Alliance Boots Pestel Analysis Business Essay

Alliance Boots Pestel Analysis Business Essay The global pharmaceutical industry has been overwhelmingly changing in the last decade creating rigorous globalization and increased competitiveness. The global market shares are creating new challenges for pharmaceutical companies strengthening the consolidation of the world pharmaceutical industry through alliancing and acquisitions as a strategic orientation for global pharmaceutical companies. Many global companies including pharmaceutical believe that alliance will not only create awareness but will also create successful strategic collaborations capable of creating more global interaction opportunities and integration with other markets. The aim of this report is to explore Alliance Boots future strategic directions. Organisation Background It is a multinational company with strong recognition and reputation as one of the leading pharmaceutical and beauty companies in the world. Alliance Boots revenue is more than  £22.5 billion in excess; it also has various outlets in more than 20 countries. Alliance Boots core areas of business are pharmaceutical and beauty, formed in 2006 as a merger Boots Group and Alliance UniChem and recently a global merger with Walgreens. The company main purpose is to help its customers to look and feel better than ever, by providing exceptional customer and patient care with great value for its customer. Product brands Alliance Boots Pharmaceutical Wholesale Division is experiencing a rapid growth and global sales; the company believes that its product innovation and development competences are some of the resourceful factors, which enable the company to develop new and existing products for global consumption. Some of these products are, No7, Soltan and Botanics, 17, Almus and Alvita that were successfully launched in recently. Organisation Structures Alliance Boots have over 185,000 employees and numerous pharmaceutical outlets. The aim of the company is to work closely with manufacturer of pharmaceutical, beauty and health products and use experienced pharmacists to provide services to their customers. Alliance Boots headquarters is in Zug Switzerland. Alliance Boots Strategy Options It is important that when a global business organisation wants to adopt a sustainable development strategy for its products and brands, such strategy needs to be applicable across a wide range of different product types, also has to be flexible to cope with the rapid turnover of products. Alliance Boots also believe that: The strategy also has to be robust so as to be able to cope with the main three routes by which products are introduced at Alliance Boots(own manufacture, third party supply of Alliance Boots brands and proprietary brand). Its strategy must provide leadership on where and how improvements and such improvement must be commercially successful. Marketing strategy Alliance Boots believe that by putting its customers first for all its pharmaceutical and beauty products with outstanding quality and service at a competitive cost will help the company to achieve excellent profitable margins in the global competitive market. Its unique strategy will also help Alliance Boots with continue profit growth through a balance of strong global sales growth. Ansoffs Matrix Ansoffs Matrix is a unique marketing tool, which provides strategic choices to business organisations in order to achieve the objective for growth. Ansoffs Matrix has for main categories namely: Market penetration: Market penetration creates a good avenue for a company like Alliance Boots to sell existing products into existing markets. It is important for Alliance Boots to continuing promoting its product with the new features and good quality .This is helping Alliance Boots to invest heavily and focus more on research and development in new market research creating more distribution channel. Market development: Alliance Boots uses Market development as a growth strategy to sell its existing products into new markets, including new geographical markets; for example product exportation to a new country. It also includes new product packaging new distribution channels (e.g. Boots Pharmacy stores across UK and selling via e-commerce and mail order). Its ability to target new market makes Market development a unique strategy. Product development: Alliance Boots uses Product development as growth strategy creating a unique avenue for its business to introduce new products into existing pharmaceutical markets with great expectation that they will gain more customers and market share. Such strategy may involve the development of new capabilities and requires Alliance Boots to develop modified products, which can appeal to existing markets. Diversification: Alliance Boots Diversification strategy allows the company to diversify easily to another geographical market. In 2012, Alliance Boot acquired Nanjing Pharmaceutical Company Limited; Nanjing has a strong market position and operating distribution centres in 12 cities and across eight provinces in China. Such diversification into China Pharmaceutical market now makes Alliance Boots, as the largest shareholder is Nanjing Pharmaceutical Group Limited creating new products and opportunities in the Chinese market. Alliance Boots SWOT Analysis Alliance Boots Swot analyses are: Strength: Alliance Boots has an excellent and long-standing relationship with all its customers. The company also has a strong historical reputation for all its quality, using nectar card to gather customer intelligence. Availability of Boots Pharmacy stores everywhere in the UK and Europe. Weaknesses: Due to strong competition with other pharmaceutical companies in the global market, Alliance Boots is struggling to cope with the increased competition in the market. Opportunities: Alliance Boots continue to use the internet opportunity to keep increasing its presence by using online shopping to transact with its domestic and global customers. Using it retail stores advantage across the global market such as Boots Pharmacy to create the right products with right combination of price and promotion to achieve the firms aims of long-term growth. Threats: The major threat to pharmaceutical industries including Alliance Boots is the government higher tax on the price on medicine that Alliance Boots and other retailers must deal with. Porters Five Forces: The five forces of Porter can be used to make an analysis and attraction of business organisation structure as follows: Supplier Power: It plays important role in competitive force, more suppliers one can greatly increase y bargaining power with these suppliers. For example, Alliance Boots successfully bargained with over 80 suppliers to lower prices of some of the drugs they sell over the counter in 2007. Buyer Power: Increasing customer loyalty is a way of reducing the power of the buyer, the introduction of nectar card by Alliance Boots is a way to reward its customers. Because of this, it allows the buyers to save considerably. It also allows Alliance Boots to capture useful information and monitor consumers purchasing habits. Threats of New entrants: There has been huge increase in the number of new entrants in the pharmaceutical marketing making difficult for Alliance Boots to expand in the way the company wants. For example, Tesco is planning various new supermarkets across Britain that would restrict Alliance Boots ability to expand. This poses a real threat, which means that Alliance Boots need to change its marketing strategy with possibility of reducing prices through advertising. Threat if substitute: In order to save money many businesses may decide to outsource their products and service to another company at a cheap cost. Alliance Boots did not outsource its products and services; instead, the company IT department was able to make changes in the way customers pay for their products by replacing its traditional till machines to touch screens capability giving customers a faster way to shop on their own. Competitive Rivalry: This affects many businesses in terms of price competition and products identification. For example, other rivals in the business like Lloyds Pharmacy, Superdrug are expanding rapidly. Because of this, Alliance Boots are constantly improving its stores marketing strategy making its products more affordable and available everywhere in the UK and continue to provide outstanding customer service. Alliance Boots PESTEL Analysis Political Factors: Various political decisions can have a huge impact in the business operate and its performance. For example the impact of government UK policies on the business allowing some major supermarkets to open numerous pharmaceutical stores within their stores. The government believes that such policy will increase NHS services and improved healthcare. Such move will not help Alliance Boots, instead, it will create a huge competition, which will eventually make Alliance Boots to lower its products prices and operate for longer hours. Economic Factors: The global economic recession is badly affecting every business sector including healthcare, with many businesses suffering. There has been a huge increase in the prices of global healthcare affecting the way customers spend and how much they want to spend in buying healthcare products especially Beauty products. In addition to this, the rising fuel costs also have a huge impact in the supply chain channel of Alliance Boots leading to an overall price increase increasing prices and passing over the cost to consumers. Social Factors: the prices of its The social factors is creating more awareness about how everyone should take care of himself or herself through, exercise, eating habit, type of food that is good for the body and many more. For example, government campaign that is promoting healthy eating (eatwell.gov.uk 2012 online) as a result in the rapid increasing level of obesity within the UK (Department of health 2012 online).Such information is boosting Alliance Boots sales by encouraging its customers to try its healthier products at a cheaper price than other companies. Technological Factors: The evolution of internet is helping online retail sales, Alliance Boots is making use of the internet technology to its advantage with internet is now generating more than a third of all revenue for Alliance Boots products and services. Alliance Boots Centre for Innovation is investing hugely for the development of inventive products and technologies that focus on: Ways to diagnose treat and monitor key aspects of health, beauty and wellbeing. Providing positive support to ageing products and working very hard to produce new products. Environmental Factors: Many countries are now committing to green energy ever than before due to the risk of global warming is becoming a reality, Many companies like Alliance Boots have been told to play key role in reducing carbon footprint and increasing energy efficiency (Bream 2008). Because of this, Alliance Boots will have to invest more on greener products (selling of organic healthy product) and reducing their impact of carbon footprint on the environment. Legal Factors: There are various legal issues that are facing the way companies operate globally, for example, Alliance Boot Cases include application to European Court of Justice in sex discrimination case of Neath versus Hugh Steeper Limited. New laws keep emerging everyday especially on healthy product and drinks, which mean Alliance Boots will have to be more cautious about it packaging and labelling policies, which will be extra financial liability on the Alliance Boots. Globalisation Drivers The drivers of globalisation can be classified into Market Drivers: Increasing travel create global consumers Growth of global and regional channels Establishment of world brands 2. Cost Drivers: Fast-tracking technological innovation Transportation and distribution channel 3. Government Drivers Reduction of tariff barriers and non-tariff barriers Privatisation in previously state-dominated economies 4. Competitive Drivers Strong rise in global strategic alliances with other companies. Rise of new competitors with intension of becoming global competitors Future Strategic Partnership Walgreen Co., US largest drug store chain is the latest future strategic partnership and direction that Alliance Boots is taking. Under this new strategy, Alliance Boots and Walgreen Co are bringing together the strengths and proficiency of both companies to create the first global pharmacy-led, health and wellbeing enterprise. Recommendations In order for Alliance Boots to maintain its global presence and continue to be one of dominant forces in the Pharmaceutical companies, the following are the vibrant future strategic direction that Alliance Boots must take for its business. Delivering of new innovative medical research using the next generation technology. A new global approach to marketing by sponsoring various events related to wellbeing of Alliance Boots customers. Expansion of general merchandise ranges which in return will create sales with greater growth potential and effectiveness. Conclusion In conclusion, strategic management with a dedicated market focus is a driver to build a successful future globalization and merger processes of pharmaceutical industry. The greater the strength of the competitive drivers, the greater the tendency for an industry to globalise. Alliance Boots continues to internationalise its key product brands, selling them to distributors, independent pharmacies and retail partners including online shopping sites globally.

Express and Courier Industry

Global express and courier industry overview Introduction The primary business of the express industry is the delivery of time-sensitive shipments, typically with a transit time of two to three days. These are delivered mainly by air and ground. The industry has been witnessing significant growth as a result of the constant rise in demand for express and courier services over the last decade across user industries, including manufacturing, pharmaceutical, financial services and high-tech sectors. In the last decade, the advent of e-commerce business models and their subsequent penetration along with increasing demand from the financial services sector contributed to strong industry growth. Most companies provide an additional range of activities besides pure transportation, including online tracking of shipments, online payment collection and insurance facilities. However, in recent times, the industry has witnessed a deceleration in growth as a result of rising fuel costs and reduced demand from user industries due to the global economic slowdown. Major players Traditionally, due to low demand and high costs of operation, the express industry has been dominated by national postal departments. While some of them still continue to be dominant in their respective national markets, others have evolved into larger regional and global players with multi-modal operations such as Deutsche Post World Net (which also operates DHL) and La Poste. Globally, the industry is dominated by the big four — Deutsche Post World Net (DHL), FedEx, United Postal Service (UPS) and TNT, all of which have strong multi-modal arms with worldwide operations. Key markets The US is the single largest market for express services, followed by Europe and the Asia–Pacific region. In recent years, the Asia-Pacific region has experienced tremendous growth, largely attributed to increased demand for express and courier services in China and India as well as sustained demand growth in Japan, Korea and Australia. Strong economic growth and increased international trade due to manufacturing outsourcing from the western countries has particularly resulted in the fast-growing demand for express and courier in India and China. Key challenges Rising fuel prices: Rising fuel costs have been the biggest concern of the express and courier industry globally over the past two years. Rising fuel costs have affected the industry directly via an increase in input costs and also indirectly by hampering growth prospects due to decreased demand from user industries. Environmental concerns: As part of the transport industry, the express industry has also come under renewed pressure from both environmental groups and governments to lower its carbon footprint. Environmental laws have necessitated increased usage of vehicles run on alternative fuel to transport and deliver shipments across the globe. DHL, UPS and FedEx have begun to deploy vehicles run on alternative fuel for deliveries and collection, especially in the mature US market. Outlook Over the past two years, the global express market has been reeling under the pressure of rising fuel and transportation costs and decrease in demand from the western countries. However, demand for express services is set to rise over the medium term with sustained growth of the Chinese and Indian economies. Over the longer term, the industry is expected to witness the emergence of large integrated players in the emerging markets of China and India. The market is expected to witness consolidation activities and a shift toward third-party logistics (3PL) and fourth-party logistics (4PL) players.

Life is Beautiful

Life is Beautiful Sooner or later everyone wants to find an answer what he or she lives for. The majority of us is trying to understand the meaning of human life. During thousands of years the mankind tried to answer the question, what the meaning of life is and what life itself is – pleasure or suffering. As concerning the meaning of life, every person should execute his or her own program. Since programs for all people are different, the meaning of life is different as well. All people want to find marital happiness, experience true love, have reliable friends, etc. Life is really beautiful, because we are masters of our fate and creators of our happiness. We should take certain decisions that change our destiny in one way or another every day, every hour, every minute. The true purpose of life is to do as many good deeds as possible. The main protection for any person is kindness of the soul. And our main goal is not to hurt anyone, either directly or indirectly. The meaning of human life is to give love, kindness and warmth, receiving joy, smiles and human gratitude in return. We must be tolerant and kind to others, love this world, enjoy each passing day in order to be happy not only when receiving something, but sharing something as well. Take a look around life is beautiful! Love this world, love all mankind, love all creatures! We are here to live our life with dignity. Always remember that all difficulties are only tests to be endured and make us stronger. Only we can decide how to live. And only we are able to realize that life is beautiful.

Essay on Abortion Policy - 4189 Words

Abortion Policy Abortion is one of about six major issues that the public considers when voting (Witwer). It is a complex issue that has been passionately debated for centuries. The various methods used to carry out the procedure range from disassembling the fetus and crushing the skull in order to suck it all out of the woman’s womb to the procedure called RU-486, that gives the woman a pill to prevent her body from giving the fetus the nutrients to stay alive. Also, some consider certain forms of birth control, Norplant, IUD, and emergency contraceptives to be abortions as well. Many people argue about when in the pregnancy abortions should be allowed, if there should be an age limit, if abortion should be allowed only in certain†¦show more content†¦(Wlezien). Those in the pro-life group are typically much less educated, poorer, conservative and Christian. Organizations such as the NARL (National Abortion and Reproductive Rights Action League) and Choice USA are a few of th e pro-choice groups (Wlezien) (Luker, pg.3). Public opinion presents an important part when deciding a stance. Class, location, beliefs, age, and political affiliations contribute to the difference of opinion among people. According to an article printed in Political Behavior, authors Wlezein and Goggin suggest that public opinion on abortion varies little through the years with a large increase in the 1980’s that resulted in the majority of the public being in favor of abortion â€Å"as it is now† (Wlezien, 381). Since the decision of Roe V. Wade in 1973, approximately 23% of adults believe abortion should be legal in all cases, 19% believe it should be illegal in all cases and a majority of 56% believe it should be legal in some cases (Wlezien, 381). Wlezein and Goggin conducted a general social survey that indicated that an overwhelming majority of at least 81% proved that a legal abortion should be possible if the woman’s health is seriously endangered by the pregnancy, if she became pregnant as a re sult of a rape, or if there is a strong possibility of a defect in the baby (Witwer). Though this data is from 1989, a poll conducted in 1999Show MoreRelatedPolicies in Relation to Abortion4374 Words   |  18 PagesPolicies in Relation to Abortion Before and After the Roe v. Wade Supreme Court Case New Mexico State University Jennifer Walker Abstract The Roe versus Wade Supreme Court Case has had a huge impact on abortion laws in the United States. Before 1973, abortions were illegal and criminal, with few exceptions. Overnight, the decision in the case legalized first trimester abortions while leaving the specifications of the other trimesters up to the states. This case has led to many debates overRead More The Shift in Abortion Policy in the 1800s Essay5421 Words   |  22 PagesThe Shift in Abortion Policy in the 1800s In 1800 no jurisdiction in the United Sates had enacted any statutes whatsoever on the subject of abortion... Yet by 1900 virtually every jurisdiction in the United States had laws upon its books that proscribed the practice sharply and declared most abortions to be criminal offenses (Mohr p. VII). Societal Changes from the Early 1800s to the Mid 1800s During the early 1800s, abortion at the beginning of a pregnancy was neither immoral nor criminalRead MoreThe Issue Of The Abortion Policy Essay1966 Words   |  8 Pages The topic on the issue of the abortion policy is one that has been around for decades. This topic is one that has caused great controversy throughout the course of history, prompting individuals to side either, pro-choice or pro-life, allowing little room for any gray area. 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For example, in 2009 with President Obama on Friday repealed the Mexico City policy, a controversial Reagan-era measure that withheld funding toRead MoreShould Abortion Be Legalized?1685 Words   |  7 PagesToday many people are against women having an abortion, no matter what situation they are in, the point of women having their own rights should include whether they choose to have their own kid or not. The United States today is very divided on the whole abortion issue, typically republicans are against it calling theirselves â€Å"pro-lfe† and democrats are typically for abortion and they call theirselves â€Å"pro-choice.† Abortion had been practiced in the United States ever since 1880, but it wasn t

Mental Illness And Its Effects On People s Mood,...

Mental illness, a medical condition, are disorders that can affect people’s mood, thinking, and behavior. Many people don’t pay much attention to these disorders, because they are not familiar with psychiatric illness. Not paying attention to detecting and treating mental illness is an issue, because it can increase the risk of violence more than treated mentally ill people. For example, the failure to treat the ill can have dire consequences because it can increase the risk of mass shootings. Being able to recognize the signs of mental illness is important to help prevent incidents because most people are not informed well and don’t recognize the symptoms of mental illness on time, which can be very risky to the community. Although many crimes could be linked with mental health issues, not all mentally ill are dangerous. Although it is considered a myth by recent discoveries, many people believe that all mentally ill people are dangerous. The majority of people fear mentally ill people because they relate the mentally ill with school massacres and shootings. For example, when the Virginia Tech massacre happened many people started proposing gun policies to prohibit guns from people who had any sort of relation with mental illness for fear of another lose mad man. According to a survey a national public opinion survey that tested the public attitudes about mental illness, Overall and among People with and without Experience with Mental Illness, â€Å"Almost half of respondentsShow MoreRelatedSymptoms And Symptoms Of Multiple Personality Disorder773 Words   |  4 PagesAs an overview, schizophrenia is a brain mental disorder. A schizophrenic person has lost touch with reality. They may also experience hallucinations, delusions, hearing voices, seeing things that are not there.They may believe that other people are threatening to harm them. Sometimes they don t make any sense when they talk. 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Ethics of Doctor Assisted Suicide Free Essays

string(41) " it will be time to decide on the means\." One of the most hotly debated topics going on now is the one concerning the ethics of assisted suicide and euthanasia. Nowadays with all the progress that the medical profession has gained, people who are terminally ill have more options, and there have been continued efforts to give them the â€Å"right to die† when they choose this option. I was interested in researching this topic because I think the debate has a lot to do with politics. We will write a custom essay sample on Ethics of Doctor Assisted Suicide or any similar topic only for you Order Now This dilemma has been hotly debated and I was open to seeing how this movement was progressing. In the beginning, I was a proponent on this issue, and believed people should not be denied their wishes when they wanted to end their pain. However, I was open to learning more about the opposite stance and what the reasons for opposition were. It always seemed unusual to me that suicide was not illegal, but it was illegal to assist in one even with a consenting party. I wondered how this could be, and how people could deny people this right in unending pain. There never seems to be a prosecution of doctors who participate in these acts, even though they frequently go to court. I wondered why this occurred and what the laws really said regarding this. I also wondered how people distinguished between forgoing medical interventions and actually assisting in the suicide. As I approached the research, my main questions were regarding the opposition. I really did not know all the problems that could occur. Research about this brought to light many things that are not discussed in the media, although this is a highly publicized subject. I found that it is very difficult to end the debate because all the arguments are just matters of opinion. Opposers and protestors have good arguments. No one really knows what would happen, so opinions are used to predict it. Since all the media attention, I will try not to discuss the many things that are already known. I found myself intrigued at what I did not know, and found my views profoundly affected. After reading current articles about what was going on legally and about cases, reviewing the history of this topic, and reading books showing the two opposing viewpoints, I have made my conclusions. I will show how people are currently handling this and how they are being viewed. I will discuss the main arguments on both sides. Finally, I will show what I concluded from this and how my views have been altered by information that I did not know before. I will begin by explaining how the terms are defined. Euthanasia derived from Greek roots and means â€Å"good death. † Active euthanasia is a direct and deliberate intervention to kill the patient. It is â€Å"intended to end the life of the competent, terminally ill patient who makes a fully voluntary and persistent request for aid in dying. † Voluntary euthanasia takes place when the patient requests the action and it is involuntary if the patient is not mentally competent enough to make the right choice. Passive euthanasia is withholding treatment from a patient. A physician-assisted suicide occurs when the patient does the actual act, but the physician provides either enough information or the means to do it. One source defines it as a â€Å"desperate measure, justified only in exceptional cases where every effort has first been made to care for a dying person by other means. † The terms euthanasia and physician-assisted suicide usually are used for the same thing and are not generally distinguished from one another. Typically the means of suicide is lethal doses of a poison such as pills, an injection, or gas. Motive causes euthanasia to be distinguished from murder, because its intent is merciful and is done out of kindness. The physician’s intentions can make considerable differences concerning how their act will be classified. The most common reason for a patient to want this aid is a terminal illness. Unbearable suffering has caused the person to become intolerant of the physical and/or emotional pain. The other reason is a physical handicap that is debilitating and the patient would rather die than live with it. Most people are able to cope with this, but in some cases, it is impossible for the patient to do so. In ancient times, euthanasia was encountered often. However, suicide was condemned. During the sixteenth century, some people began to see it as more of a personal choice. It eventually became decriminalized, but assisted suicide and euthanasia are still crimes in most countries. The introduction of powerful analgesics caused a rise in the interest in the â€Å"right to die† movement. It was advocated in the late 1800’s, and has been a topic for debate since the early 1900’s. Doctors have been helping patients die for centuries. Some cultures today have people that will stop eating and wait to die when they become seriously ill. The â€Å"right to die movement† is encouraged by several factors. Modern technology has come along to extend human life. The fear of the dying process is of great concern to some people, especially when it accompanies physical and psychological suffering. Patients are becoming more in charge of their own fate and have more of a voice. Finally, there is a concern about the high health care costs. They cost more than 60 billion annually, and 1/3 of Medicaid payments go to patients in their last year of life. Medicine’s main goal has always been the preservation of life. Now, this is being challenged in an attempt to change it. The two sides of the issue are being debated. On one side are the people who think it is not a physicians place to kill a patient, because he/she should only help, not harm. The opposition thinks that suffering is the real harm. The debate comes at the point of the onset of the terminal illness, when it will be time to decide on the means. You read "Ethics of Doctor Assisted Suicide" in category "Essay examples" This is sometimes called the â€Å"Kevorkian moment. † Proponents give examples of people who could be helped, while opponents give counterexamples of people who may be harmed. There are many moral and legal considerations. The support for a physician’s participation is increasing. According to opinion polls, about 60% of people in the U. S. are supporters. About 15% of physicians practice it when it is justified. It is actually impossible to know for sure how much takes place because incidents are usually kept secret to avoid prosecution. Most people who have reported that they would consider it give reasons such as that they would not want to be a burden, would not want to live in pain, or would not want to depend on machines or others. The main argument for the support of euthanasia and physician-assisted suicide is that people should have the right to control their life and death, and should be able to end their lives when they wish if they are suffering needlessly. It is argued that it is a private choice and society has no right to be concerned. They usually portray it as a case of individual liberty. One source states â€Å"euthanasia, if legalized, would be the ultimate civil liberty, since it would secure the freedom to determine and to control our own death. † Physicians must then decide if they are willing to take part in either directly killing the patient or by assisting the patient in suicide. The physician should follow the demands of the patient, even if it means killing them, because that would respect their wishes and the rights of the patient. Physicians treat patients with the purpose of restoring health. If the patient can’t be restored to a reasonable level of living, it shouldn’t be wrong to discontinue it. Euthanasia supporters often try to get sympathy by relating stories to make one feel like suicide is the only option in their case. The media has sparked a lot of interest, and continues to show stories like this. Simi Linton, psychologist, says, â€Å"I’m disturbed at how the media treats it, as: here are these poor folks; let’s help them end their lives† (qtd. in 1). It makes it seem as if would be inhumane to deny anyone this option. Basically, it is the quality of life that is the main concern of the patient. They may feel that life is not worth living in their state. It would not be humane to insist that every means be taken to keep someone alive. A physician’s main concern is to relieve suffering, so sometimes there is only one way to achieve that goal. At the time that efforts are no longer doing any good, the main concern is to make the patient comfortable and alleviate symptoms such as pain. Drugs do not always get rid of all the pain, especially when it is excruciating. Sometimes a patient will be drugged into unconscious with severe pain that cannot be controlled. This does not seem like effective pain management to me. I do not believe people will be satisfied living in such a state as that. They would want to be put out of their misery. Legalization would cause many changes. It would give rights to the person who does it, rather than the person who dies. It is about the right to kill, rather than the right to die. 9 Physicians would need to be trained in more areas regarding this, such as information about medications and dosage, and about the mentality of the patient. They will need to gain expertise in understanding patients’ motivations for requesting it, assessing their mental status, diagnosing and treating depression. The medical profession is developing greater expertise in managing terminal illness but would need to develop similar expertise in responding to requests for physician-assisted suicide. The debates over assisted suicide have forced clinicians to be more aware of what can be done to relieve suffering. Doctors are improving palliative care and their own behavior. Patients are becoming more aware of their options. The problems associated with legalizing assisted suicide are usually not talked about when the proponents make their argument. The discussion of the potential for abuse, the ways it could be prevented or better helped are put on a backburner. The main argument against legalization is that human life is sacred, and it is not a human right to take it away. Some say that there is no need for suicide, because health care should resolve all problems and pain management has come a long way. Most people who commit suicide suffer from depression, so it is often debated whether this could be the reason for someone wanting assisted suicide. Often, when their depression is treated, the patient responds well, and would like to live. A regular physician cannot make the determination of whether a patient is suffering from depression. This is something that is difficult to diagnose in terminally ill patients. Just because a patient request suicide does not mean this will be an appropriate solution. Sometimes, a patient may even request suicide, but when the time draws near, they change their mind because it did not seem so imminent before. The will to request the suicide must be voluntary, but this decision is left up to the physician. How can a physician judge whether it is voluntary or not? It is also difficult to determine what terminal is. When people say that it should be reserved for people who are terminally ill, they cannot define it. It is used to mean someone whose death will occur in a relatively short time. Some people may say that if they will die in 6 months it is considered terminal, but it is difficult to determine exactly how long someone has to live. They may live much longer than that. A person could also be terminal who is in a vegitative state, but will live for years in that state with continued medicine. People cannot reach an agreement on what the definition of terminal would be, some even say old age is terminal. Marianne Smith, Program Development Director of the Death with Dying National Center defines it as â€Å"an illness in which there is no chance of recovery and that death is imminent. â€Å"15 Activists of euthanasia use the demonstration that suicide is the only means to control unbearable pain. Most pain is supposed to be able to be eliminated, or greatly reduced. Many people do not get enough pain control. 6 One reason is the underknowlege many physicians have about this, and that they are afraid the patient will become addicted. Also, too much pain medication can cause symptoms that may be worse than the disease was itself. One source says that â€Å"patients and physicians alike may be unaware of the options available in the medical system, including advances in pain control that could help patients but are not routinely provided. â€Å"3 There may be no solution to these problems, but some things can be done. Better health care education, more access to health care, and informing patients of their rights. 6 Everyone has the right to pain relief. Patients should get adequate health care, and not killed. Physicians argue that if good care of the dying is being provided, then a request for suicide would be rare. 4 Some patients may want to consider suicide, but are incapable of administering medicine. Some people may also lose their mental capabilities, and will be unable to request it. It is difficult to assess fairness in cases like these. Some people use a form of advance directive and make their request before deterioration occurs. It is hard to extend the same rights to all patients without causing abuse. If someone is unable to communicate their request, it would be frightening for someone to make that decision for them and to say that their life is not worth living, so we must kill them. There is great potential for abuse if it were to be legalized. Depressed people, elderly, and very frightened people would be greatly affected. People may feel pressured into giving up. Elderly are especially vulnerable to this. Now that there are more people living longer, this problem will increase. They may tend to feel they are a burden on their families, or are selfishly consuming resources. If a physician advocates it, they also may be swayed. People may also feel distrustful of the physician’s advice. This may cause a hardship in getting appropriate care. 10 Legalization will only encourage more people to take part in it. It does not seem as if we would be ready for this to occur, because we are only just beginning to explore some realms of the medical world. It took a long time to figure out about adequate care for many patients and when is the right time to withdraw life support, so it would not seem that we would be ready for this step. The â€Å"slippery slope† argument is used by opponents, saying that legalization will lead to involuntary euthanasia. My own opinion is that if assisted suicide were legalized, we may not be as inclined to advance medical progress and knowlege. It would seem easier to just put the patient out of his/her misery. They may not use their experience to increase what we know about medicine and learn how to help the illness, or better cope with it. Proponents have said that euthanasia should be considered â€Å"medical treatment. † If this is so, there could be great potential for abuse. Then it may be more likely to be administered to people who cannot make the request. Some decisions that have gone to court say that assisted suicide is a constitutional right and that someone else can make the decision for the patient. If direct killing can be legalized by someone else, someone who is not competent could be euthanized without ever expressing that wish. It seems to be inevitable that patient are going to be killed without permission if legalization occurs, even with rules about consent. The main argument of how abuse of the practice could occur is called the â€Å"slippery slope argument. † It says that â€Å"even if particular acts of killing are sometimes morally justified with particularly pain-ridden patients, sanctioning practices of killing would run serious social risks of abuse, misuse and neglect. 3 The bad consequences of legalization would occur over time as this practice became more used. Another potential form of abuse lies in the fact that it would be cheaper to euthanize a patient than to continue medical treatment. It is thought that it could become a means of health care cost containment. Some of the main supporters of euthanasia are people concerned about lowering health care costs. 6 Religion has caused many people to debate it. Most churches are adamantly opposed to the idea of suicide. However, some Christians believe that God would not want them to suffer. 9 Although most religions and churches disagree with intentionally killing a patient, many people who hold this stand will allow the withdrawal of life support. It is believed that there is a difference between killing and letting die. Someone who is against euthanasia may agree with letting someone die who is being kept alive solely by life support that is not really helping them. 3 People feel that the intent in these cases is different. The more accepted approach does not involve killing. One interpretation of the difference shows that the intent is different because actively killing is aiming at death, and withdrawing support simply accepts that we are limited to help the dying and cannot reverse the process. 8 However, some peole believe that since death is the outcome no matter what, there is no moral difference between them. Another matter of intent distiction regards what is called the â€Å"double effect. † A physician will administer a pain medication to relieve pain, but knows that it may cause death. The patient would be in pain without it, but it may cause death if it is administered. It is usually believed to be moral if the doctor’s intent is to relieve the suffering, and not to cause death. It is allowed if the death is foreseen but not intended, because it is the intent that makes it wrong. Although suicide is no longer a crime, giving assistance in it is, everywhere except for Switzerland, Germany, Norway, and Uraguay. In Australia, a law was passed that allows terminally ill patients to ask for assistance by injection or taking drugs themselves. 7 There is a debate about it because Parliament wants to overturn the statute, which is the world’s only voluntary euthanasia statute. In the Netherlands, it is actually a crime, but it has been ruled that physicians may assist in death under certain conditions. Some of these are that the patient must be ruled competent, and two doctors must conclude that the patient has less than 6 months to live. 8 The United States has used them as an example to see what would happen if it were to occur here. They are having problems with it, mainly with abuse. The physicians there have reported that the main reasons people request it are â€Å"low quality of life, the relatives, inability to cope, and no prospect for improvement. 0 Some sources show that people are requesting it for physical symptoms that it is almost ridiculou that they would go to such an extreme measure for. I think that the potential for abuse here may be great, because it is getting out of hand over there. People are becoming afraid to go to hospitals because euthanasia is becoming so commonplace. It now accounts for 15% of deaths. 1000 unconsenting deaths occur each year. 1. In 1994, the state of Oregon passed a ballot that gives limited physician-assisted suicide legality. This makes it the first in the nation to do so. A doctor must determine the patient has less than six months to live. A second doctor must decide that they are mentally competent and not suffering from depression. The patient must request it in writing with two witnesses, and then 48 hours before the doctor delivers the prescription the request must be repeated orally. 1 It must be a voluntary act. However, those jugements are left to the physician. So far, it has never been put into action. Other states are considering similar legislation, such as California which has proposed a law that is similar to the guidelines that the Dutch have adopted. Lawsuits in Washington State and New York were ruled by the 9th and 2nd U. S. Circuit Courts of Appeals that laws prohibiting physician-assisted suicide are unconstitutional. The legal fate will be determined by the Supreme Court. In 1990, the decision of Cruzan v. Missouri Department of Health resulted in people having the right to avoid unwanted medical treatment, including food and water. 5 It recognized the right to terminate unwanted medical treatment even when death would be the result. 14 People often use the Constitution as a basis for argument. The 14th amendment prohibits the state from depriving â€Å"any person of life, liberty, or property without due process of law. † So to deny a dying patient medical assistance when requested is to â€Å"threaten this patient’s request for help is judged denial of constitutionally protected due process. â€Å"4 As the courts were in session to hear a case about whether terminally ill people have a constitutional right to physician assisted suicide, demonstrators sang and picketed outside a Supreme Court building. The emotions of the rights issue has been compared to that of abortion. Both of these issues dig into whether we have the right to choose such personal issues. People can feel very strongly about the issues of mercy killing, whether they oppose or support it. The lack of laws cause people to avoid prosecution for assisting in a suicide. Kevorkian has escaped prosecution because there is not a state law prohibiting it, according to a Michigan judge. 9 People are afraid that activities such as his would become widespread if assisted suicide were legalized. His actions have been opposed not because of the assistance, but because he had no real relationship with his patients and had not given them any kind of clinical evaluation. Many were also not terminally ill. 3 It seems to show what is lacking in the medical sysytem, or what could become of it. Every case of assisted suicide is not convicted or prosecuted, even in states that make it illegal. However, the fact that there are many landmark â€Å"right to die† cases, shows that the law is commited to the prohibition. However, the procedures are not described as killing. If this were the case, the act would have to be justified similar to killing someone out of self defense. 4 It is hard to define the conditions that there must be in order to make it legal, because there is so much that we do not know. For euthanasia to be ethical, there must be certain guidelines. The person must be a mature adult, and has been shown to be mentally competent and willing to make the decision. Some medical help will have already been given, and it should seem that the fight is hopeless. 9 Many organizations have beliefs on this and they try to educate the public on euthanasia and what their views are. I contacted Marianne Smith, the Program Development Director of the Death with Dignity National Center. 15 She explained to me in e-mail how the organization feels about euthanasia and what they do to educate the public about it. The organization is working toward better health care for paients. She feels that assisted suicide should be legal, but that â€Å"physician-assisted dying should be the response of last resort,† and â€Å"when all other options fail to relieve unbearable suffering, when the patient is acting on his or her own initiative, is not clinically depressed, and is capable of administering the medication personally. The people who could be elgible are â€Å"only terminally ill, competent adults with decisionmanking capacity. † I also asked whether euthanasia could be avoided with adequate pain medicine. Her response was that â€Å"Physicians, medical associations and hospices all have stated that not all pain can be controlled. † Their view, which is one I encountered a lot, is that the medical professionals have not been trained adequately in pain management. Regarding the issues of potential â€Å"slippery slope† abuse, she says that physician’s aid in dying is more common than people realize, and legalization would just make it happen openly, instead of secretly. However, the state regulation should provide strict guidelines and penalties for violations. I think that it is hard to make sure that the decisions are correct, so it should be carefully thought out. We are dealing with a very serious issue, which is death. It should not be an easy decision to make or to carry out. Becaue death is the consequence, the decision to kill oneself, and carrying it out should be very difficult and carefully thought out. This would help ensure that people have thought about it enough and know that this is the best decision. I don’t know how a solution can be thought of to deal with the debate, but things such as more health care education and informing patients of their rights should be a consideration. I hope that if legalization ever were to take place, that they would carefully restrict who qualified for euthanasia. After all my research, most of my questions have been answered. It is difficult to come to a conclusion because there is no right or wrong answer. I don’t know how anyone can determine what should be done. Who can put a price on life and say who has the right to die? The basic choice is whether to let doctors help people die, and if so, how? I have found many great arguments either opposing or protesting this issue, which has led me to my conclusions. When I began this paper, I dove into it thinking that I was going to condone the idea of assisted suicide. I knew I could convince someone that it should be the moral and legal thing to do. I could not imagine a life without the ultimate choice or having to endure great suffering. I was going to defend this side, but also show the opposing side. Once I got into the research, I found many facts that I had not known before about why it has not yet been legalized. Many questions and opinions showed me that there were things I had not even bothered to think about before. What a surprise to me that I could begin a project as a supporter, and then turn around my views. I now see where the opposers are coming from. There are just too many problems and considerations to think about before this could ever happen, and there are alternate solutions. I cannot say that this has given me a complete turn in the opposite direction, but I am definitely leaning toward the opposing side except in extreme circumstances when nothing could ever help the patient. 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In brief the NAI Policy Dialogue questions the World Bank recommendations for large scale agriculture to solve the productivity and equity problems in African agriculture. The whole issue of property rights is intimately linked to the question about agriculture and development. The contribution by Benjaminsen and Sjaastad on aspects of property rights formalization in Africa draws on recent processes in Mali and Tanzania. A general conclusion is that the formalization of property rights in rural areas is a very complex and problematic issue.There is a high risk of the process being co-opted by officials and a wealthy elite, if necessary provisions are not made. Finally, Kjell Havnevik draws our attention to the relationship between inequality and climate change. This contribution is based on a presentation he made in Berlin in June 2007. Decoding the evolving China–Africa relations is the theme of an article written by NAI Research Director Fantu Cheru. We will write a custom essay sample on China in Africa or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page He suggests that policies and programmes to deal with the present imbalances between China and Africa require us to revisit and redefine the NEPAD agenda.A regional approach will, in his opinion, help African countries to negotiate from a stronger and better platform. During 2008 researchers at NAI will continue to devote attention to this topic. In our interview section we present one interview with Martha Qorro, professor in English language, on the question about the language of instruction in Tanzania. She is of the opinion that the best way to teach English is not to use it as the language of instruction. She also responds to the question why the question of language of instruction has become such a sensitive political issue in Tanzania.In our second interview Jerome Verdier, chairman of the Liberia Truth and Reconciliation Commission, points to the fact that the TRC’s part of the conflict resolution is nothing new. Liberia has a history of resolving community conflicts at the round table. But in the past there were no prolonged conflicts, such as the recent 4 year period of massive human rights violation. In the research section we present the result of a conference which took place at NAI, Uppsala, in September 2007 regarding the ongoing discussions between EU and the ACP countries on Economic Partnership Agreements.The discussion at the conference highlighted the lack of connection between the poverty alleviation goal and the reality of the negotiations, despite numerous political declarations on both the EU and ACP sides. Key decisions on EPAs will soon be made by EU and A CP ministers. The Africa Europe Group of Interdisciplinary Studies, AEGIS, of which NAI is an active member, is presented through three contributions. Photo by Susanne Linderos News from the Nordic Africa Institute 3/2007 First, we bring you an interview with the AEGIS Chair, Professor Patrick Chabal of King’s College, London.