Ricky’s assessment

 

 

 

 

 

Ricky, age 4 years, arrives in the clinic with his mother. Ricky lives with his mother and father, who both work full-time, and his infant sister. Their extended family lives in a different state more than 100 miles away. Both parents are of average height and in good health. Ricky’s mother mentions that Ricky often expresses frustration, particularly in regard to food. Conflict over food occurs every day. Mealtime is a battle to get him to eat, unless his mother feeds him. Ricky’s baby sister seems to tolerate all baby foods but requires her mother to spoon-feed. Ricky’s mother is quite frustrated and concerned that he will become malnourished.

Reflective Questions

1. What additional assessment information would you collect?

2. What questions would you ask, and how would you further explore this issue with the mother?

3. In what ways does the distance of the extended family influence this family’s approach to health promotion?

4. What factors would you consider to determine whether malnourishment is a factor in this family?

 

 

Sample Solution

To further assess the situation and gain a better understanding of Ricky’s difficulty with food, I would ask questions to explore the family dynamics including: who is present at mealtime (mother, father, other family members?), what activities take place before mealtime (TV/electronics, playtime?), are there any distractions or disruptions during meals (sibling crying or fighting?), and has the family tried any different strategies that have worked in the past? Additionally, it would be important to understand if there is anything specific about meals that causes Ricky distress such as certain textures and flavors. To this end I would inquire on how he typically responds to different foods, how often he eats throughout the day, what type of snacks he likes to eat (if any), and if his tastes have changed since his baby sister was born.

I believe these questions could help uncover additional information about Ricky’s eating habits which might provide clues into why these difficulties are occurring for him. Knowing more about his behaviors around food may give us insight into potential underlying issues such as sensory processing issues or social-emotional concerns due to changes in the home environment. It may also indicate that assistance from an outside source is necessary such as a pediatric dietician or mental health practitioner who can provide specialized guidance on addressing nutrition needs while also helping Ricky learn healthier ways to express himself when faced with difficult situations.

Furthermore ,I think it’s important for me to show active listening during our discussion by offering empathy and understanding towards both Ricky and his mother’s experiences.. By expressing my curiosity in their story rather than judgement will demonstrate my commitment towards finding a solution together as well as highlighting their strengths rather than focusing solely on weaknesses. This way they can leave with hope knowing they don’t have tackle this challenge alone but rather that we are all part of a team working towards success.

 

Would it be advisable for us to be permitted to take our very own lives?

In numerous societies antiquated and not all that old suicide has been viewed as the best alternative in specific conditions. Cato the Younger submitted suicide instead of live under Caesar. For the Stoics there was nothing essentially corrupt in suicide, which could be normal and the best choice (Long 1986, 206). On the other hand, in the Christian convention, suicide has to a great extent been viewed as unethical, resisting the desire of God, being socially unsafe and restricted to nature (Edwards 2000). This view, to pursue Hume, overlooks the way that by dint suicide being conceivable it isn’t against nature or God (Hume 1986). By the by, being permitted to take our very own lives encroaches on the morals of open strategy in an assortment of ways. Here we will quickly look at the instance of doctor helped suicide (PAS) where a person’s desire to pass on might be supported by the activity of another.

Hume viewed suicide as ‘free from each attribution of blame or reprimand’ (Hume 1986, 20) and in reality suicide has not been a wrongdoing in the UK since 1961 (Martin 1997, 451). Helping, abetting, guiding or securing a suicide is anyway a unique statutory wrongdoing, albeit couple of indictments are brought. As of late the issue of PAS has realized the discussion ‘whether and under what conditions people ought to have the capacity to decide the time and way of their demises, and whether they ought to have the capacity to enroll the assistance of doctors’ (Steinbock 2005, 235). The British Medical Association restricts willful extermination (leniency slaughtering) yet acknowledges both legitimately and morally that patients can reject life-drawing out treatment – this that they can submit suicide (BMA 1998). Neglecting to forestall suicide does not establish abetting (Martin 1997, 451) despite the fact that PAS ‘is the same in law to some other individual helping another to submit suicide’ (BMA 1998). In Oregon, be that as it may, PAS, limited to capable people who ask for it, has been authorized (Steinbock 2005, 235, 238). A qualification ought to be kept up among suicide and (leniency) slaughtering, acts in which the specialists vary, however obviously precisely where the line ought to be drawn is a piece of the issue.

The moral contentions in help of PAS include enduring and independence (Steinbock 2005, 235-6). The principal affirmation is that is merciless to draw out the life of a patient who is in torment that can’t be medicinally controlled; the second, in the expressions of Dr Linda Ganzini dependent on her investigation in Oregon, includes the possibility that ‘being in charge and not subject to other individuals is the most essential thing for them in their diminishing days’ (cited in Steinbock 2005, 235). The coherent result of these contentions is that, if PAS can be supported on the grounds of torment or self-governance, for what reason would it be a good idea for it to be limited to skillful people or the critically ill? Surely the judge in Compassion in passing on v State of Washington (1995) expressed that ‘if at the core of the freedom secured by the Fourteenth Amendment is this uncurtailable capacity to accept and follow up on one’s most profound convictions about existence, the privilege to suicide and the privilege to help with suicide are the right of no less than each rational grown-up. The endeavor to limit such rights to the critically ill is deceptive’ (Steinbock 2005, 236).

As noted above, religious dissatisfaction with suicide has turned out to be less pertinent an as referee of morals and approach. In fair social orders that may best be depicted as mainstream with a Christian legacy, the perspectives of religious gatherings ought not confine the freedom of people in the public arena (Steinbock 2005, 236). Others contend that the job of the doctor is to mend and help and not to hurt, however supporters of PAS would state that passing isn’t constantly destructive and helped suicide is an assistance. Undoubtedly, in a nation where PAS isn’t lawful individuals who wish to bite the dust without condemning the individuals who aid their suicide might be driven abroad, as on account of Reginald Crew who was kicking the bucket of engine neurone sickness and made a trip to Switzerland for AS, biting the dust in January 2002 (English et al. 2003, 119). This may cause more damage through the worries of disengagement and stress than enabling the PAS to happen.

The two most genuine concerns are that PAS would be mishandled and would prompt negative changes in the public arena. This could occur from numerous points of view through defenseless gatherings, for example, poor people, the elderly and so on, being constrained into picking PAS (Steinbock 2005, 237). The BMA underscores a worry for the message that would be given to society about the estimation of specific gatherings of individuals (BMA 1998). This is a piece of a more extensive concern additionally communicated in a Canadian Senate enquiry of 1995 (BMA 1998) which focuses to a strategy of suicide anticipation among some defenseless gatherings that would be rendered odd by looking to ease suicide among the debilitated. Notwithstanding, the introduction is somewhat deceitful, since there is a distinction in the explanation behind potential suicide that must be examined. For instance, looking to counteract suicide among the adolescent may include projects of social consideration or expanding life prospects, and this style of arrangement isn’t appropriate on account of the individuals who may look for PAS.

In Oregon in any event, it appears that feelings of dread about PAS have not emerged, and one specialist presumes that the generally low utilization of PAS is characteristic of it being excessively prohibitive (Steinbock 2005, 238). Clients of PAS, as opposed to being poor people and socially defenseless as anticipated, would in general be working class and taught, with more youthful patients bound to pick it than the elderly, and most were selected in hospice care. Issues about PAS and killing should be cleared up and contended independently. With regards to this issue at any rate, the topic of whether suicide ought to be permitted is the wrong one to inquire. A beginning stage is to ask how skilled people can be permitted to satisfy their desires as to life and demise issues without imperiling other individuals, regardless of whether specialists or friends and family and whether widely inclusive enactment is possible.

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