Overcrowding in Hospitals

Over the years, one of the biggest problems that have come to plague hospitals is that of access block and overcrowding. The result has been that there has been a negative effect on developed countries, including the United States, the United Kingdom, and Australia. Access block involves a situation where patients are unable to access beds within eight hours of presentation in the emergency department (Chan et al., 2015). This is an extremely serious situation because it involves a situation where there is essentially a failure in the process of making sure that there is not only efficient healthcare provision, but also the achievement of better patient outcomes. Overcrowding in hospitals has the potential of leading to a significant crisis because healthcare providers are under increased pressure to make sure that they provide quality services to as many people as possible. Cases of overcrowding have grown over the years mainly because of an increase in the number of patients that are admitted to hospitals while the number of nursing staff has essentially remained the same. A consequence of this situation has been that there has been a considerable reduction in the quality of care in hospitals, and this has required that new strategies for the advancement of patient interests are developed. Overcrowding has brought a situation where it is necessary to make sure that there is the creation of better means through which to provide services efficiently while at the same time helping the swift movement of patients in hospitals.

Overcrowding in hospitals is mainly caused by an increase in the number of people that need help in the emergency room. It has led to a situation where there is a constant need for beds which has essentially forced a slowdown in the process of service delivery. It has also led to a situation where it has become essential to advance the need to not only expand services, but also create better means through which to ensure that patients are provided with services as swiftly as possible. The burden of caring for patients waiting for beds often falls on nurses and this makes them not to provide as much attention as needed for other patients. Overall, there are a considerable number of people who need beds in hospitals and the situation has grown to such an extent that about 40% of patients in the emergency room are forced into situations where they have to wait for hours before they gain access (Chan et al., 2015). It is also likely that the outcomes of admitted patients is negatively affected because foremost, they are left in situations where they do not have sufficient care, because most of available nurses are taking care of patients in the emergency room. The case of staff exhaustion can be a significant cause of a reduction of good patient outcomes because there is very few nursing staff that are available for all patients. Therefore, the adoption of strategies aimed that advancing an end to overcrowding in hospitals is necessary to make sure that patients are able to attain good services.

Overcrowding is detrimental to the morale of nurses because they are forced into scenarios where they have to divide their time among numerous patients. Furthermore, there are instances where the supervision of junior doctors is hampered because most of the patients involved are not able to access the most essential services that are required through attaining beds in hospitals. It is essential to make sure that there is the advancement of means through which to help patients get the most essential care through the expansion of ward rooms in hospitals as well as the employment of more nurses so that they can be able to provide the services needed for patients. Overcrowding is an unacceptable condition in hospitals and there is the necessity to advance the creation of strategies aimed at bringing about patient satisfaction through the rapid provision of services. There is a need to ensure that there is a reduction of primary care attendance in the emergency department in order to bring about a situation where there is the achievement of the relative reduction of overcrowding. Moreover, the fast-tracking of dealing with minor injuries is essential in making sure that there is the advancement of rapid services to prevent overcrowding and helping to advance the need to prevent overcrowding. There has been a large surge of demand for hospital beds which has led to the development of means through which there is an increase of bed capacity so that the overcrowding issue can be dealt with efficiently.

Euthanasia

Euthanasia can be defined as the bringing about the death of a being for humane reasons, or it is the killing of a person with the intent of ending his or her suffering. There are two main types of euthanasia and these are passive euthanasia, which is legal in the United States, and active euthanasia, which is considered illegal but it is still practiced by some physicians. Active euthanasia is undertaken on an individual when his or her doctors and family members make the decision to actively kill to end the agony suffered by this loved one. Passive euthanasia, on the other hand, lets the suffering person die by withholding the necessary medical care and allowing the disease to kill the person instead of a fellow human being. The American Medical Association holds that active euthanasia is impermissible due to its involving the intentional ending of human life by another human being and many contemporary philosophers have argued for and against this view discussing the moral permissibility of such an action and some of the most notable arguments come from James Rachels and Thomas Sullivan.

Rachels states that a strong case can be made against the American Medical Association’s doctrine and his main point is that passive euthanasia is not always preferable to active euthanasia. He states that in some cases, there is simply no moral difference between active and passive euthanasia because they are morally equivalent at that time and that active euthanasia may actually be better than passive euthanasia. He says that once a decision the decision has been made not to prolong the patient’s agony, active euthanasia would be preferable because the latter would lead to an unnecessary period of suffering. His most vivid example is the case of severe Down’s syndrome babies born with intestinal obstructions about whom he states that sometimes in such cases, the babies are allowed to die even though if this matter were considered deeply, we would find compelling moral grounds for preferring active euthanasia to passive euthanasia in the vastly greater degree of suffering involved in letting the baby die.

The doctrine that passive euthanasia is preferable to active euthanasia is challenged by Rachels who declares that it leads to decisions concerning life and death based on irrelevant grounds as to whether a person’s life should continue or not. He argues that ordinarily, an intestinal obstruction can be fixed and is not a life or death matter but in the case of a baby with Down’s syndrome who has an intestinal obstruction, the baby is allowed to die because of the Down’s syndrome and not the intestinal obstruction. The presence of the intestinal obstruction in the baby becomes irrelevant due to its having down’s syndrome and it is this argument which justifies allowing the prolonged suffering of the baby before it dies instead of fixing the intestinal obstruction which would relieve it of the pain. This justifies Rachels’ argument against the American Medical Association’s doctrine that this doctrine rests on a distinction between killing and letting die that itself has no moral importance because they both lead to the same end and the means of getting there is inconsequential.

Sullivan, on the other hand, states that Rachels’ interpretation of the American Medical Association’s doctrine is flawed and argues that Rachels’ interpretation that this doctrine draws a distinction between killing and letting die is misplaced and that in fact, it does not draw a distinction between intentionally killing and not intentionally killing. Despite his disagreement with Rachels on this matter, he agrees with Rachels that killing is not always worse than letting die. He states that it is true that if someone is trying to bring about the death of another, then it makes little difference from the moral point of view if his purpose is achieved by action or by malevolent emission. He further agrees with Rachels that passive euthanasia can prolong pain and suffering by stating that it is cruel to stand by and watch a baby with Down’s syndrome die an agonizing death when a simple operation would remove the intestinal obstruction.

According to Sullivan, Rachels treats killing as an act and letting die as an omission; he then argues that there is no moral difference between the two. Contrary to what Rachels says, the American Medical Association does not distinguish between the act of killing and the omission of letting die. He states that refraining from the use of ordinary means to prolong life is intentional killing and therefore wrong but refraining from the use of extraordinary means may not be intentional killing and as such is permissible, and this, Sullivan argues is the real distinction drawn by the American Medical Association and not the one as interpreted by Rachels. He further argues that a physician’s decision to refuse to give extraordinary treatment to his patient may not be prompted by the purpose of bringing about the patient’s death but by other more noble motives. For example, the physician may realize that any further administration of treatment may present little hope of reversing the patient’s dying process or the use of such extraordinary means may cause excruciating to his patient. He argues that such cases do not involve intentional killing because a physician does not intend for his patient to die although he foresees this as the result.

In conclusion, we find that the views of Rachels and Sullivan are not as different as one would at first be tempted to think. In fact, some of their ideas come so close together, it is hard to distinguish one from another. However, there are some differences in their argument that we have noted above, namely, their different points of view concerning the interpretation of the American Medical Association’s doctrine on euthanasia. We are of the opinion that Rachels’ argument is more convincing because it is true that a very thin line divides active euthanasia from passive euthanasia and in fact, the former would be preferable considering that it immediately ends the suffering undergone by a terminally ill patient. In fact, since his or her physicians have already determined that the illness which they have is terminal, it would be better if the suffering of such people would be ended swiftly because keeping them alive by artificial means or by drugs will not save them from their fate. Both active and passive euthanasia end with the same result (death) and it would be wrong for all parties involved not to allow it to come sooner rather than later. Therefore, we argue that the best thing to do would be to allow either the patients themselves, their families, or their physicians to decide what the best thing to do is under the situations named above and that the government and courts should have nothing to do with it.

The Child Behavior Checklist & Behavior Assessment System

Introduction

Assessing the behavior of children is an important aspect of making sure that there is the effective development of an understanding of the reasons behind why they behave the way that they do. There are a number of tools that have been adopted for the purpose of making sure that there is the advancement of understanding concerning the behavior of children in different scenarios. This is especially considering that these tools involve a situation where it is essential to not only assess, but also make an analysis of the behavioral problems that these individuals might encounter. In this paper, there will be an assessment of the Behavioral Assessment System for Children (BASC) and the Child Behavior Checklist (CBCL).

The Behavior Assessment System

The BASC is a well-designed and essentials set of measures that can be used for making sure that there is the creation of an understanding of children of school going age. This is especially the case when it comes to assessing and identifying the emotional disturbances that they might experience as well as the detection of behavioral disorders. There are a number of measures that are used in bringing about a full BASC diagnosis and these involve the following: teachers, parents, direct observations, students, and historical records (Garcia-Barrera, Duggan, Karr, & Reynolds, 2014). This variety of sources is important in the advancement of the assessment of child behavior because it combines information from a number of sources in a way that ensures that there is a well-rounded approach to behavioral problems. It can be a useful tool both in the schools and home environment because it ensures that children are monitored at all times while at the same time aiding psychologists to have a better assessment of the manner through which the emotional and behavioral states of these individuals are governed (Kiperman, Black, McGill, Harrell-Williams, & Kamphaus, 2014). The achievement of this goal is a fundamental aspect of BASC because it allows for behavioral problems in children to be detected early and support systems to be put in place so that the children involved can be assisted in adjusting their behavior. Therefore, despite its shortcomings, BASC, because of its multidimensional nature, is an essential means of bringing about the best measures aimed at supporting children with behavioral disorders to achieve a sense of normalcy.

The Child Behavior Checklist

The CBCL, on the other hand, is formatted as a questionnaire in order to ensure that the different aspects of assessment are addressed directly. The questionnaires are often of high quality and are standardized in such a way that they screen measures of the child’s emotional or behavioral problems. In addition, it is made use of to analyze the social competencies of the children involved so that a clear assessment of their problems can be made. This model has been specifically developed in order to be used by parents, teachers, and children to come to terms with emotional and behavioral problems (Bordin et al., 2013). It is also a comprehensive approach aimed at making sure that there is the assessment of the maladaptive and adaptive functioning of children so that it becomes possible to guide them accordingly. The CBCL is widely used when it comes to the provision of mental health services for children, especially in the context where the child is in need to guidance, and training. Through the questionnaire format, it is possible to ask direct questions concerning the manner through which children’s emotions and behaviors are triggered and the reasons behind why they behave as they do (Hudziak, Copeland, Stanger, & Wadsworth, 2004). Through the advancement of this knowledge, it becomes possible to find out the root causes of problems and how they can be handled in such a way that makes it possible for children to attain the guidance that they need to change their behavior for the better. As an essential model of detecting inattentiveness among children, it allows for the advancement of their welfare.

Comparison of the Behavioral Assessment System and the Child Behavior Checklist

The BASC and CBCL scales are essential tools in the assessment of the behavior of children. This is especially the case with respect to finding out whether children are suffering from such conditions are attention deficit-hyperactivity disorder (ADHD) from those without the condition. Furthermore, they are also useful tools when it comes to assessing whether the children are either affected by ADHD or are essentially just individuals that are essentially the inattentive type (Ameis et al., 2016). These tools have different classification analyses that are made use of for the purpose of bringing about an understanding as well as conclusions concerning the behaviors of individuals. However, despite their being used in some of the same circumstances, both of these tools can be considered to have different strengths in a diverse number of assessments. For example, the BASC is an important tool when it comes to distinguishing between ADHD to non-ADHD children and this is an essential assessment tool because it has greater strength than the CBCL model. In addition, the CBCL is an essential means of predicting when children are inattentive and this is to such an extent that in this case, it is deemed superior to the BASC model (Villabø, Oerbeck, Skirbekk, Hansen, & Kristensen, 2016). A consequence of this situation is that it ensures that there is the advancement of methods that can be used to predict child behavior in such a way that they describe the behavioral dimensions that are associated with a diverse number of ADHD subtypes. These tools are therefore pertinent in the advancement of knowledge concerning child behavior and the manner through which they can be diagnosed effectively.

Analysis of BASC and CBCL

One of the most fundamental aspects of the CBCL is that it involves the filling in of questionnaires by parents, teachers, and children. This is aimed at getting critical information concerning the behavior of children not only from themselves, but also from those individuals that have daily interactions with them, namely their parents and teachers. A result of filling in questionnaires is that it brings about a situation where it becomes possible to assess the behavioral status of children from various viewpoints in order to ensure that the correct evaluation and diagnosis of the children’s status is reached. In addition, it ensure that there is the advancement of means through which therapists of counselors are better able to study the behavior of children, the questionnaires found in the CBCL are structures in such a way that there is a step by step assessment of the progress that a child is making towards a certain emotional or behavioral attribute, such as inattentiveness either in the class or home environments. The BASC model, on the other hand, seeks to ensure that there is the accurate assessment of children that suffer from ADHD. It is an important method because it ensures that there is the involvement of not only parents and teachers, as is the case with the CBCL, but it also seeks to analyze the records, historical or otherwise, of the child being analyzed. A result is that it takes on a well-rounded approach to emotional and behavioral problems in children; ensuring that when a diagnosis is made, it is done after all potential issues have been evaluated. The diverse symptoms and social functioning of children are assessed through the BASC to such an extent that it leads to the advancement of better means through which problems are identified at an early stage. Therefore, both BASC and CBCL are important models for the diagnosing and understanding child behavior to such an extent that they enable counselors and therapists to undertake to help those with problems efficiently.

Conclusions

The CBCL is one of the more efficient methods of ensuring that there is the effective assessment of emotional and behavioral problems among children. This conclusion is based on assessment of literature above which has shown that the CBCL has a more rigorous method that can be made use of to ensure that emotional and behavioral problems in children are approached objectively. The behavior checklist is important because it allows parents, teachers, and children themselves to ensure that they make an analysis of the child in such a way that their disparate opinions are put into consideration. The diversity of observations are essential when making the assessment because it ensures that the diagnosis is based on the observations of the different parties directly involved in the child’s life rather than being based on assumptions. Because the child himself is involved in the process, and his or her opinions are put into consideration, it becomes possible to seek out the child’s perspective of the matter and how they view their social environment. The use of questionnaires in the CBCL is an essential tool when it comes to getting an idea about the events that are taking place in a child’s life and how they might be the cause of the behavioral problems that they might be experiencing. A consequence is that the this model is more efficient than its BASC counterpart when it comes to finding out whether children are having behavioral problems; allowing for a more efficient method of dealing with the problem before they get out of hand.