Ten Commandments for CEOs Seeking Organizational Change Essay Example for Free

Ten Commandments for CEOs Seeking Organizational Change Essay In our ever-changing, fast-paced world, competitive relationships Can shift quickly when companies respond too slowly to increased competition in their industry group. Succeeding in such a competitive and changing environment demands that CEOs reshape their organization to meet todays challenges and competitive realities. But responding to change remains highly elusive because there is a natural resistance to change at all levels within the organization, including at the top. CEOs and other members of the executive suite need to take a hard look at their existing organization and culture, ask tough questions about its appropriateness for the current competitive environment, and take concrete, implemental steps to forge a preferred culture and drive it downward throughout the entire organization. But therein lies the challenge, for few management teams both establish a comprehensive strategy for remaining competitive and take a hands-on approach to implement change internally. By not getting involved, they signal to employees that the change really isnt very important. A key premise of this article is that cultural change or any organizational transformation is essentially a top-down activity. It cannot be delegated. If the CEO perceives the need for change, makes it a top priority, and gives it a great deal of time and attention, the organization will change. By the same token, if the CEO offers only limited lip service, needed changes just wont happen. This article outlines how the CEO can be an enthusiastic sponsor of change by paying enough attention to implementation to make the transformation take place. Reynierse and Leyden (1992) provide a case study incorporating these steps. 1. Strategy-Driven The process I am advocating will be relatively ineffective without a strategic framework to provide competitive advantage. This process is not a substitute for such a strategy. Rather, the strategy is the starting point that establishes the context for all other steps. However, strategies will be relatively ineffective when management pays insufficient attention to their impact on the work forcefor ultimately it is the work force who will implement the strategy and make it succeed or fail. The point is that unless such a strategic plan is implemented and executed effectively, it will not be fully realized in the competitive marketplace. An overview of this process is depicted in Figure 1. A companys business strategies, plans, and goals are the starting pointnot the endof this exercise. They formalize the CEOs vision, setting the tone and establishing direction for the company in both the long and short terms. They provide a context for all other activities and decisions, establishing the limits for making many choices along the way. In addition, they determine the direction and boundaries for building the new organizational culture, including molding employee expectations. Resources are scarce in every organization, and management must accept the fact that it cant do everything. Strategic choices reflect judgments about where companies think they have marketplace competitive advantage so that plans implemented here enable them to grow faster and earn more than their competitors in these market segments. Similarly, the resources dedicated to building the organization are determined by this strategic focus. 2. Top-Down Involvement If something is important, a good rule of thumb is to have a top-down approach to getting it done. Ideally, then, the CEO must get involved. If the CEO attends to the organization, it will improve and gain competitive advantage. Conversely, if the CEO gives it scant time and attention, little organizational growth will occur. In short, the CEO who enthusiastically sponsors a broadly conceived program for building the company is more likely to succeed and reap the benefits down the road. A company-wide initiative needs an enthusiastic and supportive CEO who does not hesitate to play a continuing role during the change process. But where is the top? And who is the CEO? Building organizations is often better served by dealing with chunk-sized bites rather than the whole company. Particularly for large companies, it often makes better sense to deal with natural strategic business units (SBUs) rather than the entire company. At one level, there are often unique problems or opportunities in a unit or company division. At another level, it is most meaningful for those involved to deal with issues that directly concern them and their business unit. The approach I am advocating includes determining the firms core values and mission. It is unlikely that every SBU or company division will share the same core values or mission. Individual business units often have unique customers, competitors, product maturity, strategies, and objectives. These units need the autonomy to develop their own focus. For such cases the division executive is functionally the CEO for that unit and can provide the vision, enthusiasm, and driving force for success. Throughout, however, the CEO must remain interested and provide broad support for what is taking place. Even when the primary leadership role resides elsewhere, the CEO must be an advocate for change and reinforce actions taken at these lower levels. 3. Organizational Assessment Periodically it is valuable to take an objective snapshot of the broader organization. This not only provides information about the companys strengths and limitations but can also identify how those strengths and limitations measure up to the mission and the core values. Effective organizations have employees who share these values, and a carefully conceived organizational assessment will identify pockets of agreement and resistance. Several techniques, including surveys, interviews, and focus groups, are used for these organizational assessments. The organizational dynamics survey (Reynierse and Harker 1986) has been particularly effective, because it provides an objective measure of the underlying values that mold organizations. For example, the surveys broad customer orientation category taps a cultural value related to making customers a priority and satisfying their needs. Surveys are particularly important because they get every employee involved; everyone has the chance to be heard. Surveys also provide an opportunity for management to pay attention to employees concerns and to build their trust. This is achieved when management openly communicates with employees regarding key issues and responds to problems by taking timely, corrective action. At the same time, establishing trust is the first step in getting employees to buy in to managements broader vision. 4. Clarify Core Values Peters Waterman (1982) have one all-purpose bit of advice for management figure out your value system. Decide what your company stands for. Today many frequently echo this management theme. Identifying and clarifying core values are central to this approach as well. When they are integrated with a companys business strategies, core values help provide a focused mission. All too often, companies or their natural business units lack focus; their employees are confused about what the company stands for and what it is trying to achieve. However, when the focus and the mission are clear, they can drive the entire organization or SBU. Mission statements ideally should be brief, concise, and to the point. They should identify primary business activities, integrate key strategies, and reflect the firms core values. When we speak about core values we are dealing with many attractive virtuesMcLaughlin, McLaughlin Lischick (1992), for example, identified more than 100and it is tempting to include as many as possible. In my experience, however, an organization can give proper attention to only a fewsay, three to fiveclearly stated core values. Anything more will be too diffuse and will only confuse employees and dilute managements efforts. In other words, management has to make some hard choices, and established strategies provide the context for focus. There are no shortcuts; there is no generic mission statement. To build a focused organization, the management team has to participate in the process. We use a value clarification exercise when working with top and senior management. This exercise consists of 30 corporate values that are relevant (and credible) for business and industry. Each is defined and serves as an effective probe, placing key issues on the table for discussion. Some representative examples are shown in Figure 2. Because many are presented with a different thrust or emphasis, they can generate a provocative and lively discussion. This value-clarification process gains agreement for key priorities and direction, and fosters team-building through shared values and mission. Similarly, it lays the groundwork for resolving internal differences between functional groups that may have varied goals or priorities. Finally, it sets the stage for driving the process downward through the entire work force so other employees can buy in and share the focused mission as well. The risk in all this, says Peters (1992), is that management does such a good job that these values become fixed, even though they no longer are appropriate. The necessary caveat here is to return to strategy and competitive marketplace reality. Very simply, if the strategy is no longer appropriate and requires changes, the core values and focused mission probably need to be changed as well. They must therefore be revisited and modified as necessary to be congruent with any new strategies. A case can be made that because clarifying core values is so central to this approach, it should occur earlier in the process. There are benefits, however, of having it follow the organizational assessment step because this gives management another opportunity to respond to the input and reactions of the work force. Their perceptions of what the company really values are important and may indicate that changes are needed. 5. Work Force Involvement and Participation One of the advantages of the employee survey approach to assessing an organization is that all employees have the opportunity to participate and express their opinion. In other words, at an early stage in the process they have the chance to level with management, provide an employee perspective, and establish an agenda for later stages. While we begin the more intensive activities at the top with senior management, we involve lower-level employees, particularly lower levels of management, as quickly as possible. Although every situation will be different and will require different solutions, management should be vigilant for opportunities to involve new participants. A valuable tool is the use of focused task forces to address any priority issues that may have emerged from the organizational assessments or team-building sessions. This permits additional employee involvement at the problem-solving and solution-generating stages of the exercise. A fundamental assumption is that a focused organization requires a work force that shares this focus. The key to successful implementation, then, is the steps that are taken to drive the process downwardto downstreamso that all employees feel they are a part of this focused mission. Implementing managements vision demands paying attention to employees, managing their expectations, and responding to their concerns. Building the firm requires taking action steps that promote the core values and focused mission. I call these steps the culture carriers. It is through them that senior management can reinforce values consistently and frequently. Put another way, the culture carriers provide direction for marketing the core values and mission with all employees. The five culture carriers we have identified are summarized in Figure 3 and will be discussed separately. 6. Inspirational leadership Our studies of corporate culture indicate that there are two ways management stays in touch with what is going on in the company: 1. By visiting work areas and being visible to their employees. This is inspirational leadership at its best and is similar to the idea of Managing by Walking Around (MBWA), as developed by Peters Waterman (1982) and Peters and Austin (1985). 2. Through the balance sheet and financial focus. In general, however, many top executives emphasize financial performance and focus to the extent that they neglect their leadership roles. The broad process for organizational change outlined here provides structure for MBWA and for being a cheerleader. Although executives tend to underestimate their leadership effectiveness, they in fact exert considerable power by virtue of their leadership positions. As DePree (1989) observed, Leaders need to be concerned with the institutional value system. Each time they go out to a work area and talk to an employee or group of employees represents an opportunity to exercise influence and reinforce the companys mission and core values. This clearly communicates to employees what is important to the organization and what is expected of them. When the CEO or division head is leading the charge, everyone quickly picks up on it, and any ambiguity regarding what is taking place is quickly removed. The results are multiplied when this leadership role is being exercised by the entire management team. As an example, the management team of one of my client organizations made a contract with one another during a planning retreat to spend 15 minutes a day walking around, getting to know employees, and talking with them in each of their subordinate organizations. Though initially they were ambivalent and self-conscious about their task, it soon became an accepted and high-priority activity. They would confront each other daily by asking, Have you spent your 15 minutes walking around yet today? This, together with several other steps, quickly led to a turn-around in an otherwise demoralized work force. It was an important step for management to become informed, get on top of operations, get in touch with its people, and communicate direction. 7. Communication Put as simply as possible, employees cannot accept or implement top managements vision if they are unaware of it. Frequent formal and informal channels of communication are needed with all employees to introduce the focused mission and core values and reinforce them over a period of time. Executives must make liberal use of meetings, video presentations, posters, newspaper articles, brochures, and so on. If there is a rule of thumb, it is that you cant do too much in this area. Some of our clients have successfully used kick-off meetings in which they celebrated the focused mission and core values, gave every employee a wallet-sized card containing the mission statement, and provided other symbolic itemspins, coffee mugs, pencils, hatsthat focused on elements within the mission and its values. Primarily held to share information, the meetings were also used to rally employees and build enthusiasm for the new organization. The informal mixing that occurs at such kick-offs is also a va luable time for management to energize employees and talk with them further about the focus. 8. Financial Focus Well-ran companies have a strong financial focus that emphasizes both profitability and cost containment. It can play a significant resource allocation role that simultaneously provides increased funds and resources to programs that support the core values while denying (or at least sharply reducing) funds and resources to established programs that are less important to the mission. How capital is invested and what activities are expended carry important messages to employees. It is necessary to examine investment decisions in terms of a strategic standard that includes the companys core values and focused mission. Having done so, it may be necessary to withhold capital or budgetary expense dollars for those projects that fail to qualify under this standard. When capital investments and highly visible expenses are consistent with the values and mission of the company, they will provide support for and reinforce this focused mission among employees. But when inconsistency abounds, emp loyees will be confused and may withhold their support.

Of Mice and Men - 4th chapter Essay -- essays research papers

This passage comes from the fourth chapter in Of Mice and Men, by John Steinbeck. George and the other workers are â€Å"gone into town† (69). Lennie, Crooks and Candy are the only men remaining on the ranch. This excerpt characterizes Crooks and promotes the themes of loneliness and dreams. In addition, this passage characterizes Lennie and reinforces the theme of companionship. In this portion of the book, the author provides a precise characterization of Crooks. The stable buck takes â€Å"pleasure in his torture† (71) of Lennie. He suggests many scenarios that make Lennie miserable such as â€Å"Well s’pose, jus’s’pose he [George] don’t come back† (71) â€Å"s’pose he gets killed or hurt so he can’t come back† (71). Crooks’ suppositions are a sign of meanness, they demonstrate that loneliness has twisted his conscience. He also behaves this way because since â€Å"he ain’t got nobody† (72), he is jealous of Lennie’s friendship with George. Crooks suffers from loneliness. He has no one to turn to, and to be near him. He says it himself that â€Å"a guy needs somebody---to be near him† (72), or else â€Å"he ge...

Early History of America: What Factors Allowed Jamestown To survive it’s First Fifteen Years

In XVI and early XVII century many of the European nations tried to establish their colonies in that part of the New World, which is now known as North America. English attempts appeared to be most successful when Virginia Company received a relevant consent from King James I and settled a colony called Jamestown after James in 1607. Colonists had to face enormous hardships in their first years in the new country, however, they managed to found a permanent colony – a core for further exploration of the continent.This paper is to examine and analyze the factors which sustained the colonists success for fifteen years: since 1607 till 1622 using examples from the book â€Å"A Land as God Made It† by James Horn, using the edition published in 2006. The paper shall discuss those factors being divided into two periods: from 1607 to 1615 and from 1615 to 1622 and how those factors relate to the total history of Jamestown. The paper shall deal with both positive and negative ef fects of those factors to make a complex and balanced research. Horn’s book possesses two remarkable characteristics.On the one hand it is a rather calm and reserved story told without unnecessary fanfares. To the first look it may seem that the author is at all not interested in Jamestown as he speaks about Indians inhabiting the place, previous colonization attempts, and does not admire the romantic story of Pocahontas. English colonists are only a part of the epic history of European movement to America and he describes the story in context. On the other hand Horn is able to create a feeling of â€Å"living history†. He knows the people of XVII century well and pays much attention to their everyday life.A reader can smell smoke of fires, hear gunshots and warlike shouts, being personally in the story. â€Å"A Land as God Made It† is a very atmospheric book. At that Horn does not lose the trend and remains a historian but not a belletrist. The book is based on facts but not on legends and is a solid scientific research. Although Horn gives more descriptions than analysis, the factors which influenced Jamestown can be easily derived from the book. Further those factors shall be found and analyzed. The first major factor, leading to survival of Jamestown throughout it’s entire history was the GEOGRAFIC LOCATION.Actually, Jamestown has not been the very first settlement of Europeans in Virginia. Already in 1570 the Spanish have created a fort of Saint Augustine to protect their trade routes from the pirates as well as for protection of a Catholic mission from the Indians. There were several French attempts to colonize the place but they failed mostly because of the Spanish attacks and little interest of the French government to Virginia. And in fact the Spanish seemed to be the most dangerous enemies of the English in America as well as the French and the Dutch.So the departing colonists have been instructed to find a place, which wo uld be safe and easy to defend from attacks of Europeans, but little attention has been paid to Indians and to solving hardships with food supplies, which the people of Jamestown later faced. The colonists have made their first permanent camp after several weeks of explorations on a peninsula in the southern part of Chesapeake Bay, and there were several important reasons for this. The chosen place has been situated about fifty miles away from the oceanic coast to avoid surprise attack by the Spanish.It was surrounded with water with only a narrow portion of sandy terrain tying it with the land. This vulnerable direction could be easily defended by a wooden fence, which the settlers immediately started to build. There was plenty of fish in the bay for food. The bay itself was deep enough to allow big ships sail in it and moor near Jamestown transporting provision, arms and equipment and taking colonial production from Jamestown. On the side of the river the settlement could be defen ded by ship’s cannons . However, there were also several disadvantages.The land was quite moistly and unsuitable for agriculture, as well as the peninsula itself lacked building materials like wood and stone. Fresh water was dirty and the surrounding waters were salty. There were no proper sources of water in the surrounding, which later caused many hardships to the settlers including diseases and numerous deaths from dehydration when the colonists were not able to get water from outside the settlement. Local Indians appeared to be very antagonistic to the Englishmen and this often precluded them from leaving the settlement and forced the colonists to survive on a small site of land.Some of those difficulties were solved via negotiations with the Indians. This makes the second factor: BUILDING RELATIONSHIPS WITH INDIANS. Captain’s John Smith diplomatic ability played an important role in survival of the colony right after it has been founded. Local Indian tribes have b een united to the Powhatan alliance headed by a great chief Wahunsonacock. Smith became engaged in the series of negotiations, which Horn called â€Å"one of the most remarkable series of encounters between Englishmen and Indians in the New World.† Smith managed not only to provide the safety of the colony from Indian attacks in it’s first and most vulnerable two years, but also to barter enough food for colonists in their first and most harsh winter. Smith organized explorative expeditions around the Chesapeake Bay and successfully traded food with Nansemond Indians. Later he entered into negotiations with Powhatan Confederacy of Indians, which were initially successful, and than after certain misunderstandings arose, almost lead Smith to death and saving by Pocahontas.The relations between colonists and Indians have been to a great extent based on Smith’s personal authority and his ability to understand and accept Indian customs. It is known that he even recei ved proposals to leave the settlement and become a mighty chief of the local tribes, which he rejected. In 1609 Smith had an accident with firearms and has been sent to England for medical treatment. There is little clarity with the accident and Horn makes an assumption that this could be a result of quarrels between colonists themselves.Whichever thing happened, Smith’s departure resulted in frosting of the relationships and further conflict between the Indians and the settlers. Negotiations after 1609 were mostly fruitless, and the war broke out again until in the last portion of the colonists was killed in a slaughter leaving the colony deserted in 1622. Shortly thereafter however it has renewed and the British government of Virginia started expelling all indigenous peoples from the country except those who became slaves. Thus a policy of graduate displacement of Indians by the Europeans has begun.Trading food with Indians allowed the settlement only to survive it’s harshest times, however, active living and exploration would never be possible without the next crucial factor which is active SUPPORT FROM THE HOMELAND. As soon as the first fortifications in Jamestown have been completed, the ships Newport and Susan Constant left back for England with samples of local minerals, leaving only one small vessel to serve the settlers needs. In the next 18 months Newport has twice sailed to from England to Jamestown and back bringing 70 new colonists and small supplies of food and materials.This is now known as the first and second supply missions, but in fact there were too little supplies for colonists to survive, so they had to make contacts with Indians. Together with Newport other vessels brought skilled craftsmen recruited by the Virginia Company to start industry in Jamestown, including people from Holland, Germany and even Poland. Later these were added by Italians, perhaps starting a tradition of national diversity in America and making Jamest own the first â€Å"melting pot† in North America. Seeing colonists hardships in the new land Virginia Company decided to take the point of supplying Jamestown more seriously.The Sea Venture, a new flagship of the Company, together with eight other vessels sailed to Jamestown in 1609 carrying the third batch of supplies for the colony. In the course of the voyage the fleet had to face a mighty hurricane and Sea Venture was lost near the Bermuda Islands. The survivors managed to build a smaller vessel from the remains of Sea Venture and local tincture and arrive to Jamestown in May 1610. They have found only about a hundred colonists out of original 500, who were willing to leave the colony. However, the governor of Virginia forced them to come back on the half-way home and continue the settlement .Thusly, imperative will of the British authorities can be considered to be a yet another factor, which contributed to development of Jamestown. In May 1611 three more ships arrived to Jamestown, bringing supplies, cattle and a new governor appointed by the Company – Sir Thomas Dale. The latter decided, that living conditions at the site were unhealthy and called upon reconstruction of Jamestown as well as started arranging expeditions to find a better site for the colony near James River. At a distance up the river Dale started building a settlement of Henricus – a probable place for a new capital of Virginia.A remarkable supply party arrived in 1619, which included the first Africans to live in North America (unfortunately as slaves) and 90 unmarried women, who were to become wives for single men of Jamestown. However, they were not the first women in Jamestown, as the first ones arrived as wives and maids in 1607, and by 1619 there were already several growing children of Englishmen, who could proudly call themselves Americans. The fourth important factor influencing life in Jamestown was PRODUCTION AND TRADE WITH THE BRITISH HOMELAND.Virginia Company had a precise aim of obtaining profits from the colony and would never support the colonists, in case they would generate none. Already in 1608 the Company demanded the council of the colony to send commodities which would pay the voyage and to start winning gold, as they were sure that there is enough gold in the New World. Already Newport brought samples of local mineral pyrite, which the colonists confused with gold. However, by 1611 the colony was almost dead since it’s economic effect was vanishing and only King’s desire to have an outpost in America supported the existence of Jamestown.The only goods which the colonists were able to produce and attempted to export were artifacts of glass. In 1611 however John Rofle’s attempts to raise an export of tobacco yielded their fruits. He started growing new sorts of Nicotiana Tobacco brought from England which were better than local Nicotiana rustica. Successful export of tobacco grown at Rofle’s fa rm began in 1612. In 1616 he took a voyage to England to persuade investors to provide funds for further development of industry in Jamestown. Upon his return to Jamestown Rofle continued to improve the quality of tobacco, so by 1622 it’s production grew rapidly .Due to rising interest of investors to tobacco production in Jamestown, the so-called â€Å"hundreds† have been established. A hundred was a sort of agricultural division capable of growing certain amounts of agriculture at a certain area. The hundreds created tobacco plantations in the surroundings of Jamestown and later throughout Virginia. In 1617 the export of tobacco reached 50 000 pounds annually creating an economic basis for survival of the colony. Except the mentioned factors there were some, which are less measurable: religious and moral ones.Almost all the settlers were protestants, who, by virtue of their religious beliefs, took rough with smooth and had a habit for hard work and moderation as well as carried spirit of enterprise and initiative with them. This attitude and this spirit later contributed to prosperity of the country. Europeans tried to begin living in North America for many times. Jamestown appeared to be one of the most successful project of all. Each of the mentioned factors was present in other European colonies, but their successful combination and perhaps luck made exactly Jamestown the most successful of all.

Impacts of Medical Technology - Free Essay Example

Sample details Pages: 6 Words: 1689 Downloads: 6 Date added: 2019/02/20 Category Medicine Essay Level High school Tags: Medical Ethics Essay Did you like this example? The advancements in medical technology has completely impacted the healthcare industry. The structure and organization of the entire medical field has been changed. Medicine is continually moving forward due to technology. Don’t waste time! Our writers will create an original "Impacts of Medical Technology" essay for you Create order The rise of technology has helped with diagnoses, access to care, treatment plans, and much more. Diseases are being cured, and earlier diagnoses’ have created a healthier and more productive lifespan. Nowadays, we have the capability to keep a life going for an extensive amount of time. Most people would agree that living longer would be wonderful, but for patients’ suffering, that may not be ideal. Prolonged life has become a topic of ethical debate, and there are many things to be considered when discussing it. There are many difficulties when looking at the quantity vs. the quality of a life. Most patients, when asked, would choose quality over length. Someone who is seriously ill, without the ability to take care of themselves, is no longer able to enjoy their quality of life. One of the most widely used medical advancements is the mechanical ventilator, or breathing machine. A ventilator helps the patient breath while allowing the body to rest and heal. The ventilator is capable of totally breathing for the patient. While this can be great in cases for younger bodies who are capable of springing back to life after their illness passes, an elderly patient is much less likely to recover from conditions causing respiratory failure (Zitter 2017). These patients will live the rest of their life connected to a life-prolonging machine that will, most likely, prevent them from ever moving from a hospital bed again. Realistically, an elderly patient placed on a ventilator will unlikely ever to be freed from it. In an article by Jessica Zitter she stated that, â€Å"my experience tells me that if patients actually understand what living on these technologies looks like, they will think twice before accepting these treatments† (Zitter 2017). Furthermore, in a 2008 study in The Journal of the American College of Cardiology, 28 percent of patients with advanced heart failure said they would trade one day of excellent health for another two years in their current state. To make the decision to be put on Prolonged Mechanical Ventilation, or PMV, one must be informed about the condition of permanent dependence. Often older patients that benefit from these life-extending technologies are not properly informed of the pros, cons, and alternatives (Butler). If a patient knew their life would be drawn out, they would choose to receive less technological intervention. At times, patients are too ill to discuss or determine their decision and the choice must be determined by the patients loved ones. Most of the time, those loved ones have no clue what the patient might want and out of emotion favor toward a longer life, even if that means being put in an anguish state. Even if the patient is well enough to make that decision, without being well-informed, they might choose to go with the more aggressive treatment unaware of the possible outcomes. Some may argue that doctors purposely provide a lack of information in order to receive the financial incentives associated with performing the aggressive treatments. It’s quite alarming how seldom doctors talk with their patients about the range of options and the hardship of these famed technologies. A big debate within the medical community is the free-for-service medical care. This is where providers charge fees for specific services. If a provider performs more aggressive treatments and continues to run unnecessary tests, he is going to rack up more money for his bank, which is morally unethical. In a Medicare study, it proved that more than $125 billion, is spent on services for the 5% of beneficiaries in their last year of life. As well, a study from Mount Sinai School of Medicine found that out of pocket expenses for Medicare recipients during the five years before their death average about $39,000 for individuals, $51,000 for couples, and $66,000 for people with long-term illnesses like Alzheimer’s (Wang 2012). A new plan of action needs to be put in place in the medical market systems that lowers the profit margins, so physicians would give their patients the best options available. Making a turn in these incentives, could help to solve the problem of the lack of information provided to patients and their loved ones. One of the most common overlooked ethical issues with prolonged life treatments, besides the patients themselves, is the life of the caregiver. A caregiver is not always someone that is hired to watch over a person. Generally, caregivers are some part of the family, whether that’s the spouse, child, sister etc. Patients in need of a caregiver are, in most cases, requiring round the clock care. This is time consuming and a caregiver is sacrificing that time out of his or her life. This brings us back to quality vs. quantity of life. In a study of caregivers who deal with patients who have Parkinson’s disease, 77% of people report deterioration in health as a direct result of their caregiving role (Parkinson’s Disease Vol. 12 2012). Many complain of stress, anxiety, depression, and lack of sleep. It creates physical and psychological strain over extended periods of time, and is accompanied by high levels of unpredictability and uncontrollability. This not o nly creates stress with the loved one they are watching over, but in multiple life domains such as work and family relationships. Lives are essentially lost when they are tied up in the arduous work of taking care of their loved one, all while watching them suffer. In Katy Butler’s article, she discussed the effects caring for her father had on her mother, â€Å"†¦my 77-year-old mother found herself on duty more than 80 hours a week. Her blood pressure rose and her weight fell. On a routine visit to [the doctor], she burst into tears. She was put on sleeping pills and antidepressants† (Butler). There are caregivers and at home nurses that work for service, while other patients are put in nursing homes to live the rest of their lives. Though this is easier on the family members, the quality of life for that loved one still suffers. The ethical value here is that the family members who play the role of the caregiver, are trading their life and health for the extra time with their loved one. Those caregivers are still in the good years of their lives, and those years are lost in caring for their loved one that has the life-extending technology. This begins a cycle of care from one generation to the next. It would only make sense for us to stop that cycle and focus these medical advancements on younger people, who still have a long life to live. In an article by Thomas Lee he asks, â€Å"If you had x amount of dollars, would you spend it on an 80-year-old who has already lived a long life, or a 12-year-old boy dying of cancer?† (Lee 2010). Younger people would be a better investment because they have so much longer that they will be alive to benefit from the technology. We should end this life trade-off cycle, and focus our efforts on the young people that need medical help. A great deal of patients would prefer to have the ventilator, a life-extending technology, removed from healthcare. However, by doing this, it creates another controversy. Should the caregivers of the patient have a say if the ventilator should be turned off? This question is the biggest issue because if the patient is unresponsive, how is the caregiver going to make this decision. Also, if the caregiver is a loved one of the patient, this decision could be a conflict of interest. Some relatives might turn it off because they do not want to see their family member suffer. On the other hand, the majority will act out of selfishness and want to keep the patient alive on the device since they want them to still be here with them on this earth. Some relatives might act out of greediness which is another problem. They might want to â€Å"pull the plug† in order to collect belongings from the family member like life insurance or other collectables that are in the will. Ther e is no way of really knowing of why the caregiver is turning the ventilator off. Herein lies the supposed ethical difficulty. This reality requires that doctors and families make the difficult decision about when to pull the plug, because once a patient is on a ventilator, they have no control over their situation. Controversy of assisted suicide has been around since the beginning of high-technology and PMV’s. When the caregiver wants to turn the machine off, a lot of them turn to the doctors which can be seen similar to an act of assisted suicide. Doctor’s do not like this because it creates legal issues so, they try to remove themselves from this situation. The State of Oregon stopped using the term â€Å"physician-assisted suicide† in 2006. Similarly the American Medical Women’s Association rejects any terms associated with suicide as â€Å"inaccurate and inappropriate,† adopting instead â€Å"the less emotionally charged, value neutral, and accurate terms ‘aid in dying’ or ‘physician-assisted dying† (DeathwithDignity 2018). For some, these life-extending devices are not the only means of staying alive. The devices it helps to prevent strokes, breathing issues, and heart attacks. The moral issues in removing or turning off these prolonged-life devices, should not factor into a physician’s decision because there is no intent to kill, but to simply end their suffering. Death comes from the lack of strength for one to sustain life on his or her own. The ethical issues in these prolonging technologies is abundant. Doctors must inform patients, caregivers, and family members of all options as well as the hardships they may endure from these devises. This will allow patients and caregivers to make an educated decision, rather than live the rest of their lives suffering. Additionally, it will allow the opportunity for a younger individual in the need of these technologies, to take advantage of the many benefits it could potentially have on their life.