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UK Surgeons take step towards euthanasia - New guidelines for surgeons mean the profession is one step closer to sanctioning euthanasia. The Senate of Surgery of Great Britain and Ireland says that if a brain-damaged patient will live a "demonstrably awful life" then the surgeon has the moral right not to prevent death. But it also says that the final decision should only be taken by the consultant in charge. BBC News 12/9/97

How to Be a Patient - Being a patient in a hospital is not what it used to be. No more lying back, being cared for, leaving the driving to others. Along with fundamental changes in hospitals, doctors' offices and the organizational structure of medical care, it seems that patients too are expected to change. They have new roles and new responsibilities. (Book Review) Washington Post 12/9/97

Preserve and protect patient privacy - Early a decade ago, Congress passed the "Video Privacy Protection Act of 1988." That law covers individuals whose video rental records are at issue, and requires a warrant, a grand jury subpoena or a court order establishing probable cause and formal notice to the individual to obtain such information. It would seem logical that an individual's medical records would receive at least as much protection from law enforcement agencies, but such is not the case. (Editorial) American Medical News 12/8/97

Waiting to inhale: hemp for health? - Since Proposition 215 legalized marijuana as medicine in California, as many as 1,200 people have flocked daily to just one of the seven buyers’ clubs in the Bay Area. There, they can purchase pot to “treat” conditions from headaches to AIDS. Yet the question remains: Does basic scientific evidence support the use of hemp for better health? (Includes additional articles and slide show) MSNBC 12/8/97

Worried patients - As a patient, I have not encountered any truly coldhearted clinicians. Most, in fact, are kind and supportive. Nonetheless, it's reassuring to learn that more and more medical schools are trying to teach their students to be sensitive to patients' anxieties and limited knowledge of health matters. Among other instructional methods, they videotape the fledgling doctors meeting with patients and then conduct reviews of their interview and examination techniques, with a view to taking the rough edges off such encounters. The Lancet 12/6/97

Top AMA official resigns amid flap - The chief executive officer of the American Medical Association resigned Thursday amid controversy over whether the largest U.S. doctors group should endorse commercial products in return for a share in their revenue. P. John Seward, the AMA’s CEO and executive vice president, said a contract the group had entered into with Sunbeam Corp. last summer was a “serious mistake” for which he accepted responsibility. MSNBC 12/6/97

Patients Need To Know Doc's Mistakes - Doctors have an ethical obligation to tell their patients about significant mistakes they have made, policy experts said this week. Currently, doctors admit they have made mistakes only about 25% of the time, according to the study published in the Journal of General Internal Medicine. Reuters 12/5/97

Patients' Rights, Patients' Responsibilities - While the main focus of the president's health care "Bill of Rights" is on the obligations of health plans to patients, the inclusion of consumer responsibilities signals a broader change in the culture of medicine. Patients are no longer seen as passive recipients of physician expertise. They are expected to be active participants in every aspect of their care from picking a health plan to deciding on a particular treatment. Washington Post 12/2/97

Demand for organ donors far outstrips supply - Josh Stixrood, 23, couldn't resist a chance to test the '67 Mustang he had rebuilt practically from scratch. A few days before Christmas last year, with his 20-year-old sister Chelsea in the passenger seat, he raced two friends down Texas 5 north of Dallas. The car spun out of control, hit a bridge and plunged into Wilson Creek. Their friends dived into the frigid water and struggled to hold Chelsea's head up until paramedics arrived and flew her to Methodist Medical Center in Dallas. It was too late for Josh. Houston Chronicle 12/1/97

Médecins Sans Frontières faces new challenges - The international president of Médecins Sans Frontières, Doris Schopper, tells Hilary Bower that she wants her organisation to have a louder voice in humanitarian issues. She hopes to do this without losing the spontaneity, individual commitment, and creativity of MSF. British Medical Journal 11/29/97

Medical care in Iraq after six years of sanctions - In April 1996 we visited Iraq to assess medical care services six years after the United Nations imposed economic sanctions. We visited a range of hospitals and health centres, which included 20% of Iraq's civilian institutional beds, in all regions of the country, except the Kurdish Autonomous Region. British Medical Journal 11/29/97

Humanitarian action: the duty of all doctors - Many doctors are not active in promoting social reform, but should they be? Every doctor knows that those who live on the margins of our world - those who are poor, vulnerable, elderly, addicted, insane, imprisoned, unemployed, discriminated against, tortured, homeless, condemned, caught up in wars - have higher rates of sickness and ill health. Doctors should be paying great attention to those people, but too often, like everyone else, they neglect them. British Medical Journal 11/29/97

Doctoring: The Nature of Primary Care Medicine - It is Eric J. Cassell's impassioned thesis that the patient -- the person, sick or well -- has been pushed to the margins of 20th-century medicine by a cardinal and emblematic error, "the belief that medicine involves the application of impersonal facts to an objective problem that can be seen separately from the person who has it." In this distorted view, he argues, diseases are categorical objects, not processes, and patients are simply containers of pathologic processes, their bodies a mechanism gone wrong.(Book Review) New England Journal of Medicine 11/27/97

First, Do No Harm (Pending Prior Approval) - A discussion between Hippocrates and an HMO executive. (Opinion) New England Journal of Medicine 11/27/97

Probe P&G tie, AMA panel urged - A consumer group Tuesday called on a business ethics task force from the American Medical Association to investigate whether the doctors group endorsed a controversial fat substitute in exchange for an $800,000 fee. Chicago Sun-Times 11/26/97

Demand for Organs Fosters Aggressive Collection Methods: In D.C., Consent Not Required Before Transplant Preparation - When a gas pipe exploded at an Arlington construction site on Nov. 4, Juan Mancia took the brunt of the blast. The 20-year-old's heart stopped while he was being helicoptered to Washington Hospital Center, where he was declared dead upon arrival at 11:36 that morning. At that moment, Mancia crossed the line from patient to potential organ donor. And at that moment, because of an unusual and controversial District law, surgeons converged on Mancia -- a man who had never consented to organ donation -- and started to prepare his kidneys for transplantation Washington Post 11/24/97

Iowa Septuplets Multiply Critics of Fertility Therapy - The unprecedented birth of septuplets in Iowa sparked intense criticism from ethicists and doctors yesterday, with several warning that fertility treatments are being used indiscriminately and irresponsibly at great medical risk to women and their offspring and at growing expense to the general public. Washington Post 11/21/97

The Social Missions of Academic Health Centers - Academic health centers provide two distinct kinds of goods and services: those that can be effectively and efficiently provided and distributed in private markets and those that cannot. Because they provide health care goods and services for which private markets exist, critics sometimes advocate forcing them to compete on the basis of price and quality, just like any other private provider of health care services, educational products, or research-based goods and services. New England Journal of Medicine 11/20/97

CalPERS Calls on Doctors and Hospitals for More Humane Care for the Dying - Saying the wishes of dying patients are sometimes ignored, the California Public Employees' Retirement System (CalPERS) is calling on doctors, hospitals and health plans for more compassionate and humane care for the terminally ill. Business Wire 11/20/97

Clinton seeks enactment of 'bill of rights' for patients - President Clinton is calling on Congress to implement a consumer "bill of rights" that promises new protections to help patients navigate a changing health-care system of tighter cost controls and less doctor choice. AP/Nando Times 11/20/97

Doctors to face rating by AMA - In the future, doctors may come with a seal of approval-from the American Medical Association. The AMA is launching a nationwide accreditation program, starting in New Jersey, and plans to evaluate physicians’ training, skills, performance and ethics and advise them on how to improve. But the plan has many skeptics. MSNBC/AP 11/20/97

EDITORIAL: Mohammed Jarawish's noble act - "My son is dead ... I don't care to whom his organs go if it will save lives." So said Mohammed Jarawish, the Palestinian father of a seven-year-old boy who died after being shot in the head by a rubber bullet fired by an IDF soldier repelling stonethrowers. The decision of Ali Jarawish's parents to donate his organs to anyone who needed them, Jew or Arab, was a refreshing act of humanity which now may save the lives of three Israeli-Arab children. Jerusalem Post 11/17/97

Third World Must Not Be Deprived Of The Most Advanced Medical Treatments Against AIDS, UNESCO Director-General Declares UNESCO 11/17/97

Paired-Kideny Exchange Programs - The International Forum for Transplant Ethics strongly supports paired kidney exchange, as proposed by Ross et al. (June 12 issue). It is ethically acceptable and would allow more living-donor kidneys to be transplanted. There are countries, however (such as the United Kingdom), where such a program would require a change in the law, as the following case illustrates. New England Journal of Medicine 10/6/97

Suicidal Tendencies: Will the Disabled Fall Victim to the Right to Die? - A majority of Americans, according to a recent Gallup poll, believe that doctor-assisted suicide should be legalized to ensure that everyone has the right to a dignified death. But members of Not Dead Yet, a coalition of disabled people, beg to differ. Utne Reader 5/24/97

What Should a Doctor Do?: When a patient's religious beliefs conflict with her medical needs - One day two Octobers ago, an anxious middle-aged woman walked into neurosurgeon Fraser Henderson's office at Georgetown University Medical Center in Washington, D.C. "Can I talk to you about my daughter?" she asked. Three weeks before, the 15-year-old girl had been paralyzed below the neck -- her spine horribly shattered -- in a car collision. Hospitalized elsewhere, the girl needed surgery to repair her spine, but the doctors had not acted. One reason soon became clear. The girl refused to allow blood transfusions during surgery because of her religious beliefs as a Jehovah's Witness. Medscape Aug 97

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Article	Source	Date
UK Surgeons take step towards euthanasia - New guidelines for surgeons mean the profession is one step closer to sanctioning euthanasia. The Senate of Surgery of Great Britain and Ireland says that if a brain-damaged patient will live a "demonstrably awful life" then the surgeon has the moral right not to prevent death. But it also says that the final decision should only be taken by the consultant in charge.	BBC News	12/9/97
How to Be a Patient - Being a patient in a hospital is not what it used to be. No more lying back, being cared for, leaving the driving to others. Along with fundamental changes in hospitals, doctors' offices and the organizational structure of medical care, it seems that patients too are expected to change. They have new roles and new responsibilities. (Book Review)	Washington Post	12/9/97
Preserve and protect patient privacy - Early a decade ago, Congress passed the "Video Privacy Protection Act of 1988." That law covers individuals whose video rental records are at issue, and requires a warrant, a grand jury subpoena or a court order establishing probable cause and formal notice to the individual to obtain such information. It would seem logical that an individual's medical records would receive at least as much protection from law enforcement agencies, but such is not the case. (Editorial)	American Medical News	12/8/97
Waiting to inhale: hemp for health? - Since Proposition 215 legalized marijuana as medicine in California, as many as 1,200 people have flocked daily to just one of the seven buyers’ clubs in the Bay Area. There, they can purchase pot to “treat” conditions from headaches to AIDS. Yet the question remains: Does basic scientific evidence support the use of hemp for better health? (Includes additional articles and slide show)	MSNBC	12/8/97
Worried patients - As a patient, I have not encountered any truly coldhearted clinicians. Most, in fact, are kind and supportive. Nonetheless, it's reassuring to learn that more and more medical schools are trying to teach their students to be sensitive to patients' anxieties and limited knowledge of health matters. Among other instructional methods, they videotape the fledgling doctors meeting with patients and then conduct reviews of their interview and examination techniques, with a view to taking the rough edges off such encounters.	The Lancet	12/6/97
Top AMA official resigns amid flap - The chief executive officer of the American Medical Association resigned Thursday amid controversy over whether the largest U.S. doctors group should endorse commercial products in return for a share in their revenue. P. John Seward, the AMA’s CEO and executive vice president, said a contract the group had entered into with Sunbeam Corp. last summer was a “serious mistake” for which he accepted responsibility.	MSNBC	12/6/97
Patients Need To Know Doc's Mistakes - Doctors have an ethical obligation to tell their patients about significant mistakes they have made, policy experts said this week. Currently, doctors admit they have made mistakes only about 25% of the time, according to the study published in the Journal of General Internal Medicine.	Reuters	12/5/97
Patients' Rights, Patients' Responsibilities - While the main focus of the president's health care "Bill of Rights" is on the obligations of health plans to patients, the inclusion of consumer responsibilities signals a broader change in the culture of medicine. Patients are no longer seen as passive recipients of physician expertise. They are expected to be active participants in every aspect of their care from picking a health plan to deciding on a particular treatment.	Washington Post	12/2/97
Demand for organ donors far outstrips supply - Josh Stixrood, 23, couldn't resist a chance to test the '67 Mustang he had rebuilt practically from scratch. A few days before Christmas last year, with his 20-year-old sister Chelsea in the passenger seat, he raced two friends down Texas 5 north of Dallas. The car spun out of control, hit a bridge and plunged into Wilson Creek. Their friends dived into the frigid water and struggled to hold Chelsea's head up until paramedics arrived and flew her to Methodist Medical Center in Dallas. It was too late for Josh.	Houston Chronicle	12/1/97
Médecins Sans Frontières faces new challenges - The international president of Médecins Sans Frontières, Doris Schopper, tells Hilary Bower that she wants her organisation to have a louder voice in humanitarian issues. She hopes to do this without losing the spontaneity, individual commitment, and creativity of MSF.	British Medical Journal	11/29/97
Medical care in Iraq after six years of sanctions - In April 1996 we visited Iraq to assess medical care services six years after the United Nations imposed economic sanctions. We visited a range of hospitals and health centres, which included 20% of Iraq's civilian institutional beds, in all regions of the country, except the Kurdish Autonomous Region.	British Medical Journal	11/29/97
Humanitarian action: the duty of all doctors - Many doctors are not active in promoting social reform, but should they be? Every doctor knows that those who live on the margins of our world - those who are poor, vulnerable, elderly, addicted, insane, imprisoned, unemployed, discriminated against, tortured, homeless, condemned, caught up in wars - have higher rates of sickness and ill health. Doctors should be paying great attention to those people, but too often, like everyone else, they neglect them.	British Medical Journal	11/29/97
Doctoring: The Nature of Primary Care Medicine - It is Eric J. Cassell's impassioned thesis that the patient -- the person, sick or well -- has been pushed to the margins of 20th-century medicine by a cardinal and emblematic error, "the belief that medicine involves the application of impersonal facts to an objective problem that can be seen separately from the person who has it." In this distorted view, he argues, diseases are categorical objects, not processes, and patients are simply containers of pathologic processes, their bodies a mechanism gone wrong.(Book Review)	New England Journal of Medicine	11/27/97
First, Do No Harm (Pending Prior Approval) - A discussion between Hippocrates and an HMO executive. (Opinion)	New England Journal of Medicine	11/27/97
Probe P&G tie, AMA panel urged - A consumer group Tuesday called on a business ethics task force from the American Medical Association to investigate whether the doctors group endorsed a controversial fat substitute in exchange for an $800,000 fee.	Chicago Sun-Times	11/26/97
Demand for Organs Fosters Aggressive Collection Methods: In D.C., Consent Not Required Before Transplant Preparation - When a gas pipe exploded at an Arlington construction site on Nov. 4, Juan Mancia took the brunt of the blast. The 20-year-old's heart stopped while he was being helicoptered to Washington Hospital Center, where he was declared dead upon arrival at 11:36 that morning. At that moment, Mancia crossed the line from patient to potential organ donor. And at that moment, because of an unusual and controversial District law, surgeons converged on Mancia -- a man who had never consented to organ donation -- and started to prepare his kidneys for transplantation	Washington Post	11/24/97
Iowa Septuplets Multiply Critics of Fertility Therapy - The unprecedented birth of septuplets in Iowa sparked intense criticism from ethicists and doctors yesterday, with several warning that fertility treatments are being used indiscriminately and irresponsibly at great medical risk to women and their offspring and at growing expense to the general public.	Washington Post	11/21/97
The Social Missions of Academic Health Centers - Academic health centers provide two distinct kinds of goods and services: those that can be effectively and efficiently provided and distributed in private markets and those that cannot. Because they provide health care goods and services for which private markets exist, critics sometimes advocate forcing them to compete on the basis of price and quality, just like any other private provider of health care services, educational products, or research-based goods and services.	New England Journal of Medicine	11/20/97
CalPERS Calls on Doctors and Hospitals for More Humane Care for the Dying - Saying the wishes of dying patients are sometimes ignored, the California Public Employees' Retirement System (CalPERS) is calling on doctors, hospitals and health plans for more compassionate and humane care for the terminally ill.	Business Wire	11/20/97
Clinton seeks enactment of 'bill of rights' for patients - President Clinton is calling on Congress to implement a consumer "bill of rights" that promises new protections to help patients navigate a changing health-care system of tighter cost controls and less doctor choice.	AP/Nando Times	11/20/97
Doctors to face rating by AMA - In the future, doctors may come with a seal of approval-from the American Medical Association. The AMA is launching a nationwide accreditation program, starting in New Jersey, and plans to evaluate physicians’ training, skills, performance and ethics and advise them on how to improve. But the plan has many skeptics.	MSNBC/AP	11/20/97
EDITORIAL: Mohammed Jarawish's noble act - "My son is dead ... I don't care to whom his organs go if it will save lives." So said Mohammed Jarawish, the Palestinian father of a seven-year-old boy who died after being shot in the head by a rubber bullet fired by an IDF soldier repelling stonethrowers. The decision of Ali Jarawish's parents to donate his organs to anyone who needed them, Jew or Arab, was a refreshing act of humanity which now may save the lives of three Israeli-Arab children.	Jerusalem Post	11/17/97
Third World Must Not Be Deprived Of The Most Advanced Medical Treatments Against AIDS, UNESCO Director-General Declares	UNESCO	11/17/97
Paired-Kideny Exchange Programs - The International Forum for Transplant Ethics strongly supports paired kidney exchange, as proposed by Ross et al. (June 12 issue). It is ethically acceptable and would allow more living-donor kidneys to be transplanted. There are countries, however (such as the United Kingdom), where such a program would require a change in the law, as the following case illustrates.	New England Journal of Medicine	10/6/97
Suicidal Tendencies: Will the Disabled Fall Victim to the Right to Die? - A majority of Americans, according to a recent Gallup poll, believe that doctor-assisted suicide should be legalized to ensure that everyone has the right to a dignified death. But members of Not Dead Yet, a coalition of disabled people, beg to differ.	Utne Reader	5/24/97
What Should a Doctor Do?: When a patient's religious beliefs conflict with her medical needs - One day two Octobers ago, an anxious middle-aged woman walked into neurosurgeon Fraser Henderson's office at Georgetown University Medical Center in Washington, D.C. "Can I talk to you about my daughter?" she asked. Three weeks before, the 15-year-old girl had been paralyzed below the neck -- her spine horribly shattered -- in a car collision. Hospitalized elsewhere, the girl needed surgery to repair her spine, but the doctors had not acted. One reason soon became clear. The girl refused to allow blood transfusions during surgery because of her religious beliefs as a Jehovah's Witness.	Medscape	Aug 97