51 died under Washington’s assisted-suicide law in 2010

My lede:

Fifty-one patients in Washington died after taking lethal medication prescribed by physicians under the first full year of the state’s aid-in-dying law, according to a state health department report released in March.

Sixty-eight physicians wrote life-ending prescriptions for 87 patients, 51 of whom took the medication and died. As of Feb. 9, 15 died of their illnesses before taking the lethal medication, and another 15 patients were still alive. For the remaining six deaths, it is unclear whether the patients ingested the medication prescribed under the law, the report said.

The physician-assisted suicide total represents a 42% rise from the 36 doctor-aided deaths in 2009, though the law didn’t take effect until March of that year. In Oregon, the only other state with a law authorizing physician-assisted suicide, 65 patients died last year after taking life-ending medication prescribed by their doctors, according to a state report released in January. Oregon has allowed physician-assisted suicide since 1998.

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Universal coverage may not eliminate health disparities

My lede:

The 32 million Americans expected to obtain insurance coverage by 2019 under the Patient Protection and Affordable Care Act are likely to have better access to health care. But if Canada’s experience is any guide, disparities in health outcomes will continue.

Researchers followed 14,800 Canadian patients over 10 years and studied their use of health care services and health outcomes. Although all the patients were insured under Canada’s single-payer health system, health outcomes varied by patients’ income and educational levels, said a study in the February issue of Health Affairs.

“There is evidence out there that giving people who are uninsured some health insurance coverage will reduce disparities,” said David A. Alter, MD, PhD, the study’s lead author. “The word of caution is that will not eliminate disparities.”

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Opioid prescribing requires close monitoring

My lede:

Opioid analgesics help alleviate the symptoms of patients with chronic pain, but they also are vulnerable to abuse. About 14,000 people die annually from opioid overdoses, and the medicines are implicated in more than 300,000 emergency department visits each year, according to estimates from the Centers for Disease Control and Prevention.

To reduce the overdose risk, pain specialists advise that doctors prescribing opioids to patients with chronic pain monitor them closely to ensure that they do not misuse the drugs, especially if the patients have a history of substance abuse. But a study shows that some primary care doctors are not aggressive in pursuing monitoring strategies that could help prevent misuse and diversion.

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1 in 3 surrogate decision-makers carries lasting emotional burden

My lede:

A third of surrogate decision-makers experience stress, guilt and other upsetting emotions related to their role in determining a loved one’s care, according to a March 1 Annals of Internal Medicine systematic review of 40 studies.

The emotional burden on surrogate decision-makers often lasts for months — and sometimes years — after the treatment choice, researchers found. One study cited in the review found that stress levels of surrogates were comparable to those of people who experienced construction disasters or lost their homes to fire.

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ICU central-line infections drop dramatically nationwide

My lede:

American hospital intensive care units cut central line-associated bloodstream infections by about 60% over nearly a decade, saving an estimated 27,000 lives and avoiding up to $1.8 billion in medical costs, said a new report from the Centers for Disease Control and Prevention.

“This is the first national success we have for patient safety in this country,” said Peter J. Pronovost, MD, PhD. He is principal investigator of a bundle of central-line infection prevention techniques that in 2006 demonstrated success statewide in Michigan and has spread to nearly 1,000 hospitals in 43 states.

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Comedic skills for a serious role

My lede:

The game is attacker-defender. Each player spontaneously selects another person in the room to “kill” with a tag. The targeted player selects another person as a “defender,” trying at all times to use that person as a shield against the attacker. When they are killed, players die a loud, dramatic death.

The game — a warm-up exercise for six students learning improvisational skills — quickly elicits a cacophony of shouts and squeals reminiscent of playground days. But all noise and movement stops with an unexpected knock at the door, the way children go mum during a sleepover when Mom checks in to see how things are going.

“Umm, could you kind of keep the noise down a little bit?” says the young woman who knocked. “We’re taking an exam next door.”

Oops.

The place — a medical school — is what makes this improv class unusual. Chicago, birthplace of the famed Second City improv comedy troupe that has served as the training ground for John Belushi, Bill Murray and many others, also is home to what appears be to the country’s only recurring improv class that also is part of a medical school curriculum.

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