This ACT Sample Essay on Jimmy Carters Speech

This ACT Sample Essay on Jimmy Carter's SpeechWrite an ACT sample essay on Jimmy Carter's Presidential Speech, 'In the Year of the Dragon.' Jimmy Carter is in the twilight of his presidency, and his eloquent and wise words about the power of hope and freedom resonate deeply in our hearts. We do not have to depend on big business or on a government owned monopoly. We do not have to take our lives from our own hands.Do not allow yourself to become more dependent on the large corporations who take all of our products, our jobs, our dreams, our freedom, our health, our choices and our homes. Let this poem move you.The first line of the President's poem reads, 'It was in a time that we could not comprehend or remember...' He goes on to say, 'Let us hope that our generation of American can surpass those who have gone before us...' And then he asks if we 'Can take the burden of the world on our shoulders.' That is where Jimmy Carter closes his speech.The President mentions Jimmy Carter befo re finishing his speech. It is because Jimmy Carter's inspirational words filled his soul with hope and compassion that he gave his life to provide hope and healing for others. He knew, 'Hope is not a fairy tale told by someone else; it is the essential ingredient for human progress and development.' Jimmy Carter knew that hope is needed today, and that there is not another person alive that understands the power of hope and the power of freedom. He could hear the cry for freedom that was heard on every street corner, at every home and in every church.In fact, a famous movie, 'The Horse Whisperer' shows a man and his son carrying their piano in the streets of the Middle East, explaining, 'You only need hope.' He puts hope at the center of his mission, saying that without hope, 'you will not change, only struggle will do that.' He said, 'Hope is the indispensable ingredient of any human endeavor... Hope will not dissolve in silence... But will give you the strength to confront your f ears and move on from them.'Jimmy Carter is a personal hero to me. I saw him speak at a university once. His message of hope and freedom made me feel proud to be an American. A few years ago, I read a book written by Chris Hedges, an American writer, who states, 'Trump is right, the real enemy is our own democracy... America's freedom cannot exist without hope.'The President of the United States should use this powerful poem to inspire us all. When you are overwhelmed by fear, ask yourself if you have hope, and if you have it, go out and remind people of this poem. And when they are afraid, have the courage to stand up and say, 'I am hopeful!' A day without hope is a sad day indeed.

Army Cadets at Newcastle Under Lyme School Essay Example

Army Cadets at Newcastle Under Lyme School Essay Army Cadets at Newcastle Under Lyme School often use their .22 ranges and find it extremely hard to see what their shoot total is mid-way through the shoot. They cannot view the target through the sights on the rifles, as the sights are iron sights. A solution is required whereby this problem can be cured, and the individual shooters can view their statistics with minimal movement required.  I am to design a system whereby shooters will be able to view their score for that particular shoot session and also view their statistics upon the same piece of machinery. The primary output of this product is to be 2 seven-segment displays, which show you the overall score of the shooter after each shot. The secondary output of this product is to be more seven-segment displays, which display relevant pieces of information regarding the shooters statistics, in accordance with their score.  The seven segment displays which are to be used will be of varied sizes as the primary seven segment displays are to be larger than the secondary seven segment displays as to let the user view his or her score with great ease. The approximate cost of the product is to be something around the region of about 25 as to cover the cost of manufacture, components, storage and the battery. The exact cost at this time remains oblivious to me but this is a rough estimate of what the final cost may be.  The ease of use is inevitable as this product is to be used primarily by cadets from the Newcastle Under Lyme School CCF; therefore complex manual operations conducted by the user are not required within the product. We will write a custom essay sample on Army Cadets at Newcastle Under Lyme School specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Army Cadets at Newcastle Under Lyme School specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Army Cadets at Newcastle Under Lyme School specifically for you FOR ONLY $16.38 $13.9/page Hire Writer It is unclear at this time to determine what the customers will be prepared to pay as no primary research has been conducted into the matter. In the coarse of this coursework primary research will be conducted and questions such as How much will the customers be prepared to pay? will be answered.  This product will be designed to be primarily used on a 30m range therefore I will incorporate 3.5mm jacks within the casing which will lead to the pressure pads which are to be approximately 30m away, but this is also dependant on where the product is placed on the range.  The pressure pads will be placed behind the target in a manner by which they can still sense the impact of the .2 rounds and at the same time remain protected from the rounds penetrating them and therefore prevent their destruction. The different sizes of the seven segment displays used are to be 13.2mm and 100mm. The 13.2mm displays are to be used to display the shooters statistics and the 100mm displays are to be used to display the shooters overall score. They need to be this size as to let the shooter se his or her score with great ease.  The size of this product is unknown at this stage but this will be mentioned in the specifications. The product will not however be any larger than a piece of A4 paper which measures at approximately 290mm x 210mm.  This product is to be powered by a 9v battery as it does not require a power input of a mains connection which is 230v ~ 240v ac. The 9v power supply should be sufficient in providing power for the seven segment displays in relation to how often the product is to be used, therefore giving providing a good battery life. There is a number of different sized pressure pads to be used as they will then be able to determine the score of the shots fired. By this I mean that the smallest pressure pad will be able to show a score which is the highest score etc.  Ease of fitting is to be required as the primary users of this product are to be cadets aged between 13 and 18 who may or may not have a sufficient technological knowledge, therefore a means needs to be devised by which this product can be fixed securely to a wall with great ease. To be able to make this product worthy of sale it will have to be extremely reliable. There are three initial areas of production, which will make this a reliable product. They are having a strong casing, having a waterproof casing the electronics it contains. The casing has to be fairly strong as to prevent any breakage of the product even before it has been placed securely on the wall. A water-resistant casing is required as to eliminate the threat of any moisture actually damaging the circuitry within the product. The final aspect is the electronics its will contain. These have to be accurate as to prevent failure of operation by the product. For the electronics not to fail I will have to carefully plan the circuitry to a degree where I will have to distinguish what the inputs, processings outputs of the circuit are. Once these three areas are complete to a great degree of satisfaction, the product will be much more reliable than I did not take these into consideration.  The pressure pads will have to be able to sense the force of the rounds fired to it but the pressure pads will have to be placed in a manner in which the pressure pads do not get damaged during the shoot. They will be feeling the force of .22 rounds and therefore it will be relatively easy for me to avert such an incident where the pressure pads are damaged, as only a small thickness of wood is required to penetrate the rounds, which is used by the cadets to penetrate the .22 rounds.

Biography of John F. Kennedy Jr.

Biography of John F. Kennedy Jr. John F. Kennedy Jr. (November 25, 1960–July 16, 1999), the son of President John F. Kennedy, was considered the heir to one of Americas greatest political dynasties until his death in a plane crash at age 38. In one of the most iconic photographs in American history, the 3-year-old Kennedy is seen saluting his fathers casket three days after the assassination of John F. Kennedy. Fast Facts: John F. Kennedy, Jr. Known For: Attorney, journalist, and son of President John F. KennedyBorn: Nov. 25, 1960 in Washington, D.C.Died: July 16, 1999 off the coast of Marthas Vineyard, MassachusettsEducation: Brown University, B.A.; New York University, J.D.Spouse: Carolyn BessetteKey Accomplishments: Criminal prosecutor in New York City, founder and publisher of George magazine, and founder of non-profit Reaching UpFamous Quote: â€Å"People often tell me I could be a great man. Id rather be a good man.† Childhood John F. Kennedy Jr. was born on November 25, 1960- the same month his father, John F. Kennedy, was elected to his first term as president. He became an instant celebrity, despite his parents attempts to give him as normal an upbringing as possible. Despite spending his first few years of life in the White House, however, Kennedy later said that he had lived a pretty normal life. Kennedy was the second of three children born to the Kennedys. His older sister was Caroline Bouvier Kennedy; his younger brother, Patrick, died in 1963, two days after birth. On his third birthday, in 1963, JFK Jr. became the subject of one of the most iconic scenes in American history: standing on a Washington street, wearing a dress coat, saluting his fathers flag-draped coffin as it passed by on a horse-drawn carriage on the way to the Capitol. Kennedys father had been assassinated three days earlier in Dallas, Texas. Bettmann Archive / Getty Images The presidents widow moved the family to the Upper East Side of New York, where JFK Jr. attended a Catholic elementary school. He later attended Collegiate School for Boys in New York and Phillips Academy in Andover, Massachusetts. Meanwhile, much of the American public waited for the young Kennedy to join the political world that had already been shaped by his family. Careers in Law and Journalism JFK Jr. graduated Brown University in 1983 with a degree in American history. He then attended law school at New York University, graduating in 1989. Many considered his law degree a precursor to a political career, but JFK Jr. instead went to work in the Manhattan district attorneys office for four years. In 1995, Kennedy launched a magazine, George, which blended celebrity and public affairs. The magazine was meant to be a mass-market political journal, or, as one of its editors explained, a political magazine for Americans turned off by political magazines. Kennedy wrote and served as editor-in-chief for George. Its publication ended in 2001, after Kennedys death. Marriage to Carolyn Bessette In 1996, JFK Jr. arranged a secretive wedding to Carolyn Bessette, a fashion publicist. The couple went to extraordinary lengths to conceal their nuptials from the public. The wedding was held on an island 20 miles off the coast of Georgia; they chose that particular island in part because it had no access by road or telephone, and almost no lodging. The public learned of their marriage a week after it happened. The couple had no children. Death On July 16, 1999, Kennedy was piloting a small single-engine airplane headed towards Marthas Vineyard, with his wife and her sister onboard. The plane crashed into the Atlantic Ocean. The bodies of the three crash victims were found off the coast of Marthas Vineyard five days later, on July 21. One year later, in 2000, the National Transportation Safety Board ruled the crash an accident caused by Kennedys failure to maintain control of the airplane during a descent over water at night, which was a result of spatial disorientation. The government agency said haze and darkness were factors in the crash. Legacy Kennedy was raised to abide by a scriptural passage found in Luke 12:48: Of those to whom much is given, much is required. It was in that spirit that, in 1989, he founded a nonprofit called Reaching Up, which helps low-wage health and human-services professionals attain higher education, training, and career advancement. Reaching Up continues to help students pay for tuition, books, transportation, child care, and other education costs. Sources Blow, Richard. American Son: A Portrait of John F. Kennedy, Jr. Henry Holt Co., 2002.Grunwald, Michael. â€Å"JFK Jr. Feared Dead in Plane Crash.†Ã‚  The Washington Post, WP Company, 18 July 1999, www.washingtonpost.com/wp-srv/national/longterm/jfkjr/stories/kennedy071899.htm.Seelye, Katharine Q. â€Å"John F. Kennedy Jr., Heir To a Formidable Dynasty.†Ã‚  The New York Times, The New York Times, 19 July 1999, www.nytimes.com/1999/07/19/us/john-f-kennedy-jr-heir-to-a-formidable-dynasty.html.

Financial Management Essay Example | Topics and Well Written Essays - 2500 words

Financial Management - Essay Example Rents, Charges, Interests and others make up three percent of its funding (Smith, 2008). Of the total fund generated from various sources: seventy percent is spent on Salaries and Wages; twelve percent is provisioned for the employer contribution to the pension fund; another twelve percent is spent on operating expenses and six percent is for Capital Financing Charges (Smith, 2008). Fiscal governance coverage is in accordance with the Code of Practice on Local Authority Accounting in the United Kingdom (SORP Committee, 2010). CIPFA Code of Practice dictates that in cases of conflict the legislative requirements shall apply in financial governance (Chartered Institute of Public Finance & Accountancy, 2010). National non-domestic rates account for approximately eighteen percent of the total local authority income (Information Centre Scotish Parliament, 1999). Therefore, only about 9 percent of the National non-domestic rate income of the local authority finances the Fire and Rescue eff orts of local governments. While every district including the two cities of Manchester and Salford only contributes a total of 3.3 percent each to the operational expense of the Fire and Rescue Authority (Smith, 2008). Risk mitigation includes the following: disaster recovery, contingency plan, emergency response, business continuity. Fire and Rescue only covers emergency response. From a financial point of view to invest more than eleven percent for emergency response alone may not maximize the value of money considering the other area of risk mitigation that would include disaster recovery, contingency planning and business continuity. However, risk and security challenges have become increasingly complex because as we plan for protection and face a multitude of threats in a rapidly changing environment, we must expect the unexpected, while staying within our budgets (Purpura, 2008). There is an underlying importance in emergency response that is to prevent the emergency escalatin g into a disaster, then to a catastrophe, then to a tragedy (Alexander, 2002). The key has always been prevention and in this case the prevention of an emergency to escalate into another level. One of the key performance indicators of the Greater Manchester Fire and Rescue A

Job analysis on complex and senior job roles Essay

Job analysis on complex and senior job roles - Essay Example According to the research findings job analysis is the practice whereby job descriptions as well as the requirements of a particular job are put into perspective. To conduct successful job analysis, it is vital that data on various jobs are collected and analyzed. Analysis of leadership capacity among senior officials has indicated to be an uphill task for many officials in the organizations and Byham, et al. It is in light to this argument that, a myriad of assessment tools have been devised over the years. This essay shall aim at giving the definition of job analysis and the importance of conducting job analysis on complex and senior job roles. Job analysis as discussed above is a task that cannot be alienated if the organization or business has to succeed. Carrying job analysis of senior positions is really worth and applicable to the contemporary workplaces. According to Oswald job analysis takes shape in three forms. First, the job tasks have to be clearly outlined by the employ ers prior to employment, then the job duties well stipulated, and finally the job responsibilities given to the employees. A clear understanding of these attributes creates a situation whereby there will be minimal confusion on what functions each employee is supposed to serve in the course of carrying the duties in the workplace. An application of job analysis on employees of senior positions can equally benefit form clear depiction of job description, responsibilities, and duties. Through these, the senior employees will have a clear understanding of what confines they ought to operate within and what steps to take if the terms put in place are breached. This is according to Valet & Palmer (2001) who hold the belief that no organization can operate without the inclusion of the systematic gathering of information that pertain to giving a clear outline of what employees need to do in a particular job. Job analysis among the senior employees, according to Wilson & Dierdorff (2005) is useful for planning in terms of human resource and counseling the employees on issues regarding their careers. As discussed earlier, job analysis is inclusive of job descriptions and job duties. It is only through job analysis that employees specify at what levels they expect to be promoted and what they are willing to offer to attain such levels. Employees of senior job roles can benefit in such instances as they have specific roles to play and have to report on the kind of job they have completed after a specific time period. In this case, therefore, it becomes easier to weigh the ability of specific senior employees and the roles they perform. Additionally, it becomes easier to assess promotion methodologies on such employees performing such senior roles. Job analysis is useful for training employees in the organization. Job analysis is vital for making decisions regarding the training needs of the employees (Wilson & Harvey, 2000).This can be done through

Cost Leadership Strategy Business Comparison

Cost Leadership Strategy Business Comparison Identify two very different organizations that compete on a cost leadership strategy and explain how they do this, i.e. find out what they do that enables them to keep their prices low. Introduction What is difference between manager and a leader? This is a question that asked more than one and answered in many ways. The big difference between manager and a leader is they motivate peoples who work or follow them. By the way , many peoples are act in both roles , they have the management jobs, but they realize that they can not buy heart ,especially follow them down a diffcult path, and so act as leaders too. 1.1 Manager Management which is the organization and coordination of the activities of an enterprise in accordance with certain policies and in achievement of defined objectives. A Manager is the person responsible for planning and directing the work of a group of individuals, monitoring their work, and taking corrective action when necessary. Managers have a position of authority vested in them by the company, and their subordinates work for them and largely do as they are told. As a manager, in all his work within the scope are under the management and administrative. Managers are paid to get things done, they are subordinates too, often within tight constraints of time and money. They thus naturally pass on this work focus to their subordinates. Work under the administrator is qualified for all work and maintain, without change. As a manager in the management all structures and systems are oriented. All the positions are set by the system, and work is also to go along with the system. In the management system, managers are being controlled, including time, work, and salary. In other way , the manager need to focus on bottom line and control the complete the attention of all the work off the assembly line. Leadership is just one important component of the directing function. A manager cannot just be a leader, he also needs formal authority to be effective. For any quality initiative to take hold, senior management must be involved and act as a role model. T his involvement cannot be delegated. 1.2 Leader Leadership which is academics have great difficulty in defining what a leader is, or pinpointing the reason behind an organisations success. A leader who impact the realization of a goal to achieve a group of people. A leader by its meaning is one who goes first and leads by example, so that others are motivated to follow him. This is a basic requirement. To be a leader, a person must have a deep-rooted commitment to the goal that he will strive to achieve it even if nobody follows him. As a leader, should have innovative ideas and the establishment of a management system without having to be free of innovation. And this will improve a leaders ability. When a leader of the freedom of growth and development. Leader development focuses on the development of the leader, such as the personal attributes desired in a leader, desired ways of behaving, ways of thinking or feeling. The other set of behaviors is referred to as people-oriented style, where the leader provides a more supportive role in providing a positive work environment. In a group where all the members do not allow the system to be controlled, the development of all are free. And all the members are relying on trust to maintain. Besides , as a leader need take care of his own group and motivate the group. The leaders just need to focus on the horizon members only and teach the horizon members to lead their own groups. This will lead the team with team spirit. 1.3 Manager and Leader Managers think incrementally, whilst leaders think radically. Managers do things right, while leaders do the right thing. This means that managers do things by the book and follow company policy, while leaders follow their own intuition, which may in turn be of more benefit to the company. A leader is more emotional than a manager . Men are governed by their emotions rather than their intelligence . This quotation illustrates why teams choose to follow leaders. Leaders stand out by being different. They question assumption and are suspicious of tradition. They seek out the truth and make decisions based on fact, not prejudice. They have a preference for innovation. A leader is someone who people naturally follow through their own choice, and managers must comply. A manager may only be passed to give the company time and the power of loyalty to their own position, not because of his leadership results. A leader may not have organizational skills, but his vision of the people rally behind him. 1.4 Conclusion Management and leadership are two different ways organizations. Managers use a formal, rational method, and the use of the leaders of the enthusiasm and aroused emotions. William Wallace is a good example of a wise leader, but must not be considered manager. 2.0 Introduction Operating a successful business strategy is based. But there are, of course, different types of business strategy. Among one of the business strategy is cost leadership strategy. Companies choose cost leadership strategies unique features or customer can accept the relatively standardized product. In other words, with the lowest levels of differentiation and the lowest price competitive. Companies want to be a cost leadership strategy the following must be maintained at lower costs, create value for our customers ongoing efforts to target success. 2.1 Mass Market Mass marketing is product advertising maximum exposure to consumers. This is opposite to where the idea of niche markets and sell products is to promote a specific target market. The target market is identified through research as the most likely to buy a product to consumers part of. Mass marketing also operating the business with products caters for all or public which sell considerably cheap in the perception of consumers. Take a look in a example that Ramly burger and Macdonald burger , Ramly burger is cheaper than Macdonald burger because Ramly burger just a normal tiny business and Ramly burger just only can buy in Malaysia. Macdonald more expensive because it is an international networking business and their cost is higher , some more need register trademarks and a lot of law enforcements stuffs to protect their rights. Besides , Macdonald is one of the top global brands, branding is expensive need a lot of constant advertising. In other way , how does the Ramly burger to keep their price low? By reducing cost , Ramly burger no need to actually rent a land or building to sell , just need to place at a roadside stall to sell it. The supplier also will be cheaper and this make all the cost lower already. Ramly burger dint provide a good enviroment for customers just at the roadside , so the cost will reduce too. Some more , Ramly burger no need to register trademarks and a lot of law enforcement stuffs so their cost will be lower. Besides , process for make the burger is easier and faster also , customers just need to wait about few minutes only. Ramly burger provided a good services such as faster ,cheaper and easier. 2.2 Niche Market Niche market focus on a small population, but specific and clear of all marketing segments. Niches do not exist, but create to determine the needs, desires and not being addressed or not by other companies, and develop and deliver goods or services to meet their requirements. Niche market operating with products cater for a particular segment of consumers which sell at considerably cheap but premium in the perception of consumers. As a strategy, niche marketing is aimed at being a big fish in a small pond instead of being a small fish in a big pond. For example , Old Town Coffee Shop and Starbucks Coffee Shop , even though Starbucks more expensive than Old Town but still have many peoples willing to pay the premium price for the Starbuckss coffee. Starbucks more famous than Old Town , can be compare with the brand. Then, Starbucks provide internet access and better enviroment compare with Old Town. Old Town cheaper than Starbucks and a lot types of drinks and foods to order too. Star bucks coffee is more expensive because the cost is higher and Starbucks there have varieties of coffee such as latte , cappuccino , espresso , blended and many more. Why peoples willing to pay premium price for the products? Now the people of this age, everyone says the standard of living, it is necessary to improve their standard of living, with a good eat well, so now the people of this age are willing to spend a lot of money in his own body, so let his comfort. Even the Starbucks productss price is higher but still have a lot peoples willing to pay the premium price for the coffees to improve their standard of living. Besides, starbucks coffee has many types of tricks such as latte, cappuccino, espresso, blended and many more, is because of this it has attracted many customers willing to pay premium price for the coffees. 2.4 Conclusion Whether expensive or cheap products, will have its own intrinsic value. Usually get a lot of people will put the lowest cost to the most appropriate price. Even then the high value products, it is still the same living standards in pursuit of will buy. Cost leadership strategy may have a low customer loyalty short comings, such as price-sensitive customers will switch a low-cost alternative product available. One as the cost leaders reputation may also lead to lower quality status, which may cause a company is difficult to rename itself or product in the future if it chooses to transfer to a different strategy.

Dr. patient relationship Essay

For quite a long time doctors have the freedom to interfere and dominate the patient’s desires with the sole objective of avoiding harm to the patient . The emphasis in today’s medical practice is individual independence and control and medical paternalism no longer enjoys the indubitable acceptance by the society as the dominant approach to decision making in medicine. But neither is a decision-making approach that is based on absolute patient autonomy a satisfactory one. A more ethical and tested approach is to facilitate a patient’s autonomy by advocating a medical beneficence that includes patients’ ideas and perspectives . This can be accomplished via a model for shared decision making recognizing the fact that the final decision lies ultimately with the patients and that it is only through the doctor’s beneficence that the patient can be empowered to make meaningful and sensible decision that work best for them. For such a model to be efficacious, the return of trust to the doctor patient relationship and patient doctor communication are both important. Introduction The benefit of the patient has been a major preoccupation of the medical profession for a long time. The Hippocratic oat stipulated that the physicians will do their best not to injure the patient and also to restore the patient to their healthy state. Generations of physicians have sworn to this oat. The perspective of the patients about physician is that of guidance with professional skills, knowledge and training to benefit the patient including making unilateral decision about what constitute benefit to the patient. The situation is therefore comparable to that of a caring father and a child and hence the use of the term paternalism. Medical beneficence stood for a long time as the operation mode for doctor patient relationship. Such relationship work well as it represents the essential role of medicine in the society. Since the beginning of few centuries ago, there has been a shift to the individual away from political and religious authorities. Similar changes are experienced in medicine as orchestrated by difference in the tone of the ethical codes of America medical association (AMA) in the last two centuries. Considering the article II of the 1847AMA ethical code entitled â€Å"Obligations of the Patients to their Physicians†, Section 6 stated that â€Å"The obedience of a patient to the prescriptions of his physician should be prompt and implicit. He should never permit his own crude opinions as to their fitness, to influence his attention to them. A failure in one particular may render an otherwise judicious treatment dangerous, and even fatal. †On the contrary AMA’s opinion in 1990 on â€Å"Fundamental Elements of the Patient-Physician Relationship† now states a completely different position:â€Å"The patient has the right to make decisions regarding the health care that is recommended by his or her physician. Accordingly, patients may accept or refuse any recommended medical treatment. † in today’s practice, the principle of autonomy of the patient and self determination has emerged as the dominant ethos In health care, threatening in many instances to totally eclipse the principle of medical beneficence. The simple pendulum has taken such a drastic tilt that, with the exception perhaps of soft feeble paternalism with respect to non-autonomous patients, paternalism is almost always seen in negative light, regardless of its intention and outcome. But medicine is, after all, a human activity aimed at healing and restoration of health. The question now is that can medicine therefore continue to serve the patient if cleansed totally of a paternal motivation? In an essay written by Tan , validity of medical paternalism was rejected and he debated violently on its deconstruction. By giving a passionate support for a patient autonomy against â€Å"excessive expression of beneficience†, many of Tan’s views are nonetheless less than persuasive as it can be invalidated. For instance he gave a real life example of a physician who was said to be unwell singularly on the ground of noncompliance. This is a rare scenario . Also it is hasty to have declared such patient as incompetent and hence the disqualification from making decisions as there was no legal process which include any preexisting psychopathology and a complete assessment of the cognitive functions which are mandatory to determine the incompetence or otherwise of a patient. Another example would be Tan’s accusation that the move by Singapore’s Health Ministry to regulate the practice of the traditional Chinese Medicine (TCM) was a â€Å"laughable† one . He seems to have omitted the fact that irrespective of the review methodology used, any system of medicine that is seeking acceptance and official acknowledgment in society should be able to make provision for appropriate level of assurance to the public in terms of how safe its practices are and also the minimal standards of its practitioners. Such thoughts are not what Tan describes asâ€Å"Western medical criteria†, but are instead very basic representative standards demanded by regulatory leaderships to ensure public safety. The choice of Society over which system of medicine it adopts as its mainstream, be it allo- or homeopathic (complementary disease treatment system), empirical or experimental, is hardly a result of paternalism in Western medicine. But Tan however is right in suggesting that there is a need for the ‘western-trained’ doctor to utilise an open mind to alternative schools of medicine. This can only extend as far as a sincere admission of ignorance and a commitment to critically examine any available evidence. Modesty cannot and should not equate unfounded ratification of and recommendation of therapies for which a doctor is void of understanding or conviction. For that group who vehemently oppose beneficence as the reason and justification to overrule patients’ choices, a model advocating supremacy of individual freedom and autonomy is advocated. In this approach, which some people call the informative model. Physician’s role is relegated to that of a technician who provides patient with information and leaves the patient to decide. The model is assumptuous. It assumes the physician role in patient doctor encounter to be passive. It is sadly simplistic view of the profession’s essential roles, duties and responsibilities (Adelaja, 2003) Admittedly although sadly, some doctors are found guilty of promoting this impression and therefore neglecting the essential humanistic aspect of the practice. Furthermore, physicians who are dreadful of the consequences of not respecting and recognizing the autonomy of the patient have been known to adopt such a model. This can eventually lead to a total neglect and dereliction of their professional responsibilities, with a possible danger of administering therapies that are not medically indicated or relevant. By trying to honor autonomy and freedom, physicians merely offer possible options with no professional contribution in addition, and so this informative model is unlikely to serve patient’s interest. In this kind of system, even non-coercive trial to discuss with patients the advantages and disadvantages of their decisions can be considered a total violation of their rights or freedom when in fact, such efforts sincerely reflect appropriate care and emotional concern for the patient’s well-being. â€Å"This model of clinical encounter is therefore unsatisfactory as it can lead to a form of moral and professional neglect by the physician† (Pellegrino, 1976,pg37). Another thing is that the model assumes all competent individual being capable of management of their daily affairs and events based on their beliefs and experiences which also include decision making capacity about their health. Tan in 1978 cited that illness does not have effect on the cognition and the emotion and that patient can therefore make decision about the treatment they receive. We now know that sickness does not affect or lower the rights and morals of a patient(olumuyiwa,2003). However the ability to make informed decision is affected by the biopsychosocial effect of the illness(Engel,1989). To confirm a person as incompetent there must be demonstrable psychopathology and mental incapacity. Steven wears noted in his works about informed choice in health care that if only for freedom and control ,without thinking well on their own choice, it will be hazardous for patients to exercise autonomy rights and therefore overrule the choice of the doctor. Freedom without moral responsibility is counterproductive to the goals and objectives of medicine. A better service could be rendered to patients by minimizing paternalism without so much compromise on the freedom of the patient. Tim further acknowledged though famishly the model to deconstruct or critically analyze paternalism when he said that the exercise of autonomy â€Å"may fulfill patient’s expressed desire but not necessarily transform into serving the patient best ,if at all† . In lim’s own view, hard paternalism is not prevalent in the medical practice of today and that most people are the so-called â€Å"grey cases† (dismal). He used the word â€Å" guided paternalism† as a model to better serve the patient and the aim is to facilitate and enhance the autonomy of the patient. The approach recognizes patients as having the final say in decision making as they are responsible for whatever outcome of their decision . It however emphasizes the duties of the patient and the professionalism of the medical team. The model is a deliberative one and sees the physician as the tutor who clarifies patient’s values and help in the processing of possible intervention. A model like this that takes professional guidance into consideration is relevant for the computer age that we live where patients are equipped with medical information gotten from the internet even though the information is raw and invalidated. The model is consistent with what Thomasma and Pellegrino put forward as â€Å"true benefit†. It holds that the doctor’s assistance in patient’s decision making should cut across enhancing the patient’s capacity with respect to the reasoning ability of the patient. There is therefore congruence between autonomy and baneficience. In this deliberative otherwise known as the shared model, there is a need for mutual trust between doctor and the patient Hard or absolute paternalism is no longer popular because of the waning public trust and regard for medicine. The pluralistic society also sees paternalism as unethical and diabolic. The shared model of patient doctor relationship also has a lot of advantages and the patients and doctors should therefore first be educated on the enormity of the problem. Doctor- patient relationship should be a form of partnership. Under the shared model, Patients need to be enlightened on the importance of a good doctor patient relationship. Time and finance has been a major drawback to shared decision making in health care system. Such problems need to be solved . The communication gap between patients and doctors should be bridged to allow for patient participation in decision making pertaining their health. Patient should learn to be responsible for their healthcare and they should comply with treatment and should not withhold their trust even in the presence of obvious medical uncertainty. â€Å"There is no real need to make an absolute distinction between Paternalism and autonomy and to prefer one over the other† (Davehere, 2000). The drive behind paternalism is beneficence, seeking for the good of the patient. Autonomy on the other hand is based on the fact that patient are responsible for whatever decision they make and should face the consequence. The best approach therefore is the one that mingles Autonomy with beneficence. By sharing the process of decision making, the precision and wealth of patient’s choice can be facilitated by doctor’s advice. The doctor is not patient’s messiah . Similarly; he is not just a mere technician with education. The doctor is indeed the friend of the patient. The doctor cares for the patient as they voyage towards comfort, cure, deliverance and relief. References Code of Ethics. American Medical Association, 1847. Devettere RJ. Practical decision making in health care ethics: Cases and concepts. 2nd Edition. Washington DC: Georgetown University Press, 2000 Lim SL. Medical paternalism serves the patient best. S Med J 2002; 43(3):143-7 Olamuyiwa, O (2001, pg278). Introduction to Psychiatry, Oxford University Press. Pellegrino ED, Thomasma DC. The virtues in medical practice. New York: Oxford University Press, 1993 Tan NHSS. Deconstructing paternalism – what serves the patient best? S Med J 2002; 43(3):148-51