Pharmaceutical(Pill Mills) Industry Regulate and profitability Research Paper

Pharmaceutical(Pill Mills) Industry Regulate and profitability - Research Paper Example Due to their short business span in a given location, they have huge crowds waiting to see the doctor and they have body guards just in case of invasion. This is misuse of pharmaceutical industry which calls for immediate action to protect lives of citizens and health sector (Drugs Policy Alliance, 2007). Yes, the pharmaceutical industry is regulated. Secondly, the law requires a medical professional to write prescriptions if you want to move large amount of pain killers in America. There is also existence of Healthcare Distribution Management Association [HDMA] which controls the supply of narcotic substance. Finally, DEA’s power to suspend/revoke licenses of distributors in case of ethical malpractices acts as control measure (United States-Canada Regulatory Cooperation Council, 2011). DEA regulates the industry by formulating the policies to govern production, distribution and prescription of narcotic substances. Also HDMA in its management on distribution of health care products and combating drug abuse role. Food and Drugs Administration [FDA] is a regulator in that it supervises food safety, dietary supplements, prescriptions of over- the- counter medicines, blood transfusion and other medical and dietary specializations. As discussed above Pill Mills are not legitimate and their operations involve procurement of sub-standard drugs and supplements which are then prescribed to patients inappropriately. Law enforcement and implantation of drugs policy Acts make it hard for these businesses to transact. For instance, regulation of the amount of pain killers to be produced by DEA and monitoring of distribution channels by HDMA will affect their supply and establishment of their quack businesses. In addition, proper scrutiny of food and narcotic products by FDA makes it difficult for Pill Mills to establish their business (FDA’s International Post, 2010). Pill Mills are established with an immediate response to the common problems

Persuasive Research Paper on ( Gun Control) Example | Topics and Well Written Essays - 750 words

Persuasive on ( Gun Control) - Research Paper Example There were 280 million firearms in private hands in America in 2005 and there were only 300,000 gun crimes (Kessler 46). For Kessler, this means that at least 279,700,000 guns did nothing wrong (46). Further, Kessler added that in 89% of the crimes, the person who used the gun was not the one who bought the gun (46). Kessler interpreted the data to mean that the root of America’s crime problem is not the number of guns in the hands of American (46). Kessler’s key argument is that American should not restrict gun rights but should â€Å"deepen† instead the sense of gun ownership (47). In a way, Jim Kessler hit the nail on the head. Indeed, deepening the sense of gun ownership will probably decrease the crime rate. However, this sense of ownership can be deepened not through liberal gun laws but by regulating people’s access to guns. This should not be interpreted as curtailment of rights. In the same way that the right to free speech is moderated by libel laws, the rights to gun ownership will have to be moderated by society’s consideration for the general good. This is because not all persons are ready enough to own guns. Not all individuals are responsible enough to have unhampered access to guns. Responsible gun ownership is promoted best not through liberal gun laws but through gun control. In 1993, Professor Martin Killias of University of Lausanne, Switzerland, examined the correlations between household gun ownership and rates of homicides and suicides using a gun in eleven European countries, Australia, Canada and the United States (Killias 1721). Killias found that there is a positive correlation between gun ownership and the rates of homicides and suicides using a gun in the fourteen countries (1721). In citing examples, Killias pointed out that the United States homicide was 3.7 times higher than Britain and the US suicide with a handgun was 175 to 1 compared with the US (1722). He

Ethics In The Health Care Industry Social Work Essay

Ethics In The Health Care Industry Social Work Essay Ethics as it is being used in the health sector is a concept that has evolved over time. There is no doubt that every player in the sector seeks to continually improve their services delivery as well as attaining maximum patient satisfaction in the process. In the last few years, ethics in health has developed through a number of stages. Hippocratic culture dominated traditional ethics in the 1960s where health care providers established relationships with patients. The core values of this relationship were derived from culture. The technological advancements and intensive research has seen developments in biological sciences and biotechnology. With such changes, a new ethical dimension was introduced. Ethical principles of human dignity, compassion, non-malfeasance and social justice However, with time a dilemma arose from the liberalization of health care industry. There emerged a need to harmonize the differences in health needs and resources availed for filling the gap. The scope of health ethics was thus expanded to include quality control, economics, policy formulation and implementation as well as massive research and development. Such efforts and resource harmonization gave birth to an era of health policy and ethics. As time advances there are debates on human rights protection and respect of human dignity (Bryant, Hyder and Kauser, 2007). It is now a fundamental right for every individual to enjoy quality health care without discrimination of any kind. The most recent dimension of health ethics is the fusion of lauded human rights and the fundamental right to obtain quality health services. Contrary to direct definition of health, as the entire state of well being in terms of mental social and physical status of an individual, ethics and human dignity issues are more complicated to completely expound on them. Ethics is solidly founded on cultural convictions developed over time. It derives its relevance and strength from religious and philosophical advocacies deeply embedded on the present leadership systems. It is considered as the ability of a community to clearly and amicably draw a boundary separating what is perceived as wrong and what remains a right thing. Such a boundary touches on the aspects of life right from the way of doing things to the general perception of life. It becomes a big understatement to define ethics without mentioning the famous dimensions used to describe it. It is a cumulative approach of respect to humanity with specific focus on maintenance of autonomy of a person, delivery of justice, rights and upholding of human dignity. Ethics in health policy formulation and implementation focuses on the most cost effective means of delivering a quality health care to all. It is in this light therefore, that ethics attempts to strike a balance between the policies and values cherished by an entire community. Equity is another paramount aspect of importance which cannot be neglected. It is about all that appertains to fairness in the ultimate distribution of gains derived from a robust health advancement which is socially acceptable. It is a concept that goes beyond just accessing health care products but touches on the response aimed at meeting the needs of all persons. Equity aims at ensuring that no one individual is favored in the allocation of resources as well as availing of equal chances of accessing health care (Bankowski, Bryant and Gallagher, 2007). It is therefore a process justified by the outcome. It is important to examine the impact of decisions made on equity. The specific health decisions must go a long way in fostering equity in access to health care services. The health status of most vulnerable groups remains the action points of equity development. There are no specific parameters of determining a group to be classified as vulnerable. However, there are general features which help us in this. There are those who are vulnerable due to social construction while others are as a result of congenital disability. It is usually possible to get an overlap between the two possible causes of vulnerability. The United Nations charter identifies the promotion of human dignity to be one of its core principles. This is evident in the ratifications, conventions and declarations of numerous international agreements in respect of this. One thing that we cannot fail to talk about at the mention of health care is this core principle of promotion of human rights and upholding of human dignity. A good example is the right to information an individual is entitled to on everything that affects his or her health. It is this right that compelled cigarette manufacturing companies to put an information label on their packets. In the recent past, efforts have been put on the reduction of public health burden on the rights of individuals (Sen, Germain and Chen, 2004). Trampling on the rights of a few individuals through quarantine, mandatory testing and isolation in the name of benefiting the majority is no longer ethically acceptable. A good and most recent example is United Nations advocacy of elimination of discrimination against people living with HIV. Together with human rights, dignity is considered an inherent and universal concept. Wide scopes of research in the biomedical field have continued to become the center of discussion on the inherent issues on human dignity. Law enforcers must also expand their focus to other sources of human dignity violation originating from areas outside medical field. Such determinants as political influence, economic factors, technological innovations, environmental concerns and changes in demographics must be looked into. It is important to note that advances have been made so far in the maintenance of human dignity and respect of human rights. Majority of institutions dealing with human health care services have a deliberate way of issuing instructions aimed at improving ethics amongst their staff members. The extent at which ethics instructions are being given is a clear indication of a continuous increase in the expansion in respect of human dignity. The unprecedented attention given to research on health care ethics cannot be attributed to one particular factor. There are a number of reasons as to why every player is shifting focus to this study. To start with, the knowledge explosion on the biotechnology field has availed a number of avenues available for a medical professional in the fight against diseases. It is now possible to handle situations which were once thought to be untreatable. However, this milestone in medical field has not been a bed of roses. A series of mixed reaction continue to emanate from various sections of the society on how ethical are some of these methods. Secondly, the cost of accessing basic health care is sky rocketing across the world. Most governments of the day are spending a substantial portion of their Gross Domestic Product on health care expenses yet most citizens cannot get the care they need. This leaves us in total agreement with Howard Hiatt who say that we have a few resources to use in provision of health care and therefore as a society, we need to ask ourselves two important questions. That is how we spend and allocate them. It is as a result of financial constraints that have made us witness denial of adequate health care, limited access and unfair rationing (Hiatt, 2005). Situational analysis Issues of ethics in health care are numerous. They range from an individual responsibility to the entire corporate obligations. That is why such issues can be approached from two distinct sides. To start with, macro ethical situations entail what cannot be addressed by a specific practitioner. Such issues are those in which the entire body of health professionals and the community at large must deal with in a bid to ensure that health care ethics are defined and respected. As an illustration, issues such as termination of pregnancy, health care resources allocation and organ transplants are in the category of macro situations. On the other hand, micro situations lie squarely on the hands of a single individual health care professional. It must be realized that ripple effects of macro issues are flow into micro situations. Ideally, the topic of health ethics should commence from the generally accepted responsibility a medical officer have towards meeting the needs of patients. This brings to our thoughts the issues of competence and trustworthiness of the health care practitioners. Competency goes beyond possessing enough knowledge to deal with a situation. It includes the ability to articulate issues of health and deliver the services timely and accurately. It is also equally important for a patient to have confidence in the person he or she has entrusted his or her body to. Trustworthiness therefore forms a core factor in the satisfaction of patients which finally culminate to enhancement of health care ethics (Berger, 2003). Legal and ethical rights We are living in an era with serious awakening in discovery of personal rights. The medical professionals have always been assumed to be an all knowing class. A patient would accept to undergo a surgery, take drugs and have a laboratory test without any question or hesitation. This trend referred to as medical paternalism is gradually dying. Patients are becoming consumers with a right to choose what they perceive to best suit them. It is therefore a mandatory standard practice to seek a patients consent before carrying out any procedures aimed at restoring health. Doing anything different from this will not only be unprofessional but totally unethical. The overstepping of a practitioners mandate in administering health care can also attract serious legal action whose far reaching effects can be detrimental in the career of a defendant. Just like any other customer, a patient desires to attain a definite level of satisfaction. Health professionals who are unable to meet the needs of their patients may not be such attractive in future if they survive legal actions. The legal rights of individuals are what we cannot avoid to talk about at the mention of health care ethics. The rights are those privileges a person enjoys as provided and defended in the Constitution of a country. Several legislations avails a patient with a series of rights. A patient seeking the attention of health care providers expects that clinical officers will utilize their gained experience coupled with their knowledge in striving to meet their needs. The patients rights ensure that independent individuals can expect the health care providers to meet their wishes of getting well without fear of otherwise. From a broader view, health care systems are primarily based on the rights of individuals seeking treatment. Patients have a sole responsibility of selecting who or what best suits them in terms of health care facilities and doctors. It is required that the patient gives a go ahead of any process through a fairly attained informed consent. This scheme may look very attractive to a person whose has enough economic muscle to meet the cost of treatment. The patients right assumes that everyone patient can comfortably settle hospital bills. On contrary, this right is as good as not being there for the patient who does not have a medical cover or enough money to pay (Bankowski, 2006). Although United Nations Declaration of Human Rights says that that all persons have a right medical treatment you cannot walk to a health care facility and demand for treatment. It is not enough to receive medical treatment; safety and effectiveness of the services are two paramount features that a treatment seeker is entitled to put into consideration. Ethical rights impose a responsibility on health care practitioners. The Hippocratic Oath results in a duty by the health professionals to do all they can in benefiting the patients and avoidance of any foreseeable harm. It can be argued that the health care providers must act at the best interest of the patients with disregard to how others are affected by their actions. A legality dilemma created by this Hippocratic Oath is diffused by the controversial exposition by Rem Edwards who claims that the health care providers are obligated to alleviating the aching and suffering of health care seekers. The defects in this point of view are evident on the side of health professionals who operate under strict constraints of laws. The responsibilities of health professionals are thus in conflict with earlier mentioned rights of the patients in the light of ethical and legal correctness. Ordering a health care expert to pursue a personal approach and do what contradicts the law, yet ethical, process in the patient with total disregard of what may befall them legally is as good as telling them to suppress what is important to them in favor of the patient. Ethical analysis It is important for a health care provider to continually examine his action so as to ascertain whether he is doing the right thing or not. In 1989, Robert Veatch proposed a four step blueprint which can be used by the health practitioners. This method of analysis involves making sure that there is sufficient knowledge backed by facts for every situation. The second step is bringing in to play whatever is morally upright in relation to the situation at hand. Ethical principles are given a consideration it deserves at the third step. Once the three steps have been taken care of, a fourth and last step of looking in to ethical theories is done. This provides health practitioners with a reliable, powerful tool available for use when faced with a situation demanding an ethical decision making. This theory formulated by Veatch approaches situation in a chronological manner. He goes ahead to argue that an ethical dilemma can be sorted not necessarily through the four steps but by just laying down the actual facts about a condition. If the application of step number one cannot provide a way out, step two is considered. This focuses on the moral rules guided closely by confidentiality or patients consent. At the event that dilemma persists, ethical guidelines of step three are used. The ethical principle encompasses aspects such as maintenance of autonomy, fidelity, nonmaleficence and beneficence. At this point, the stalemate must have been broken. However, it is possible to have unclear solutions even with the application of ethical principles. It is because of such a situation that a health care professional is compelled to use an ultimate tool available in step four. Ethical theories are the final solution finder in a hard decision making procedure. A particle and most recent example is seeking of consent of an organ donor. There have been several conflicting issues surrounding organ transplants. The ever growing imbalance between the number of organs demanded and those available for sale has played a major role in heightening the differences between proponents and opponents of this process. It is the obligation of clinicians to make sure that the wishes of prospective organ donors are respected to the later (Beauchamp and Childress, 2009). Various regulations have been put in place to ensure the respect of free will and human dignity of a donor whether death or alive. Conclusion The challenges facing health care professionals continue to rise with technological advancements and sky rocketing costs of health care. It is therefore of paramount importance to equip them with sufficient knowledge of ethical tools for use in such situations today or in days to come. Totally relying upon ethical codes, principles and theories may not be enough in decision making but serves by providing a rough idea.

The Death of Creativity in Brave New World :: Brave New World

The Death of Creativity in Brave New World      Ã‚  Ã‚   Aldous Huxley, in his distopian novel,Brave New World, presents a horrifying view of a possible future in which society has become a prisoner of the very technology it hoped would save us.   In Brave New World Huxley's distortion of technology, religion, and family values, is much more effective than his use of literary realism found in his depiction of a savage reservation. Through his use of distortion Huxley tells a classic tale with the theme of, be careful what you wish for, because it may not truly be what you wanted.      Ã‚  Ã‚   Huxley effectively uses distortion in -Brave New World through his depiction of social values of the future. For example, when Barnard Marx hears somebody talking about Lenina in the locker room, he becomes upset. Leaving the building, everyone he passes recommends soma for his bad mood. Huxley shows the reader that drug use is becoming more and more an acceptable way out for a weak society.   He is showing society that we are becoming emotionally incapable of dealing with pain and hurt. Furthermore, the students, while speaking with the director of the London Hatchery, are told at one time people were viviparous, and were disgusted and outraged. Huxley is trying to warn society that its lack of commitment and endurance will eventually be its downfall.   Lack of the experience of pregnancy severs the emotional ties of the woman and her child.   An emotionless society feels no guilt.   In addition, Lenina, when accused of lack of promiscuity by Fanny while in the locker room, religiously denies it. Monogamy requires commitment, pain, and work.   Huxley is predicting humans progressing to a society of people who are unable to focus on anything but pleasure; unable to handle the work of a commitment.   He knew the road we were on would lead the wrong way.      Ã‚  Ã‚   Huxley also uses distortion to open peoples eyes to the world of religion.   For example, Bernard Marx hurries and frets about being late to his orgy-porgy session because he is running behind.   Huxley's prediction of the church moving away from God and towards man is becoming evident even sixty-three years after his book appeared.   Church figures, such as, Jim Bakker and Jimmy Swaggert, have appeared numerous times on the news and in the papers for using the church for money and sex.   Furthermore, when Bernard and Lenina visit the reservation they are appalled at the practice of a cross of Christianity and Hinduism.  Ã‚   A warning that lack of religious tolerance could be one of the greatest downfalls of our time.

Petronius’s Satyricon: Trimalchio and Encolpius Essay

Satyricon is a unique literary work which is a combination of first-person narration and tales encompassing the lives of even the ordinary Greek people. Gaius Petronius wrote it around 61 AD inspired by the lavish lifestyle in Rome, literature, art, and self-expression, vulgar abuse of wealth, pretension, and religious superstition depicting Nero in some parts of the novel (Wilson, 2007). Tacitus, a famous historian, was the main source of Petronius’ life. Petronius worked as a consul during Nero’s reign. He is known as â€Å"the Arbiter† which means â€Å"judge of elegance† whom Emperor Nero often consults about matters regarding luxury, extravagance, art and literature. However, a rival got jealous over who accused him of treason. In response, Petronius committed suicide instead of being executed (Ruden, 2000). Petronius wide experience on literature and arts allowed to explore write a sophisticated book about the people in different ranks. Satyricon main characters include (1) Encolpius, who is the narrator; (2) Trimalchio, a slave; (3) Agamemnon , teacher of Encolpius; and (4) Fortunata, the wife of Trimalchio (â€Å"†Dinner with Trimalchio† from the Satyricon,†). Encolpius is very clever and adventurous man who is also a student of rhetoric who composes and delivers speeches. Encolpius was cursed by the phallic god, Priapus, to be impotent and he travels all along with his friends Giton and Ascyltos just to find a cure. Ascyltos, a young and gay, is also a student of rhetoric. Giton, on the other hand, is a slave who accompanied them throughout their journey. Along their travel, they a met a poet named Eumolpus whom they met on the road and decided to travel with them also (Sergius, 2005). They traveled to Campania, a Greek town and delivered a speech there about his dislike on the prevailing literature. He said accused the proponents of declamatory education as the root. However, Agamemnon who is a declaimer, blame in on the parents instead. His friend Ascyltos on the other hand, left in escape from Agamemnon. More disputes has happened, but one of the most significant events in on the novel is the Dinner with Trimalchio. Trimalchio used to be a slave; but because of his perseverance, he was able to freed himself and attain wealth and power at the same time. The foursome happens to be invited by Trimalchio and his wife, Fortunata, on a lavish dinner that they never imagined. Aside from the Encolpius and his friends, high ranking people are also invited such as the rich, lawyers, traders, merchants, and other free men. Trimalchio’s house, as described by Encolpius, is very spectacular especially the wall paintings of a watch dog whom Encolpius thought was real; painting of the Trimalchio’s life; Iliad and Odyssey; and gladiatorial combat (Wilson, 2007). Encolpius is fascinated by all the wall paintings saying that, â€Å"There was no time in which to examine them all†. Trimalchio is fashioned with napkin with purple border, his left hand wearing rings one of pure gold with iron stars around it, a golden arm-band on his right arm, and a bracelet mad of ivory. Trimalchio is described as a senator and equestrian fanatic. Trimalchio believes in some superstition such as right foot forward first, preoccupation with death and zodiac dish. Each zodiac is represented with a specific dish such as ram on Aries, beef on Taurus, kidneys on Gemini, crown on cancer, sow’s womb on Virgo, African fig on Leo, balance on Libra, seafish on Scorpio, bull’s eye on Saguitarrius, lobster on Capricorn, goose on Aquarius and mullet on Pisces (Gill, 2007). Encolpius asked a servant and learned more of the how wealthy Trimalchio is. Trimalchio purchased expensive wool, pitch, pepper, rams, bees from Attica and other sorts of things he bought. His wealth continues to increase and is clever enough to conceal if his business goes bankrupt by announcing an auction. Throughout the dinner, Trimalchio tried to discuss and boast all about his life and how he got the wealth he is enjoying. He is implying that he used to have nothing at all; but despite of that, he is now richer and powerful. He entertains hi guest with extravagant dishes and exhibitions, the way he treated his slaves and his pretence of education (Gill, 2007). When Trimalchio excused himself to the toilet, the freedmen soon discussed about different sort of things such as weather, public games, education of their children, and the problems they encounter. After Trimalchio finished, he continues to delight them with more dishes. Stories are told about witches, and werewolf. Another guest came, a stonesmason named Habinnas, with his wife and chat with Trimalchio’s wife about their jewelries. However, Encolpius and his friends are getting bored and irritated and tried to leave the dinner. The foursome are prevented to escape by a servant; but after hearing a sound of horns when Trimalchio tried to portray his funeral, they escaped (Gill, 2007). More adventures followed as the foursome tried to escape by the sea. The setting of the dinner is speculated to have happened either in Naples or Pompeii. Petronius tells about freedman and it is assumed that most of the freedmen in Satyricon are Greek or Macedonian slaves who have learned Latin without receiving any proper education (Sergius, 2005).

How does Plath use intricate patterning of sounds, words, images and rhythm to create an impact on the reader?

Almost all of Plath's poems are so deep and full of emotions that it would be impossible to be impacted by them. However, her intricate use of linguistic and literary devices help the reader to understand the true meaning of her poems therefore adding to the impact. For this essay I will look mainly at the linguistic and literary features Plath uses in her poem ‘Daddy'. This poem, like many of her others, uses an intricate patterning of sounds to create a certain moods at points in the poem. For instance the first three stanzas of the poem uses assonance; the soothing sound ‘oo'; â€Å"you do not do†, â€Å"I have had to kill you† and, â€Å"Where it pours bean green over blue†. This sound draws out the words resulting in a longer, protracted sound. This slows the flow of these stanzas and creates a calm mood. This patterning of sounds can also be seen in her other poems. For example in Miss Drake Proceeds to Supper, in which she patterns the ‘d' harsh sound to create a faster pace and cutting mood. Plath creates imagery in many of her poems with the use of colour. In Daddy she patterns the use of colour from black and white in the first stanza to black and red in the eleventh and twelfth stanza. The colours black and white are antithetical and when placed in close proximity connote racism, or in this case fascism. The black is used to connote the evil of the Germans while the white represents the innocence of the Jews. Therefore Plath is using colours to create imagery of her view of the suppression of the Jews, this creates an empathetic impact on the reader. However, the later patterning of black and red are used symbolically. She writes, â€Å"Bit my pretty red heart in two.† The adjective she has used to describe her heart is ‘red' but in the last line her use of the adjective black is also linked to the description of the heart symbolising that her heart is black, which connotes death. This imagery is very emotive; therefore, creating a significant impact on the reader. Furthermore, in this poem Plath uses the linguistic device of apostrophe to create an impact on the reader. She writes, â€Å"Daddy, I have had to kill you.† This device conveys to the reader that this poem is addressed to her Father. Many of Plath's poems are about her father but the device of directing this poem at him has a much stronger effect on the reader because she speaks so openly to him in the poem, even though the reader may be aware of the fact that he is dead. Plath patterns the pronoun ‘you' to sustain the direct address of her father throughout the poem. However, she also used this pronoun with a concealed intention as it seems also to be addressing the reader. The last stanza use the pronoun in every line, â€Å"There's a stake in your fat black heart And the villagers never liked you†¦Ã¢â‚¬ ¦Ã¢â‚¬  This patterning of the pronoun includes the reader because it seems as though she is subtly talking to the reader of the poem as well. In this case this linguistic device makes a stronger impact on the reader than if Plath were to have written the poem in first or third person because of the emotive nature of much of the lexis in the poem that appears to be directly addressed to the reader. The lexical field within this poem, as has been the case in some of Plath's other poetry, is that of war. The phrase, â€Å"barb wire snare† and her numerous references to â€Å"Jews†, â€Å"Germans† and fascism are just some of the lexis that connote that of war. Her overindulgence in lexis from this field is so overwhelmingly hyperbolic that it gives the poem a sarcastic tone. Plath purposefully does this to create a light hearted twist in a poem that on the surface seems to the reader to be very derisive and cruel. Plath creates a childlike feeling in the thirteenth stanza when she writes, â€Å"And they stuck me together with glue.† This line alludes to the children's poem ‘Humpty Dumpty' reinforcing the childish noun ‘Daddy'. This juxtaposition of the childlike allusion and lexis with the hard hitting, raw lexical field of war creates a binary opposition. The association of these two opposite images is rather unpleasant making the reader feel uncomfortable. Plath's use of enjambment has a strong effect as the poem seems to pour out of Plath and onto the page in a disordered but constant stream of imagery and sadistic phrases. This creates the hateful tone that Plath intentionally uses in some of her other poetry about her Father. Caesura is used to help make the poem somewhat readable but does not break the flow of ‘hate' that the enjambment creates. The syntax of many of the sentences in the poem is also disordered which adds to this effect. Combined the syntax and enjambment create an impact on the reader because of the overflowing feeling of Plath's hate that they convey. In conclusion it is clear to see that the subject of this poem is one that Plath feels incredibly strong emotions towards, in this case hate. It would therefore be impossible to not have some sort of impact on the reader. However, through her use of linguistic and literary devices like assonance, imagery, apostrophe, lexical fields, allusions and enjambment Plath conveys her message and emotions effectively to the reader resulting in a much stronger impact.