The irony of 80's Uk Punk

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the uniform of leather jackets and mowhawks worn by the generation of punks that just missed punk in my opinion defies the importance of punk. Punk meant you didnt have to wear a uniform to be a punk,it was about individulism. Unfortunately they didnt grasp this and were tied down by the shackles of being a punk.

Judged solely for what it is Fever is about as good as dance-pop records come. Kylie Minogue's snappy good looks certainly played a big role in getting her breaks but she hasn't squandered her opportunities. She stakes out a carefully delineated identity. It's this identifiable image that shows up not just in videos and pictorials but the music itself. She certainly has at her disposal the best studio tools. She adds just enough input herself. Fever offers more than most similar material. This isn't an important release in any respects. It does play its part with brio.

Minogue's dance-pop formula is a familiar one. She makes no illusions about predictability though. That makes Fever relatively refreshing. Fever is watery; it manages to succeed being just that. Making a record that follows all the rules takes a certain skill.

Her songs all have a fantasy aspect to them, like the single "Can't Get You Out of My Head." They play into pop escapism quite well. Minogue can play an object of desire or the one with desires. Fever is flexible enough to maximize its appeal.

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Kylie Minogue has been recording since a few chance events in 187 took her away from the realm of Australian soap operas. She came under the wings of pop hitmakers Stock Aitken and Waterman. Minogue eventually broke away from the crafty production team a number of years ago. She accomplished exactly what Rick Astley couldn't. She doesn't do anything too dissimilar from the hit machines but her sound isn't forced in any unnatural directions. Minogue succeeds by using all her strengths and not venturing into too deep of waters.

In years past Minogue has connected with some notable talent. She has sung with Australia's resident master Nick Cave on his dark ballad "Where the Wild Roses Grow" and co-starred in the video. In this sense she does her part to support music beyond building a multimedia pop empire (she does sell her own line of lingerie).

Fever is complete with foldout photo spreads of Minogue. She knows what sells records. Her music is at its best here. Fever is a very respectable album for a pop star like Kylie Minogue.

 

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Symbolism in Heart of Darkness

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Symbolism in Heart of Darkness

When Conrad writes Heart of Darkness, the British colonial empire is at its height. Britain is the preeminent world power during the second half of the nineteenth century. She has colonies around the world including Africa. The Heart of Darkness centers around Marlow, a sailor, and his journey up the Congo River to meet Kurtz, reputed to be an idealistic man of great abilities. Marlow takes a job as a riverboat captain with the company- a large ivory trading firm working out of the Congo. As he travels to Africa and then up the Congo, Marlow encounters widespread inefficiency and brutality in the Company's station.

In Heart of Darkness, Conrad packs this story with symbolism. Symbols are objects, characters, figures, or colors used to represent abstract ideas or concepts. Its plot is simple enough on the surface but beneath the surface, lays the book's complicated themes and most importantly, symbols. Conrad gives much food for thought about the nature of humankind and the possibilities for both good and evil using these symbols. This paper will therefore discuss how Conrad uses symbolism to convey the theme of Imperialism between Europe and Africa.

Almost every action, object and character in Conrad's book has a deeper more relevant meaning behind it. The images from the Thames in Heart of Darkness lend support to the belief that this is, at a basic level, a novel about imperialism. At the beginning of the novel, Conrad connects the Thames to the Congo. The Thames is "a waterway leading to the uttermost ends of the earth." It is connected to the Congo like "an interminable waterway." It is connected both physically and symbolically. It is connected physically as all rivers are connected to each other. It is also connected by shared humanity and connected economically.

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Marlow, as a character, symbolizes the positiveness of Imperialism. Marlow realizes the evil that negative Imperialism has cause and decides it is truly unnecessary. When Marlow states, 'I had got a heavenly mission to civilize you,' he expresses his good intentions to help the Africans progress and advance. Furthermore, when he says, 'I was an imposter,' Marlow recognizes the fact that he is an invader into foreign land, yet he sticks to his moral values. Marlow observes many kinds of abuse of power by other whites, simply because they have better weapons of war. When the manager severely battered a young black boy for the burnt shed Marlow disapproves. However, when he sees abuses and unjust treatment he does not physically try to stop it. Instead, he just turns away and accepts that it is happening. That is one of Marlow's flaws; he does not support his convictions.

Marlow also symbolizes the uncorrupted men that traveled to foreign lands to help the 'uncivilized' become cultured, but unlike the others, Marlow does not become indoctrinated by an alternative motive. He is able to see through the materialistic ideals that plague the men before him. Marlow has the open-mindedness and sensitivity that is absent during Imperialism, but does not have the courage or power to stop the abuses that is going on. Marlow is proof that when confronted, a man's evil side can be both informative and perilous.

The manager is the epitome of the negative effects of the institution of Imperialism. He is corrupt, uncaring, arrogant and self-centered. He symbolizes the arrogance of Europeans as they encounter native Africans. His good health symbolizes the everlastingness of Europeans who invades Africa and their ability to continually come to Africa and rape it of its natural resources. He is the true symbol of the evil and cold-heartiness of imperialism. The manager is an illustration of an 'established imperialist power'. He is well settled in, as demonstrated by the fact he controls all the stations. An example of his power over others is when he has the black boy thrashed for the burning of a shed. In addition, he wishes to destroy Kurtz and gain a monopoly on the ivory trade. The manager's discussion with his uncle is yet another example of his ruthlessness. Marlow realizes the manager is evil and has a certain dislike for him, as do all of the natives. Through this, symbolizes the overall detestment of imperialiszed countries toward the aggressor. By assigning all the blame for the terrible conditions on the manager, Conrad stresses the feeling that Europeans are not 'bringers of technology, but distributor of immoral corruption.'

Kurtz is one of the more interesting and enigmatic characters in the book. Kurtz was once what Marlow is, however, he becomes increasingly corrupt, as he is isolated from civilization of Europe. He exploits the Africans for their ivory. Kurtz truly symbolizes Europe, in that his mother and father are half-French and half-Europe. He is also a 'renaissance man' and very talented. He stands by his virtues and symbolizes the good intentions of Europeans. Under the influence of the manager, though, his sinister and harmful side is exposed. Kurtz has gained the respect of Marlow as well as the natives and that symbolizes the minor amount of respect given to the imperialists by the natives due to their advance degree of technology. His terminal illness represents the eventually death of imperialism due to its inability to adapt and respect the culture and peoples of the invaded country.

Kurtz's oil painting of a blindfolded woman carrying lighted torch has a distinct significance. It symbolizes the blind and foolish ivory company forgoing its way into the jungle and enlightening the savage natives. However, they do not really realize the detrimental effect they have on Africa. Most important the painting shows Kurtz's understanding of his role and position in the continent. Overall, Kurtz symbolizes Europe towards the end of imperialism when they began to recognize and realize their actions as harmful and evil. Kurtz's relationship to the mistress represents Europe's love for their imperialized country, however, the passion is only temporary. When Marlow tells Kurtz's girlfriend that, the last words on his lips were she, that symbolizes the nobleness of imperialists and desire to 'explore for the mother country' and do things in her honor.

In Heart of Darkness, Conrad successfully manipulates color, the imitation of color and descriptions of color to convey his symbolic messages to the readers. When Marlow is starring at the map on the wall of the Brussels office, he observes large sections of red, which he remarks as always good signs of civilizations. The red denotes English territories abroad. He also recognizes yellow areas that represent his homelands.

Darkness and its opposite light, are contrasted in Heart of Darkness to reveal the irony of imperialism. Traditionally, light and darkness represent civilization and the uncivilized world, respectively. In some cases, the description of darkness appears racist, yet it serves to reveal how the opposite of the European colonialist way of thinking is true. Marlow tells his shipmates about his childhood dreams of visiting uncharted places on maps. However, once a space has been discovered by Europeans, it had ceased to be a blank space of delightful mystery - a white patch for a boy to dream gloriously over. It had become a place of darkness (). Once the location has been discovered by the civilized world, it was exposed to the light of development. Without the arrival of the light of the Europeans for use in comparison, the Congo would be neither light nor dark; it is civilization that creates the primitive darkness. The initiative that compels imperialism is the idea that the radiance of civilization will bring light to the darkness of uncivilized nations. However, since the darkness does not exist until the light arrives, the notion of imperialism places a result before its cause. The irony of imperialism is introduced in the first scene of the novel, where the narrator states that London seemed condensed into a mournful gloom, brooding motionless over the biggest, and the greatest, town on earth (17). The pinnacle of European civilization is covered in darkness, the same darkness that surrounds the uncivilized Congo, a colossal jungle, and so dark green as to almost be black (8). Marlow describes the black natives of the jungle as possessing bone, muscle, a wild vitality, an intense energy of movement, that was as natural and true as the surf along their coast (8). Despite their outward dark appearance, they inside they are vibrant. There is an irony in that behind what the colonists see as darkness, brightness shines though. When black inhabitants are forced to work under the conditions of European mechanical labor, they acquire expressions of the deathlike indifference of unhappy savages (0). The imposition of European progress brings the men closer to savagery. The people that the colonists view as savage become even more so when placed in chain gangs, which suggests that it is the Europeans who actually possess the savageness. A further indication of the dark side of imperialism is the setting of Marlows narrative. The sun is setting before he starts his tale. When he is finished, it is fully dark and the tranquil waterway leading to the uttermost ends of the earth flowed sombre under and overcast sky (5). This symbolizes how the sailors were exposed to the true darkness of their disposition. The darkness and grave tone are similar to the somberness of the chain gang. When Europeans are exposed to the bleakness of imperialism, their darkness is revealed to them, just as when the Africans were exposed to imperialism and became engulfed in the European gloom.

Conrad uses light instead of darkness to indicate something that is an illusion, or hiding the truth. Along the river in the Congo, the blind whiteness of the fog obscures the vision of the men on the steamboat (58). The brightness of the fog does not illuminate the darkness of the jungle, but it masks it. In a sense, light actually serves as darkness. Similarly, the supposed enlightenment of imperialism is in fact darkness. This is further shown in the accountant, who was devoted to his books and maintaining European culture in the jungle setting. The accountant is the epitome of imperialism, yet inside his office he is described as barred from neck to heels with narrow strips of sunlight (). The image that is portrayed is bright and illuminated by rays from the sun, but there is also an image of bars enclosing the accountant. He is imprisoned by his false ideals. The light that surrounds him masks the true nature of imperialism; he believes in the advancement of his civilization and the imposition of its customs on other cultures. He comes from the same origins as the native peoples, however. Additionally, the previous captain of the steamboat is suggested to have died because the sun got too much for him in Africa (). In this case, the sun represents the illusions he held concerning imperialism; eventually, he could not live with them.

The disillusionment of imperialism eventually leads to the death of Kurtz. He entered the jungle with the intention of civilizing the native peoples, but his last words, The horror! The horror! expresses his realization of the true nature of imperialism (86). Though Marlow expresses the loss of his illusions as well, is able to survive the experience by creating illusions for another person. Kurtzs Intended sincerely believes in Kurtzs greatness and his value to civilization and imperialism. She has never experienced the darkness of Africa, and her illusory ideals are intact. Marlow perpetuates her illusions and does not tell her the truth about Kurtzs fate. He recognizes the faith that was in her, before that great and saving illusion that shone with an unearthly glow in the darkness, in the triumphant darkness from which I could not have defended her-from which I could not even defend myself (). While he could not sustain his own illusions, it would have been too dark-too dark altogether to destroy her faith (4). Due to her unconditional belief, the Intended is full of light. To expose her to the darkness of the truth would be too horrid for both of them. This is because, while she has faith in Kurtz, Marlow believes in her faith. Marlow must retain faith in some principle now that he does not believe in the ideals of civilization and its expansion through imperialism. The Intended is satisfied in preserving her faith, and Marlow endures by knowing that he has secured and can depend on her faithfulness to Kurtz and imperialism.

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Communication skills between genders

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Aside from it being an interesting topic of sheer importance, communication between genders is relatively simple to observe. The word communication has been used in dozens of different ways. We use communication to refer to the process of the humans creating, receiving, sending and interpreting signals. Communication is the perception, interpretation and response of people to signals produced by people. Making communication skills productive is very important in order to conduct a successful management. Most of them have different style when it comes to communicating. The different styles will definitely lead to significant misunderstandings and misperceptions. Men and women are working together more often than ever before. It is increasingly important to help the sexes learn to communicate more effectively in order to maximize understanding, cooperation, and productivity. There are vast differences between men and women in communication. Men are generally more aggressive and loud when they are communicating whereas women are more likely to be more emotional and passive when they are communicating with others. Women tend to base their ideas about relationships on daily conversations, where men reported their daily conversations to have little effect on their relationships. Communication styles of men and women and the problems faced and arise because of the varying style. When men talk he would highlight on how to emphasize on their own status and when women talks they would create connection using men's conversation. Women speak and hear a language of connection and intimacy while men hear and speak about language of status and independence. This is clearly showing that for a man communication is a way to preserve independence and maintaining their status, while for women it is a way of getting closer to people. Field of male and female communication differences identifies the inherent problem with relationships the balance of involvement, or intimacy and independence. Man frequently complains that women talk about their problems. Women would critize men for not hearing it. Effective communication skills among opposite sexes are important in all organizations to meet successful management goals. How is it possible to manage these differences in communication styles to keep gender differences from becoming barriers to effective management?

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Response to the Character of Macbeth

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My response to the character of Macbeth

In the first scene the three witches meet upon heath. It is here that they plan to meet Macbeth and it is in their very first conversation that the audience discovers the major theme in the play appearances can be deceiving. Lady Macbeth later echoes this when she says, 'False face must hide what the false heart doth know'. Throughout the play the line, 'foul is fair' is often repeated to bring us back to the main point of the play.

In the opening scenes of the play Macbeth is described as a brave and valiant soldier. It is clear from this that he is a highly respected man and it is said that he has very admirable qualities. We know this because a bloody soldier tells the King of his fierce fighting with Banquo. They both fought like they were possessed; 'cannons overcharged with double cracks', at one point Macbeth is even described to have killed Macdownald by 'unseeming him from the nave to th' chops'. When both Lennox and Ross return from Fife, both of them also comment on the fighting and the battle. In Ross' speech he describes how the Thane of Cawdor was seen fighting Bellona's Bridegroom. Both Ross and Angus have come from Fife and so it is easy to interpret that as Macbeth. However the Thane of Fife is Macduff and so it would seem more logical that he would be fighting there. Instead it is reported that Macbeth was the bravest and the most courageous. This highlights another of the plays themes, loyalty. Here Macbeth is rewarded for his bravery and Macduff is not, despite that fact that he too fought in the battle.

Once we see Macbeth and Banquo together, the audience can understand that he, as well as being a brave soldier, also has a friendly personality and is capable of getting on with everyone. When they meet the witches though, it is easy to see how easily he can be led into temptation. The witches tell Macbeth that he will be King in the future and they tell Banquo that his descendants will be Kings. This is rather surprising information for both the soldiers but they eventually laugh it off saying that it would never happen. However Macbeth does consider the prospect of being King and Banquo reflects on this saying, 'What, can the devil speak the truth?' when Macbeth finds out that he is the Thane of Cawdor. This is a crucial part in the play because both Thanes' have been told their future. It is up to them to decided whether or not they should act upon it and if so, how they do it. It is clear that Macbeth and Banquo chose two very different ways to follow their prophecies. Macbeth is influenced and corrupted by his ambition, his wife and the witches, whilst Banquo leaves his future to chance.

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The audience can begin to see that Macbeth is already thinking his future over when he finds out that the King's son, Malcolm, is going to be crowned the 'Prince of Cumberland'. This automatically triggers off thoughts in Macbeth's mind and he says aside,

'The Prince of Cumberland that is a step

On which I must fall down or else o'erleap,

For in my way it lies. Stars hide your fires;

Let not light see my black and deep desires'

From this speech we can immediately see that Macbeth is being driven by his ambition, (also his fatal flaw) to achieve what has been predicted. The scene ends and Duncan, the King decides to spend the night in Macbeth's home.

Another main influence is that of his wife. Upon reading his letter telling her all about the witches, she begins to plan how he can fulfil the full potential of it. She knows that she has to persuade Macbeth if he wants to gain all that there is to claim, because she describes his nature as 'too full of the milk of human kindness'. This contradicts almost everything that we know about Macbeth because the audience has only seen him as a spirited soldier. After her careful persuasion it is Macbeth who finally agrees to murder the King. It is important to see that although Macbeth is driven by his ambition, he didn't start out evil. He does have second thoughts about the murder and raises questions like is it dishonourable to murder a king who has honoured him? Who is a guest in his house? And perhaps even more important, someone who is also his cousin?

'He's here in double trust

First, as I am his kinsman and his subject,

Strong both against the deed.'

Still, despite these points, he does agree to commit the murder and realises that this may be his only chance to gain the throne.

In the play there are many symbolic references. Just before Macbeth is going to carry out the murder, Fleance and Banquo are seen having a conversation. Fleance notices that it is a very dark night and that there is no starlight, 'the candles are all out'. The candles represent the stars and this reference refers to Macbeth's previous speech about the Prince of Cumberland. Macbeth discovers the two and makes polite conversation with Banquo, admitting that he hasn't thought about the weird sisters. This is an obvious lie and it appears he is carrying out previous advice, 'False face must hide what the false heart doth know'.

One of the most important scenes is that where Macbeth begins to hallucinate and claims that he sees a bloody dagger. This shows the audience that he does have a conscience and the crime he is about to commit will haunt him. He says some very influential things such as; 'wicked dreams abuse the curtained sleep'. I think this is important because later on in the play both Lady Macbeth and her husband have problems sleeping. Macbeth believes he has murdered sleep and ends up having very bad nightmares whilst Lady Macbeth is traumatised and begins to sleepwalk.

After the murder the audience can notice a dramatic change in character. He is unable to say 'Amen' at the end of the prayers and he is also not thinking clearly because he brings the daggers back out with him. This shows that he is already tormented by what he has done and because of this feels he has to confess. When everyone else realises what has happened to the King, Macbeth stands there and says, 'O, yet I do repent me of my fury that I did kill them'. Macbeth is very close to letting the others know what he has done so Lady Macbeth takes it upon herself to divert their attention and save her anguished husband from anything further. This is not the only time she has to protect Macbeth and it becomes apparent that she has a much stronger character than Macbeth. However, in defence of Macbeth, he was the one who actually carried out the murder.

It is fair to say that Macbeth was driven to insanity by his ever-growing ambition. At one point in the play, he is upset that his offspring will not be King. Yet why it effects him is unclear because he does not have any children and all through the play he does not refer to wanting them either. It seems as though minor things are now capable of bothering him and he is becoming paranoid. This is why he ends up killing Banquo and Fleance (although Fleance does escape). He is worried that Banquo might say something to someone about the witches' premonitions and they would then believe that Macbeth murdered the King.

There are two very different explanations to the downfall to Macbeth. The first is that he brought it upon himself. That it was because of his ambition, curiosity and weakness that led him to his death. Others think that it was his destiny to die. This is because the supernatural plays a fairly significant part in the play. After their first meeting, Macbeth becomes instantly attracted to the witches' predictions and goes about trying to make them all come true. It may be for this reason that he returns to them a second time. Here he demands to know what the future has in store for him and so the witches use his curiosity and his desperateness to trick him into believing he is safe. In Act four, scene one, the witches discourage Macbeth from knowing anymore than he does.

'Witches Seek to know no more.

Macbeth I will be satisfied. Deny me this,

And an eternal curse fall on you. Let me know.'

In many adaptations it has been interpreted that the witches trick him purposely, as if they knew that he was going to return to them. I think that this is a good interpretation because it makes the audience think better of Macbeth. It is like he cannot control the future and what is going to happen because the witches decide his fate. Even thought the witches tell him to seek to know no more, they know that in the end, his curiosity will drive him to the point of insanity and then he would truly fall. They use this against him and it is almost through teasing him that they tell him what is going to happen in the future. However one chooses to interpret it, we still are able to see a false confidence build inside Macbeth because of these predictions. He believes he is invincible and actually describes himself as 'leading a charmed life'. This is why when the battle begins at Dunsinane, we see him bold and confident. He is so dependent on the predictions to be true that he doesn't take the time to stop and think through everything he has heard.

It is in the end scene, when he finally realises what has happened, that the audience sees the gallant Macbeth for one last time. They see that despite the odds, he is still willing to die honourably and all the qualities come back to him. He has reached a stage in his life when he realises that all of his pretences that he was relying on have been torn in two. These pieces of information were the only things keeping him together because everything else has gone wrong. I think that despite the fact he has committed some severe sins, the audience is capable of feeling sympathy for him. He was not evil, he did not believe in hurting his friends, but as times got desperate, he felt he had to do what he did. In the last scene we see how far he has fallen. What was once a brave, chivalrous soldier, has now become a broken man with nothing to live for. His best friend is dead, his wife has committed suicide and his own army turned their backs on him. It is here that we finally see what kind of man he truly was.

Even though he does die and his head is stuck on a pole, like that of the Thane of Cawdor, the audience are able to sympathise with Macbeth. I think it is interesting to see how different directors portray Macbeth. In some productions, I have felt that it was his fault and he did deserve death because he had caused so many other problems for other people. No matter how he is portrayed it is still clear that he did commit some terrible actions. For example when he sent murderers out to try and kill both Banquo and Fleance.

However in other productions I have felt that he was led to his death by so many factors that he wasn't in control of. He was a victim of his own ambition and that one flaw was fatal. I think that in the end, he was also driven by his own insanity. It had been previously said that he couldn't sleep and I think that in the end he needed a way out. It was the best solution for everyone because this way Macduff gets his revenge, Macbeth will not be able to suffer from his ambition anymore and Fleance will ultimately be King (although this is not mentioned in the text it is very likely that this comes true as all the other predictions did).

It is important to note that Shakespeare was writing for a specific audience and therefore he probably would have distorted the truth to please his audience. He was writing for a living and so he finished his play in a way that would be deemed acceptable by the King and the rest of the audience. The ending is perhaps the most important part of the play because it is the last thing witnessed by the audience before they leave the theatre. In order for a tragic hero to work as a theme, the audience has to be moved to both pity and fear. The audience is able to connect with both these things because not only can they sympathise with Macbeth, but also with other characters and they can also feel fear because Shakespeare creates a situation that can easily be related to people's everyday lives. He describes a downfall that can be associated with the average male. It just happens to be more interesting when it happens to a person of Noble position, which is why Shakespeare chose to write about it.

From just reading the text I find it hard to solely sympathise or fear Macbeth's character. I think that both of these emotions play a part when I reflect on what has happened throughout the play. These feelings can either be emphasised or played down depending on how the director chooses to portray the character of Macbeth.

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Multiple Intelligence Theory

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Multiple Intelligence Theory

Howard Gardner American Harvard Lecturer

Intelligence is the ability to solve problems or fashion products that are of consequence in particular cultural setting or community.' (Gardner, Kornhaber and Wake 16 p0).

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Wide spectrum of intelligences.

1. Logical Mathematical

. Linguistic

. Musical

4. Spatial sense of direction

5. Bodily Kinaesthetic

6. Interpersonal between people

7. Intrapersonal knowing self

8. Naturalist intelligent with environment

Evidence for MI

- Brain-damaged people. Individuals who were once 'normal' display a breakdown on capacity in one area of functioning.

- Savants. These are individuals who score low on IQ tests but who display a remarkable ability for a particular skill.

- Prodigies. These are individuals who posses remarkable skills in certain areas and yet are unexceptional in other areas.

- Experimental psychology. Some abilities operate independently and this has been shown from studies.

- Psychometric findings. The autonomy of the seven intelligences is further demonstrated by the lack of correlation between similar IQ scores and scores on tests for specific MI fields.

- Evolution. The ways in which certain attributes develop naturally, e.g. language whilst other abilities do not go beyond the initial stage. E.g. mathematical ability.

Critisms of MI

- Psychology does not observe intelligence as a monolithic structure. A supporter of IQ would state that IQ is not meant to reflect the range of human abilities rather it represents a sample of intellectual performance.

- MI confuses intelligence, personality and areas of special ability.

- Social considerations have motivated MI theory more than scientific considerations. Society values some skills more than others therefore they are more likely to be deemed to be indicators of intelligence.

- The seven areas are not entirely autonomous; degrees of correlation have been uncovered.

- If MI's are truly autonomous then there must be an overarching processing centre or executive function.

- On the application front, which has mainly been education, MI theory has been criticised for not giving concrete examples as to how the theory can be applied in an education setting.

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Do you still remember

How we used to be

Feeling together, believe in whatever

My love has said to me

Both of us were dreamers

Young love in the sun

Felt like my saviour, my spirit I gave ya

Wed only just begun

Hasta Manana,

Always be mine

Viva forever, Ill be waiting

Everlasting, like the sun

Live forever,

For the moment

Ever searching for the one

Yes I still remember,

Every whispered word

The touch of your skin, giving life from within

Like a love song that Id heard

Slipping through our fingers,

Like the sands of time

Promises made, every memory saved

Has reflections in my mind

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Always be mine

[CHORUS]

Back were I belong now,

Was it just a dream

Feelings unfold, they will never be sold

And the secrets safe with me

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[CHORUS]

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Do you still remember

How we used to be

Feeling together, believe in whatever

My love has said to me

Both of us were dreamers

Young love in the sun

Felt like my saviour, my spirit I gave ya

Wed only just begun

Hasta Manana,

Always be mine

Viva forever, Ill be waiting

Everlasting, like the sun

Live forever,

For the moment

Ever searching for the one

Yes I still remember,

Every whispered word

The touch of your skin, giving life from within

Like a love song that Id heard

Slipping through our fingers,

Like the sands of time

Promises made, every memory saved

Has reflections in my mind

Hasta Manana,

Always be mine

[CHORUS]

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Was it just a dream

Feelings unfold, they will never be sold

And the secrets safe with me

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Always be mine

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Death and Dying

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Running Head Death and Dying

Death and Dying

Jacqueline Lewis

Medical Ethics

J. Holly.

Outline

Introduction Death and Dying

I. Death

a) Definition

1) Clinical

) Physical

II. Types

a) Physical

b) Clinical

III. Dying

a) Stages

b) Needs

IV. Advance Directives

a) Definition

b) Types

V. Losses / Grief

a) Child

b) Spouse

V I. Conclusion

Death

Death is a cessation of all life (metabolic) processes. Death involves the organism as a whole (Somatic) or is confined to cell and tissues within the organism (physical). Certain criteria determine if death has occurred; loss of a heartbeat, decrease in body temperature, loss of color in the body, and biological disintegration. Some causes of death include but are not limited to injury, acute or chronic disease, and neophasia (cancer).

A physical death is called "Necrobiosis" or death of cells caused by external changes, i.e. an abnormal lack of blood supply (necrosis). A clinical death is known as a "Somatic" death which is the discontinuance of cardiac activity and respirations. This leads to death of all body cells due to a lack of oxygen. However there is a six minute span of time after somatic death in which vital organs have not been damaged and can be revived.

Types

There are only two types of deaths, "clinical and physical" Brain death is another stage of death this is now a legal condition used in most states for declaring deaths. It requires the absence of the behavioral reflux motor functions above the neck, pupillary reflexes, jaw reflex, gag reflex, no response to noxious stimuli, and no respiratory movement for at least twelve hours. Cardiac death is defined as death in which the heart has stopped functioning; this too is considered a legal death. In the United States the top fifteen leading causes of death are, diseases of the heart, cancer, cardiovascular disease, chronic respiratory disease, accidental (unintentional injuries), diabetes, mellitus, influenza and pneumonia, Alzheimer's, nephritis, septicemia, suicide, cirrhosis, hypertension, homicides, and pneumonitis are deaths that occur in larger numbers in the United states yearly.

Dying

The process of dying has been divided into stages. Doctor Elizabeth Kubler-Ross devoted much of her life to studying the dying process. She believes that patient, family members and caregivers all go through these stages. Dr. Kubler Ross states that the stages overlap and may not be experienced by everyone in the stated order, but all are present in the dying patient. (Medical Law and Ethics)

The first stage is, "Denial" a refusal to believe that they are dying. This may be a time when the patient (or family) needs to adjust to the reality of approaching death. This stage cannot be hurried, next is "Anger". The patient may be angry with everyone and may express an intense anger toward God, family, and even health care professionals. The patient may take this anger out on the persons closes to them, usually a family member. In reality, the patient is angry about dying. Third is "Bargaining". This involves attempting to gain time by making promises in return. Bargaining may be done between the patient and God. The patient may indicate a need to talk at this stage. Fourth is "Depression". There is a deep sadness over the loss of health, independence, and eventually life; there is an additional sadness of leaving loved ones behind. The grieving patient may become withdrawn at this time. Finally there is "Acceptance". When this stage is reached there is a sense of peace and calm. The patient makes such comments as, "I have no regrets. I'm ready to die." It is better to let patient talk and not to make denial statements such as, "Don't talk like that. You're not going to die."

Allow the stages to happen naturally and you will find out the patients true wants and needs. Some may express the need for spiritual comfort. At this point patients often take stock of their lives and may contact estranged friends or relatives to address unresolved issues. Spiritual questions and concerns may emerge as a part of a search for personal meaning n their lives. Families should be prepared to listen and encourage patients to address and perhaps resolve unsettled issues.

Patients often need to be able to make choices in the types of medical care they receive. Let them try a limited trial of therapy, like chemotherapy or radiation. The patient's family and physician must be willing to uphold the patient's desire to stop treatment if the patient says so desires. The patient may want to die at home, which is feasible with the necessary support system; hospice care is available in many areas. Hospice is a multidisciplinary system of services for providing palliative care to the terminally ill patient. The hospice philosophy emphasizes quality, not quantity, of life, but it does not advocate assisted suicide. A hospice program offers a primary care physician, skilled nursing care, physical and occupational therapy and counseling for the entire family. Here in hospice is where the planning for the end of life begins.

Advance Directives

Advance Directives are legal documents that state the patients final wishes should the patient not be able to do so themselves. An (AD) tells your doctor what kind of care you would like to have if you become unable to make decisions (if you are in a coma, for example). The goal of advance care planning from the perspective of legal scholars is to assist patients to make treatment decisions for the event of incapacity. From the patient's perspective the advance care planning is more commonly preparing for death and dying. Once a central ritual of social and religious life, death has been hidden, and implicitly made taboo. Advance planning can help people to prepare for death. This tends to help them achieve a sense of control, relieve burdens on loved ones, and reach closure.

Advance Directives come in several forms such as the Durable Power of Attorney for Health Care or DPA. This states who you have chosen to make health care decisions for you. It becomes active anytime you become unconscious or unable to make medical decisions. A DPA is generally more useful than a living will. However a DPA may not be a good choice if you don't have another person you trust to make these decisions for you. A Do Not Resuscitate (DNR) order is another kind of advance directive. A DNR is a request not to have cardiopulmonary resuscitation (CPR) if your heart stops or if you stop breathing. (Unless given other instructions, hospital staff will try to help all patients whose heart has stopped or who have stopped breathing.) You can use an advance directive form or tell your doctor that you don't want to be resuscitated. In this case, a DNR order is put in your medical chart by your doctor. DNR orders are accepted by doctors and hospitals in all states. A patient may also use a living will, another type of advance directive. It only comes into effect when you are terminally ill. Being terminally ill generally means that you have less than six months to live. In a living will, you can describe the kind of treatment you want in certain situations. A living will doesn't let you select someone to make decisions for you.

Advance directives and living wills do not have to be a complicated legal document. They can be short, simple statements about what you want done or not done if you can't speak for yourself. You may change or cancel your advance directive at any time, as long as you are considered of sound mind to do so. Being of sound mind means that you are still able to think rationally and communicate your wishes in a clear manner. Your changes must be made, signed and notarized according to the laws in your state. Make sure that your doctor and any family members who knew about your directives are also aware that you have changed them. If you do not have time to put your changes in writing, you can make them known while you are in the hospital. Tell your doctor and any family or friends present exactly what you want to happen. Usually, wishes that are made in person will be followed in place of the ones made earlier in writing.

Losses / Grief

Grief most commonly comes from the loss of a loved one. In order to understand bereavement, we need to make the distinction between grief and mourning. Grief is a person's internal experience, thoughts and feelings related to the experience of a great loss. Mourning is the external expression of one's grief. Thus, a person may experience extremely painful grief but, because of a need to appear stoic, may not mourn.

Grief and mourning are intensely personal and unique experiences. We often refer to stages of grief, but these often do not occur in an orderly progression. Depending on the situation and the individuals involved, one may not experience some stages, or may cycle in and out of the same emotional state several times.

The dying child does not fear death itself they fear more for their parents and sibs after they are gone. Often times attempting to keep the secret of dying from the child in question creates more problems for the family. Marriages suffer from the stressful demands of treatments for the dying child, many marriages end in divorce. As the illness drags on and death becomes imminent both parents feel the pressure as if they have somehow failed to be a good parent to the child. Most bereaved parents experience one or more of the following emotions tightness in the throat, heaviness in the chest, or a lump in the stomach like a rock, an empty feeling with appetite loss. They might wander aimlessly, forget a thought in the middle of a sentence, neglect to finish tasks, feel restless, look for activity, but cant concentrate. Some may experience respiratory reactions - excessive yawning, gasping, hyperventilating. Parents will have feelings of anxiety, and think they are losing their mind. A parent may even sense the child's presence and expect the child to walk in the door or phone at the usual time of day. They may cry at unexpected times, be unable to cope and then fall back again - a see-saw type of reaction.

Death in the adult or spouse is surrounded mainly by fear. Fear and grief often aggravates itself. Adults may lay in bed worrying, not wanting to deal with the outside world. The list of physical symptoms that can be caused by fear is long, ranging from physiological effects to psychosomatic symptoms. One of the most disturbing losses is the loss of the respect of others that is reflected in their expressions of pity. Unlike feelings of sympathy, pity demeans the person. The loss of respect is aggravated if we patronize, infantilise, or denigrate the patient. Giving the patient space and the ability to be in control is foremost to them.

Conclusion

Dying no matter how clinical it is, is still the cessation of life, be it that of a loved one, a child, a spouse, mother, father, friend, sister, brother. It hurts and makes no sense to the ones left behind. Some say letting a patient go is the most humane thing to do that is until they are the one who has to let go. It has been thought that if your plan for you death it helps the ones you leave behind. No amount of pre-planning will lessen the grief they will feel by the vacancy left from a loved one's passing.

With current approaches in bioethics we have underestimated the importance of social and family ties. Facing death in the context of loved ones may be an important redeeming accomplishment. End-of-life decision making is influenced by culturally shaped values. The principle of autonomy is the domain of ethics in health care.

Reference

1. Black, Dora. The Dying Child (coping with loss, part 8). British Medical Journal 16. 18 May . 17-7

. Bryan-brown, C., Dracup, K. End of Life Care. American Journal of Critical Care.00 July. Bristol-Myers. 00. 1-

. Goodlin, S. Winzeberg. G.Teno, J. Whedon, M, Death in the Hospital. Archives of Internal Medicine 158 no.14. 18 July 7. American Medical Association.18

4. Herbst, L.Lynn, J, Rhymes, A. What do Dying Patients want and need? (Includes related articles). Patient Care no. 4. 15 February 8. Medical Economics Publishing 15. 1-10

5. Martin, D.; Emanuel, L. Singer, P. Planning for the End-of-Life. The Lancet 56 no. 4.The Lancet Ltd. 000.1-8

6. Parkes, Colin Murray. The Dying Adult. (Coping with loss, part 7). British Medical Journal 16 no7140. British Medical Association. 15

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