DS 1

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Discussion: Research and Ethics in PsychologyDevelopmental psychology attempts to understand cognitive, physical, and social-emotional development throughout the lifespan. In order to understand, for example, how maternal stress during pregnancy might impact the child later in life, pregnant women and children could be studied. Vulnerable populations, such as pregnant women, newborns, children, cognitively impaired individuals, incarcerated individuals, or older adults, require additional consideration and protection when planning to conduct research with them.When conducting research in the field of human development, particularly with vulnerable populations, it is important to keep in mind that a unique set of ethical considerations should be taken into account. These populations need extra care to ensure their rights because some individuals may lack the mental capacity to give informed consent, may have decreased free will, or may be vulnerable in terms of their physical or mental welfare. As you approach this Discussion, keep in mind how ethical considerations might have affected the type of research that could be conducted.For this Discussion, you will examine the role of ethics in developmental psychology research as it relates to vulnerable populations.To prepare for this Discussion:Review the example of a Discussion post and response found in this week’s Learning Resources as well as the Discussion Rubric to understand the Discussion’s expectations.Review the Learning Resources related to ethics and research in the field of developmental psychologyChoose a population from the following:         ChildrenWomen who are pregnantGeriatric individualsIndividuals with cognitive disabilitiesAdolescentsBy Day 4Based on the population you selected, post an explanation of the role of ethics in developmental psychology research with attention to the characteristics of this vulnerable population. Be specific in your post and use the Learning Resources to support your post. Use proper APA format and citations to support your explanation.

Discussion—Biomes, Development, Pollution, and You

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Each part of the United States has at least one ecological crisis based on location, biome, and industrialization pattern. For example, the Midwest was once a prairie with very fertile soil. However, when people realized that with the right watering and drainage system this area could become productive farmland, there arose ecological problems. The conversion of the prairie to farmland is the root cause of many ecological problems in this region.

Regardless of what biome you consider, humans have likely had an impact on the ecology of that area.

For this assignment, identify the biome in which you live. The following are a few examples of biomes:

  • Tropical rainforests: This biome has high average temperatures, high moisture levels, and high species diversity.
  • Prairies: The prairies have grassland-variable temperatures, variable moisture levels—depending on proximity to mountain ranges—and are mainly dominated by grasses and ungulate herbivores.
  • Deserts: These biomes have hotter average temperatures, low moisture, lower species diversity, and a composition of species limited mainly to those that are adapted to hot temperatures.
  • Temperate forests: The temperate forests have variable temperatures, high moisture levels, and higher species diversity.
  • Taigas: These biomes have colder average temperatures, lower moisture levels, and lower species diversity.
  • Tundras: The tundras have cold average temperatures, low moisture levels, and low species diversity.
  • Coral reefs: These biomes have high average temperatures and high species diversity.
  • Open oceans: These biomes have a wide range of temperatures and species diversity varies.
  • Chaparrals: The chaparrals have higher average temperatures, lower moisture levels, and are dominated mainly by grasses and shrubs.
  • Alpines: These biomes have low average temperatures, low precipitation, and receive high ultraviolet (UV) rays due to high elevation.

Using the readings for this module, the Argosy University online library resources, and the Internet, respond to the following:

  • Explain how humans have impacted the biome in which you live. List the types of environmental damage that have been caused and the species that have been impacted.
  • Describe the major pollution issues for your biome, and elaborate on the sources of this pollution.
  • List any species that have become extinct in this biome.

Support your statements with appropriate examples and scholarly references.

Write your initial response in approximately 300–350 words. Apply APA standards to citation of sources.

ABS200 week 2 discussion 2

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Stress and Coping

 

Prepare Icon Prepare: Prior to completing this discussion, be sure to interact with the Health Psychology learning object located in the left navigation bar of your online course, ensure you have finished the reading and video for this week, and have reviewed any relevant Instructor Guidance that will help prepare you for this activity.

 

Reflect.png Reflect: Take the role of a mental health professional invited to give a presentation on stress management. Identify a target audience (e.g.,, children, adolescents, adults) and any relevant demographics (e.g., ethnicity, age ranges, sexual orientation, religion, etc.) and other characteristics unique to your target population (e.g., older adults, military spouses, children of divorce, newlywed couples, living in a high crime area, unemployed for more than a year, victims of bullying, excessive parental pressure to achieve, etc.). The primary stressors experienced by your target population can be due to positive and/or negative life events.  Research effective strategies for coping with stressors and skills to develop resilience. You will use the information from your research to examine uses and applications of applied behavioral science to stress and coping interventions and identify current trends in how applied behavioral science is used to develop resilience.

 

Write.png Write: Create a written summary of the information you would include in a presentation on the assigned topic.

Required topics to be addressed: Your summary must cover each of the following topics in the order presented below in your own words. Be sure to write in complete sentences. 

Identify specific characteristics of your target audience.

Briefly define stress and give examples relevant to your target audience.

Discuss at least two specific stressors relevant to your target audience’s primary concerns.

Describe healthy and unhealthy ways in which people may respond to the two stressors listed in #3 above.

Select one specific skill a mental health professional might teach to help individuals cope effectively with stress.

Define resilience and identify at least three factors associated with resilience.

Identify at least three ways to build resilience.

Discuss the importance of flexibility in maintaining resilience.

List at least one online, print, video, and/or local resources in your community where participants may receive additional help in learning to effectively cope with life stressors and develop/enhance their resilience skills.

Be sure to include in-text citations and a reference list that are in accordance with APA style as outlined in the Ashford Writing Center. For further assistance in researching scholarly sources, be sure to access the tutorials page on the Ashford University Library website.

Principles of macroeconomics

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What is short term aggregate supply and how does it differ from long term aggregate supply? Also, what can an economy do that desires to increase long term aggregate supply?

In addition to contributing your answer by Saturday, please provide thoughtful, thorough responses to at least two classmates by Tuesday.

ALSO PLEASE REPLY TO ANOTHER STUDENTS COMMENT BELOW 

ARIE:

Short term aggregate supply refers on the way to the overall invention of goods and services by an economy at different prices yet the resources needed to produce them are the same. When prices increase, the quantity of supply also increases. In the short term, the amount slopes up because the cost of at least one factor is constant. Short term supply is always linked to inflation and unemployment. Higher inflation leads to high prices which in turn increases the output. Higher rises are also linked to low rates of unemployment in an economy.

While long term aggregate supply refers to the relationship that exists among the cost of production and output in the long run. It varies from short term aggregate supply in the sense that the cost of production or resources is not assumed to be constant. This relationship reflects the belief by economists that the changes in demand only have a temporary effect on the output of the economy. When production factors such as labor are changed or shifted, it is likely to affect the quantity of production (Khan, 2012)

To increase long term aggregate supply, the economy should introduce policies that increase production and increase long term supply. The economy can do so by lowering unemployment rates. When most people are employed, there will be enough supply of labor and the production will be high. Secondly, the economy should encourage privatization to ensure steady supply from both private and public firms. A long term aggregate supply can also be increased by minimizing regulation and reducing taxes to encourage investors to venture into production to ensure adequate and maximum amount that meets the demand in the market.

hmgt 495 assignment

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Correctional Health Care Assignment

2-3 pages with credible references of at least three.

You applied and were accepted in an internship program of a state-level, Female Correctional Health Care Operation in the South Eastern United States and your primary responsibility is to work on the assigned projects related to the provision of inmate health care.

Associated materials: 

The Health and Health Care of US Prisoners: Results of a Nationwide Survey

Public Health Behind Bars

Sample Tool Control Policy

Inmate Sick Call Procedures-Corrections

For the incarcerated population in the United States, health care is a constitutionally guaranteed right under the provisions of the eight amendment which is the prohibition against cruel and unusual punishment (see Estelle v. Gamble). This particular prison can hold in excess of 1,728 offenders and routinely houses between 1,600 and 1,700 women on any given day. This institution incarcerates all custody classes to include minimum security, medium security, close custody, death row, and pretrial detainees. 

The health care operation provides the highest level of care for the female offender in the state. The health care facility is a 101 thousand square foot, 150 bed, three-story building that cost the taxpayers $50 million dollars to construct and is a hybrid of an ambulatory care center, long-term care center, and a behavioral care center. The health care facility also houses an assisted living dorm.

The patient demographic includes women who have multiple co-morbidities including substance abuse, seriously persistent mental illnesses (SPMI), diabetes, cardiovascular disease, cancer, morbid obesity, HIV / AIDs, hepatitis, etc. On any given day there will also be 30 to 60 offenders who are pregnant, with 98% of those offenders having a history of substance abuse; all pregnant offenders are considered high-risk. The dental health of this patient population is exceptionally horrendous because of excessive drug abuse coupled with a sugary diet and poor oral hygiene practices. It is not uncommon for a 23-year-old to need all of her teeth extracted.

There are approximately 300 FTEs to include correctional staff that operate the facility and provide care to the offender population. The healthcare facility is comprised of the following directorates: (a) Medical, (b) Nursing, (c) Behavioral Health, (d) Pharmacy, (e) Dental, (f) Medical Records, (g) Health Service Support, and (h) Operations and Security.

Although the health care facility has a vast amount of capability, there limitations: (a) This facility does not have advanced cardiac life support capability (ACLS), (b) no surgical capability, (c) no ability to conduct telemetry, (d) no oral surgery beyond simple extractions, (e) no obstetrical capability beyond out-patient clinics, (f) MRI, (g) level 2 ultrasound, and the list goes on.

Those inmates who have medical needs that cannot be addressed by the health services staff at the correctional facility will need appointments with external health care providers who have a business relationship with the prisons in this area. On any given month, there will be approximately 300 offenders who will go to outside medical appointments and making certain that these appointments take place this is where the challenge lies. Similar to many health care operations, the prison Utilization Review / Case Management Department facilitates all external appointments and form the lynchpin between the correctional facility health care providers who refer offenders for specialty appointments, and the outside organization providing that appointment.  

Your assignment: You are the Case Coordinator. You have 300 patients that need to be scheduled for outside specialty appointments every month. You are tasked by the Administrator to develop a strategic plan organizing the out of the facility appointments without impairing internal services.

As the first step, develop a Memorandum addressing:

  1. Provide an overview of Estelle v. Gamble and how that 1976 Supreme Court ruling pertains to the provision of inmate health care.
  2. Examine the challenges of providing health care in a correctional environment.
  3. What are the challenges of providing health care to a female offender population that may not exist in a male prison?
  4. What framework would you apply to the strategic planning? Why? (HINT: Remember all the available frameworks that you learned in the previous classes as well as in this class to make a correct choice). 

Make sure to cite in APA format when appropriate. Support your statements with credible evidence. a minimum of 3 references.

Reflective Analysis and Interpersonal Improvement Plan

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By the due date assigned, complete the following assignment:

In Module 1, you identified a personal, academic, and professional goal. In Module 3, you created an action plan for achieving your goals. Now, you will reflect on the implementation of your action items, analyze their effectiveness, and submit your final Interpersonal Improvement Plan.

Example:
Here is what a reflective analysis looks like using the example we have been using with Tom’s professional goal:
Professional Goal: Work on nonverbal communication so my words match my nonverbal cues.

  • Intermediate Goal 1: Take a course on interpersonal effectiveness.
    • Action Item 1: Review the course catalog to learn about the available courses about Interpersonal Effectiveness.
    • Action Item 2: Speak to my academic advisor about when I can enroll.
  • Intermediate Goal 2: Practice conversations with myself—either talking to myself in the mirror or video recording conversations so I can see what others are seeing.
    • Action Item 1: Learn to use the video record function on my smart phone by asking a tech-savvy friend.
    • Action Item 2: Set aside ten minutes three times a week to practice using a positive tone of voice and facial expression when I speak.
  • Intermediate Goal 3: In each team meeting, remember to smile and offer positive feedback.
    • Action Item 1: At the very next team meeting, draw a smiley face on the top of my notebook to remind me to smile and make eye contact during the meeting.
    • Action Item 2: Plan to say one brief supportive statement to each co-worker as they present their weekly reports.

Looking at Intermediate Goal 1, I reviewed the course catalog, spoke to my academic advisor, and discovered an interpersonal communication  class is not available until next January. So, while that is definitely a goal, I am changing it to something I can use immediately. Through an online search, I discovered an interpersonal effectiveness seminar happening in my town next weekend so I signed up it and will attend.
Intermediate Goal 2 has been interesting because once my friend showed me how to use the record function on my phone, I noticed that I wear a natural scowl on my face. Each time I pass a mirror, I make an effort to notice my facial expressions. I also notice that I have a natural tendency to cross my arms in conversation. Although this feels comfortable I know that it makes me appear closed off or upset. Since I have been more conscious about how I appear to others, I have noticed that people I don’t normally interact with in the office are now starting conversations with me. 
Intermediate Goal 3 has shown the greatest improvement. After the first team meeting, a coworker commented that they really appreciated the positive feedback I gave them. In a meeting later in the week, the supervisor shook my hand and said that he appreciated my contribution to the discussion. It looks like the plan is working.

For this assignment, reflect on changes that you have experienced from implementing the action items for each of your goals. You may decide that a certain action seemed like a good choice at first but had to be changed.

Now that you have worked through the steps of the model for improving interpersonal skills you will submit your final Interpersonal Improvement Plan. Use this worksheet as a template for your assignment.

Save your your final Interpersonal Improvement Plan as 

*** Module 3 Assignment is attached. please us the Module 3 goals and action plans.****

Psychology Discussion: Designing Mixed Methods Research code 002500420019EE

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Psychology Discussion: Designing Mixed Methods Research code 002500420019EE

Please it psychologological course, so please do something related to psychology.

Psychology Discussion:
 Designing Mixed Methods Research

Subject Area

Discussion assignment

No.of pages/Wordcount

1 page

Urgency 4 to 5 hours. 

Citation Style

APA Style

Assignment Details

Detailed description

This week’s readings provide an overview of various types of mixed methods research designs. As with previous discussions on design, the selection of the most appropriate mixed design is guided by the study’s purpose and research questions and/or hypotheses. The choice of design links the research questions and/or hypotheses to the data that will be collected achieving alignment among research components.
In this Discussion, you will explore the basics of mixed methods research designs, calling upon your growing understanding of both quantitative and qualitative research.
With these thoughts in mind:

By Day 4

Post your response to the question, “To what extent is mixed methods research simply taking a quantitative design and a qualitative design and putting them together?” Next, explain the types of research questions best served by mixed methods research. Then, explain one strength and one limitation of mixed methods research. Finally, provide a rationale for or against the utility of mixed methods research in your discipline.

Resources that may help.

Burkholder, G. J., Cox, K. A., & Crawford, L. M. (2016). The scholar-practitioner’s guide to research design. Baltimore, MD: Laureate Publishing.
Chapter 6, “Mixed Methods Designs and Approaches”

Johnson, R. B., & Onwuegbuzie, A. J. (2004). Mixed methods research: A research paradigm whose time has come. Educational Researcher, 33(7), 14–26. doi: 

10.3102/0013189X033007014
Retrieved from the Walden Library databases.
Please this is psychological course

____

Respond to my two classmate discussions 150 words Only in 5 hours

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 1.

  1. cover Letters
  2. Goal Management
  3. Academic Plan

This course has helped me realize three major key concepts that I can use in my life, both present and future. To start, the cover letter assignment has taught me how to properly compose a cover letter in order for my letter to appear more professional to the hiring manager for the position I am applying for. I learned how to list key skills that will help identify my strengths when it comes to a certain position I am applying for. Another thing I learned, was how to organize my goals to better motivate my self to actually get important things done in the time I intended. This will help with the procrastination trait that I seem to have and help me better my career path. Lastly, I learned how to manage my Academic life and was able to project how many credits I could finish within a quarter and identify what grades I initially want. I firmly believe I have obtained a lot of helpful knowledge from this course that will definitely be useful in the future whether near or far. 

 

2.

The three key take-aways from this course for me personally were:

 1. Academic Plan to stay on track. 

2. The importance of communication 

3. Persistence is the key to success 

One key take-away was creating an academic plan for that future is an imperative step in achieving goals. Tracking and maintaining your grades is a critical part of successfully achieving your academic goals, and achieving goals. Planning is the best form of prevention and it reduce anixety.It helps to gain a better understanding of interests, identify possible job opportunities, and gain career market information.

Good communication ensures what is expected of them, that the appropriate person receives the correct information.Clear and concise communication and the consequences of poor communication need to be understood by the accountancy profession.

Persistence is the ability to maintain action regardless of your feelings. You press on even when you feel like quitting, until you achieve that important goal. I surprise myself everyday. People give up too soon because they have wrong expectations of themselves and the outcome.

Response #4 haas

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         The recent actions of interest groups and the effect on the legislative agenda of Congress have changed how congress is run in multiple ways. Here in America we are aware that when a special interest group uses their money to lobby for a change in policy, they have the power to block individuals from being fairly represented by not allowing them to speak and they are not governed by accountability. It is very important that our American leadership stands strong and has viable answers to ensure that, according to the Constitution, the government is working “for the people” as it should be (American progress.org, Sept. 27, 2017).

         Lobbyists have spent more than $6 billion of their resources in 2015 and 16, which is almost equal to how much was spent for federal campaigning in that time frame (American progress.org). When we look at how much Congress spends on their professional staff, it is considerably less than that $6 billion and it should be noted that there are only 20 certified lobbyists included for every member of Congress. Now, this doesn’t include all the non-certified lobbyists or “shadow” lobbyists that have walked right in because of easy registration requirements and the lack of enforcement of rules (American progress, 2017). 22 these facts, the members of Congress are compromised during their campaign because they have accepted donations from these lobbyists and quite often, lobbyists become members of their staff and promote their interests throughout the campaign. This is due to the fact that many lobbyists are retired lawmakers that work for the special interest groups and inundate themselves back into the system (American progress). Finally, the overspending we see in the campaigning process is directly undermining the Constitution and our democratic process (A. P., 2017). We can see that the special interest groups are placing themselves in a position where they can affect congressional decision-making and block legislation that they oppose while attacking the wallets of their wealthy corporate clients (A.P., 2017).

         According to US history.com, we have seen three major interest groups that have significantly changed the face of American politics. These three groups include; animal-rights, environmental interests and public interest groups (2018). We see many other types of interest groups that crop up from the myriad of groups that feel they are not paid enough for their services, these include; the American Bar Association, medical Association and the Federation for teachers (part of the national education Association). As a whole, mainly business and trade corporations create interest groups in order to gain more wealth and power or resources. An example of some of these would be the oil and tobacco industries specifically because they are seen quite often on the steps of the Capitol (2018). These interest groups tried to convince policymakers to go along with their agenda by persuasive actions and measures. These measures include; talking to the media or the press, having direct contact with government officials and lobbying (US history).

         When there is a hearing held in Congress, we see these lobbyists there pushing their agenda and campaigning for government officials to make a change. A recent example of this is when Congress was playing with the idea of trying to make private clubs same-sex organizations. One of these “private clubs” was the Boy Scouts and Girl Scouts, who wanted their organizations to be same-sex. As we know, now girls and boys can join either organization because of the work of these lobbyists and special interest groups. Many times these special interest groups accuse their influence through being politically involved in active in the campaign process in order to see favor-ability for their position. They also will attempt to elect candidates who are not opposed to their position and are able to defeat their opponents. There is what we call political action committees that are the front runners for the special interest groups and help to protect their mission (US history). 

         There has been a surge in the numbers for political action committees or PAC. This trend started in the early 1970’s during the campaign finance reform laws passing. There is such a thing is campaign donations that are written to the PAC’s, which then will funnel that money directly over to contributions for the campaign of the individual that they selected as a candidate. This has significantly changed the face of the election and campaign process. It is believed that much of the money comes from corporations and businesses in order to influence how American government is run (US history). The general public is allowed to create a public interest group in order to connect themselves to the government and be a persuasive factor during the decision-making process for policy and laws. It is things like this that make American democracy better and upholds the constitutional laws by connecting the people directly to the government and its processes (2018).

         On the other side of the issue, there are those who would like to reduce the power of special interest groups over policymaker’s decisions. There is the suggestion that we being on fund raising for all lobbyists and only allow them to contribute a certain amount per candidate per election. This would help there direct relationship with the campaign process and great that connection for buying “favorable interest” (American process.org). Another suggestion is to ban members of congress from allowing special interest groups to contribute to them during their committees. The United States house of ethics would have to implement new legislation along with the US Senate, so that they can identify who the individual contributors are and to stop funding from wealthy special interest groups on behalf of the American people (American progress). There should be a push for public servants to focus more on the public and not on the special interest groups because of funding. Lawmakers would be the end from accepting a lobbying position for one to five years or possibly permanently. This would stop some of the special interests lobbying that occurs within Congress. Finally, implementing effective policy to fight the corrupting influence of special interest lobbyists depends on an accurate and effective system of lobbyist’s registration according to American progress.org (2017). This would stop one person from enticing another to lobby on their behalf or to stop an individual from continuing to lobby more than once in a two-year period. If this was to have been, the public would better understand where the money is being spent and who is trying to influence the government, making representatives more accountable (American progress, 2017).

         In article 3 of the Constitution states that “the judicial power of the United States, shall be vested in one Supreme Court, and in such inferior courts as Congress may from time to time ordain and establish” (US courts.gov). I take this to mean that in order to protect the Constitution, we need to control the special interest groups and stop them from influencing policymakers through monetary means. It should not be a point of interest for those who are in Congress to make money, it is their job to protect the interests of the people in the public at large. I believe that the special interest groups should have a voice, however, I do not believe that they should be allowed to persuade members of Congress by giving them donations towards their campaign. Everyone has an opinion, but we need to protect the rights of everyone’s opinion and not just those who have the money to pay for it.

Maybe you could respond to this posting through these questions. Answer in summary or essay type format.

How about at the state level? What are the biggest and most powerful (two or three) interest groups in your state and what area of policy do they influence? Do you think they have too much power? Why or why not? 1/2page

hmgt 372 assignment

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}  .d2l-button-icon-1[h-align=”text”] button.d2l-button-icon {   left:calc(((2rem + 2px – 0.9rem) / 2) * -1); }  [dir=”rtl”] .d2l-button-icon-1[h-align=”text”] button.d2l-button-icon, .d2l-button-icon-1[dir=”rtl”][h-align=”text”] button.d2l-button-icon {   left:0;right:calc(((2rem + 2px – 0.9rem) / 2) * -1); }  [dir=”rtl”] .d2l-button-icon-1:host([h-align=”text”]) button.d2l-button-icon, .d2l-button-icon-1[dir=”rtl”]:host([h-align=”text”]) button.d2l-button-icon {   left:0;right:calc(((2rem + 2px – 0.9rem) / 2) * -1); }  [dir=”rtl”] .d2l-button-icon-1[h-align=”text”] button.d2l-button-icon, .d2l-button-icon-1[dir=”rtl”][h-align=”text”] button.d2l-button-icon,.d2l-button-icon-1 [dir=”rtl”] [h-align=”text”] button.d2l-button-icon {   left:0;right:calc(((2rem + 2px – 0.9rem) / 2) * -1); }  :host([dir=”rtl”] .d2l-button-icon-1[h-align=”text”]) button.d2l-button-icon, :host(.d2l-button-icon-1[dir=”rtl”][h-align=”text”]) button.d2l-button-icon {   left:0;right:calc(((2rem + 2px – 0.9rem) / 2) * -1); }  .d2l-button-icon-1 button.d2l-button-icon::-moz-focus-inner {   border:0; }  .d2l-button-icon-1 button[disabled].d2l-button-icon:hover,.d2l-button-icon-1 button[disabled].d2l-button-icon:focus,.d2l-button-icon-1[active] button[disabled].d2l-button-icon {   background-color:transparent; }  .d2l-button-icon-1 button.d2l-button-icon:hover,.d2l-button-icon-1 button.d2l-button-icon:focus,.d2l-button-icon-1[active] button.d2l-button-icon,.d2l-button-icon-1.d2l-button-icon-hover button.d2l-button-icon,.d2l-button-icon-1.d2l-button-icon-focus button.d2l-button-icon {   background-color:#e6eaf0; }  .d2l-button-icon-1 button.d2l-button-icon:focus,.d2l-button-icon-1.d2l-button-icon-focus button.d2l-button-icon {   border-color:rgba(0, 111, 191, 0.4);box-shadow:0 0 0 4px rgba(0, 111, 191, 0.3); }  .d2l-button-icon-1 .d2l-button-icon.d2l-button-icon {   height:0.9rem;width:0.9rem; }  .d2l-button-icon-1[translucent] button.d2l-button-icon {   background-color:rgba(0,0,0,0.5);transition:background-color 0.5s; }  .d2l-button-icon-1[translucent] .d2l-button-icon.d2l-button-icon {   color:white; }  .d2l-button-icon-1[active][translucent] button.d2l-button-icon,.d2l-button-icon-1[translucent].d2l-button-icon-hover button.d2l-button-icon,.d2l-button-icon-1[translucent].d2l-button-icon-focus button.d2l-button-icon,.d2l-button-icon-1[translucent] button.d2l-button-icon:hover,.d2l-button-icon-1[translucent] button.d2l-button-icon:focus {   border:none;background-color:#006fbf;box-shadow:none; }  .d2l-button-icon-1 button[disabled].d2l-button-icon {   cursor:default;opacity:0.5; } .d2l-button-icon-0[d2l-visible-on-ancestor-init] {   visibility:hidden; }  .d2l-button-icon-0[d2l-visible-on-ancestor-transition] {   transition:transform 200ms ease-out, opacity 200ms ease-out !important; }  .d2l-button-icon-0[d2l-visible-on-ancestor-hide] {   opacity:0 !important;transform:translateY(-10px) !important; }  @media only screen and (hover: none), only screen and (-moz-touch-enabled: 1) { .d2l-button-icon-0[d2l-visible-on-ancestor-hide] {   opacity:1 !important;transform:translateY(0px) !important; }  .d2l-button-icon-0[d2l-visible-on-ancestor-hide][d2l-visible-on-ancestor-no-hover-hide] {   opacity:0 !important;transform:translateY(-10px) !important; }  }  .d2l-button-icon-0 {   display:inline-block; }  .d2l-button-icon-0[hidden] {   display:none; }  .d2l-button-icon-0 button.d2l-button-icon {   background-color:transparent;border-color:transparent;font-family:inherit;box-shadow:0 0 0 4px rgba(0, 0, 0, 0);border-radius:0.3rem;border-style:solid;border-width:1px;box-sizing:border-box;cursor:pointer;display:inline-block;margin:0;min-height:calc(2rem + 2px);outline:none;text-align:center;transition:box-shadow 0.2s;-webkit-user-select:none;-moz-user-select:none;-ms-user-select:none;user-select:none;vertical-align:middle;white-space:nowrap;width:auto;border-radius:4px;min-height:1.7rem;min-width:1.7rem;position:relative; }  .d2l-button-icon-0[h-align=”text”] button.d2l-button-icon {   left:calc(((2rem + 2px – 0.9rem) / 2) * -1); }  [dir=”rtl”] .d2l-button-icon-0[h-align=”text”] button.d2l-button-icon, .d2l-button-icon-0[dir=”rtl”][h-align=”text”] button.d2l-button-icon {   left:0;right:calc(((2rem + 2px – 0.9rem) / 2) * -1); }  [dir=”rtl”] .d2l-button-icon-0:host([h-align=”text”]) button.d2l-button-icon, .d2l-button-icon-0[dir=”rtl”]:host([h-align=”text”]) button.d2l-button-icon {   left:0;right:calc(((2rem + 2px – 0.9rem) / 2) * -1); }  [dir=”rtl”] .d2l-button-icon-0[h-align=”text”] button.d2l-button-icon, .d2l-button-icon-0[dir=”rtl”][h-align=”text”] button.d2l-button-icon,.d2l-button-icon-0 [dir=”rtl”] [h-align=”text”] button.d2l-button-icon {   left:0;right:calc(((2rem + 2px – 0.9rem) / 2) * -1); }  :host([dir=”rtl”] .d2l-button-icon-0[h-align=”text”]) button.d2l-button-icon, :host(.d2l-button-icon-0[dir=”rtl”][h-align=”text”]) button.d2l-button-icon {   left:0;right:calc(((2rem + 2px – 0.9rem) / 2) * -1); }  .d2l-button-icon-0 button.d2l-button-icon::-moz-focus-inner {   border:0; }  .d2l-button-icon-0 button[disabled].d2l-button-icon:hover,.d2l-button-icon-0 button[disabled].d2l-button-icon:focus,.d2l-button-icon-0[active] button[disabled].d2l-button-icon {   background-color:transparent; }  .d2l-button-icon-0 button.d2l-button-icon:hover,.d2l-button-icon-0 button.d2l-button-icon:focus,.d2l-button-icon-0[active] button.d2l-button-icon,.d2l-button-icon-0.d2l-button-icon-hover button.d2l-button-icon,.d2l-button-icon-0.d2l-button-icon-focus button.d2l-button-icon {   background-color:#e6eaf0; }  .d2l-button-icon-0 button.d2l-button-icon:focus,.d2l-button-icon-0.d2l-button-icon-focus button.d2l-button-icon {   border-color:rgba(0, 111, 191, 0.4);box-shadow:0 0 0 4px rgba(0, 111, 191, 0.3); }  .d2l-button-icon-0 .d2l-button-icon.d2l-button-icon {   height:0.9rem;width:0.9rem; }  .d2l-button-icon-0[translucent] button.d2l-button-icon {   background-color:rgba(0,0,0,0.5);transition:background-color 0.5s; }  .d2l-button-icon-0[translucent] .d2l-button-icon.d2l-button-icon {   color:white; }  .d2l-button-icon-0[active][translucent] button.d2l-button-icon,.d2l-button-icon-0[translucent].d2l-button-icon-hover button.d2l-button-icon,.d2l-button-icon-0[translucent].d2l-button-icon-focus button.d2l-button-icon,.d2l-button-icon-0[translucent] button.d2l-button-icon:hover,.d2l-button-icon-0[translucent] button.d2l-button-icon:focus {   border:none;background-color:#006fbf;box-shadow:none; }  .d2l-button-icon-0 button[disabled].d2l-button-icon {   cursor:default;opacity:0.5; }  .d2l-button-subtle-0 {   display:inline-block; }  .d2l-button-subtle-0 button.d2l-button-subtle {   background-color:transparent;border-color:transparent;font-family:inherit;padding:0.5rem 0.6rem;position:relative;box-shadow:0 0 0 4px rgba(0, 0, 0, 0);border-radius:0.3rem;border-style:solid;border-width:1px;box-sizing:border-box;cursor:pointer;display:inline-block;margin:0;min-height:calc(2rem + 2px);outline:none;text-align:center;transition:box-shadow 0.2s;-webkit-user-select:none;-moz-user-select:none;-ms-user-select:none;user-select:none;vertical-align:middle;white-space:nowrap;width:auto;font-size:0.7rem;line-height:1rem;font-weight:700;letter-spacing:0.2px; }  .d2l-button-subtle-0[h-align=”text”] button.d2l-button-subtle {   left:-0.6rem; }  [dir=”rtl”] .d2l-button-subtle-0[h-align=”text”] button.d2l-button-subtle, .d2l-button-subtle-0[dir=”rtl”][h-align=”text”] button.d2l-button-subtle {   left:0;right:-0.6rem; }  [dir=”rtl”] .d2l-button-subtle-0:host([h-align=”text”]) button.d2l-button-subtle, .d2l-button-subtle-0[dir=”rtl”]:host([h-align=”text”]) button.d2l-button-subtle {   left:0;right:-0.6rem; }  [dir=”rtl”] .d2l-button-subtle-0:host([h-align=”text”]) button.d2l-button-subtle, .d2l-button-subtle-0[dir=”rtl”]:host([h-align=”text”]) button.d2l-button-subtle,.d2l-button-subtle-0 [dir=”rtl”] :host([h-align=”text”]) button.d2l-button-subtle {   left:0;right:-0.6rem; }  [dir=”rtl”] .d2l-button-subtle-0[h-align=”text”] button.d2l-button-subtle, .d2l-button-subtle-0[dir=”rtl”][h-align=”text”] button.d2l-button-subtle,.d2l-button-subtle-0 [dir=”rtl”] [h-align=”text”] button.d2l-button-subtle {   left:0;right:-0.6rem; }  .d2l-button-subtle-0 button.d2l-button-subtle::-moz-focus-inner {   border:0; }  .d2l-button-subtle-0 button[disabled].d2l-button-subtle:hover,.d2l-button-subtle-0 button[disabled].d2l-button-subtle:focus,.d2l-button-subtle-0[active] button[disabled].d2l-button-subtle {   background-color:transparent; }  .d2l-button-subtle-0 button.d2l-button-subtle:hover,.d2l-button-subtle-0 button.d2l-button-subtle:focus,.d2l-button-subtle-0[active] button.d2l-button-subtle,.d2l-button-subtle-0.d2l-button-subtle-hover button.d2l-button-subtle,.d2l-button-subtle-0.d2l-button-subtle-focus button.d2l-button-subtle {   background-color:#e6eaf0; }  .d2l-button-subtle-0 button.d2l-button-subtle:focus,.d2l-button-subtle-0.d2l-button-subtle-focus button.d2l-button-subtle {   border-color:rgba(0, 111, 191, 0.4);box-shadow:0 0 0 4px rgba(0, 111, 191, 0.3); }  .d2l-button-subtle-0 .d2l-button-subtle-content.d2l-button-subtle {   color:#006fbf;vertical-align:middle; }  .d2l-button-subtle-0[icon] .d2l-button-subtle-content.d2l-button-subtle {   padding-left:1.2rem; }  .d2l-button-subtle-0[icon][icon-right] .d2l-button-subtle-content.d2l-button-subtle {   padding-left:0;padding-right:1.2rem; }  [dir=”rtl”] .d2l-button-subtle-0:host([icon]) .d2l-button-subtle-content.d2l-button-subtle, .d2l-button-subtle-0[dir=”rtl”]:host([icon]) .d2l-button-subtle-content.d2l-button-subtle {   padding-left:0;padding-right:1.2rem; }  [dir=”rtl”] .d2l-button-subtle-0:host([icon]) .d2l-button-subtle-content.d2l-button-subtle, .d2l-button-subtle-0[dir=”rtl”]:host([icon]) .d2l-button-subtle-content.d2l-button-subtle,.d2l-button-subtle-0 [dir=”rtl”] :host([icon]) .d2l-button-subtle-content.d2l-button-subtle {   padding-left:0;padding-right:1.2rem; }  [dir=”rtl”] .d2l-button-subtle-0[icon] .d2l-button-subtle-content.d2l-button-subtle, .d2l-button-subtle-0[dir=”rtl”][icon] .d2l-button-subtle-content.d2l-button-subtle,.d2l-button-subtle-0 [dir=”rtl”] [icon] .d2l-button-subtle-content.d2l-button-subtle {   padding-left:0;padding-right:1.2rem; }  [dir=”rtl”] .d2l-button-subtle-0:host([icon]):host([icon-right]) .d2l-button-subtle-content.d2l-button-subtle, .d2l-button-subtle-0[dir=”rtl”]:host([icon]):host([icon-right]) .d2l-button-subtle-content.d2l-button-subtle {   padding-left:1.2rem;padding-right:0; }  [dir=”rtl”] .d2l-button-subtle-0:host([icon]):host([icon-right]) .d2l-button-subtle-content.d2l-button-subtle, .d2l-button-subtle-0[dir=”rtl”]:host([icon]):host([icon-right]) .d2l-button-subtle-content.d2l-button-subtle,.d2l-button-subtle-0 [dir=”rtl”] :host([icon]):host([icon-right]) .d2l-button-subtle-content.d2l-button-subtle {   padding-left:1.2rem;padding-right:0; }  [dir=”rtl”] .d2l-button-subtle-0[icon][icon-right] .d2l-button-subtle-content.d2l-button-subtle, .d2l-button-subtle-0[dir=”rtl”][icon][icon-right] .d2l-button-subtle-content.d2l-button-subtle,.d2l-button-subtle-0 [dir=”rtl”] [icon][icon-right] .d2l-button-subtle-content.d2l-button-subtle {   padding-left:1.2rem;padding-right:0; }  .d2l-button-subtle-0 d2l-icon.d2l-button-subtle-icon.d2l-button-subtle {   color:#006fbf;display:none;height:0.9rem;position:absolute;top:50%;transform:translateY(-50%);width:0.9rem; }  .d2l-button-subtle-0[icon] d2l-icon.d2l-button-subtle-icon.d2l-button-subtle {   display:inline-block; }  .d2l-button-subtle-0[icon][icon-right] d2l-icon.d2l-button-subtle-icon.d2l-button-subtle {   right:0.6rem; }  .d2l-button-subtle-0[dir=”rtl”][icon][icon-right] d2l-icon.d2l-button-subtle-icon.d2l-button-subtle {   left:0.6rem;right:auto; }  [dir=”rtl”] .d2l-button-subtle-0[icon][icon-right] d2l-icon.d2l-button-subtle-icon.d2l-button-subtle, .d2l-button-subtle-0[dir=”rtl”][icon][icon-right] d2l-icon.d2l-button-subtle-icon.d2l-button-subtle,.d2l-button-subtle-0 [dir=”rtl”] [icon][icon-right] d2l-icon.d2l-button-subtle-icon.d2l-button-subtle {   left:0.6rem;right:auto; }  .d2l-button-subtle-0 button[disabled].d2l-button-subtle {   cursor:default;opacity:0.5; }  d2l-menu-item {   background-color:#ffffff;box-sizing:border-box;cursor:pointer;display:block;font-size:0.8rem;outline:none;width:100%; }  d2l-menu-item[disabled],d2l-menu-item[disabled]:hover,d2l-menu-item[disabled]:focus {   cursor:default;opacity:0.75; }  d2l-menu-item[hidden] {   display:none; }  d2l-menu-item {   display:flex;padding:0.75rem 1rem; }  d2l-menu-item > span.d2l-menu-item {   flex:auto;line-height:1rem;overflow-x:hidden;overflow-y:hidden;text-overflow:ellipsis;white-space:nowrap; }  d2l-menu-item > d2l-icon.d2l-menu-item {   flex:none;margin-top:0.1rem; }  d2l-menu-item-separator {   display:block; }  d2l-menu-item-return {   background-color:#ffffff;box-sizing:border-box;cursor:pointer;display:block;font-size:0.8rem;outline:none;width:100%; }  d2l-menu-item-return[disabled],d2l-menu-item-return[disabled]:hover,d2l-menu-item-return[disabled]:focus {   cursor:default;opacity:0.75; }  d2l-menu-item-return[hidden] {   display:none; }  d2l-menu-item-return {   display:flex;padding:0.75rem 1rem; }  d2l-menu-item-return > span.d2l-menu-item-return {   flex:auto;line-height:1rem;overflow-x:hidden;overflow-y:hidden;text-decoration:none;text-overflow:ellipsis;white-space:nowrap; }  d2l-menu-item-return > d2l-icon.d2l-menu-item-return {   flex:none;margin-right:1rem;margin-top:0.1rem; }  [dir=”rtl”] d2l-menu-item-return > d2l-icon.d2l-menu-item-return, d2l-menu-item-return[dir=”rtl”] > d2l-icon.d2l-menu-item-return {   margin-right:0;margin-left:1rem; }  [dir=”rtl”] d2l-menu-item-return > d2l-icon.d2l-menu-item-return, d2l-menu-item-return[dir=”rtl”] > d2l-icon.d2l-menu-item-return,d2l-menu-item-return [dir=”rtl”]  > d2l-icon.d2l-menu-item-return {   margin-right:0;margin-left:1rem; }  .d2l-menu-0 {   box-sizing:border-box;display:inline-block;position:relative;left:0;overflow:hidden;width:100%;-webkit-transition:height 300ms linear;transition:height 300ms linear; }  .d2l-menu-0[child-view] {   display:none;position:absolute;top:0;left:100%; }  .d2l-menu-0[shown] {   display:inline-block; }  .d2l-menu-0 .d2l-hierarchical-view-content.d2l-child-view-show.d2l-menu {   -webkit-animation:show-child-view-animation-d2l-menu-0 forwards 300ms linear;animation:show-child-view-animation-d2l-menu-0 300ms forwards linear; }  .d2l-menu-0 .d2l-hierarchical-view-content.d2l-child-view-hide.d2l-menu {   -webkit-animation:hide-child-view-animation-d2l-menu-0 forwards 300ms linear;animation:hide-child-view-animation-d2l-menu-0 300ms forwards linear; }  @keyframes show-child-view-animation-d2l-menu-0 { 0% {   transform:translate(0,0); }  100% {   transform:translate(-100%,0); }  }  @-webkit-keyframes show-child-view-animation-d2l-menu-0 { 0% {   -webkit-transform:translate(0,0); }  100% {   -webkit-transform:translate(-100%,0); }  }  @keyframes hide-child-view-animation-d2l-menu-0 { 0% {   transform:translate(-100%,0); }  100% {   transform:translate(0,0); }  }  @-webkit-keyframes hide-child-view-animation-d2l-menu-0 { 0% {   -webkit-transform:translate(-100%,0); }  100% {   -webkit-transform:translate(0,0); }  }  .d2l-menu-0 {   box-sizing:border-box;display:block;width:100%;padding-top:1px; }  .d2l-menu-0[active] .d2l-menu-items.d2l-menu d2l-menu-item-return[role=”menuitem”].d2l-menu,.d2l-menu-0[active] .d2l-menu-items.d2l-menu > [role=”menuitem”],.d2l-menu-0[active] .d2l-menu-items.d2l-menu > [role=”menuitemcheckbox”],.d2l-menu-0[active] .d2l-menu-items.d2l-menu > [role=”menuitemradio”] {   position:relative; }  .d2l-menu-0 .d2l-menu-items.d2l-menu d2l-menu-item-return[role=”menuitem”].d2l-menu,.d2l-menu-0 .d2l-menu-items.d2l-menu > [role=”menuitem”],.d2l-menu-0 .d2l-menu-items.d2l-menu > [role=”menuitemcheckbox”],.d2l-menu-0 .d2l-menu-items.d2l-menu > [role=”menuitemradio”] {   margin-top:-1px;border:1px solid transparent;border-top-color:#e6eaf0;color:#565a5c; }  .d2l-menu-0 .d2l-menu-items.d2l-menu d2l-menu-item-return[role=”menuitem”].d2l-menu,.d2l-menu-0 .d2l-menu-items.d2l-menu > .d2l-menu-item-first[role=”menuitem”],.d2l-menu-0 .d2l-menu-items.d2l-menu > .d2l-menu-item-first[role=”menuitemcheckbox”],.d2l-menu-0 .d2l-menu-items.d2l-menu > .d2l-menu-item-first[role=”menuitemradio”] {   border-top-color:transparent; }  .d2l-menu-0 .d2l-menu-items.d2l-menu d2l-menu-item-return[role=”menuitem”].d2l-menu:focus,.d2l-menu-0 .d2l-menu-items.d2l-menu d2l-menu-item-return[role=”menuitem”].d2l-menu:hover,.d2l-menu-0 .d2l-menu-items.d2l-menu > [role=”menuitem”]:focus,.d2l-menu-0 .d2l-menu-items.d2l-menu > [role=”menuitem”]:hover,.d2l-menu-0 .d2l-menu-items.d2l-menu > [role=”menuitemcheckbox”]:focus,.d2l-menu-0 .d2l-menu-items.d2l-menu > [role=”menuitemcheckbox”]:hover,.d2l-menu-0 .d2l-menu-items.d2l-menu > [role=”menuitemradio”]:focus,.d2l-menu-0 .d2l-menu-items.d2l-menu > [role=”menuitemradio”]:hover,.d2l-menu-0 .d2l-menu-items.d2l-menu > .d2l-menu-item-first[role=”menuitem”]:focus,.d2l-menu-0 .d2l-menu-items.d2l-menu > .d2l-menu-item-first[role=”menuitem”]:hover,.d2l-menu-0 .d2l-menu-items.d2l-menu > .d2l-menu-item-first[role=”menuitemcheckbox”]:focus,.d2l-menu-0 .d2l-menu-items.d2l-menu > .d2l-menu-item-first[role=”menuitemcheckbox”]:hover,.d2l-menu-0 .d2l-menu-items.d2l-menu > .d2l-menu-item-first[role=”menuitemradio”]:focus,.d2l-menu-0 .d2l-menu-items.d2l-menu > .d2l-menu-item-first[role=”menuitemradio”]:hover {   z-index:2;background-color:#e8f2f9;border-top:1px solid #29a6ff;border-bottom:1px solid #29a6ff;color:#006fbf; }  .d2l-menu-0 .d2l-menu-items.d2l-menu > .d2l-menu-item-last[role=”menuitem”]:focus,.d2l-menu-0 .d2l-menu-items.d2l-menu > .d2l-menu-item-last[role=”menuitem”]:hover,.d2l-menu-0 .d2l-menu-items.d2l-menu > .d2l-menu-item-last[role=”menuitemcheckbox”]:focus,.d2l-menu-0 .d2l-menu-items.d2l-menu > .d2l-menu-item-last[role=”menuitemcheckbox”]:hover,.d2l-menu-0 .d2l-menu-items.d2l-menu > .d2l-menu-item-last[role=”menuitemradio”]:focus,.d2l-menu-0 .d2l-menu-items.d2l-menu > .d2l-menu-item-last[role=”menuitemradio”]:hover {   border-bottom-color:#29a6ff; }  .d2l-menu-0 .d2l-menu-items.d2l-menu > d2l-menu-item-separator {   position:relative;z-index:1;margin-top:-1px;border-top:1px solid #b9c2d0; }  .d2l-dropdown-menu-1 {   box-sizing:border-box;color:#565a5c;display:none;left:0;position:absolute;text-align:left;top:calc(100% + 12px);width:100%;z-index:1000; }  .d2l-dropdown-menu-1[opened] {   display:inline-block; }  .d2l-dropdown-menu-1[opened] {   -webkit-animation:d2l-dropdown-animation-d2l-dropdown-menu-1 300ms ease;animation:d2l-dropdown-animation-d2l-dropdown-menu-1 300ms ease; }  .d2l-dropdown-menu-1[opened-above] {   bottom:calc(100% + 12px);top:auto;-webkit-animation:d2l-dropdown-above-animation-d2l-dropdown-menu-1 300ms ease;animation:d2l-dropdown-above-animation-d2l-dropdown-menu-1 300ms ease; }  .d2l-dropdown-menu-1 .d2l-dropdown-content-pointer.d2l-dropdown-menu {   position:absolute;display:inline-block;clip:rect(-5px, 21px, 8px, -7px);top:-7px;left:calc(50% – 7px);z-index:1; }  .d2l-dropdown-menu-1 .d2l-dropdown-content-pointer.d2l-dropdown-menu > div.d2l-dropdown-menu {   background-color:#ffffff;border:1px solid #d3d9e3;border-radius:0.1rem;box-shadow:-4px -4px 12px -5px rgba(86, 90, 92, .2);height:16px;width:16px;transform:rotate(45deg);-webkit-transform:rotate(45deg); }  .d2l-dropdown-menu-1[opened-above] .d2l-dropdown-content-pointer.d2l-dropdown-menu {   top:auto;clip:rect(9px, 21px, 22px, -3px);bottom:-8px; }  .d2l-dropdown-menu-1[opened-above] .d2l-dropdown-content-pointer.d2l-dropdown-menu > div.d2l-dropdown-menu {   box-shadow:4px 4px 12px -5px rgba(86, 90, 92, .2); }  .d2l-dropdown-menu-1[no-pointer] .d2l-dropdown-content-pointer.d2l-dropdown-menu {   display:none; }  .d2l-dropdown-menu-1 .d2l-dropdown-content-position.d2l-dropdown-menu {   border-radius:0.3rem;display:inline-block;position:absolute; }  .d2l-dropdown-menu-1 .d2l-dropdown-content-width.d2l-dropdown-menu {   background-color:#ffffff;border:1px solid #d3d9e3;border-radius:0.3rem;box-shadow:0 2px 12px 0 rgba(0, 0, 0, 0.15);box-sizing:border-box;min-width:70px;max-width:370px;position:absolute;width:100vw; }  .d2l-dropdown-menu-1[opened-above] .d2l-dropdown-content-width.d2l-dropdown-menu {   bottom:100%; }  .d2l-dropdown-menu-1 .d2l-dropdown-content-container.d2l-dropdown-menu {   box-sizing:border-box;display:inline-block;max-width:100%;outline:none;padding:1rem; }  .d2l-dropdown-menu-1[no-padding] .d2l-dropdown-content-container.d2l-dropdown-menu {   padding:0; }  .d2l-dropdown-menu-1 .d2l-dropdown-content-top.d2l-dropdown-menu,.d2l-dropdown-menu-1 .d2l-dropdown-content-bottom.d2l-dropdown-menu {   height:5px;position:relative;z-index:1; }  .d2l-dropdown-menu-1 .d2l-dropdown-content-top.d2l-dropdown-menu {   border-top-left-radius:0.3rem;border-top-right-radius:0.3rem; }  .d2l-dropdown-menu-1 .d2l-dropdown-content-bottom.d2l-dropdown-menu {   border-bottom-left-radius:0.3rem;border-bottom-right-radius:0.3rem; }  .d2l-dropdown-menu-1 .d2l-dropdown-content-top-scroll.d2l-dropdown-menu {   box-shadow:0 3px 3px 0 rgba(0, 0, 0, 0.05); }  .d2l-dropdown-menu-1 .d2l-dropdown-content-bottom-scroll.d2l-dropdown-menu {   box-shadow:0 -3px 3px 0 rgba(0, 0, 0, 0.05); }  [dir=”rtl”] .d2l-dropdown-menu-1, .d2l-dropdown-menu-1[dir=”rtl”] {   left:auto;right:0;text-align:right; }  [dir=”rtl”] .d2l-dropdown-menu-1, .d2l-dropdown-menu-1[dir=”rtl”] {   left:auto;right:0;text-align:right; }  @keyframes d2l-dropdown-animation-d2l-dropdown-menu-1 { 0% {   transform:translate(0,-10px);opacity:0; }  100% {   transform:translate(0,0);opacity:1; }  }  @keyframes d2l-dropdown-above-animation-d2l-dropdown-menu-1 { 0% {   transform:translate(0,10px);opacity:0; }  100% {   transform:translate(0,0);opacity:1; }  }  @-webkit-keyframes d2l-dropdown-animation-d2l-dropdown-menu-1 { 0% {   -webkit-transform:translate(0,-10px);opacity:0; }  100% {   -webkit-transform:translate(0,0);opacity:1; }  }  @-webkit-keyframes d2l-dropdown-above-animation-d2l-dropdown-menu-1 { 0% {   -webkit-transform:translate(0,10px);opacity:0; }  100% {   -webkit-transform:translate(0,0);opacity:1; }  } .d2l-dropdown-menu-0 {   box-sizing:border-box;color:#565a5c;display:none;left:0;position:absolute;text-align:left;top:calc(100% + 20px);width:100%;z-index:1000; }  .d2l-dropdown-menu-0[opened] {   display:inline-block; }  .d2l-dropdown-menu-0[opened] {   -webkit-animation:d2l-dropdown-animation-d2l-dropdown-menu-0 300ms ease;animation:d2l-dropdown-animation-d2l-dropdown-menu-0 300ms ease; }  .d2l-dropdown-menu-0[opened-above] {   bottom:calc(100% + 20px);top:auto;-webkit-animation:d2l-dropdown-above-animation-d2l-dropdown-menu-0 300ms ease;animation:d2l-dropdown-above-animation-d2l-dropdown-menu-0 300ms ease; }  .d2l-dropdown-menu-0 .d2l-dropdown-content-pointer.d2l-dropdown-menu {   position:absolute;display:inline-block;clip:rect(-5px, 21px, 8px, -7px);top:-7px;left:calc(50% – 7px);z-index:1; }  .d2l-dropdown-menu-0 .d2l-dropdown-content-pointer.d2l-dropdown-menu > div.d2l-dropdown-menu {   background-color:#ffffff;border:1px solid #d3d9e3;border-radius:0.1rem;box-shadow:-4px -4px 12px -5px rgba(86, 90, 92, .2);height:16px;width:16px;transform:rotate(45deg);-webkit-transform:rotate(45deg); }  .d2l-dropdown-menu-0[opened-above] .d2l-dropdown-content-pointer.d2l-dropdown-menu {   top:auto;clip:rect(9px, 21px, 22px, -3px);bottom:-8px; }  .d2l-dropdown-menu-0[opened-above] .d2l-dropdown-content-pointer.d2l-dropdown-menu > div.d2l-dropdown-menu {   box-shadow:4px 4px 12px -5px rgba(86, 90, 92, .2); }  .d2l-dropdown-menu-0[no-pointer] .d2l-dropdown-content-pointer.d2l-dropdown-menu {   display:none; }  .d2l-dropdown-menu-0 .d2l-dropdown-content-position.d2l-dropdown-menu {   border-radius:0.3rem;display:inline-block;position:absolute; }  .d2l-dropdown-menu-0 .d2l-dropdown-content-width.d2l-dropdown-menu {   background-color:#ffffff;border:1px solid #d3d9e3;border-radius:0.3rem;box-shadow:0 2px 12px 0 rgba(0, 0, 0, 0.15);box-sizing:border-box;min-width:70px;max-width:370px;position:absolute;width:100vw; }  .d2l-dropdown-menu-0[opened-above] .d2l-dropdown-content-width.d2l-dropdown-menu {   bottom:100%; }  .d2l-dropdown-menu-0 .d2l-dropdown-content-container.d2l-dropdown-menu {   box-sizing:border-box;display:inline-block;max-width:100%;outline:none;padding:1rem; }  .d2l-dropdown-menu-0[no-padding] .d2l-dropdown-content-container.d2l-dropdown-menu {   padding:0; }  .d2l-dropdown-menu-0 .d2l-dropdown-content-top.d2l-dropdown-menu,.d2l-dropdown-menu-0 .d2l-dropdown-content-bottom.d2l-dropdown-menu {   height:5px;position:relative;z-index:1; }  .d2l-dropdown-menu-0 .d2l-dropdown-content-top.d2l-dropdown-menu {   border-top-left-radius:0.3rem;border-top-right-radius:0.3rem; }  .d2l-dropdown-menu-0 .d2l-dropdown-content-bottom.d2l-dropdown-menu {   border-bottom-left-radius:0.3rem;border-bottom-right-radius:0.3rem; }  .d2l-dropdown-menu-0 .d2l-dropdown-content-top-scroll.d2l-dropdown-menu {   box-shadow:0 3px 3px 0 rgba(0, 0, 0, 0.05); }  .d2l-dropdown-menu-0 .d2l-dropdown-content-bottom-scroll.d2l-dropdown-menu {   box-shadow:0 -3px 3px 0 rgba(0, 0, 0, 0.05); }  [dir=”rtl”] .d2l-dropdown-menu-0, .d2l-dropdown-menu-0[dir=”rtl”] {   left:auto;right:0;text-align:right; }  [dir=”rtl”] .d2l-dropdown-menu-0, .d2l-dropdown-menu-0[dir=”rtl”] {   left:auto;right:0;text-align:right; }  @keyframes d2l-dropdown-animation-d2l-dropdown-menu-0 { 0% {   transform:translate(0,-10px);opacity:0; }  100% {   transform:translate(0,0);opacity:1; }  }  @keyframes d2l-dropdown-above-animation-d2l-dropdown-menu-0 { 0% {   transform:translate(0,10px);opacity:0; }  100% {   transform:translate(0,0);opacity:1; }  }  @-webkit-keyframes d2l-dropdown-animation-d2l-dropdown-menu-0 { 0% {   -webkit-transform:translate(0,-10px);opacity:0; }  100% {   -webkit-transform:translate(0,0);opacity:1; }  }  @-webkit-keyframes d2l-dropdown-above-animation-d2l-dropdown-menu-0 { 0% {   -webkit-transform:translate(0,10px);opacity:0; }  100% {   -webkit-transform:translate(0,0);opacity:1; }  }  d2l-menu-item-link {   background-color:#ffffff;box-sizing:border-box;cursor:pointer;display:block;font-size:0.8rem;outline:none;width:100%; }  d2l-menu-item-link[disabled],d2l-menu-item-link[disabled]:hover,d2l-menu-item-link[disabled]:focus {   cursor:default;opacity:0.75; }  d2l-menu-item-link[hidden] {   display:none; }  d2l-menu-item-link {   display:block;padding:0; }  d2l-menu-item-link > a.d2l-menu-item-link {   color:inherit;display:block;line-height:1rem;outline:none;overflow-x:hidden;padding:0.75rem 1rem;text-decoration:none;text-overflow:ellipsis;white-space:nowrap; }  d2l-dropdown {   display:inline-block;outline:none;overflow:visible;position:relative; }  .d2l-dropdown-content-1 {   box-sizing:border-box;color:#565a5c;display:none;left:0;position:absolute;text-align:left;top:calc(100% + 0px);width:100%;z-index:1000; }  .d2l-dropdown-content-1[opened] {   display:inline-block; }  .d2l-dropdown-content-1[opened] {   -webkit-animation:d2l-dropdown-animation-d2l-dropdown-content-1 300ms ease;animation:d2l-dropdown-animation-d2l-dropdown-content-1 300ms ease; }  .d2l-dropdown-content-1[opened-above] {   bottom:calc(100% + 0px);top:auto;-webkit-animation:d2l-dropdown-above-animation-d2l-dropdown-content-1 300ms ease;animation:d2l-dropdown-above-animation-d2l-dropdown-content-1 300ms ease; }  .d2l-dropdown-content-1 .d2l-dropdown-content-pointer.d2l-dropdown-content {   position:absolute;display:inline-block;clip:rect(-5px, 21px, 8px, -7px);top:-7px;left:calc(50% – 7px);z-index:1; }  .d2l-dropdown-content-1 .d2l-dropdown-content-pointer.d2l-dropdown-content > div.d2l-dropdown-content {   background-color:#ffffff;border:1px solid #d3d9e3;border-radius:0.1rem;box-shadow:-4px -4px 12px -5px rgba(86, 90, 92, .2);height:16px;width:16px;transform:rotate(45deg);-webkit-transform:rotate(45deg); }  .d2l-dropdown-content-1[opened-above] .d2l-dropdown-content-pointer.d2l-dropdown-content {   top:auto;clip:rect(9px, 21px, 22px, -3px);bottom:-8px; }  .d2l-dropdown-content-1[opened-above] .d2l-dropdown-content-pointer.d2l-dropdown-content > div.d2l-dropdown-content {   box-shadow:4px 4px 12px -5px rgba(86, 90, 92, .2); }  .d2l-dropdown-content-1[no-pointer] .d2l-dropdown-content-pointer.d2l-dropdown-content {   display:none; }  .d2l-dropdown-content-1 .d2l-dropdown-content-position.d2l-dropdown-content {   border-radius:0.3rem;display:inline-block;position:absolute; }  .d2l-dropdown-content-1 .d2l-dropdown-content-width.d2l-dropdown-content {   background-color:#ffffff;border:1px solid #d3d9e3;border-radius:0.3rem;box-shadow:0 2px 12px 0 rgba(0, 0, 0, 0.15);box-sizing:border-box;min-width:70px;max-width:370px;position:absolute;width:100vw; }  .d2l-dropdown-content-1[opened-above] .d2l-dropdown-content-width.d2l-dropdown-content {   bottom:100%; }  .d2l-dropdown-content-1 .d2l-dropdown-content-container.d2l-dropdown-content {   box-sizing:border-box;display:inline-block;max-width:100%;outline:none;padding:1rem; }  .d2l-dropdown-content-1[no-padding] .d2l-dropdown-content-container.d2l-dropdown-content {   padding:0; }  .d2l-dropdown-content-1 .d2l-dropdown-content-top.d2l-dropdown-content,.d2l-dropdown-content-1 .d2l-dropdown-content-bottom.d2l-dropdown-content {   height:5px;position:relative;z-index:1; }  .d2l-dropdown-content-1 .d2l-dropdown-content-top.d2l-dropdown-content {   border-top-left-radius:0.3rem;border-top-right-radius:0.3rem; }  .d2l-dropdown-content-1 .d2l-dropdown-content-bottom.d2l-dropdown-content {   border-bottom-left-radius:0.3rem;border-bottom-right-radius:0.3rem; }  .d2l-dropdown-content-1 .d2l-dropdown-content-top-scroll.d2l-dropdown-content {   box-shadow:0 3px 3px 0 rgba(0, 0, 0, 0.05); }  .d2l-dropdown-content-1 .d2l-dropdown-content-bottom-scroll.d2l-dropdown-content {   box-shadow:0 -3px 3px 0 rgba(0, 0, 0, 0.05); }  [dir=”rtl”] .d2l-dropdown-content-1, .d2l-dropdown-content-1[dir=”rtl”] {   left:auto;right:0;text-align:right; }  [dir=”rtl”] .d2l-dropdown-content-1, .d2l-dropdown-content-1[dir=”rtl”] {   left:auto;right:0;text-align:right; }  @keyframes d2l-dropdown-animation-d2l-dropdown-content-1 { 0% {   transform:translate(0,-10px);opacity:0; }  100% {   transform:translate(0,0);opacity:1; }  }  @keyframes d2l-dropdown-above-animation-d2l-dropdown-content-1 { 0% {   transform:translate(0,10px);opacity:0; }  100% {   transform:translate(0,0);opacity:1; }  }  @-webkit-keyframes d2l-dropdown-animation-d2l-dropdown-content-1 { 0% {   -webkit-transform:translate(0,-10px);opacity:0; }  100% {   -webkit-transform:translate(0,0);opacity:1; }  }  @-webkit-keyframes d2l-dropdown-above-animation-d2l-dropdown-content-1 { 0% {   -webkit-transform:translate(0,10px);opacity:0; }  100% {   -webkit-transform:translate(0,0);opacity:1; }  }  d2l-dropdown-button-subtle {   display:inline-block;outline:none;overflow:visible;position:relative; }  d2l-dropdown-more {   display:inline-block;outline:none;overflow:visible;position:relative; }  d2l-dropdown-more[d2l-visible-on-ancestor-init] {   visibility:hidden; }  d2l-dropdown-more[d2l-visible-on-ancestor-transition] {   transition:transform 200ms ease-out, opacity 200ms ease-out !important; }  d2l-dropdown-more[d2l-visible-on-ancestor-hide] {   opacity:0 !important;transform:translateY(-10px) !important; }  @media only screen and (hover: none), only screen and (-moz-touch-enabled: 1) { d2l-dropdown-more[d2l-visible-on-ancestor-hide] {   opacity:1 !important;transform:translateY(0px) !important; }  d2l-dropdown-more[d2l-visible-on-ancestor-hide][d2l-visible-on-ancestor-no-hover-hide] {   opacity:0 !important;transform:translateY(-10px) !important; }  }  d2l-dropdown-more {   display:inline-block; }  iron-a11y-announcer {   display:inline-block;position:fixed;clip:rect(0px,0px,0px,0px); }  iron-input {   display:inline-block; }  .shown.d2l-course-image {   opacity:1; }  img.d2l-course-image {   object-fit:cover;object-position:center;height:100%;width:100%;opacity:0;transition:opacity 0.5s; }  iron-scroll-threshold {   display:block; }  d2l-sticky-element {   position:-webkit-sticky;position:sticky;top:0;z-index:4;line-height:0; }  d2l-table-wrapper {   background-color:transparent;display:block;width:100%; }  d2l-table {   background-color:transparent;display:block;width:100%; }  d2l-rubric-criteria-groups {   display:block; }  d2l-rubric-criteria-group.d2l-rubric-criteria-groups {   padding-bottom:24px; }  d2l-alert-toast {   display:block; }  d2l-alert-toast .d2l-alert-toast-container.d2l-alert-toast {   display:none; }  d2l-alert-toast[open] .d2l-alert-toast-container.d2l-alert-toast {   border-radius:0.3rem;bottom:1rem;box-shadow:0 0.1rem 0.6rem 0 rgba(0,0,0,0.10);display:block;left:0;margin:0 auto;max-width:710px;opacity:0;position:fixed;right:0;transition-duration:250ms;transition-property:transform, opacity, visibility;transition-timing-function:ease-in;transform:translateY(0);visibility:hidden;width:100%;z-index:10000; }  d2l-alert-toast[open] .d2l-alert-toast-container.d2l-alert-toast-container-opened.d2l-alert-toast {   opacity:1;transform:translateY(-0.5rem);visibility:visible; }  d2l-dropdown-button {   display:inline-block;outline:none;overflow:visible;position:relative; }  d2l-dropdown-button d2l-icon.d2l-dropdown-button {   height:0.8rem;width:0.8rem; }  d2l-dropdown-button .d2l-dropdown-button-text.d2l-dropdown-button {   margin-right:0.6rem; }  d2l-dropdown-button[primary] d2l-icon.d2l-dropdown-button {   color:white; }  [dir=”rtl”] d2l-dropdown-button .d2l-dropdown-button-text.d2l-dropdown-button, d2l-dropdown-button[dir=”rtl”] .d2l-dropdown-button-text.d2l-dropdown-button {   margin-left:0.6rem;margin-right:0; }  [dir=”rtl”] d2l-dropdown-button .d2l-dropdown-button-text.d2l-dropdown-button, d2l-dropdown-button[dir=”rtl”] .d2l-dropdown-button-text.d2l-dropdown-button,d2l-dropdown-button [dir=”rtl”]  .d2l-dropdown-button-text.d2l-dropdown-button {   margin-left:0.6rem;margin-right:0; }  d2l-button-group-menu[mini] .d2l-dropdown-opener.d2l-button-group-menu {   padding-left:0.5rem;padding-right:0.5rem; }  d2l-button-group {   display:block; }  d2l-button-group .d2l-button-group-container.d2l-button-group {   display:flex;flex:0 1 auto;flex-wrap:wrap; }  d2l-button-group .d2l-button-group-container.d2l-button-group > d2l-button,d2l-button-group .d2l-button-group-container.d2l-button-group > d2l-button-subtle,d2l-button-group .d2l-button-group-container.d2l-button-group > d2l-button-icon,d2l-button-group .d2l-button-group-container.d2l-button-group > d2l-link,d2l-button-group .d2l-button-group-container.d2l-button-group > span,d2l-button-group .d2l-button-group-container.d2l-button-group > d2l-dropdown,d2l-button-group .d2l-button-group-container.d2l-button-group > d2l-dropdown-button,d2l-button-group .d2l-button-group-container.d2l-button-group > .d2l-button-group-custom-item {   margin-right:0.75rem; }  d2l-button-group .d2l-button-group-container.d2l-button-group > [chomped] {   display:none !important; }  d2l-button-subtle-group-menu[mini] .d2l-dropdown-opener.d2l-button-subtle-group-menu {   padding-left:0.5rem;padding-right:0.5rem; }  d2l-action-button-group {   display:block; }  d2l-action-button-group .d2l-button-group-container.d2l-action-button-group {   display:flex;flex:0 1 auto;flex-wrap:wrap; }  d2l-action-button-group .d2l-button-group-container.d2l-action-button-group > d2l-button,d2l-action-button-group .d2l-button-group-container.d2l-action-button-group > d2l-button-subtle,d2l-action-button-group .d2l-button-group-container.d2l-action-button-group > d2l-button-icon,d2l-action-button-group .d2l-button-group-container.d2l-action-button-group > d2l-link,d2l-action-button-group .d2l-button-group-container.d2l-action-button-group > span,d2l-action-button-group .d2l-button-group-container.d2l-action-button-group > d2l-dropdown,d2l-action-button-group .d2l-button-group-container.d2l-action-button-group > d2l-dropdown-button,d2l-action-button-group .d2l-button-group-container.d2l-action-button-group > .d2l-button-group-custom-item {   margin-right:0.75rem; }  d2l-action-button-group .d2l-button-group-container.d2l-action-button-group > [chomped] {   display:none !important; }  d2l-dropdown-context-menu {   display:inline-block;outline:none;overflow:visible;position:relative; }  d2l-dropdown-context-menu[d2l-visible-on-ancestor-init] {   visibility:hidden; }  d2l-dropdown-context-menu[d2l-visible-on-ancestor-transition] {   transition:transform 200ms ease-out, opacity 200ms ease-out !important; }  d2l-dropdown-context-menu[d2l-visible-on-ancestor-hide] {   opacity:0 !important;transform:translateY(-10px) !important; }  @media only screen and (hover: none), only screen and (-moz-touch-enabled: 1) { d2l-dropdown-context-menu[d2l-visible-on-ancestor-hide] {   opacity:1 !important;transform:translateY(0px) !important; }  d2l-dropdown-context-menu[d2l-visible-on-ancestor-hide][d2l-visible-on-ancestor-no-hover-hide] {   opacity:0 !important;transform:translateY(-10px) !important; }  }  d2l-dropdown-context-menu {   display:inline-block; }  .d2l-input-search-0 {   ; }  .d2l-input-search-0 input[type=”text”].d2l-input.d2l-input-search,.d2l-input-search-0 input[type=”search”].d2l-input.d2l-input-search,.d2l-input-search-0 input[type=”tel”].d2l-input.d2l-input-search,.d2l-input-search-0 input[type=”url”].d2l-input.d2l-input-search,.d2l-input-search-0 input[type=”email”].d2l-input.d2l-input-search,.d2l-input-search-0 input[type=”password”].d2l-input.d2l-input-search,.d2l-input-search-0 input[type=”number”].d2l-input.d2l-input-search {   border-radius:0.3rem;border-style:solid;box-sizing:border-box;display:inline-block;margin:0;min-width:calc(2rem + 1em);vertical-align:middle;width:100%;transition:background-color 0.5s ease, border-color 0.5s ease;color:#565a5c;font-size:0.8rem;font-weight:400;letter-spacing:0.02rem;line-height:1.2rem;min-height:calc(2rem + 2px);background-color:#ffffff;border-color:#d3d9e3;border-width:1px;box-shadow:inset 0 2px 0 0 rgba(185, 194, 208, .2);padding:0.4rem 0.75rem;height:auto; }  .d2l-input-search-0 textarea.d2l-input.d2l-input-search {   border-radius:0.3rem;border-style:solid;box-sizing:border-box;display:inline-block;margin:0;min-width:calc(2rem + 1em);vertical-align:middle;width:100%;transition:background-color 0.5s ease, border-color 0.5s ease;color:#565a5c;font-size:0.8rem;font-weight:400;letter-spacing:0.02rem;line-height:1.2rem;min-height:calc(2rem + 2px);background-color:#ffffff;border-color:#d3d9e3;border-width:1px;box-shadow:inset 0 2px 0 0 rgba(185, 194, 208, .2);padding:0.4rem 0.75rem;height:auto;; }  .d2l-input-search-0 input.d2l-input.d2l-input-search::placeholder,.d2l-input-search-0 textarea.d2l-input.d2l-input-search::placeholder {   color:#d3d9e3;font-size:0.8rem;font-weight:400; }  .d2l-input-search-0 input.d2l-input.d2l-input-search::-webkit-input-placeholder,.d2l-input-search-0 textarea.d2l-input.d2l-input-search::-webkit-input-placeholder {   color:#d3d9e3;font-size:0.8rem;font-weight:400; }  .d2l-input-search-0 input.d2l-input.d2l-input-search::-moz-placeholder,.d2l-input-search-0 textarea.d2l-input.d2l-input-search::-moz-placeholder {   color:#d3d9e3;font-size:0.8rem;font-weight:400; }  .d2l-input-search-0 input.d2l-input.d2l-input-search:-ms-input-placeholder,.d2l-input-search-0 textarea.d2l-input.d2l-input-search:-ms-input-placeholder {   color:#d3d9e3;font-size:0.8rem;font-weight:400;font-size:0.8rem; }  .d2l-input-search-0 input.d2l-input.d2l-input-search:hover:disabled,.d2l-input-search-0 textarea.d2l-input.d2l-input-search:hover:disabled {   background-color:#ffffff;border-color:#d3d9e3;border-width:1px;box-shadow:inset 0 2px 0 0 rgba(185, 194, 208, .2);padding:0.4rem 0.75rem; }  .d2l-input-search-0 input.d2l-input.d2l-input-search:hover,.d2l-input-search-0 input.d2l-input.d2l-input-search:focus,.d2l-input-search-0 textarea.d2l-input.d2l-input-search:hover,.d2l-input-search-0 textarea.d2l-input.d2l-input-search:focus {   border-color:#006fbf;border-width:2px;outline-style:none;outline-width:0;padding:calc(0.4rem – 1px) calc(0.75rem – 1px); }  .d2l-input-search-0 input.d2l-input[aria-invalid=’true’].d2l-input-search,.d2l-input-search-0 input.d2l-input.d2l-input-search:invalid,.d2l-input-search-0 textarea.d2l-input[aria-invalid=’true’].d2l-input-search,.d2l-input-search-0 textarea.d2l-input.d2l-input-search:invalid {   border-color:#cd2026; }  .d2l-input-search-0 input.d2l-input.d2l-input-search:disabled,.d2l-input-search-0 textarea.d2l-input.d2l-input-search:disabled {   opacity:0.5; }  .d2l-input-search-0 input.d2l-input.d2l-input-search::-webkit-search-cancel-button {   display:none; }  .d2l-input-search-0 input.d2l-input.d2l-input-search::-ms-clear {   display:none;width:0;height:0; }  .d2l-input-search-0 {   display:inline-block;position:relative;width:100%; }  .d2l-input-search-0 input[type=”text”].d2l-input.d2l-input-search {   font-family:inherit;padding-right:2.4rem;overflow:hidden;text-overflow:ellipsis;white-space:nowrap; }  [dir=”rtl”] .d2l-input-search-0 input[type=”text”].d2l-input.d2l-input-search, .d2l-input-search-0[dir=”rtl”] input[type=”text”].d2l-input.d2l-input-search {   padding-right:0.75rem;padding-left:2.4rem; }  [dir=”rtl”] .d2l-input-search-0 input[type=”text”].d2l-input.d2l-input-search, .d2l-input-search-0[dir=”rtl”] input[type=”text”].d2l-input.d2l-input-search,.d2l-input-search-0 [dir=”rtl”]  input[type=”text”].d2l-input.d2l-input-search {   padding-right:0.75rem;padding-left:2.4rem; }  .d2l-input-search-0 .d2l-input-search-hover.d2l-input-search input[type=”text”].d2l-input.d2l-input-search,.d2l-input-search-0 .d2l-input-search-focus.d2l-input-search input[type=”text”].d2l-input.d2l-input-search {   border-color:#006fbf;border-width:2px;outline-style:none;outline-width:0;padding:calc(0.4rem – 1px) calc(0.75rem – 1px);padding-right:calc(2.4rem – 1px); }  [dir=”rtl”] .d2l-input-search-0 input[type=”text”].d2l-input.d2l-input-search:hover, .d2l-input-search-0[dir=”rtl”] input[type=”text”].d2l-input.d2l-input-search:hover,[dir=”rtl”] .d2l-input-search-0 input[type=”text”].d2l-input.d2l-input-search:focus, .d2l-input-search-0[dir=”rtl”] input[type=”text”].d2l-input.d2l-input-search:focus,[dir=”rtl”] .d2l-input-search-0 .d2l-input-search-hover.d2l-input-search input[type=”text”].d2l-input.d2l-input-search, .d2l-input-search-0[dir=”rtl”] .d2l-input-search-hover.d2l-input-search input[type=”text”].d2l-input.d2l-input-search,[dir=”rtl”] .d2l-input-search-0 .d2l-input-search-focus.d2l-input-search input[type=”text”].d2l-input.d2l-input-search, .d2l-input-search-0[dir=”rtl”] .d2l-input-search-focus.d2l-input-search input[type=”text”].d2l-input.d2l-input-search {   padding-right:calc(0.75rem – 1px);padding-left:calc(2.4rem – 1px); }  [dir=”rtl”] .d2l-input-search-0 input[type=”text”].d2l-input.d2l-input-search:hover, .d2l-input-search-0[dir=”rtl”] input[type=”text”].d2l-input.d2l-input-search:hover,.d2l-input-search-0 [dir=”rtl”]  input[type=”text”].d2l-input.d2l-input-search:hover,[dir=”rtl”] .d2l-input-search-0 input[type=”text”].d2l-input.d2l-input-search:focus, .d2l-input-search-0[dir=”rtl”] input[type=”text”].d2l-input.d2l-input-search:focus,.d2l-input-search-0 [dir=”rtl”]  input[type=”text”].d2l-input.d2l-input-search:focus,[dir=”rtl”] .d2l-input-search-0 .d2l-input-search-hover.d2l-input-search input[type=”text”].d2l-input.d2l-input-search, .d2l-input-search-0[dir=”rtl”] .d2l-input-search-hover.d2l-input-search input[type=”text”].d2l-input.d2l-input-search,.d2l-input-search-0 [dir=”rtl”]  .d2l-input-search-hover.d2l-input-search input[type=”text”].d2l-input.d2l-input-search,[dir=”rtl”] .d2l-input-search-0 .d2l-input-search-focus.d2l-input-search input[type=”text”].d2l-input.d2l-input-search, .d2l-input-search-0[dir=”rtl”] .d2l-input-search-focus.d2l-input-search input[type=”text”].d2l-input.d2l-input-search,.d2l-input-search-0 [dir=”rtl”]  .d2l-input-search-focus.d2l-input-search input[type=”text”].d2l-input.d2l-input-search {   padding-right:calc(0.75rem – 1px);padding-left:calc(2.4rem – 1px); }  .d2l-input-search-0 d2l-button-icon.d2l-input-search {   ;position:absolute;height:1.7rem;width:1.7rem;top:0.2rem;right:0.2rem; }  [dir=”rtl”] .d2l-input-search-0 d2l-button-icon.d2l-input-search, .d2l-input-search-0[dir=”rtl”] d2l-button-icon.d2l-input-search {   left:0.2rem;right:auto; }  [dir=”rtl”] .d2l-input-search-0 d2l-button-icon.d2l-input-search, .d2l-input-search-0[dir=”rtl”] d2l-button-icon.d2l-input-search,.d2l-input-search-0 [dir=”rtl”]  d2l-button-icon.d2l-input-search {   left:0.2rem;right:auto; }  .d2l-input-search-0 d2l-button-icon[hidden].d2l-input-search {   display:none; }  .d2l-navigation-band-0 {   border-top-color:#a30606;border-top-style:solid;border-top-width:4px;display:block; }  .d2l-navigation-0 {   ; }  .d2l-navigation-0 .d2l-navigation-centerer.d2l-navigation {   margin:0 auto;max-width:1230px; }  .d2l-navigation-0 .d2l-navigation-gutters.d2l-navigation {   padding-left:2.439%;padding-right:2.439%;position:relative; }  @media (max-width: 615px) { .d2l-navigation-0 .d2l-navigation-gutters.d2l-navigation {   padding-left:15px;padding-right:15px; }  }  @media (min-width: 1230px) { .d2l-navigation-0 .d2l-navigation-gutters.d2l-navigation {   padding-left:30px;padding-right:30px; }  }  .d2l-navigation-0 .d2l-navigation-shadow-gradient.d2l-navigation {   background:linear-gradient(to bottom,  rgba(249,250,251,1) 0%,rgba(249,250,251,0) 100%);bottom:-150px;display:block;height:150px;width:100%;pointer-events:none;position:absolute;z-index:-100; }  .d2l-navigation-0 {   display:block;position:relative; }  .d2l-navigation-0 .d2l-navigation-shadow-drop-border.d2l-navigation {   background-color:rgba(0,0,0,0.02);bottom:-4px;height:4px;pointer-events:none;position:absolute;width:100%; }  .d2l-navigation-button-1 {   ; }  .d2l-navigation-button-1 {   display:inline-block;height:100%; }  .d2l-navigation-button-1 button.d2l-navigation-button::-moz-focus-inner {   border:0; }  .d2l-navigation-button-1 button.d2l-navigation-button > * {   pointer-events:none; }  .d2l-navigation-button-1 button.d2l-navigation-button:hover,.d2l-navigation-button-1 button.d2l-navigation-button:focus,.d2l-navigation-button-1 button.d2l-navigation-button:hover > *,.d2l-navigation-button-1 button.d2l-navigation-button:focus > * {   color:#006fbf;outline:none; }  .d2l-navigation-button-1 button.d2l-navigation-button:hover > * *,.d2l-navigation-button-1 button.d2l-navigation-button:focus > * * {   color:#006fbf;outline:none; }  .d2l-navigation-button-1 button.d2l-navigation-button:hover .d2l-navigation-button-top-border.d2l-navigation-button,.d2l-navigation-button-1 button.d2l-navigation-button:focus .d2l-navigation-button-top-border.d2l-navigation-button {   background:#006fbf; }  .d2l-navigation-button-1 button.d2l-navigation-button {   align-items:center;background:transparent;border:none;color:#565a5c;cursor:pointer;font-size:inherit;height:100%;margin:0;min-height:40px;outline:none;overflow:visible;padding:0;position:relative;text-decoration:none;font-family:inherit;outline:none; }  .d2l-navigation-button-1 .d2l-navigation-button-top-border.d2l-navigation-button {   background:transparent;border-bottom-left-radius:4px;border-bottom-right-radius:4px;display:block;height:4px;left:-7px;position:absolute;top:0;width:calc(100% + 14px); }  .d2l-navigation-button-1 .d2l-offscreen-description.d2l-navigation-button {   ; }  [dir=”rtl”] .d2l-navigation-button-1 .d2l-offscreen-description.d2l-navigation-button, .d2l-navigation-button-1[dir=”rtl”] .d2l-offscreen-description.d2l-navigation-button,[dir=”rtl”] .d2l-navigation-button-1 .d2l-offscreen-description.d2l-navigation-button, .d2l-navigation-button-1[dir=”rtl”] .d2l-offscreen-description.d2l-navigation-button,.d2l-navigation-button-1 [dir=”rtl”]  .d2l-offscreen-description.d2l-navigation-button {   ; }  .d2l-navigation-button-1[disabled] button.d2l-navigation-button {   opacity:.5;cursor:default; } .d2l-navigation-button-0 {   ; }  .d2l-navigation-button-0 {   display:inline-block;height:100%; }  .d2l-navigation-button-0 button.d2l-navigation-button::-moz-focus-inner {   border:0; }  .d2l-navigation-button-0 button.d2l-navigation-button > * {   pointer-events:none; }  .d2l-navigation-button-0 button.d2l-navigation-button:hover,.d2l-navigation-button-0 button.d2l-navigation-button:focus,.d2l-navigation-button-0 button.d2l-navigation-button:hover > *,.d2l-navigation-button-0 button.d2l-navigation-button:focus > * {   color:#006fbf;outline:none; }  .d2l-navigation-button-0 button.d2l-navigation-button:hover > * *,.d2l-navigation-button-0 button.d2l-navigation-button:focus > * * {   color:#006fbf;outline:none; }  .d2l-navigation-button-0 button.d2l-navigation-button:hover .d2l-navigation-button-top-border.d2l-navigation-button,.d2l-navigation-button-0 button.d2l-navigation-button:focus .d2l-navigation-button-top-border.d2l-navigation-button {   background:#006fbf; }  .d2l-navigation-button-0 button.d2l-navigation-button {   align-items:center;background:transparent;border:none;color:#565a5c;cursor:pointer;font-size:inherit;height:100%;margin:0;min-height:40px;outline:none;overflow:visible;padding:0;position:relative;text-decoration:none;font-family:inherit;outline:none; }  .d2l-navigation-button-0 .d2l-navigation-button-top-border.d2l-navigation-button {   background:transparent;border-bottom-left-radius:4px;border-bottom-right-radius:4px;display:block;height:4px;left:-7px;position:absolute;top:0;width:calc(100% + 14px); }  .d2l-navigation-button-0 .d2l-offscreen-description.d2l-navigation-button {   position:absolute !important;overflow:hidden;width:1px;height:1px;white-space:nowrap;left:-10000px; 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Assignment #4IMPORTANT NOTE: This paper must be submitted by Saturday in the last week of class no later than 11:59pm EST and if late will not be accepted. In addition to the written instructions, there are 2 VIDEOS that explain this assignment. See above links for videos.
The final project for this course is an analysis of the legal and or ethical issues involved in the below health care scenario. See questions to be answered at end of this factual scenario below. I have also provided, after the formatting requirements for the paper, two articles that will aid you in your analyzing the scenario and writing your paper.  The two articles to base the analysis of your paper are entitled:Clinical Ethics Issues and Discussion andA Framework for Thinking EthicallyThis is the final paper for the class and must be double spaced and be approximately 4-5 pages in 12 point New Times Roman font. Include a cover page [not counted as a page] which should have student name and title of your paper. See more formatting requirements later in these paper instructions.NOTE: For this paper it is unnecessary to do any research beyond the two articles I furnished with this assignment. Both are after the specific paper requirements.  You may use all the articles in the class also. To do internet research would only be wasting your valuable time.Case ScenarioA 72 year old woman was admitted to the Neurological Intensive Care Unit following a cerebral hemorrhage which left her with severe brain damage and ventilator dependent. One year before this event, the patient and her husband had drawn up “living wills” with an attorney. She was diagnosed by her treating physician as being in a permanent unconscious condition. The patient’s living will specified that the patient did not want ventilator support or other artificial life support in the event of a permanent unconscious condition or terminal condition.The patient’s husband is her legal next of kin and the person with surrogate decision-making authority. When the living will was discussed with him, he insisted that the patient had not intended for the document to be used in a situation like the present one. Further discussion with him revealed that he understood that the patient would not be able to recover any meaningful brain function but he argued that the living will did not apply because her condition was not imminently terminal. He further indicated that he did not consider his wife to be in a permanent unconscious condition.  The immediate family members (the couple’s adult children) disagreed with their father’s refusal to withdraw life support.The treatment team allowed a week to pass to allow the husband more time to be supported in his grief and to appreciate the gravity of his wife’s situation.  Nevertheless, at the end of this time, the husband was unwilling to authorize withdrawal of life support measures consistent with the patient’s wishes as expressed in her living will. End of scenario.You paper should have 3 major sections. Each is numbered 1, 2 and 3. Questions to be discussed based on the facts above. You must weave into your discussion the relevant facts from above scenario to support your discussion in discussion areas 2 and 3 below. And for discussion area 3 you must weave into your discussion the ethics philosophy you pick for each issue from the article A Framework for Thinking Ethically. A penalty will be deducted if you fail to use appropriate headings in your paper. 1. Three Legal/Ethical Issues. Just list the three most important legal/ethics issues in this scenario that you will discuss. They must be three separate, different and distinct issues. Pay particular attention to the article I furnished with this assignment. No explanation needed, just state them 1, 2, 3.2. Discussion of Three Legal/Ethical Issues.  Discuss the three most important ethical/legal issues you listed above. Must use the relevant facts in the scenario to support your discussion of the legal/ethical issues.          Must use headings below.  Headings will be:           Legal/Ethical Issue 1 [state the issue] then discussion           Legal/Ethical Issue 2 [state the issue] then discussion           Legal/Ethical Issue 3 [state the issue] then discussion      For each legal/ethical issue above discuss            a. Why each is a legal /ethical issue?            b. Discuss each issue in the context of the scenario facts and            c. Define the concepts you use3. How I would Handle Each Issue.  First, in this section and for each issue, as a health care provider, how would you handle each of the three issues discussed above and why?  Must use the relevant facts in the scenario to support your positions. Secondly for each issue, using the article in these requirements, entitled “A Framework of Thinking Ethically” fully discuss the specific ethics philosophy that would epitomize your handling of each issue. Fully define the specific ethics philosophy used and weave the ethics philosophy into your discussion. See article below entitled A Framework for Thinking Ethically. Must use headings below.  Headings will be:Handling of Legal/Ethical Issue #1 (followed by the discussion)
Handling of Legal/Ethical Issue #2 (followed by the discussion)Handling of Legal/Ethical Issue #3 (followed by the discussion)[A penalty will be deducted if you fail to use appropriate headings in your paper. ]This is an independent paper and you are on the honor system not to discuss or consult with any students or other individuals about this paper. You may use the information we have discussed in the class, the articles in the class, and the two articles I have furnished below. Just so you know, all you need to read to analyze the questions for your paper are the two articles I have furnished with this assignment and information in the class.All you need to read to analyze the questions for this paper are the two articles below entitled:Clinical Ethics Issues and Discussion & A Framework for Thinking EthicallyThe paper must be:Late submission – No late assignment 4 papers will be accepted. Paper is due Saturday in the last week of class no later than 11:59pm EST.. Paper must be in narrative format not outline or bullets. Double spaced and be 4-5 pages in 12 point New Times Roman font. [No deduction if paper exceeds a page or so.  Thus 3 and half page paper will be penalized.]Must cite to source of all your  facts in the text of your paper in APA format. You can cite directly to the original source. Here are the links to the sources where the University received copyright permissions for the materials:Clinical Ethics and Law:http://depts.washington.edu/bioethx/topics/law.htmlA Framework for Ethical Decision Making:https://www.scu.edu/ethics/ethics-resources/ethical-decision-making/a-framework-for-ethical-decision-making/Include a cover page [not counted as a page] which should have student name and title of your paper [Provide a short name for the legal responsibility the specific health care organization has for one type of patient right in a specific setting ] A the end of the paper a list of references [not counted as a page]    Be prepared using word-processing software and saved with a .doc, .docx, or .rtf extension. No pdf.Be uploaded to your Assignments Folder by 11:59 p.m. EST on the due date.    The paper is to be posted in Assignment #4 drop box.Grading rubric for assignment is with assignment in Assignments area of class.Background articles to support the issues you will discuss in the paper. Article One of Two Clinical Ethics Issues and Discussion ArticleRelationships: I. clinical ethics, law & risk managementDefinitions and sources of authorityIn the course of practicing medicine, a range of issues may arise that lead to consultation with a medical ethicist, a lawyer, and/or a risk manager. The following discussion will outline key distinctions between these roles.Clinical ethics may be defined as:  a discipline or methodology for considering the ethical implications of medical technologies, policies, and treatments, with special attention to determining what ought to be done (or not done) in the delivery of health care. Law may be defined as: established and enforceable social rules for conduct or non-conduct; a violation of a legal standard may create criminal or civil liability.Risk Management may be defined as: a method of reducing risk of liability through institutional policies/practices.Many health care facilities have in-house or on-call trained ethicists to assist health care practitioners, caregivers and patients with difficult issues arising in medical care, and some facilities have formally constituted institutional ethics committees. In the hospital setting, this ethics consultation or review process dates back to at least 1992 with the formulation of accreditation requirements that mandated that hospitals establish a “mechanism” to consider clinical ethics issues.Ethics has been described as beginning where the law ends. The moral conscience is a precursor to the development of legal rules for social order.  Ethics and law thus share the goal of creating and maintaining social good and have a symbiotic relationship as expressed in this quote:[C]onscience is the guardian in the individual of the rules which the community has evolved for its own preservation.  William Somerset MaughamThe role of lawyers and risk managers are closely linked in many health care facilities. Indeed, in some hospitals, the administrator with the title of Risk Manager is an attorney with a clinical background. There are, however, important distinctions between law and risk management. Risk management is guided by legal parameters but has a broader institution-specific mission to reduce liability risks. It is not uncommon for a hospital policy to go beyond the minimum requirements set by a legal standard. When legal and risk management issues arise in the delivery of health care, ethics issues may also exist. Similarly, an issue originally identified as falling within the clinical ethics domain may also raise legal and risk management concerns.To better understand the significant overlap among these disciplines in the health care setting, consider the sources of authority and expression for each.Ethical norms may be derived from:LawInstitutional policies/practicesPolicies of professional organizationsProfessional standards of care, fiduciary obligationsNote: If a health care facility is also a religious facility, it may adhere to religious tenets. In general, however, clinical ethics is predominantly a secular professional analytic approach to clinical issues and choices.Law may be derived from:Federal and state constitutions (fundamental laws of a nation or state establishing the role of government in relation to the governed)Federal and state statutes (laws written or enacted by elected officials in legislative bodies, and in some states, such as Washington and California, laws created by a majority of voters through an initiative process)  Federal and state regulations (written by government agencies as permitted by statutory delegation, having the force and effect of law consistent with the enabling legislation)Federal and state case law (written published opinions of appellate-level courts regarding decisions in individual lawsuits)City or town ordinances, when relevantRisk Management may be derived from law, professional standards and individual institution’s mission and public relations strategies and is expressed through institutional policies and practices.Conceptual Models Another way to consider the relationship among the three disciplines is through conceptual models:LinearDistinctionsInterconnectednessOrientation to law for non-lawyersPotential legal actions against health care providersThere are two primary types of potential civil actions against health care providers for injuries resulting from health care:  (1) lack of informed consent, and (2) violation of the standard of care. Medical treatment and malpractice laws are specific to each state.Informed Consent. Before a health care provider delivers care, ethical and legal standards require that the patient provide informed consent. If the patient cannot provide informed consent, then, for most treatments, a legally authorized surrogate decision-maker may do so.  In an emergency situation when the patient is not legally competent to give informed consent and no surrogate decision-maker is readily available, the law implies consent on behalf of the patient, assuming that the patient would consent to treatment if he or she were capable of doing so. Information that must be conveyed to and consented to by the patient includes: the treatment’s nature and character and anticipated results, alternative treatments (including non-treatment), and the potential risks and benefits of treatment and alternatives. The information must be presented in a form that the patient can comprehend (i.e., in a language and at a level which the patient can understand) and that the consent must be voluntary given. An injured patient may bring an informed consent action against a provider who fails to obtain the patient’s informed consent in accordance with state law.From a clinical ethics perspective, informed consent is a communication process, and should not simply be treated as a required form for the patient’s signature. Similarly, the legal concept of informed consent refers to a state of mind, i.e., understanding the information provided to make an informed choice.  Health care facilities and providers use consent forms to document the communication process. From a provider’s perspective, a signed consent form can be valuable evidence the communication occurred and legal protection in defending against a patient’s claim of a lack of informed consent.  Initiatives at the federal level (i.e., the Affordable Care Act) and state level (e.g., Revised Code of Washington § 7.70.060)  reflect approaches that support shared decision-making and the use of patient decision aids in order to ensure the provision of complete information for medical decision-making.Failure to follow standard of care. A patient who is injured during medical treatment may also be able to bring a successful claim against a health care provider if the patient can prove that the injury resulted from the provider’s failure to follow the accepted standard of care. The duty of care generally requires that the provider use reasonably expected knowledge and judgment in the treatment of the patient, and typically would also require the adept use of the facilities at hand and options for treatment.  The standard of care emerges from a variety of sources, including professional publications, interactions of professional leaders, presentations and exchanges at professional meetings, and among networks of colleagues. Experts are hired by the litigating parties to assist the court in determining the applicable standard of care.Many states measure the provider’s actions against a national standard of care (rather than a local one) but with accommodation for practice limitations, such as the reasonable availability of medical facilities, services, equipment and the like. States may also apply different standards to specialists and to general practitioners. As an example of a statutory description of the standard of care, Washington State currently specifies that a health care provider must “exercise that degree of care, skill, and learning expected of a reasonably prudent health care provider at that time in the profession or class to which he belongs, in the State of Washington, acting in the same or similar circumstances.”      III.            Common clinical ethics issues: medical decision-making and provider-patient communicationThere are a number of common ethical issues that also implicate legal and risk management issues. Briefly discussed below are common issues that concern medical decision-making and provider-patient communication.If a patient is capable of providing informed consent, then the patient’s choices about treatment, including non-treatment, should be followed. This is an established and enforceable legal standard and also consistent with the ethical principle of respecting the autonomy of the patient. The next two sections (Surrogate decision-making; Advance directives) discuss how this principle is respected from a legal perspective if a patient lacks capacity, temporarily or permanently, to make medical decisions. The third section briefly introduces the issue of provider-patient communication, and highlights a contemporary dilemma raised in decisions regarding the disclosure of medical error to patients.Surrogate decision-makingThe determination as to whether a patient has the capacity to provide informed consent is generally a professional judgment made and documented by the treating health care provider. The provider can make a determination of temporary or permanent incapacity, and that determination should be linked to a specific decision. The legal term competency (or incompetency) may be used to describe a judicial determination of decision-making capacity. The designation of a specific surrogate decision-maker may either be authorized by court order or is specified in state statutes.If a court has determined that a patient is incompetent, a health care provider must obtain informed consent from the court-appointed decision-maker. For example, where a guardian has been appointed by the court in a guardianship action, a health care provider would seek the informed consent of the guardian, provided that the relevant court order covers personal or health care decision-making.If, however, a physician determines that a patient lacks the capacity to provide informed consent, for example, due to dementia or lack of consciousness, or because the patient is a minor and the minor is legally proscribed from consenting, then a legally authorized surrogate decision-maker may be able to provide consent on the patient’s behalf.  Most states have specific laws that delineate, in order of priority, who can be a legally authorized surrogate decision-maker for another person. While these laws may vary, they generally assume that legal relatives are the most appropriate surrogate decision-makers. If, however, a patient has previously, while capable of consenting, selected a person to act as her decision-maker and executed a legal document known as a durable power of attorney for health care or health care proxy, then that designated individual should provide informed consent.In Washington State, a statute specifies the order of priority of authorized decision-makers as follows: guardian, holder of durable power of attorney; spouse or state registered partner; adult children; parents; and adult brothers and sisters. If the patient is a minor, other consent provisions may apply, such as: court authorization for a person with whom the child is in out-of-home placement; the person(s) that the child’s parent(s) have given a signed authorization to provide consent; or, a competent adult who represents that s/he is a relative responsible for the child’s care and signs a sworn declaration stating so.  Health care providers are required to make reasonable efforts to locate a person in the highest possible category to provide informed consent. If there are two or more persons in the same category, e.g., adult children, then the medical treatment decision must be unanimous among those persons.  A surrogate decision-maker is required to make the choice she believes the patient would have wanted, which may not be the choice the decision-maker would have chosen for herself in the same circumstance. This decision-making standard is known as substituted judgment. If the surrogate is unable to ascertain what the patient would have wanted, then the surrogate may consent to medical treatment or non-treatment based on what is in the patient’s best interest.Laws on surrogate decision-making are slowly catching up with social changes. Non-married couples (whether heterosexual or same sex) have not traditionally been recognized in state law as legally authorized surrogate decision-makers. This lack of recognition has left providers in a difficult legal position, encouraging them to defer to the decision-making of a distant relative over a spouse-equivalent unless the relative concurs. Washington law, for example, now recognizes spouses and domestic partners registered with the state as having the same priority status.  Parental decision-making and minor children. A parent may not be permitted in certain situations to consent to non-treatment of his or her minor child, particularly where the decision would significantly impact and perhaps result in death if the minor child did not receive treatment. Examples include parents who refuse medical treatment on behalf of their minor children because of the parents’ social or religious views, such as Jehovah’s Witnesses and Christian Scientists.  The decision-making standard that generally applies to minor patients in such cases is known as the best interest standard.  The substituted judgment standard may not apply because the minor patient never had decision-making capacity and therefore substituted judgment based on the minor’s informed choices is not able to be determined. It is important to note that minors may have greater authority to direct their own care depending on their age, maturity, nature of medical treatment or non-treatment, and may have authority to consent to specific types of treatment. For example, in Washington State, a minor may provide his or her own informed consent for treatment of mental health conditions, sexually transmitted diseases, and birth control, among others. Depending on the specific facts, a health care provider working with the provider’s institutional representatives could potentially legally provide treatment of a minor under implied consent for emergency with documentation of that determination,  assume temporary protective custody of the child under child neglect laws, or if the situation is non-urgent, the provider could seek a court order to authorize treatment. Advance directivesThe term advance directive refers to several different types of legal documents that may be used by a patient while competent to record future wishes in the event the patient lacks decision-making capacity.   The choice and meaning of specific advance directive terminology is dependent on state law. Generally, a living will expresses a person’s desires concerning medical treatment in the event of incapacity due to terminal illness or permanent unconsciousness. A durable power of attorney for health care or health care proxy appoints a legal decision- maker for health care decisions in the event of incapacity. An advance health care directive or health care directive may combine the functions of a living will and durable power of attorney for health care into one document in one state, but may be equivalent to a living will in another state. The Physician Orders for Life Sustaining Treatment (POLST) form is a document that is signed by a physician and patient which summarizes the patient’s wishes concerning medical treatment at the end of life, such as resuscitation, antibiotics, other medical interventions and artificial feeding, and translates them into medical orders that follow patients regardless of care setting. It is especially helpful in effectuating a patient’s wishes outside the hospital setting, for example, in a nursing care facility or emergency medical response context.  This relatively new approach is available in about a dozen states, although the programs may operate under different names: POST (Physician Orders for Scope of Treatment), MOST (Medical Orders for Scope of Treatment), MOLST (Medical Orders for Life-Sustaining Treatment), and COLST (Clinician Orders for Life-Sustaining Treatment).  The simple one page treatment orders follow patients regardless of care setting. Thus it differs from an advance directive because it is written up by the clinician in consultation with the patient and is a portable, actionable medical order.  The POLST form is intended to complement other forms of advance directives. For example, Washington State recognizes the following types of advance directives: the health care directive (living will), the durable power of attorney for health care, and the POLST form. Washington also recognizes another legal document known as a mental health advance directive, which can be prepared by individuals with mental illness who fluctuate between capacity and incapacity for use during times when they are incapacitated.State laws may also differ on the conditions that can be covered by an individual in an advance directive, the procedural requirements to ensure that the document is effective (such as the number of required witnesses) and the conditions under which it can be implemented (such as invalidity during pregnancy).Advance directives can be very helpful in choosing appropriate treatment based upon the patient’s expressed wishes. There are situations, however, in which the advance directive’s veracity is questioned or in which a legally authorized surrogate believes the advance directive does not apply to the particular care decision at issue. Such conflicts implicate clinical ethics, law and risk management.Provider-patient communications: disclosing medical errorHonest communication to patients by health care providers is an ethical imperative. Excellent communication eliminates or reduces the likelihood of misunderstandings and conflict in the health care setting, and also may affect the likelihood that a patient will sue.One of the more contentious issues that has arisen in the context of communication is whether providers should disclose medical errors to patients, and if so, how and when to do so. Disclosure of medical error creates a potential conflict among clinical ethics, law and risk management. Despite a professional ethical commitment to honest communication, providers cite a fear of litigation as a reason for non-disclosure. Specifically, the fear is that those statements will stimulate malpractice lawsuits or otherwise be used in support of a claim against the provider.  An increase in malpractice claims could then negatively affect the provider’s claims history and malpractice insurance coverage.  There is some evidence in closed systems (one institution, one state with one malpractice insurer) that an apology coupled with disclosure and prompt payment may decrease either the likelihood or amount of legal claim.  In addition, a number of state legislatures have recently acted to protect provider apologies, or provider apologies coupled with disclosures, from being used by a patient as evidence of a provider’s liability in any ensuing malpractice litigation. It is currently too early to know whether these legal protections will have any impact on the size or frequency of medical malpractice claims. For this reason and others, it is advisable to involve risk management and legal counsel in decision-making regarding error disclosure.  Article Two of TwoA Framework for Thinking Ethically ArticleThis document is designed as an introduction to thinking ethically. We all have an image of our better selves-of how we are when we act ethically or are “at our best.” We probably also have an image of what an ethical community, an ethical business, an ethical government, or an ethical society should be. Ethics really has to do with all these levels-acting ethically as individuals, creating ethical organizations and governments, and making our society as a whole ethical in the way it treats everyone. What is Ethics?Simply stated, ethics refers to standards of behavior that tell us how human beings ought to act in the many situations in which they find themselves-as friends, parents, children, citizens, businesspeople, teachers, professionals, and so on.It is helpful to identify what ethics is NOT:• Ethics is not the same as feelings. Feelings provide important information for our ethical choices. Some people have highly developed habits that make them feel bad when they do something wrong, but many people feel good even though they are doing something wrong. And often our feelings will tell us it is uncomfortable to do the right thing if it is hard.• Ethics is not religion. Many people are not religious, but ethics applies to everyone. Most religions do advocate high ethical standards but sometimes do not address all the types of problems we face.• Ethics is not following the law. A good system of law does incorporate many ethical standards, but law can deviate from what is ethical. Law can become ethically corrupt, as some totalitarian regimes have made it. Law can be a function of power alone and designed to serve the interests of narrow groups. Law may have a difficult time designing or enforcing standards in some important areas, and may be slow to address new problems.• Ethics is not following culturally accepted norms. Some cultures are quite ethical, but others become corrupt -or blind to certain ethical concerns (as the United States was to slavery before the Civil War). “When in Rome, do as the Romans do” is not a satisfactory ethical standard.• Ethics is not science. Social and natural science can provide important data to help us make better ethical choices. But science alone does not tell us what we ought to do. Science may provide an explanation for what humans are like. But ethics provides reasons for how humans ought to act. And just because something is scientifically or technologically possible, it may not be ethical to do it.Why Identifying Ethical Standards is HardThere are two fundamental problems in identifying the ethical standards we are to follow: 
1. On what do we base our ethical standards?
2. How do those standards get applied to specific situations we face?If our ethics are not based on feelings, religion, law, accepted social practice, or science, what are they based on? Many philosophers and ethicists have helped us answer this critical question. They have suggested at least five different sources of ethical standards we should use.Five Sources of Ethical StandardsThe Utilitarian Approach
Some ethicists emphasize that the ethical action is the one that provides the most good or does the least harm, or, to put it another way, produces the greatest balance of good over harm. The ethical corporate action, then, is the one that produces the greatest good and does the least harm for all who are affected-customers, employees, shareholders, the community, and the environment. Ethical warfare balances the good achieved in ending terrorism with the harm done to all parties through death, injuries, and destruction. The utilitarian approach deals with consequences; it tries both to increase the good done and to reduce the harm done. The Rights Approach
Other philosophers and ethicists suggest that the ethical action is the one that best protects and respects the moral rights of those affected. This approach starts from the belief that humans have a dignity based on their human nature per se or on their ability to choose freely what they do with their lives. On the basis of such dignity, they have a right to be treated as ends and not merely as means to other ends. The list of moral rights -including the rights to make one’s own choices about what kind of life to lead, to be told the truth, not to be injured, to a degree of privacy, and so on-is widely debated; some now argue that non-humans have rights, too. Also, it is often said that rights imply duties-in particular, the duty to respect others’ rights. The Fairness or Justice Approach
Aristotle and other Greek philosophers have contributed the idea that all equals should be treated equally. Today we use this idea to say that ethical actions treat all human beings equally-or if unequally, then fairly based on some standard that is defensible. We pay people more based on their harder work or the greater amount that they contribute to an organization, and say that is fair. But there is a debate over CEO salaries that are hundreds of times larger than the pay of others; many ask whether the huge disparity is based on a defensible standard or whether it is the result of an imbalance of power and hence is unfair. The Common Good Approach
The Greek philosophers have also contributed the notion that life in community is a good in itself and our actions should contribute to that life. This approach suggests that the interlocking relationships of society are the basis of ethical reasoning and that respect and compassion for all others-especially the vulnerable-are requirements of such reasoning. This approach also calls attention to the common conditions that are important to the welfare of everyone. This may be a system of laws, effective police and fire departments, health care, a public educational system, or even public recreational areas. The Virtue Approach
A very ancient approach to ethics is that ethical actions ought to be consistent with certain ideal virtues that provide for the full development of our humanity. These virtues are dispositions and habits that enable us to act according to the highest potential of our character and on behalf of values like truth and beauty. Honesty, courage, compassion, generosity, tolerance, love, fidelity, integrity, fairness, self-control, and prudence are all examples of virtues. Virtue ethics asks of any action, “What kind of person will I become if I do this?” or “Is this action consistent with my acting at my best?” Putting the Approaches TogetherEach of the approaches helps us determine what standards of behavior can be considered ethical. There are still problems to be solved, however.The first problem is that we may not agree on the content of some of these specific approaches. We may not all agree to the same set of human and civil rights.We may not agree on what constitutes the common good. We may not even agree on what is a good and what is a harm.The second problem is that the different approaches may not all answer the question “What is ethical?” in the same way. Nonetheless, each approach gives us important information with which to determine what is ethical in a particular circumstance. And much more often than not, the different approaches do lead to similar answers. Making DecisionsMaking good ethical decisions requires a trained sensitivity to ethical issues and a practiced method for exploring the ethical aspects of a decision and weighing the considerations that should impact our choice of a course of action. Having a method for ethical decision making is absolutely essential. When practiced regularly, the method becomes so familiar that we work through it automatically without consulting the specific steps.The more novel and difficult the ethical choice we face, the more we need to rely on discussion and dialogue with others about the dilemma. Only by careful exploration of the problem, aided by the insights and different perspectives of others, can we make good ethical choices in such situations.We have found the following framework for ethical decision making a useful method for exploring ethical dilemmas and identifying ethical courses of action.A Framework for Ethical Decision MakingRecognize an Ethical IssueCould this decision or situation be damaging to someone or to some group? Does this decision involve a choice between a good and bad alternative, or perhaps between two “goods” or between two “bads”?Is this issue about more than what is legal or what is most efficient? If so, how?Get the FactsWhat are the relevant facts of the case? What facts are not known? Can I learn more about the situation? Do I know enough to make a decision?What individuals and groups have an important stake in the outcome? Are some concerns more important? Why?What are the options for acting? Have all the relevant persons and groups been consulted? Have I identified creative options?Evaluate Alternative ActionsEvaluate the options by asking the following questions:Which option will produce the most good and do the least harm? (The Utilitarian Approach)Which option best respects the rights of all who have a stake? (The Rights Approach)Which option treats people equally or proportionately? (The Justice Approach)Which option best serves the community 
as a whole, not just some members? 
(The Common Good Approach)Which option leads me to act as the sort of person I want to be? (The Virtue Approach)Make a Decision and Test ItConsidering all these approaches, which option best addresses the situation?If I told someone I respect-or told a television audience-which option I have chosen, what would they say?Act and Reflect on the OutcomeHow can my decision be implemented with the greatest care and attention to the concerns of all stakeholders?How did my decision turn out and what have I learned from this specific situation?This framework for thinking ethically is the product of dialogue and debate at the Markkula Center for Applied Ethics at Santa Clara University. Primary contributors include Manuel Velasquez, Dennis Moberg, Michael J. Meyer, Thomas Shanks, Margaret R. McLean, David DeCosse, Claire André, and Kirk O. Hanson. It was last revised in May 2009. End of article.