A group of Hawaii physicians is offering to write lethal prescriptions for terminally ill patients in a bid to test whether doctor-assisted suicide is allowed under state law.

Unlike Oregon and Washington, the only two states where writing such a prescription is explicitly allowed and regulated, Hawaii has no law authorizing physician-assisted suicide. Moreover, Hawaii Attorney General David M. Louie issued an opinion in December 2011 saying that manslaughter charges could be brought against physicians who write prescriptions with the intention of causing death.

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Medical ethics is often the stuff of esoteric academic debates and journal articles littered with $10 words. Now one of America’s most venerable bioethics think tanks is expanding its reach with a public TV special and a patient-focused website that addresses the ethical challenges of emerging medical technologies.

Genetic testing, assisted reproduction, children’s mental health and end-of-life care are among the issues addressed at The Hastings Center’s site, called “Help with Hard Questions.” The website was launched in March to coincide with the airing of an episode of the PBS program “NOVA” that was co-produced by the center and focuses on the brave new world of genomics. The program can be viewed online.

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Three decades after hospice emerged as the standard of care for terminally ill patients, the end-of-life treatments that palliative medicine physicians provide are frequently referred to as murder, euthanasia and killing.

More than half of hospice and palliative medicine physicians say patients, family members and even other health professionals have used those terms to describe care they recommended or implemented within the last five years, according to a nationwide survey of 663 palliative care doctors in the March Journal of Palliative Medicine.

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Less than half of U.S. states require hospitals to report surgical site infections, and only a fraction of these states have publicly posted the information for patients to use in deciding where to seek care, said a study published online March 2 in theJournal for Healthcare Quality.

Twenty-one states require reporting of infections acquired during surgical procedures such as coronary artery bypass grafts and hip and knee replacements. Only 14 of these states have so far posted any of the information publicly. Moreover, states differ on data collection procedures and risk-adjustment standards.

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Many state and local government agencies and health systems are not ready to coordinate the response to a disaster that overwhelms available medical resources and requires a shift in standards of care, said an Institute of Medicine report released in March.

In the event of a catastrophe such as pandemic flu that results in a shortage of ventilators, hard choices will have to be made about who gets the high-tech breathing help. Ethical and legal “crisis standards of care” should be triggered by predefined indicators of disaster, yet few states have taken action to implement such a process, said the IOM report.

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Recent outbreaks of vaccine-preventable diseases and a growing immunization opt-out rate are pushing physician organizations in California and Vermont to seek greater restrictions on exemptions from school-entry immunization requirements.

Every state allows exemptions for children with medical contraindications verified by a physician, and all but two states let parents with religious objections skip immunizing their children.

An additional 20 states allow exemptions based on parents’ philosophical or personal beliefs. Requirements for securing personal-belief exemptions vary by state but are often as easy as signing a form.

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The mortality rate for obese patients who regularly take sleeping pills is nine times higher than the death risk for similar patients who do not use the drugs, said a study presented at an American Heart Assn. scientific meeting in March.

Researchers examined the medical records of more than 34,000 patients treated in the Geisinger Health System in Pennsylvania. After controlling for sex, age, smoking status, alcohol use, marital status and ethnicity, the obese patients who took hypnotic medicines regularly — at least 132 pills annually — were 9.3 times likelier to die than patients with similar health who did not. Even obese patients who took 18 pills or fewer annually had a death rate eight times higher.

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