My lede:

It is legal and ethical to honor patient requests to deactivate implanted cardiac devices, and physicians should take the initiative in talking with terminally ill patients and their families about turning off the devices, according to a new expert panel consensus statement released in May.

Implantable cardioverter-defibrillators, or ICDs, can impose a particularly heavy burden on terminally ill patients, continuing to send electrical shocks as the patient dies.

“His defibrillator kept going off,” one family member of a dying patient told the authors of a study in the Dec. 7, 2004, Annals of Internal Medicine. “It went off 12 times in one night.”

The whole shebang.

My lede:

New changes to Medicare and Medicaid payment could address the emotionally wrenching dilemma faced by physicians and terminally ill patients forced to choose between continuing curative treatments and taking advantage of hospice care programs’ in-home palliative, psychological and spiritual services.

The health reform law enacted in March directs state Children’s Health Insurance Programs and Medicaid plans to immediately cover “concurrent care” — a combination of curative efforts and hospice care — for children with terminal illnesses. The Congressional Budget Office estimates that the expanded coverage will cost $200 million over 10 years.

The law also calls on the Health and Human Services secretary to conduct a three-year, budget-neutral demonstration project of concurrent care for Medicare patients at 15 hospice-care sites.

The whole shebang.

My lede:

With more medical tests being ordered, the odds are greater that findings requiring follow-up action will fall through the cracks.

New recommendations in The Joint Commission Journal on Quality and Patient Safety in May highlight what physician practices and hospitals can do to reduce the risk of missing test results.

The whole shebang.

My lede:

Informed consent has long been a bedrock principle of medical ethics, but the form intended to document a patient’s understanding of a proposed intervention is too often written at a college reading level and is ambiguous about risks.

Some doctors are out to change that, bringing a personalized medical approach to informed consent.

Nine medical centers around the country — including the Mayo Clinic in Rochester, Minn., and the Henry Ford Hospital in Detroit — are testing an informed-consent process for patients undergoing nonemergent cardiac catheterization and potential angioplasty. The Web-based program draws on a national cardiovascular database to predict individualized risks of death, bleeding or restenosis.

Proponents of the effort say informed consent should include even more data, telling patients about cost, alternative treatments, and doctors’ and hospitals’ quality performance.

The whole shebang.

My lede:

Under scrutiny from politicians and physician critics, some medical specialty societies are pledging to disclose the industry funding they receive and say what that money pays for.

The promise comes as part of a code approved in April by the Council of Medical Specialty Societies, whose member organizations together represent more than 650,000 American physicians. The pressure on physician organizations to tell the public about industry support and limit the companies’ influence on their educational, research and advocacy activities has been building over the last year.

The whole shebang.

My lede:

One in five primary care physicians working in religiously affiliated health care organizations has experienced a conflict over faith-based patient care policies, according to a new study in the Journal of General Internal Medicine.

The findings, based on a nationwide survey of 446 family physicians and internists, appear to be the first to document how frequently doctors disagree with institutional policies in areas such as reproductive and end-of-life care, said Debra B. Stulberg, MD, the study’s lead author.

The whole shebang.