I am a golden god
I mean, I always thought so, but now it’s been confirmed by an outside source.
The American Society of Business Publication Editors‘ Midwest-South Region handed out its annual “Azbee” awards last night and I was a winner. One of my articles from last year — “Oregon still stands alone: Ten years of physician-assisted suicide” — won the gold award in the feature article category.
Here are the first few grafs of the story, which ran months before Washington became the second state to legalize doctor-aided dying:
It was 10 springs ago that a Portland woman in her mid-80s sat to talk about her impending death. Doctors guessed the metastatic breast cancer wracking her body would kill her within two months. As the city shook off its winter slumber, the woman — whose identity is still a secret — anticipated her eternal rest.
“I’m looking forward to it,” she said in a recording later made available to reporters. “I can’t see myself living a few more months like this.”
Disease set her on the path toward death, but the woman was determined to choose when and how to take her final steps. For that, she needed a doctor’s help.
On a Tuesday in 1998, in the presence of her family, she became the first patient to commit suicide with a physician’s aid under Oregon’s Death With Dignity Act.
A physician prescribed a lethal dose of barbiturates. The woman washed down a mixture of the medication and syrup with a glass of brandy and died shortly thereafter.
Whether the path chosen was a victory for patient autonomy or an ethical tragedy depends upon one’s view of this wrenching issue. But what is clear — and what comes as a surprise given the predictions of supporters and opponents of physician-assisted suicide — is that it is a path still lightly traveled.
Through the end of last year, only 340 more Oregonians had chosen physician-assisted suicide. And after a decade, Oregon still stands as the lone state to legalize the practice.
There is no tidal wave of patients moving to Oregon to die, and there is no evidence of a slippery slope toward involuntary euthanasia there, as opponents once feared. At the same time, there is no sign that many states will rush to follow Oregon’s lead on physician-assisted suicide, as supporters still hope.
Though Oregon’s law remains seldom used and unduplicated, its impact on physicians, patients and the movement to improve end-of-life care cannot be overstated.
The whole shebang.
FDA found lax in regulating medical devices
My lede:
The Food and Drug Administration is falling short in how stringently it evaluates medical devices before they are approved and how well it detects problems with the products once they hit the market, according to a Government Accountability Office report issued in June.
“These shortcomings … raise serious concerns about FDA’s regulation of medical devices,” concluded the GAO report.
The whole shebang.
When “Who’s your donor?” becomes “Who’s your daddy?”
My lede:
Dad needs a new kidney. His son, wanting nothing more than to return the gift of life his father gave him, gets tested to see whether he can donate a kidney. But the test reveals that he is not just a bad match, but also not biologically related to the man he believes is his father.
In such a situation, are physicians and other transplant professionals obliged to tell what they have learned about the paternity? If so, whom do they tell?
Although rare, wrongly attributed paternity is discovered during histocompatibility testing in 1% to 3% of all living kidney donations, according to a study of U.S. and Canadian transplant data published May 27 in the journal Transplantation.
The whole shebang.
5 die under Washington assisted suicide law
My lede:
Five Washington patients with terminal illnesses ingested lethal doses of medication prescribed for them by physicians under their state’s new death-with-dignity law, approved by 58% of voters in a November 2008 ballot initiative.
At this article’s deadline, 14 patients had made written requests for life-ending prescriptions, according to a Web site updated weekly by the Washington State Dept. of Health. Thirteen lethal prescriptions had been dispensed by pharmacies. In two of these cases, a mental health professional was consulted and filed a compliance form. The psychiatric referral is required if the attending or consulting physician has doubts about the patient’s mental competence.
The whole shebang.
Pertussis risk much higher among unvaccinated children
My lede:
Some parents, concerned that vaccines could injure their children, choose to forgo or delay childhood immunizations. One barrier to convincing on-the-fence parents of the benefits of vaccines is that the downside of refusing seems minimal. Parents who opt out often have good reason to believe that herd immunity will protect their children from harm.
But a new study finds that, at least with regard to pertussis, vaccine refusal is not risk-free. Children whose parents refused the pertussis vaccine were 23 times likelier to contract the disease than were immunized children, according to a June Pediatrics study of 156 pertussis cases drawn from the Kaiser Permanente Colorado health plan. One in 10 pertussis cases was due to vaccine refusal, the study found (pediatrics.aappublications.org/cgi/content/abstract/123/6/1446/).
The whole shebang.
Many hospitals cut back on infection-control efforts
My lede:
Hospital-associated infections annually kill an estimated 100,000 people and add $20 billion to the nation’s health care bill. The increasing prevalence of multidrug-resistant organisms, state infection reporting mandates and the looming threat of an influenza A(H1N1) pandemic have made the job of preventing infections and controlling their spread that much harder.
But amid the worst recession in decades, hospitals are cutting back wherever they can, and infection-control professionals report that their departments are not being spared.
The whole shebang.
Retail clinics avoid medically underserved areas
My lede:
Under criticism from physician organizations and others for further fracturing an already disjointed health system, store-based health clinics and their supporters have argued that these nurse-practitioner-staffed offices offer uninsured patients affordable, walk-in care at convenient locations.
But most retail clinics — 86.4% — are located in well-to-do areas that are not classified as medically underserved, according to a May 25 Archives of Internal Medicine study (archinte.ama-assn.org/cgi/content/abstract/169/10/945/).
The whole shebang.
Doctors, lung cancer patients skirt hospice talk
My lede:
The typical patient with metastatic lung cancer lives four to eight months after diagnosis. Yet barely more than half of doctors caring for these patients discuss using hospice care to help manage these last months of life, according to a May 25 Archives of Internal Medicine study.
Bringing up hospice when patients and families often want to keep fighting the cancer is a challenge for doctors, said study co-author John Z. Ayanian, MD, professor of medicine and health care policy at Harvard Medical School in Massachusetts.
“But in situations like this, where the overall prognosis is poor, it’s important for physicians to have open and honest discussions so that patients understand their options and don’t suffer when good palliative care could make their remaining quality of life much better,” Dr. Ayanian said.
The whole shebang.
Clinics fall short in treatment of transgender patients, doctors
My lede:
Only 10 in 166 outpatient clinics and hospitals got a perfect score on a set of model equal-treatment policies for gay, lesbian, bisexual and transgender patients and health professionals, according to a May report released by the Gay and Lesbian Medical Assn. and the Human Rights Campaign advocacy group.
Most of the organizations that participated in the survey listed sexual orientation in their nondiscrimination policies, allowed equal visitation access for same-sex partners and parents, had cultural competency training on sexual orientation and offered health benefits for employees with same-sex partners. But even among these gay-friendly hospitals and clinics, only 7% pledged in writing not to discriminate against transgender patients.
The whole shebang.
Ethics block
In Slate magazine, Farhad Manjoo writes that “it’s hard to make an honest claim that [Web ad-blocking] programs are ethical,” though he doesn’t bother to rebut head-on the perfectly valid arguments he mentions (”it’s my browser and my computer, so I can choose what I want to download”).
Steven D. Schroeder at Sturgeon’s Law does an excellent job of taking apart Manjoo’s claim. I also tackled the argument back in 2005, here. By the way, if Manjoo thinks ad-blocking plug-ins are problematic, he’ll probably compare the folks behind Readability to Charles Manson.
Vermont bans industry gifts, tightens reporting rules
My lede:
Starting July 1, Vermont physicians will get no more free lunches from the pharmaceutical industry.
That is one of many changes doctors in the state can expect thanks to a new state law that may be the most sweeping attempt yet to target the influence of industry marketing on physicians’ medical decisions.
The whole shebang.
Health care quality showing slow improvement
My lede:
Twin government reports released in May that track the American health system’s performance show that quality of care has improved at a dilatory 1.4% pace, while markers of racial and ethnic health disparities have stagnated.
“The progress of quality is incredibly slow, and disparities are persisting,” said Ernest Moy, MD, PhD, who directs the team at the U.S. Agency for Healthcare Research and Quality that produces the companion reports on health care quality and disparities (www.ahrq.gov/qual/qrdr08.htm).
The whole shebang.
Industry conflicts common in cancer studies
My lede:
Nearly a third of oncology studies published in influential journals are authored by researchers with financial conflicts of interest, according to a May 11 study published online by the journal Cancer.
Researchers examined more than 1,500 studies published in 2006 in high-impact journals such as Cancer, The Lancet Oncology, and The New England Journal of Medicine, noting when authors disclosed conflicts of interest.
The review found some kind of financial conflict, such as industry funding of research, consulting income or stock ownership, in nearly half the articles presenting the results of prospective clinical trials.
The whole shebang.
