terms, a hedonist strives to maximize net pleasure (pleasure minus pain).Ethical hedonism is the idea that all people have the right to do everything in their power to achieve the greatest amount of pleasure possible to them. It is also the idea that every person's pleasure should far surpass their amount of pain. 3. 1. 3. Cost ; Benefit Analysis: Going by the theory of utility, A. Raja might have done the benefit cost analysis as follows: Benefits Loss | | A. Raja will be getting lots of money | A. Raja can be caught, but the chances are very less because in India politicians are never caught | With money there will be power.Moreover he will be a friend of big corporate personalities. | Shareholders will get affected with this decision| The huge benefit of under-pricing or unfair subsidiary was given to the mobile telephone services| The person who is not a shareholder or customer of any mobile telephony company has sold his share in spectrum on cheap prices and lost his money which would have been spent for the development of his nation| The subsidy was given to all industry majors, who regularly lobby against the subsidy to basic human need like food, water, education and shelter. When call rates were high, there would be an exclusion of masses from this information revolution. This is a simple math not a magic formula to fool all stakeholders| The huge benefit of under-pricing or unfair subsidiary was given to the mobile telephone services| | So, he might have found that he can easily escape by doing this scam and chosen to give away the licence at cheaper rate. Going by the Hedonism theory the pleasure that power and money will bring to him will be much more than that of pain so he thought of choosing the wrong path of earning money. . 1. 4. Recommendation for resolving the Dilemma: The 2G Spectrum scam is at the final stage. Now as all the politicians, Bureaucrats, Major Telecom company officials have been exposed. But if would have followed the following simple tests or models they would have definitely selected the ethically right path and avoided the consequences that followed. * Peter Drucker’s Model: â€Å"Above all, do no harm†. Peter Drucker wanted to convey to any individual that if any of his/her decisions harms any other person then that decision is unethical. Raja had thought of this philosophy then he would have avoided his action s and maintained transparency in allocating 2G spectrum. * The government officials would have brought the issue in front of the judicial system if they followed this simple principle. Corporate executives would have refused help from A. Raja as profit making is ethical but profiteering is not * Warren Buffet’s first page of the4 Newspaper’s Test: If all the people imagined the newspaper headlines that were published all throughout 2010, 2011 and 2012, they probably would have not done what they did.Some examples are included below: 1. Court issues notice to CBI on A. Raja's 2G spectrum scam plea 2. Why did not PM act on A. Raja: SC 3. A. Raja informed Manmohan Singh about change in policy: Siddharth Behura 3. 2. Dilemma Faced By Corporates: The basic dilemma faced by the Corporates was whether to abide by the law of the country and obtain the licenses they were capable of obtaining in an ethical manner or whether to unethically obtain licenses in order to increase cus tomer base and earn instant profits.On account of Utilarianism, benefits they achieved were that they were able to attain the shares at much lower cost and thereby incurring huge profits and it also thus provided them with an competitive edge over their competitors as they were able to outrun them that too in such short duration. Also if they did not buy these licences some other companies will buy and attain profits so without considering the harmful repercussions they went on with buying with the licences. 3. 2. 1. Role of Corporates: India found itself in the centre of such protests in 2010-2011 over the scam in 2G spectrum allocation to telecom companies.The 2G scam went a long way to show how the Indian economy, one of the fastest growing in the world, is dominated by a small set of tightly connected power players. Industry observers felt that if not checked soon, the deep-rooted problem of crony capitalism in the country could adversely affect India’s growth and develop ment. They wondered how the accountability could be fixed and the unholy nexus broken. The distributive justice states that equal people should be treated equally. There is nothing wrong in, corporate making profits but it should not be at the cost of other people.When the corporates involve in a scam like this, the tax payers are burdened which is not fair. Ultimately it is the tax payer, who pays for each Scam. Corporate as a part, of the society has got some social responsibility which means, they have every right for making profit but not profiteering by harming the society. Their rights should not harm the interest of the common man. The corporates by involving in the scam are not only cheating the common man but its own people like its shareholders. Transparency in the long run pays of great results.Here being ethical should not only an instrumental value to the corporates, but should be an intrinsic value. Business ethics plays a very important role. th legal frame work may n ot be always be ethical but here observing the legal standards provides an important ethical dimension. The business values like transparency, fairness and justice are universal. Observing these values as an intrinsic value would benefit the business in the long run. When business is ethically strong, it will have the same impact on its employees. When employees are ethically strong, consumer satisfaction will be high and so the business has to sustain. Corporations involved were: Allianz Infra, Aircel, Dishnet wireless, loop mobile, Reliance communications, S Tel, Swan telecom, Tata Tele Services, Unitech Group, Videocon Telecommunications Limited, Vodafone Essar, Virgin Mobile India. * Corporate Personalities involved were: Anil Ambani (Reliance Group-ADAG), Ratan Tata, Shahid Balwa (DB Reality and Etisalat DB Telecom), Vinod Goenka (Dinamix Group), Venugopal Dhoot (Videocon Group), and Prashant Ruia (Essar Group). 3. 2. 2. Ethical Theories: * Utilitarianism: Going by this theory, the corporates involved Utilitarianism i. e. aximising their profits, specifically defined as maximizing happiness and reducing suffering. For them what is good is that which produces pleasure, happiness, contentment or welfare and what is right is that which maximizes one or more of these things. Utilitarian’s call the method for maximizing good the principle of utility and they use the term optimific to describe the achievement of this maximization. The Corporates on their part in order to maximise their profits instantly and in an easy manner went on 2G scandal, without considering the ramifications. 3. 2. 3. Cost and Benefit Analysis: Swan Telecom paid Rs. , 537 crore for 2G licences in 13 circles, they soon sold 45 per cent equity in this company to Etisalat for Rs. 4,200 crore. Unitech obtained licences in 22 circles for Rs. 1,658 crore and then sold 60 per cent equity in the company to Telenor for Rs. 6,100 crore. Thereby, providing them with instant benefits. 3. 2. 4 . Recommendation for Resolving the Dilemma: * Peter Drucker’s model: â€Å"Thou shalt not steal† and â€Å"Primum Non Nocere. † Which in English means, above all (or first) do no harm. According to Peter Drucker wanted to convey that an individual’s decision is unethical if it harms any other person’s.Thus, abiding by the Peter Drucker model to resolve this ethical dilemma involved the corporate personalities involved should have rejected the proposal offered by A. Raja as achieving profit is fairly ethical but what turned out in this case was ‘profiteering’ which is unethical. 3. 3 Dilemma faced by the Government: In this context ethical dilemma was on the part of the government after the case got uncovered as it involved many politicians, bureaucrats, & ministers so either to put charge on all of them showing the vulnerable state of the nation or to allege a single minister for the same. 3. 3. 1. Role of Government:The list had many well known ministers like Dayanidhi Maran(Union cabinet minister for textiles), P. Chidambaram(Union cabinet ministers for home affairs), Andimuthu Raja (Union cabinet minister for communication & information technology), Kanimozhi Aravindhan (Member of Rajya Sabha) and also many renowned bureaucrats like Siddharhta Behura, Pradip Baijal, R K Chandolia. 3. 3. 2. Ethical Theories: * Utilitarianism: Going by the this theory, it states that actions and policies should be evaluated on the basis of the benefits and costs they produce for everyone in society and also referred to as consequentialism.It holds that morally right course of action in any situation is the one that, when compared to all other possible actions will produce the greatest balance of benefits over costs for everyone affected. * Hedonism: A school of thought that argues that pleasure is the only intrinsic good. In very simple terms, a hedonist strives to maximize net pleasure (pleasure minus pain). In this context goi ng by the above mentioned theory in order to maximize the net profits its better on the part of government not to disclose anything and spare from the pain that can incur f they do so. 3. 3. 3. Cost and Benefit Analysis: In the context of 2G scam the cost and benefit analysis can be done as follows: * Cost: The major threat was the impact on stock market and investment in India. The mobile phone market is the world’s fastest growing making it a must-invest market for any major global operator but after looking at the corruption level and the people involved they might not willing to come over and invest. Moreover it will also shatter the trust factor of the citizens and they will not have any faith in the government. Benefit: Disclosure of all the names involved in the scam will lead to a situation of distrust. In a globalized world such a situation will negatively affect the Indian corporate scenario and may even jeopardize the economy as a whole. Going by the above mentione d theory it was certainly better on their part to go for benefits and not to disclose any names. 3. 3. 4. Recommendation for resolving the Dilemma: To resolve the dilemma’s 3 steps can be followed, they are: * Step 1: Analyze the consequences Assuming that the resolution to the ethical dilemma is to be found within the confines of law.Ethical dilemma that arise should be resolved at least within the bare minimum of law and legal framework as otherwise it will lead to a sort of mafia business. One has to look at the consequences that would follow one’s proposed actions. And when one has several options to choose from, there will be an array of consequences connected with each of such options, both positive and negative. Before one acts, answers to the following questions will help find the type of action that can be contemplated; 1. Who are the beneficiaries of your action? . Who are likely to be harmed by your action? 3. What is the nature of the ‘benefitsâ€℠¢ and ‘harms’? (the answer to this question is important because some benefits may be more valuable than others. Letting one enjoy good health is better than letting one enjoy something which gives trivial pleasure. Likewise, some ‘harms’ are less harmful than others. ) 4. How long or how fleetingly are these benefits and harms likely to exist? * Step 2: Analyze the actions Once option is identified, concentration should be on the actions.Find out how the proposed actions measure against moral principles such as ‘honesty, fairness, equality, respect for the dignity and rights of others, and recognition of the vulnerability of people who are weak, etc. ’ Then there are questions of basic decency and general ethical principles and conflicts between principles and the rights of different people involved in the process of choice of the options that have to be considered and answered in one’s mind. After considering all these possible factors in the various options, it is sensible to choose the one which is the least problematic.Step 3: Make a decision After considering all factors that lead to various options, choose an option and analyze it carefully and then take a rational decision. 3. 4. Dilemma faced by Media: It is media’s duty to show the truth to the public, moreover it also considered as a trustworthy source which helps in creating awareness regarding the actual happenings in the world. The Media persons accused faced the ethical dilemma of whether to diligently follow the duties of a journalist and uncover the real truth or be loyal to their friends. 3. 4. 1. Role of mediaThe 2G spectrum scam, which has snowballed into a major controversy involving Indian politicians and businessmen, became hotter for journalists to handle when it allegedly involved two of their senior members. Media sources such as OPEN and Outlook reported that two senior journalists Barkha Dutt (group editor of NDTV) and Vir Sanghvi (editorial director of Hindustan Times) knew that corporate lobbyist Nira Radia was influencing the decisions of appointment of telecom minister. Radia wanted A Raja to be made telecom minister. The two magazines made public the telephone conversations between Nira Radia, Barkha Dutt & Vir Sanghvi.Radia's phones were being tapped by the Income Tax Department. Critics allege that Barkha Dutt and Vir Sanghvi knew about nexus between government and the media industry but still they supported this corrupt activity and suppressed news reporting the discovery of the corrupt practice. In November 2010, OPEN magazine carried a story which reported transcripts of some of the telephone conversations of Nira Radia (a political lobbyist) with senior journalists, politicians, and corporate houses, many of whom have denied the allegations.The Central Bureau of Investigation has announced that they have 5,851 recordings of phone conversations by Radia, some of which outline Radia's attempts to br oker deals in relation to the 2G spectrum sale. The tapes appear to demonstrate how Radia attempted to use some media persons to influence the decision to appoint A. Raja as telecom minister. Vir Sanghvi, editorial director of Indian national daily Hindustan Times and India’s television news channel NDTV’s group editor Barkha Dutt are apparently featured in the transcripts.They are heard promising to fix things for Radia, who is known to be close to the sacked minister A Raja, and her clients besides her political cronies. While Sanghvi allegedly took notes from Radia on what he could point out in his weekly Sunday column of Hindustan Times even as Radia asked him to write against Reliance Group's Anil Ambani and the high court decision on the gas pricing issue. Barkha Dutt had allegedly assured Radia of getting ruling Congress party’s general secretary Ghulam Nabi Azad to talk to the supremo of his party’s chief ally in the government M.Karunanidhi to fi x portfolios for the ally according to wishes of Karunanidhi’s daughter Kanimozhi. One thing to be noticed in this case was, initially the news gained prominence following sustained pressure on social networking sites Twitter and Facebook against an attempted blackout orchestrated by many prominent Indian TV channels and newspaper. Initially, only handful of newspaper like Deccan Herald and The Indian Express wrote about the tapes. Some newspaper like HT Media, mint and NDTV told that the authenticity of these transcripts cannot be ascertained.Not Touching Corporate Biggies: Now media is deliberately trying to highlight a few names like those of Shahid Balwa, A Raja, Kanimozhi, Sanjay Chandra, Karim Morani, and Vinod Goenka while not touching corporate biggies such as Tatas and Ambanis. It is quite clear that in this 2G spectrum case, only a few are conspired to be indicted in the case while others are clearly kept out. Instead of providing valuable insights, the media is try ing to become the judiciary.The media has targetted easy scapegoats, revolving their stories around a selected few because even they know that it is difficult for them to target certain big names like the Tatas, Ambanis and Ruias. It is a well-known fact that the trial for 2G Spectrum case is going on, and nobody can be proved guilty unless and until it is proved in court, but, without taking it into account, our media has started blaming people and highlighting a only few names without mentioning the rest of the suspects. 3. 4. 2. Ethical Theories: Utilitarianism: If we apply utility theory on media then cost in hiding the facts was that people will not trust the media if they come to know that facts were hidden from them but the benefits were that they will not spoil their relations with big politicians and corporate biggies. So benefits were more than the cost, as it is said that common man has very short memory and you can cheat them. But as pressure started building from opposi te party and moreover opposite party had their friends in the media, the names of big politicians came into picture.But then also media maintain its silence on corporate biggies. 3. 4. 3. Recommendation for resolving the Dilemma: Laura Nash’s model: Following the 12 questions that Laura Nash has raised in her model would have stopped media from taking the first step. Some of the 12 questions that would have helped the accused persons to clear their thought processes are: * How would you define the problem, if you stood on the other side of the fence? * To whom and with what are your loyalties? What are your intensions in making this decision? * How does these intentions compare with the likely results? * Whom could your actions injure? 4. Recommendations for avoiding Recurrence of the Issue Modern scams are victimless in that the victims are not obvious. The victims of these crimes are the taxpayers and citizens of the country to whom this money and assets belong. The only pe rmanent way for us to stop scams is to work on both prevention and deterrence. 4. 1. Plan to avoid recurrence of such a scam 1.Increase disclosure requirements by the government on all contracts and concessions involving public money or assets. 2. Improve the effectiveness of parliamentary oversight on government and executive by making parliamentary committees stronger as well as more transparent to the public. 3. It should be ensured that the Criminal Penal code has amendments to deal with and enable rapid prosecution of white collar crimes and scams. Judiciary should be independent and free of any external influence. It should be capable of taking strong action against the corrupt politicians.While severe punishment is given to a poor village officer when he takes a bribe of Rs10, politicians who cheat the public and earn crores are many a time let free by the court of law. 4. There is a requirement of complete overhaul and changes in our criminal justice system that is still des igned around petty crime and criminals. There is a need for new and stronger laws for dealing with sophisticated financial crimes of the day. One such example is removing the Section 311 that requires prior sanction from the government to prosecute its officers. 5.Media played a very important role in forming an opinion among the citizens therefore there should be effective parliamentary oversight of the government and such oversights be transparent and available to media and citizens. 6. The government must have outside legal and advisory help while negotiating contracts and not rely only on bureaucrats. There should be a creation of a new cadre of independent regulators, backed by parliamentary statutes that oversee most of these sectors. 7. For example, bureaucrats must be chosen as regulators only in exceptional cases of high integrity and capability.Such Independent Regulators must also have oversight on them to ensure that there is no regulatory capture. 8. Ensure that governm ent policy is always about the public and not about private and personal interests. 9. Legislation must be initiated to regulate lobbyists and business chambers, to prevent advocacy changing to corruption and to protect against policy capture instead of policy advocacy. 10. Ensure government policies are not always bombastic rhetoric and full of loopholes for exploitation. This will minimize administrative/political discretion. 1. Another way to stop corruption is to avoid the coalition form of governance. A single party must be allowed to rule the country independently without seeking the support of innumerous minor parties. In the 2G spectrum case, the accused, A. Raja is a representative of DMK which is supporting the congress. In such a situation, an able and efficient prime minister like Manmohan Singh could not take action but had to inadvertently support him as otherwise DMK would have withdrawn their support and thus follows an utter rout for the congress.Lastly and most imp ortantly both media and the general public must create awareness that the government is a trustee of public money and assets and the people are the real owners. If trustees violate the trust, people should not sleep, but must react. A permanent solution, thus, to such scams and corruption is alert citizen and conscientious media. 5. References 5. 1. WEBSITES * http://aishmghrana. wordpress. com/2012/09/01/conflict-of-interests-among-stakeholders-in-2g-allocations/ * http://www. icmrindia. org/casestudies/catalogue/Business%20Ethics/Indian%202G%20Spectrum%20ScamExce2. tm#Can%20Accountability * http://www. isidelhi. org. in/hrnews/HR_THEMATIC_ISSUES/Corruption/Corruption-2011. pdf * http://www. scribd. com/doc/71816181/2g-scam-project * http://www. processexcellencenetwork. com/process-improvement-case-studies/columns/drucker-on-business-ethics/ * http://en. wikipedia. org/wiki/Radia_tapes_controversy * http://www. slideshare. net/amyberi/2g-spectrum-scam-casestudy * http://realityche ck. wordpress. com/2010/12/03/wheres-our-story-media-on-2g-spectrum-scam-shyness-or-something-more/ 5. 2. BOOKS * Business Ethics: An Indian Perspective by A. C. Fernando

Why Fahrenheit 451 Will Always Be Terrifying

There’s a reason dystopian science fiction is evergreen—no matter how much time goes by, people will always regard the future with suspicion. The common wisdom is that the past was pretty good, the present is barely tolerable, but the future will be all Terminator-style robots and Idiocracy slides into chaos. Every few years political cycles cause an uptick in attention being paid to classic dystopias; the 2016 Presidential election pushed George Orwell’s classic 1984 back onto the bestseller lists, and made Hulu’s adaptation of The Handmaid’s Tale a depressingly appropriate viewing event. The trend continues; HBO announced a film adaptation of Ray Bradbury’s classic 1953 science fiction novel Fahrenheit 451. If it seems surprising that a book published more than six decades ago might still be terrifying for modern audiences, you probably just haven’t read the novel recently. Fahrenheit 451 is one of those rare sci-fi novels that ages wonderfully—and remains just as terrifying today as it did in the middle of the 20th century, for a variety of reasons. More Than Books If you’ve been alive for more than a few years, odds are you know the basic logline of Fahrenheit 451: In the future, houses are largely fireproof and firemen have been re-purposed as enforcers of laws that prohibit the ownership and reading of books; they burn the homes and possessions (and books, natch) of anyone caught with contraband literature. The main character, Montag, is a fireman who begins to look at the illiterate, entertainment-obsessed, and shallow society he lives in with suspicion, and begins stealing books from the homes he burns. This is often boiled down to a slim metaphor on book-burning—which is a thing that still happens—or a slightly more subtle hot-take on censorship, which by itself makes the book evergreen. After all, people are still fighting to have books banned from schools for a variety of reasons, and even Fahrenheit 451 was bowdlerized by its publisher for decades, with a â€Å"school version† in circulation that removed the profanity and changed several concepts to less alarming forms (Bradbury discovered this practice and made such a stink the publisher re-issued the original in the 1980s). But the key to appreciating the terrifying nature of the book is that it isn’t just about books. Focusing on the books aspect allows people to dismiss the story as a book nerd’s nightmare, when the reality is that what Bradbury was really writing about is the effect he saw mass media like television, film, and other media (including some he couldn’t have predicted) would have on the populace: Shortening attention spans, training us to seek constant thrills and instant gratification—resulting in a populace that lost not just its interest in seeking the truth, but its ability to do so. Fake News In this new age of â€Å"fake news† and Internet conspiracy, Fahrenheit 451 is more chilling than ever because what we’re seeing is possibly Bradbury’s terrifying vision of the future playing out—just more slowly than he imagined. In the novel, Bradbury has the main antagonist, Captain Beatty, explain the sequence of events: Television and sports shortened attention spans, and books began to be abridged and truncated in order to accommodate those shorter attention spans. At the same time, small groups of people complained about language and concepts in books that were now offensive, and the firemen were assigned to destroy books in order to protect people from concepts they would be troubled by. Things are certainly nowhere near that bad right now—and yet, the seeds are clearly there. Attention spans are shorter. Abridged and bowdlerized versions of novels do exist. Film and television editing has become incredibly fast-paced, and video games have arguably had an effect on plot and pacing in stories in the sense that many of us need stories to be constantly exciting and thrilling in order to keep our attention, while slower, more thoughtful stories seem boring. The Whole Point And that’s the reason Fahrenheit 451 is terrifying, and will remain terrifying for the foreseeable future despite its age: Fundamentally, the story is about a society that voluntarily and even eagerly abets its own destruction. When Montag tries to confront his wife and friends with thoughtful discussion, when he tries to turn off the TV programs and make them think, they become angry and confused, and Montag realizes that they are beyond help—they don’t want to think and understand. They prefer to live in a bubble. Book-burning began when people chose not to be challenged by thoughts they didn’t find comforting, thoughts that challenged their preconceptions. We can see those bubbles everywhere around us today, and we all know people who only get their information from limited sources that largely confirm what they already think. Attempts to ban or censor books still get robust challenges and resistance, but on social media you can witness people’s hostile reactions to stories they don’t like, you can see how people create narrow â€Å"silos† of information to protect themselves from anything scary or unsettling, how people are often even proud of how little they read and how little they know beyond their own experience. Which means that the seeds of Fahrenheit 451 are already here. That doesn’t mean it will come to pass, of course—but that’s why it’s a frightening book. It goes far beyond the gonzo concept of firemen burning books to destroy knowledge—it’s a succinct and frighteningly accurate analysis of precisely how our society could collapse without a single shot being fired, and a dark mirror of our modern age where unchallenging entertainment is available to us at all times, on devices we carry with us at all times, ready and waiting to drown out any input we don’t want to hear. HBO’s adaptation of Fahrenheit 451 doesn’t have an air date yet, but it’s still the perfect time to re-introduce yourself to the novel—or to read it for the first time. Because it’s always a perfect time to read this book, which is one of the most frightening things you could possibly say.