The lede:

Since their rise more than three decades ago, hospital ethics committees have sought to help physicians, patients and their families resolve ethical disagreements and navigate the treacherous terrain that so often accompanies medical care at the end of life.

The role of these committees was cemented in 1992 when the Joint Commission mandated that health care organizations come up with some way of addressing ethical concerns. Ninety-five percent of general hospitals surveyed in 1999 and 2000 offered ethics consultation or were starting up a consult service.

Yet at the median, these services handled only three cases in the previous year, according to the survey of more than 500 general hospitals whose results were published in February 2007 in The American Journal of Bioethics.

The use of ethics consultation services varies widely from hospital to hospital, but physician experts and ethicists agree that they frequently are underused. That leads, they say, to increased medical costs and ugly disputes among physicians, patients and families.

Physicians’ reluctance to seek aid when dilemmas arise is partly grounded in the notion that a call for help is equivalent to hauling in the “ethics police.” But the problem, experts say, goes far deeper.

The whole shebang.

The lede:

Nearly half of physicians use placebos in clinical care, and only 4% tell their patients the truth about it, according to a survey of Chicago academic physicians that was published this month in the Journal of General Internal Medicine.

Only 8% of the 231 physicians surveyed used placebos more than 10 times during the last year, but experts were alarmed by doctors’ self-reported, less-than-straightforward conversations with patients about placebos.

The study is troubling because deceptive use of placebos is “inconsistent with what we now understand as the rights of patients to decide on treatment in a knowledgeable way and the duties of physicians to disclose to patients the treatments that they are providing,” said Paul S. Appelbaum, MD, director of the
division of psychiatry, law and ethics in the psychiatry department of Columbia University College of Surgeons.

The whole shebang.

The lede:

Nearly 100,000 Americans are waiting for an organ transplant. Every day, the wait for 17 of those people ends in death.

It is a wait that could be drastically shortened or even eliminated if a market for live and cadaveric organs were allowed to operate, according to a paper co-authored by Nobel Prize-winning economist Gary S. Becker, PhD, and published last year in the Journal of Economic Perspectives.

The study comes on the heels of what observers say is slow but steady progress in breaking down opposition to testing the idea of financial incentives in an effort to combat an organ shortage growing by 5% each year. But resistance among many in the transplant community is still fierce, as other efforts such as paired donation exchanges begin to take off.

The whole shebang.