Long Term Care-Hospice Essay Example for Free

Long Term Care-Hospice Essay Hospice is a process to end-of-life care and a kind of support facility for terminally ill patients. It provides comforting care, patient-centered care and related services. Comforting care relieves discomfort without improving the patient’s condition or curing his illness. Hospice is extended in a healthcare facility or at home. Its objective is to provide compassionate, emotional, and spiritual care for the dying patient. The origin of the word â€Å"hospice† in medieval times meant â€Å"way station for weary travelers† (Perry). The first hospices were run by members of religious orders in the medieval times that cared for weary travelers whom found refuge with them until their death. Modern hospices are believed to have started in the United Kingdom in the mid-19th century in Dublin, Ireland. Roman Catholic Sisters of Charity provided a clean and caring place for the terminally ill. The name hospice was first applied to the care of dying patients by Mme Jeanne Garnier who founded the Dames de Calaire in Lyon, France, in 1842. The name was next introduced by the Irish Sisters of Charity when they opened Our Ladys Hospice in Dublin in 1879 and St Josephs Hospice in Hackney, London 1905. The practice became popular in England, Asia, Australia and Africa. It was only in the early 70s that the hospice concept was introduced and accepted in the United States through the efforts of physicians Cicely Saunders and Elisabeth Kobler-Ross. These practices included effective pain management, comprehensive home care services, counseling for the patient, and acceptance of death as the natural end of the care delivery by health care professionals, bereavement counseling after the patient’s death, and continued research and education (Wexler Frey). Quality care at the end of life soon combined with grief counseling and bereavement care. The government stepped in to contain health-care costs when reimbursement for inpatient hospitalization was significantly reduced. Home-based hospice care also became popular as a more inexpensive alternative to hospitalization or care in a nursing facility (Wexler Frey). The hospice concept was not immediately accepted by conservative health professionals. The concept emphasizes caring more than curing. It also allows interaction with complementary and alternative medicine practitioners. A hospice’s primary function or service is to enable the patient and his family to accept death as a natural part of the life cycle (Wexler Frey, 2004). In addition, it provides pain management and psycho-spiritual support and complementary and alternative therapies. Approximately 80% of hospice patients are in the terminal or end-stage of cancer. Traditional medical facilities provide pain medications when requested, a hospice administers these medications regularly and before they are needed. The intention is to prevent pain from recurring. Furthermore, the problem of addiction and other long-term consequences is not a concern in the case of terminal illness. The concern is to provide effective relief to the greatest degree possible (Wexler Frey). A second major service of a hospice is to relieve physical, psychological, emotional and spiritual discomfort to the patient’s family and others close associates (Wexler Frey, 2004). It relies on members of the clergy, pastoral counselors, social workers, psychiatrists, massage therapists and other trained volunteers to alleviate the discomfort. A hospice also provides grief and bereavement counseling and support groups to assist family members in expressing or resolving emotional tensions. And it allows the use of complementary and alternative therapies, in addition to conventional medicine, in the control of symptoms and in improving the patient’s well-being. A 2002 study conducted on the inclusion of such therapies showed that patients who received them expressed more satisfaction with hospice care than those who did not receive them. These therapies include acupuncture, music therapy, pet therapy, bodywork, massage therapy, aromatherapy, Reiki or energy healing, Native American rites, herbal treatment and similar methods intended to soothe the patient and his family and friends (Wexler Frey). A survey was conducted in 2000 on more than 9,000 patients discharged from more than 2,000 hospices on the services they received (Carlson, 2007). It revealed that 22% of them received five major palliative care services, which varied among the hospices. These palliative care services were nursing care, physician care, medication management, psychological care, and caregiver support. Approximately 14% of the hospices provided all five services and 33% provided only one or two services. Only 59% of these patients received medication management services. These included administering medication, dispensing correct dosages, and setting and following dosage schedule. Growth Projections The National Hospice and Palliative Care Organization reported that, as of 2003, there were 3,139 hospice programs in operation in the United States, Guam and Puerto Rico (Wexler Frey, 2004). The Centers for Disease Control and Prevention National Center for Health Statistics said that, in 2000, there were 11,400 combined home health and hospice care agencies, which served 1.5 million patients. It also reported that, at present, more than 90% of hospice care is delivered at home, although based in medical facilities. Hospital-based programs often provide hospice care in a wing or a floor in the building. There are also independent and for-profit hospices exclusively for the care of the terminally ill. Most programs offer both inpatient and home care and allow patients to use one or both types of service (Wexler Frey). In 2005, the National Hospice and Palliative Care Organization reported that more than 4,100 hospice programs were operating nationwide (Marshall, 2007). A third of these were for-profit companies. The rise in figures led financial analysts to view the hospice industry as among the strongest growing areas in healthcare. Hospice is cost-effective and more people are getting aware of the concept. Records showed that hospice spending had grown at 26% annually since 1989 as compared with 7% increase in overall health expenses in the same period. Despite this statistical increase, the hospice market has yet to be substantially tapped. Of the approximately 2 million apparent deaths in 2003, only 710,000 were in hospice. But new government regulations in the 80s boosted the growth of hospices. These regulations allowed hospice providers into assisted living centers and nursing facilities. Since their exposure to the patients, the industry became a more attractive enterprise. The hospice concept has grown from a voluntary effort to a highly profitable industry worth $9 billion today. It is predicted to continue growing as baby boomers opt for the â€Å"good death.† Of the 47 hospices in Colorado, 53% are non-profit and 36% are for-profit. Nationwide, for-profit hospices multiplied four times between 1994 and 2004 at six times the growth of non-profit hospices (Marshall). Issues and Approaches Hospices operate on thin investment margins of only 8 to 12% on the average and receive Medicare payments of only $125 per day per patient for routine home care (Marshall, 2007). They are lucky to have thousands of volunteers to support operation. But making a profit can be difficult. Medicare regulations state that hospice can be used only up to six months. Yet many patients die just weeks from arrival. If death comes within two weeks of admission, the costs go quite high. Another problem that for-profit hospices confront is maintaining a level of quality care (Marshall). Most hospices require physicians to estimate that the patient is unlikely to survive to six months (Wexler Frey, 2004). This intention is to maintain Medicare eligibility. This disqualifies terminal patients with uncertain prognoses, the homeless and isolated patients. Moreover, health care costs constrain patients to limit their stay in hospices. The shortened stay reduces the chance and time for pastoral and psychological counselors to help the patient and the family to deal with the situation effectively (Wexler Frey). Short stay also incurs more and more costly care (Solnik, 2002). Medicare and private insurers pay per diem, which means that reimbursements remain the same and hospices must cover the rest of the expenses. Furthermore, the patient may not need much care at times and that increases the delivery cost per day. But hospices realize they have to live with this reality (Solnik). Other problems arise when staying too long in a hospice (Solnik, 2002). Prior to admission, two physicians must agree that the patient probably has six months or less to live. The patient must also agree to replace the use of life-saving equipment and treatments with palliative ones. The purpose is to keep him comfortable. If he survives the six-month limit, Medicare payments drain and the hospice must eventually reimburse some of the payments (Solnik). The cost of more effective pain medication has added to the cost of hospice care (Solnik, 2002). Hospices admit they are losing money because of the treatment modes applied to end-of-life care. Regulations must cover all the expenses incurred in all the stages of terminal illness. Medical procedures, like chemotherapy and radiation, are frequently used to alleviate pain and symptoms and for cure. Intravenous medications tackle pain but are also costlier than other forms. The appearance of new and costlier drugs blurs the fine line between life-saving and mere comfort-giving. Chemotherapy can shrink a tumor to allow swallowing and radiation can ease or reduce pain. If the hospice is not well financed, one or two patients who demand these procedures can bring cost problems to the hospice. Shareholders who fear that the return on their investment is jeopardized may decide to cut down on staff. They may also shed off community grief centers, extensive bereavement care, alternative therapies, and inpatient care centers. The multicultural view of death is another issue in hospices in the United States and Western Europe (Wexler Frey, 2004). Migrants with Easter cultures have an entirely different perspective from those with Western cultures. The Chinese’s concept of death is a sharp example. The views of death and end-of-life values of other cultures should be incorporated into the policies of hospice care programs (Wexler Frey). The low rate and significant increase of physician services are additional troubles for hospices (Carlson Morrison, 2007). In most cases, hospice physicians participate only in care planning meetings, not in direct or actual patient care. The 6% increase in the number of patients receiving physician services was not considered significant. Still less than a third of these patients received hands-on physician services. This could be the offshoot of the original and non-medical concept of hospice care (Carlson Morrison). The range of hospice services provided in different regions has also been found to vary by region (Solnik, 2002; Wexler Frey, 2004). Patients in the Northeast received a significantly narrower set of services than those in other regions. Alternative forms of palliative care for end-of-life patients are quite common in the Northeast. These forms have recently expanded as hospital-based palliative care programs more than in other regions. This trend could have influenced the role and scope of hospice care offered in that region (Solnik, Wexler Frey). One more issue or problem is regulation of hospices itself (Solnik, 2002). In order to pay for hospice care, Medicare or a private insurer requires two physicians to sign a document that the patient has only six months or less to live. It then pays only for palliative treatment or management of symptoms and pain, not for the cure of the disease. This compels the patient to choose comfort or care over cure. The hospice industry has been by lobbying for a change in the regulation to allow or include curative treatment in hospice care. In collaboration with this initiative, the National Hospice and Palliative Care Association has also been lobbying for increased insurance reimbursements to include payments for costly procedures, like chemotherapy and radiation therapy (Solnik). Some approaches to these issues have been noted. Increased disease complexity, the diversity of diagnoses and symptom burden are likely to increase direct physician care (Carlson Morrison, 2007). The patient’s primary care physician may continue to monitor the patient’s condition but he is also unlikely to possess appropriate training, knowledge and skills on palliative care (Carlson ^ Morrison). Consolidation efforts in the industry has helped hospice care providers gain greater access to fund sources (Solnik, 2002). This is illustrated by the merging of hospice services among the Charles Hospital and Rehabilitation Center, Mercy Medical Center and Good Samaritan. They created Good Shepherd. They, however, found that reducing the costs of products and services would not sustain them without extensive financing or fund-raising (Solnik). Some studies focused on the availability of hospice care to the elderly in the rural areas (Solnik, 2002). Findings showed that the range of hospice services in the areas were comparable with those in the urban areas. The probability of fewer services in the rural areas can be dealt with by increasing reimbursement to cover trave l expenses and attract skilled health professionals (Solnik). A New York legislation would expand Medicaid payment for freestanding hospices in response to the six-month limit requirement (Solnik, 2003). The initiative encouraged the construction of freestanding hospices, such as The Visiting Nurse Service Hospice of Suffolk, Inc. on Long Island and the Hospice Care Network in Manhasset. Freestanding hospices would create and provide facilities for the exclusive use of hospice care. Hospice beds in hospitals and nursing homes are currently only a small part of the overall facility. This would provide family support to take care of patients who do not have it and need it in their condition. Hospice care providers consider freestanding hospices a potentially important part of their industry (Solnik). Community Assessment The City of South Bend in Indiana is the seat of St. Joseph County in a region known as â€Å"Michiana (Answers.com, 2008).† The region covers counties in Indiana and Michigan. South Bend is famous for the University of Notre Dame and the winning football team, â€Å"The Fighting Irish.† It has a 107,789 population as of 2000. The City’s has nine medical centers, prominently the Hospice of St. Joseph County (McMahon, 2008). Employment in the health care and social services is 13.4% of the total.(McMahon). The Indiana Hospice Palliative Care Organization supervises hospice care in the City. Among the issues it confronts are treating the homeless at the end-of-life, the costs of end-of-life care to elderly patients, pain management, care-giving at the end-of-life, and futile care (2007). Treating the homeless at the end-of-life is a major concern for the City. They can seldom access hospice service for lack of resources for inpatient hospice, a home or social supp ort (Indiana Hospice Palliative Care Organization, 2007). In addition, these homeless are already beset with substance abuse problems and mental illness. Their need for hospital care is 3-4 times greater than expected and 36% longer than poor patients who have homes and encounter similar health problems. Some organizations offer them medical respite, short-term shelter with basic services for those too sick to function on the street. These organizations cannot, however, care for those who are nearing death. (Indiana Hospice Palliative Care Organization). Keeping to a medication regimen is a critical problem among homeless patients. They lack the money to buy them, lose their belongings or suffer from symptoms of mental illness or substance abuse (Indiana Hospice Palliative Care Organization, 2007). Other problems they confront are the control of pain, the inability to discuss death and dying at home. Because of drug abuse, they may be opioid-tolerant and, thus, may need higher doses. If they stop taking drugs, they need specific treatment to handle withdrawal reactions. The homeless also less willing to discuss death on account of what they have been denied in life. A study found that the homeless expect to die suddenly and violently. This expectation affects their willingness to discuss death. The homeless are also unlikely to have a surrogate or confidant who can make decisions for them in the event of incapacitation. Ethics committees or court-appointed guardians take their place for the function. And dying at home is not an option because they have no home. They are also unlikely to observe house rules in hospices. Experts recommend that homeless patients at the end-of-life be encouraged to form trusting relationships to insure or enhance curative and palliative care at that period (Indiana Hospice Palliative Care Organization). City laws are slated for revision to respond to these issues ((Indiana Hospice Palliative Care Organization, 2007). One will direct the Health Department to name a commission, which will â€Å"enact rules for physicians to order for life-sustaining treatment.† The other revision will further strengthen healthcare powers of attorney. Living wills merely provide instructions concerning life-sustaining treatment. Powers of attorney concerning the end-of-life wishes of a patient belong to the spouse as first priority, followed by adult children and then close friends ((Indiana Hospice Palliative Care Organization).# BIBLIOGRAPHY Carlson, M. D. A., et al (2007). Hospice care: what services do patients and their Families receive? Health Services Research: Health Research and Educational Trust. Retrieved on November 20, 2008 from http://findarticles.com./articles/p/mi_m4149/os_4_46/ai_n27331524?tag=content;col1 Indiana Hospice Palliative Care (2007). Crossroads. Indiana Hospice Palliative Care, Inc. Retrieved on November 20, 2008 from http://www.ihpco.org/January%2007%20crossroads.pdf McMahon, P. M. (2008). Economic development for South Bend, Mishawaka and St. Joseph County. Project Future. Retrieved on November 20, 2008 from http://www.projectfuture.org/index.htm Marshall, L. (2007). The business of dying. ColoradoBiz: Wiesner Publications, Inc. Retrieved on November 20, 2008 from http://findarticles.com/articles/p/mi_hb6416/is_8_34/ai_n29369110?tag=content;col1 Solnik, C. (2002). Hospice industry: struggling despite being busier than ever. Long Island Business News: Dolan Media Newswires. Retrieved on November 20, 2008 from

Citizen Soldiers essay -- essays research papers

In the book Citizen Soldiers by Stephen E. Ambrose, the title explains mainly what the book is about. The title itself gives you the insight about how the war was fought through the perspective of a regular citizen fighting in the biggest war in history. During the war there were many casualties, as a result more regular citizens were being drafted to go right into battle. In this book Ambrose exemplifies the fact that there were many regular citizens in the war and that they took the situation that they were in and made better of it and overcame it to come home as heroes. The men of the story were ordinary citizens put into an extraordinary situation and came out on top. These men often bonded together through some of the harder times, for example in the text there was a time where one soldier was able to be sent home to the states but refused it because he wanted to stay with his friend. â€Å"It’s either I stay here or he comes too,† those were the feelings of many people in the war that shared a special attachment with another man.   Ã‚  Ã‚  Ã‚  Ã‚  The book was able to clarify many of my questions left over from Band Of Brothers, like how the men of the companies got along with the newer recruits and how they shared their feelings for them. I soon realized that the citizen soldiers of this book had their really close friends but they really didn’t see the new people as intruding on their war lifestyle and being too anxious to fight. They didn’t react to cruelly...

Aristotle and John Stuart Mill on Happiness and Morality

Aristotle and John Stuart Mill on Happiness and Morality In this paper I will argue that Aristotle’s conception of eudaimonia disproves Mill’s utilitarian view that pleasure is the â€Å"greatest good. † The purpose of this paper is to contrast Aristotle’s and Mills views on the value of happiness and its link to morality. First I will describe Aristotle’s model of eudaimonia. Then I will present Mill’s utilitarian views on happiness and morality. Lastly, I will provide a counterargument to Mill’s utilitarian ethical principles using the Aristotelian model of eudaimonia.In this section I will explain Aristotle’s definition of eudaimonia and its relationship to happiness, morality and the virtues. Aristotle defines eudaimonia in the first book of the Nicomachean Ethics as â€Å"virtuous activity in accordance with reason† and that this is the highest good for human beings. For Aristotle, eudaimonia can be translated into a â€Å"human life of flourishing† since it occurs throughout a person’s life. This lifelong happiness is complete and sufficient in itself, meaning that a person lives it as an end in itself and not for anything else beyond it.An important aspect of reaching our own eudaimonia is to function well as human beings. Aristotle presents his concept of the human function by stating that what makes human function so distinct is not just to obtain nutrition and to grow because that aspect of life is shared with plants and it is also not perception because that is something shared with animals. Our ultimate human function therefore is reason and not just reason alone but to act in accordance to reason. Achieving excellence in human rational activity according to Aristotle is synonymous with leading a moral life.To lead a moral life is a state in which a person chooses to act in accordance to the right virtues. Aristotle, defines virtue as  a mean between two extremes (excess and deficiency). He argues that the mean is not necessarily the average or half way point, but rather changes in relation to each individual. For example, a person who just finished jogging needs more water after jogging than a person who was not jogging, so the mean between too much water and too little water is different for the jogger and non-jogger.According to Aristotle, it is very difficult to discover the mean, to discover the exact point between the two extremes that is best suited for you. As he says, there are many ways to be wrong and only one way to be correct. Aristotle explains that the choice of the mean is going to depend on what the virtuous person’s reasoning is. As in the case of the jogger, he will drink just enough water to quench his thirst (deficiency) but won’t drink too much that would result in water in water intoxication (excess).Aristotle focuses his moral theory on virtuous action and argues that virtue is necessary, but not sufficient for happiness. You need virtue to lead a happy life, but ultimately, virtue alone will not make you happy. What matters most is that you make a habit out of choosing to act in accordance with the right virtues, which leads to a balance in one’s life and ultimately leads you closer and closer to achieving your own eudaimonia. In this next section I will present Mills utilitarian views and the link between happiness and morality and how his views do not coincide with Aristotle’s eudaimonistic ideals.In chapter two of Utilitarianism, John Stuart Mill introduces his concept of utility, also known as the â€Å"Greatest Happiness Principle† to hold that â€Å"actions are right in proportion as they tend to promote happiness, wrong as they tend to produce the reverse of happiness. By happiness is intended pleasure, and the absence of pain; by unhappiness, pain, and the privation of pleasure. †Ã‚  In other words, Mill makes it certain that pleasure and freedom from p ain are the only things desirable as goals and all things that we do is desirable because they produce pleasure or prevent pain.Mill understood that it would be demeaning to humans to reduce life to pleasures as this would then put us at the same level as animals. Thus, he introduces the idea of higher and lower pleasures. The higher pleasures are those of a higher quality of that are determined by â€Å"competent judges. † This competent judge is someone who is acquainted with both the higher and lower quality pleasures. In regards to morality, Mill anchors its definition on the premises of the greatest happiness principle stated above.Unlike Aristotle who puts emphasis on the agent (the person themselves) in regards to acting morally, Mill is very indifferent and states that the character of the person and their motives do not matter only the consequence of those actions matter. For Mill, the morality of the action only depends on whether that action will produce pleasure f or greatest number of people. As state before, he explains that pleasure leads to happiness, and happiness is the ultimate goal of each individual. However, morality is â€Å"the rules and precepts for human conduct,† nd not simply the causes of human behavior. Desire may drive human actions, but that doesn’t mean that desire should propel human actions. Morality is the ideal, not the reality. Because of his views on morality Mill would not agree with Aristotle that the completely ethical person will not be conflicted about his ethical choice. According to Mill a person could do the right thing, and act morally while also having the desire to do the wrong thing. To explain this, he gives the example of a rescuer who saves another person from drowning.He helps this person because it is morally right, regardless of being seen as a good Samaritan or if he would’ve been compensated for his actions. Mill would also disagree with Aristotle’s argument that it is determined whether or not someone led a eudaimonistic life only after this person has died. Mill essentially believes in concrete happiness and believes that people should be happy while they are alive. Mill states that pleasures are parts of our happiness and not an â€Å"abstract† means as Aristotle puts it.In this third section I will provide a counterargument to Mill’s utilitarian ethical principles using the Aristotelian model of eudaimonia. I firstly disagree with Mill’s idea that happiness is equated with pursuing acts that only lead to pleasure and avoiding those that decrease pleasure. I side completely with Aristotle in that he believes that the purpose of pleasures is to serve as side product of activity to perfect our activities. For example, for a mathematician to become an excellent mathematician he must become very talented in doing mathematical activities but also must have the pleasure in doing this activity.I also side with him on his statemen t in Book Ten of the Nicomachean Ethics certain pleasures such as those of touch â€Å"can lead us to become servile and brutish† and says that â€Å"it attaches to us not in so far as we are men but in so far as we are animals. † For example those who eat food to the excess have slavish characters because they are choosing to eat past their bodily intake limit. I agree here with Aristotle that those persons who are destitute of self-control do not use their reason, take pleasures exceedingly, in the wrong way and in the wrong objects.Ultimately, in order to act virtuously a person must act rationally in a manner that is between the two extremes of deficiency and excess when it comes to matters of pleasure. Thus, pleasure should not be sought just for its own sake. In terms of moral actions, Mill arguments also seem to be flawed. He believes that the goodness of an action is based on whether or not it produced pleasure and happiness for the greatest number of people. T here is little emphasis on the disposition and character of the agent performing the action.This idea seems illogical because then everyone would be acting without reason and doing things for the wrong intentions. As Aristotle says in Book One of the Nicomachean ethics, â€Å"the man who does not rejoice in noble actions is not good; the good man judges well in matters of the good and the noble. † Here he is referring to the fact that a person who is not performing actions for the right intentions is not a good man at all. To explain this further I will use the example of the drowning person.Aristotle would advise that I should save a drowning person because I have the positive and noble intention to do so and not because someone is going to pay me for helping them. I think Mills view on happiness and morality that pleasures should equate with happiness sounds like it would be ideal to live this type of life. However, this type of logic would not work out in today’s so ciety. He tells us that in order to find out what kinds of pleasures are most valuable we should look to â€Å"competent judges† who seem to just know what are considered the better â€Å"higher† pleasures because they have experienced both the â€Å"higher† and â€Å"lower† pleasures.As Aristotle states, however, not all pleasures are universal to all men because not everyone is directed to the same things. What if their idea of a higher pleasure is to rape women on the streets? The problem with Mill’s argument then is that what this â€Å"competent judge† may consider to be a higher pleasure may actually be a lower pleasure and be very wrong about what they consider to be right. Aristotle would respond to Mills statement that happiness should be concrete by stating that happiness in Mill’s view seems to just be a fleeting experience.For example, if a person spends their whole life trying to figure out a cure for cancer it wonâ€℠¢t be determined whether this person’s life work was meaningful only until we examine this person’s life work. To conclude, I have stated both Aristotle’s and Mills arguments in relation to happiness and morality. Aristotle’s conclude that happiness (eudaimonia) is to have flourishing life in which actions are performed in accordance to virtuousness and reason.Mill, on the hand believes that pleasure is ultimately the greatest type of good and therefore is equated with happiness. I have argued that Aristotle’s concept of eudaimonia disproves Mill’s â€Å"greatest happiness priniciple† on the grounds that pleasure is only a small part of happiness and that the emphasis on living a happy life should be placed on the agent to habitually act in a rational and virtuous manner.

Margaret Atwood s The Handmaid s Tale - 1305 Words

In the period following the â€Å"sexual revolution† of the 1960s and 1970s characterized by a religious conservative revival, Margaret Atwood wrote the novel The Handmaid’s Tale. With the elections of Ronald Reagan as president of the U.S. and Margaret Thatcher as Prime Minister of Great Britain, both religious conservatives, many feminists feared that all the progress towards equality they had made during the ‘60s and ‘70s would be reversed. Atwood, thinking no differently than them, decided to create a novel that explored the implications and effects of a nation, Gilead, that has completely obliterated feminist progress. In Gilead, women have no decision-making power; they are merely objects. Even though the disparity between the sexes was not so wide in Atwood’s time, Gilead is still representative of a possible future for society. Atwood uses the motifs of color and nomenclature found in the fictitious nation of Gilead to make a connection to soc iety, and prove that society forces both women and men to have feminine and masculine power respectively and pits those two types of power against one another. Colors and coloration greatly represent the two types of power and their struggle against one another. The two most prevalent colors are red and black, the colors for the game of checkers. Checkers is a strategic game of power and promoting pieces in order to win. The pieces in this game are representations of the people found in Gilead and society. There is also a strategicShow MoreRelatedThe Handmaid s Tale By Margaret Atwood1357 Words   |  6 PagesOxford definition: â€Å"the advocacy of women s rights on the ground of the equality of the sexes† (Oxford dictionary). 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Gilead is a society that demands the women who are able to have offspring be stripped of all the identity and rights. By demeaning these women, they no longer view themselves as an individual, but rather as a group- the group of Handmaids. It isRead MoreThe Handmaid s Tale By Margaret Atwood1237 Words   |  5 Pages The display of a dystopian society is distinctively shown in The Handmaid’s Tale, by Margaret Atwood. Featuring the Republic of Gilead, women are categorized by their differing statuses and readers get an insight into this twisted society through the lenses of the narrator; Offred. Categorized as a handmaid, Offred’s sole purpose in living is to simply and continuously play the role of a child-bearing vessel. 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Told from the main character s point of view, Offred, explains the Gilead regime and its patriarchal views on some women, known as the handmaids, to a purely procreational function. The story is set the present tense in Gilead but frequently shifts to flashbacks in her time at the RedRead MoreThe Handmaid s Tale By Margaret Atwood1540 Words   |  7 Pages Name: Nicole. Zeng Assignment: Summative written essay Date:11 May, 2015. Teacher: Dr. Strong. Handmaid’s Tale The literary masterpiece The Handmaid’s Tale by Margaret Atwood, is a story not unlike a cold fire; hope peeking through the miserable and meaningless world in which the protagonist gets trapped. The society depicts the discrimination towards femininity, blaming women for their low birth rate and taking away the right from the females to be educated ,forbidding them from readingRead MoreThe Handmaid s Tale By Margaret Atwood1256 Words   |  6 Pageshappened to Jews in Germany, slaves during Christopher Columbus’s days, slaves in the early 1900s in America, etc. When people systematically oppress one another, it leads to internal oppression of the oppressed. This is evident in Margaret Atwood’s book, The Handmaid’s Tale. This dystopian fiction book is about a young girl, Offred, who lives in Gilead, a dystopian society. Radical feminists complained about their old lifestyles, so in Gilead laws and rules are much different. For example, men cannotRead More The Handmaid s Tale By Margaret Atwood1667 Words   |  7 Pagesrhetorical devices and figurative language, that he or she is using. The Handmaid’s Tale, which is written by Margaret Atwood, is the novel that the author uses several different devices and techniques to convey her attitude and her points of view by running the story with a narrator Offred, whose social status in the Republic of Gilead is Handmaid and who is belongings of the Commander. Atwood creates her novel The Handmaid’s Tale to be more powerful tones by using imagery to make a visibleness, hyperbole