Health care in the Amish culture

Health care in the Amish culture The religious and cultural beliefs of the Amish culture have led to variations in health care practices that are different from main stream American culture. The Amish have a health care belief system that includes traditional remedies passed from one generation to the next. Amish families are without health insurance and though concerned about paying medical expenses, most of the time the extended family, friends, and the church help pay for the expenses. For example if a female infant of the Amish family is in the hospital for an extended period of time the biological and extended family visit frequently and bring in their own food in bags. The grandmother and neighbors would gather the children in the hospital waiting room to feed and entertain them while the mother would visit her baby daughter in the neonatal care unit. The father would most likely visit on weekends. The family would speak Pennsylvania Dutch among themselves but use English in speaking with the health care provi ders. The children in the family are dressed like undersized replicas of their parents. They are in distinctive clothing that is subdued and devoid of any designs of flowers, figures or animals on the material. The little girls wear long dresses and head coverings, while the little boys wear trousers with suspenders. Some of the older boys wear broad-brimmed hats. All are very polite and well mannered. This Amish family appears to come from another time, another place. In an instant the Amish family came into another world, the world of high tech health care. One may well surmise the cultural shock of this encounter. AMISH HERITAGE The Amish are a conservative Protestant group who emerged after 1693 as a descendent of the Anabaptist movement that originated from Switzerland and spread to neighboring Germany. The Amish parted ways with the larger Anabaptist group, now known as the Mennonites, over a doctrinal dispute, (Hostetler 1993) and immigrated to America in the 17th 18th century after experiencing religious persecution in Europe. The diverse subgroups of the Amish Culture have distinctive beliefs, values, and behaviors). Today the Amish stand somewhere between the parent body, the Mennonites, and the four groups of Amish: Swartzentruber (ultra conservative), Andy Weaver (conservative), Old Order (conservative), and the New Order (less conservative). The New Order leads a more progressive path that diverged from the Old Order in 1968 (Blair Hurst 1997). The New Order of Amish attempts to balance distinctive rituals and practices against accommodations. Over time the Amish have adapted to some change but at their own pace. In various rural regions of the United States, especially in Indiana, Ohio, and Pennsylvania, there are large settlements or communities of Amish families. About 75% of the estimated Amish total population of over 130,000 is concentrated in Indiana, Ohio, and Pennsylvania. In these areas good farmland can be purchased reasonably as agriculture is the main stay of their economy. Holmes County in Millersburg, Ohio has the largest population of Amish in the United States as compared to the more widely known areas of Amish settlements in Lancaster, Pennsylvania or Elkart, Indiana. The population in Holmes county is 38, 943 and about 18,000 of that are of Amish descent (Holmes County Chamber of Commerce 2002). Amish Mutual Network The Amish community has a very strong network of mutual support and assistance for its families. Amish barn raising is one example where several hundred men from many church districts gather to build a new barn. The Amish women plan and prepare the meals for the workers and take the food to the site. Smaller networks with projects called frolics occur when several neighbors and extended families and friends gather to help build a small building such as a shed or corn crib. Another example of Amish mutual aid is the harvesting of crops. A serious illness or accident brings an immediate response of both emotional and financial support from their community. In Holmes County, Ohio, for example, a cooperative effort by both Amish and non-Amish people resulted in the formation of the Rainbow of Hope Foundation. This foundation assists all families in the area with health care costs affecting infants and children. Bake sales, benefit auctions, and private donations assist in raising the needed funds. There is a genuine ritualistic response to human troubles in the Amish close knit family environment. Family Roles The Amish father is responsible for providing for his family through farm work or by employment in the local community. Many Amish men are working away from the farm with the declining availability of farmland. Many Amish men work as carpenters, masons or laborers in factories. Some have home based businesses such as furniture making, harness repair or the shoeing of horses. Amish culture teaches girls to serve and please others such as their parents, husbands and relatives. An Amish wife is identified by using her husbands name, eg. Eli Katie means Elis wife, Katie. The social life for an Amish woman is centered around church, funerals, quilting bees, baking, barn raising and frolics. Amish families usually have many children. Amish women raise on average seven children. On the family farm, parents and older siblings model work roles for the younger siblings. Children are an economic asset to the family as they assist with farm chores, gardening, mowing of lawns, housework or work i n a small family business. These activities involving children serve to strengthen family ties and promote survival of the Amish life-style. Genetics Intermarriage among the Amish culture has resulted in the presence of a large number of recessive disorders, many of which are unrecognized outside of the Amish population. Consanguinity (relatives marrying relatives) accounts for the transmission of these various disorders. When a group of individuals mates only among themselves allele (alternate form of a gene) frequencies may change as a result of chance sampling from a small pocket of a population. This change of allele frequency is termed genetic drift. The founder effect is a common type of this genetic drift. A founder effect is when a community of people have descended from a few founders and have their own collection of inherited disorders that are rare in other areas (Lewis 2001). Amish couples are not deterred from having more children when they have a child with a hereditary defect. An abnormal child is referred to as a special child and is accepted as Gods will (Julia 1996). http://dw.com.com/redir?tag=rbxira.2.a.10destU rl=http://www.cnet.com/b.gif CONCEPTION, PRENATAL CARE, AND BIRTH Babies are a welcomed gift in the Amish culture and are viewed as a gift from God. The Amish view fertility as a family and community gift. They nurture these children in preparation for eternal life (Purnell 1998). Most Amish couples do not use birth control to limit their family size, since it is believed that use of birth control would be interfering with Gods will. Therapeutic abortions, amniocentesis and other invasive prenatal diagnostic testing are also not acceptable. Amish folk wisdom is an integral part of their prenatal practices, for example: walking under a clothesline will result in a stillbirth or crawling through a window or under a table will cause the umbilical cord to be wrapped around the babys neck. Lamaze classes are usually held in a church close to the Amish community to ease transportation barriers. Prenatal care is started in the first trimester for a first pregnancy and much later for subsequent pregnancies if the mother has no problems. The distance to the doctor and cost of care can influence the number of prenatal visits and how soon prenatal care is started. Complications such as pregnancy induced hypertension and diabetes is low in the Amish culture most likely due to the well nourished state of the mother (Julia, 1996). Typically prenatal visits are scheduled every eight weeks, rather than every 4 weeks, during the first two trimesters to reduce the expenditures of money and time for prenatal care. Amish express their preference for prenatal care that promotes the use of nurse midwives, lay midwives, home deliveries, and limited use of high technology. The Amish desire culturally congruent and safe health care services. In preparation for childbirth a five week formula (5-W) is sometimes used in the last five weeks of pregnancy. It is thought that the herbs in this formula tone and calm the uterus, quiet the nerves, ease pain, and help make labor easier and on time. In addition, it has been known to help with menstrual disorders, morning sickness and hot flashes. The herbs included in this formula are: Red Rasberry Leaves: This herb has been used as an old friend to treat diarrhea, vomiting and the flu. It is used for similar purposes of relieving nausea and pain in labor. Red raspberry capsules and red raspberry teas are also used. Butchers Broom Root: This herb is used for hemorrhoids, varicose veins, and thrombosis. In addition, it is a diuretic, anti-inflammatory and improves circulation. This herb contains pseudo steroidal saponins which cause blood vessels to constrict and blood to thin. During the final months of pregnancy women may have circulatory problems such as varicose veins; therefore this herb is considered important. Black Cohosh Root: This is a hormonal herb. It has an estrogenic effect because it contains compounds which mimic the effects of estrogen; therefore it is contraindicated in the early stages of pregnancy as it could bring on premature labor. This herb has a nervine effect which relieves spastic muscles, dilates peripheral blood vessels and helps reduce blood pressure. These actions aid the uterus and other muscles during labor. The anti-cramping effect of black cohosh is thought to help reduce pain during delivery. Black cohosh is also used to treat menopausal and PMS symptoms and menstrual cramps. Because black cohosh may minimic the action of estrogen, anyone who has had a cancer thats estrogen sensitive, such as breast, endometrial or ovarian, should avoid using it. Since this root contains a blood-thinner, it should not be taken with bloodthinning medications (such as coumadin or heparin). Dong Quai Root: The anti-inflammatory and diuretic effect of this herb is used for treating swelling prior to labor. During labor it eases smooth muscle contractions and gives a general sedative effect. This herb, in Chinese medicine, is considered a blood building tonic as it is high in iron, magnesium, and niacin. This Chinese herb is sometimes referred to as a female ginseng and is used extensively in China as a postpartum tonic. Squaw Vine Root: This herb is used to prepare the uterus for childbirth and is also used to speed up delivery and encourage regular contractions. It has an antispasmodic action. (Pederson, 1987; Willard, 1991; Tarr, 1984, Block, 1984). The Amish have no major taboos or requirements for labor and delivery. The women labor in soft pastel colored gowns. Men may be present and most husbands choose to be involved. Delivery may be at home with a midwife, at the birthing center, or at a hospital. VISITING THE AMISH COMMUNITY Their simple life style practices numerous social controls to avoid modernization. However, interaction with the outside world often occurs in the health care arena when an Amish person requires hospitalization for medical care. To better understand the Amish culture related to obstetrical care several nursing faculty visited an Amish Birthing Center in Indiana called the New Eden Care Center which is located in the beautiful countryside of Topeka, Indiana. An adaptation by the Amish to modern medical and nursing practices are the Amish Birthing Centers (Kreps Kreps 1997). This Amish Birthing Center was built in 1997, not from local, state, or federal government funds but from private subscriptions and donations mainly from the surrounding community. This facility is designed to be an alternative for those who prefer not going to the hospital for the delivery of their babies but who recognize the need for skilled care before, during, and after delivery. New Eden Care Center is a place where the physician or midwife can bring their patient for delivery in a more relaxed, home-like environment (Philosophy of New Eden Care Center). Since this facility provides services for the low risk population, all women are screened by their physician or nurse midwife before their arrival. Admission to the facility is opened to anyone upon recommendation and approval of their physician or nurse midwife. The need for this birthing center came from the fact that many of the people in the area are Amish and do not have commercial insurance or coverage for obstetrical car e. Thus the Amish prefer not to go to the hospital with its high cost. This center features a plain relaxing decor with no television sets or phones in the patients rooms, and no separate nursery or delivery room. Labor, delivery and postpartum care are all given in the patients room, better known as LDRP rooms. Newborn babies stay in the room with the mothers. Fees for the use of the New Eden Care Center cover current expenses, repairs, and maintenance of this facility. A flat fee is charged for the birth itself and 72 hours of care starting from the time of admission. There are additional fees for extra supplies such as PKU screening, intravenous solutions, and medications. The nurse midwives and physicians fees are separate from the birthing center fees. At times the fees are bartered for. For example, one of the nurse midwives had a new front porch put on her home to cover for her fee. In addition meats have been given for payments. Services of the birthing center included general nursing care, housekeeping, and meals brought in during the patients stay. Families bring in food for the delivering mother and often eat together in the large home-like kitchen area provided at the birthing center. The center includes 3 MSN prepared nurse midwives and 9 physicians. No prenatal classes are offered by the center but the classes are provided by a staff RN from the center at a nearby church. Prenatal care is provided by the midwives either at their offices, located at the center, or in the homes of their patients. Many of the mothers prefer coming to the midwives offices for the prenatal classes as they enjoy the private and quiet time. The care center provides hitching posts with special parking areas for the traditional horse and buggy as well as a barn for overnight lodging of the Amish horses. Since there are no phones in Amish homes, a red bag tied to a large hook placed on the top of the barn is used to signal neigh bors whenever additional help is needed in the center (cleaning and laundry). All of the midwives, upon request, will do home deliveries. Suction, oxygen, and IV equipment are a few of the supplies they routinely take with them. One of the midwives described her experience following a home delivery. It was a very foggy night and it took me awhile to get to the Amish home. It was well worth the difficult drive when following the delivery a great peace seemed to take over in the still of the night as I listened to the singing of the dad to the newborn, the creaking of the dads rocking chair, and the hum from the kerosene lantern. Where else could one hear such beautiful, peaceful sounds. Culture exerts a great influence on the prenatal family and determines the appropriate interventions to be given to provide competent nursing care. It is increasingly necessary to understand the cultural and behavioral patterns of the individuals whom we serve in our practices. Rapid growth of the Amish population and diverse geographical locations augment the probability that health care practitioners may care for Amish families. Health care practitioners can tailor their delivery of care for Amish families if they understand the Amish cultural practices and modify their services to keep it simple. This Amish Birthing Facility, New Eden Care Center, is an example of wonderful adaptation by the Amish people to modern nursing and medical practices while at the same time maintaining their values of simplicity, low cost and accommodation to the use of their horse and buggy. Here the Amish can remain separate from the wider English society while still interfacing with it when health care is involved in birthing babies. Obstetrical Amish health care can be of excellent quality, with licensed medical and nursing personnel, at a reduced cost to both the Amish and the English society. This is an important consideration in todays ever increasing health care costs.

Philosophy Behind the Leadership Position in a Learning Organization

Imagine this. You have served for years as an assistant to the Principal at a local high school. Recently, the school has become plagued with administrative problems affecting the day to day operations of the school, the quality of education for students, and teacher development. As someone with long-standing experience in that school, you have been promoted to the highest leadership position at that school. Part of your role in the leadership of a learning organization includes policy development, decision making, professional development, and the monitoring of organizational progress. This paper will identify and examine the relevant leadership skills and strategies necessary to develop a successful, thriving learning organization. The philosophy behind the leadership position in a learning organization has emerged in recent years as a concern for parents, teachers and policy-makers alike. Changes must be implemented in the current supervisory process, as the role of leadership in a school setting has progressed from the principal as an instructional leader, to the principal as a transactional leader and, most recently, to the role of transformational leader. High performing leaders have a personal vision for their school and the knowledge, skills, and dispositions to develop, articulate and implement a shared vision that is supported by the larger organization and the school community (Anonymous author, 2001). Numerous studies on the topic have revealed the importance of leadership skills and strategies of the school leader. These studies clearly indicate that improved education for students requires improved leadership and supervisory skills. The leader in a learning organization must develop and administer policies that provide a safe school environment and establish operational plans and processes to accomplish strategic goals. Research indicates that a necessary aspect of policy development is the intertwining of the daily operations of the school to school and student learning goals (Anonymous author, 2001). Additionally, the major sources of fiscal and nonphysical resources for the school including business and community resources must be analyzed and identified (Anonymous author, 2001). The financial and material assets must be managed, as well as capital goods and services, allocating resources according to district or school priorities (Anonymous author, 2001). Policy development includes an efficient budget planning process that is driven by district and school priorities and involves the staff and community. A strong leadership quality is the ability to identify and organize resources to achieve curricular and instructional goals (Anonymous author, 2001). Research indicates that the process of planning, developing, implementing, and evaluating a district budget must be analyzed, and techniques and organizational skills necessary to lead and manage a complex and diverse organization must be demonstrated (Anonymous author, 2001). Furthermore, policy development includes the planning and scheduling of one's own and others' work so that resources are used appropriately, and short- and long-term priorities and goals are met (Anonymous author, 2001). Policy development lies at the basis for a successful learning institution where the needs and goals of students, teachers and the community are met. Research indicates that the decision a leader in a learning organization makes has a strong influence on what will or will not occur in classrooms throughout the country. The leader must take a results oriented approach, and frame, analyze, and resolve problems using appropriate problem solving techniques and decision making skills (Anonymous author, 2001). In this way, good decisions can be made by viewing events and problems from multiple perspectives, and through the use of multiple sources of data to inform decisions. Additionally, decisions must be made based on the moral and ethical implications of policy options and political strategies (Anonymous author, 2001). Research indicates that the leader must recognize situations that require forcefulness and self-confidence in making decisions and delegate authority and responsibility clearly and appropriately to accomplish organization goals (Anonymous author, 2001). Finally, logical conclusions and making high quality, timely decisions must be based on the best available information. According to Marks and Printy (2003), the decision making tasks to be accomplished encompass those of supervision and evaluation of instruction, of staff development activities, of curriculum development knowledge and activities, of group development knowledge and activities, of action research, of development of a positive school climate, and of the creation of links between school and community. Technical skills include goal setting, assessment and planning, instructional observation, research and evaluation; whereas, interpersonal skills are those of communication, motivation, decision making, problem solving, and conflict management (Marks & Printy, 2003). In order to meet the rapidly changing needs of our students, teachers must be given the authority to make appropriate instructional decisions. Therefore, the basis for school leadership must include teachers and parents, as well as the principal, in the role of problem finding and problem identification (Marks & Printy, 2003). Youngs and King (2002) state that a prominent way in which leaders shape school conditions and teaching practices is through their beliefs and actions regarding teacher professional development. Individual teacher competence is necessary for effective classroom practice, and that teachers must be able to integrate knowledge of students, subject matter, and teaching context in planning out units and lessons and assessing student work (Youngs & King, 2002). The studies discussed by Youngs and King examine the relationship of capacity to instructional quality and student achievement, finding that effective school leaders can sustain high levels of capacity by building trust, creating structures that promote teacher learning, assist in the implementation of general reforms. Their study results also suggest that during transitions in school leadership, incoming leaders must be cognizant of shared norms and values among their faculties before initiating new practices into the curriculum, instruction, or school organization (Youngs & King, 2002). Other research on the topic indicates that speaking with teachers in and outside of instructional conferences was the cornerstone of effective leadership (Blase, 1999). Organizational leaders in a school setting use five primary talking strategies with teachers to promote reflection: 1) making suggestions; 2) giving feedback; 3) modeling; 4) using inquiry and soliciting advice and opinions; and 5) giving praise (Blase, 1999). Another important aspect of effective leadership is the promotion of teachers' professional growth with respect to teaching methods and collegial interaction about teaching and learning (Blase, 1999). According the to Blase study, effective instructional leaders used six teacher development strategies: 1) emphasizing the study of teaching and learning; 2) supporting collaboration efforts among educators; 3) developing coaching relationships among educators; 4) encouraging and supporting redesign of programs; 5) applying the principles of adult learning, growth, and development to all phases of staff development; and 6) implementing action research to inform instructional decision making. The study results found that school leaders that were effective provided former staff development opportunities to address emergent instructional needs. These opportunities resulted in innovation and creativity, variety in teaching, risk taking and positive responses to student diversity as well as effects on motivation, efficacy and self-esteem (Blase, 1999). Monitoring of Organizational Progress Finally, a core leadership skill of a learning organization is the continual monitoring of the school's progress. The studies discussed by Youngs and King (2002) reach the conclusion that school leaders can affect achievement indirectly by establishing a mission or set of goals and building school-wide commitment to them. As a result, higher student achievement can be associated with higher levels of school professional community and program coherence (Youngs & King, 2002). Along with monitoring the school's goals and mission, leaders must continue to facilitate the development and implementation of a shared vision and strategic plan for the school that places student and faculty learning at the center (Anonymous author, 2001). The leader of a learning organization must align instructional objectives and curricular goals with the shared vision and articulate the district's or school's vision, mission and priorities to the community (Anonymous author, 2001). The learning organization must be understood as a political system, relating the vision, mission, and goals to the welfare of students, and its' leader must articulate and reinforce that vision in written and spoken communications. In this way, a positive school culture for learning is created, along with conditions that enhance the staff's desire and willingness to focus energy on achieving educational excellence (Anonymous author, 2001). Finally, the leader must model professionalism, collaboration and continuous learning in order to successfully monitor the organizations progress. Learning to become a leader of an learning organization is a complex, multidimensional task. If school leaders believe that growth in student learning is the primary goal of schooling, then it is a task worth learning. In today's rapidly changing world that means becoming a leader of leaders by learning and working with teachers, students, and parents to improve instructional quality. Goal setting and problem solving become site-based, collective collaborative activities. The leadership of the principal is pivotal in ensuring that the process is informed of all school issues, especially those that relate to student instruction. As indicated by the literature available, policy development, decision making, professional development and progress monitoring are all key areas for leadership. If these areas are enhanced by strong leadership qualities, the future of the educational system will remain very bright. Additional studies on the leadership skills and strategies necessary to effectively lead a learning organization will assist in determining the next steps of our future leaders.

Literature Mirror of Society - 1167 Words

Literature: Mirror of Society That literature is a reflection of the society is a fact that has been widely acknowledged. Literature indeed reflects the society, its good values and its ills. In its corrective function, literature mirrors the ills of the society with a view to making the society realize its mistakes and make amends. It also projects the virtues or good values in the society for people to emulate. Literature, as an imitation of human action, often presents a picture of what people think, say and do in the society. In literature, we find stories designed to portray human life and action through some characters who, by their words, action and reaction, convey certain messages for the purpose of education, information and†¦show more content†¦The novel mirrors the society and shows how the society’s misconception about the purpose of education, coupled with government policies, produce intellectually and morally bankrupt leaders. The novel also shows how both societal and family deman ds and expectations compel the emergent elite to live above their personal incomes and to consequently resort to corrupt means of self-enrichment as exemplified by Obi’s corrupt action. In the novel, Achebe paints a society where extravagant spending of public funds by public officers is the norm, and where corruption has been institutionalized. By taking bribe, Obi Okonkwo has merely done what everyone else does; it is his weakness and inability to escape being caught that is actually frowned at by his kinsmen. The novel aptly depicts the situation in our society, where those who loot the public treasuries, without being caught, are held in very high esteem and are honoured with chieftaincy titles. Another example of literature as a mirror of the society is Wole Soyinka’s The Trial of Brother Jero. This play exposes religious charlatanism, a prevailing problem in our society. 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Nebraska Press Association v. Stuart Supreme Court Case

In Nebraska Press Association v. Stuart (1976), the U.S. Supreme Court addressed a conflict between two constitutional rights: freedom of the press and the right to a fair trial. The Court struck down a gag order, finding that pre-trial media coverage does not, on its own, guarantee an unfair trial. Fast Facts: Nebraska Press Association v. Stuart Case Argued: April 19, 1976Decision Issued: June 30, 1976Petitioner: Nebraska Press Association et. al.Respondent: Hugh Stuart, Judge, District Court of Lincoln County, Nebraska et al.Key Questions: Can a judge issue a gag order prior to legal proceedings in the interest of ensuring a fair trial?Unanimous Decision: Justices Burger, Brennan, Stuart, White, Marshall, Blackmun, Powell, Rehnquist, StevensRuling: Restricting media coverage of a trial prior to jury selection is unconstitutional under the First Amendment. Respondents could not show that limiting publicity would safeguard jury impartiality. Facts of the Case Police discovered the bodies of six people in relation to a violent sexual assault in a small Nebraska town in 1975. The alleged perpetrator, Erwin Charles Simants, was apprehended by police shortly after. The crime rocked the town, and its severity meant that media flocked to the courthouse. The defendant’s attorney and the prosecuting attorney asked the judge to reduce the level of media intensity prior to jury selection, out of concern that coverage might bias jury members. They specifically expressed concern about broadcasting information related to Simants confession, potential medical testimony, and statements written by Simants in a note the night of the murder. The judge agreed that such information might bias future jury members and issued a gag order. Days later, members of the media including publishers, reporters, and press associations asked the court to remove the gag order. The case eventually made its way up to the Nebraska Supreme Court, which sided with the initial judge who issued the order. Under New York Times v. U.S., the Nebraska Supreme Court argued that gag orders may be used in specific instances in which a person’s right to a fair trial through an impartial jury is at risk. This, it found, was one of those instances. The gag order ended by the time the case reached the Supreme Court, but the justices, acknowledging that this would not be the last time that the right to free press and the right to a fair trial would be at odds, granted certiorari. Arguments An attorney on behalf of Judge Stuart argued that First Amendment protections were not absolute. The judge appropriately balanced First and Sixth Amendment protections when granting the gag order, as it was limited in scope and duration in order to protect the defendant’s right to a fair trial. In an extraordinary situation such as this, the court should be able to limit publicity prior to jury selection. The Nebraska Press Association argued that the gag order, a form of prior restraint, was unconstitutional under the First Amendment. There was no guarantee that restricting media coverage would ensure a fair and impartial trial. There were other, more effective means to ensure that an impartial jury would be impaneled in Simants case, the attorney argued. Constitutional Issues Can a court issue a gag order, suppressing freedom of the press, in order to protect a defendant’s right to a fair trial? Can the Supreme Court rule on the legitimacy of the gag order, even if it had already expired? Majority Opinion Chief Justice Warren E. Burger delivered the unanimous decision, finding in favor of the Nebraska Press Association. Justice Burger first stated that the expiration of the gag order did not prevent the Supreme Court from taking on the case. The Supreme Court has jurisdiction over actual cases and controversies. The dispute between the press and the rights of the accused was â€Å"capable of repetition.† Simants trial would not be the last court case to attract media attention, Justice Burger wrote. Justice Burger noted that the issue in Nebraska Press Association v. Stuart was as old as the Republic, but the speed of communication and pervasiveness of the modern news media had intensified the issue. Even the Founding Fathers, Justice Burger wrote, were aware of the conflict between press and a fair trial. Relying on previous cases before the Court, Justice Burger determined that pre-trial publicity, no matter how extreme, does not inevitably result in an unfair trial. Justice Burger wrote that prior restraints on speech and publication are the most serious and the least tolerable infringement on First Amendment rights. There were other measures, short of a gag order, that Judge Stuart could have undertaken to ensure Simants right to a fair trial, Justice Burger wrote. Some of those measures included moving the trial, delaying the trial, sequestering jurors, or instructing jurors to only consider facts presented in the courtroom. If a judge wants to use prior restraint they should be able to demonstrate three things: the extent of the media coverage, a lack of any other means of ensuring a fair trial, and that a gag-order would be effective, the Court found. Justice Burger added that by restraining the press, the gag order had allowed rumors and gossip to flourish in the small community. Those rumors, he wrote, could have been more damaging to Simants trial than the press reports themselves. Impact In Nebraska Press Association v. Stuart, the Supreme Court upheld the importance of the freedom of the press. Though not a complete ban on prior restraint, the Court set a high bar, severely restricting the situations in which a gag order could be issued. This ensured that reporters and editors faced fewer pre-trial restrictions on publishing court-related material. Sources Nebraska Press Assn. v. Stuart, 427 U.S. 539 (1976).Larson, Milton R, and John P Murphy. â€Å"Nebraska Press Association v. Stuart - A Prosecutor s View of Pre-Trial Restraints on the Press.†Ã‚  DePaul Law Review, vol. 26, no. 3, 1977, pp. 417–446., https://via.library.depaul.edu/cgi/viewcontent.cgi?refererhttps://www.google.com/httpsredir1article2592contextlaw-review.Hudson, David L. â€Å"Supreme Court Said No to Prior Restraints on Press 25 Years Ago.†Ã‚  Freedom Forum Institute, 28 Aug. 2001, https://www.freedomforuminstitute.org/2001/08/28/supreme-court-said-no-to-prior-restraints-on-press-25-years-ago/.