Please response to my peer discussion.thank you

Please response to my peer discussion.thank you Miguel Dacaynos Ethical/Cultural Inquiry Paper Ethical Inquiry According to Mary Dever, a bill titled the Commander John Scott Hannon Veterans Mental Health Care Improvement Act Public Law 116-171 written by Senator Jon Tester and Jerry Morgan was signed into law in October 2020 by President Donald Trump. The bipartisan legislation according to the article titled “veterans mental health bill signed into law” published Dever in 2020 is an aggressive and thorough approach to not only get veterans the mental health care that they earned and desperately need, but it’s also intended to aggressively combat the negative effects of suicide and contour to the specific needs of veterans. This law imposes changes on the authorities of the Department of Veterans Affairs and amends different strategies for veterans in general such as transitioning from military to civilian life, suicide prevention, mental health care research and oversight. This bill was signed into law because it was intended to unchain the hands of the VA by allowing them the opportunity and authority to use several strategies to provide mental health care for veterans as they see fit. As the National Legislative Director Joy Ilem has asserted, “This law allows VA to take a new approach to fighting the veteran suicide crisis.” In addition to that, the bill mentions a plethora of new policies that make VA facilities more effective by increases the number of their mental health professionals this would help strengthen telehealth programs for both rural and remote veterans, it would also increase their availability and ease of access by promoting innovative treatment options. It’s extremely paramount that this law was implemented when it was was because it compliments several laws that already in places such as the “Supporting the Resiliency of Our Nation’s Great (STRONG) Veterans Act”. According to an article titled “There’s a bill to bulk up VA mental health services” published by Saintsing in 2022 the STRONG Veterans Act, also known as HR 6411 was intended to grow the VA by increasing their resources that supports veteran’s mental health. In addition to complimenting certain laws already in place, it’s important that the Commander John Scott Hannon Veterans Mental Health Care Improvement Act Public Law 116-171 was implemented because as the COVID-19 Pandemic shows no signs of slowing down, the rules and regulations of isolating ourselves from the public goes on. As the chairman of the house of Veteran’s Affairs Committee has asserted in 2022, “This comprehensive bipartisan package will bolster VA’s efforts to support veterans’ mental health and ensure that all veterans can equitably access VA’s lifesaving resources especially as the COVID-19 pandemic continues.” The representative of California Mark Takano has joined the chairman asserting that “veteran suicide prevention has long been a top priority of mine, and while we made significant progress last Congress, our work is not finished”. That being said, the bill being implemented into law will benefit the nation’s veterans by increasing cultural competence in the mental health employees who work for the VA whilst implementing unique and effective suicide prevention strategies. In addition to that, debt reduction programs are also mentioned in the bill to help alleviate unique personal problems that veterans may face as they transition into civilian life. “There is simply no greater or more urgent challenge within the veteran community right now than addressing mental health concerns and ensuring our nation’s heroes have access to the support they need to both prevent and mitigate crisis,” as asserted by the National Commander Andy Marshall. It’s quite prevalent for military personnel to face ethical challenges during their time of military service. In times of war where seconds matter, many combatants may witness several occasions in which they are forced to act unethically and transgress from their moral beliefs. According to a study conducted by Schwartz and others in 2021, potentially morally injurious events or PMIEs are significant stressors that push veterans to end their own life. Research indicates that the prevalence of PMIE suicides tend to vary branches of Military, eras, and graphical areas. That being said, there are three kinds of PMIEs, first is PMIE-Self or events performed by the individual, the second is PMIE-Other in which they witness another commit a moral transgression, and the third is PMIE-Betrayal which essentially means that they commit betrayal, or they witness someone else do so. Data collected by the study conducted by Schwartz and others indicates that in a sample of US Veterans, 10.8% report that they commited a moral transgression, 25.5% of which report that they witnessed other so so and another 25.5% report that they committed or witnessed acts of betrayal. All kinds of PMIE result in what Schwartz and others calls Moral injury or MI. MI are social impacts whether that be psychological, biological, spiritual, or behavioral. Adverse effects of such result I extreme psychological outcomes such as suicidal ideation. With rates of veteran suicide increasing rapidly at a steady pace, studies show that PMIE-Self is prevalent in most cases of Veteran suicide. Moreover, PMIE-Self is known to cause moral dissonance between a veteran’s ethical beliefs and their actions at the time of the event. In states of intense internal conflict, veterans tend to contour their attitudes to match their reaction at the time, which causes the veteran to justify their actions. Essentially speaking, for veterans to advert certain feelings of self-condemnation, they will go out of their way to right their wrongs one way or another, going as far as to perform unethical actions such as suicide in the hopes that they don’t have to experience guilt, shame, or depression any longer. Veterans who agreed to participate in the study were fairly and thoroughly briefed of the risks and their compensation upon completion of the study. They were also informed that their data would be completely anonymous. The extensive procedure of the study gained ethical approval from not only the Ruppin Acadmic Center but also several internal ethical board. This study was done because it was intended to conclude whether ethical problems were prevalent in the decision making of veterans with regard to suicide or not, which was proven to be true as data indicates a strong positive correlation between PMI-Self and suicidal ideation. Serving in the military is hard enough, however witnessing traumatic events and surviving thereafter makes it harder to live a normal life as military personnel transition even after deployment. According to the study done by Schwartz and others in 2022, data indicates that potentially morally injurious events that were committed at their own hand had a very clear positive correlation with suicidal ideation when testing a small volunteer sample of 336 combat veterans that came from Israel. Collective hatred towards an outgroup may also perpetuate suicicdal thoughts in veterans, the “outgroup” being themselves. “In these studies, years after their release from the military service, combat veterans who committed atrocities still showed shame, hatred (toward themselves and others), felt they were unforgivable, and had the urge to self-punish.” (Schwartz, et al,. 2022). It is argued that the urge to self-punish derived from hatred towards themselves and this hypothesis was proven based on dynamic therapy studies conducted on veterans. Lastly, studies illustrate that when veterans are exposed to PMIEs even years after deployment whether that be from images, videos, or even movies, veterans start to crown or feel consumed by the painful memories which leads to steady premonitions of a short future, thus pushing them over the edge and ending their own life due to shame and hate toward themselves. In another study conducted by Zerach and others in 2019, research depicts exposure to PMIEs as a significant stressors that lead to adverse mental health effects in veterans, which also include what Zerach and others call “self-injurious thoughts and behavior” or SITB. This study was conducted to analyze the growing interest in the concept of Moral injury and how its tied to veterans ending their own lives. Moral injury experiences have been defined as “the last- ing psychological, biological, spiritual, behavioral, and social impact of perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations” (Zerach, et al,. 2019). As of now, no sources or reliable experts in the field have published studies and given evidence to prove the contrary. As unique as the topic may be, not one source or study has been conducted that provided evidence arguing against the major points mentioned earlier. However, Zerach and other argue that despite no source very clearly arguing the opposite and proving it, only a few studies have delved into the risks and internal factors that can thoroughly explain how the PMIEs contribute and maintain suicidal thoughts in veterans. Cultural Inquiry The culture examined in this paper will focus primarily on the white culture because according to a study conducted by Yin in 2006, although suicide makes a good portion of deaths in the United States, ranking as the 11th leading cause of death. With over 11 deaths per 100,000 caused by suicide, data indicates that white men over the age of 65 commit suicide at triple the rate mentioned previously, overall. Men are also 8 times more likely to fall victim to suicide compared to women of the same age according to Yin. Moreover, research also indicates that white men make double the rate of suicide compared to the rate of all other groups of male contemporaries. Although analysts and credible researchers are divided on what exactly makes white men more susceptible to suicide, data indicates that the best possible reason as to why the statistics of suicide in white men is disproportionate when compared to statistics of other male contemporaries or women, as a matter of fact, is due to the lack of coping ability or strategies that lead to strong resilience. Other studies indicate that white men are more likely to have unique choices for their method or means of suicide, these methods guarantee immediate death. Examples include firearms, opioid overdose, etc. this is because white men tend to be intrinsically more violent than other suicide victims according to the study conducted by Yin in 2006, this is because unlike women who simply have the thought of suicide, men were actually more likely to do it. Combine this with white men’s natural tendency to be violent, it’s no wonder why 73% of veteran suicide and 80% of all firearm suicide were caused at the hand of white males. Research conducted by Yin also depicts substantial disparities along ethnic lines for elderly males. Unlike white males, Asians or Pacific islanders commit suicide at a rate of 17.5 per 100,000. Hispanics or Latinos fall at 15.6 per 100,000 and African Americans commit suicide at a rate of 9.2 per 100,000. In another study conducted by Kent in 2010, data indicates that although the risk of suicide greatly varies by several uncontrollable factors such as age, sex, and race, substance abuse is a key risk factor that leads to suicide. Kent finds white men, regardless of their age have the highest suicide rates. From 2005 to 2007, the rate of white men committing suicide went up to 22 per 100,000 and is rapidly increasing at a steady pace even to this day. This is due to the fact that as Yin argues, white men in particular struggle with maintaining health and genuine social relationships with other people. The lack of genuine connections with anyone else other than themselves of licensed therapist make it easier for white men to turn to suicide as a result. “Regular interaction with family members is especially important, but social interactions with nonfamily members including neighbours, work colleagues, or club members also lowers suicide risk” (Kent, 2010). Moreover, data indicates that married men are less likely to commit suicide, however likewise, should a divorce or separation from their partner occur, the likelihood of suicide is increased dramatically. This aspect of suicide in veterans can be backed by research conducted by Porter and others in 1997, in their study, its indicated that suicide in the military is more likely to occur in single or divorced men. “This correlational descriptive study sought to identify the characteristic profile of telephone hotline users among veterans, their triggering crisis events, and whether the methods commonly used in suicide attempts relate to certain types of crisis” (Porter, et al., 1997). In addition to that, the findings in their study indicate that the most prevalent sociodemographic factor in veterans who are at risk of suicide was loneliness. And that the most common methods of suicide were drug overdose and self-inflected gunshots. The research conducted by Kent was done because it was intended to find out what is it about white male veterans that makes them more susceptible to suicide when compared to women or their other male contemporaries. Because previous studies left no clear correlation as to why white males are more at risk, this study was conducted to connect the dots and find connections. That being said, data indicates that generally, systemic obstacles such as cultural bias and difficulty in the primary care system are what most likely leads to suicide in white men. More specifically, however, it’s the lack of coping strategies that leads to the lack of strong resilience against intrusive thoughts. Suicide in the veteran population is a difficult topic to comprehend because most people have not seen what a veteran has seen in times of war. That being said, white men in particular are most susceptible to suicide because as argued by Yin, a cultural bias is present, that bias being the assumption that depression is a natural feature for men who came back from war. Secondly, white men lack the coping ability or strategies that could develop healthy resilience to combat intrusive thoughts. As Kent argued in his study, regular and healthy interactions with anyone other than themselves or a licensed therapist are healthy because these relationships lower the risk of suicide. maintaining social relationships protects people from attempting suicide. (Kent, 2010). And thirdly Yin argues that because men are more intrinsically violent in nature, white men are more likely to take it a step forward and manifest their intrusive thoughts into reality by committing suicide. Kent backs up this finding by citing his works which indicate that white men have easier access to easier or more lethal means of suicide such as firearms and illicit substances such as opioids. The arguments mentioned above are also reinforced by a study conducted by Im and others in 2015, as data collected from research they conducted indicates that US veterans who were prescribed opioid medications for the management of chronic pain, which is not uncommon in veterans, are at elevated risk of attempting suicide. In addition to that, patients who are on long-acting opioid treatment along with sedative co-prescriptions were also at an increased risk of suicide. Because of this, Im and others argue that it would be best for doctors who prescribe these medicines legally to encourage consistent drug screenings and follow-ups within 4 weeks of new opioid prescriptions or sedatives. Upon analysis of the sources currently used in the writing of this paper, there’s not much critique to be made as each author thoroughly covered the topic they decided to research. However, some might argue that the study conducted by Im and others only focuses of opioids that were obtained legally. There are several instances in which drugs can be obtained illegally so for Im and others to negate or ignore that factor of substance abuse and drug overdose within the veteran population in the study they conducted in 2015, the argument that they did not do enough or did not delve into the topic of substance abuse disorder much deeper is a very valid argument as this is one of the main causes in veteran suicide right after self-inflicted gunshots. However, to the credit of Im and others, they mention something a factor that has not been mentioned by other researchers in their studies. Im and others make a point to mention that substance abuse and opioid overdose can be prevented from getting worse. That being, more drug screening. “At the facility level, patients on opioid therapy within the facilities ordering more drug screens were associated with decreased risk of suicide attempt. In addition, patients on long-acting opioid therapy within the facilities providing more follow-up after new prescriptions were associated with decreased risk of suicide attempt” (Im, et al,. 2015)

******CLICK ORDER NOW BELOW AND OUR WRITERS WILL WRITE AN ANSWER TO THIS ASSIGNMENT OR ANY OTHER ASSIGNMENT, DISCUSSION, ESSAY, HOMEWORK OR QUESTION YOU MAY HAVE. OUR PAPERS ARE PLAGIARISM FREE*******."