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.

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.

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.

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.

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.

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.

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.

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.

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.

My lede:

Proper hand hygiene is one of the most important infection-control techniques. Yet getting doctors and others who encounter patients to clean their hands at the right times and in the right manner has proven to be daunting, with studies showing compliance rates of about 50% nationally.

Nearly as perplexing as why many who know better sometimes skip hand washing is how to accurately measure hand-hygiene rates.

The whole shebang.

My lede:

Yale-New Haven Hospital in Connecticut cut adverse obstetrics outcomes by about 40% after implementing a comprehensive patient safety program.

The results, published in the May American Journal of Obstetrics & Gynecology, are the latest to show the positive effect of strategies such as training doctors and nurses in electronic fetal heart monitoring interpretation, properly using oxytocin for inducing labor and reducing elective inductions before 39 weeks’ gestation.

The whole shebang.

My lede:

The North Carolina Medical Board exceeded its authority under state law when it adopted policy threatening disciplinary action against physicians who take an active role in executions, the Supreme Court of North Carolina ruled in early May.

The 4-3 decision appears to end the board’s policy barring doctors from participating in executions, the only one of its kind in the country.

The whole shebang.

My lede:

Only 38% of licensed drivers have joined their states’ organ donor registries, with many deterred by long-held misconceptions about how the transplant system works, according to poll results released in April.

The survey of 5,100 American adults, conducted on behalf of the organ-donation advocacy group Donate Life America, found that:

• 50% think that registering as organ donors means physicians will not try as hard to save their lives.
• 44% say there is a black market in the U.S. for organs or tissue.
• 26% believe that patients determined to be brain dead can recover from their injuries.
• 23% who are undecided about donation wrongly worry that age or health conditions would make them unacceptable donors.

The whole shebang.