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Essay Instructions: This assessment is for the subject: Pharmacology.
It requires answering 2 questions in regards to Opiates, Morphine and assessment of a graph - Dose Response Curves for the Analgesic and Depressant Effects of Morphine.

Question 1:
The answer should be approximately 3 pages long in total.
This questions has two parts, each should be equally weighted.

Part 1) Morphine has properties that may lend it to misuse. What are the reasons for this?

Please present the properties of Morphine first then which of these properties lend it to be misused and why.

Part 2) Australia is one of the major producers of poppy-based drugs, such as morphine. Please develop a strategy to prevent the misuse of morphine for the government.

Question 2: Please evaluate the dose-response curves of morphine below and explain the information provided by the curves/graph.

I will need to scan this graph and submit to you asap however following is guidance the lecturer gave to aid in answering this question correctly:
- Mention and note that the 2 lines are similar in shape but are using different doses, why do different doses produce different effects?
- The first line (analgesic one) is a lower dose and used for pain relief, the second line (depressive one) is a higher dose and can have a depressive effect on the nervous system, describe what the 2 curves mean
- What is a margin of safety? (it is the distance between the desired effect and the toxic effect, please elaborate on this)
- Why is a bigger margin of safety better than a small one?
- Explain why each of the lines flatline at the top and why the second line also flatlines to begin with.

There are faxes for this order.

Essay Instructions: The biography of O’Neill will provide you with an excellent background of the American playwright who was the first to acquire international respect. Many scholars argue that with O’Neill America finally had a playwright who had the courage, insight, and skill to reflect the human condition in a very real well. His was a rocky life. His father was a matinee idol who largely ignored him and his mother became addicted to morphine. He was the first American playwright to receive a Nobel Prize for Literature.

The video will give you background information as to what theatre was like before his time (It even includes a clip from a production of the melodrama Uncle Tom’s Cabin) and the steps he had to take to acquire the respect he so badly wanted.

His was not a happy life, and he was largely a cruel father to his children.


1. What are your personal feelings about the man, Eugene O’Neill? Were there any specific themes contained within his body of work as described in the video that you find interesting and that might compel you to read or see more of his work? (Approximately 250 words)

2. Regarding Desire Under the Elms, argue for or against the following: Eugene O’Neill, in an interview, maintained that the play is life affirmative, that regardless of the horrible crime Abby and Eben commit, Eben’s character especially experiences genuine change, that by play’s end he has found the meaning of real love and is ready to sacrifice himself for Abby. (Approximately 250 words)

Essay Instructions: GRADING CRITERIA and Points Possible
Relevant ethical principles are discussed in relation to the case
20
Ethical decision-making framework presented in text is followed
The nurse must be the primary decision maker
20
Relevant legal issues are identified and discussed
Identified and discussed a distributive justice theory
20
Identify and discuss an ethical theory that supports your resolution to the dilemma
20
General Paper Format: Reflects Baccalaureate level writing
Current APA format
Typing: Margins, headings, page numbers, spacing, quotes, citations, etc.
5
Style:
Grammar: subject/verb agreement, complete sentences, no run-on sentences, etc
Mechanics: spelling, punctuation, capitalization, abbreviations, etc
5
Minimum of 4 nursing journal references
8
Paper length 6-7 pages text, not including cover page and reference page
1
Grading criteria attached 1
TOTAL
100
ETHICAL ISSUE PAPER
1.The purpose of the Ethical Issue Assignment is to provide the student with the opportunity to explore,discuss and debate an ethical dilemma

2.The student will synthesize additional readings with knowledge gained from the text, journal resources, and lecture outlines to respond and support a stance taken related to the discussion topic.

3.Follow criteria carefully and completely. The nurse must be the primary decision maker in the situation.

4.Credible WEB sites may be used as a reference but may not be substituted for the required nursing journals.

5.The APA 5th Edition Manual must be used to format the paper, citations, and references. Headings must be used to clearly identify each criteria element and/or phase or step of the decision-making framework.

6.References must be current (within the last 5 years)

7.Strongly recommend having the paper reviewed by the writing center prior to submission.

8.Avoid the use of personal pronouns, excessive quoting; use paraphrasing.

ETHICS SCENARIO (Do not include this in the paper):
A 56 year old male is admitted with a diagnosis of acute myocardial infarction (MI) and cardiogenic shock. He has severe coronary artery disease and has had several MI's in the past 3 years. There is an advanced directive and a do-not-resuscitate order on the chart. On assessment the patient is short of breath and sweating profusely, B/P is 69/36 and heart rate of 162. Respirations are labored and 42/min. He is mentally alert and states he is having crushing mid-sternal chest pain radiating into his jaw and down his left arm. He is crying and requesting the nurse give him something for the pain. There is an order for IV morphine, 2-10 mg for pain every 1-2 hours as needed. The nurse on the off-going shift refused to give the IV morphine because of the patient's compromised status and fear of further depressing his respiratory and cardiac status. After receiving report from the evening nurse you enter the room and find his wife and son. They are very upset and demand that you administer the IV pain medication immediately.

PLEASE FOLLOW THE GRADING CRITERIA AS YOU WORK ON YOUR PAPER. THIS IS APPLICATION OF WHAT YOU ARE LEARNING TO THE SCENARIO.

Essay Instructions: Patients' Rights Case Study



Will Huckabee, 50, is dying of cancer. When he was first diagnosed with liver cancer it had already begun to metastasize to other organs, but Will was eager to fight off the disease and live with as high a quality of life as possible. Over time, however, his upbeat attitude changed. As he became weaker and endured more pain, Will lost his early hope of maintaining a satisfying quality of life. Instead, he became increasingly anxious that his condition would become unbearable.

At first, Will's pain was controlled by oral morphine. Within a period of months, however, he required stronger palliative care (pain relief); although he remained at home with his wife, his use of a self-administered morphine pump only postponed the looming crisis brought about by his increasing struggle to control his own pain. Moreover, because a heavy dose of morphine was required, it left Will weak and drug-dependent, but it did not completely relieve his pain.

Will's doctors explained that as his cancer spread and he became sicker, many of his organ functions would decline. Although aggressive surgical and medical treatments could support his organs and extend his life, Will decided to forego these procedures and explained that he no longer wished to undergo invasive procedures with difficult side effects.

Will also made a request that caused considerable turmoil among his physicians and members of his family. He asked that his morphine pump be programmed so that it could administer a lethal dose at the point when Will decided that living with his disease had become intolerable. As he discussed his request with his friends, family, and doctors, he continually stressed his intense wish to avoid the horrors endured by his mother, who had endured a slow death by breast cancer.

Will's family had mixed feelings about his request. Although his two children were largely supportive, his wife Gloria was more ambivalent: she explained to Will that she could not bear to watch him undergo a prolonged period of even greater suffering, but she also did not want to choose a path that would hasten his death. Gloria had become exhausted while caring for Will, and she found it extremely difficult and stressful to discuss this topic with him.
Before Gloria and Will could resolve their differences, Will faced another setback: a stroke, which left him unable to communicate clearly, either orally or in writing, and which probably caused some degree of cognitive impairment. In time, his doctors believed, intensive rehabilitative therapy could help Will to regain the power to communicate. Unfortunately, Will possessed neither the time nor energy to undergo that course of therapy. Although he could no longer actively make decisions about his own healthcare, Will's anguished cries of pain wrenched at the hearts of those around him.



At the start of his illness, Will had appointed Gloria to be his surrogate health care decision-maker in case he became unable to make decisions for himself, and he also executed a legally valid medical power of attorney affirming this decision. As Gloria is deciding what to do, she tries to understand whether it would have been ethical for his doctors to agree to his earlier request had Will not had the stroke. She also struggles to understand what difference his stroke makes, and whether suffering that indignity makes it right for her to substitute her own judgment for his expressed wishes.

Question's

1) What are the ethical issues surrounding whether Will's pain and suffering justify palliative care that may ultimately result in his death?
Is it ethically acceptable to provide aggressive palliative care that is likely or even certain to hasten a patient's death? What ethical ideas inform your perspective on this issue?
Under which conditions is it appropriate for a physician to deny a patient's desired palliative treatment? For example, is it ethically acceptable for a physician to deny a patient palliative care on the grounds that this care might hasten the patient's death or cause the patient to become addicted to the pain medication?
What is Hospice and what role do they play in palliative care? Might this be a viable option in Will's situation?

2)Is Will's request to reprogram the morphine machine justified by an ethical right to decide the course of his own death?
To arrive at this consensus you should explore the following questions:
Does the right to die exist? If so, does the right consist mainly of a right to refuse intrusive medical treatment, or does it involve a broader right to determine the manner and course of one's own death?