Physician Assisted Suicide Essays

Physician Assisted Suicide Essays Physician Assisted Suicide Essay Physician Assisted Suicide Essay who travels around the Michigan area providing physician-assisted suicide, ought not be surprised at the number of women he has helped die. Out of 43 deaths, 15 of his patients were men, 28 were women (Keenan 15). It was also reported by Keenan that Kevorkians male patients had severe terminal illnesses that left them incapable of living, while the female patients suffered from breast cancer and other illnesses that are curable (16). In many cases involving female patients wanting to use Physician-Assisted suicide, it was found that most people felt their request was emotional, unreflective, and immature (Keenan 16). Many people were angered at what Kevorkian was doing and felt that he wasnt assisting the terminally ill. They believed that people should and could find an alternative method of relief for their illnesses (Gay 47). The Detroit Press reported that on, June 4, 1990, Janet Elaine Adkins, became the first patient Dr. Kevorkian assisted into death, as previously mentioned. The 54-year-old woman, from Portland, Oregon, who was a former college instructor, decided to commit suicide the day she was diagnosed with Alzheimers disease (1997). Adkins contacted Kevorkian after hearing about his suicide machine and asked for his help in assisting her into death, according to Kathlyn Gay. After hearing Adkins describe her illness, Kevorkian refused to help the patient and suggested that she try experimental drug treatments. After six months had gone by Adkins informed Dr. Kevorkian that the drug treatment had been unsuccessful and Kevorkian finally agreed to help with her request (44-45). Adkins and her husband flew to Royal Oak, Mich. , on June 3, 1990, for an interview with Kevorkian. On the basis of that one face-to-face encounter, the doctor concluded that Adkins euthanasia request was rational. The following day, as her husband waited in a nearby motel, Adkins was hooked up intravenously to an inverted bottle of saline solution hanging from a metal frame in the back of Kevorkians parked van. Acting on Kevorkians instructions, Adkins pressed a button that shut off the flow of saline solution and opened the line of sodium pentothal, causing her to lose consciousness. After one minute, an automatic timer closed the pentothal line and released the contents of the third bottle. Adkins heart stopped beating within six minutes. (Worsnop Assisted Suicide 157-158) One source reports that the second and third assisted suicides occurred on, October 21, 1991. One patient, Sherry Miller, was a multiple-sclerosis victim, and the second patient, Marjorie Wantz, complained of a severe pelvic disorder; they died within one hour of each other in a secluded cabin forty miles outside of Detroit (Worsnop Assisted Suicide Controversy 405). Worsnop also reports that the autopsy preformed on Wantz showed no evidence of any pelvic disorder that she could have been suffering from. After hearing this information, the State Board of Medicine suspended Kevorkians medical license on November 20, 1991 (Worsnop Assisted Suicide Controversy 405). Although Kevorkians medical license was suspended, he still continued to assist his patients into death. In November 1992, he helped his sixth patient, a female, into death. After this death, the Michigan House of Representatives passed a bill making assisted suicide a felony, making it punishable by four years in a state prison (Gay 47). After the deaths of Wantz and Miller, many people in Michigan, and all over the world, became angered that nothing was done to stop Kevorkian. The State of Michigan eventually put a ban on assisted suicide. Kevorkian, for his part, announced March 6 that he planned to appeal Michigans ban on assisted suicide to the U. S. Supreme Court. The American Civil Liberties Union (ACLU), representing two cancer patients, had filed a separate appeal of the ban to the Supreme Court a week earlier. On April 24, the Supreme Court rejected both appeals without comment, clearing the way for Kevorkian to stand trial on murder charges in the Wantz-Miller case. (Worsnop Assisted Suicide Controversy 410) According to Richard L. Worsnop, Kevorkian was later put into jail, but released after Judge Richard C. Kaufman ruled that the states assisted-suicide ban was unconstitutional. Worsnop continued by saying, Judge Kaufman dismissed the charges against Kevorkian on the basis of the quality of the patients life, saying that the patients life was significantly impaired by a medical condition that was extremely unlikely to improve. Kaufman also said that people have a constitutional right to commit suicide and Mrs. Adkins assisted suicide would fit into these conditions (Worsnop Assisted Suicide 405). A poll was later conducted across Michigan, from 310 people, and 102 people from Oakland County, where the Kevorkian case was being heard. From the 310 people, five to one believed that Kevorkian had not committed murder, and in the Oakland County area the decision was ten to one in favor of acquitting Kevorkian of murder charges (Gay 48). Due to Kevorkian assisting in the death of those that did not fit into the terminally ill category, patients now have to be more informed about their illness, so that they are aware of what their final options may be. When a physician has diagnosed a patient with a terminal illness, it is vitally important that the physician provides valid information, about the illness the patient is suffering. According to the Oregon Death with Dignity Act, Terminal disease means an incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgement, produce death within six (6) months (2). The physician is also responsible for letting the patient know of any experimental drugs and any other treatments that may benefit the patient in any way. Another responsibility of the physician is to educate the patient as to what their final options may be. They are required to inform the patient about their diagnosis, the results of taking any medication that could be given, all alternatives that could be used to treat the patient, and also having the patient contact another physician to confirm the diagnosis (The Oregon Death with Dignity Act 3, hereafter known as The Oregon). Some people feel that when a physician provides a patient with a deadly drug and instructions on how to use the medicine, they have as much responsibility as the patient themselves (Callahan 71). It is important that physician inform their patients that death is not the last option they have; many people feel that the terminally ill need to be reassured that they dont need to be in pain and that they wont be alone during their final stages of life, their interest in assisted suicide goes away (Worsnop Assisted Suicide Controversy 411). It is also vitally important that patients know that once they have made their decision to go through with assisted suicide, they can change their mind at any stage along the way (Oregon 3). The ultimate task of physicians is deciding whether or not to help their patient with their final request. In a magazine article by Jon Fuller, he reports that physician-assisted suicide causes much stress and emotional drain to the physician. This feeling, in turn, makes it much easier and faster for the physician to come to the decision to help the patient and move on to the next patient. Fuller also feels that if physicians werent overworked and stressed, they would be a lot less likely to use assisted suicide (10). If people started believing that their physician would act this way, many would start to wonder about the commitment their physician had to his/her patient with a terminal illness (Johnson and Koop 52). For some physicians, the process of participating in physician-assisted suicide had a great emotional impact. In response to general, open-ended inquiries, prescribing physicians offered comments such as, It was an excruciating thing to do it made me rethink lifes priorities. (Department of Human Resources 7, Hereafter known as Department) Evidence shows that many physicians are prepared to sacrifice their careers to help a patient in a great deal of pain, and many people in todays society feel that it is wrong to put such a heavy decision on doctors (Medical Ethics 9). There are still many physicians that are troubled by the thought of ending the life of one of their patients, because they have been trained to preserve life, not end it (Worsnop Assisted Suicide 147). A second type of physician response to euthanasia followed in the footsteps of many nineteenth-century practitioners: the prolongation of life takes absolute priority over the easing of suffering. In 1896, for example, Isaac N. Quimby was asked, Is it right to prolong the agony of a patient if the physician knows positively that death is inevitable in a short time? To the bitter end, Quimby asserted. A physician has no right to terminate the life of a patient, even when to prolong that life is to cause the most agonizing tortures. (Vanderpool 41) Some people feel that our society is unfair towards physicians that do decide to use assisted suicide, because in all American states, a physician must be present when a criminals are executed. People in society feel that this is as unethical as using assisted suicide, but it hasnt become an issue, such as physician-assisted suicide (Medical Ethics 9). If an Oregon physician does decide to provide the patient with a lethal dose of medications, the prescription that is written out must provide specific information so that the Oregon Health Department can make sure that it is in compliance to the law (Department 2). The only state, today, where assisted suicide can take place is Oregon; physicians in other states may not write prescriptions, for lethal doses of medications, without breaking the law. According to the Oregon Health Department, a survey was taken in Oregon, before the Death with Dignity Act was passed, and found that seven percent of physicians had already provided prescriptions for terminally ill patient (Department 9). Harold Y. Vanderpool reports that T. T. Robertson was the first American doctor to publicly admit that he had practiced euthanasia by giving two patients narcotics to shorten their lives by a few hours (41). For those people who believe that physician-assisted suicide should be their choice, they feel it should be legalized because: they dont want to go through the suffering caused by the terminal illness, they fear the loss of autonomy/independence, becoming a burden to their family and/or friends, and they also fear dying alone; as previously mentioned. It was reported, in Richard L. Worsnops Assisted Suicide Controversy, that many people fear living a life in excruciating pain (411). Ed Newman states that one of the arguments in favor of assisted suicide is the mercy argument, which states, The immense pain and indignity of prolonged suffering cannot be ignored. We are being inhumane to force people to continue suffering in this way (1). One source states, And at the risk of finding myself out on a theological limb, I say that if it is playing God to reduce human suffering, then I do not believe that the God of mercy and compassion would mind if we mere mortals play God under such circumstances (Barnard, C. 70). Another source said that, The most literal translation of the word euthanasia would be a good death. So who could be against that, except an extremist who would argue that terminal suffering should be accepted, unchanged by human intervention, as fate or Gods will? I personally believe that helping someone die in peace and without pain, even if that might hasten the biological timetable of death by a few hours or even days, is not only acceptable but is mandatory for modern medical care (Johnson and Koop 39). Another argument that people feel should be considered to make assisted suicide legalized, is the economic argument. This argument notes the cost of keeping someone alive and on life support, although they are in a vegetative state (Newman 2). Newman believes that society is wasting precious resources by keeping these people alive for so long, even though the life will not return to normal (2). According to Margaret Battin, assisted suicide would not mean that society would be giving up on the elderly and those with terminal illnesses (19). It would in fact do them a good deed by letting them choose when they had enough treatment and wanted to stop the insults to their body (Battin 19). One source feels that todays technology is to blame for people wanting to commit assisted suicide. We die more slowly today, Verhey notes. Even worse, we do it in hospitals, surrounded by technology rather than by friends and family. And this is what makes it especially frightening to some people' (As qtd. by Thomas 16). Also for some, the thought of being hooked up with tubes in every orifice of our body is not the way they want to leave their life (Vanderpool 56). Another reason people believe physician-assisted suicide should be available for those who request it, is because people fear the loss of their autonomy. One source stated that more patients fear loss of control than they do actually suffering from a terminal illness (Gardner 68). The Oregon Health Department said that, The fact that 79% of persons who chose physician-assisted suicide did not wait until they were bedridden to take their lethal medication provides further evidence that controlling the manner and time of death were important issues to these patients (Department 9). Some people feel that life is only worth living when they can actually do things for themselves and not have to worry about people doing anything for them. Another reason for people to be in favor of physician-assisted suicide is some fear becoming a burden to their family and/or friends, and this makes people more susceptible to choosing assisted suicide, rather than letting a family member take care of them. Terminally ill patients feel guilty about having to have another person take care of them, instead of being able to take care of themselves and do things for themselves. 75% of those who asked for assistance in suicide cite fear of burdening spouses and families (Arguments Against Physician-Assisted Suicide 2, hereafter Arguments). In the cases of Dr. Kevorkian, as mentioned earlier, most of the female patients were more worried about becoming a burden to friends and family, while the males were more likely to commit suicide due to the suffering (Keenan 16). Another issue is for the family to keep the patient alive, even if they are in a state of vegetation, because they fear living with the guilt of killing a member of their own family (Johnson and Koop 41-42). The family members felt that if they did help in the assistance of the suicide, that they were abandoning the patient rather than helping with their final  wishes, even in the cases of the patient only wanting the family to put them out of their misery (Thomas 17). Most people that believe physician-assisted suicide should become a legal option for anyone who requests it, use the idea that everyone has the freedom of choice. In the book, Lawful Exit: The Limits of Freedom, Derek Humphry quotes Archibald MacLeish by saying, Freedom is the right to choose: the right to create for yourself the alternatives of choice. Without the possibility of choice and the exercise of choice a man is not a man but a member, an instrument, a thing (8). Another source states that, Since there is no absolute legal, medical, or moral answer to the question of what constitutes a good or correct death in the face of a terminal illness, the power to make the decision about how someone dies can rest with only one individualthe person living in that particular body (Shavelson 153). There are many arguments in favor of assisted suicide, and the reality argument simply states that, people are already being helped into death, so why not just continue with it (Newman 2). Some people have even come as far as believing that since the democratic view is free of religion, suicide should be viewed as a pro, because those who see it as a negative issue, are seen as imposing their moral beliefs on everyone else (Thomas 19). The patients Right to Self-determination gives the patient the power to decide not only when they die, but also how, because it is in fact their body, their pain, and their life, so whats the point in keeping someone alive if they dont see any reason themselves (Newman 2). In a newspaper article one source states, Proponents of assisted suicide always insist that the practice will be carefully limited: It will be available, they claim, only for those who request it and only for those who are dying, anyway (Wagner 622K3096). People do have a constitutional right to commit suicide, if they are impaired with a terminal illness that can not be cured and they are unlikely to improve, as mentioned earlier in the paper (Worsnop Assisted Suicide Controversy 405). Another big issue that comes up in the discussion of assisted suicide, is people wanting to die with dignity. Dr. Christiaan Barnard states, With an open-door approach to technical progress, with the emergence of candor in discussions of death-related subjects, with landmark changes in ethical and legal constraints to medical practice, I feel that society is ready to take a giant step toward a better understanding of the dignity of death-and the attainment of that dignity, if necessary, through euthanasia and suicide (x). Some people have even gone as far as believing that euthanasia is the only merciful thing to do when patients are suffering and cannot be helped (Euthanasia 53). People also believe that since sending criminals to prison is viewed as a positive idea, it should be acceptable to help those with terminal illnesses end their lives when they have done nothing wrong, but only want to help themselves (Barnard, C. 68). Another idea to think about when deciding if assisted suicide is a negative idea or a positive idea, is that people are afraid of dying alone. Patients already possess the legal authority to give up eating, or to refuse antibiotics or insulin. The only thing a patient now lacks is control over the exact hour of his or her death, making the patient unable to gather family, say good-bye, and then immediately die (Thomas 21). In a study done in Oregon, loneliness was also a factor in the assisted suicide of several patients. Of the fifteen people who took the lethal drugs, two were married, and nine were either widowed or divorced (Gardner 68). In Richard Worsnops report, he said that more people were afraid of abandonment then they were of death (Worsnop Assisted Suicide Controversy 411). Along with the many arguments for physician-assisted suicide, there are as many, if not more reasons assisted suicide should not be legalized and practiced. In the early years (1800s), it has been reported by Darrel Amundsen, that Christians invented suicide. They believed that by committing suicide, they would be able to reunite with the deceased, be rewarded as a martyr, and even be part of the highest spiritual state. This was stopped when Augustine said it was a sin; his idea quickly took hold and is accepted by Christians today (7-8). Amundsen also reports that Justin Martyr said, If we should kill ourselves we would be the cause, as far as it is up to us, why no one would be born and be instructed in the divine doctrines, or even why the human race might cease to exist; if we ourselves will be opposing the will of God (14-15). When dealing with religious beliefs the question of whose right is it to take a life will always come up. For those who believe in a higher power, they feel that only that power can take them out of life, while those without religious beliefs say it is their right to decide. Pro-lifers generally believe that human beings have no right to determine when a life is over; they feel that only God can decide that (Worsnop Assisted Suicide Controversy 412). In the book, Moral Issues, it states that, Man as trustee of his body acts against God, its rightful possessor, when he takes his own life. He also violates the commandment to hold life sacred and never to take it without just and compelling cause. (Taking Sides: Clashing Views on Controversial Moral Issues 291, hereafter known as Taking Sides) In one assisted suicide case, a man in Oregon was given the option to use a lethal dose of medications to take his own life, but he was a committed Christian and did not even consider the option. He became more independent with time, and became more dependent on God; his faith gave him the strength to resist the temptation of an escape (Gardner 68). One source feels that the communities should be the ones to decide whether or not physician-assisted suicide should take place, not the doctors, because people go to doctors to get help not to have them kill people (Fuller 12). Those people with religious beliefs also feel that life is still worth living, even if you cant do anything and have to rely on others. One source reported that, The press now refers to opponents of euthanasia as vitalists; the term stems from the word vital, which has a variety of definitions, one of them being characteristic of life or living being. The vitals earned their name because of their deep belief that life is so precious that it must never be ended other than by natural causes (Dolan 85). Some people would even go as far as feeling that people should not want to withdraw from life, when they still have the ability to interact, in any way, with their fellow human beings (Johnson and Koop 41). In another case of a man in Oregon, with Lou Gehrigs disease, the man had gotten a hold of a package of barbiturates and was ready to kill himself, when he realized that he was still living a valuable life, because he was capable of making the decision to take his own life (Gardner 70). The issue of becoming dependent on others during a terminal illness shouldnt make the patient feel bad because they have, most likely, helped someone out at their time of need (Parry 21). Physician-assisted suicide also goes against Gods plan of a natural death for some. According to one source, Euthanasia does violence to this natural goal of survival. It is literally acting against nature because all the processes of nature are bent towards the end of bodily survival. Euthanasia defeats these subtle mechanisms in a way that, in a particular case, disease and injury might not (Taking Sides 291). The source went on to say that, Furthermore, in doing so, Euthanasia does violence to our dignity. Our dignity comes from seeking our ends. When one of our goals is survival, and actions are taken that eliminate the goal, then our natural dignity suffers (291). Another source believes that if people believed that everything ended after death, then people would choose to prolong life (Johnson and Koop 40-41). The source went on to say that those who did believe there was something after death, they would go when their time arrived and not prolong, they would also believe that God planned their exit and that interfering would be wrong (40-41). The issue of involving another person in the taking of a life has become a valid part of anti-assisted suicide groups. In a video produced by Derek Humphry he informs that when a doctor is asked to assist a suicide, he has the right to refuse the patients request. If he refuses, he must discharge that patient from his care, and if he does not discharge them, it would be considered illegal (The Right to Choose to Die). When family members, friends, and lovers are asked to help people die, it is said to be one of the most agonizing decisions anyone could ever make, because if that person does decide to help with the death they have to live with the knowledge that they killed a loved one and if they dont help out, they live with the torment of watching someone suffer (Shavelson 33). A big argument against legalizing physician-assisted suicide is that it is not part of medical ethics and should not become a part. The appeals court noted that the American Medical Associations Code of Ethics declares physician-assisted suicide to be fundamentally incompatible with the physicians role as healer. The court then added a comment of its own: The physicians commitment to caring is the medical professions commitment to medical progress. Medically assisted suicide as an acceptable alternative is a blind alley. (Worsnop Assisted Suicide Controversy 397) The Slippery Slope argument was made against the legalization of physician-assisted suicide, and it says that there are certain situations when nothing should be done that is acceptable because it will only lead to a course of consequences that are not acceptable (Newman 3). Newman goes on to say that, Our attitudes toward the elderly, people with disabilities and the devaluation of individuals for the higher good of society should be reflected upon (3). The issue of pain being a part of the reason for people choosing assisted suicide is also argued against. One source says that, Pain is controllable. Modern medicine has the ability to control pain. A person who seeks to kill him or herself to avoid pain does not need legalized assisted suicide but a doctor better trained in alleviating pain (Key Points for Debating Assisted Suicide 1, hereafter known as Key Points). Richard Thorne, a physician in Salem, Oregon, tells that, As a physician, I was always taught to be a healer, Thorne says. Im sad and anguished that this chapter of medicine will come to an abrupt end unless challenges in the court overturn it' (Kellner 55). Doctors today are not ready to help patients end their lives and they are not ready to sacrifice their professional career because one patient is suffering with the medication that is available today. As one source points out, The doctor has to decide whether she is prepared to sacrifice her professional creed (and perhaps even her career) out of compassion for her patient (Medical Ethics 9). Many people believe that if physician-assisted suicide becomes legal, the relationship between physicians and patients will become unstable. One source states, In contrast, participation in the active taking of life, even if only by prescribing medications that a patient will self-administer, crosses a threshold and threatens the trust in beneficence that is the root of the physician-patient relationship. Our collective unconscious must already contend with living memories of the abuse of the physicians power, most notoriously in the Nazi medical experiments and in the Tuskegee project. (Fuller 11) Another reason physicians should not be granted this power, is because it would make society look at their physician as a killer instead of a healer, which would eventually ruin the relationship between physician and patient (Fuller 10). The Hippocratic Oath is another idea that is keeping doctors from believing assisted suicide is acceptable. Even before doctors begin seeing and treating patients, they must take an oath with says that they will do anything in their power to heal a patient and in no way will they lessen the amount of life the patient may have (Battin 17). You do solemnly swear, each by whatever he or she holds most sacred that you will be loyal to the Profession of Medicine and just and generous to its members that you will lead your lives and practice your art in uprightness and honor that into whatsoever house you shall enter, it shall be for the good of the sick to the utmost of your power. Your holding yourselves far aloft from wrong, from corruption, from the tempting of others to vice that  will exercise your art solely for the cure of your patients, and will give no drug, perform no operation, for a criminal purpose, even if solicited, far less suggest it that whatsoever you shall see or hear of the lives of men and women which is not fitting to be spoken, your will keep inviolably secret these things do you swear. Let each bow the head in sign of acquiescence. And now, if you will be true to this, your oath, may posterity and good repute be ever yours; the opposite, is you shall prove yourselves forsworn. (Hippocratic Oath 1997) This oath has been used and dated back to the fifth century B.C. and is given at the graduation ceremonies of most doctors entering the work force (Euthanasia 52). A strong argument against the legalization of physician-assisted suicide is that it will eventually get out of control, and possibly target certain groups in todays society, as mentioned earlier. According to one source, Euthanasia could and would be abused. Over doses of readily accessible laudanum, for example, could do the business of death without leaving a trace of evidence. Euthanasia would give rise to a sea-change of lessened care and concern for invalids. It would release social instincts of selfishness and cruelty toward helpless and vulnerable persons. It would undermine the care of the grievously sick and dying (Vanderpool 39). Vitalists fear that the acceptance of passive euthanasia will cause society to regard as less valuable the sanctity of human life. As they see it, ending the lives of the incurably ill could be just a step away from justifying the deliberate elimination of all people judged to be unfit by a society. The old, the unproductive, the mentally deficient, the physically weak-all could then become the victim.

Cool Boy Essay

Cool Boy Essay Cool Boy Essay Assignment 1 International Interest Nowadays everything seemed relate to international aspects because the world is becoming as a global village. A lot of organization is also containing international components in order to have a higher quality organization. For example, one of my interests is basketball association. I like to play basketball and enjoy watching the players competed for their honor of the teams. An international organization called Peace Players International, which is helping to develop sports skills from different area`s children from age 10 to 14 is organized by South Africa, Northern Ireland, and Middle East. Peace Players International has four main objectives, bridge social divides, develop future leaders, educate children to lead healthy, constructive lives and build community involvement to ensure long-term sustainability. Peace Players International was founded in 2001 on the premise that â€Å"children who play together can learn to live together.† Peace Players International effectively blends together proven theories of social modeling, conflict resolution and public diplomacy to operate basketball and life-skills programs in historically divided regions that bring together thousands of children from different religious, racial, and cultural backgrounds. The programs attract children to participate in basketball and life-skills activities that enable them to learn leadership skills and how to live as friends and neighbors. A key component to Peace Players International's effectiveness is that the programs target children aged 10–14. These are the children old enough to pick up the basics of the sport, but young enough that many prejudices have not yet been cemented. Through the power of sport and education and the strategic integration of public diplomacy, Peace Players International is altering the pattern of preconceived prejudice and equipping children with the skills and education needed to address the serious social and health issues they face. Peace Players International established a program in Cyprus in October 2006 that is using the game of basketball to facilitate positive dialogue and interaction between Turkish Cypriot and Greek Cypriot youth, with the ultimate goal being improved relations between the Greek and Turkish communities in Cyprus. The project is led by a group of 3 Peace Players International-Cyprus directors and 16 local coaches who direct activities that bring 10- to 12-year-old Turkish Cypriot and Greek Cypriot youth together to play the sport in an inclusive, fun environment. The program was launched in partnership with the United Nations Development Programmed. Working with the UNDP and other local partners, Peace Players International-Cyprus has the following objectives: Peace Players International is bring hundreds of Turkish Cypri ot and Greek Cypriot children together to play basketball in a fun, inclusive environment and also train and employ local young audits from both communities to work together as coaches, leaders and role models In addition, Peace Players International develop links between Turkish Cypriot and Greek Cypriot sports clubs and other community organizations and build community involvement and investment. Another organization that I am interesting is called National Basketball Association. The National Basketball Association is the pre-eminent men's professional basketball league in North America, and is widely considered to be the premier men's professional basketball league in the world. It has thirty franchised member clubs, and is an active

Nursing Mentoring Program Assignment Example | Topics and Well Written Essays - 1000 words

Nursing Mentoring Program - Assignment Example After evaluation of the career development needs, next objective is to design an evidence-based mentoring program for the career development needs of the nursing staff working at the Jackson VA Medical Center.   3a. Arrange dialogues and meetings with clinical nurses and other employees working for some other mentoring program at the VA Medical Center in order to have their guidance during the development phase of the program.   3b. Take suggestions from the mentor and the colleagues for the development of an appropriate mentoring program.   3c. Review of the evidence-based literature related to the most effective mentoring programs.   3d. Carry out a detailed research on the effective pairing of mentors and mentee.   3e. Set specific criteria and develop the mentoring agreement for anyone who wants to serve as a mentor in order to promote quality mentoring. 3a. The inclusion of information obtained through the meetings and dialogues with the clinical nurses and employees along with minutes of the meetings in the clinical journal.   3b. Making use of relevant information gathered from the mentor and mentoring colleagues in the development of the mentoring program.   3c. The inclusion of the most recent literature and the annotated bibliography in the project’s PowerPoint presentation.   3d. The inclusion of the copy of an evidence-based mentoring program in the mentoring project.   3e. Documentation of results and inclusion of the dates and results of the review of the literature in the clinical journal.   3f. The inclusion of the copy of mentoring agreements and criteria for mentors and mentees in the clinical journal. Another objective is to evaluate the learning effectiveness of the student nurses who participated in the mentoring program at the Jackson VA Medical Center. 4a. In order to analyze the learning perceptions of the nurses, conduct an evidence-based literature review on appropriate questions of an assessment tool.   4b. Review the prepared draft with the mentor and the clinical nurse researcher.   4c. Consult the procedure of developing an assessment tool for the evaluation of the effectiveness of the mentoring program with the mentor and the clinical nurse researcher. 4c.   Develop an assessment tool not only to assess the efficacy of the mentoring program in meeting the academic needs of nurses but also to review the results of the learning process.   4d. Evaluate the results by consulting the assessment report with the mentor and the clinical nurse researcher.