Suffering is not inevitable advance directives prove Texas Medical Association 10 (Advance Directives http://www.texmed.org/Template.aspx?

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Research proves the presence of an advance directive s&ch as a living will is associated with decreased family stress and increased patient comfort . 'n the a(sence o) advance directives* however* )amilies )ind ma+ing treatment decisions
near the end o) li)e )or terminall, ill loved ones extremel, stress)&l* and the )amil, is more li+el, to insist &pon ine))ective and expensive treatments that increase patient s&))ering. $edicine-s !.// Agenda 0ass legislation that promotes advance care planning and the completion o) advance directives. 1inanciall, s&pport pilot programs in &r(an and r&ral co&nties to implement s,stematic advance care planning in a variet, o) chronic care sites. 2reate a single page ph,sician order sheet that ens&res a patient-s wishes will act&all, )ollow the patient. $edicine-s $essage TA A was a good law when passed3 it remains a

good law toda,. !ne of its most important goals is to relieve suffering at the end of life" Suffering is not inevitable" #e can see it coming$ plan to deal with it appropriately$ and follow those plans" Altho&gh
advance directives have proven (ene)its )or patients and )amilies* )ew patients have them. Advance care planning incl&des an ongoing dialog&e among patient* )amil,* and ph,sician* and m&st (egin when the patient is not &nder the stress o) a health crisis.

Suffering is not inevitable Abu habi %allup &enter 11 ($arch* 4g,pt: The Arithemetic o) 5evol&tion*
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8nemplo,ment and povert, alone did not lead to the overthrow o) 4g,pt-s government. 't was the perceived di))erence (etween what sho&ld (e and what was that created the driving )orce )or the co&ntr,-s historic &prising. 'xperience of hardship alone does not move people to resist" To shift from misery to a mass movement$ people must first discover (moral anger and a sense of social in)ustice"( This is according to 9arrington $oore-s seminal wor+ 'n:&stice: The ;ocial 9ases o) <(edience and 5evolt* a study of revolutions throughout history. 'n other words* he writes* the idea that the societal distribution of pain is unfair and the suffering is not inevitable as the prere*uisite to action . $an, credit the s&ccess)&l o&ster o) 9en Ali in T&nisia )or providing 4g,pt the necessar, co&nter example to rid it o) its c&lt&re o) political )atalism. The citi=ens o) 4g,pt harnessed their collective discontent and changed the social and political )&t&re o) their co&ntr, in the da,s spanning >an&ar, !5 to 1e(r&ar, //* !.//. ?&ndreds o) tho&sands o) citi=ens too+ to the streets in a peace)&l stance o) solidarit, that res&lted in one +e, o&tcome 7 an end to ?osni $&(ara+-s nearl, .7,ear r&le. +f Tunisia,s revolt provided the trigger )or 4g,pt-s &prising* the gap between what 'gyptians expected and what they experienced provided the fuel"

There are various degrees and types of suffering -rishnamurti 11 (>* The 9oo+ o) @i)e* http://www.:+rishnam&rti.org/+rishnam&rti7teachings/view7dail,7A&ote/!.//."/
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There are so many varieties and complications and degrees of suffering" Be all +now that. Co& +now it ver, well* and we carr, this (&rden right thro&gh li)e* practicall, )rom the moment we are (orn &ntil the moment we collapse into the grave.') we sa, that it is inevita(le* then there is no answer3 i) ,o& accept it* then ,o& have stopped inA&iring into it. Co& have closed the door to )&rther inA&ir,3 i) ,o& escape )rom it* ,o& have also closed the door. Co& ma, escape into man or woman* into drin+* am&sement* into vario&s )orms o) power* position* prestige* and the internal chatter o) nothingness. Then ,o&r escapes (ecome all7 important3 the o(:ects to which ,o& )l, ass&me colossal importance. ;o ,o& have sh&t the door on sorrow also* and that is what most o) &s do. Dow* can we stop escape o) ever, +ind and come (ac+ to s&))ering? That means not see+ing a sol&tion )or s&))ering. There is physical suffering.a toothache$ stomachache$ an operation$ accidents$ various forms of physical sufferings which have their own answer" There is also the fear of future pain$ which would cause suffering" Suffering is closely related to fear and$ and without comprehension of these two ma)or factors in life$ we shall never comprehend what it is to be compassionate$ to love" So a mind that is concerned with the comprehension of what is compassion$ love$ and all the rest of it must surely understand what is fear and what is sorrow

/loc0s1 A2 3ear of eath -riti0 415" 3irst$ conse*uentialism is best" 'ven moral absolutists concede that catastrophic impacts come first 6aber 2002 >oram Era) ?a(er* Disting&ished 0ro)essor o) 0hilosoph, at 9ergen 2omm&nit, 2ollege* A(sol&tism and 'ts 2onseA&entialist 2ritics* p. F.
1&rthermore* not onl, are Anscom(e* Donagan* and Eeach a(sol&tists (in the wea+ sense o) the term#* (&t so are 2harles 1ried and 9ernard Billiams. A)ter de)ending what he calls a(sol&tism (;election %'#* 1ried o(serves: Be can imagine extreme cases where +illing an innocent person ma, save a whole nation. 'n s&ch cases it seems )anatical to maintain the a(sol&te ness o) the :&dgment* to do right even i) the heavens will in )act )all. And so the catastrophic ma, ca&se the a(sol&teness o) right and wrong to ,ield G

And again: The concept o) the catastrophic is a distinct concept :&st (eca&se it identi)ies the extreme sit&ations in which the &s&al categories o) :&dgments (incl&ding the categor, o) right and wrong# no longer appl,./6 'n passages li+e these. 1ried shows himsel) an advocate o) Gwea+ a(sol&tismG (, sa,ing that catastrophic cases prod&ce concept&al anarch,. As 1ried sa,s later on* ' do not +now . . . whether ' wo&ld (e willing to +ill an innocent person to save the whole o) h&manit, )rom excr&ciating s&))ering and death. There are (o&ndaries to each o) these concepts themselves* and the concepts themselves o)ten (ecome (l&rred* indeterminate* s&(:ect to :&dgments o) pr&dence at those (o&ndaries.G Th&s* 1ried is committed to the view that G'n no sit&ation co&ld it (e right to HI#G except when a catastrophe occ&rs* (&t that doesn-t co&nt since in that sit&ation the concepts o) right and wrong no longer appl,. 9ernard Billiams s&ggests tho&gh does not exactl, endorse a similar view when he intimates that in extreme sit&ations (when the conse7 A&ences o) not coping wo&ld (e disastro&s#* Git cannot matter an, more what happens.G/F ( #. The negative team ta0es the authors of their evidence out of context" 7udge$ this is ridiculous.the authors of the criti*ue definitely wanted to prove that fearing death was bad$ but they never directly ob)ect to ta0ing simple policy measures to save the lives of innocent people and prevent catastrophic impacts" (6#. 8erm1 do both" 8ass the affirmative plan and rethin0 our fear of death" o everything except re)ect the affirmative" The problem solving nature of realism can incorporate the criticism"
Alastair Murray, 1997 Reconstructing Realism, p. 17

2hapter F addresses the contri(&tion that realism might ma+e to contemporar, post7 international theor,. The de)ining characteristic o) this (od, o) theor, is its AJosition to the rationalist orthodox,."6 'n that realism is &s&all, presented as an archet,pe o) s&ch rationalism* it is condemned as a )&ndamentall, conservative +rce in international theor,.

/y examining the criticisms made from the perspective of constructivism (, Bendt* )rom critical theor, (, @in+later* )rom post7modernism 7v Ashle,* and )rom )eminism (, Tic+ner* the chapter attempts to demonstrate three things. 1irst* that the acco&nt o) realism as part o) the conservative rationalist orthodox, is )&ndamentall, mista+en. ;econd* that the re)lectivist criticism o) this rationalist orthodox, is itsel) pro(lematic* s&ggesting that a s,nthesis o) the two is necessar,. Third* that because realism incorporates both a distinctly problem.solving approach to contemporary international issues and a much more critical reflection on their sources and potentialities$ it contains the potential to build a bridge between the two perspectives which might offer us a more constructive foundation from which to approach international politics" (5#. The perm solves best" The criti*ue will lead to endless epistemological discussion" #e must loo0 at real world policies along with our rethin0ing of thin0ing in order to craft meaningful theory about the world

7arvis$ senior lect&rer K 8niversit, o) A&stralia* 2(D.;.@. 'nternational 5elations and the 2hallenge o) 0ostmodernism #

There are* o) co&rse* pro(lems with ontologicall, derived )orms o) theor,. 0ostmodemists nat&rall, dismiss this conception o) theor, and are not entirel, wrong )or doing so. Realism is not above criticism$ and structural.realism even more so.5L /ut then again$ neither is postmodernism9 9&t this is not the point. ' am not here attempting to de)end realism against postmodcrnism or to dismiss postmodernism entirel, )rom the p&rview o) 'nter national 5elations. 5ather* what + am attempting to do is defend the institution of theory against postmodemism which$ in its more virulent forms$ aims at its deconstruction and obliteration" So too am + attempting to defend the ontological aspect of theory against those who would engage exclusively in epistemological debate" 3or there to be theory in +nternational Relations$ ontological description must be the first order of things: without first defining the domain of international politics$ identifying those entities and things we wish to explain and understand$ epistemological debate would be altogether pointless" ;ave )or this* the discipline threatens to transpose itsel) into philosoph, and not 'nternational 5elations* to (e condemned to perpet&al metaph,sical re)lection (&t witho&t re)erence to the social world we are attempting to &nderstand. <) co&rse* this does not exonerate &s )rom previo&s mista+es. 'nternational 5elations* largel, (eca&se o) the dominance o) positivism in the discipline* has* in the past* (een apt to ontological description in the a(sence o) epistemological re)lection. 0ractitioners in the discipline have rarel, seen a need to A&estion the epistemological (asis o) their scholarship as Thomas 9ierste+er )orce)&ll, ac+nowledged.5M Cet* as he also reminds &s* developing theor, and generating +nowledge reA&ires :&dicio&s &se o) (oth ontological description and epistemological explanation. These are not m&t&all, excl&sive dimensions o) theoretical disco&rse* (&t the elemental ingredients necessar, to the constr&ction o) disco&rse itsel). The excl&sive )oc&s &pon one dimension to the detriment o) the other pro(a(l, explains wh,* according to Billiam Nreml and 2harles Negle,* 'nternational relations research toda,. . . has )ailed to reach agreement a(o&t several )&ndamental iss&es. . . (/# the central A&estions to (e as+ed* (!# the (asic &nits o) anal,sis (e.g.* states or nonstate actors#* ( # the levels o) anal,sis at which vario&s A&estions sho&ld (e explored* (6# the methods (, which h,potheses sho&ld (e tested and &nwarranted in)erences prevented* (5# the criteria (, which theoretical progress is to (e :&dged* and (F# how inA&ir, sho&ld (e organi=ed in order to generate the

+nowledge that will lead to international peace* prosperit,* and :&stice. 4;5" Turn1 Representations of fear are 0ey to mobili<ing coalitions for action that benefits humanity %reenspan =0> $iriam. Healing through the Dark Emotions. http://www.spirit&alit,health.com/newsh/excerpts/(oo+review/excpO55/ .html G<&r onl, protection is in o&r interconnectedness. This has alwa,s (een the message o) the dar+ emotions when the, are experienced most deepl, and widel,. Erie) is not :&st Gm,G grie)3 it is the grie) o) ever, motherless child* ever, witness to horror in the world. Despair is not :&st Gm,G despair3 it is ever,one-s despair a(o&t li)e in the twent,)irst cent&r,. 1ear is not :&st -m,- )ear3 it is ever,one-s )ear P o) anthrax* o) n&clear war* o) tr&c+ (om(s* o) airplane hi:ac+ings* o) things )alling apart* (lowing &p* sic+ening and d,ing. G') )ear is onl, telling ,o& to save ,o&r own s+in* there-s not m&ch hope )or &s. 9&t the )act is that in conscio&s )ear* there is a potentiall, revol&tionar, power o) compassion and connection that can (e mo(ili=ed en masse. This is the power o) )ear. <&r collective )ear* which is intelligent* is telling &s now: 1ind new wa,s to +eep this glo(al village sa)e. 1ind new )orms o) international cooperation that will root o&t evil in wa,s that don-t create more victims and more evil. @eap o&t o) the con)ines o) national egos. @earn the wa,s o) peace. 1ind a ceremon, o) sa)et, so that not :&st ,o& and ' (&t all o) &s can live together witho&t )ear.G 4?5" Turn1 3ocusing on catastrophic impacts mobili<es individual resistance we can undercut the possibility of these impacts becoming a reality -ateb 1@@2 Eeorge* pro)essor o) politics K 0rinceton 8niversit,. GThe 'nner <cean: 'ndivid&alism and Democratic 2&lt&re.G 2iti=ens* however* ma, )ind in the perspective o) extinction a power)&l impet&s to thin+ a(o&t the n&clear sit&ation and to act as the, can. 9&t even the, need not arg&e a(o&t whether extinction is a possi(ilit,. This is m, cr&cial point. 2iti=ens ma,* instead* challenge the right o) an, government* their own incl&ded* to threaten or to in)lict massive cas&alties and destr&ction* or to act so as to ris+ or act&all, (ring on s&ch cas&alties and destr&ction to their own people. 2iti=ens wo&ld insist* contrar, to o))icial n&clear doctrine* that a special or limited &se is as &naccepta(le as a si=a(le &se* (eca&se the potentialit, o) a si=a(le &se is present in the other +inds. 9&t (e,ond that* there is no need )or )&rther insistence on a point that governments ignore or deridePthat is* the possi(ilit, o) extinction. All that citi=ens have to do is to )oc&s on massive cas&alties and massive destr&ction. A theoretical (arrier to s&ch cas&alties and destr&ction is sim&ltaneo&sl, a (arrier to the n&clear so&rce o) the possi(ilit, o) extinction (to leave aside s&ch so&rces as (iological and chemical war)are#. ?ere thenPin the possi(ilit, o) massive disasterPis the theoretical (attle gro&nd. And this is where the moral doctrine o) individ&alism ma+es a noteworth, contri(&tion. (L#. 3ear of death is an improvement from the Status Auo$ which is neurotic

repression

(M# Turn1 &onfronting the death of others is vicarious suffering.itBs a way of overcoming ones fear of death

(/.#. &ounter.-riti01 The negative fears fear$ which is counterproductive

(//#. &ounter.-riti01 6umans all have an innate instinct to survive" Thus$ fearing death is human nature Anesi, 0ro)essor at 8niversit, o) 2hicago: Dept. o) ;ocial ;ciences* //!M/ 0C (Eeorge* <) $anQs Desires and 1ears acc. To Thomas ?o((es* 0ages !7 # Hhttp://maroon.&chicago.ed&/anesi/ho((es.pd)R The concepts o) desire and aversion and the simple passions* however* go well (e,ond explaining :&st ever,da, li)e. The, are the main stepping7stones )or ?o((es (etween his (asic o(servations o) man* and his de)inition o) h&man nat&re and nat&ral law. ?o((es ma+es the claim that among manQs desires is power. ' p&t )or a general inclination o) all man+ind* a perpet&al and restless desire o) power a)ter power* that ceaseth onl, in death. (@eviathan* xi.!#. The desire for power is based in some sense on the simple passions$ but its foundation is set in avoiding manBs principal aversion$ death$ and fulfilling manBs principal desire$ survival" This underlies natural law. A DA# !3 EATFR' (lex nat&ralis5 is a precept or general rule$ found out by reason$ by which a man is forbidden to do that which is destructive of his life or ta0eth away the means of preserving the same" (@eviathan* xiv./#. 6obbes has set down the basis for human nature" 'very human act$ conscious or unconscious$ is aimed at survival" 4125" Attempts to alter human nature leads to disastrous conse*uences.communism proves The 'poch Times* 4poch Time 2ommentaries on the 2omm&nist 0art,* 0art 6 o) M* Decem(er /6th !.0C* H http://en.epochtimes.com/news/67/!7/6/!6M5 .htmlR
In the last hundred years, the sudden invasion by the communist specter has created a force against nature and humanity, causing limitless agony and tragedy. It has also pushed civilization to the brink of destruction. Having committed all sorts of atrocities that violate the Tao and oppose heaven and the earth, it has become an extremely malevolent force against the universe. Man follows the earth, the earth follows heaven, heaven follows the Tao, and the Tao follows what is natural. [2] In ancient China people believed in compl in! with, harmoni"in! and co# e$istin! with heaven. Man%ind inte!rates with heaven and the earth, and e$ists in mutual dependence with them. The Tao of the universe does not chan!e. The universe runs accordin! to the Tao in an orderl manner. The earth follows the chan!es of heaven, therefore it has four distinct seasons. & respectin! heaven and the earth, man%ind en'o s a harmonious life of !ratitude and blessin!s. This is reflected in the e$pression heaven(s favorable timin!, earth(s advanta!eous terrain, and harmon amon! the people. [)] *ccordin! to Chinese thou!ht, astronom , !eo!raph , the calendar s stem, medicine, literature, and even social structures all follow this understandin!. &ut the Communist Party promotes humans over nature and a philosophy of struggle in defiance of heaven, the earth, and nature. !ao "edong said, battling #ith heaven is endless $oy, fighting #ith the earth is endless $oy, and struggling #ith humanity is endless $oy. +erhaps the Communist +art did ac,uire real 'o from these stru!!les, but the people have paid tremendously painful costs.