Types of Abortions Abortion is the the early termination termination of a pregnancy. pregnancy. A spontaneous abortion (also (also called a miscarriage) miscarriage) occurs on its own. An induced abortion is the intentional termination of a pregnancy and expulsion of a fetus, whether by surgery or the administration of pharmaceuticals. There are 2 kinds of induced abortions: surgical and chemical.
urgical Abortion !rocedures ". Manual Vacuum Aspiration : within 7 weeks after last menstrual period #ilators (metal rods) are used to stretch the cer$ical muscle until the opening is wide enough for abortion instruments to pass through the uterus. A hand%held syringe is attached to tubing, which is inserted into the uterus. The fetus is suctioned out. 2. Suction Curettage : after 14 weeks from the last menstrual period The abortionist uses a dilator or laminaria to open the cer$ix. &aminaria are thin sticks from a kelp species that are inserted hours before the procedure and allowed to slowly absorb water and expand, thereby dilating the cer$ix. 'nce the cer$ix is dilated, the abortionist inserts tubing into the uterus and attaches the tubing to a suction machine. uction pulls apart the fetus body and out the uterus. After suction, the doctor and nurses must reassemble the fetus dismembered parts to ensure they ha$e all the pieces. . D & C (Dilation and Curettage): within first 12 weeks The cer$ix is dilated. A suction suction de$ice is placed in the uterine ca$ity to remo$e the fetus and placenta. Then the abortionist inserts a curette (a loop%shaped knife) into the uterus. The abortionist uses the curette to scrape any remaining fetal parts and the placenta out of the uterus. *. D & E (Dilation and Evacuation): within 13-24 weeks after last menstrual period The fetus literally doubles in si+e between the "" ""th th and "2th weeks of pregnancy. oft cartilage hardens into bone at " weeks, making the fetus too large and strong to pass through a suction tube. The # - procedure begins by inserting laminaria a day or two before the abortion, opening the cer$ix wide to accommodate the larger fetal si+e. The abortionist abortionist then both tears and cuts the fetus and u ses the $acuum machine to extract its remains. /ecause the skull is too large to be suctioned through the tube, it must be crushed by forceps for remo$al. !ieces must be extracted $ery carefully because the 0agged, sharp pieces of the broken skull could easily cut the cer$ix. 1. Saline: after 15 weeks of pregnancy This procedure is conducted in the same manner as amniocentesis (a prenatal test used to diagnose a fetus potential chromosomal abnormalities). A long needle is inserted into the womans abdomen, directly into the amniotic sac. t is at this point that a saline abortion and amniocentesis differ. n a saline abortion, amniotic fluid is remo$ed from the woman and replaced by a strong saline (salt) solution. As the fetus lungs absorb the salt solution, it begins to suffocate. t may struggle and may e$en ha$e con$ulsions. The saline also burns off the fetus outer layer of skin. aline abortion can take one to six hours before the fetus is no longer $iable. The woman begins labor after approximately "2 hours, and she may take up to 2* hours to deli$er. d eli$er. /ecause /ecause the procedure is often 3uite long, many times the woman is left to labor
alone. . Prostaglandin: after 15 weeks of pregnancy This procedure is conducted in the same manner as a saline abortion, except prostaglandin (a hormone that causes the woman to start labor) replaces saline. !rostaglandin acti$ates contractions. t can cause o$erly painful or intense labor4 there ha$e been cases in which the $iolence of the contractions ruptured the mothers uterus." This type of abortion is not preferred by abortionists because there is a *56 higher chance of a li$e birth. 7. Hysterotomy: after 18 weeks This procedure is the same as a cesarean section (in which the doctor cuts through the abdomen and uterus to deli$er the baby), except that in a hysterotomy, no medical attention is gi$en to the baby upon deli$ery to help it sur$i$e. 8ost often, a wet towel is placed o $er the babys face so it cant breathe. ometimes the baby placed in a bucket of water. The goal is to ha$e a baby that wont sur$i$e. 9. D & (Dilation and E!traction) : from 20 weeks after last menstrual period to full term. lso called !partial "irth a"ortion.#
This procedure takes three days. #uring the first two days, the womans cer$ix is dilated. he is gi$en medication for cramping. 'n the third day, she recei$es medication to induce labor. As the woman labors, the abortionist uses an ultrasound to locate the babys legs. The abortionist then grasps a leg with forceps and deli$ers the baby up to its head. ext, using a scissors, the abortionist creates an opening in the base of the babys skull. A suction catheter is inserted into the skull opening, and the babys brains are suctioned out. The skull collapses, and the rest of the babys body is deli$ered through the birth canal.
;hemical Abortion 'ptions ". "#$%' (Miepristone): within 4-7 weeks of the last menstrual period. Also called “the abortion pill.”
This drug interferes with le$els of progesterone, a hormone that keeps the fetus implanted in the wall of the uterus. The woman is prescribed progesterone and then returns to the clinic two days later to recei$e a prostaglandin drug that induces labor and expels the dead fetus. A third $isit may be re3uired if the baby is not expelled, at which time a woman has a 1%96 likelihood of needing a surgical abortion to complete the process. <=%*9 is documented to be unsafe for women.2 2. Metotre!ate and Misoprostol 8ethotrexate is used for treatment of cancer, and 8isoprostol is used for ulcer treatment. n a chemical abortion, these two drugs are used in combination. 8ethotrexate causes cells in the placenta (the organ that nourishes the fetus) to die. 8isoprostol empties the fetus from the uterus by causing the uterus to contract and push the fetus out. 8ethotrexate is a drug used in chemotherapy and has the potential for serious li$er toxicity. . *Morning Ater+ Pill: sometimes used in rape cases =p to 72 hours after intercourse, a woman is administered large doses of birth control pills (or le$onorgestrel, also known as !lan /) to pre$ent the embryo from implanting in the uterus wall. Twel$e
hours after the first dose, a second dose is gi$en. &arge doses of b irth control pills work to pre$ent o$ulation and hinder sperm motility.
Clinical death >rom ?ikipedia, the free encyclopedia
Clinical deat is the medical term for cessation of blood circulation and breathing, the two necessary criteria to sustain human and many other organisms@ li$es. "B t occurs when the heart stops beating in a regular rhythm, a condition called cardiac arrest. The term is also sometimes used in resuscitation research.
topped blood circulation has historically pro$en irre$ersible in most cases. !rior to the in$ention of cardiopulmonary resuscitation (;!<), defibrillation, epinephrine in0ection, and other treatments in the 25th century, the absence of blood circulation (and $ital functions related to blood circulation) was historically considered the official definition of death. ?ith the ad$ent of these strategies, cardiac arrest came to be called clinical death rather than simply death, to reflect the possibility of post%arrest resuscitation. >or medical purposes, it is considered the final physical state before legal death.citation needed B At the onset of clinical death, consciousness is lost within se$eral seconds. 8easurable brain acti$ity stops within 25 to *5 seconds. 2B rregular gasping may occur during this early time period, and is sometimes mistaken by rescuers as a sign that ;!< is not necessary.B #uring clinical death, all tissues and organs in the body steadily accumulate a type of in0ury called ischemic in0ury. Contents hideB
" &imits of re$ersal 2 Cypothermia during clinical death &ife support during clinical death * ;ontrolled clinical death 1 ;linical death and the determination of death ee also 7
Limits of reversaleditB 8ost tissues and organs of the body can sur$i$e clinical death for considerable periods. /lood circulation can be stopped in the entire body below the heart for at least 5 minutes, with in0ury to the spinal cord being a limiting factor.*B #etached limbs may be successfully reattached after hours of no blood circulation at warm temperatures. /one, tendon, and skin can sur$i$e as long as 9 to "2 hours.1B
The brain, howe$er, appears to accumulate ischemic in0ury faster than any other organ. ? ithout special treatment after circulation is restarted, full reco$ery of the brain after more than minutes of clinical death at normal body temperature is rare. B7B =sually brain damage or later brain death results after longer inter$als of clinical death e$en if the heart is restarted and blood circulation is successfully restored. /rain in0ury is therefore the chief limiting factor for reco$ery from clinical death. Although loss of function is almost immediate, there is no specific duration of clinical death at which the non%functioning brain clearly dies. The most $ulnerable cells in the brain, ;A" neurons of the hippocampus, are fatally in0ured by as little as "5 minutes without oxygen. Cowe$er, the in0ured cells do not actually die until hours after resuscitation. 9B This delayed death can be pre$ented in $itro by a simple drug treatment e$en after 25 minutes without oxygen. DB n other areas of the brain, $iable human neurons ha$e been reco$ered and grown in culture hours after clinical death. "5B /rain failure after clinical death is now known to be due to a complex series of processes called reperfusion in0urythat occur after blood circulation has been restored, especially processes that interfere with blood circulation during the reco$ery period. ""B ;ontrol of these processes is the sub0ect of ongoing research. n "DD5, the laboratory of resuscitation pioneer !eter afar disco$ered that reducing body temperature by three degrees ;elsius after restarting blood circulation could double the time window of reco$ery from clinical death without brain d amage from 1 minutes to "5 minutes. This induced hypothermia techni3ue is beginning to be used in emergency medicine. "2B"B The combination of mildly reducing body temperature, reducing blood cell concentration, and increasing blood pressure after resuscitation was found especially effecti$eEallowing for reco$ery of dogs after "2 minutes of clinical death at normal body temperature with practically no brain in0ury."*B"1B The addition of a drug treatment protocol has been reported to allow reco$ery of dogs after " minutes of clinical death at normal body temperature with no lasting brain in0ury."B ;ooling treatment alone has permitted reco$ery after "7 minutes of clinical death at normal temperature, but with brain in0ury."7B =nder laboratory conditions at normal body temperature, the lo ngest period of clinical death of a cat (after complete circulatory arrest) sur$i$ed with e$entual return of brain function is one hour ."9B"DB
Hypothermia during clinical death editB
Life support during clinical death editB The purpose of cardiopulmonary resuscitation (;!<) during cardiac arrest is ideally re$ersal of the clinically dead state by restoration of blood circulation and breathing. Cowe$er there is great $ariation in the effecti$eness of ;!< for this purpose. /lood pressure is $ery low during manual ;!<,2*B resulting in only a ten%minute a$erage extension of sur$i$al.21B Jet there are cases of patients regaining consciousness during ;!< while still in full cardiac arrest. 2B n absence of cerebral function monitoring or frank return to consciousness, the neurological status of patients undergoing ;!< is intrinsically uncertain. t is somewhere between the state of clinical death and a normal
functioning state. !atients supported by methods that certainly maintain enough blood circulation and oxygenation for sustaining life during stopped heartbeat and br eathing, such ascardiopulmonary bypass, are not customarily considered clinically dead. All parts of the body except the heart and lungs continue to function normally. ;linical death occurs only if machines pro$iding sole circulatory support are turned off.citation needed B
Controlled clinical death editB ;ertain surgeries for cerebral aneurysms or aortic arch defects re3uire that blood circulation be stopped while repairs are performed. This deliberate temporary induction of clinical death is called circulatory arrest. t is typically performed by lowering b ody temperature between "9G; (* G>) and 25G; (9 G>) and stopping the heart and lungs. This state is called deep hypothermic circulatory arrest. At such low temperatures most patients can tolerate the clinically dead state for up to 5 minutes without incurring significant brain in0ury.27B &onger durations are possible at lower temperatures, but the usefulness of longer procedures has not b een established yet. 29B ;ontrolled clinical death has also been proposed as a treatment for exsanguinating trauma to create time for surgical repair .2DB
Clinical death and the determination of death editB %ain article& %edical definition of death
#eath was historically belie$ed to be an e$ent that coincided with the onset of clinical death. t is now understood that death is a series of physical e$ents, not a single one, and determination of permanent death is dependent on other factors beyond simple cessation of breathing and heartbeat. ""B
;linical death that occurs unexpectedly is treated as a medical emergency. ;!< is initiated. n a =nited tates hospital, a ;ode /lue is declared and Ad$anced ;ardiac &ife upport procedures used to attempt to restart a normal heartbeat. This effort continues until either the heart is restarted, or a physician determines that continued efforts are useless and reco$ery is impossible. f this determination is made, the physician pronounces legal death and resuscitation efforts stop. f clinical death is expected due to terminal illness or withdrawal of supporti$e care, often a #o ot
!rinciples of /ioethics ome of the early founders of bioethics put forth four principles which form this framework for moral reasoning. These four principles are:
Autonomy N one should respect the right of indi$iduals to make their own decisions ,onmaleicence N one should a$oid causing harm -eneicence N one should take positi$e steps to help others .ustice N benefits and risks should be fairly distributed
'ne commentator has said, OPthe four principles shouldPbe thought of as the four moral nucleotides that constitute moral #A N capable, alone or in combination, of explaining and 0ustifying all the substanti$e and uni$ersalisable moral norms of health care ethicsPQ
ePr i maFac i eDu t i e so rMor al Gu i d el i n es 1.Fi del i t y .Dut i esoffi del i t yar edut i est ok eepone�sp r omi s esa ndc on t r a ct sa ndno tt oen ga gei n dec ep t i o n.Ros sd es c r i best hem a s" t h os er es t i n gonapr omi s eorwha tma yf ai r l ybec al l edani mpl i c i t pr omi s e,s uc hast hei mpl i c i tunder t ak i ngnott ot el l l i eswhi c hs eemst obei mpl i edi nt heac tofent er i ng i nt oc onv er s at i on...orofwr i t i ngbook st hatpur por tt obehi s t or yandnotfi ct i on"( Ros s,145) 2.Rep ar at i on.Thi si sadut yt omak eupf ort h ei nj ur i esoneha sdonet oo t her s .Ros sd es c r i best hi sdu t y as" r es t i ngonapr ev i ouswr ongf ul ac t "( Ros s,i bi d. ) 3.Gr at i t ude.Thedut yofgr at i t udei sadut yt obegr at ef ul f orbenef ac t i onsdonet oones el fandi fpos si bl e t os howi tbybenef ac t i onsi nr et ur n. 4.Noni nj ur y . Thedu t yofnoni nj ur y( al s ok no wnasnonmal efi c enc e)i st hedu t yno tt ohar m ot her s phy si c al l yorps yc hol ogi c al l y :t oav oi dhar mi ngt hei rheal t h,s ec ur i t y ,i nt el l i genc e,c har ac t er ,orhappi nes s. I tal s oi nc l udesadut yt opr ev enti nj ur yt oot her s . 5.Benefi c enc e.Thedut yt odogoodt oot her s :t of os t ert h ei rheal t h,s ec ur i t y , wi s dom,mor al good nes s ,or happi nes s .Thi sdu t y , s ay sRos s ," r es t supo nt hef ac tt hatt h er ear eo t herbei ngsi nt hewor l dwhos e c ondi t i onwec anmak ebet t eri nr es pec tofv i r t ue,orofi nt el l i genc e,orofpl eas ur e"( Ros s,146) . 6.Sel f I mpr o v ement .Thedu t yofs el f i mpr o v emen ti st oac ts oast opr omo t eon e �sowngood,i . e. , one�so wnheal t h ,s ec ur i t y , wi s dom,mor al go odnes s ,an dhappi nes s .Ros shi ms el fment i ons" v i r t ue "o r " i nt el l i genc e"i nt hi sc onnec t i on( 146) . 7.J us t i c e.Thedut yofj us t i c er equi r est hatoneac ti ns uc hawa yt hatonedi s t r i but esbenefi t sand bur densf ai r l y .Ros shi ms el femphas i z est henegat i v eas pec toft hi sdut y :hes ay st hatt hi st y peofdut y " r es t sont hef ac torpos si bi l i t yofadi s t r i but i onofpl eas ur eorhappi nes s( ort hemeanst her et o)t hati snot i na cc or dwi t ht hemer i toft hep er s onsc onc er ned;i ns uc hc as est her ear i s esadu t yt oups etorpr e v en t s uc hadi s t r i but i on"( 146) .Thust hedut yofj us t i c ei nc l udest hedut y ,i ns of araspos si bl e,t opr ev entan unj us tdi s t r i but i onofbenefi t sorbur dens .
atural &aw thics: The Three #eterminants of 8oral Action ". 'b0ect The ob0ect is which the will intends directly and primarily. t could be a thing or an action.
2. ;ircumstances ;ircumstances may mitigate of aggra$ate. There are se$en circumstances mentioned by t. Thomas A3uinas: a. who % special 3uality, prestige, rank or excellence of the person % t is bad to kill a man. t is worse to kill the president of the =nited tates. b. what % 3uantity or 3uality of a moral ob0ect % t is good to send money to the orphanage. t is better to send money to the orphanage and also take time to $isit the children there. c. where % the place % t is good to ha$e a dental mission in a public school in the city. t is better to ha$e a dental mission in a public school in the pro$inces. d. by what means % means in carrying out the act % t is bad to shoot your enemy. t is worse to torture your enemy before shooting him. e. why % The end or purpose affects the goodness of badness of the action. % t is bad to steal money. t is worse to steal money and use it to buy illegal drugs. f. how % manner in which the action is done % t is good to send $olunteers to help the typhoon $ictims. t is better to go to help the $ictims yourself. g. when % time element % t is good to be with your friend in her graduation. t is better to be with your friend in her frustrations.
. The nd or !urpose t is the integral part of moral acts. ?e should not employ e$il means to attain a good end.
DETERMINANTS OF MORALITY
The factors in human conduct that determine whether it is good or bad. There are three such determinants of morality, namely the ob0ect, the end, and the circumstances. /y ob0ect is meant what the free will chooses to do%%in thought, word, or deed% or chooses not to do. /e end is meant the purpose for which the act is willed, which may be the act itself (as one of lo$ing Rod) or some other purpose for which a person acts (as reading to learn). n either case, the end is the moti$e or the reason why an action is performed. /y circumstances are meant all the elements that surround a human action and affect its morality without belonging to its essence. A con$enient listing of these circumstances is to ask: whoS whereS howS how muchS by what meansS how oftenS ome circumstances so affect the morality of an action as to change its species, as stealing a consecrated ob0ect becomes sacrilege and lying under oath is per0ury. 'ther circumstances change the degree of goodness or badness of an act. n bad acts they are called aggra$ating circumstances, as the amount of money a person steals. To be morally good, a human act must agree with the norm of morality on all three counts: in its nature, its moti$e, and its circumstances. #eparture from any of these makes the action morally wrong. Top 6 Qualities of a Healthcare Professional July 3rd, 2013 Those who succeed in a career in medicine and ain the most ful!llment, enter it with a certain set of intani"le #ualities and personality traits$ %t is a "oomin industry, "ut "efore you decide to enter this world, do you &now if you ha'e what it ta&es to ma&e healthcare a successful career( )ommunication *&ills +reat communication s&ills include not only spea&in and "ut listenin$ ou need to "e a"le to follow directions without pro"lem and easily and e-ecti'ely communicate
with other healthcare practitioners and patients in order to understand and e.plain treatments and needs$ /etail rientation ein an oranied, detailoriented person is crucial for someone in the healthcare !eld$ %n fact, attention to detail can 4in many instances5 "e a life or death matter$ ssessment, medication, procedures and documentation all rely on 'ery speci!c information, with little to no marin for error$ ein a"le to dou"le and triplechec& will ser'e you well$ 7motional *ta"ility medical wor&er needs to "e emotionally sta"le$ Healthcare is a stressful 8o"$ ou will see many traumatic situations, includin the 8oy of "irth, the pain of catastrophic in8ury and the aony of su-erin and death$ ou need to "e a"le to wor& without internaliin the stress and allowin it to cause personal harm$ 7mpathy %f you cannot care a"out the people you are ser'in, you will pro"a"ly not succeed in this !eld$ ou will "e carin for 4not only5 the sic& and in8ured "ut interactin with their worried family mem"ers on a daily "asis$ ou need to a"le to put yourself in their shoes and empathie with their situation if you are to truly pro'ide hih #uality of care$ Howe'er, empathy is di-erent than the emotional insta"ility$ The "est medical wor&ers are a"le to empathie "ut not internalie others9 emotional and physical pain$ dapta"ility :o day is #uite li&e the ne.t, so you need to "e a"le to adapt to circumstances$ People ha'e di-erent personalities, which can "e di;cult enouh, "ut under duress they can "ecome unpredicta"le$ *o a typical wor&day will re#uire a hih amount of
*ee more at> http>??"lo$snellin$com?2013?0@?top6#ualitiesofahealthcare professional?Asthash$a%tB@p"$dpuf
