Public health intelligence is taken as a tool for estimating the status of health and behaviour of population. This data is further served by health ministers who are responsible for preventing and controlling diseases (Quah, 2016). This report is going to demonstrate the critical appraisal of public health data, where people of Oregon are suffering from anxiety and depression as well as request for euthanasia. The main outcomes which are highlighted in research measures the diagnosis of depression and level of anxiety of people suffering from ill-terminally disease. It has also evaluated that such patients who request for dying didn't have depressive disorders. Therefore, this assignment doesn't show any evidence about reasons why such patients still request to die. Furthermore, main issue in this regard is extracted as presence of a disorder and determination of its influence.
As per present scenario, a research has done to identify the prevalence of anxiety and depression in terminally ill people. They are requesting from physicians to help them in dying. For this process, Oregano state of UK is taken where petition of Death with Dignity Act was passed in 1994. According to this law, physicians have right to prescribe a lethal dosage of drugs to patients to give them relief from pain (Fairchild, Bayer and Colgrove, 2014). For this process, physicians will make sure that people are terminally ill and mature as well as willing to end their life. After this law has passed on, from every thousand deaths, one or two of them are died by lethal ingestion. To determine prevalence of this act, 58 Oregonians who are suffered from incurred diseases like cancer or amyotrophic lateral sclerosis, are taken for investigation. These participants may be requested from physicians to die or they contact to advocacy organisations for the same.
According to this research report, it has analysed that participants who are belongs to Oregon are suffered from some critical diseases. The main outcomes related to diagnosis of depression are measured by using effective techniques (Waitzkin, 2015). It includes Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Hospital anxiety and depression scale etc. Through these measured it has concluded that mostly terminally ill Oregonians do not have mental or depressive disorders. Due to high severe pain, they had requested to die. Through investigation, it has evaluated that 15 among 58 Oregonians have met criteria for depression while 13 with anxiety. During research period, near about 42 patients have died, from which number of patient who received a dosage of lethal drug as per Death with Dignity Act are 18. Other than this, 9 died by lethal ingestion. Furthermore, it has investigated that among 18 died patients who have taken a course of lethal drug under supervision of physicians. In this regard, only three were found as high depressive order while others didn't. Therefore, the recent practice of Death with Dignity Disorders has failed to prevent those people who willing to die due to terminally ill disease and under depression as well as take course of lethal drug.
An expert who is engaged with public health sector to collect and analyse data related to healthcare issues are known as public health analyst (Ratcliffe, 2016). They perform various responsibilities to collect reliable and accurate information and rely on effective technology for entire process of gathering. Some major duties played by such experts in public health sector are:
To perform such duties, the necessary skills required by an analyst in public health sector are given as below:-
The main strong point of this research is its objective where researches prepare investigation report on the prevalence of depression and anxiety. For this process, research is done on terminally ill patients who are requesting to die from physicians. Therefore, it refers to a serious topic which is helpful for analysing whether petition for death with dignity is right. For this process, some people of Oregano who were suffering from incurable diseases are taken. Researchers use inclusive approach to categorise respondents on the basis of depression, severe depression or no depression disorder. But this investigation fails to give result if medical consultancies for a lethal drug are prescribed according to Death with Dignity Act and should be made legally continue or not. Apart from this, as the main objective of this report is to identify whether all patients who are suffered from terminally ill diseases are influenced by depression for a lethal drug or not. Therefore, the study conducted in this manner gives a large contribution to meet criteria. Along with this, information which is extracted from statistical report are also compiled by Oregon Department of Human Services. This shows authenticity of data with reasonable medical judgement. A discussion is made in present study where some methods are applied on selected patients. These respondents are requested to physicians for lethal drug prescriptions. It has evaluated that major portion of them didn't have any depressive disorder. Thus, it indicated that recent practice to allow ineligible patients to take lethal drug is illegal also.
The strength of this research is that it made both in theoretical and conceptual manner. It includes a standard measure of depression and a blinding system, which adhere a control on those patients who are found to have psychiatric disorders (Schneider, 2016). Furthermore, study on measures of depression and anxiety evaluate the two main aspects of psychiatric assessment. It includes symptoms of disorder and influence determination; measures to identify eligibility for aid in dying should be mental disorder or not. In contrast, investigation on euthanasia from population of Oregon states that psychological disorders and depression are prominent among terminally ill people who are voluntarily to death petition. In this regard, the main drawback of present research is that some findings are remained uncertain. It fails to ascertain that whether findings from respondents are extrapolated from those patients who are willing to die by lethal drugs or requested for dying to legal physicians.
Researchers of present report use various sources to notify patients to take participation in investigation. Some of them had contacted to legal agencies like Compassion and Choices for requesting aid to die (Jones, Greenberg and Crowley, 2015). This organisation of Oregon provide information about terminally ill patients who choose aid in dying. Furthermore, project-makers of public health sector, use inclusive approach to categorise patients on the basis of depressive disorder. To represent information in statistical manner, data analysis has used. Here data is presented as frequencies and proportions for categorical items. To analyse the data and make interpretation on it, statistician of present research has used Student's t-distribution for compare means. But this report fails to entail which research methodologies have taken by researchers in order to collect data related to public health issues.
In order to interpret the data, public heath analyst use Student t-distribution method. Under this process, two tailed hypothesis are taken with 5% analysis of variance to make judgements and draw valid conclusion on the same. But as it has evaluated that data explored by using t-distribution table often mislead the conception. It provides inappropriate data when continuous data is taken for calculation.
Present data is made in ethical manner where any type of personal information related to terminally ill patients are not given. Only name of state is used to explore the result which is based on determination of prevalence of anxiety as well as depression in ill people who have requested for aid of physicians to die. But this report fails to give detail if whole group of data in which sample is taken, have requested to take lethal drug for die or not.
The design of present research is made on cross sectional survey where data about problems and reasons for euthanasia are given in clear and concise manner. It provides not complete but enough data on which further investigation can be made.
To conduct this research, investigators has used simple random sampling method with an inclusive approach. Under this process, 178 Compassion and Choices participants are included in total population among which few are selected on random basis. Furthermore, it has analysed that 58 of them who are requesting for dying are lie under age of 66 years. The patients with cognitive impairment are excluded from selection criteria. To get feedback and views of selected participants, researchers have made a proper questionnaire format. This would help in analysing mental state or depression level of selected participants. Through this process, investigators have drawn a valid conclusion about relevance of euthanasia. Moreover, it has also evaluated that for numerical analysis, researchers have represented data in the form of normal distribution. In this regard, they have applied Student's t-distribution where all two tailed hypothesis are measured under 5% of variance. These approaches are quite looking effective for drawing effective conclusion. But this method gives inappropriate reasons about current practice of Death with Dignity Act in Oregon. As this method fails to protect people who are mentally ill and request for dying. Therefore, in terms of reliability and validity of data, this work seems to give appropriate result.
Through this appraisal report it has interpreted that most people who are suffering from incurable diseases and requesting for aid to physicians in dying do not belongs to high disorder category. The practice related to Death with Dignity Act in Oregon fails to protect and prevent patients who are psychological ill and high depression disorder. It has also summarised from this assignment to work on public health intelligence, an analyst is required to have appropriate skills and knowledge. It will help in gathering, analysing and interpreting data in more accurate manner.
Books and Journals
Jones, D. E., Greenberg, M. and Crowley, M., 2015. Early social-emotional functioning and public health: The relationship between kindergarten social competence and future wellness. American journal of public health. 105(11). pp.2283-2290.
Schneider, M. J., 2016. Introduction to public health. Jones & Bartlett Publishers.
Holland, S., 2015. Public health ethics. John Wiley & Sons.
Karimi, L. and et. al., 2014. Emotional rescue: The role of emotional intelligence and emotional labour on well‐being and job‐stress among community nurses. Journal of advanced nursing. 70(1). pp.176-186.
Ratcliffe, J. H., 2016. Intelligence-led policing. Routledge.
Waitzkin, H., 2015. Medicine and public health at the end of empire. Routledge.
Fairchild, A. L., Bayer, R. and Colgrove, J., 2014. The renormalization of smoking? E-cigarettes and the tobacco “endgame”. New England Journal of Medicine. 370(4). pp.293-295.
Quah, S. R., 2016. International encyclopedia of public health. Academic Press.
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