Patrol Rifles Arming Officers to Succeed Free Essays

string(61) " and higher risk of over penetration through interior walls\." PATROL RIFLES: ARMING OFFICERS TO SUCCEED Sergeant Scott Buziecki North Aurora Police Department A Research Paper Submitted to the Northwestern University Center for Public Safety School of Police Staff Command Class #175 Naperville, Illinois December 9, 2002 Executive Summary The North Aurora Police Department currently allows officers to carry their choice of 9mm or . 45 caliber pistols; no long guns are available. The Firearms Training Unit has proposed that the department adopt the . We will write a custom essay sample on Patrol Rifles: Arming Officers to Succeed or any similar topic only for you Order Now 223 caliber rifle for patrol officer use. The reasons for this proposal are: (1) pistols are inherently less accurate and have a shorter effective range than long guns such as rifles and shotguns, (2) pistol caliber bullets penetrate more heavily through interior walls than . 223 rifle caliber bullets, which causes an increased risk of unintended persons being hit, and (3) pistol caliber bullets will not penetrate body armor and many other obstacles commonly encountered, while most . 223 caliber bullets will. The objective of this research is to determine if the NAPD should adopt a long gun for patrol officer use or keep the current pistol-only program as it is. The types of weapons under consideration are pistol caliber rifles (9mm and . 45 caliber), shotguns (slugs and buckshot), and the . 223 caliber rifle. These weapons will be compared and contrasted with respect to accuracy range, ease of use, wounding ability, and barrier penetration. Immediate Incapacitation Officers shoot to immediately achieve physiological incapacitation of a suspect who is threatening life. This means that the suspect is rendered physically incapable of continuing his or her life threatening behavior. This is done by (1) damaging or destroying the suspect’s central nervous system by shooting the brain or upper spinal cord, or (2) interrupting blood flow to the brain, to cause unconsciousness, through shooting the center mass of the suspect. Stopping blood flow to the brain is done by creating as much trauma and bleeding as possible. Some projectiles cause these effects better than others. Decisions on weapons, ammunition, and training should be made with the goal of immediate incapacitation in mind. Accuracy Range Pistols are less accurate than rifles and shotguns due to their short sight radius. Their useful range is 25 yards or less. Shotguns have a range of about 30 yards with buckshot and about 50 yards with slugs. Pistol caliber rifles (9mm and . 45 caliber) have a useful range of about 50 yards. The best range and accuracy of all the choices is found in the . 223 caliber rifle. It is accurate to over 100 yards, even in the hands of average officers, the majority of the patrol workforce. Officers should be armed with a weapon capable of the longest range that they might reasonably need to engage with lethal force. The longest hallway at Jewel Middle School is about 180 feet or 60 yards. Compare this to the above listed weapons ranges. Other buildings, such as factories and warehouses are usually very large and would likely require long gun capability to adequately respond to an active shooter situation. Even though an active shooter here is unlikely, officers should still be prepared to respond to one. The weapon with the best accuracy and range is the . 223 caliber rifle, followed by pistol caliber rifles, shotguns, and pistols. Ease of use Compared with the shotgun, the rifle (either pistol caliber or rifle) is more comfortable for officers to shoot and be confident with, an important consideration for risk management. The shotgun is known for heavy recoil, something that makes controlling it difficult, especially for female officers and smaller male officers. Rifles, on the other hand, have a mild recoil. Because of this, its use is as easy for women as it is for men. If a weapon is uncomfortable for officers to shoot, it is not an effective weapon. With respect to ease of use, the best weapon is one that the majority of patrol officers can operate effectively, and in this case, rifles are easier to shoot than shotguns. Wounding ability Handgun bullets have minimal fragmentation and a very small temporary cavity, which causes very little or no additional wounding so their wounding effectiveness is determined simply by the size of the permanent cavity and the depth of penetration. Shotgun slugs produce very devastating wounds due to very high penetration and if that were the only factor in choosing the appropriate round, the best projectile would be a slug. Rifle bullets produce adequate penetration, larger temporary cavitation, and fragmentation, depending on the weight and design. The temporary cavity, acting on tissues already damaged by bullet fragments, causes additional trauma and bleeding. These elements combine to make . 223 bullets more severe than pistol bullets. Penetration tests illustrate that, in general, . 223 caliber bullets cause more severe trauma than pistol calibers. Barrier Penetration Pistol bullets have been shown, through ballistic testing, to penetrate further after going through a common interior wall. This is also true for shotgun slugs and buckshot. 223 caliber bullets, on the other hand, have been shown to fragment more and penetrate less after going through an interior wall, thereby reducing the risk of a bystander being injured in an adjacent room. .223 caliber bullets also reliably penetrate body armor, while pistol bullets and shotgun ammunition do not. This would be vitally important if officers must fa ce violent criminals wearing body armor, such as during the 1997 Hollywood bank robbery shootout. Long Gun Survey Of 21 suburban Chicago area agencies surveyed, every one allows patrol officers to carry a long gun (100%). While it is not surprising that some are carrying shotguns, it is a little surprising to find that the majority of departments surveyed (71%) are actually carrying rifles. In fact, several agencies carry both a shotgun and a rifle or give officers their choice of either weapon. Of those that carry rifles, the majority (80%) uses . 223-caliber ammunition. Conclusion Handguns are inadequate for some situations because of their limited effective range, limited accuracy, lesser wounding ability, and higher risk of over penetration through interior walls. You read "Patrol Rifles: Arming Officers to Succeed" in category "Essay examples" 223 caliber rifles have less recoil, better accuracy, greater range, superior wounding ability, more favorable interior wall penetration, and the ability to penetrate body armor. Since patrol officers are the first to respond to any life threatening criminal incident, however infrequent they may be, law enforcement agencies should arm them with a long gun o f some kind. Anything less and they will not be adequately prepared to respond. Having adequate weapons will increase the chances that responding officers can reduce the ability of the suspect to resist. Recommendations The North Aurora Police Department should adopt . 23-caliber ammunition for patrol rifle use. Further investigation of specific . 223 rounds in various weights and configurations should be done to precisely determine each round’s performance for various uses. Based on anecdotal information from firearms trainers, the Department should select one round for barrier penetration (when this is desired) and one for close quarters use (when interior penetration is not desired). More focused research and/or ballistic testing will help determine the specific cartridges. In addition, the FBI’s ammunition testing data will be of some help as well. Submitted to Chief Thomas Fetzer Sergeant Scott Buziecki North Aurora Police Department The Village of North Aurora, a community of about 12,500 residents, is not a violent community; in fact, the North Aurora Police Department considers itself â€Å"service† oriented. Still, the citizens expect the police to be able to protect lives, our most important service. Currently, officers of the North Aurora Police Department are armed with only a sidearm, their choice of a 9mm or . 45-caliber semi-automatic pistol. There is no supplemental weapon available, such as a shotgun or rifle. Even though officers in North Aurora are rarely called upon to face armed, violent offenders, it could happen at any moment. Since the Columbine massacre of 1999, police agencies have begun training their patrol officers in rapid deployment procedures for active shooter situations and other critical incidents. The NAPD has done this as well. However, while many other police agencies, both large and small, carry side arms and long guns, the North Aurora Police Department is only prepared to respond to these incidents with handguns, a significant tactical disadvantage. Columbine was the law enforcement community’s wake up call and there is no longer any excuse not to be prepared. This does not mean that every agency should field a SWAT team. Patrol officers are the backbone of every police department and the first to respond to every call. They should have the tools and training to handle any reasonably predictable incident. Even though they are rare in North Aurora, incidents of violence are not confined to any particular jurisdiction size or socioeconomic class, so it could happen anywhere. During the North Hollywood bank robbery shootout in Los Angeles, California in 1997, heavily armed offenders wearing several layers of body armor outgunned responding patrol officers for 45 minutes. Since this incident, police agencies across the nation began arming their patrol officers with rifles. On Halloween 2002 in St. Charles, a man fired several shots through his apartment door at children trick or treating. Patrol officers were the first to respond to these incidents and they handled at least the first several minutes until relieved by better-equipped personnel. What would have happened if the armed suspect confronted the police? What would have happened if that happened in North Aurora, where sidearms are the only weapons available to officers? While North Aurora has been blessed by being relatively violence-free, it is not immune to violence. There is nothing to indicate that any of those incidents could not have happened in North Aurora. Police administrators are responsible for ensuring that their agencies are prepared to respond to life threatening emergencies. This means adequately equipping and training personnel to meet challenges that could reasonably be expected. If it is predictable, then it is preventable. PROBLEM STATEMENT The North Aurora Police Department currently allows officers to carry their choice of 9mm or . 45 caliber pistols. No long guns are currently authorized for use. Members of NAPD’s Firearms Training Unit have suggested that the pistol is inadequate for all situations and that a long gun should be adopted. The deficiencies in the current pistol-only program are: (1) pistols are inherently less accurate and have a shorter effective range than long guns such as rifles and shotguns, (2) pistol caliber bullets penetrate more heavily through interior walls than . 23 rifle caliber bullets, which causes an increased risk of unintended persons being hit, and (3) pistol caliber bullets will not penetrate body armor and many other obstacles commonly encountered, while most . 223 caliber bullets will. The primary issue is to evaluate whether or not a supplementary long gun is necessary for patrol officer use in the North Auror a Police Department. If a long gun is needed, what is the best type to choose: a . 223 caliber rifle, a pistol caliber rifle (9mm or . 45 cal. ), or a shotgun (buckshot or slugs)? ACHIEVING IMMEDIATE INCAPACITATION According to the law, a police officer can only shoot in defense of his or her own life or that of another—to immediately stop the life threatening behavior of the suspect. Police officers shoot to achieve immediate physiological incapacitation—defined as â€Å"the sudden physical or mental inability to pose any further risk of injury to others. † (Patrick). If not physiologically incapacitated, the suspect is still able to continue life-threatening behavior. In some cases, a hit to a suspect’s arm or leg might obtain psychological incapacitation, where the suspect voluntarily stops fighting due to the ‘shock’ of being shot. In this type of case, the suspect is still physically able to continue the fight, but chooses to surrender. Psychological incapacitation is very unreliable, since it varies greatly from person to person without regard to a particular cartridge. (Roberts 17) Therefore, we must strive to achieve immediate physiological incapacitation to stop life threatening behavior. Decisions on weapons, ammunition, and training should be made with this goal in mind. There are only two ways to cause immediate physiological incapacitation. The first is to damage or destroy the Central Nervous System, by shooting the brain or upper spinal cord. In order to damage or destroy the CNS, officers are taught that a hit in the triangle between the eyes and nose is most likely to succeed. Hits outside that area have a higher chance of hitting bone at an angle and can actually fail to penetrate, bouncing off. Or they can hit a part of the brain that will not incapacitate the suspect. â€Å" . . . individuals can perform tasks or even survive gunshot wounds of the brain—especially if they involve the frontal lobes. In documented cases of suicide, an individual has fired a bullet through the frontal lobes, to be followed by a second fatal shot into the basal ganglia. † (DiMaio 210) The author once responded to a shooting where the victim was shot at close range in the side of the head with a . 25 caliber bullet at an angle and the bullet bounced off his skull. He suffered only a minor flesh wound. Shooting the brain or spinal cord usually causes death or permanent disability so it is usually done only as a last resort to prevent imminent great bodily harm. The second way to cause immediate physiological incapacitation is to interrupt blood flow to the suspect’s brain, which causes unconsciousness. The best way to do this quickly is to cause heavy bleeding by shooting vital organs or blood arteries and vessels. The faster the suspect bleeds, the faster blood flow to the brain will stop and the sooner that unconsciousness will occur. Since the highest concentration of vital organs and blood vessels is located in the chest and abdomen of the human body, officers are taught to shoot at that area, called the center of mass. Shooting at the center of mass also increases the likelihood of getting a hit, since it is the largest part of the human body. Shooting an arm or leg to wound, as some might suggest police should do, is not likely to cause physiological incapacitation. Physiological incapacitation takes a minimum of 10-15 seconds to occur because even when shot directly through the heart, the suspect’s brain and muscles still have a small supply of oxygen and can function until it is exhausted. The limiting factor for consciousness is the oxygen supply to the brain. When the oxygen in the brain is consumed, unconsciousness occurs. Experiments have shown that an individual can remain conscious for at least 10-15 seconds after complete occlusion of the carotid arteries. Thus, if no blood is pumped to the brain, an individual can function, e. g. , run, for at least 10 sec before collapsing. (DiMaio 210) Put simply, the best bullets are the ones that cause physiological incapacitation the quickest. By measuring several factors of projectile wounding, the most appropriate type of round(s) can be selected for the various types of applications. There are four factors of projectile wounding: (1) Depth of penetration, (2) Permanent cavity, (3) Temporary cavity, and (4) Fragmentation. Depth of penetration is the amount of tissue that the bullet passes through and destroys, which is important because in order to cause physiological incapacitation, the projectile must make it deep enough to damage vital organs and blood vessels. (Patrick) The permanent cavity is the hole left by the bullet’s path through the body. (Patrick) As it passes though, tissue is crushed and bleeding occurs. The bigger the hole, the more tissue that is damaged, the more bleeding that will occur. The temporary cavity is the tissue surrounding the permanent cavity that stretches away from the bullet as it passes through the body. (Patrick) This is a little like what happens when a rock is thrown into water. The impact of the rock initially moves the water out of the way, causing a temporary hole in the water. The water quickly moves back and fills the hole. The amount of damage caused by this effect varies greatly based (generally) on the velocity of the bullet and the elasticity of the tissue. Anatomical structures such as blood vessels, muscles, lungs, and bowels are able to survive significant stretching with a minimum amount of damage but inelastic tissues will sustain significant damage because of the temporary cavity stretching. (Patrick) â€Å"Inelastic tissues such as the liver, kidney, spleen, pancreas, brain, and completely full fluid or gas filled hollow organs, such as the bladder, are highly susceptible to severe permanent splitting, tearing, and rupture due to temporary cavitation insults. † (Roberts 18) Fragmentation is the breakup of the bullet. Patrick) Fragments of the bullet can spread out wider than the permanent cavity, causing multiple, smaller permanent cavities and bleeding as they pass though tissue. â€Å"Projectile fragmentation in tissue can also greatly increase the perma- nent cavity size. When a bullet fragments in tissue, each of the multiple fragments spreads out radially from the main wound track, cutting its own path through tissue . † (Roberts 20) Fragmentation also increases the chances that the bullet will remain in the body, thereby, reducing the chances that an innocent bystander will be seriously injured by a bullet that passes through the target’s body. The extent of injuries caused by a bullet depend, in part, on how well the bullet produces the four listed wounding components and how well they compliment each other. Temporary cavity and fragmentation, under the right conditions, can complement each other because the bullet fragments can weaken surrounding tissue, which can then be detached by the temporary cavity, in effect creating a larger permanent cavity with additional trauma and bleeding. â€Å"It is the synergy of the temporary cavity acting on tissue that has already been riddled with bullet fragments that produces the increased permanent cavity . . . (Fackler 27) Therefore, the temporary cavity is reliant on the velocity of the bullet, where in the body it hits, and what the bullet does inside the body. According the Federal Bureau of Investigation, depth of penetration and permanent cavity are considered the most important of the wounding components, especially for pistol ammunition. The FBI recommends penetration of at least 12 inches to ensure this damage. (Patrick) Pistol ammunition involves a very small temporary cavity and very little fragmentation. However, the component that most affects the severity of a gunshot wound is the size of the temporary cavity. Due to their very high velocities and high kinetic energies, rifles can produce very severe wounds. (DiMaio 142) As stated earlier, the more trauma and bleeding caused, the more likely physiological incapacitation will occur. IS A LONG GUN NECESSARY? Before considering whether a supplementary long gun is necessary, we must first compare and contrast pistols and long guns. The greatest strength of pistols is that they are always readily accessible, while their weakness is their limited accuracy and short useful range. Long guns, however, have increased accuracy and longer range than handguns. Their weakness is limited accessibility in unexpected situations. However, some policy makers, in spite of the evidence, will still be concerned about liability. â€Å"Liability issues should not be the main focus of whether rifle/carbines are permitted to be carried by officers. Public safety and officer survival should be the prime consideration. † (Chudwin 15) Since public safety and officer survival are the focus, the differences of pistols and long guns in accessibility, accuracy, and range will be shown. In addition, results of a long gun survey as well as some views opposed to patrol rifles will be presented. Accessibility The greatest strength of pistols is that they readily available. They are best suited for use at close range (under 25 yards) in situations in which an unexpected threat confronts officers. â€Å"When faced with a non-anticipated life-threatening situation, a peace officer is best armed with the firearm of convenience, a handgun . . . .† (Bollig 24) The National Tactical Officers Association, in its Tactical Team Weapon Selection position paper agrees: â€Å"It is recommended by the Association that members tasked with entering high-risk areas be adequately armed with a shoulder-fired weapon . . . Handguns are to be carried as ‘secondary’ or ‘back up’ weapons and not as primary entry weapons. † (â€Å"Tactical Team Weapons Selection† 5-6) Special Agent Urey Patrick, of the Federal Bureau of Investigation, agrees: A review of law enforcement shootings clearly suggests that regardless of the number of rounds fired in a shooti ng, most of the time only one or two solid torso hits on the adversary can be expected. This expectation is realistic because of the nature of shooting incidents and the extreme difficulty of shooting a handgun with precision under such dire conditions. The probability of multiple hits with a handgun is not high. Experienced officers implicitly recognize that fact, and when potential violence is reasonably expected, their preparations are characterized by obtaining as many shoulder weapons as possible. Since most shootings are not anticipated, the officer involved cannot be prepared in advance with heavier armament. As a corollary tactical principle, no law enforcement officer should ever plan to meet an expected attack armed with only a handgun. Patrick) The most general description of a situation where a pistol is inadequate and a long gun would be preferred is one where officers reasonably believe that lethal force might be necessary. Accuracy Pistols are inherently less accurate than long guns. â€Å"The . 223 has advantages relative to a handgun, partly by creating greater wound trauma, but primarily through greater accuracy of fire and the associated extension of effective range. † (MacPherson 30) At the practice range, missed shots are caused by the failure of the shooter to align the sights at the moment the trigger breaks and the bullet leaves the barrel. In real life, where both the shooter and the target are usually moving, missed shots are very common. In a study of 19 officer-involved shootings the Joliet, Illinois Police Department found that officers, using various types of firearms, missed their intended target 71 percent of the time. (Kerr and Wilkerson 10) Pistols are imprecise for two main reasons. The first reason is simply the distance between the front and rear sights. Pistols have a short sight radius, while long guns have a much greater distance between the sights. The greater the sight radius, the greater the accuracy will be. The second reason for pistols limited accuracy when compared to long guns is the stability (or instability) of the way that pistols and long guns are held. Most officers use a two-hand hold when firing a pistol, while a long gun allows a four-point hold—both hands, cheek, and shoulder. (Lesce 28) With a two handed pistol hold, misalignment of the sights from the eye of the shooter happens with only a slight movement of the wrist or a lowering of the arms, which is very easy to do in a gunfight. This misalignment is possible because of the short sight radius and the unanchored hold. Any misalignment of the sights translates to a missed shot. In order to break the eye-rear sight-front sight alignment using a long gun, an officer would have to hold the weapon incorrectly. The superior range of long guns is closely related to greater effective range than pistols. Effective Range In contrast with the performance of handguns, long guns offer greater range. The useful range of a pistol is 25 yards or less. For some officers the ideal pistol range may be only as far as 15 yards. When used with buckshot, a shotgun’s maximum useful range is around 30 y ards. With slugs, the maximum range for the average officer is no more than 50 yards, while a rifle, on the other hand, is best for intermediate ranges (up to 100 yards). (Fairburn 39) Sniper rifles, of course, are useful for longer ranges but patrol officers would not have a need for such longrange accuracy. Armed with a patrol rifle, an officer can control a 100 yard radius which â€Å" . . . allows fewer officers to control a given area and still deliver far more close-range precision than that offered by a sidearm or a shotgun. † (Fairburn 59) Specifically, long guns would be advantageous to deploy in the following types of situations: hostage situations, barricaded subjects, felony stops, perimeter containment, confronting armed criminals wearing body armor, tactical entries on search and arrest warrants, and crimes involving weapons. Their advantages in accuracy and range increase the tactical advantage for responding officers, allowing them to be farther away behind better cover. Long Guns Used SPSC 175 Shotguns 29% Long Gun Survey A number of area police agencies currently use long weapons of some kind or another and many have replaced their shotguns with patrol rifles. Of 21 agencies surveyed, every one allows patrol officers to carry a long gun (100%). Of those, seven (33. 3%) carry only rifles, eight (38. 1%) carry rifles and shotguns or the officer’s choice, and six (28. 6%) carry only shotguns. Therefore, 71. 4% of the agencies surveyed allow patrol officers to carry rifles and 28. 6% carry only shotguns. See pie chart in figure 1. Of the fourteen departments that allow rifles, eleven of them (78. 6%) use . 223-caliber ammunition Only three of fourteen, (21. 4%) use 9mm ammunition. Class survey) While this survey is not scientific, it certain demonstrates that long guns are the norm and patrol rifles are not a revolutionary idea. Rifles 71% Figure 1 Opposing Views Even though a number of departments have switched or are switching to the use of rifles by patrol officers, there are opposing viewpoints. One view says that if police are armed with more firepower, they will feel pressure to use them. â€Å"‘It’s courting trouble ,’ said Tom Diaz of the Violence Policy Center, a Washington-based non-profit research group that studies the effects of violence. ‘The average cop never has the occasion to use his gun,’ Diaz said. So if this kind of firepower is available, there is an implicit pressure to use it. Yet the average officer often lacks the training and experience. ’† (Vogt 8) Some of the LAPD officers involved in the 45 minute long North Hollywood bank robbery shootout probably had never used their guns in the line of duty before and they clearly needed a more powerful weapon that day. While events like this are not likely in North Aurora (or anywhere for that matter), patrol officers should be reasonably prepared to respond Another viewpoint says that community policing and more firepower do not mix. â€Å"Particularly problematic . . . s that while the federal government is arming police departments, it is also promoting a softer, gentler approach to law enforcement with the Community Oriented Policing program. † (Elbow 5A) Community policing is based on officers responding to the problems and concerns of the community, along with the community members. If an armed offender is endangering the community, the community wants the police to come prepared to put an end to it. Is the community going to care what the weapon looks as long as it helps the police conclude the incident safely? Will they be upset if an innocent bystander is hurt by a rifle or shotgun? Of course they will, but this would also be the case if a bystander were hurt by an officer armed with only a pistol. Finally, this opposing viewpoint agrees that more heavily armed suspects are a problem for the police. He says that arming police with such weapons is not a good idea and offers no better way to deal with the problem. It takes little imagination to guess the difficulties this poses for the police in the future. Shootouts with criminals equipped with handguns are dangerous. Facing adversaries armed with military assault rifles substantially increases the risk to both police and innocent citizens . . . Increasing police weaponry is really not a sound solution to the problem. In a gun battle, the police are usually not in a position to unleash the fury of an automatic weapon at an armed opponent. Most gun battles take place in an urban setting. Firing off a clip of ammunition in the direction will, sooner or later, result in the killing of an innocent bystander. The poli ce are therefore limited in their ability to respond to sophisticated weaponry. (Holden 341) Mr. Holden agrees that heavily armed criminals pose a great risk to police and civilians and he is right about that. His point that the police are not n a position to use an automatic weapon misses the point. First, very few departments, if any, are actually arming patrol officers with fully automatic rifles. Rather, they are semi-automatic rifles, which fire one round at a time with each trigger pull. In unexpected confrontations with armed offenders, his point is accurate, because they cannot call timeout to get their rifle. However, the value of having patrol officers armed with rifles is that when they are responding to a situation where they can reasonably expect an armed offender, they can have the rifle in their hand when they exit their patrol car (with an interior mounted rack. This is no slower than drawing their pistol from its holster. Finally, Mr. Holden refers to a magazine, th e container that holds the cartridges, as a ‘clip. ’ If he does not even know what the name of the part, how knowledgeable is he and how intensive was peer review of his book? The above opinions expressed against arming patrol officers seem either misinformed or based on something other than facts and tactical principles. Is a long gun a necessary piece of equipment for a patrol officer to carry? The answer is an emphatic ABSOLUTELY. Without long guns, officers will be nearly tactically helpless beyond 25 yards. WHAT TYPE OF LONG GUN IS BEST SUITED FOR PATROL USE? Many agencies are concerned about liability and rightly so. However, choosing the wrong tools and training for the job seems more at risk for incurring liability than doing careful research and then selecting the best solution. It is a far greater liability risk to fail to give officers the tools skills they need to survive and succeed. â€Å"The key case of City of Canton v. Harris (1989) identifies ‘deliberate indifference’ toward civil rights on the part of city policy makers as the mental state needed to subject a municipality to Section 1983 liability. Recall here that deliberate indifference is akin to recklessness in the disregard of risk to others. † (Mijares et. al 36) In other words, to be aware of a risk and fail to prepare for it can create civil rights liability. Which type of weapon (and what cartridge) is best ultimately depends on the needs of each particular agency, but weapons that are easy for officers to operate will be the best choice. The primary choice each agency must make is first, to decide the caliber and second, to decide the configuration (i. e. full metal jacket, hollow point, etc. ) and in what situations each type will be used. Then they should select the weapon to use with the ammunition. First, some ammunition-related definitions, since these terms and abbreviations are used throughout this discussion: †¢ Full metal jacket (FMJ): This bullet has a metal jacket surrounding the lead or steel core, to prevent it from expanding on impact. The FMJ is the bullet configuration used by the military. (DiMaio 143) †¢ Jacketed soft point (JSP): Unlike the full metal-jacketed bullet, a metal jacket partially covers the soft point bullet. The core is exposed at the tip, which helps the bullet expand upon impact. Soft point bullets are usually used for hunting. (DiMaio 143) †¢ Jacketed hollow point (JHP): Like the soft point bullet, the hollow point bullet has a metal jacket partially covering it. However, the exposed tip is hollow, which encourages expansion upon impact. Hollow point bullets are usually used for hunting and shooting competitions. (DiMaio 144) Hollow point bullets are the official bullets of the NAPD. The three different types of ammunition under consideration are (1) Pistol Calibers (9mm and . 45 calibers), (2) Shotgun (both buckshot and slugs), and (3) Rifle Calibers (. 23 caliber). 9mm and . 45 caliber bullets are being considered because these are the currently issued duty ammunition for the North Aurora Police Department. Shotgun slugs and buckshot are being considered because they have always been the standard second weapon of law enforcement. Finally, . 223 caliber bullets are being considered because they seem to be the most popular rifle round that agencies sele ct. .308 caliber bullets are not being considered because they are generally considered too powerful for patrol use. They are most commonly used by police snipers. Deciding what caliber to use requires some knowledge about the wounding mechanics of each of the major choices for long guns. Comparisons will be made between shotguns, pistol caliber rifles, and . 223 caliber rifles in the areas of ease of use, accuracy and range, wounding ability, interior wall penetration and body armor penetration. Ease of Use Compared with the shotgun, the rifle is more comfortable for officers to shoot and be confident with, an important consideration for risk management. While this is not an advantage over pistol caliber rifles, it is huge advantage over shotguns. The shotgun is a difficult gun to master. Its recoil is excessive for many small-statured officers and at least bothersome to even the biggest, strongest men. This recoil hampers precise placement of slugs as well as limiting the practice many need to be effective with shot. . . . The shotgun, despite its long history of use in the United States, is not an ideal second weapon for police agencies (Fairburn 39) If officers are not comfortable with a weapon, they will not practice as well and their handling of the weapon during real-life situations will be tentative. This becomes a liability issue. As police agencies become more sensitive to the liability aspects of police firearms training, specifically the lack of such training, the rifle or carbine becomes more attractive. Officers are more comfortable with a rifle since it allows more precision and metes out less abuse. The comfort factor promotes increased training and familiarity, which in turn, increases confidence. And being confident with one’s weapon is the secret to effective use. (Fairburn 39) Would you want officers, armed with a weapon that they do not feel comfortable with, to respond to a life-threatening situation? Due to the excessive recoil, training is limited because the body can only take so much. With limited training comes limited confidence and limited familiarity. These are not acceptable qualities of a weapon for law enforcement. In contrast with shotguns, the rifle’s low recoil makes it as easy to master for women as it is for men. The . 223 cartridge offers a milder recoil than shotguns and full size rifle cartridges because it is an intermediate sized cartridge. This is important for training female and smaller male officers. Parker 3-4) â€Å"It is my experience that training officers to effectively use the rifle/carbine is easier due to the shoulder mounted stability, low recoil, and long sight radius. † (Chudwin 17) Once an officer is taught the proper way to hold the rifle, getting accurate hits is as simple as lining up the sights with the target and making a smooth trigger pull. Accuracy Range Long gun accuracy, from least accurate to most accurate, is the shot gun, the pistol caliber rifle, and the . 223 caliber rifle. Slugs and buckshot are the least accurate of all three types of long gun ammunition under consideration. When used by the average officer, the shotgun has a useful range of around 30 yards with buckshot and about 50 yards with slugs. Buckshot is terribly imprecise since the pellets spray outward after they leave the barrel. They spread wider the farther they travel, which is why the range is so limited. (Fairburn 39) While the best officers might be able to hit a suspect farther than 50 yards away with a shotgun with good quality sights, average officers are not capable of this, and they represent a much larger percentage of the patrol workforce. The accurate range of a pistol caliber rifle may be no more than 50 yards, although a patrol rifle should be capable of accurate head shots at 50 yards and accurate body shots at 100 yards (or more). (Fairburn 59) In comparison, a rifle caliber weapon, in the hands of an average officer, is capable of accurate shots to a range of at least 100 yards, if not more. (â€Å"Tactical Team Weapons Selection† 2) Well-trained officers might be capable of distances greater than that but probably would not be much need for a shot to be taken at those ranges. The most accurate long gun, of those under consideration, that you can arm a patrol officer with is rifle chambered in an intermediate rifle cartridge, such as the . 223. Critics might suggest that the range of the . 223 caliber bullet makes missed shots too dangerous because they will travel a very great distance, increasing the chances for an innocent bystander to be struck. However, Chief Jeff Chudwin, of the Olympia Fields Police Department and a police rifle instructor, points out that the maximum range (with optimum barrel angle) of the . 223 (8,300 ft. ) is similar to that of the 9mm (6,800 ft. and the . 357 magnum (7,100 ft. ). The 12 ga. 1 oz. Slug, which weighs considerably more than the others do, travels only 1,830 feet. â€Å"Any stray round is a hazard and it is illogical to claim one type of firearm is more or less dangerous than another based only the maximum range of the round. The key issue is, what is the penetration and ricochet potential of the bullet type and c aliber in a residential area? † (16) Wounding Ability The FBI recommends projectile penetration of at least 12 inches in order to ensure that the projectile gets deep enough to damage vital organs and large blood vessels. Patrick) Dr. Martin Fackler, a world-renowned ballistic expert, believes that in order for the . 223 bullet to cause adequate tissue damage, it must produce a 14-15 cm temporary cavity along with bullet fragmentation of 30-50%. (27) In terms of terminal wound ballistics (the study of what projectiles do after they hit something), there is no more devastating projectile than a shotgun slug. In tests of hollow point projectiles shot into bare gelatin conducted by Dr. Gary Roberts, a 12-gauge 1- ounce shotgun slug had an average penetration of 26. inches and average maximum temporary cavity of 13. 0 cm. 12 gauge 00 buckshot had an average penetration of 22. 8 inches. Maximum temporary cavity was not measured for this round. A 9mm 147gr JHP bullet (similar to an NAPD issued round) had an average penetration of 13. 2 inches and an average maximum temporary cavity of 5. 5 cm. A . 45 cal 230gr JHP bullet (similar to an NAPD issued round) had an average penetration of 14. 2 inches and an average maximum temporary cavity of 6. 5 cm. The shotgun slugs and pistol bullets did not fragment in the testing. The . 223 bullets (various weights and configurations) tested had varied performance depending on the grain weight and the configuration of the round. The average penetration ranged from 6. 1 inches to 16. 8 inches, while the average maximum temporary cavity ranged from as small as 7 cm to as large as 14 cm. The . 223 bullets fragmentation ranged from as little as 2. 4% to as high as 100%. (28) In contrast with rifle bullets, handgun bullets cause a much smaller temporary cavity, which does not usually add wounding effectiveness. Roberts Bullian 143) Part of this is because rifle rounds travel close to 3,000 feet per second and pistol bullets travel around 1,000 fps, depending on the caliber. (Roberts 28) All handgun wounds will combine the components of penetration, permanent cavity, and temporary cavity to a greater or lesser degree. Fragmentation, on the other hand, does not reliably occur in handgun wounds due to the relatively low velocities of handgun bullets. Fragmentation oc curs reliably in high velocity projectile ounds (impact velocity in excess of 2000 feet per second) inflicted by soft or hollow point bullets. In such a case, the permanent cavity is stretched so far, and so fast, that tearing and rupturing can occur in tissues surrounding the wound channel which were weakened by fragmentation damage. It can significantly increase damage in rifle bullet wounds. (Patrick) The high velocity of rifle bullets, when rapidly slowed by the body, causes the tearing and rupturing associated with the temporary cavity, especially when combined with fragmentation. Research by the military has revealed that the feature of a bullet’s interaction with soft tissue that contributes most to the severity and extent of the wound is the size of the temporary wound cavity. The size of this cavity is directly related to the amount of kinetic energy lost by a bullet in the tissue. Rifle bullets, by virtue of high velocities, possess considerably more kinetic energy than pistol bullets. The severity and extent of a wound, however, are determined not by the amount of kinetic energy possessed by the bullet but rather by the amount of this kinetic energy that is lost in the tissue. The major determinants of the amount of kinetic energy lost by a bullet in the body are (1) the kinetic energy possessed by the bullet at the time of impact with the body, (2) the shape of the bullet, (3) the angle of yaw at the time of impact, (4) any change in the presented area of the bullet in its passage through the body, (5) construction of the bullet, and (6) the biological characteristics of the tissues through which the bullet passes. (DiMaio 142) Pistol bullets, unlike rifle bullets, have insufficient velocity to cause fragmentation. DiMaio 47) â€Å"Individuals shot with high-velocity rifle bullets, whether full metal-jacketed military rounds or soft-point hunting rounds, show more severe wounds than people wounded by pistol bullets. This is especially true of [rifle] hunting ammunition. It is also true that [rifle] hunting ammunition, because it is soft-point, does fragment in the body. † (DiMaio 311) If the pistol bullets do fragment, the fragments stay very near the permanent cavity (within 1 cm), essentially reducing wounding effectiveness since the smaller main bullet will cut a smaller permanent cavity. Roberts 20) Rifle bullets break up easier than pistol bullets due to their small size and weight and the increased stress caused by the high velocity. To summarize, with handgun bullets there is essentially no fragmentation and a very small temporary cavity, which causes very little or no additional wounding so wounding effectiveness is determined simply by the size of the permanent cavity and the depth of penetration. Therefore, by going with a pistol caliber rifle, an agency does not really gain anything but better accuracy over a handgun. Shotgun slugs produce devastating wounds due to very high penetration and if that were the only factor in choosing the appropriate round, the best projectile would be a slug. But the fact is that pistol bullets and shotgun slugs and buckshot have a tendency to penetrate more than rifle bullets. Rifle bullets can produce adequate penetration, temporary cavitation, and fragmentation, so by selecting a rifle, an agency gains range, accuracy, and wounding ef- fectiveness over pistols shotguns. While Dr. Roberts’ test results are not conclusive enough select one specific cartridge (due to the limited number tested), they do demonstrate better overall performance by the . 223 caliber cartridge than pistol calibers cartridges and shotgun slugs and buckshot. Examination of more test results are needed to specify an exact cartridge for duty use. Acceptable wounding performance of the . 223 bullet is based, at least partly, on its velocity and the type of weapon (length of barrel) used. â€Å"5. 56mm/. 223 weapons require a minimum barrel length of 14. inches to optimize incapacitation potential, as 5. 56mm/. 223 weapons with barrel lengths shorter than 14. 5 inches . . . exhibit significantly decreased wounding effects and limited incapacitation potentials, similar to those produced by the 9mm pistol bullets used in handguns and SMG’s [submachine guns]. † (Roberts 24) In order to ensure fragmentation and effective wounding ability, weapons used should have a long eno ugh barrel length to produce muzzle velocities above 2,500 feet per second. Examples of weapons that meet this criterion are the Colt M-16/AR-15 and M-4/CAR-15, HK G41 and HK33, and the Ruger Mini-14. (Roberts Bullian 145) While recommending a specific weapon and specific ammunition is outside the scope of this paper, it is important to keep these factors in mind when making selections. Barrier Penetration While deep penetration in soft body tissue is desirable for wounding effectiveness (immediate physiological incapacitation), there must be a balance of enough penetration without too much. Since the selected shoulder-mounted weapon will undoubtedly be used in close quarters, such as during a high risk raid or near residences, police must try to prevent missed shots from over penetrating and striking an innocent bystander in an adjacent room or on an adjacent floor. While some police administrators select pistol calibers for their rifles to reduce the perceived over penetration liability risk with rifle calibers, there is actually an increased liability with pistol calibers when used inside structures. Handgun bullets, including rounds similar to NAPD’s duty rounds, have been shown to penetrate further through common building materials than do rifle bullets. â€Å"The fragmenting behavior of most 5. 56mm (. 223) bullets in both soft tissue and building materials, drastically limits their over penetration potential compared with that of many pistol bullets. † (Roberts Bullian 145) â€Å"As suspected based on previous testing, all of the 9mm 147 gr JHP, . 40 SW 180 gr JHP, and . 45 ACP 230 gr JHP bullets failed to expand and had very deep, excessive penetration after passing through the interior wall, due to plugging of the hollow point. With the hollow point plugged, the bullets performed nearly identical to FMJ pistol bullets† (Roberts 23) The NAPD issues Speer brand jacketed hollow point (JHP) ammunition in both 9mm 145 grain and . 45 ACP 230 grain. In tests of hollow point projectiles shot through a simulated interior wall into bare gelatin, a 1-ounce shotgun slug had an average penetration of 22. 8 inches and average maximum temporary cavity of 14. 0 cm. 12 gauge 00 buckshot had an average penetration of 23. 2 inches. Average maximum temporary cavity was not measured. A 9mm 147gr JHP bullet (similar to an NAPD issued round) had an average penetration of 22. 8 inches and an average maximum temporary cavity of 2. 0 cm. A . 45 cal 230gr JHP bullet (similar to an NAPD issued round) had an average penetration of 29. 7 inches and an average maximum temporary cavity of 3. 0 cm. (Roberts 28) In these tests, all projectiles had more penetration into gelatin (a simulation of the consistency of human soft tissue) after having penetrated a common interior wall than without penetrating a wall. As stated above, the drywall plugs the hollow point, causing it to function like a full metal jacket bullet. The . 223 bullets tested (various weights and configurations), on the other hand, had less penetration gelatin into after Interior Wall Penetration (Roberts 28) .223 Fed 55 gr. JSP . 223 Win 55 gr. FMJ . 45 cal. Win 230 gr. JHP 12 ga. Rem shotgun 1 oz. slug HPRS 12 ga. Rem 00 buckshot 9mm Fed 147 gr. JHP 0 Figure 2 penet rating the wall. interior Their 14. 4 16. 1 29. 7 22. 8 23. 2 22. 8 5 10 15 20 25 30 35 average maximum penetration from ranged 10. 6 inches to 16. 1 inches, their Avg. Penetration in Inches average maxi- mum temporary cavity ranged from 7. 0 cm to 14. 0 cm, and their fragmentation ranged from 11. 8% to 79. 5%. See figure 2. While some rounds still have sufficient penetration to cause a serious wound after penetrating an interior wall, their penetration is clearly less than that of the pistol calibers. (Roberts 28) The FBI has done extensive testing on the terminal ballistics of all kinds of bullets, however, they will not allow law enforcement agencies to share these statistics outside of their own agency. This is the reason why FBI testing is not cited here. While their bare gelatin testing results will be helpful for a future internal study of ammunition, their penetration tests may not be helpful. â€Å"Unfortunately, the testing and evaluation criteria are exactly backwards relative to law enforcement use in gunfight scenarios; the testing and assessment was designed to find ammunition that would produce substantial wound trauma after penetrating housing barriers. † (MacPherson 32) The ideal round would be one that produces incapacitating wounds when striking the intended target but would not produce substantial wound trauma after penetrating walls. . . . stray 5. 56mm/. 23 bullets seem to offer a reduced risk of injuring innocent bystanders and an inherent reduced risk of civil litigation in situations where bullets miss their intended target and enter or exit structures. 5. 56mm/. 223 caliber weapons may be safer to use in CQB situations and in crowded urban environments than 9mm, . 45 SW, or 12 ga. weapons. (Roberts 24) In a nother test conducted by the Joliet and Crest Hill, Illinois police departments, pistol ammunition, shotgun slugs and buckshot were found to stay intact after penetrating two residential walls (four pieces of drywall), while many . 223 rounds fragmented significantly. Pistol ammunition, shotgun slugs, and buckshot represent â€Å"a greater threat to citizenry and other officers than does several of the . 223 rounds tested. † (Kerr and Wilkinson 14) More testing is needed in this area to be able to select a specific round, but it is clear that pistol caliber bullets and shotgun slugs fired inside a structure during a raid, for example, penetrate more than . 223 caliber bullets. Body Armor Penetration Unlike pistol bullets, shotgun slugs, and buckshot, rifle bullets penetrate soft body armor, which is very important if officers have to confront violent offenders wearing body armor. Recall that the suspects in the LA bank robbery shootout wore body armor. In testing published in Journal of International Wound Ballistics Association, 9mm, . 40 SW, and . 45 ACP bullets plus the 12 gauge 00 buckshot pellets failed to penetrate the body armor. The shotgun slugs did penetrate some, but not all, layers of the body armor. While they did push the armor panels into the gela- tin, simulating blunt trauma injuries, the body armor did stop the slug from entering the body in every case. Unlike the pistol calibers and shotgun slugs, all . 23 bullets defeated the body armor. (Roberts 24) â€Å"As law enforcement officers increasingly confront criminals protected by soft body armor designed to defeat pistol bullets and shotgun pellets, the ability of the 5. 56mm/. 223 bullets to defeat soft body armor has become a significant factor. † (Roberts 16) To summarize, of the three types of weapons under consideration, the . 223 caliber rifle is by far the most accurate. Becaus e of this, its effective range is also superior to the other choices. In the area of wounding effectiveness, the . 23 caliber is, again, superior to the pistol calibers. The shotgun, at close ranges, is probably the most devastating firearm that there is. But pistol calibers and shotguns penetrate more through common building materials than the . 223 caliber bullet, which increases the chance that an innocent bystander could be seriously hurt by a missed round that penetrates a wall. Moreover, pistol caliber bullets and shotgun slugs and buckshot will not penetrate body armor, while . 223 caliber bullets will. Conclusion Since patrol officers are the first to respond to any life threatening criminal incident, however infrequent they may be, law enforcement agencies should arm them with a long gun of some kind. Anything less and they will not be adequately prepared to respond. The North Aurora Police Department Firearms Training Unit trains officers according to the Police Training Institute’s philosophy and methodology, which in part says the Strategic Objective of any tactical operation is to â€Å". . . diminish the potential for resistance. Should resistance occur, overcome rapidly with minimal risk. Officers are taught to â€Å". . . create and maintain a recognizable advantage . . . † (Police Training Institute) Having adequate weapons will increase the chances that responding officers can reduce the ability of the suspect to resist. If he does resist, officers will be better able to defeat his resistance quickly with the least amount of risk to themselves and others. L ong guns are more intimidating to criminals and simply deploying one may convince some offenders to give up without a fight. If they do not give up, the officers will be better prepared to defend themselves. If officers confront an armed criminal with less than adequate weapons, they give up some of their tactical advantage, thereby increasing the risk to themselves and innocent bystanders. Handguns are inadequate for some situations because of their limited effective range, limited accuracy, lesser wounding ability, and higher risk of over penetration through interior walls. The . 223 caliber rifles have less recoil, better accuracy, greater range, superior wounding ability, more favorable interior wall penetration, body armor penetration. Police agencies across the nation, including the NAPD, have been trained in rapid deployment procedures for active shooter situations such as at schools and businesses. These are necessary skills for officers to possess in society today. However, the skills and knowledge gained from these classes is not put to full use unless officers are given the correct tools for the job. Consider the differences between rifles and pistols in the context of active shooter incidents. Many schools and large businesses have long hallways, some in excess of 200 feet. For example, Jewel Middle School’s longest hallway is approximately 180 feet long (60 yards). If there were an active shooter at the end of the hall shooting at students and responding officers, a body shot against the suspect would be the minimum need. Of course, this would not immediately physiologically incapacitate the suspect—he or she could continue shooting for 10-15 seconds. How many more students or officers could be shot in this time? It would be optimal for officers to take a precise head shot and immediately end the suspect’s life threatening behavior. A pistol is incapable of making an accurate shot at that range and shooting from that far away is truly ‘spraying and praying’ for a hit. For these situations, the only effective weapon is one capable of accurate shots from at least 100 yards away. Recall the earlier cited maximum ranges: Pistol—25 yards, Shotgun with slugs—less than 50 yards, Shotgun with buckshot—30 yards, Pistol caliber rifle—50 yards, and . 223 rifle—100 yards or more. It would be tactically prudent for officers holding the perimeter of such an incident to be behind adequate cover as far away from the building as possible. Of those under consideration, the best weapon for this mission is a rifle chambered in . 223 caliber. 223 caliber rifles are available in various weights and configuration that will limit their penetration through common interior walls to reduce the chances of an innocent bystander being seriously injured in an adjacent room. Pistol caliber bullets have been shown to penetrate more in ballistic gelatin (a simulant for human soft tissue) after penetrating a common interior. While more accurate th an a pistol, pistol caliber rifles have less wounding ability than a . 223 rifle bullet. A shotgun, while superior in wounding ability, is limited in range and inferior in accuracy compared to a rifle plus it penetrates even more than pistol bullets. Think of patrol officers responding to a hostage situation where the armed suspect is holding his victim from behind and yelling, â€Å"If I can’t have her, then no one will. † Officers are only armed with pistols and it will take at least thirty minutes for a police sniper to arrive and set up. After fifteen minutes, efforts to convince him to surrender are unsuccessful as he gets increasingly agitated and officers believe that he is about to kill her when he starts raising the gun toward her head. Officers would be derelict in their duty if they did not use lethal force at that point. A headshot would be the only option to immediately incapacitate the suspect before he shoots the victim. Taking that shot with a pistol would be a lot less likely to be successful than the same shot with a rifle. A well-placed shot would likely end the situation successfully. A missed shot could result in the tragedy of the victim being killed, either by the suspect or by the police. Granted, a situation like this is unlikely in any town, but the police should still be adequately prepared to respond. Because of the totality of the information available, it is this author’s recommendation for the North Aurora Police Department to adopt . 23 ammunition for patrol rifle use. For those concerned about incurring additional liability, consider this: â€Å"As John Hall of the FBI pointed out in his series of articles in the FBI Journal, a firearms training program that addresses legal, practical and policy considerations will likely win in court. † (Chudwin 15) Further investi gation of specific . 223 rounds in various weights and configurations should be done to examine more closely their performance in both desired penetration (shooting through barriers at a suspect behind cover) situations as well as limited penetration (inside structures). If this does not produce clear enough data to make an informed choice, then the Department should conduct gelatin testing before selecting official ammunition. Rifle bullets, including the . 223 is not the magic bullet (pardon the pun) that works perfectly in all applications. But certain weights and configurations perform well in their intended missions and can be deployed based on the situation. Ballistic testing must be done with each of the various cartridge configurations (i. e. full metal jacket, hollow point, soft point, etc. ) in order to auge their effectiveness for the given application. This testing can usually be arranged through the Illinois Tactical Officers Association or various ammunition manufacturers for free or at a very low cost. In closing, Chief Chudwin’s comments sum up the need for a patrol rifle program the best: In conclusion, establishing a rifle/carbine program is a positive approach to meet needed officer survival and public safety demands. From r ural America to the big cities, law enforcement officers have faced violent, heavily armed offenders. Let history be our guide. There is a proven need for the rifle/carbine as a patrol weapon. These firearms, in the hands of select well-trained officers, are a line of defense against the ultimate predators. (20) Works Cited Bollig, Tim. â€Å"Structural Penetration Testing. † San Diego County Sheriff’s Department report, Jan. 2000. Rpt. in Patrol Rifle. CD-ROM. Sept. 2002 version. Doylestown, PA: National Tactical Officers Association. Chudwin, Jeff. â€Å"Establishing a Police Rifle/Carbine Program. † The Tactical Edge Winter 1999: 15-20. Class survey. School of Police Staff and Command class #175 (Naperville, IL). Northwestern University Center for Public Safety. 15 Nov. 2002. DiMaio, Vincent J. M. Gunshot Wounds: Practical Aspects of Firearms, Ballistics, and Forensic Techniques. Boca Raton: CRC, 1993. Elbow, Steven. â€Å"Military Muscle Comes to Mayberry† Capitol Times 18 Aug. 2001: 5A. Fackler, Martin L. â€Å"Perspectives on the . 223 Remington. † Journal of the International Wound Ballistics Association. Vol. 3. 4 (19xx): 27. Holden, Richard N. Modern Police Management. Englewood Cliffs: Prentiss Hall, 1994 Kerr, Patrick, and Wilkerson, Dwayne. â€Å"The . 223 Remington Cartridge in an Urban Environment. † ITOA News Fall 1997: 10 Lesce, Tony. â€Å"The Police Carbine. † Law and Order Apr. 2001: 27. MacPherson, Duncan. â€Å". 223 Ammunition for Law Enforcement. † Journal of the International Wound Ballistics Association Vol. 3. 2 (19xx): 30-33. Mijares, Tomas C. , Ronald M. McCarthy, and David B. Perkins. The Management of Police Specialized Tactical Units. Springfield, IL: Thomas, 2000. Parker, Robert W. â€Å"Police Rifles. † Omaha, Nebraska Police Department memorandum, 26 Mar. 1997. Rpt. in Patrol Rifle. CD-ROM. Sept. 2002 version. Doylestown, PA: National Tactical Officers Association. Patrick, Urey W. â€Å"Handgun Wounding Factors and Effectiveness. † U. S. Department of Justice, Federal Bureau of Investigation. Washington: 1989. 31 Oct. 2002 . Roberts, Gary K, and Bullian, Michael E. â€Å"Comparison of the Wound Ballistic Potential of 9mm vs. 5. 56mm (. 223) Cartridges for Law Enforcement Entry Applications. † Association of Firearm and Toolmark Examiners Journal Vol. 25. 2 (1993): 142-148. Appendix A Patrol Rifle survey Please fill in as much information as you know return to Scott Buziecki. ) Department name ____________________________________ 2) Does your department allow patrol officers to carry any long guns in their pat How to cite Patrol Rifles: Arming Officers to Succeed, Essay examples

Relative and Absolute Morality free essay sample

Explain the differences between absolute and relative morality Absolute morality is when someone has a view they are sure of. This view can be applied to any life situation, and it is a view that will never change. It is absolute. For example, if someone says ‘abortion is wrong, and always will be’, then this is their absolute rule. It does not necessarily mean that it is ‘right’, but it is a belief that the person themself thinks is right and that it will never change.Relative morality is when someone believes in something, but it changes depending on the situation. For example, if someone says ‘abortion should be prevented, unless it is the most kind and loving thing to do’. This idea could be applied to a situation if, for example, a young girl was raped, and her future would be better without a baby. Aborting the baby could be called the most kind and loving thing to do. We will write a custom essay sample on Relative and Absolute Morality or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page This is relative morality. The main difference between absolute and relative morality is the exceptions.Absolute morality has no exceptions, it is not dependant on the situation and it will never change. Relative morality is full of exceptions, and a large part of relative morality is depending on the ethics of the situation. Absolute morality is supposedly truth to the individual, whereas relative morality is full of different opinions. Absolute morality tends to be more religion orientated. In the Bible there are the Ten Commandments, such as ‘Thou shalt not kill’ meaning ‘you must not murder’. Any Christian will not question these rules, because they are from God. And so it goes without question that this is an absolute rule. Anyone who doesn’t follow a religion may tend to be more of a relativist, and they may say ‘Murder should be prevented, unless murdering one person could stop the murder of hundreds more’, (like in the case of Osama Bin Laden or other terrorists). Relative morality focuses more on the outcome of the actions, rather than absolute morality which focuses on the actions themselves, and whether they are right and wrong.

Lucretius and Plato on the Mortality of the Soul Essay Example

Lucretius and Plato on the Mortality of the Soul Essay Patrick McCleery Essay I: Lucretius and Plato on the Mortality of the Soul In this essay it will be argued that the soul is mortal and does not survive the death of the body. As support, the following arguments from Lucretius will be examined: the â€Å"proof from the atomic structure of the soul,† the â€Å"proof from parallelism of mind and body,† the â€Å"proof from the sympatheia of mind and body,† and the â€Å"proof from the structural connection between mind and body. The following arguments from Plato will be used as counterarguments against Lucretius: the â€Å"cyclical argument,† the â€Å"affinity argument,† the â€Å"argument from the form of life,† and the â€Å"recollection argument. † It will be shown that Plato’s premises lack validity and that Lucretius’ position is the more reasonable of the two. The first argument put forward by Lucretius is the â€Å"proof from the atomic structure of the soul. â₠¬  This argument states that the soul is a â€Å"fine material substance,† akin to an invisible gas (Lucretius 3. 425-44). When the vessel that contains a gas shatters, the gas escapes and dissipates. Therefore, when the vessel (body) containing the soul shatters (dies), the soul dissipates. Plato argues that the soul partakes of the Form of Life, and that Forms are eternal and unchanging. Therefore, the soul cannot die. Plato’s argument lacks validity because there is no compelling reason to believe that the soul partakes of the form of life. It is simply taken for granted that â€Å"the soul (mind) is what brings life so the soul (mind) partakes of the form of life. † Plato could be accused of â€Å"begging the question,† or assuming the existence of that which he should be proving. We will write a custom essay sample on Lucretius and Plato on the Mortality of the Soul specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Lucretius and Plato on the Mortality of the Soul specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Lucretius and Plato on the Mortality of the Soul specifically for you FOR ONLY $16.38 $13.9/page Hire Writer This is also called â€Å"arguing in a circle† (Earle 262). It is also worth noting that many of the problems of the ancient arguments regarding the soul result from equivocating â€Å"mind† with â€Å"soul. † The existence of the soul is presupposed as a result of this equivocation. Since people think, they must have souls. For now, we will ignore this problem and focus on Plato and Lucretius’ arguments. A: The soul is a fine-material substance like a gas B: When the vessel containing a gas shatters, the gas dissipates C: When the body shatters (dies), the soul dissipates A ? B ? C A ? B ?C The second argument put forward by Lucretius is the â€Å"proof from parallelism of mind and body. † This argument is based on an observation that both mind and body follow a similar path in life: â€Å"both move from weakness in youth to growth and strength, then to weakness again in old age† (Lucretius 3. 445-58). The implied conclusion is that because both mind and body follow a similar path in life, the soul dies because the body dies. Plato’s â€Å"cyclical argument† could be used as a counterargument to the â€Å"proof from parallelism. The cyclical argument is also sometimes called the â€Å"opposites argument,† because it states that those things which have an opposite and also â€Å"come to be† are caused by their opposite. The opposite of â€Å"life† is â€Å"death,† and the opposite of â€Å"coming alive† is â€Å"dying. † If dying and coming alive are opposite processes, they are als o the cause of each other, since both â€Å"coming alive† and â€Å"dying† are things that â€Å"come to be. † Plato concludes from this that the souls of the living must come from the souls of the dead and vice versa. Souls are constantly â€Å"recycled,† and therefore they must be immortal. Plato could be accused of equivocation when making this argument. When Plato asserts that all things which have an opposite and â€Å"come to be† are caused by their opposite, he is referring to concepts. Conceptually, this statement makes sense: it is impossible for a person to conceive of â€Å"hot† without something either less hot or hotter to compare it to. Thus, the concept of hot will always make its appearance alongside the concept of cold and it is impossible for either concept to occur in the mind in isolation from its opposite. However, this doesn’t mean that â€Å"hot† and â€Å"cold† will always occur simultaneously and in equal amounts in reality. Plato could be accused of equivocation because he acts as if the behavior of concepts is the same as the behavior of the concrete objects which they describe, but he does not demonstrate that this is necessarily the case. A: The soul and the body are parallel to each other B: The body moves in one direction C: The soul moves in the same direction A ? B ? C A ? B ?C The next argument from Lucretius is the â€Å"proof from sympaethia of mind and body. The argument from medicine is an example of this type of argument. The argument from medicine states that the mind can be cured by medicine just like the body, which is mortal. Since that which is immortal cannot be altered in any way, it could not be cured. Since the mind can be cured, the mind (soul) is not immortal. The â€Å"affinity argument† from Plato could be seen as a counterarg ument. The affinity argument states that the soul resembles that which is invisible and divine, while the body resembles the visible and corporeal. Since the invisible and divine outlasts the visible and corporeal, the soul must outlast the death of the body. This argument fails in a number of ways, but in relation to Lucretius, no reason is given for why the soul cannot resemble the visible and corporeal, as Lucretius demonstrates in the sympaethia arguments. A: The mind can be cured with medicine B: To be cured requires alteration C: The mind (soul) can be altered A ? B ? C A ? B ?C The final argument from Lucretius is the â€Å"proof from the structural connection of mind and body. This argument first states that if a part of our being were located somewhere other than where it was, it could not perform its function. Since the mind is a part of our being that affects and controls our bodies, it has a fixed location in our body. Since those things with a fixed location must necessarily be material, the soul is therefore material. Material things are mortal, therefore the soul is mortal. As a counterargument, Plato’s â €Å"argument from recollection† states that certain a priori knowledge, and therefore the mind (soul), must have existed prior to birth, and thus cannot have a fixed location in the body. The first part of this argument is the â€Å"argument from interrogation,† which basically states that because people possess a priori knowledge, and because all knowledge must have been learned at some point, such knowledge must have been gained in a previous life. This argument fails because it is not necessarily the case that all types of knowledge must be learned, and it also fails because it is self-contradictory. This argument is really an argument stating that a priori knowledge does not exist; all concepts must have been based on experience either in this or a past lifetime. Plato is guilty of begging the question; he should be seeking to prove that there is no such thing as a priori knowledge, but this violates his basic premise that forms are eternal and unchanging, as well as the implied premise that â€Å"nothing comes from nothing. † Plato goes on to contradict himself with the second part of the argument, the â€Å"equality argument. † This states that because no two sticks are of exactly equal length, but we are reminded of equality when we see sticks that are â€Å"striving to be equal,† that we therefore possessed the knowledge of equality prior to experience, and that such is the case with all forms. This contradicts Plato’s implied premise in the interrogation argument that a priori knowledge cannot exist (all knowledge must be based on experience at some point). If we accepted the idea that our concept of equality was gained from experience in a previous life, we are led to the absurd conclusion that it is impossible for two sticks to be of equal length in this lifetime but that it was possible in a past lifetime. A: The mind is a part of our being that has a physical function; that is, it affects and controls our bodies. B: Parts of our being that have a physical function can perform that function if located elsewhere in the body than where they are located C: The mind (soul) has a fixed location within the body A ? ~B ? C A ? ~B ?C In conclusion, it has been demonstrated that the soul is mortal and that Plato’s arguments against Lucretius are false. It has been shown that the arguments put forward by Lucretius have more validity than those put forward by Plato. Plato’s counterarguments against Lucretius lack validity because the premises are false. That which is immortal is unchanging, unmoving, non-physical and without a physical location in the body; while Lucretius has demonstrated the soul moves, changes, has a fixed physical location in the body, and is a material substance. A: The soul (mind) is a material substance (like a gas) B: The soul has a fixed location in the body C: The soul has movement D: The soul can be changed E: That which is immortal has movement F: That which is immortal can be changed G: That which is immortal has a fixed location in the body H: That which is immortal is a material substance I: The soul is not immortal A ? B ? C ? D ? ~E ? ~F ? ~G ? ~H ? I A ? B ? C ? D ? ~E ? ~F ? ~G ? ~H ?I It should be noted that any of the above arguments by themselves would be sufficient to prove that the soul is not immortal, for example: A ? ~H ? I A ? ~H ?I Works Cited Earle, William James. Introduction to Philosophy. New York: Mcgraw-Hill, 1992. Lucretius. De Rerum Natura. Other reference material used â€Å"Phaedo. † Wikipedia, 2010. Web. Oct. 2010.

Rumative Coping Strategies essays

Rumative Coping Strategies essays The journal review I chose to do was Early adolescent gender differences in the use of ruminative and distracting coping strategies by Patricia C. Broderick. Her hypothesis was that rumination is manifested to a greater extent by girls than by boys prior to the onset of adolescence. The independent variable in this study is the fourth and fifth grade boys and girls, meaning their actual gender is the independent variable. The dependent variable is the survey of two vignette scenarios for three different categories, being school, family, and peer groups, totaling six scenarios. The sample was four groups of fourth and fifth graders each group consisted of a different school. Research has shown that women experience more depressive moods than men. This depressive moods and disorders can be experienced from adolescence all the way to adulthood. The most common ages for depression to appear are between thirteen and eighteen. The reason for this test is to clarify why depression occurs during adolescence because it is not understood what would cause this to happen. However it is known that early events in a persons life can lead to depression at a later time. The survey or test that was given tested for the different coping strategies used by these adolescents. The two main strategies looked for during this test were Rumination and Distraction. Rumination is, according to the document written by Broderick, a stable, emotional-focused coping style conceived as a pattern of behaviors and thoughts that focus the individuals attention on his or her emotional state and inhibit any actions that might distract the individual from his or her mood. Broderick defines distraction as, behaviors or thoughts that take the persons mind off the problem and lessen the impact of negative mood on information processing and memory. The survey was given to the sample of children as...

Changes in Management Assignment Example | Topics and Well Written Essays - 250 words

Changes in Management - Assignment Example e way of functionality of an organization, the management process comprises five significant functions that encompass coordinating, directing, staffing, planning and organizing. With the dramatic change in the current competitive business world and the process through which different organizations belonging to diverse industry operate, it can be stated that the management functions play a decisive part at large. However, with respect to the aforesaid scenario, it can be affirmed that the process through which company recruits its employee i.e. the function of staffing would experience the most dramatic change out of the above stated management functions. This can be justified with reference to the fact that there exists the prevalence of extreme business market competition in this present day context making this particular management function to be changed in the next decade (Tripathi 3-7). On the other hand, the management task or the function of ‘directing’ would have least change as the function is basically related with the process of motivating, leading and directing the employees of various organizations making the organizations more result-oriented (Tripathi

Principles of Persuasion Essay Example | Topics and Well Written Essays - 750 words

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Palliative Care within the Acute Care Setting

Palliative Care within the Acute Care Setting Palliative Care during End-of-life: An Annotated Bibliography Waldrop and Kirkendall (2009) surveyed employees from a 120-bed suburban nonprofit nursing home to explore how their staff recognized a dying patient and identified standards of care which would be put into place once palliative care has been initiated. Using a qualitative method to gather data, 42 employees were interviewed which included nurses, chaplains, social workers, nursing assistants, housekeepers, and administrators to provide multiple perspectives on the dying experience. The survey was done in the form of a 30-minute interview in a quiet location of the nursing home away from the nursing unit (Waldrop Kirkensall, 2009). An affiliated research assistant or investigator whom has had training in conducting interviews and qualitative data analysis conducted it. They asked the employees open-ended and objective questions about frequency and standards of care for dying patients and their families. All interviews were audio taped, transcribed by a professional transcriptionist, and labeled with a letter number combination (e.g., N[urse]-1). The transcripts were entered into Atlas ti software for data organization and management(Waldrop Kirkensall, 2009). The survey identified physical, behavioral, and social factors as the three main indicators of impending death. Physical indicators included altered breathing patterns (including apnea), anorexia, or increase in pain; behavioral indicators included mood changes and diminished activity level and social indicators sometimes included withdrawal from interaction with staff or family (Waldrop Kirkendall, 2009). During the survey the staff explained that Comfort care is initiated when patients began to exhibit these signs. At this nursing home standard order sets were not used and comfort care measures were described as being very patient individualized and holistic. Comfort care includes an interrelationship of symptom management, family care, interpersonal relationships, and interdisciplinary cooperation in which each member of the healthcare team participates in the care of the patient, according to their scope of practice (Waldrop Kirkendall, 2009). The survey revealed that health care employees deliver comfort care in different ways and it identified the need for more comparison studies in other nursing homes to explore standards of care in other facilities because this was just one study of one nursing home. By further comparing nursing homes which use different models of care comfort care standards and or improvements can be made. This survey was conducted in a nursing home setting but its results reflect on hospital end-of-life care. At the present time the standard of care for dying patients in a hospital setting consists of pre-printed order sets which are not individualized to the specific needs of the patient. This study promotes use of the holistic, individualized care approach to ensure a more satisfying and comforting dying experience. Level of evidence: VI Single descriptive qualitative/physiologic study Jarabek, B.R., Cha, S.S., Ruegg, S.R., Moynihan, T.J., McDonald, F.S. (2008). Use of a palliative care order set to improve resident comfort with symptom management in palliative care. Palliative Medicine, 22, 343-349. Jarabek, Cha, Ruegg, Moynihan, McDonald, (2008) began a study within the Internal Medicine Residency Program at Mayo Clinic in Rochester, Minnesota hypothesized that standard palliative order sets within a hospital setting would enhance physician comfort with managing 4 aspects of end-of-life care: pain, secretions, agitation, and dyspnea. A 5-question, pre-intervention web-based survey regarding physician comfort in diverse aspects of palliative care was given to 144 internal medicine resident physicians before the release of the palliative order set, which would later be used within the hospital. Each question included a 5-item Likert response scale, ranging from 1, very comfortable to 5, very uncomfortable(Larabek et al., 2008). Three months later an educational email was sent to all house staff and faculty addressing end-of life-care along with the initiation of the order set, which consisted of physical ailment provisions. Another 3 months was spent allowing staff to use and or work with the order sets at which point a post-intervention survey was performed. Results of the post-intervention survey were that 88% had utilized the palliative order sets and 63% stated that they felt increasingly comfortable with palliative care (Jarabek et al., 2008). There was an overall 10% increase in resident comfort regarding the 4 aspects of palliative care with the initiation of order sets, but no change in social or communication-related comfort (Jarabek et al., 2008). The survey concluded that palliative order sets can increase physician comfort in providing care to patients during end-of-life, but it also revealed that the order sets do not address the psychosocial needs of the patient when providing comfort care. Although physicians find comfort in having order sets as guidelines for end-of-life care, they are only guidelines and open communication needs to be initiated between the health care team and the patient to ensure all the comfort care needs of the patient and family are met in a holistic way so that they may have a peaceful dying experience. Level of evidence: Teno, J.M., Clarridge, B.R., Casey, V., Welch, L.C., Wetle, T., Shield, R., Mor, V. (2004). Family perspectives on end-of-life care at the last place of care. Journal of the American Medical Association, 291(1), 88-93. Teno, clarridge, casey, welchl wetle,shield, mor (2004) evaluated 1578 adult patients with different, chronic illnesses end of life experiences by surveying the decedents loved ones and determining whether their perspectives on quality end-of-life care were influenced by the environment where the patient spent their last 48 hours of life. A survey was devised from a conceptual model for patient-focused, family-centered medical care and the calculation of scores and psychometrics of the measures were taken from an online tool formulated by Brown University. Within 9 to 15 months from the time of death a close family member or informant whom was listed on the death certificate was surveyed and was asked about the quality of care their loved one received during their last 48 hours of life. Five different domains were used in the survey, including whether healthcare workers provided patient physical comfort and emotional support, supported collaborative decision-making with the physician , treated the patient with respect, attended to family needs, and provided coordinated care with other healthcare workers or facilities (Teno., et al. 2004). Teno et al. (2004) concluded that 69% of the decedents site of death and last place to receive care was in a hospital or nursing home setting, 31% home, 36% without nursing service, 12% home nursing, and 52% home hospice. The survey showed that family perceptions of the quality of care were different according to where their loved one last received care. Families of patients who were in nursing homes or had home health had a higher rate of unmet needs for pain (Teno., et al. 2004). Over half of the families in hospital or nursing home settings reported unmet emotional needs. In addition, 70% of families receiving home health care reported inadequate emotional support in comparison to 35% in families who utilized home hospice care. Patient and family respect was also a concern to families and varied in different settings. Only 68% of nursing home residents families felt they had been treated with respect and consideration compared to the 96% of families receiving hospice care (Teno et al., 2004). Survey participants felt that physical symptom management was adequately managed so it was comparably equal throughout all patient settings. Although families did not experience a difference in pain or dyspnea management in comparison to other nursing services families who used hospice services overall, 71% reported excellent care (Teno et al., 2004). Kolcaba, K.Y., Steiner, R. (2004). Efficacy of hand massage for enhancing the comfort of hospice patients. Journal of Hospice and Palliative Nursing, 6(2), 91-102. Kolcaba, Dowd, Steiner, and Mitzel (2004) identified the need for comforting interventions for patients at end of life that are simple, easy to learn and administer, and require minimal effort on behalf of the patient. Bilateral hand massage is a good intervention because it is noninvasive, easy to do, does not take long, and relies on caring/healing touch( Kolcaba., et al. 2004). The purpose of their study was to determine empirically if a bilateral hand massage provided to patients near end of life twice per week for 3 weeks was associated with higher levels of comfort and less symptom distress. 31 adult hospice patients from 2 hospice agencies participated in the study. Each patient was English-speaking and expected to remain alert and oriented for the duration of the trial, 13 months. Data collectors who were unknown to the patients called the homes of the patients, explained the study, and then scheduled an appointment for a research visit. Data was collected at the patients homes and at the hospice centers(Kolcaba., et al. 2004). After informed consent, participants were randomly divided into the treatment group (with 16 patients) and the comparison group (with 15 patients). All participants were asked to complete a modified General Comfort Questionnaire (GCQ), tailored for end-of-life patients, once a week for 3 weeks. After completing the questionnaire each week, the treatment group then received the hand massage intervention twice a week for 3 weeks. The comparison group received the intervention once at the end of the study period. The study concluded no significant difference between the treatment and comparison groups in regard to enhanced comfort or decreased symptom distress over time (Kolcaba et al., 2004). However, comfort did increase some in the treatment group even as the patient approached death. The study also revealed that the hand massage seemed to allow more time for therapeutic or face to face communication allowing the patients to talk about how they feel and their feelings on transitioning to death, and patients receiving the intervention reported it to be a personalized experience something they could engage in that feels good, and family members were appreciative of the care and attention their loved one was getting (Kolcaba et al., 2004). Because this intervention is easy to learn and requires minimal time for the caregiver to do and minimal effort for the patient it is an excellent intervention that can even be taught to the family. This study identifies interventions that can be used withi n the hospital setting and any other setting to enhance comfort during end-of-life. Nurses and family members can use this intervention to increase communication by using caring touch, which provide psychosocial care and therefore holistic comfort for the patient. Bakitas, M., Lyons, K. D., Hegel, M. T., Balan, S., Brokaw, F. C., Seville, J., Hull, J. G., Li, Z., Tosteson, T. D., Byock, I. R., Ahles, T. A., (2009). Effects of a palliative care intervention on clinical outcomes in patients with advanced cancer. The Journal of the American Medical Association. 302 (7): 741-749. Bakitas, Lyons, Hegel, Balan, Brokaw, Seville, hull, Li, Tosteson, Byock, Ahles, (2009) using project ENABLE combined with a nurse-led intervention with ongoing assessment, coaching, symptom management, crisis prevetion, and timely referral to palliative care and hospices hypothesize that patients newly diagnosed with advanced cancer if exposed to this intervention right away would become informed, active participants in their care, and would experience an improved quality of life, mood, and have better symptom relief. The study protocol and data and safety monitoring board plan were approved by the institutional review boards of the Norris Cotton Cancer Center and Dartmouth College in Lebanon, New Hampshire, and the Veterans Administration (VA) medical center in White River Junction, Vermont. All patient and caregiver participants signed a document confirming their informed consent.(Bakitas., et al (2009). Participants completed baseline questionnaires when they were enrolled and th en completed a follow-up one month later. Using a stratified randomization scheme patients and their caregivers were randomly assigned to the interventions or usual care group. One of 2 advanced practice nurses with palliative care experience conducted 4 structured educational problem solving sessions first one lasting 41 minutes and sessions 2 through 4 approx 30 minutes each and at least monthly telephone follow-up sessions until the participant died or the study ended (Bakitas., et al.2009) The advanced practice nurse began all contacts with an initial assessment by administering the Distress Thermometer, an 11-point rating scale recommended by the National Comprehensive Cancer Network guidelines. It identifies sources of distress in the 5 areas of practical problems physical problems, family problems, spiritual, emotional problems or religious concerns. If distress intensity was higher than 3, the advanced practice nurses then identifies the sources of distress and checks to see if the participant would like to problem/solve to take care of their issue. The nurse then covers the assigned module for that session. The participants clinical teams are responsible for all medical decisions and inpatient care management, however the advanced practice nurse was readily available by telephone for the participants and they could also facilitate ancillary resources. The participants also were able to participate in group shared medical appointments (SMAs), which are led by certified palliative care physicians. The usual care participants were allowed to use all oncology and supportive services without restriction. Follow-up questionnaires were mailed every 3 months until the patient died or study completion in December 31, 2007. Quality of Life was measured with a 46-item tool called the Functional Assessment of Chronic Illness Therapy for Palliative Care. It measures the participants physical, social, emotional, and functional well being along with the concerns of a person whom has a life-threatening illness. Of 1222 screened, 681 were eligible and were approached and 322 were enrolled (47% participation rate). There were a total of 134 participants in the usual care group and 145 participants in the intervention group. A systematic review of specialized palliative care identified 22 trials (16 from the United States) between 1984-2007 with a median sample size of 204, half exclusively with cancer patients. There was lack of evidence due to contamination, adherence, and recruitment etc. The trial addressed these issues and contributed to the increasing evidence that palliative care may improve quality of life and mood at the end of life. In our study, intervention participants higher quality of life and lower depressed mood may be attributed to improved psychosocial and emotional well being. Mood is a determinant of the experience of quality of life and suffering despite a mounting burden of physical symptoms(Bakitas., et al. 2009). However, while patients in the intervention group had improvement in these outcomes, we conservatively planned our original target trial enrollment of 400 based on a significance level of .01. Statistical inferences based on this stringent critical value would lead to the conclusion that there were no statistically significant differences between groups in quality of life or mood(Bakitas., et al. 2009). The study concluded that compared with participants receiving usual oncology care those receiving a nurse-led, palliative care-focused interventions that takes care of the patient holistically provided at the same time with oncology care had higher scores for quality of life and mood, but did not have improvements in symptom intensity scores or reduced days in the hospital (Bakitas., et al. 2009). Level of evidence- Summary The research presented reveals while palliative care order sets provide a helpful guideline or tool which reassures health care providers in giving consistent good quality care, patients care needs should be assessed and individualized orders and interventions should be implemented to ensure a peaceful and comforting dying experience. Hospice care settings have been shown to provide excellent holistic care for dying patients and they have also been shown to show compassion to the family as well. The comfort interventions from these facilities can be modified for application in the hospital for use in the acute care setting. Holistic comfort care interventions include hand massage, music therapy, or the utilization of a visual analog scale the faces to measure comfort. These are some of the ways hospitals can utilize the findings from this research into daily practice to ensure quality holistic patient comfort is achieved and ultimately a peaceful death.