Effect of Calpain-calpastatin System in Meat Tenderness

Effect of Calpain-calpastatin System in Meat Tenderness 1.0 Introduction Meat quality is the freshness of the meat. This is the most crucial things which supplier always find and think in order to fulfill the high demand from the customer. This shows researcher play an important role in increasing the quality of meat because of the high demand from the wholesalers or consumer. The critical point of appraisal of meat quality occurs when the consumer eats the products and they comment on the colour, nutritional value, and price determines the decision to repurchase (Boleman et al., 1997).In addition, consumer evaluation of eating quality is the most determination of meat quality as tenderness, juiciness and flavor of meat are the most important elements (Tarrant, 1998; Bindon Jones, 2001). The variability in tenderness cause by a lot of factors before post mortem, like the feeding types and the environment (French et al., 2001) and after post-mortem, like temperature, pH, sarcomere length and proteolysis (Charlotte Maltin et al., 2003). In this study it focusing majorly on the role of genetic traits which play an important function in order to get the high quality of meat (Williams, 2008). Interest of this study is to identify the relationship between the microsatellite repetition and the calpastatin type1 promoter region effects in meat tenderness. In mid 1980s (Mullis Faloona, 1987; Saiki et al., 1985) as the advent of Polymerase Chain Reaction(PCR), microsatellites were detected in eukaryotes genome and they are the most promising PCR-based markers. Microsatellites are simple sequence tandem repeats (SSTRs) of variable length that distributed throughout the eukaryotic nuclear genome in both coding and non-coding region (Jarne Lagoda, 1996). This can be amplify and identify by the PCR method (Sunnucks, 2000, Strassmann et., 1996, Shriver et., 1995). Due to the high mutation rate of microsatellites, they are potentially the most informative marker with advantages of easy and low-cost detection. Thus, the microsat ellites repeat in calpastatin can influence the tenderness of meat because of the different types can produce with different role. The aim of this findings is to characterise the expression of microsatellite repeat in calpastatin type I promoter region in bovine, to identify the  regulation of CAST gene inhibitory calpain system in affecting the tenderization of meat and to develop a mechanism that can control the calpastatin gene in maintaining the tenderization of meat. 2.0 Literature review 2.1 Meat Quality and consumer perception Meat quality is a term used to describe a range of attributes of meat. Those factors such as post mortem factors, pH, temperature, proteolysis, sarcomere length, and the most important elements is tenderness and juiciness that affect the consumer to repurchase the meat (Warris, 2000). Besides that, meat quality also determine by color, flavor and texture which influence the consumer to enjoy the meat product (Glitsch, 2000). However, the main cause of failure of consumer complain to repurchase is the variability in eating quality, especially in tenderness. Some of the consumer that has more knowledge will concern on the safety of consuming meat. They will think of the health implication like the composition of the polyunsaturated fat and saturated fat, and the microbial contamination especially during handling the meat products. According to the statistical of meat consumption in Ninth Malaysian Plan, the Malaysian government targets to increase the production of beef in order to reduce the import dependence. As per capita consumption which 0.5 kg in 2003 of mutton is very low, more attention is paid to the beef market which increased from 2.3 kg to 5.8 kg (FAO, 2007). Due to the high demand, the qualities of meat need to be increased in order to make sure consumer will repurchase. Anderson and Ferguson (2001) emphasize that quality as the top priority in making decision to buy and consume more meat. Similarly , factors that effect the consumer to repurchase red meat other than economic one is meat quality (Taljaard et al., 2006). 2.2 Tenderness Tenderness is a primary factor that influencing the consumers reaction (Glitsch, 2000).Tenderness is an integrated textural property made up of mechanical, particulate and chemical components (Paerson and Young, 1989).The appreciation of tenderness when eating is not explained by the force required to cut through a piece of meat, but is affected by the way the muscle fibers breakdown and the release of juices and flavor while chewing. Several independent studies have identified a locus on bovine chromosomes 29 with affect on tenderness. The caplain1 (CAPN 1) gene that codes for a calcium dependent protease involved in meat tenderization post- mortem. According to the research Miller et al., 2001, meat tenderness (texture) is the most important organoleptic characteristics that influence the acceptability for consumer. Tenderness is the consequences of postmortem physicochemical and biochemical changes in muscle of myofibrillar. After slaughtering, muscle is extensible and elastic until the onset of the rigor mortis, when the energy for muscle relaxation is depleted (Alberle et al., 2001). 2.3 Tenderization phase 2.3.1 Pre-rigor phase The duration of pre-rigor phase is dependent on the animal species. After the slaughtering of animal, blood, oxygen and nutrient supply are cut to the muscle and these triggers the pre-rigor phase to start (Lawrie, 1998).For chicken is less than 0.5 to 1.0 h and for beef 4 to 6 h (Aberle et al., 2001). The muscle will becomes gradually stiff and its tension reaches maximum on the completion of rigor. This is due to the formation of an irreversible actomysin complex in muscle which lead to the shorten sarcomere length. This will cause the toughening of muscle at the beginning of the post-mortem process (Koohmaraie et al., 1996). 2.3.2 Rigor phase At this phase, muscles maintain the homeostasis by metabolize muscle glycogen by aerobic glycolysis. Thus, it will continue supply of ATP. During this phase, the depletion of ATP will increase the concentration of calcium ion in sarcoplasma. Sarcoplasma reticulum functioning in removing of calcium ion across the membrane utilizing the calcium ATPase pump and dependent on ATP for this active process (Robbins et al., 2003). In the meat process, anaerobic glycosis is take place in order to maintain the production of ATP. From this the lactic acid will produced and decrease in pH value and lead to the depletion of creatine phosphate because of lack of ATP. Thus, the availability of substrate required to maintain the contractile proteins actin or myosin in relaxation state. The irreversible cross bridge and rigor mortis occur because of actin and myosin and these will made the muscle reaches to the maximum toughness as the consequences of shortening the sarcomere length (Goll et al., 1995 ). 2.3.3 Post-rigor phase In the post-rigor, the proteolytic enzyme system are responsible in continuing the tenderness (Kemp et al., 2010; Koohmaraie et al., 1996). This phase started about 24 hours to 14 days of meat storage. The rate change is variable due to the proteolytic degradation of myofibrillar and cytoskeletal proteins cause the loss of structural integrity of myofibrils which enhancing the meat tenderization (Koohmaraie et al., 1996). The calpain/calpastatin(calcium-dependent), proteosomal and lysosomal systems have been extensively investigated for their involvement in post-rigor proteolytic degradation and meat tenderization (Kemp et al., 2010; Koohmaraie et al., 1996). 2.4 Factors that affect the meat tenderness 2.4.1 Muscle pH After the bovine is being slaughter, they need to maintain their homeostasis. So, the muscle will undergoes anaerobic respiration and regenerate the production of ATP by aerobic respiration. The amount of ATP produced is less than normal. During anaerobic, the glycogen is metabolized into pyruvate and then converts into lactic acid. The lactic acid will gradually decrease the pH value of the muscle tissue (Maltin et al., 2003).This level of of pH will give varies effects on glycogen level, ATP turn over and the metabolic characteristic of muscle tissue (Lawrie, 1998). The high level of pH which is greater than 7.5 , typically dark and easy to bacteria to survive on it. This will shorten the shelf life of the meat and this bring to the variability if the tenderness as the low of glycogen substrate (Watanabe et al., 1996). 2.4.2 Temperature Temperature during the pre-rigor and post-rigor phase will affect on the metabolism of the muscle tissue of meat(Hertzman et al., 1993).Meat toughness will increase during the higher temperature (Bruce and Ball, 1990). The declination of muscle temperature will lead to the shortening of muscle. This is because of the reduced calcium sequestering ability by the sarcoplasmic reticulum as a result of the depletion of energy compounds which cause the muscle to contract and increase the toughness of meat (Huff Lonergan et al., 2010). There are a researched found that, at 15 Celsius is the best temperature for maintaining meat tenderization (Geesink et al., 2000). 2.4.3 Juiciness Juiciness is defined as the feeling in the mouth of moisture from cooking meat and chewing. The juiciness is closely related to the attribute of flavor as this latter attribute is also affected by the level of IMF in the meat. The high the intramuscular fat content (IMF) , the higher the meat quality (Kerry et al., 2002). 2.4.4 Proteolysis Proteolysis is a conversion of muscle to meat entrains changes in tenderness due to changes in the properties of muscle fibre and connective tissue. The steps are toughness increase into rigor, proceed with proteolysis and last the rigor is resolve. Proteolytic system is divided into four which, first, cathepsin-lysomal system second, ATP-dependent ubiquitin –proteasome system, third, calpain-calpastatin system and last is matrix Metalloproteinases (MMP) (Thompson and Palmer, 1998). Tenderization increasing during ageing and it is primarily a result of calpain-mediated degradation of myofibrillar and cytoskeleton proteins. Most of researcher doing the investigation on proteolytic system and the have a A1QWdebate on these. But most of the studies agreed that the calpain system has play the major role in post-mortem tenderization (Boehm et al., 1998; Koohmaraie.1992b; Taylor et al., 1995a). Proteolysis involve calpain occurs between 3-14 d post mortem when activity of  µ-calpain low ,  µ-calpain maybe bound to the myofibril and inactivated during post mortem storage but the m-calpain active when the level of calcium arise. Calpain is calcium-dependent which function in softening the muscle tissue of the meat. In proteolysis it involve the calpain proteases and caplain-specific inhibitor, calpastatin. When the low level of calpastatin produce, the more calpain protease produce .Then, the tenderness of meat will increase. 2.5 Microsatellite Microsatellites are simple sequence tandem repeats (SSTRs).The repeat units are generally di-, tri-, tetra- or pentanucleotides (Powell et al., 1996) .Like repetition in birds is ACn, where it`s means two nucleotides A and C are repeated in bead-like fashion a variable number of times. The n could be range from 8 to 50.This always occur on a non-coding region of DNA. On the each side of the repeat unit are flanking regions which consist of unordered DNA. This flanking region is dangerous because they will allow the development of locus-specific primers to amplify the microsatellites with PCR. By having a forward and reverse primer on each side of microsatellites it will be able to amplify a fairy short (100 to 500bp) locus-specific microsatellite region(Sunnucks, 2000, Strassmann et., 1996, Shriver et., 1995). Microsatellites were designed for generative neurology disease in human but it shows a great applicability in other species. Microsatellites act as markers was classified based on the number of bases like short repeats are microsatellites while longer repeats are minisatellites. Besides that, it also classified by the type of repeated sequence present whether it is perfect, imperfect or composite. Imperfect means the repeated sequence was interrupted by different nucleotides which are not repeated while composites when two or more different motifs in tandem (Selkoe Toonen, 2006).In addition, microsatellites is co-dominant and it is widely distributed throughout the genome and transferable between species. These features provide their successful function in these fields (Chistiakov et al., 2006). 2.5.1 Microsatellites mutation Microsatellites are useful genetics markers because they tend to be polymorphic. Normally, human microsatellites with 20 or more alleles ad heterozygosities. This is because their mutation occurs different from the â€Å"classical† point mutations, where the substitution of one nucleotide to another occurs. The mutation in microsatellites occur through slippage replication where two strands could slip relative position a bit but still manage to get the zipper going down the beads. One strand can be lengthened or shortened by the addition or excision of the nucleotides. So, the repeat unit can be one longer and the other is shorter than the original (Selkoe et., 2006). 2.6 Calpastatin Study of calpastatin gene promoter activity had been done by some of the researcher .Calpastatin is proteinase inhibitor for calpain which family of calcium-activated neutral proteases that regulate the of Ca2+. It is encoded by single gene in mammal which produces proteins isoforms through the alternating splicing, There are four types of CAST which are Type I, Type II, Type III has been characterized in porcine with the study of the three promoters directing expression(Parr et al., 2004) while in bovine calpastatin transcripts including Type IV had been characterized with the studied of four functional promoters in the gene (Raynaud et al., 2005).This four types of CAST can bind to the calpain and inhibit proteolytic activity. A single calpastatin can inhibit several caplain molecules in vitro. Several isoforms of calpastatin exist due to the alternative promoter usage and differential splicing (Parr et al., 2001; Raynaud etal., 2005).Increasing response on calpastatin expression to ß- adrenergic stimulation has been associated with skeletal muscle hypertrophy in livestock (Parr et al., 1992; Killefer and Koohmaraie, 1994) and related inversely with the tenderization rates(Koohmaraie, 1996). ß- adrenergic stimulation act by the cyclic adenosine monophosphate (cAMP) responsive elements in calpastatin promoter regions(Cong et al., 1998a, b).three types of promoters located in the 5 region of gene upstream of exons 1xa, 1xb, and 1u generate calpastatin mRNA transcripts the types I, II, and III respectively (Takano et al., 2000; Parr et al., 2004).In pig, these promoters have putative motifs for another transcription factors that will imply other signaling pathways of calpastatin expression(Parr et al., 2001; Raynaud etal., 2005). 2.6.1 The types of calpastatin genes From the previous studies, there were found calpasatin has four types of repetitive-inhibitor domains which are Type I, Type II, Type III and Type IV. The isolated cDNAs from the various mammalian species have conspicuous differences in the regions encoding the N-terminal sequences. These four different types has different function and from the different sources. The Type I and Type II in mouse and bovine respectively also differ from each other in the uttermost N-terminal sequences, possess longer domain L sequences than those of rabbit, pig and human inhibitors which are Type III.The previous obtained mouse calpastatin cDNA is encoded by as many as 31 exons including the first exon. The other three additional exons specifying the N-terminal sequences of the types were identified in the mouse genomic DNA sequence. The mRNAs for Type I and Type III were expressed in the liver, the Type II high in heart and skeletal muscle .Besides , the Type IV abundance in testis. These findings sho w that the calpastatin isoforms possessing different N-terminal sequences are generated by the alternative transcription initiation from their own promoters and skipping of the mutually exclusive exons (Takano et al., 2000). Cong et al. (1998), reported cAMP-dependent transactivation of the bovine calpastatin gene whose promoter located on the upstream of exon .They identified a sequence GTCA which was important for the cAMP responsiveness and corresponded to the half site of the full CRE(a consensus palindromic cAMP-responsive cis-element; TGACGTCA).They demonstrated that mutation of GTCA at -76 nt to ATCT completely abolished the dibutyryl-cAMP .Comparison of the nucleotide sequences of the mouse and bovine genomic DNAs did not show a high similarity but little similar sequence GTGCGGTGTCAGCCGG (identical residues are underlined) containing GTCA was found. The differential expression patterns of the type I, II, III mRNAs among different animal suggests that the presence of different transcriptional regulatory elements upstream of the respective promoters. Besides that, the differences in N-terminal sequences might affect the intracellular distribution of the action calpain-calpastatin system in stimula tion of meat tenderness (Takano et al., 1999). 2.7 Calpain Calpain were intracellular calcium-dependent cysteine proteinases which present in all mammalian(Goll et al., 2003; Sorimachi et al., 2001).In catalysing the limited proteolysis of cytoskeletal and membrane protein , the calpain were play a big role.This regulation occur with help of specific protein inhibitor calpastatin.In striated muscle, the calpain/calpastatin system has been proved in regulation protein turnover especially in meat texture development (Sensky et al., 2001). 2.8 The effect of calpain-calpastatin system in meat tenderness The calpain and calpastatin proteolytic enzyme system is believed to be the main contributor to the tenderness of meat at post mortem.The present of calpastatin in meat influence the calpain by acting as inhibitor. Calpastatin is a marker in order to determine the tenderness of meat. The researcher found the activity of the calpastatin in meat at 24 hours was highly related to shear force value after 14th day after post mortem. It showed that an early event after the animal being slaughter could be predictive of ultimate shear force because of the low activity of calpastatin (Whipple et al., 1990). The findings was repeated in pork. The higher level of calpastatin after 2 hours of post mortem is increasing the toughness (parr et al., 1999).We can conclude that the activity of calpastatin was responsible in variation of tenderness of meat by the differences in proteolytic rate of the animals. A more complex study is performed by the Shackleford et al.(1994) that correlate between both calpastatin level and meat toughness and the possibility of using these for selection purposed to improve the meat quality.

Mary Shelley

Why it is a Classic Mary Shelley was one of the most famous and greatest writers of the early 1800s. She wrote many great novels and short stories that could be considered classics, such as Frankenstein and â€Å"The Invisible Girl†. A classic is not just any average novel or short story; to be a classic it must have good use of literary elements, along with a new and different idea for a plot. Mary Shelley uses literary elements in a special way that makes her a classic writer. There are many great pieces of classic writing by Mary Shelley.Frankenstein, one of her best works, is a classic, because she uses suspense, psychological aspects, and tone to create a masterpiece. One of the many things that sets Frankenstein and Mary Shelley apart from others; is her excellent ability to create a mood. In Frankenstein she creates a mysterious and suspenseful mood that really captures the reader’s attention. In the novel Victor says â€Å"It was already one in the morning; the rain pattered dismally against the panes, and my candle was nearly burnt out, when, by the glimmer of the half-extinguished light, I saw the dull yellow eye of the creature open;†(Ch. ,pg 41) this quote from the novel creates a scary and intense mood. Not only does Mary Shelley show her ability to create a mood in Frankenstein, but also in the short story â€Å"The Invisible Girl†. The excellent ability of Mary Shelley to create a mood, in a story or novel is one of the many things that make Frankenstein a classic novel. Mary Shelley also uses suspense and foreshadowing in her writings to keep the reader involved. The monster in Frankenstein tells Victor â€Å"I shall be with you on your wedding-night. †(Ch. 20); this is a great example of foreshadowing.When the monster tells Victor this, it becomes obvious that something bad is going to happen and it keeps the reader guessing what it will be, while sending a shiver of terror through their body. Mary Shelley use s the element of suspense a lot in the novel Frankenstein; the reader will always be wandering who will be the monsters next victim and how Victor will react. The use of foreshadowing and suspense in Frankenstein are two things that make it a classic. Frankenstein is also a very unique story and has some psychological aspects to it.The plot of the novel seems to be ahead of its time, it could be called one of the first science fiction novels. Mary Shelley’s idea of someone creating life was very unique for the 1800’s time period. Plots that involved science fiction did not seem to be as popular until technology became more modern; but this is one of the things that make Frankenstein a classic, it was ahead of its time. Frankenstein is also a psychological novel in some ways. It can show the reader that there can be a monster in anyone, although it does not have to be a physical monster.Although Victor is not physically a monster, he becomes a monster mentally; he becom es insane and enraged by the monster that killed his friends and family. The psychological aspects and how unique Frankenstein is, are reasons why it is a classic. There are many elements about Frankenstein that make it one of the best classic novels of all time. Mary Shelley was a master of using literary elements to create a classic. Not just anyone can write a classic novel; it must be something different and skillfully written.She did a wonderful job of creating suspense using foreshadowing throughout the novel. Also one of the biggest things that make this novel a classic is how unique and ahead of its time it was during the 1800s. Frankenstein will be one of the best classic novels for many years to come. ? Works Cited Merriman, C. D. â€Å"Mary Wollstonecraft Shelley. † – Biography and Works. Search Texts, Read Online. Discuss. Jalic Inc. , 2006. Web. 8 May 2012. . Mould, Chris, and Mary Wollstonecraft Shelley. Frankenstein. Oxford: Oxford UP, 1997. Print.

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Exercise and Diet Needed to Lose Weight Essay - 713 Words

Losing weight comes down to burning more calories than your body uses on a daily basis. This caloric deficit can be accumulated through dieting and exercising. The latter should include cardiovascular exercise, which in addition to burning calories, also reduces your risk of health conditions, such as high blood pressure and osteoporosis, and improves your heart health, mood and stamina. (See References 1) For quick weight loss, incorporate small adjustments that can optimize your cardio routine. General Cardio Recommendation The American Heart Association favors 30 to 60 minutes of moderate cardio on most days to lose weight. (See References 2) By completing the full range of motion of the exercise of your choice. you can get the most†¦show more content†¦For instance, walk briskly on a treadmill for 15 minutes, then use an elliptical for 15 minutes, and follow this with 15 minutes on a stair climber. The exercise variety prevents overuse injuries and boredom, which is essential if you want to stick to your workout routine. Multi-Beneficial Circuit Training Although circuit training is often associated with strength training due to its muscle-stimulating benefit, it also has a cardiovascular benefit that promotes caloric burn and weight loss. During circuit training you cycle between various strength-training exercises with minimal rest between the sets. By incorporating cardio into your routine, your heart rate stays elevated and you burn more calories. For instance, perform a set of bench presses followed by jumping jacks, then do a set of lunges and crunches, followed by one minute of jumping rope, a set of squats, pushups, and butt kickers. The ACE recommends cycling through circuits up to three times, and performing circuit training two to three times a week. Things to Consider In addition to cardio, strength training on at least two days of the week, and a reduced-calorie diet, can optimize your weight loss. Strength training helps preserve muscle tissue, which burns more calories than fat and boosts your resting metabolism. (See References 7) Always perform a five to 10-minute, low-intense cardio warm up before yourShow MoreRelatedTaking a Look at the Tapeworm Diet853 Words   |  3 PagesIndividuals seeking to lose weight are constantly confronted with a variety of diets, supplements, and weight-loss products to choose from. The tapeworm diet is a quick and significant way to lose weight. This method involves consuming parasites called tapeworms, which possibly can cause a person to become seriously ill and can even lead to fatal complications. 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Consent forms Free Essays

Although many people may think that signing a consent form is crazy, but there are many different think that people may hear about signing consent forms such as; you have to pay for the form, there are a lot of questions on the form, and they are not real at all. The real question we should all ask ourselves is that. Should informed consent be limited in certain situation? I’m about to give you some good reasons why we should sign consent forms at the doctor’s office and the hospital. We will write a custom essay sample on Consent forms or any similar topic only for you Order Now For example, while reading he book about Henrietta Lacks gave me a different outlook on what really goes on in the doctor’s office and the hospital, and we all need to watch out and read everything that we get from the hospital and doctors. Now if Henrietta got consent form she would have read that paper before she signed it and then the doctor’s would have never took her cells Just to run some test on them without her knowing, and that is where the consent form comes in at. As though many of us do not read everything that is on that form and the entire only thing that we do see on the paper is ignature and date, but we really need to read the whole thing before we go and sign a form and we have no idea what they will do without cells Just like Henrietta. One of the quotas that stand out to me in â€Å"Transparency: informed consent in primary care (Hoard Brody)†, and I feel that this quote was a good one because it gets right to the point about signing consent forms: Physicians may also view informed consent as an empty charade, since they are confident in their abilities to manipulate consent by how they discuss or divulge information (Brody par 4). While reading this quote had e thinking about a lot of thing that we may not know about these consent forms because our doctors do not really tells us about them, yet the only thing they do is give it to us so that we can read it and sign the paper. However many of us may have a lot of questions that about signing a consent form at the doctor’s office and we may not think that it is very important to sign and most of us do not want to sign that paper and they doctors may do something to you cells, and you did not sign that paper the only person that you can be upset with is yourself because you did not ead that consent form all of the way, but the one that you was ready to do is not sign that paper and Just walk out the doctor’s office. Another quote that I thought that Howard Brody wrote about in his article was: Some positive side-effects of this might be more focus on good diagnostic and therapeutic decision making on the physician’s part, since it will be understood that the patient will be made aware of what the physician’s reasoning process has been like, and better documentation of management decisions in the patient record (Brody middle of par 18). The speed of edical research together with drug companies race to create products has overtaken the system designed to keep people safe (Robert Davis par 2). While reading this quote from â€Å"U. S. : Human Medical Test Lack Oversight (Robert Davis)†, I feel that we should get a better understanding of the medical, and consent forms because if we don’t read and understand something then we will signing something tor someone to take without us knowing. In conclusion many people may not understand why we should sign a consent form Just in the case something may happen to us while we are at the doctor’s office or in the hospital. While reading these articles and the Henrietta Lacks book made me realize that signing a consent form is important because you do not give the doctors the rights to take anything from you that they did not ask for, but back in the day they could Just take anything that didn’t belong to them; however, now you have to ask that patience if you can, but most of the time they will say no. How to cite Consent forms, Papers

Medical Ethics Rescue Principle

Question: Describe about the Medical Ethics for Rescue Principle. Answer: 1. Rescue principle has two connected parts. The first part explains that life and death are important above everything. The second part highlights though society has an unequal distribution of wealth; every individual must provide with the equal health care facilities. The principle helps to understand the pain of human in the context of life and death. But the principle has done more harm to the standard of health-care as it fails to explain about the spending of society. In prudence insurance ideal the insurance company paid an amount of money for the health care service brought by patient and doctor. The insurance money is subsidized by the government. In this case, the patient paid the actual cost indirectly by the expense on other materials and services. 2. If the physicians find the situation is less complicated, then they did not inform the patient but in the case of higher risks they informed the patient for better collaboration. To avoid the depression feeling of the patient, the physicians do not use the cancer word. The physicians have suggested informing the patient about the complicacy of the situation by tittering the risk level measured by research. The consent of the patient about the research is very low, and it is a legal duty of the physicians to disclose the detailed information to the patient for participating in the research. For the research purpose, the physicians are not allowed to override the rights and immunities of the patient. 3. The patient has a malignancy in one of her breasts, and she has two choices with an equal rate of surviving by mastectomy or by radiation with minimal surgery. The physicians explained the nature of both operations and the patient chose the breast preservation process. And this model is superior because the patient should decide the process suitable for her welfare. Jehovah's Witnesses of prohibition blood transfusion not support the medical treatment and suggests that faith will cure the ailment. But the consent model allows the patient to know about the medication process applied to him/her. The model also makes the patient aware of the danger of refusing a blood transfusion. 4. The physicians have no control over the coercing party. Mrs. R must contend with her pain in the abdominal region which is very common in the case of appendicitis. Mrs. R has to decide whether to perform an appendectomy or not. But the patient decision is controlled by negative arguments on which the physicians have no control. The physicians must proceed with the ECT as Mrs. R's consent is not invalid. Furthermore, the decision of the patient to undergo surgery originates from the pain in appendix then it is morally justified for the physician. But if the coercion of family members is supported by the physician then it is not justified. 5. The decision making the capacity of the patient depends upon the choice between appropriate treatment option and understanding the relevant information provided by the physicians which include the current status of patient and complication of the medication process. It is necessary that the patient should have their view of the medical condition and consequences. They must provide relevant reasons for the treatment option they have chosen. 6. Death is not at all bad because people remain in a long state of unconsciousness, and it is impossible to imagine that state. It is not very easy to say when an individual will suffer death. Death is considered as bad due to it remove the desirability of life. The moment a person died then, the person do not exist anymore. If a brain injury reduces a man's mental health to that of an infant, then it will free the man from care. The intelligent person then will be considered as a subject of misfortune. People around the person pity on him but the person do not mind because he merely exists. 7. Active euthanasia associated with the dying of patient due to some other person. And when the patient died because of the inactivity of professionals then it termed as passive euthanasia. If a wounded soldier wants to extend his life although of his injury, then the other soldier must support the moral decision of letting die over killing. Charity attaches individuals for doing a favor to each others. Justice is associated with the positive service and the fact what men owe to each other. 8. When someone in the family seriously gets ill, and the entire family is suffering both mentally and economically then to relief them from suffering the patient have to choose the decision of death. The physician can help the process by assisting in a suicide and by not abandoning the patient at the death moment.