Whirlwind Essays - The Rush Limbaugh Show, American Christians

Whirlwind Essays - The Rush Limbaugh Show, American Christians Whirlwind Subject: English Book Report/Review (See I Told You So, Rush Limbaugh) It is not very often that a person has his own national television show, radio show, and two books that have been on the New York Times Best Seller List. Rush Limbaugh happens to be one of these unique people, his radio show is popular, his television show has the largest audience for a program of its type and his new book is one of the best of its kind. Limbaugh always backed up his comments with facts or statistics. While the book was informative and factual, it was also very humorous. See, I Told You So was definitely a conservative use of 363 pages. Without question, Rush Limbaugh is a spokesperson for a conservative majority within the United States. His book follows what he says on his radio and television programs, which is a conservative and republican view on issues. A few of the things he stresses in his book are that conservatives are the silent majority and President Clinton cannot ruin this country in four years. Although he stresses that conservatives are the majority, he says that liberals are trying to regain control by forcing the public schools get rid good things like the Bible and competition, and replace them with Outcome-Based Education. Most importantly, we need to motivate people to pursue excellence and not feel sorry, pity and coddle underachievers. While the purpose of his book is to express these views, he also covers many other topics from the environment, to Dan's Bake Sale. The spectacle was enough to drive a stake through the heart of liberalism (p.101), says Rush Limbaugh about Dan's Bake Sale. Sixty-five thousand people flocked to Fort Collins, Colorado for what was called Rushstock '93. This all started as a quest for Dan Kay to make $29.95 for a subscription to The Limbaugh Letter and escalated to a full day event that even Limbaugh attended. While Rush Limbaugh discusses many different controversial and serious issues, he manages to make it entertaining. He makes these serious issues amusing by sarcastic comments and pionting out the irony in government today. Parts of the book are made for just entertainment like the Politically Correct Liberal Dictionary and the Lies, Lies chapter in which Limbaugh backs up his theory that, the Clinton administration, has cataloged an avalanche of false hoods with 7 pages of Clinton's major contradictions. Rush Limbaugh makes many controversial comments throughout his book, but instead of just commenting, he supports what he says. An example is, when he talks about the environment. He uses references to scientific studies, other than just speculating. Limbaugh states, Most scientists say a supernova 340,000 years ago disrupted 10 to 20 percent of the ozone, causing sunburn in prehistoric man.... Man has never done anything close to the radiation and explosive force of a supernova.... if prehistoric man merely got a sunburn, how are we going to destroy the entire ozone with our air conditioners and under arm deodorants and cause everybody to get cancer.... (p.178) I thought this book was very intresting. I attribute this sucesss to the fact that rarly has there been a radio/TV commentator who consistently makes sense on so many subjects: taxess, environmentalism, animal rights, crime, education, the inner cities, extreme feminism, government regulation and Congress. See, I Told You So is a serious and important book, but Rush Limbaugh, whatever your opinion of his politics, is an marvelous entertainer.

The Nature-Culture Divide

The Nature-Culture Divide Nature and culture are often seen as opposite ideas- what belongs to nature cannot be the result of human intervention and, on the other hand, cultural development is achieved against nature. However, this is by far not the only take on the relationship between nature and culture. Studies in the evolutionary development of humans suggest that culture is part and parcel of the ecological niche within which our species thrived, thus rendering culture a chapter in the biological development of a species. An Effort Against Nature Several modern authors- such as Rousseau- saw the process of education as a struggle against the most eradicated tendencies of human nature. Humans are born with wild dispositions, such as the one of using violence to achieve one’s own goals, to eat and behave in a disorganized fashion, and/or to act egotistically. Education is that process which uses culture as an antidote against our wildest natural tendencies; it is thanks to culture that the human species could progress and elevate itself above and beyond other species. A Natural Effort Over the past century and a half, however, studies in the history of human development have clarified how the formation of what we refer to as culture in an anthropological sense is part of the biological adaptation of our ancestors to the environmental conditions in which they came to live.Consider, for example, hunting. Such an activity seems an adaptation, which allowed hominids to move from the forest into the savannah some millions of year ago, opening up the opportunity to change diet and living habits. At the same time, the invention of weapons is directly related to that adaptation- but from weapons descend also a whole series of skill sets characterizing our cultural profile, from butchering tools to ethical rules relating to the proper use of weapons (e.g., should they be turned against other human beings or against uncooperative species?). Hunting also seems responsible for a whole set of bodily abilities, such as balancing on one foot as humans are the only primates that can do that. Now, think of how this very simple thing is crucially connected to dance, a key expression of human culture. It is then clear that our biological development is closely tied to our cultural development. Culture as an Ecological Niche The view that came to be most plausible over the past decades seems to be that culture is part of the ecological niche within which humans live. Just as snails carry their shell, so do we bring along our culture. Now, the transmission of culture seems not to be directly related to the transmission of genetic information. Certainly the significant overlap between the genetic makeup of humans is a premise for the development of a common culture that can be passed along from one generation to the next. However, cultural transmission is also horizontal among individuals within the same generation or among individuals belonging to different populations. You can learn how to make lasagna even if you were born from Korean parents in Kentucky just as you can learn how to speak Tagalog even if none of your immediate family or friends speak that language. Further Readings on Nature and Culture The online sources on the nature-culture divide are scarce. Luckily, there are a number of good bibliographical resources that can help out. Here is a list of few of the more recent ones, from which older takes on the topic can be recovered: Peter Watson, The Great Divide: Nature and Human Nature in the Old World and the New, Harper, 2012.Alan H. Goodman, Deborah Heat, and Susan M. Lindee, Genetic Nature/Culture: Anthropology and Science Beyond the Two-Culture Divide, University of California Press, 2003.Rodney James Giblett, The Body of Nature and Culture, Palgrave Macmillan, 2008.

Zappos Term Paper Example | Topics and Well Written Essays - 1000 words

Zappos - Term Paper Example During the period of past 9 years, the brand has greatly evolved to new heights. The objective of the company is essentially to provide the customers’ with best services online not only shoes as the product but also in other categories. The vision of the company reflects that out of total sales, 30 percent of retails trade will be made through online. Furthermore, the company’s vision also replicates that best services will be offered to the end customers’. The company deals in the sales of clothing and shoes through online. Its primary revenue is gained from the sales of shoes that contribute around 80 percent of the entire business. On analyzing the company background, it can be observed that Zappos is sells around 50,000 varieties of shoes within the market. The company believes in the ‘loyalty business model’ along with ‘relationship marketing’. The vital reason behind the acceleration of the company’s growth can be considered as its repeat customers. Moreover, the company has not invested much in the advertising aspect; in-fact the word-of mouth has ensured extensive growth and development. It is also famous for its reputation pertaining to customer service. For example, every new employee being hired within the corporate office requires a vigorous training of weeks on customer loyalty. This training is the initial phase and compulsory for all the employees before they enter into the actual workplace (Zappos, 2013). Four Problems Being Faced By Zappos Every organization in the present business environment faces an assortment of challenges. It has been recognized that an organization trading through online website faces certain viable challenges as compared to traditional ‘Brick-and-Mortar’ organizations. The persistent risk of online organization is hacking of the information. Zappos being an online company also faced the problem of hacking. It has been ascertained from a news report that t he hackers got hold of around 24 million of customers’ personal information. This has created an immense problem for the company. In relation to hacking, the customers’ of the company have filed a suit against it. The management of Zappos wanted the matter to get into settlement pertaining to the terms of service. However, the court overruled the petition and the company was asked to present in the court for trial session (Thomas, 2012). Another major problem faced by the company that it needs to overcome is recognized to be the traditional one way thinking. According to the company CEO Tony Hsieh, the organizational culture tops the priority list than customer service. For any organization to sustain, both the aforementioned requirements are necessary. Only focusing on effective organizational culture without rendering proper customer service might lead to adverse intricacies. Organizational culture and customer satisfaction facilitate to establish a concurrent relati onship (Edwards, 2012). In keeping with Zappos, another problem relates with ordering shipment. It has been recognized that the intense security check of Zappos also creates numerous problems for the customers pertaining to shipment. Problem pertaining to the order shipment has significantly affected the customer base of the company. The hurdle in the continuous and steady flow of cash within the company is another problem that has taken place within the problems’ purview. Technologies being applied within the company are not that effective in tracking the customers’ security alert and receive instant cash against the services being paid (Hsieh, 2010). Action Plan for Zappos In order to mitigate the problems being faced by the comp

Sustainability Assessment Assignment Example | Topics and Well Written Essays - 3000 words

Sustainability Assessment - Assignment Example Sustainable building methods are building methods that do not deplete the resources of the environment, but rather can be supported by them. The concept of sustainable development and sustainable building methods are no longer new. In Our Common Future (1987) the World Commission on Environment and Development (WCED) states that, "sustainable development is development that meets the needs of the present without compromising the ability of future generations to meet their own needs." The document, popularly known as the Brundtland Report goes on to state that the term needs gives priority to "the essential needs of the worlds poor" and that, inevitably, limitations are placed on sustainable development by "the state of technology and social organisation," the environments capacity, and consideration of future needs and circumstances. Sustainability, be it in project design or international development, must not deplete the asset stock of the natural environment. Therefore, sustainable development can be defined as development that the environment can support without depletion or degradation both in the present and in the future. Beyond this, sustainability means more than environmentally friendly development. Sustainability consists of a triple bottom line. The environment is one of three considerations that include also the economy and society at large. The concept of sustainability is no longer new. The concept of sustainable building methods is newer but also no longer new. However, the theoretical development of a concept and its application do not occur coincidentally. Beyond the concept of sustainability, sustainable building methods need to be developed and implemented to realize the concept of sustainable building in practice. Finally, metrics have to be developed to determine the relative sustainability of comparative methods and the overall sustainability of a given technique or structure. According to Integral Sustainability, the concept

Analysis on Guy de Maupassant’s The Necklace Essay Example for Free

Analysis on Guy de Maupassant’s The Necklace Essay There is a great deal in keeping and evoking good and rational values. This is the chief lesson of that famous short story titled ‘The Necklace’ written by Guy de Maupassant (1) in the late Eighteenth Century. This short story tells about the proud-turned-tragic life of Madame Mathilde Loisel who dreams of an aristocratic status in life so that she would be able to experience the patrician lifestyle of some of her Parisian female friends. The life of Madame Mathilde Loisel shares a moral story that one has to have the right and proper moral values in order not to be blinded by empty materialism and pompous luxurious lifestyle. This means that there are more valuable intangible things in life that cannot be acquired by money; they can only be obtained by having rational insights and principles in life. These precious things are our human values. Human values cannot be measured by any material or monetary estimation, nor can they be taken away so easily like any commodities in the market. This means that if one possessed the right and rational values, he/she cannot be deceived by any fine and worldly things. But this does not mean that one has to denounce materialism totally. Â  The Necklace (Maupassant 5) centers on the covetous life of Madame Mathilde Loisel who is not satisfied with her middleclass position in life. Her secret sorrow is her not having all the material lavishness she desires around her. She hates the impoverished people who worked their bodies like animal just to eat three times a day. Most of the time, she spends the day thinking herself as a wealthy chatelaine who basks in the praises and admiration of people around her. She wants to be the center of attraction, and the only way to achieve this is to have expensive and luxurious garments and jewelry. Â  Madame Mathilde Loisel’s husband, Monsieur, cannot satisfy her desire in life since the latter’s salary as a clerk in the Ministry of Public Instruction is not enough to even buy her an expensive evening dress for a ballroom party. The night that changed her life forever comes when her husband receives an invitation to an official social gathering at the Ministry. Stricken by her desire to be the center of attraction at the said party, Madame Loisel is troubled because she has no appropriate elegant outfit and ornaments for the party. Luckily, her husband buys her a new dress taken from his own savings, while she borrows a stunning diamond necklace from her friend, Madame Jeanne Forestier. That night, Madame Loisel catches the attention of all the guests and even high-ranking officials because of her beauty. She enjoys the fleeting moment as the center of attraction at the dance party. However, her tragedy begins upon realizing that her diamond necklace is missing. They try to look for the missing necklace but to no avail. Â  Because of her lingering pride, the Loisel couple decides to purchase a matching diamond necklace as replacement for the lost necklace of her friend. The new diamond necklace that worth thirty-four thousand francs costs Madame Loisel her entire inheritance and the couple also incur huge debts. As a result, Monsieur and Madame Loisel have to work extra jobs in order to make both ends meet. After ten years, Madame Loisel is now older, shabbier, and less refined from a decade of physical work. Still proud and appearing tough, Madame Loisel still has the audacity to her old associates that she had once lost a diamond necklace. In the end, she is deeply depressed when she is informed by Madame Forestier that the long lost necklace is just a replication costing not more than five hundred francs. Had it not been for her covetousness and immodest desire for finer things, Madame Loisel would not have suffered her sorry fate. Her story is never new to people during her time, much more to people in this contemporary era. Today most people live beyond their means just to please others, or just to show others that they can afford to buy trendy stuff and hi-tech gadgets like cell phones and gaming gizmos. This only means that one has to have the rational and proper values so as not to be blinded by things of material value. These values may include industry, patience, humility, discipline, contentment, respect for others, and sense of self. People like Madame Loisel lack most of these good, rational qualities. If Madame Loisel only had the right values, she would have been content of what she has. But make no mistake, it is not wrong to desire for material things as long as you have the capacity to obtain them. To a person with proper values, he/she will have to work first before coveting for material objects around him/her. Â  One has to be patient in his/her work. If one wants a particular product displayed in a fashion boutique, he/she has to work hard for it. Having the right values, a person cannot be easily swayed by the tempting material luxuries around him— what he will do is to take it as an inspiration to improve his status in life. Reference: De Maupassant, Guy. The Necklace. Dramatic Publishing,

A Fairy Tale :: creative writing

He knew that his first prey, the firebird, lived high up in the trees in the heart of the forest. Like lightening, they were hard to miss, and the piercing of its beak left a burn that could never be forgotten. Suddenly, the boy heard a shriek, and he whirled his head to see the blood-red bird swooping toward his face. Panicking, the boy lunged for the ground, and for the net that the wise man had given him. He hurled it at the bird - and missed. The bird, angry, made another giant swoop at the boy - and tore its flesh as it flew straight into the blade of the boy's sword. That was one creature taken care of. His next target, the freezing spider, could be either much harder, or much easier, the boy knew not which. The spider could not run, or jump, unlike some of its relatives, but it was harder to find, and its poison froze the human blood and made its victims helpless, lying on the ground shivering until the arachnid finally took pity on his prey and ate it. He tried not to think about it.  Ã‚  Ã‚  Ã‚  Ã‚  Instead the boy thought of ways to attract his prey; if he could get it to come to him, the killing would be easier - and definitely much safer. The freezing spider would eat any kind of flesh it could, but it was well known that the spider loved most to eat the flesh of humans. Well, what should he do? Obviously bait was safer than waiting for an attack, so the boy pulled out his dagger and held it to his upper arm. That was when he saw the grey bristles of the freezing spider. It was sitting quietly on a nearby shrub, its back toward the boy. Holding back a sigh of relief, he took one quiet step toward his prey, holding the dagger high, and stabbed it through the spider before it knew what hit it. A little less active a kill than the firebird, but just as exhilarating. Now the only victim left in this task of the boy's was the netherworld wolf, and what a creature. About the size of a pig, these dogs could tear up a man in two minutes flat, or so it wa s said. However, being the largest of the creatures made it the easiest target.

An Essay on Clinical Negligence

An Essay on Clinical Negligence â€Å"We have always thought of causation as a logical, almost mathematical business. To intrude policy into causation is like saying that two plus two does not equal to four because, for policy reasons, it should not. † (Charles Foster NLJ 5/11/2004 page 1644). To what extent do you consider that Charles Foster is correct in that causation and clinical negligence should be a â€Å"mathematical business† and the courts have, by introducing matters of policy, confused what should be a logical approach? Introduction: In the article of â€Å"It should be, therefore it is†1, its author, Charles Foster examined the surprise House of Lords judgment in Chester v Afshar2, what he described as â€Å"an exercise in legal creativity that abolishes the requirement for causation in any meaningful sense. † To discuss the above issue, one must consider the legal requirements of clinical negligence. In order for a patient to succeed in a claim for clinical negligence against his doctor, he must be able to satisfy three requirements: first, he must establish that a duty of care was owed by the doctor or hospital to himself; second, he must prove that the doctor has breached that duty of care by failing to reach the standard of care required by the law; lastly, the patient must prove that his injury was caused by the doctor’s negligent act. Each of these requirements for negligence will be considered as the strict requirements for a successful claim of the patient suffering from an adverse event in a medical context. These steps were referred by Charles Foster as the logical â€Å"mathematical business† 3towards establishing the causation in a clinical negligence case. Is Chester’s case a relaxation of the causation requirements? To discuss this statement, one must consider whether the breach of duty causes the harm to the patient. Even if a doctor breaches his duty of care by falling below the standard of care, a patient can only recover his damages if he can prove that breach has caused some harm to him. 1. â€Å"It Should Be, Therefore It is† (2004) 154 New Law Journal 7151. 2. [2004] UKHL 41. 3. Charles Foster New Law Journal 5/11/2004, p. 644. If the doctor breaches his duty of care, but the patient suffered no injury, or would have suffered an identical harm regardless of the doctor’s failing, then the doctor is not proven negligent. This can be illustrated by the case of Barnett v Chelsea and Kensington Hospital Management Committee4. In this case, the doctor ha s breached his duty of care to the deceased man by not examining him personally, but the action for clinical negligence failed, because even if the patient had been seen by the doctor, the arsenic poisoning was regarded as too far advanced for an antidote to be life-saving. In other words, by the time the patient arrived at the hospital, he was destined to die irrespective of the actions or negligent omissions of the doctors. Although his doctor failed to meet the requisite standard pf care in treating him, this did not in itself cause any harm to the patient. 4. There are two ways of interpreting this causation requirement. On the one hand, there exists a reasonable principle that a person should not be held liable for damage which he did not cause. On the other hand, there is no legal evidence for incompetent medical care unless the patient can prove that the doctor’s action indeed caused some identifiable harm. The particular patient is Barnett should have been attended by a doctor, but the fact that he was not subject to compensation. In recent years, the English legal system has recognized that a very strict application of the causation requirement can result in injustice for the patient and therefore there have been gradual moves towards a relaxation of this requirement. In Bolitho v City & Hackney Health Authority5, for instance, a strict application of the traditional causation test of â€Å"but for† – that is the harm would not have been caused but for the doctor’s clinical negligence- was self-evidently not satisfied. It could be recalled in this case the doctor failed to attend the patient but argued that, if she had indeed attended, she would not have provided the treatment (intubation) which could have save the child. Therefore, it is crystal clear that the harm of the child’s death would have occurred even if the doctor had met her duty of care by attending the patient. Despite the court was not willing to settle for this conclusion and instead enquired into whether the doctor’s intended failure to intubate if she had attended would have been clinically negligent in itself. This implies that it was considered by the court at all is an indication that, if some serious harm has occurred, the courts will take into considerations the entire circumstances of the case before coming to the conclusion as to whether the causation requirement has been satisfied. 4. [1968] 1 A11 ER 1068. 5. [1997] UKHL 46, HL. The approach can be seen even more controversially in the 2004 case of Chester v Afshar6, which Charles Foster has made his comment on as mentioned. This case involved a doctor’s clinical negligent failure to warn a patient about the risk inherent in a medical procedure. There exists a need for the patient’s consent to medical treatment to be fully informed. The complication with respect to causation arose because the patient admitted that she would have still undergone the surgery even if she had been warned about the risks of paralysis which unfortunately materialized during the medical procedure. Therefore, the doctor’s failure to disclose this risk, although a breach of his duty of care, did not on the strict application of the causation requirement, cause the harm suffered by the patient. When Chester reached the House of Lords, the House was divided on the issue of causation. The Court of Appeal, taking a strong and pragmatic approach, held that the claimant could succeed by applying conventional causation principle. Therefore it could be said that the claimant’s injury had resulted from receiving a particular operation at a particular time. If the defendant had warned her about the risks, she would not have that particular operation- she would have had an operation (with the same risks) at a later date. If she had had this later operation, in all probability, the very small risk of disability would not have happened. On this basis, it could be said that the defendant’s failure to warn had led to the claimant’s disability. However, the House of Lords did not find this kind of approach attractive. As Lord Hoffman put it, the approach of the Court of Appeal was: †¦about as logical as saying that if one had been told, on entering a casino, the odds on the number 7 coming up were only 1 in 37, one would have gone away and come back next week or gone to a different casino. The question is whether one would have taken the opportunity to avoid or reduce the risk, not whether one would have changed the scenario in some irrelevant detail. †7 In the House of Lords, both the majority and minority rejected r easoning of the Court of Appeal and held that the claimant could not succeed in proving causation on conventional principles. For the minority (Lord Hoffman and Bingham), this was sufficient to dispose the case. However, the majority went on to state that, for policy reasons, the traditional rules of causation ought to be relaxed to allow the claimant to 6. [2004] UKHL 41 7. [2005] 1 AC 134, per Lord Hoffman, at paragraph 31. succeed. Central to their Lordship’s reasoning was the need to give effect to the right of a patient to make an informed choice about whether and when to undergo medical treatment. In law, this right was made possible by a doctor’s duty to warn the patient about any significant risks involved in the medical treatment. There would therefore be injustice if breach of this duty did not lead to a remedy. If the doctor were not made liable for such a breach, the duty to inform the patient about significant risks would, as Lord Hope put it, be a â€Å"hollow one†. His Lordship said: â€Å"The function of the law is to enable rights to be vindicated and to provide remedies when duties have been breached. Unless this is done the duty is a hollow one, stripped of all practical force and devoid of all content. It will have lost its ability to protect the patient and thus to fulfill the only purpose which brought it into existence. On policy grounds therefore I would hold that the test of causation is satisfied in this case. †8 Lord Steyn shared this view that the vindication of the patient’s rights was the overriding considerations: â€Å"Her right of autonomy and dignity can and ought to be vindicated by a narrow and modest departure from traditional causation principles†¦This result is in accord with one of the most basic aspirations of the law, namely to right wrongs. †9 On policy grounds, therefore, Lord Hope, Steyn and Walker held that the test of even though they agreed with Lord Bingham and Hoffman that this required a departure from the traditional principles. The simple fact that the patient’s injury was â€Å"intimately involved with the duty to warn†10 was sufficient for Lord Hope, while Lord Walker emphasized that the doctor had failed in his professional duty and the patient â€Å"has suffered injury directly within the scope and focus of that duty†. 11 In summary, the two dissenting Lords emphasized that Miss Chester had failed to prove that the doctor caused her injury. Lord Bingham said that â€Å"she cannot show that the clinical negligence proved against Mr. Afshar was, in any ordinary sense, a cause of her loss†12 and Lord Hoffman noted that â€Å"on ordinary principles of tort law the 8. 2005] 1 AC 134, per Lord Hope, at paragraph 87. 9. [2004] 4 A11 ER 587, per Lord Steyn, paragraph 24-25. 10. [2004] 4 A11 ER 587, per Lord Hope, paragraph 87. 11. [2004] 4 A11 ER 587, per Lord Walker, paragraph 101. 12. [2004] UKHL 41, per Lord Bingham, paragraph 9. defendant is not liable†. 13 Both of these j udges therefore held that Miss Chester could not recover damages with respect to Mr. Afshar’s negligent disclosure. Even the judges in the majority acknowledged that the traditional causation requirement had not been satisfied in this case. Lord Hope, for instance, who gave the leading judgment, accepted that â€Å"a solution to this problem which is in Miss Chester’s favour cannot be based on conventional causation principles†. 14 The majority allowed Miss Chester to recover damage based on some vague policy reasons. Lord Hope elaborated that the key question for the House of Lords was â€Å"whether in the unusual circumstances of this case, justice requires the normal approach to causation to be modified†. 15 Lord Hope further explained that â€Å"the function of the law is to enable rights to be vindicated and to provide remedies when duties have been breached. Unless this is done, the duty is a hollow one, stripped of all practical force and devoid of all content†. 16 Lord Steyn shared this view that the vindication of the patient’s rights was the overriding consideration: â€Å"Her right of autonomy and dignity can and ought to be vindicated by a narrow and modest departure from traditional causation principles†¦This result is in accord with one of the most basic aspirations of the law, namely to right wrongs. †17 As a result, the consequence is that where there is a breach of duty to disclose and the plaintiff suffers from . he actual harm he or she should have been warned about, then a claim for damages is more likely to succeed. The patient would recover if they would have deferred the procedure. The plaintiff no longer have to demonstrate that he or she would have refused the procedure completely if he or she had been told about the undisclosed risk. The adaptation of the causation requirement in Chester v Afs har has been the subject of considerable debate and criticism. Green18, for example, argues that the law of torts â€Å"is concerned not with compensating those who have suffered loss as a result of the defendant’s breach of duty†. This very point is emphasized by Lord Bingham in his dissent when he argues that â€Å"a claimant is not entitled to be compensated, and a defendant is not bound to compensate the claimant, for damage not caused by the negligence complained of†. 19 To some extent this is a convincing argument. 13. [2004] UKHL 41, per Lord Hoffman, paragraph 32. 14. [2004] UKHL 41, per Lord Hope, paragraph 81. 15. [2004] 4 A11 ER 587, per Lord Hope, paragraph 85. 16. [2004] 4 A11 ER 587, per Lord Hope, paragraph 87. 17. [2004] 4 A11 ER 587, per Lord Steyn, paragraph 75. 18. Sarah Green, â€Å"Coherence of Medical Negligence Cases: A Game of Doctors and Purses†. (2006) 14 Med Law Rev. 1, p. 4. 19. Chester v Afshar [2004] 4 A11 ER 587, paragraph 9. Miss Chester was awarded full damages for the injury she suffered even though this injury was not really caused by the doctor’s actions, which seems unjust. However, the point which is missed here is that the doctor’s negligent non-disclosure did cause a different loss to Miss Chester. Green20 argues that Miss Chester â€Å"lost nothing of value†, but I believe this is not true: she lost her right to make an autonomous choice about her medical treatment. In daily clinical practice, autonomy with respect to healthcare requires that a patient is fully informed about the medical treatment before he or she can consent to it. On the other hand, the right to refuse consent to medical treatment, which is protected in both English common law and international human right law, requires that an informed choice be made by the patient. In Miss Chester’s case, she was denied of this particular right. She agreed to undergo the surgery in ignorance of its risks and true nature. Her right to autonomy was therefore denied. Green’s opposing view can be explained as follows: â€Å"A patient’s dignity and right to decide is protected by the law of tort’s recognition that a doctor has a duty to warn, not by the readiness to override causal considerations in the claimant’s favour. If a breach of that duty to warn causes the patient no loss, then a finding of no liability does not violate that right. It merely serves as an acknowledgment that the patient’s inability to exercise that right did not, on this occasion, causes any harm†. 21 A fundamentally different viewpoint of this situation is taken here. The inability to exercise a right to autonomy is regarded as a harm in itself, regardless of the actual physical injury resulted. This rights-based approach means that Mason and Brodie22 are correct to regard the award of full damages to Miss Chester as inconsistent with the House of Lords’ modified approach to causation as follows: â€Å"One can understand the concern to allow the plaintiff to vindicate her rights. However, the measure of damages allowed does not, in truth, reflect the loss suffered because, at the end of the day, the loss lay in an invasion of autonomy per se, and an award of full damages can be said to over-compensate. 23 20. Sarah Green, â€Å"Coherence of Medical Negligence Cases: A Game of Doctors and Purses†. (2006) 14 Med Law Rev. 1, p. 14. 21. Sarah Green, â€Å"Coherence of Medical Negligence Cases: A Game of Doctors and Purses†. (2006) 14 Med Law Rev. 1, p. 9-10. 22. K Mason and D Brodie, â€Å"Bolam, Bolam- Wherefore Are Thou Bolam? † (2005) 9 Edin LR298, p. 305. 23. K Mason and D Brodie, â€Å"Bolam, Bolam- Wherefore Are Thou Bolam? † (2005) 9 Edin LR298, p. 305. The House of Lords judgment in Chester v Afshar represents a significant departure from the traditional requirements of a negligence action. It is an imperfect the emphasis upon vindication of the patient’s rights is insufficiently explained and justified. But it is also encouraging from a human rights perspective to see this judicial recognition at the highest level that causation requirements should not act as a barrier to recovery where a patient’s rights have been infringed during the provision of medical care. Manson and Laurie24 refer to a trend to â€Å"assist the plaintiff over the causation hurdle in medico-legal cases†25 and, given the great hurdle still in place with respect to proving a breach of the duty of care, this should in general be welcome. Andrew Grubb26 argues that the majority in Chester made the right decision: â€Å"It is difficult to argue with [the majority’s] reasoning. It would undermine the rule and be unjust for a doctor to require a patient to show that she would never have a particular procedure in the future. It is also counterintuitive to think that because the patient may run the risk in the future- by agreeing to and having the procedure- the negligence is not connected to her injury. At worst, she will be exposed to a small risk of injury which is unlikely then to eventuate. She had in a real and immediate sense suffered injury that she would not otherwise have suffered. That should be sufficient to establish a causal link†. 27 If Miss Chester‘s loss is better described as the loss of the right to make an informed consent, rather than exposure to a risk which she would have avoided if given proper information, it could be argued that damages should be directed towards compensating her for this deprivation of autonomy, rather than for the physical injury she suffered. It is interesting that the majority in Chester did not consider the possibility of making a â€Å"conventional award† as they had done in Rees v Darlington memorial NHS Trust28, for the patient’s loss of autonomy. The majority awarded Miss Chester full damages for physical injury, despite the fact that their judgments describe the real loss in this case as the deprivation of the right to make an informed choice. As 24. JK Mason, A McCall Smith & G Laurie, Law and Medical Ethics, 7th edit, (Oxford, Oxford University Press, 2006), p. 39. 25. JK Mason, A McCall Smith & G Laurie, Law and Medical Ethics, 7th edit, (Oxford, Oxford University Press, 2006), p. 339. 26. â€Å"Consent to Treatment: The Competent Patient†, 31-203 in A Grubb with J Laing(eds), Principles of Medical Law, 2nd edition, (Oxford, Oxford University Press, 2004), p. 200. 27. â€Å"Consent to Treatment: The Competent Patient†, 31-203 in A Grubb with J Laing(eds), Principles of Medical Law, 2n d edition, (Oxford, Oxford University Press, 2004), p. 200. 28. [2003] UKHL 52. J Kenyon Mason and Douglas Brodie29 point out, this may mean that Miss Chester was over-compensated: â€Å"However, the measure of damages allowed does not, in truth, reflect the loss suffered because, at the end of the day, the loss lay in an invasion of autonomy per se, and an award of full damages can be said to over-compensate. What is, in some ways, surprising is that, the solution adopted in Rees v Darlington Memorial NHS Trust was not applied here. There, the requirements of distributive justice meant that damages should not be awarded to compensate the plaintiff for the loss that ad arisen as the result of a failed sterilization operation†¦The solution adopted was to award a â€Å"modest† conventional sum by way of general damages to acknowledge the infringement of the plaintiff’s autonomy by the fault of the defendant†. 30 The possibility of a conventional award was mentioned by Lord Hoffman, in his dissenting judgment: †I can see that there m ight be a case for a modest solatium. †31 In the end, he rejects this solution for two reasons: it would be difficult to settle on an appropriate amount, and on the grounds of costs, the courts would be an unsuitable place to pursue what would always be a modest award. Effectively, then, the consequence of Chester’s case is that autonomy-based right to make an informed consent is so important that doctors who fail to warn patients about material risks associated with treatment may have to indemnify patients should those risks materialize, despite the exercise of all proper skill and care in carrying out the operation, and critically, despite the fact that the patient admits that they would have been prepared, in fact, to knowingly run this risk on another occasion. Difficulty in proving causation: The full impact of the House of Lords’ relaxation of causation principles in Chester v Afshar remains to be seen. There are a number of reasons why the causation requirement raises particular difficulties in actions for negligence non-disclosure of relevant information. 29. â€Å"Bolam, Bolam- Wherefore Are Thou Bolam? † (2005) 9 Edin Law Rev. p. 298-305. 30. â€Å"Bolam, Bolam- Wherefore Are Thou Bolam? † (2005) 9 Edin Law Rev. p. 298-305. 31. [2004] UKHL 4, per Lord Hoffman, paragraph 34. 32. â€Å"A warning about causation† (1999) 115 Law Quarterly Rev. 1-27, p. 23. 33. â€Å"From Informed Consent to Patient Choice: A New Protected Interest† (1985) 95 Yale Law Journal 219. 34. â€Å"From Informed Consent to Patient Choice: A New Protected Interest† (1985) 95 Yale Law Journal 219. First, a successful claim in negligence for failure to disclose a material risk is in practice synonymous with strict liability for medical mishaps. Informed cons ent therefore becomes a route for patients to seek financial compensation for unfortunate but blameless medical outcomes. Doctors who exercised all reasonable care and skill in performance of an operation will be found liable for the consequences of an accident which they could have done nothing to prevent just because their pre-operation disclosures were inadequate. As Peter Cane32 explains, â€Å" whatever the ideological basis of the duty to warn (or, in other words, the interest which it protects), its importance in practice lies in providing a basis for imposing liability for physical injury not caused by clinical negligence†. Secondly, because the claimant must prove that the inadequate disclosure caused her injury, cases only come before the courts where the patient has not been informed about the risk of an adverse outcome which has then materialized. Adequate information is not, however, confined to disclosure of risks. In order to exercise meaningful choice, it is important that the patients are told about alternatives to the proposed treatment. As Marjorie Maguire Shultz33 explains, negligently depriving the patient of choices will rarely result in the sort of damage or injury which is recognized in tort law: [P]reemption of patients’ authority by doctors may also give rise to injuries that are real but intangible, or to physical outcomes that are arguably not â€Å"injurious† except from the individual’s vantage point. These outcomes may be excluded from negligence doctrine’s definitions of harm. Thus, a patient not told about a method of sterilization that is more revers ible than the one performed may have difficulty convincing the court that non-reversibility is a cognizable physical injury. A patient who alleges that, properly informed, she would have chosen a lumpectomy rather than a radical mastectomy might find it hard, under existing negligence rules, to characterize the successful operation that removed her breast and eradicated her cancer as having â€Å"injured† her. Similarly, the patient with a desire to go home or to a hospice to die, who is instead maintained alive by hospital machinery, might have difficulty establishing â€Å"injury† under definitions of an interest in physical well-being rather than choice†. 34 Thirdly, â€Å" cause† appears to have acquired a rather special meaning in failure to warn cases, Peter Cane has explained, the doctors in these cases rarely â€Å"caused† the injury in question â€Å"in the central sense of the word â€Å"cause† as it is used outside the law†, because â€Å"failure to warn of a risk does not â€Å"cause â€Å" the materialization of the risk†. Rather the injury has usually been caused by an unfortunate and inherently unlikely combination of circumstances, and the doctor simply created the situation in which this extraordinary sequence of events could occur. The question of whether a doctor should be liable for a failure to disclose a risk is more accurately stated as whether she should be liable for creating the situation in which an accidental injury might or might not occur. Conclusion: There is an elegance to a legal structure that requires doctors to owe a â€Å"single comprehensive duty† in negligence covering diagnosis and treatment, and the associated obligations to inform. Diagnosis and treatment are essentially the exercise of the medical professional skills and therefore fall fairly into the arms of negligence. The duty to inform, however, seeks to protect the patient interest in self-determination. This seems more fairly addressed by an action that is complete with the injury to the interest protected. Such an action would be more akin to an action in battery. The fact that legal action for inadvertent misinformation in relation to the inherent risks/benefits of treatment lies in negligence rather than in battery leaves a legal structure that has some tension within in it. Where battery, constrained as it is by touching, is an ill-fitting robe negligence barely covers the mischief. In English law, negligence actions for negligent misinformation have seen this tension expressed as a strong dissent by Lord Scarmen in the case of Sidaway v Bethlem Royal Hospital Governors35, and then as a weakening of the causation rule in Chester v Afshar. Notice how weakening the causation rule in Chester v Afshar. Notice how weakening the causation requirement makes the action of clinical negligence more akin to a battery action- the very action precluded by the rule in Reibl v Hughes in such cases. In Chester v Afshar, the plaintiff would have had the operation at a different time and so something would have changed had the information about risk been given. The core of the principle in this case comes when the plaintiff does not change anything as a result of the misinformation. Can they still succeed where they suffer the very harm they should have been worried about? If so, we have a clinical negligence action that looks suspiciously like a battery action but protects the interest of self-determination. The use of clinical negligence in this context has arisen by default. The structure of a claim in clinical negligence is simply the wrong one to protect a fundamental interest like self-determination and the strain is telling.