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Ethics and ethical decision making: Case studies and discussions.

Age gracefully and live longer.

The capacity to enjoy life well into your old age is sometimes denied by all kinds of degenerative diseases. Regrettably, the information you need to enable you to prevent the diseases is found in hundreds of scientific papers that are not easily accessible by the general public. The result is that most people suffer from the diseases and die prematurely while knowledge of how to prevent or cure their condition already exists. For the first time, the work of many world scientists concerned with the causes and preventions of degenerative diseases of ageing have been put together in a single book.

To the best of our knowledge, there is no recorded evidence of death from old age; majority of deaths are due to natural causes. The 2002 world report on Violence and Health published by the World Health Organization (WHO, Geneva) identified ischemic heart disease, cerebrovascular disease, lower respiratory infections, chronic obstructive pulmonary disease, cancer, atherosclerosis and diabetes as among the 10 major causes of death in all 38 of its member states in the mid-1990s. Dr. Clayton, an eminent British scholar posited: if you can cut your risk of dyeing from these degenerative diseases, you automatically give yourself the chance of not just a longer life but a longer quality of life. The information on how to cut the risks of dyeing from the degenerative diseases is contained in hundreds of medical discoveries and trials published in internationally recognised scientific journals on which the book, “Degenerative diseases of ageing: causes and prevention”, is based.

The book presents the findings of studies of present state of knowledge regarding the causes and preventions of degenerative diseases of ageing using systematic review of scientific literature. A systematic review as used in the book involves a formalised approach to identifying and synthesising the results of research studies, especially controlled trials, and dissemination of subsequent information for the benefit of the general public. By using this approach, it became possible to review most of the world’s best-known scientific research on methods of preventing the ravages of degenerative diseases of ageing and extension of maximum life span. The outcome of the systematic review is presented in the five chapters of the book.

Reviews and endorsements:

“Recommended book for anyone, professional or lay person who ever wondered what growing old means physically and what they can do about it. Dr. Icheku’ s book, Degenerative diseases of ageing: Causes and Preventions provides an evidence based account of how to combat disease of ageing and improve overall quality of life as you are growing old.” By Dr. Nike Arowobusoye, M.B.B.S., MSc, (A member of the Faculty of Public Health, UK)

 “The chapter on stem cell research gives a clear outline of why this work is of interest in the field of regenerative medicine and many of the obstacles, both scientific and ethical that must be overcome for this work to realise its potential in the clinic.” By Dr. S.H. Cedar, Bsc.,Ph.D., Senior Lecturer in Biomedical Sciences, Faculty of Health and Social Care, London South Bank University.

“Keeping physically active and good nutrition is the key to good health and long life span. In this book, Dr Vincent Icheku provides us with yet more compelling evidence in a well-researched piece of work. The book, “Degenerative diseases of ageing: Causes and Preventions” is a must read for anyone interested in remaining healthy and increasing his/her life span.” By Karen Thorne, Senior Lecturer, Exercise and Health, Faculty of Health and Social Care, London South Bank University.

“This is a much needed book in response to the present day quest for longevity. Dr. Icheku has responded brilliantly to this by providing a much-needed wealth of scientific evidence in support of the suggestions and advice he clearly and logically presented in this book. This is very much in contrast to the anecdotal perspectives frequently seen in magazines. Although some part of the book is a culmination of the scientific findings, but the whole book makes compelling reading about causes, consequences and preventive measures of degenerative diseases of ageing. There is something in this book for everyone.” By Chioma A Onyedinma-Ndubueze, Clinical Nurse Specialist (Haemoglobinopathies) and Senior Lecturer, Adult Nursing, London South Bank University.”

Book content:

Acknowledgement, VI; Preface, VIII; About the book, X; Health experts’ reviews and comments, XVII; Chapter 1; INTRODUCTION, 1; 1) Danger signs of ageing and remedies, 3; Chapter 2; CAUSES AND PREVENTIONS OF DEGENERATIVE DISEASES OF AGEING, 40; 2) Free radical and ageing, 42; 3) Preventing free radicals induced ageing, 51; 4) Glycation and ageing, 63; 5) Preventing glycation induced ageing, 65; 6) Mitochondrial decay and ageing, 68; 7) Preventing ageing induced mitochondria decay, 73; 8) Inflammation and Ageing, 82; 9) Preventing inflammatory conditions of ageing, 86; 10) Immune system deficiency and ageing, 94; 11) Preventing immune system deficiency, 96; 12) Dietary restriction and ageing, 101; 13) Dietary restriction plans, 105; 14) Starch Neutraliser, 121; 15) Stress and ageing, 125; 16) Managing your stress, 129; 17) Mobile phone radiation and prevention, 133. Chapters; ANTI-AGEING THERAPIES AND TREATMENTS, 139; 18) Hormonal Anti-ageing treatment, 140; 19) Criticisms of hormonal treatment, 147; 20) Gerovital G3 anti-ageing treatment, 150; 21) DHEA anti-ageing treatment, 155; 22) Melatonin anti-ageing treatment, 159; Chapter 4; FUTURE OF ANTI AGEING TREATMENT, 167; 23) Therapeutic cloning technology, 167; 24) Therapeutic stem cells’ technology, 173; 25) Ethical issues in cloning and stem cells technologies, 178; Chapters; MAINTAINING GOOD HEALTH, 184; 26) Minerals and your health, 185; 27) Vitamins and your health, 191; 28) Water and your health, 201; 29) Salt and your health, 205; 30) Physical exercises and your health, 211; Conclusion, 221; Bibliography, 225; Useful addresses, 243.

This is a synopsis of the book: “Degenerative diseases of ageing: causes and preventions”. Click on the following links to get your copy:

E-book: http://tinyurl.com/crbxng2

Paperback: http://www.sgwilliamspublishing.co.uk/Health-and-Social-Care.html

The book is mainly written for nursing and social work students but is firmly grounded in practice examples. The intention is to prepare the students to deal with ethical problems in practice placement. Thus, it discusses, among other things, the ethical theories and principles, and uses case study discussions to demonstrate application of the ethical theories, principles, and models to practice problems.

Peers Review and Endorsements

“The book drew from the work of many scholars and designed a simple model to help students gain the knowledge of ethical analysis and decision making”. Vidal Johnson, Senior Lecturer in Law and Ethics, London South Bank University

 “I was impressed by the way this author consistently addressed both social work and nursing ethical issues, highlighting the importance of ethics and application in nursing and social work practice”. Michelle Evans, Senior lecturer in Learning Disability/Mental Health and Social Work, London South Bank University.

“Most other published books on nursing and social work ethics are often laden with theories and principles. This book offers an excellent contribution to the understanding of the relationship between learning ethical theories and principles and their practice applications”. Jude C. Ibe, Principal lecturer in Dept. of Family Care and Mental Health; University of Greenwich, London

Organisation of the book

Through carefully constructed chapters, the book provides details on the essential aspects of ethical knowledge that students need to work through ethical problems and make sound decisions:

We begin in Chapter 1 by examining several relevant and important themes in contemporary nursing and social work practice. These themes are ethics and branches of ethics, morals, and values. This is to help readers learn or reinforce existing knowledge of the themes.

Chapter 2 explores the main reasons given for ethics in nursing and social work education. The themes discussed include the need to meet requirements of the law, develop knowledge required for dealing with ethical dilemmas, gain knowledge of how to handle conflict that may arise in relationship with other professionals, and deal with cultural diversity of patient and client groups. The chapter argues for ethical education, which is crucial in terms of  achieving the goals.

The focus of Chapter 3 is firmly on consideration of nursing and social work as moral practice and duties to act ethically. The themes covered include duty to protect vulnerable people, duty to act as patient’s or client’s advocate, duty to assess potential risks and empower those in care, the need to work within ethical standards and laws, and the duty to maintain confidentiality of information within professional boundaries.

Chapter 4 explores values of the three ethical theories that prescribe morally right actions. The chapter also examines some of the major criticisms of the individual theories and discusses how they differ from each other.

Chapter 5 explores the four ethical principles and how they inform nursing and social work practice. As conflicting principles often give rise to ethical dilemma, the chapter discusses model for screening ethical principles and use case studies and discussions to illustrate how ethical dilemma could be resolved by identifying and applying the principle or legal obligation that take precedence over the others.

Chapter 6 examines the common ethical issues and dilemmas nursing and social work professionals usually face in practice. The issues discussed include conflicting moral imperative, informed consent, best interest, and giving information and equitable distribution of services and resources.

Chapter 7 clearly defines moral reasoning and discusses ethical principles, values, and legal-based approaches as basis for resolving ethical dilemmas and making decisions. The chapter also uses case study discussions to illustrate values of the approaches.

Chapter 8 discusses the values of models in ethical decision-making and proposes a simple model to aid analysis of ethical dilemmas and decision making. The chapter drew from the work of many scholars who had written on ethical decision-making models in order to develop a supportive approach that guide ethical decisions in nursing and social work practice. In addition, uses case studies and discussions to illustrate use of the model in ethical decision-making process.

A chapter summary is provided at the end of each of the eight chapters. The book concludes with a brief summary of how the aim of the book was met and areas requiring future research and publications.

About the Author

Dr. Vincent Icheku is a senior lecturer in ethics and law, London South Bank University where he has been leading the ethics and law unit. His teaching and research interest are: ethical issues in end of life care, evidence base practice, ethical decision making and framework for ethical analysis and decision making. He successfully developed the SIAC model for ethical analysis and decision making. He holds degrees in social sciences, and health studies respectively; and also doctorate degree in sociology and post-graduate diploma in legal studies. He has taught for eleven years on the subject of ethics, to both nursing and social work students in Further and Higher Education.

This is a synopsis of the book: “Understanding Ethics and Ethical Decision making”. Click on the following links to get your copy:  E-book: http://tinyurl.com/cprezp2 Paperback: http://www.sgwilliamspublishing.co.uk/Ethics-and-Values.html

Alex, Ethics is considered in my recent book for nursing and social work students as both singular and plural noun depending on the context in which it is used. As a singular noun, ethics was defined as a branch of moral philosophy that determines what is right (ethical) and wrong (unethical). This is in line with Thompsons (2003) view, ‘ethics is the study of how people behave, what they do, whether it is right or wrong, the reasons they give for their actions, and the rationale behind their decisions’. Similarly, Hawley (2007) defined ethics as the study of people’s moral behaviours. She further explains that moral behaviours could be regarded as right or wrong. As plural noun, ethics is the quality of moral behaviour or behaviour in response to the requirement of ethical code. It establishes professional code of behaviour, which underpins what the professionals do in practice. The problem with ethical codes is that there is no objective, universal standard of moral value applicable to professional bodies that establish them as each organisation or discipline takes upon itself the duty of shaping its own ethical code. Ethical codes are also subject to change according to the biases, whims, and caprices of the professional organisation that subscribes to them, as long as the change is effected within the law.  Ethics could be defined under this view, as moral values or/and standards adopted by organisations in an attempt to assist their respective members to gain knowledge of  what is ethical and unethical and to apply such knowledge whenever they are making ethical decisions (see Understanding ethics and ethical decision making: case studies and discussions; http://www.sgwilliamspublishing.co.uk/Ethics-and-Values.html)

Many people from my home town, Ibusa in Delta State of Nigeria decried the manner at which people were being kidnapped by unknown men. We are demanding answers to some pertinent questions that spurred on this article: WHO IS NEXT? WHAT MEASURES ARE WE TAKING TO SECURE IBUSA AND IT’S ENVIRONMENT AGAINST THE SPATE OF KIDNAPPING?  There cannot be a better time to seek answers to these questions than now. Kidnapping is pervasive and becoming a global phenomenon. It allows perpetrators to put individuals or the entire community at an alarm mode by real or imagined fear of abduction using violent or terrorizing means. Kidnapping infringes upon our cultural values and impacts negatively on the genial nature of being our brother’s keeper. The rampancy of it is already having telling effect on trust and social life of Ibusa people. We are now suspicious of one another in view of allegation that most of the kidnappings are carried by non-Ibusa indigenes with active collaboration of victims’ neighbours and relatives. It takes away the sense of peace, security and feeling at home that we all enjoy when visiting home for burial of love ones or to celebrate festive seasons, such as Christmas, New Year, Easter, New yam and many other festivals.

It is not difficult to envision the feeling of despair and sense of hopelessness the menace of kidnapping has visited upon Ibusa people both at home and in diaspora. The situation therefore demands urgent action as it continues to garner many converts by the day and could be anybody next. The situation has obvious implications for future investments, Ibusa’s development trajectory and even peaceful co-existence of indigenes and non-indigenes if not arrested. Without sounding too pessimistic or cynical, solution to the menace of kidnapping would be difficult to find given the current climate of impunity in Nigeria. Thus, this article would explore some suggestions made as preventive measures to minimise your vulnerability to kidnapping in Ibusa or elsewhere.

 In a rejoinder to a Newspaper editorial on kidnapping menace, Ausaf Husain, a retired Squadron Leader and security expert based in Karachi proposed some preventive measures against kidnapping. He argued that following his suggestions will complicate kidnappers’ planning to such an extent that they would most likely look elsewhere for their victim. Perhaps, it will be a good idea to first consider some measures taken by our governments to curb the menacing situation before sharing his suggestions with you.

Many States in Nigeria such as Abia, Akwa-Ibom, Anambra, Ebonyi, Enugu and Imo have enacted new Laws to deal with kidnapping. In Ebonyi State, for instance, there is the Internal Security and Related Matters Law 2009; Imo State Prohibition of Hostage Taking and Other Related Offences Law No. 4 of 2009; and Zamfara State sections 229 – 233 of the Shari’ah Penal Code Law 2000. Many of these states have made kidnapping a capital offence and many more are in the process of enacting similar laws that will introduce capital punishment for kidnapping in their respective States. One traditional ruler even took a more desperate step to curb the menace of kidnapping in his kingdom. It was reported recently that the Oba of Benin directed his chiefs and traditional worshippers to invoke curses on the perpetrators of kidnapping and other crimes in Edo State. Unfortunately these measures have not succeeded in arresting the situation. Capital punishment in particular has been notably ineffective in curbing crime. In 1970s, for instance, Federal Government of Nigeria introduced death penalty for the offence of armed robbery. It is on record that the capital punishment did not stop the spate of armed robbery. It is also on record that armed robbery became more pervasive and armed robbers became better organised with more sophisticated weapons, more determined and vicious.

On international level, kidnapping is pervasive especially in some countries in Africa, South America, Eastern Europe and Asia. One thing is common in these countries where death penalty was introduced as punishment for kidnapping; such measure has proved unsuccessful. For example, Priyanka Bhardwaj writing in Siliconeer, a Monthly Magazine in West Coast U.S.A. for South Asians posited that since 1992, over 2,200 abduction cases have been registered in the Indian capital, Delhi. Despite kidnappers facing death penalty, nearly 5,000 kidnapping incidents happen every year in the whole of India. Kidnapping for ransom is a social menace and effective solution can only evolve from addressing the root causes of the problem. No matter the harshness of the retribution for the offence, if the underpining causes are not eradicated, kidnapping and indeed most crimes would persevere. So, what are the main root causes?

The menace of kidnapping in Ibusa and other places where it is pervasive is occasioned mainly by political and socio-economic factors. Political factors relate directly to the breaking down of law and order and the failed policies of Nigerian governments at all levels (local, state and federal). The factors also relate to deep rooted culture of impunity which is one of the major symptoms of failed or failing states. Similar political factors could be found in failed states such as Afghanistan and Iraq after the invasion of 2001 and 2003 respectively; or failing states such as Columbia from the 1970s until about 2002 and Mexico between 2002 and 2007. However, there is exception to this view. For example, kidnapping for ransom in countries such as India and Brazil is mainly the result of socio-economic factors. These are emerging economic giants with mix of acute social and economic disparities between the very poor and the very rich. One of the negative consequences of the widening gap between mostly young successful entrepreneurs flaunting their wealth and the jobless youths and the downtrodden is kidnapping for ransom. However, one common socio-economic factor in countries where kidnapping is pervasive relates to lack of employment opportunities. Ibusa for instance, even as part of the State’s capital territory, cannot vaunt for any major employer both in private and public sector. Empirical studies have shown that high youth unemployment exacerbates crime. In other words, creation of employment opportunities would decrease the incidence of kidnapping as those who are engaged in it would become gainfully employed. It is most likely that youth joblessness is directly related to the general increase in criminality in Ibusa. The introductions of unemployment’s benefits have also been known to reduce crime as evident in the recent amnesty programme introduced by Federal government for the Niger-Delta militants. Other socio-economic factors include limited educational opportunities, the lack of the enabling environment and weak infrastructures. To date, Ibusa lacks basic infrastructure such as good roads, electricity and water supply. There is very limited secondary schools and no single tertiary institution in the town. The gap between few rich politicians and bureaucrats and ordinary citizens is widening in an atmosphere of youth uncertainty and hopelessness about the future.

It seems like a hopeless situation since it is the responsibility of the Government to provide security, eradicate deplorable conditions of poverty, diseases, unemployment, and deal with lack of the enabling environment and weak infrastructures that encourage kidnapping and other crimes that pose a threat to peace and development in the town. Governments of all levels have let Ibusa people down in view of their inability to create employment opportunities, welfare and social amenities for the benefit of our deserving youths. The State and the Local Governments have failed to have a clear strategy on crime prevention in the town. However, any successful crime prevention strategy will depend on the prospect of offenders being caught, detained, promptly prosecuted, convicted and sentenced. Successful prosecution on the other hand would depend on investment in local police intelligence gathering and arresting offenders; investigating offences committed and prosecuting offenders while respecting their fundamental human rights. The courts should have the freedom to guarantee fair and speedy trail of cases and ensure that punishments truly reflect the crime. Experts believe that any compromise in any part of this chain would impede any attempt at preventing crime. The chain is in no doubt compromised in many parts, if not all, by the culture of impunity in all spheres of Nigerian political life. The provision of security is a primary purpose of governments at all levels. Thus, the failure to stop the scourge of kidnapping which started in 2006 by Niger Delta Militants is certainly a manifestation of a failing government at all levels. The question, therefore, is what can we do as individuals to forestall the bane and nightmare of kidnapping in Ibusa?

In Ausaf’s view, kidnappers and other criminals, while targeting their potential victim, have been known to evaluate their chances of success based on the following vulnerabilities:

Media value: prominent individual in the community or corporate name recognition, product or service identification and ones standing in business, government, the entertainment industry or social circles; all add up to ones value as a potential target for kidnapping.

Apparent wealth of their potential victim: This evaluation is particular important to the kidnappers. This is because the gain for kidnapping depends on apparent ability of the potential victim or his family to pay ransom. This probably explains why spouses, parents and children of wealthy individuals are often the targeted victims of kidnapping. In other words, it is your perceived wealth that makes you vulnerable and a prime target for kidnappers. Ausaf’s suggestion is that you and your family should keep a low profile.

Accessibility to potential victim: the paradigm of the path of least resistance applies. A ‘hard’ or protected target is less likely to be a victim than a ‘soft’ or vulnerable target. In addition, professional kidnappers apply the principle of risk reduction in the selection of target. Their objective according to Ausaf is to reduce the risk of failure. Given a chance, they will focus their efforts on a target that offers the best chance of success. These are mainly potential victims whose personal security habits are lax and whose patterns of activities are predictable. He suggested that you should avoid potentially dangerous situations. He added that recognising a potentially dangerous situation without taking steps to avoid involvement is foolhardy.

Ausaf included security advice for those of you travelling home this festive session.

i.        You should make a detailed vulnerability assessment and familiarise your family members with the assessment made if they are travelling with you.

ii.        You should talk candidly about safety concerns with your family, especially as spouses and children besides being targeted could carelessly disclose information regarding your activities, which could make you or any of them prime target for kidnappers.

Ausaf also advised on what to do when you fell victim of kidnapping. He suggested that

i.        you must respond properly if confronted by kidnappers. He contended that appropriate response to a threat of kidnapping covers a broad spectrum from passive compliance to disabling the kidnapers and escaping.

Finally, adopt and follow all principles of good security.

ii.        Use common sense;

iii.        keep yourself well-informed about the day-to-day criminal activities in the area you live or are visiting.

iv.        exercise prudent judgment; and conduct your personal vulnerability assessment when necessary.

v.        Increase your awareness by learning more about the nature and scope of the threats that exist in the area you live and learn from the experience of others.

vi.        Read the accounts of kidnapping and other criminal activities in the area you are visiting in newspapers or relevant media and take necessary precautions to remain safe.

Ronke, answers to your questions would depend on whether the story of Adam and Eve is taken literally or as a metaphor. Let us explore the story as a metaphor.

In the book of Genesis Chapter 2:17, God said to Adam, “but you must not eat from the tree of the knowledge of good and evil, for when you eat from it you will certainly die.” We know that Adam and Eve ate from the tree and did not die. Adam in fact lived up to 900 years.

We also read in the story that Cain left his parents after killing his brother Abel to the Land of Nods (the land of Nods must have been populated by other humans). In the land of the Nods he slept with his wife who gave birth to a son (who was Cain’s wife? possibly from the land of Nods).

The bible (Genesis 4:17-24) says, Cain made love to his wife, and she became pregnant and gave birth to Enoch. Cain was then building a city, and he named it after his son Enoch (“then building a city”, for whom? He couldn’t have built the city for himself, his wife and Enoch his son).

Furthermore, to Enoch was born Irad, and Irad was the father of Mehujael, and Mehujael was the father of Methushael, and Methushael was the father of Lamech.   Lamech married two women, one named Adah and the other Zillah. Adah gave birth to Jabal; he was the father of those who live in tents and raise livestock.  His brother’s name was Jubal; he was the father of all who play stringed instruments and pipes. Zillah also had a son, Tubal-Cain, who forged all kinds of tools out of bronze and iron. Tubal-Cain’s sister was Naamah.

One day Lamech said to his wives, “Adah and Zillah, listen to me; wives of Lamech, hear my words. I have killed a man for wounding me, a young man for injuring me.  If Cain is avenged seven times, then Lamech seventy-seven times.” (who was this man killed by Lamech and unknown to his family? was he from another tribe?)

It would be interesting to know where Lamech’s wives and other wives mentioned in this bible chapter came from (possibly from the land of Nods or elsewhere on earth). It is very unlikely that all the above women (wives) were daughters of Adam and Eve because we know from the bible account that they did not have any other child before and between Cain and Abel.

The bible tells us that Adam had Seth, the third son when he was 100 years old. “Adam made love to his wife again, and she gave birth to a son and named him Seth,saying, “God has granted me another child in place of Abel, since Cain killed him (Genesis 4:25).” After Seth was born, Adam lived 800 years and had other sons and daughters (Genesis 5:4).

Further evidence from the bible to substantiate the view that Adam and Eve were not the first humans on earth includes: “God created mankind in his own image, in the image of God he created them; male and female he created them. God blessed them and said to them, “Be fruitful and increase in number; fill the earth and subdue it. Rule over the fish in the sea and the birds in the sky and over every living creature that moves on the ground” (Genesis 1:27-28). The same bible tells us that Adam (male) was created first and was lonesome in the Garden of Eden. God later created Eve as a companion; after everything else was created.

It is plausible to argue that there were men and women who lived on earth other than the Garden of Eden. Cain himself knew of existence of other humans when he said to God, “Today you are driving me from the land, and I will be hidden from your presence; I will be a restless wanderer on the earth, and whoever finds me will kill me” (Genesis 14:14). In response, God said, “Not so; anyone who kills Cain will suffer vengeance seven times over.” Then the Lord put a mark on Cain so that no one who found him would kill him.  (Genesis 14:15).

Finally, if Adam was not the first human on earth, then the story is a metaphor. In that case, the forbidden fruit and God’s curse on Adam and Eve will be considered metaphors which must not be taken literally. You may recall that God said that if they eat the forbidden fruit they must die. They ate the fruit and did not die. It is not surprising why many advance spiritualists put forward the view that the fruit represents a change in human mind culminating in development of the knowledge of “good and evil” and choices man had to make between them.

References:

New International Version of the Bible: http://www.biblegateway.com/passage/?search=Genesis%202:21&version=NIV

The Mystic Christ by Ethan Walker (2003), Devi Press, P. O. Box 5081, Norman, OK 73070

Quote by Vince Chase from my Facebook article on power of knowledge.