Tuesday, August 25, 2020

buy custom Social Responsibility and Ethics in Marketing essay

purchase custom Social Responsibility and Ethics in Marketing article Presentation Morals signifies human convictions about the good and bad. These convictions change starting with one organization then onto the next or starting with one individual then onto the next (Balachandran Chandrasekaran, n.d.). Be that as it may, social duty and morals are a basic piece of a showcasing technique of any organization or business. The point of advertising is to target, claim and get a specific crowd to buy a specific item or administration. While attempting to accomplish this, organizations ought to guarantee that they submit to the principles and guidelines set in the field where they work, and above all endeavor to control that their activities are moral and genuine. An organization is supposed to rehearse social duty when it is worried about the earth, society, and individuals where and with whom it works together. Social duty in advertising is taking good activities that positively affect the partners of an organization, including workers, customers, network and investors (Labbai, 2007). Now, the essential objective of the advertiser is to define and convey choices of a firm that will affect its partners. There is a rising pattern among advertisers over the globe to perceive corporate social obligation and morals in leading business that deal with interests of society while simultaneously boosting the benefit of their organizations (Balachandran Chandrasekaran, n.d.). This paper breaks down social obligation and morals in showcasing and presents models that rebuild current advertising while simultaneously proposing proper proposals. Corporate Social Responsibility (CSR) CSR is a finished arrangement of practices, approaches and projects that are fused in business tasks, dynamic procedure and flexibly chains all through the organization, and it incorporates duty regarding the past and current activities, just as the future outcomes of business action (Labbai, 2007). Viewpoints that speak to the focal point of CSR in organizations differ in the sort of business, size, sctor and geographic district. From a wide perspective, CSR incorporates issues identified with network ventures, business morals, administration, condition, human rights, work environment and a commercial center (Balachandran Chandrasekaran, n.d.). Significantly, social duty goes past charitable activities. It expects organizations to consider an effect on partners and condition while deciding. Novel corporate pioneers are planned for amplifying benefits as opposed to advancing the last mentioned (Ferrell Hartline, 2012). It means that there is a swing from responsibility to investors t owards social duty to shoppers. Advantages of being socially capable are an improved organization and brand picture, expanded piece of the pie, capacity to draw in and hold workers, capacity to pull in financial specialists and diminished working expenses. Today, the way to deal with CSR in present day business depends on the standards of good corporate administration and reasonable turn of events. Supportability proposes that organizations that are socially capable beat less socially mindful organizations over the long haul. Promoting chiefs from various firms see the importance of social issues in an unexpected way. As per Labbai (2007), the essentialness of a social issue is controlled side-effects, evaluating, limited time endeavors, dispersion strategies, and the way of thinking of conceding duty by an organization. Purchasers choose what firm is fruitful or has bombed in its CSR. All things considered, advertisers ought to guarantee their practices seem humanitarian to society. Morals Morals is characterized as an investigation of good rules that manage the manner by which organizations are directed. In present serious worldwide advertising, morals is significant since organizations manage human qualities and convictions. Obviously, business spreads over the globe. In this manner, a companys advertising division needs to manage crosscountry societies. Global enterprises (MCs, for example, Nestle have confronted various issues on account of overlookingg moral issues in their promoting rehearses. As per Ferrell and Hartline (2012), most MCs have caused billions of misfortunes as far as money related worth and lost a huge number of significant clients in view of embracing deceptive publicizing and limited time methodologies. Experts report that promoting is the human direct that is dependent upon scholarly assessment and open examination. Researchers uncover that advertisers must perceive moral principles appropriate to the organization, society and industry (Ferrell Hartline, 2012). These three gatherings have differing wants and needs; henceforth, a moral clash may happen. Advertising moral measures control organizations to make the right decision. They help to cultivate interior control, recognize adequate practices, encourage conversation and evade disarray in showcasing (Ferrell Hartline, 2012). Suggestions From the conversation above, it is clear that numerous powers have made organizations practice an elevated level of morals and social duty in showcasing (Ferrell Hartline, 2012). They go from changing representative desires, rising client desires, government enactments, new obtainment practices and financial specialists consideration of the social standard. Organizations need to assess whether their movement is socially capable and guarantee that they practice moral showcasing (Ferrell Hartline, 2012). The achievement of a business and the proceeded with fulfillment of clients and partners are connected to adjusting and actualizing high business principles and advertising conduct. The most appreciated organizations on the planet are those that submit to the code of serving the interests of others other than their own ones. Organizations must utilize the law to characterize unlawful, hostile to social and against serious practices. Moreover, they should manufacture a convention of moral conduct in the entirety of their practices and consider workers answerable for following the legitimate and moral rules. Singular advertisers should rehearse social inner voice in their dealings with partners. Purchase custom Social Responsibility and Ethics in Marketing paper

Saturday, August 22, 2020

How to spell in lieu of

The most effective method to spell in lieu of The most effective method to spell in lieu of The most effective method to spell in lieu of By Maeve Maddox At whatever point I run over a bizarre incorrect spelling, I do a pursuit to perceive how normal it is. This incorrect spelling of in lieu of grabbed my eye: †¦so I can run keynote in leu of utilizing powerpoint. A Google look for in leu of raised around 23,600,000 hits. The bank is inquiring as to whether we might want to carry out a thing in leu of abandonment. I was told I could take prison time in leu of the fine. Hair bloom in leu of a cover Anybody ever use pipe tape in leu of edge tape? To what extent would i be able to leave potatoes in the ground? (in leu of capacity) To be reasonable, the vast majority of these models are from gatherings and remarks. Google does solicit Did you mean in lieu from? The articulation came into English from French en lieu de, instead of, from the Latin expression in loco, instead of. Our English word rather is a calque of these outside articulations. It was composed as two words, in stead, until the seventeenth century. Stead implies place, as in property. Main concern: If youre not certain how to spell in lieu of, you can use rather than. Need to improve your English shortly a day? Get a membership and begin accepting our composing tips and activities every day! Continue learning! Peruse the Spelling class, check our famous posts, or pick a related post below:15 Terms for Those Who Tell the FutureThe Parts of a Word20 Movies Based on Shakespeare Plays

Sunday, August 9, 2020


Dearborn Dearborn, city (1990 pop. 89,286), Wayne co., SE Mich., on the River Rouge, adjoining Detroit; settled 1795, consolidated with the city of Fordson in 1928, inc. as a city 1929. Dearborn is the headquarters of the Ford Motor Company, and the city's economy is dominated by the automobile industry; manufacturing as well as research and development are important. Also residential, Dearborn now has a sizable Arab American population. Fairlane Town Center, one of the nation's largest shopping centers, is there. The city is home to the Henry Ford, which includes the Henry Ford Museum, Greenfield Village (a noted museum of American history and architecture, with the birthplace of Henry Ford ), and a business and history research center; and to the Arab American National Museum. Ford's estate, Fair Lane, is a national historic landmark and part of the Univ. of Michigan's Dearborn campus. The Columbia Electronic Encyclopedia, 6th ed. Copyright © 2012, Columbia University Press. All rights reserved. See more Encyclopedia articles on: U.S. Political Geography

Saturday, May 23, 2020

Analysis of Mountain Sound in the Context of Journeys

Journey Portfolio Mountain Sound Of Monsters and Men Song September 2nd, 2012 â€Å"Mountain Sound† is a song performed by Icelandic indie pop band Of Monsters and Men which was released as a second single from their debut studio album â€Å"My Head is An Animal.† Written by Arnar Rà ³senkranz, Nanna Bryndà ­s Hilmarsdà ³ttir and Ragnar Þà ³rhallsson, it tells the story of a character who commits a crime or action that opposes the values and cultural norm of his society. He then flees from the area to escape capture by the authorities and take refuge in the forest and mountain sound. Along the way, the character also runs into creatures that threaten his existence and therefore is forced to travel only at night to avoid visibility from any†¦show more content†¦This description is enforced in the form of an advice from a more superior being which in this case appears to an angel or deity, hinted by the changeover to a woman’s voice, which is stereotypically accepted as compassionate as well as the use of language which is ph rased in the form of an admonishment: â€Å"hold your horses now, sleep until the sun goes down.† This chorus supports the statement that â€Å"in a bid to escape, one journeys to a refuge that provides security and peace of mind.† In general, the essence of the song is further amplified with specific musical techniques, first of which is the echo effect created by the digital delays in the electric guitars. This effect creates a suspenseful and dramatic scene about to unfold, in reference to the second stanza where the traveller suddenly realises his vulnerability to the strangers as they surround him. Besides that, the choral section that sings the lines â€Å"sleep until the sun goes down† and â€Å"deep into the mountain sound† adds spirit and energy to the song which relates to how physical journeys are always affiliated with movement and energy. It also appears as cheer of encouragement to motivate the traveller to continue his strive for his goal. Furthermore, the incorporation of a duple simple time signature and a drum routine of a â€Å"snare, bass, snare, bass,† shows the prolonging of physical journeys and the fastShow MoreRelatedThe Newest Powered Commercial By Coca Cola Co.1710 Words   |  7 Pages Every professional athlete has his own story which made him as we see him now. Some Journeys were more difficult than others. However, the common keywords between all of them are the hard work and determination. Coca-Cola Co.’s PowerAde started its campaign â€Å"Just a kid† in the beginning of last year. PowerAde has used inspirational stories of professional athlete, who used to have a very hard start and they made their path into fame and success, to deliver a message to everyone that no one has chosenRead MoreCelta Language Analysis Assignment1840 Words   |  8 PagesCELTA Language Analysis Written assignment 2 N.B. Please write legibly in black ink or type. Content carries the most weight, but you are also marked on clarity, accuracy (e.g. grammar, spelling, punctuation) and presentation (see CELTA criteria). Please read the shaded boxes to see the marking criteria. If your assignment does not meet the specified criteria, you will be asked to resubmit it. If the second submission is not satisfactory you will be awarded a fail grade. More than oneRead MoreMetaphors In The Works Of Laozi And Mencius1460 Words   |  6 Pagesorder to explain their points. Given their topical relation to water, plants, and other elements of the natural world, both of the philosophers’ texts seem at first glance to have clear points that are strengthened by these metaphors. Upon deeper analysis, though, it becomes clear that these nature metaphors are unable to translate effectively into comparisons with mankind. Specifically, these metaphors create inconsistencies in their arguments and cannot be applied directly as they are written. HoweverRead Mor eAnalysis Of George Orwell s The Road 3871 Words   |  16 Pagesimpression of being all-powerful and godlike. Suggested by it’s name â€Å"The Road†, adapts age old idea of a journey towards discovery, which began with the chronicles of Beowulf - but instead the journey adapted from the old chronicle, to instead be a journey through hell. Another key theme of â€Å"The Road† is McCarthy’s skill in using Anglo-Saxon nouns and language. So, in my essay, through the analysis of the language in specific depiction of settings, themes, ideas and the author’s voice, how the writerRead MoreEssay on Eco-Poetics Reading in The Wate Land by T.S. Eliot3164 Words   |  13 Pagespoetics is a literary theory which favours the rhizomatic over the arborescent approach to critical analysis. The characteristics of the rhizome will provide the overarching structure for this essay. Firstly rhizomes can map in any direction from any starting point. This will guid e the study of significant motifs in ‘The Waste Land.’ Secondly they grow and spread, via experimentation within a context. This will be reflected in the study of the voice and the language with which the poem opens. ThirdlyRead MoreForms of Tourism4598 Words   |  19 Pageslooking separately at effects whether they occur on their soil or within other economies. This issue is particularly relevant in the case of tourism which by nature supposes that individuals displace from one place to another. In order to make this analysis possible, it has been necessary to develop concepts which associate tourism and its activities with the residence of the individual taking the trip, that is, developing his/her tourism activities, and the place where these activities occur. It isRead MoreThe Waste Land by T. S. Eliot2649 Words   |  11 Pagesdeath by water† (Eliot 66). This is ironic because so far the terrain had been described as â€Å"stony rubbish† and â€Å"dry stone with no sound of water.† F.R Lewis proposes that this line could have duel meanings. He wonders if perhaps the death water would bring would not be drowning from an overflow of water, but perishing from a lack of water (Anderson 12) and in this context, the water they are referring to is spiritual faith. These images are followed by the second chapter, â€Å"A Game of Chess.† ThisRead MoreDriving Sales Through Shoppers’ Sense of Sound, Sight, Smell and Touch6345 Words   |  26 PagesThe current issue and full text archive of this journal is available at www.emeraldinsight.com/0959-0552.htm IJRDM 37,3 RETAIL INSIGHT 286 Driving sales through shoppers’ sense of sound, sight, smell and touch Brenda Soars Sound Environments, London, UK Abstract Purpose – The purpose of this paper is to explain how sensory stimuli can inï ¬â€šuence environments, improve the shopper experience and change the nature of behaviour in ways beyond our consciousness. Design/methodology/approachRead MoreA Linguistic Analysis of Obama’s Inaugural Address9492 Words   |  38 PagesRhythm and Rhetoric: A Linguistic Analysis of Obama’s Inaugural Address Liilia Batluk Supervisor: Stuart Foster School of Humanities Halmstad University Bachelor’s thesis in English Acknowledgment My appreciations to my supervisor Stuart Foster for very helpful advice during the research. Abstract In this essay I shall analyze Barack Obama’s Inaugural Address, January, 2009 from the perspective of various linguistic techniques. More specifically, I shall propose and focus on the idea that theRead MoreRobert Frost : A New England Poet3698 Words   |  15 Pagesread it. Instead he recited a poem which he knew by memory â€Å"The Gift Outright†. On January 29, 1963 Robert Frost died at the age of 88 from prostate surgery. He is buried at the Old Bennington Cemetery in Bennigton, Vermont (Sullivan). Historical Context and Implications Robert Frost is considered to be one of America’s finest poets. In Robert Frost’s poems we as the readers try understanding the situations that he was going through during writing his poetry. What he was going through can be a contribution

Tuesday, May 12, 2020

The Mind Is An Immaterial Soul Essay - 1139 Words

In this paper I will refute the view that the mind is an immaterial soul by highlighting how substance dualism lacks explanatory power. To successfully dismantle the contentions offered by substance dualism, I will present two arguments illustrating how ineffectual this theory is at explaining everyday phenomena. My intention in doing so is to stress how theories that lack explanatory power in comparison to other, more robust, theories can be generally regarded as weaker. Once my arguments have been presented, I will first describe how a substance-dualists might respond to my arguments, and then proceed to show why these responses are insufficient. In responding to these objections in particular, and to the case in general, I will maintain that the mind is not an immaterial soul. Before delving into the problems with substance dualism, it might befit us to first fully understand substance-dualism. Fundamentally, substance-dualism is couched in the notion that there exist two separate substances: physical substances and non-physical substances. On the one hand, physical substances comprise everything we might call material, such as cars, rocks, and computers. On the other hand, substance-dualists claim that there exist non-physical substances that operate behind the veil of immaterialism. The world, in other words, can be partitioned between those things regarded as tangibly physical, and those things regarded intangibly non-physica. Within this criterion forShow MoreRelated Personhood Essay example758 Words   |  4 Pages Personhood What is a person? That sounds like a harmless question, but the answer can get very complicated. Is a person just a lump of skin, muscles, bones, and other materials? Is a person something immaterial like a mind or a soul? Or is a person a combination of these two things? Really there is no right answer, and it all depends on the point of view that you hold. nbsp;nbsp;nbsp;nbsp;nbsp;First of all, what is a body? Some say that a body is, like I said before, a lump of skin, musclesRead MoreAnalysis Of Descartes s First Attempt 981 Words   |  4 Pageswe can apply weight in terms relating to the body and other times relating to the soul, and just as we have the innate notion that an immaterial force â€Å"pushes† weighted objects towards the earth, so too does the immaterial soul/mind act on the body . However, this explanation proves unsatisfactory both to the modern reader and to Elisabeth herself; as this analogy fails to bridge the gap as to how something immaterial can enter into a causal relationship with something that is distinctly material.Read MoreDualism And Belief That The Mind And Brain Essay1201 Words   |  5 Pagesstates that humans are composed of both an immaterial substance and a physical substance. Moreland notes that there are contrasting differences between the minds and the brains and that they are ultimate ly separate entities. By defending dualism, Moreland seeks to make nonbelievers believe in immaterial souls, while discrediting materialism. We can look at the arguments in which Moreland uses to support the argument of dualism and belief that the mind and brain are separate entities. Dualism isRead MoreObjections to Descartes’ Interactionism1431 Words   |  6 PagesPassions of the Soul, Part I and Correspondence with Princess Elisabeth, Concerning the Union of Mind and Body. I will start by describing the basic features of how Descartes’ notion of interactionism works. Namely, that the pineal gland is the â€Å"principle seat† of the mind because it is the only singular part of the brain. The pineal gland also has a range of movements, which correspond to the body and to the soul to the capacity that it can be ‘thrusted’ by either the soul or the animal spiritsRead MoreSummary Of The Night Three Days Before Her Death 1219 Words   |  5 Pagesafterlife and things of the like. I am going to argue that Weirob is right to claim that personal identity cannot consist in the sameness of an immaterial, unobservable soul. – 45 words Exposition: In this dialogue between Weirob and some friends, she argues that one’s personal identity can’t be solely related to one’s immaterial and unobservable soul. She doesn’t understand how it is possible for one to still live if when they die and are buried, their body rots away. She brings up the questionRead MoreCartesian Dualism And The Body Essay1009 Words   |  5 Pagesmany people have really thought about what the mind is? How is the mind connected to the body? Are they two separate things or are the body and the mind the same thing? There are different theories to answer these questions. A philosopher, Descarte, believes in Cartesian Dualism, which is that the mind and body both exist, but are two distinct things: physical stuff and mental stuff. The mind is not located in physical space and is an immaterial soul, whereas the body is a physical being and theseRead MoreAquinas: the Soul1260 Words   |  6 PagesThe soul has been a very controversial a nd intriguing subject for multiple generations of philosophers, countless theories have been thought up in an attempt to explain its intellectual operation. Thomas Aquinas, a medieval philosopher and theologian, tackles the topic of subsistence (i.e existence) of the human soul by looking into its power of cognition and scrutinizing its nature; more specifically, he studies the processes through which the soul can cognize the world that surrounds us and itselfRead MoreExistence After Physical Death Considered1180 Words   |  5 Pagesdefinition of human includes the characteristic of a unique soul or spirit associated with each physical human body and, 2) Miracles, events unexplained by men’s physical and natural laws, can occur and, 3) A substance dualist philosophy that the body including the brain is physical matter but the mind – containing our knowledge, memories, and thoughts – is not physical matter and unique to each individual. Thus it is possible that the soul/spirit, absent the physical matter of the body, could retainRead MoreWhy The Mind Body Problem1200 Words   |  5 PagesOut there, in our own world, there is a battle going on that most of us are completely unaware of, and it is all comes down to the mind-body problem. The mind-body problem is how the mind and the body interact with each other. The mind is the mental side of things; thoughts, imagination, and most importantly consciousness, whereas the body is the physical side; the make up of your brain neurons and your body. On one side of this argument we have the Materialists, and according to the Oxford DictionaryRead MoreThe Theory Of Personal Identity988 Words   |  4 Pagesidentify ourselves through our individual soul, thus supporting the same soul theory. By having the same soul, we are the same person. I will support this argument by giving a brief overview of all the theories of personal identity then stating the objection of the same soul theory using the same body and same mind theorist. Last but not least, I will then respond accordingly to the objection by stating the connection and unchanging qualities from the same soul theory. There are approximately four

Wednesday, May 6, 2020

Critical Study of the Aetiology and Pathogenesis of Infantile Glaucoma Free Essays

string(100) " they had noticed either epiphora or photophobia and only 32% said their infant had these symptoms\." Introduction The incidence of glaucoma in the young population is incomparable to the incidence in the adult population, as it is very rare in infants, nevertheless it can significantly affect a child’s life, as vision is vital for a young child. Signs and symptoms of infantile glaucoma can commonly be overlooked and this can cause a delay to the treatment process. The underlying causes of infantile glaucoma have been agreed upon by most authors, however the exact mechanism by which the structures in the young eye are affected are debatable. We will write a custom essay sample on Critical Study of the Aetiology and Pathogenesis of Infantile Glaucoma or any similar topic only for you Order Now As well as primary infantile glaucoma, young children can also be affected by secondary infantile glaucoma, which again can significantly impact a young child’s life. This paper looks at the classifications, epidemiology, signs, symptoms, aetiology and pathogenesis of primary infantile glaucoma, as well as touching upon the causes of secondary infantile glaucoma. ‘Glaucoma is an Optic neuropathy with characteristic appearances of the optic disc and specific pattern of visual field defects that is associated frequently but not variably with raised intra-ocular pressure (IOP)’ (Kanski, 2003). The ciliary processes of the eye produce aqueous humor; this is then drained by the trabecular meshwork; Figure 1. A balance of this production and drainage maintains a normal IOP. The aqueous humor produced flows into the posterior chamber, then through the pupil and into the anterior chamber. The trabecular meshwork drains the aqueous humor through Schlemm’s canal. Open angle glaucoma occurs when there is a decrease in the outflow of aqueous through the trabecular meshwork, and angle closure glaucoma occurs when the iris adheres to the lens leading to a build-up of aqueous humor in the posterior chamber (Kanski, 2003). In addition to open and closed angle glaucoma there are other types of glaucoma which are classified in Figure 2. There are several classifications of congenital and infantile glaucomas, the most accepted and simplified version is presented in figure 3. Primary infantile glaucoma is defined as ‘the result of isolated abnormal development of the anterior chamber angle structures’ (Myron Yanoff, 2009) Secondary infantile glaucomas are ‘associated with a variety of ocular and systemic syndromes and with surgical aphakia’ (Myron Yanoff, 2009). Primary congenital glaucoma is present at birth however it is not always recognised at this stage and sometimes it is diagnosed later during infancy or in early childhood. To minimise problematic visual development, recognition of primary congenital glaucoma must be as early as possible followed by respective treatment or therapy, allowing the child to lead a ‘normal’ life (A.Armstrong, 2008). Glaucoma in infants and young children is relatively rare and in some cases asymptomatic (Kanski, 2003). And so, if an increase in IOP is not detected at an early stage then there is a greater risk of blindness (Robert N. Shaffer, 1970). Some cases of glaucoma in infants are only recognised and diagnosed after several months or years at which stage sometimes significant glaucomatous damage has already occurred (Robert N. Shaffer, 1970). Most cases will present bilaterally nevertheless this does not rule out the fact that it can sometimes present unilaterally (Robert N. Shaffer, 1970). Epidemiology of Primary Infantile Glaucoma Primary infantile glaucoma is extremely rare and occurs in one out of 10,000 births (MillerSJ, 1966). It accounts for 0.01% to 0.04% of cases of total blindness (A.Armstrong, 2008) (Vincent P Deluise, 1983) In the Irish childhood population primary open angle glaucoma is the cause of blindness for 4% of the population. (Morin JD, 1974) The majority of cases in the US and Europe present with bilateral primary infantile glaucoma; 65%-80% (Moller, 1977). It is also well-known that it occurs greater in males compared to females with a ratio of 3:2 respectively (Vincent P Deluise, 1983). This is proven by a study with 125 infants from Westerlund, 76 of whom were male i.e. nearly 61% were males (Vincent P Deluise, 1983). On the other hand in Japan, this is no longer true and the ratio is actually reversed (Vincent P Deluise, 1983). In another study based in Japan out of 46 children with primary infantile glaucoma 63% were actually female (Vincent P Deluise, 1983). In the majority of cases the development of primary infantile glaucoma is found to sporadic, and so it is non-familial and nonhereditary, but approximately 10% of cases are familial, transmitted to the child via autosomal recessive inheritance (Vincent P Deluise, 1983). Signs, Symptoms and Consequences of Primary Infantile Glaucoma Children are commonly referred to the Ophthalmologist due to clinical evidence of corneal oedema. Primary infantile glaucoma is commonly misdiagnosed, hence causing a delay in the correct diagnosis, as it may initially show symptoms similar to conjunctivitis such as a ‘red eye’ (Becker B, 1965). There will also be evidence of the classic triage; epiphora, blepharospasm and photophobia. (Becker B, 1965). Further examination will reveal megalocornea (enlarged corneal diameter), buphthalmos (enlarged globe), Haab’s striae (breaks in Descemet’s membrane) and optic nerve head changes (Becker B, 1965). Buphthalmos; figure 4, or ocular enlargement, occurs in primary infantile glaucoma because the globe of neonates is still distensible (Vincent P Deluise, 1983). Collagen of the cornea and scleral have not hardened enough, so expansion of the fibrils occurs due to an increase in IOP (Vincent P Deluise, 1983). This therefore causes stretching to occur in several structures of the infant eye; such as the cornea, the anterior chamber angle, the sclera, the optic nerve, scleral canal and the lamina cribrosa (Becker B, 1965). This explains why ocular enlargement due to glaucoma does not occur in adults, as the globe is no longer distensible and collagen fibres of the cornea are sclera are hardened hence expansion doesn’t occur in adults. It is agreed that delayed therapy of infants with glaucoma, will result in a poor visual outcome for the infant, which could have been prevented or at least minimised. To understand why some infants had more advanced glaucoma than others; a study with 24 infants and children was conducted (David J. Seidman MD1, 3 March 1986). Their signs and symptoms were noted. The parents of the infant were asked to indicate whether they had noticed either epiphora or photophobia and only 32% said their infant had these symptoms. You read "Critical Study of the Aetiology and Pathogenesis of Infantile Glaucoma" in category "Essay examples" A small 21% of infants presented with only signs of glaucoma, noticed by the parents but no symptoms. And finally the majority of infants, 90%, actually did have signs when presenting to the physician. It has been noted that signs of infantile glaucoma are more difficult to notice when it is bilateral, as in all 3 cases where the physicians failed several times to refer the infant to an ophthalmologist the glaucoma was in fact bilateral (David J. Seidman MD1, 3 March 1986). A normal value for the corneal diameter of a neonate is approximately 10mm, an increase to 12mm or greater, along with expansion of the corneal-scleral junction, is usually due to increased IOP (Kwitko, 1973). Enlargement of the cornea due to an increase in IOP is most likely to occur up to the age of three (Scheie, 1955) after which the sclera may become deformed up to age ten (Mann, 1957). Breaks occur in the endothelium and Descemet’s membrane due to the increase in IOP which also causes stretching in these layers (Vincent P Deluise, 1983). ‘Haab’s striae form as endothelial cells lay down new basements membrane (Descemet’s membrane) and hyaline ridges develop. Breaks in Descemet’s membrane from increased IOP rarely occur after age three’ (Vincent P Deluise, 1983). Increased IOP also causes slow expansion of the sclera of the neonate. A ‘bluish’ scleral appearance is seen due to thinning of the sclera, causing the choroid to be more apparent (Vincent P Deluise, 1983). As the neonate becomes older and growth occurs the expansion of the sclera no longer occurs due to a build-up of extracellular connective tissue (Vincent P Deluise, 1983). Even if the IOP decreases back to a value within normal the globe does not usually return to normal size (Vincent P Deluise, 1983). Studies have shown that myopia and astigmatism are the consequence of an increase in the axial length of the globe, figure 5 (Robin AL, 1979). Robin et al also found that ‘In contrast to adult eyes, the scleral canal in children apparently enlarges with high IOP. Thus, disk cup size increase in children could occur from neural tissue loss, from scleral canal enlargement, or from a combination of the two processes’ (Robin AL, 1979). ‘Myopic astigmatism and anisometropia are particularly common in cases of unilateral or asymmetric primary infantile glaucoma’ (Vincent P Deluise, 1983). A study carried out by Broughton and Parks found that all of their patients with unilateral primary infantile glaucoma had anisometropia; on the affected side an average difference of 4.93D of myopia was found (Broughton WL, 1981 May). Optic nerve changes which occur in adults with glaucoma are very different to the optic nerve changes which occur in children with glaucoma. At first Becker Shaffer initially thought that cupping in primary infantile glaucoma was a process which was gradual however it was soon discovered that optic nerve changes in primary infantile glaucoma could also occur early and rapidly (Becker B, 1965). In adults with optic nerve changes which occur due to an increase in IOP the change is very unlikely to be reversible, however in infants optic nerve cupping which occurs due to an increase in IOP can be reversed once the IOP is returned back to normal (Vincent P Deluise, 1983). The most accepted and most reasonable hypothesis which aims to explain why cupping is reversible in neonates is based on the fact that the connective tissue of the lamina cribrosa is not matured (Quigley, 1977 Sep). However there are cases when even though the pressure has decreased back to normal the Optic nerve head damage does not reverse, this is due to one of two reasons. Firstly it is possible that some of the stretching is permanent ‘with remoulding of the connective tissue’ (Vincent P Deluise, 1983). Secondly it could be due to ‘a loss of glial and axons’ (Vincent P Deluise, 1983). ‘Adult optic nerve heads with their dense connective tissue investments are more resistant to remoulding, indicating that cupping is caused by permanent loss of glia and axons’ (Vincent P Deluise, 1983). Pathology, Pathogeneses and Causes of Primary Infantile Glaucoma The explanation for the increase in IOP in primary infantile glaucoma has been described using Barkan’s membrane theory. This theory is based on the fact that the anterior chamber angle is covered by a thin and imperforate membrane, which inhibits aqueous outflow, which in turn leads to raised IOP (Vincent P Deluise, 1983). According to the theory, this raised IOP is treated by goniotomy when the surface tissue of this membrane is detached, and so â€Å"the peripheral iris falls posteriorly,† subsequently there is aqueous outflow and a decrease in IOP (Vincent P Deluise, 1983). Worst also agreed with the Barkan membrane theory, â€Å"†¦in congenital glaucoma the chamber angle is filled with a band of persistent mesodermal tissue (persistent uveal meshwork or persistent pectinate ligament). This tissue completely covers the fetal corneoscleral system, but is not the cause of the obstruction to aqueous outflow in its own right. It is the presence of an imperforate surface layer on this persistent mesodermal tissue, which is the only cause of obstructed outflow. This surface membrane, Barkan’s membrane, is probably an endothelial surface, which normally breaks apart, but which persists in congenital glaucoma† (Worst, April 1968). There is no well supported histopathologic evidence to support Barkan’s membrane theory, despite this Worst still believes that the theory along with its concepts are valid, he says â€Å"though histopathologic proof of this structure is almost completely lacking†¦this has little influence on the probab ility that this concept is valid† (Worst, April 1968). So if Barkan’s membrane theory has insufficient evidence to explain the cause of an increase in IOP in congenital glaucoma, then what is the alternativeThere is some histopathologic evidence which aims to explain in detail the anterior chamber angle and its histopathology in infants with primary infantile glaucoma see Figure 6 (Vincent P Deluise, 1983). Anderson thoroughly researched the development of the trabecular meshwork in infantile glaucoma. He said that earlier thoughts were that â€Å"the anterior chamber recess deepens by atrophy of the rarified tissue that in the earlier stage separated the trabecular meshwork and ciliary body.† He then confirmed that later thoughts highlighted the function of cleavage into the loose tissue, as there was no proof of atrophy (D.R.Anderson, 1981). These views may have seemed correct at the time however, evidence has proven that cleavage or atrophy are not the only explanations of the process of development. Both cleavage and atrophy would cause the uveal tract to become fragmented from the shell of the cornea and sclera as well as the tissue of the trabeculae (Fig 7A) (D.R.Anderson, 1981). This would result in extension of the ciliary muscle to the peripheral iris and on the posterior surface of the peripheral iris would be the ciliary processes (D.R.Anderson, 1981). However this does not actually occur, in fact the ciliary muscle and the ciliary processes continue to adhere to the envelope of the cornea and sclera although compared to their earlier position they do become depressed (Fig 7B) (D.R.Anderson, 1981). Anderson found that there is an overlay of the ciliary muscle in particular the ciliary processes over the trabecular meshwork; however they are subsequently depressed behind the scleral spur (D.R.Anderson, 1981). He found that â€Å"This repositioning can be explained only by a posterior sliding of the uveal tissues in relation to the cornea and sclera, presumably due to a differential growth rate of the various tissue elements† (D.R.Anderson, 1981). He concluded that this course of repositioning was not simply due to the â€Å"†¦sliding of the uveal tract along the inner side of the sclera. There is also a repositioning of the various layers within the uveal tract in relation to one another: initially the innermost muscle fibers have a position relatively more anterior than the outermost fibers† (D.R.Anderson, 1981) Anderson also found that compared to the ciliary muscle the ciliary processes are at first a lot more frontward, as time passes both become level behind the scleral spur and meshwork (D.R.Anderson, 1981). So, far it has been established that primary infantile glaucoma occurs because the anterior chamber does not develop normally. At what stage of development do these changes or lack of changes occurIt has been noted that at week twelve of development â€Å"a wedge shaped mass of mesenchyme can be identified at the anterior chamber angle i.e. at the junction of the papillary membrane and the lateral margins of the cornea. Within this wedge shaped portion of the tissue there is a row of small capillaries, which are lined with mesoderm-derived vascular endothelial cells† (A.Armstrong, 2008). At the beginning of the fifth month â€Å"early trabeculae are apparent separated by intervening spaces† (A.Armstrong, 2008) subsequently the capillaries fuse to form the canal of Schlemm, this is continuous with the collector channels as well as the scleral vessels (A.Armstrong, 2008). â€Å"The meshwork becomes specialised into inner uveal trabeculae, numerous intermediate layers of lamellar corneoscleral trabeculae, and a more loosely organised cribriform meshwork† (A.Armstrong, 2008). The inner surface of the meshwork is lined with cuboidal cells, perforations of these cells occur onwards from 15 weeks (A.Armstrong, 2008). Communication between the meshwork and the anterior chamber occur via these cuboidal cells (A.Armstrong, 2008). Between the sixth and ninth month development of the anterior chamber occurs (A.Armstrong, 2008). It presents â€Å"as a chink in the mesoderm between the iris root and the developing trabeculum. If the mesoderm does not entirely regres s in this region, an impervious layer may remain bridging the angle between the iris and the cornea and which impedes access of aqueous to the trabecular meshwork† (A.Armstrong, 2008). Figure 8: Comparision of optic cup asymmetry in normal infants with unilateral glaucoma infants. Taken from (Richardson, April 1968) Optic Cup Asymmetry in Primary Infantile Glaucoma It has been established that chronic open angle glaucoma is found to be bilateral and symmetrical to a certain extent, however some meticulous studies may find that there is somewhat of asymmetry in the cupping of the optic discs (Richardson, April 1968). Nevertheless the asymmetry of the discs can be used to diagnose early signs of glaucoma (Richardson, April 1968). Although optic disc cupping is assessed in infantile glaucoma it is not used as prominently compared to chronic open angle glaucoma (Richardson, April 1968). One of the reasons for this is due to the obvious fact that it is not as easy to conduct ophthalmoscopy in infants especially with added factors such as hazy corneas, miotic pupils (Richardson KT, 1966). It is also a common misconception that cupping in the optic nerve occurs at a very late stage and so it is no longer relevant to aid diagnosis (Richardson, April 1968). The opposite is actually true, as changes to the optic disc in infantile glaucoma occur relatively early on, hence valuable factor to aid prognosis (Shaffer.RN, 1967). To emphasise the importance of asymmetry of optic discs in infantile glaucoma compared to chronic glaucoma, the following study was conducted by Kenneth Richardson. Normal newborn infants, 96 hours old or less, were randomly chosen and their optic discs were assessed. Out of 468 it was found that only 11 infants had optic cup asymmetry, 2.3%; figure 8 (Richardson, April 1968). Similarly Snydacker found that out a random 500 adults only 15 had any sign of asymmetry, 3% (SyndackerD, 1964). Going back to the infants it was found that only 3 out of the 11 actually had marked asymmetry between their optic cups i.e. only 0.6%; figure 8 (Richardson, April 1968). A very different but much predicted result was found when Shaffer conducted a slightly different study (Shaffer.RN, 1967). 27 infants with unilateral glaucoma were assessed and it was found that 89% or 24 out of 27 had marked asymmetry; figure 8 (Shaffer.RN, 1967). In other infantile glaucoma studies Schaffer also found that 61% (52/85) patients had optic cups with a disc diameter greater than 1/3 in comparison to 2.6%(26/936) normal newborns who had optic cups with a disc diameter greater than 1/3 (Shaffer.RN, 1967). The above data provides vital evidence supporting the views that optic disc assessment in newborn infants is extremely important and any asymmetry in optic cupping is very significant as ‘normal’ infants are expected and likely to have symmetrical optic cups. Hence any asymmetry of cupping could be indicative of congenital glaucoma. Also it can be said that optic cupping assessment is of more importance in congenital glaucomas â€Å"since these cases are prone to follow a more asymmetrical course than adult glaucomas† (Richardson, April 1968). In order chronic glaucoma in order to be able to determine whether cupping is physiological or pathological the disc appearance must be tracked over many years. Whereas in newborns the cupping is expected to be symmetrical at birth therefore any asymmetry should be and can be picked up at birth (Richardson, April 1968). Secondary infantile glaucoma There are several causes of secondary infantile glaucoma, the most important is ocular trauma and this is due to the fact that ocular trauma is common in young infants. Blunt trauma to the eye causes compression of the globe which in turn leads to a temporary increase in IOP. When a blunt object hits the eye its cause indentation of the cornea, this then forces the aqueous humor â€Å"laterally against the anterior chambers angle structures and backwards against the iris and lens† (Robert N. Shaffer, 1970). Thereafter â€Å"in the anterior segment the iris sphincter ruptures†¦Ã¢â‚¬  (Robert N. Shaffer, 1970) the ciliary body could become separated from the scleral spur or it may just be split or torn (Robert N. Shaffer, 1970). Likewise the trabecular meshwork may become ruptured, consequently leading to glaucoma (Robert N. Shaffer, 1970). Traumatic iritis is another cause of secondary glaucoma. Blunt ocular trauma can cause inflammatory cells and increase in proteins in the aqueous humor, in the early stages. These cells along with the protein molecules then cause obstruction of the trabecular meshwork. (Robert N. Shaffer, 1970) Oedema of the trabecular meshwork will also lead to resistance in the outflow of the aqueous. Even though there is an increase in the resistance of outflow, the IOP will remain within a normal range and in some cases it may actually be lower than normal because the blow will have caused depression of the ciliary body along with hyposecretion (Robert N. Shaffer, 1970). Anterior chamber haemorrhage (hyphema) occurs due to trauma or injury to the eye. Small haemorrhages are unlikely to clot, however large haemorrhages may fill the anterior chamber and cause compression of the meshwork which in turn leads to an acute increase in IOP (Robert N. Shaffer, 1970). Another cause of secondary glaucoma is recession of the anterior chamber angle. â€Å"A significant percentage of traumatic hyphemas results from a longitudinal cleavage of the ciliary body† (Robert N. Shaffer, 1970). A chain of damage reactions which occur to the trabecular meshwork following this will decrease the outflow and lead to glaucoma. Contusion cataract can be caused by blunt trauma. â€Å"If the cataract intumesces, a phacogenic pupillary block glaucoma may result. If the cataract becomes hypermature the lens cortex which is liquefied may leak into the anterior chamber†¦Ã¢â‚¬ , (Robert N. Shaffer, 1970) a macrophage response occurs and these cells then cause an increase in IOP as they block access of the aqueous to the trabecular meshwork. (Robert N. Shaffer, 1970) This is known as phacolytic glaucoma. Dislocation of the lens most likely occurs due to trauma, and if the lens after dislocation ends up in the anterior chamber then pupillary block glaucoma is l ikely (Robert N. Shaffer, 1970). Secondary glaucoma is usually the result of a laceration to the globe. A blunt blow, by a child’s fist, is often very serious as the smaller size of the fist does not allow the orbit to provide protection and the blow lands straight on the eye (Robert N. Shaffer, 1970). Intra-ocular foreign bodies can also cause glaucoma; particles which contain iron will oxidise and can be toxic to structures within the eye such as the trabecular meshwork (Robert N. Shaffer, 1970). Severe iritis can lead to glaucoma, and transient or chronic glaucoma can result from inflammation of the trabecular meshwork with increased resistance to outflow (Robert N. Shaffer, 1970). Inflammation of the cornea can also cause secondary glaucoma, due to further inflammation of the meshwork leading to obstruction of the aqueous outflow (Robert N. Shaffer, 1970). It is well-known that glaucoma can be induced by steroids. An increase in IOP can be induced by prolonged use of topical steroids, in susceptible individuals. Ocular tumours uncommon in children, however if one is present it can sometimes lead to secondary glaucoma (Robert N. Shaffer, 1970). Retinoblastoma, a well-known and common tumour found in the young can also cause glaucoma. The tumour will invade the anterior chamber angle structures; iris and trabecular meshwork. There is a very strong link between prenatal rubella infection and glaucoma and it is now well agreed upon that prenatal rubella can in fact cause glaucoma. It is estimated that rubella infantile glaucoma occurs in 2-4% of children with congenital rubella syndrome (Robert N. Shaffer, 1970). It usually presents in the first six months of life and the symptoms are identical to those of primary congenital glaucoma; an enlarged oedematous cornea which is cloudy, a deep anterior chamber and the classic high IOP (Robert N. Shaffer, 1970). Clinically it is found to be almost impossible to distinguish rubella infantile glaucoma from primary congenital glaucoma (Robert N. Shaffer, 1970). In conclusion, it has been determined that although rare conditions both primary and secondary infantile glaucoma can significantly affect the life of a child. Hence examination of the optic discs at birth is vital to ensure that any asymmetry of optic cups is detected and the possibility of the newborn developing glaucoma is known immediately, as it has been proven that infants with glaucoma are significantly more likely to show asymmetry of optic cupping compared to ‘normal’ infants. If the glaucoma is not detected at birth it is vital that healthcare professionals are able to recognise the signs and symptoms of infantile glaucoma so it can be treated before any significant damage has occurred, as it has been proven that the majority of children present with all or some of the signs and symptoms of glaucoma yet they are either overlooked by the parents or misdiagnosed by clinicians. In relation to the pathogenesis of infantile glaucoma significant evidence or lack of has proven that Worst along with Barkan’s Membrane theory are no longer valid. Vital histopathologic evidence undermines the theory; in fact Anderson has provided substantial evidence to prove that repositioning, sliding, cleavage and atrophy play a significant role in the development of primary infantile glaucoma. Along with the histopathologic evidence it can be concluded that Anderson’s findings can be accepted. References A. Edward Maumenee, M. (1962). Further observations on the pathogenesis of congenital glaucoma. TR. AM. OPHTH J. SOC, VOl. 60, 140-162. A.Armstrong, R. (2008, December 12th). Congenital Glaucoma; The genetics of primary congenital glaucoma. Optometry Today, pp. 40-43. Becker B, S. R. (1965). Diagnosis and Therapy of the Glaucomas. St Louis: CV Mosby. Broughton WL, P. M. (1981 May). An analysis of treatment of congenital glaucoma by goniotomy. Am J Ophthalmol. , 91(5):566-72. Ching Lin Ho, F. a. (September/October 2004). Primary Congenital Glaucoma: 2004 Update. Journal of Pediatric Ophthalmology and Strabismus , Vol. 41:271-288. D.R.Anderson. (1981). The development of the trabecular meshwork and its abnormality in primary infantile glaucoma. Trans Am Ophthalmol Soc, 79:458-85. David J. Seidman MD1, L. B. (3 March 1986). Signs and Symptoms in the Presentation of Primary Infantile Glaucoma. PEDIATRICS , Vol. 77 No. pp. 399-404. Harley, R. D. (1983). Pediatric Ophthalmology. Saunders. John S Crawford, J. D. (1983). The Eye in Childhood. New York: Grune and Stratton. Kanski, J. J. (2003). Clinical Ophthalmology A Systematic Approach. Butterworth Heinemann. Kwitko, M. (1973). Glaucoma in Infants and Children (ed 2). New York: Appleton-Century-Crofts. Mann, I. (1957). Developmental Abnormalities of the Eye. Philadelphia: JB Lippincott. MillerSJ. (1966). Genetic aspects of glaucoma. Trans Ophthalmol Soc U K., 86:425-34. Moller, P. (1977). Goniotomy and congenital glaucoma. Acta Ophthal, pp. 55: 436-442. Morin JD, M. S. (1974). Primary congenital glaucoma: a survey. Can J Ophthal, pp. 9:17-28. Myron Yanoff, J. S. (2009). Ophthalmology. Mosby Elsevier. NEI. (1968-date). Glaucoma. Retrieved February 2011, from National Eye Institue: http://www.nei.nih.gov/health/glaucoma/glaucoma_facts.asp Quigley, H. (1977 Sep). The pathogenesis of reversible cupping in congenital glaucoma. Am J Ophthalmol., 84(3):358-70. Richardson KT, S. R. (1966). Optic nerve cupping in congenital glaucoma. Am J. Ophth., 62: 507. Richardson, K. T. (April 1968). Optic Cup symmetry in normal newborn infants. Investigative Ophthalmology, 137-140. Robert N. Shaffer, D. I. (1970). Congenital and Pediatric Glaucomas. USA: The C. V. Mosby Company. Robin AL, Q. H. (1979). An analysis of visual acuity, visual fields, and disk cupping in childhood glaucoma. Am J Ophthal , 88(5):847-58. Scheie, H. (1955). Symposiumon congenital glaucoma: Diagnosis, clinical course and treatment other than goniotomy (ed 2). Trans Am Acad Ophthalmol Otolaryngol 59, pp. 309–321. Shaffer.RN. (1967). New concepts in infantile glaucoma. Canad J. Ophth, 2: 243. SyndackerD. (1964). The normal optic disc. Ophthalmoscopic and photographic studies. Arch Ophthal, 58:958. Vincent P Deluise, D. R. (1983). Primary Infantile Glaucoma (Congenital Glaucoma). 28(1). Worst, J. G. (April 1968). Congenital glaucoma Remarks on the aspect of chamber angle: Ontogenic and pathogenic background and mode action of goniotomy. Investigative Ophthalmology, 7:127-134. How to cite Critical Study of the Aetiology and Pathogenesis of Infantile Glaucoma, Essay examples

Saturday, May 2, 2020

Arthur Miller, an Enemy of the People free essay sample

An Enemy of the People, depicts an intriguing playwright in which the differences of opinions between two brothers leads to a town revolution and the expulsion of one brother from the community. One brother, Dr. Stockmann, believed the contamination of the water in the town’s health spa was sufficient reasoning to be shut down. The other brother, Peter Stockmann, took an opposing stance believing that the health spa was the towns only means to economic salvation, and that closing the spa would detrimentally affect the entire population of the town. The town stood behind Peter, and the town kept the spa and maintained its financial prosperity, while Dr. Stockmann was shunned and left feeling that the town he loved had chosen the wrong priorities and was not fulfilling the moral duty to preserve life. As Peter is the protagonist in this story, the question to whether his actions were moral or immoral must be raised. We will write a custom essay sample on Arthur Miller, an Enemy of the People or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page The stance that this essay will take in answering this question is the Utilitarian standpoint described by John Stuart Mill. Utilitarianism must be defined if to be applied to this question. Before Mill, Utilitarianism promoted the idea of utility, or the promotion of pleasure over pain. Pleasure is then described as a happiness that all people wish to achieve. John Stuart Mill goes further to contribute that â€Å"some kinds of pleasures are more desirable and more valuable than others,† therefore, â€Å"the estimation of pleasures should be supposed to depend on quantity alone (Mill 162). † Mill also argues that the consequences are more important than the intentions behind actions. Therefore, if the consequences are good then the motivations don’t matter. Complementing the principle of utility, the greatest good for the greatest number, Mill’s definition of happiness would justify the morality of Peter Stockmann’s actions towards his brother. Peter Stockmann strongly felt that closing the health spa would drastically affect the entire town that his family had worked so hard to build. In his soapbox to the crowd Peter says, â€Å"we know what this town was without our Institute. We could barely afford to keep the streets in condition. It was a dead, third-rate hamlet (Ibsen 90). † Following with, â€Å"within five years the ncome of every man in this room will be immensely greater, and someday we will be one of the richest and most beautiful resort towns in the world. † Many good consequences come from a town that had nothing to a town with a beautiful and prosperous resort, these consequences include; a higher standard of living, better education, and a higher morale with a new sense dignity in the town. Af ter realizing these consequences, the town will never want to go back to the old ways. Just as Mill would do, Peter fights for the greater good of the society. In doing so he is providing the greatest good for the greatest amount of people regardless if a few people have the risk of being injured from the contaminated water. Dr. Stockmann had good intentions to protect the people in his town, but by standing up against the masses he actually made more harm than if he would have kept silent, these consequences include; causing a revolution in the town, the town losing him as a doctor, his daughter getting fired from her job, and his son not being able to go back to school. Dr. Stockmann had good intentions, but the horrendous outcome makes his efforts immoral according Mill. Peter Stockmann hurt a few to save many, whereas Dr. Stockmann wanted to potentially hurt many to save a few. Mill would conclude that Dr. Stockmann had to the duty to protect the health of humanity, but if he was not able to do so without keeping the happiness of society he should have let his duty go. Being raised with the ideology of treating your neighbor as you would treat yourself leaves me with a bitter taste in my mouth after arguing that Peter Stockmann was just in his course of actions. Family is family, and no matter how different views can become I do not agree in expulsing a family member. Democracy in society is a very controversial issue, because it brings up the question, are the decisions made by the masses the right decisions? Morally speaking the masses can be wrong. Like Dr. Stockmann said, â€Å"was it morally right for the masses to crucify Jesus? † The more the issue is confronted it almost makes sense that society is willing to hurt a few to save so many. I find this story very interesting because it brings up multiple issues.