March
Can Electronic Clinical Documentation Prevent Diagnostic Errors – An NEJM Perspective Article
GD Schiff & DW Bates, NEJM, March 25, 2010, Vol 362 (12), 1066-1069.
Not everything about a patient’s life can be gathered from a brief consultation in a clinic. Dr. Berland has devised a fascinating method of looking into the personal lives and troubles of her disabled patients – encouraging them to carry a video camera with them. Read about the unique insight that she gained through this novel, simple idea.
Historic Passage – Reform at Last – An NEJM Special Report
JK Inglehart, NEJM, March 24, 2010, Vol 362 (12)
John Iglehart reports on the passage of the health care reform bill, the first piece of major social legislation to be enacted on a strictly partisan basis.
Untangling the Web – Patients, Doctors, and the Internet – An NEJM Perspective Article
P Hartzband & J Groopman, NEJM, March 25, 2010, Vol 362 (12), 1063-1066
Medicine has built on a long history of innovation, from the stethoscope and roentgenogram to magnetic resonance imaging and robotics. Doctors have embraced each new technology to advance patient care. But nothing has changed clinical practice more fundamentally than one recent innovation: the Internet. Its profound effects derive from the fact that while previous technolgoies have been fully under doctor’s control, the Internet is equally in the hands of patietns. Such access is redefining the roles of physician and patient.
Structural Variation in the Human Genome – An NEJM Clinical Implications of Basic Research Article
R Lupski, NEJM, March 15 2007, Vol 356 (11)
Recently, biologists have found that individuals actually have many large-scale rearrangements in their genomes, such as deletions, inversions, or duplications that can affect gene fragments or even entire genes, and not just single point mutations. This “structural variation” affects the regulation of many different genes, and Dr. James Lupski explores the clinical implications of these large rearrangements.
Ethical Challenges Posed by the Solicitation of Deceased and Living Organ Donors – An NEJM Sounding Board Article
DW Hanto, NEJM, March 8 2007, Vol 356 (10)
In exploring the ethics of patients directly soliciting donations of organs from willing strangers, Douglas Hanto advocates the controversial position that organ donors and their families should not be allowed to choose what to do with the organs. Instead, he proposes forcing all donors to donate to the recipient at the top of the organ transplant lists except in those cases where a pre-existing emotional relationship exists (such as between family members).
Cesarean Delivery and the Risk-Benefit Calculus – An NEJM Perspective Article
JL Ecker and FD Frigoletto, Jr., NEJM, March 1 2007, Vol 356 (9)
The authors analyze the possible factors involved in the increasing numbers of physicians who opt for cesarean delivery over the traditional vaginal birth. They examine both the soundness of the reasoning that justifies such a trend as well as the need to educate patients about the real risks and benefits involved in the choice of delivery method.
Congress, Controlled Substances, and Physician-Assisted Suicide – Elephants in Mouseholes – An NEJM Legal Issues in Medicine Article
G. J. Annas, NEJM, March 9 2006, Vol 354 (10)
An Oregen statute permits physicians to prescribe lethal doses of drugs to terminally ill patients. Recently, the U.S. Supreme Court decided in the Gonzales v. Oregon case that the U.S. attorney general cannot forbid this practice based on national law, raising questions on the role of physicians in end-of-life care and national standards for the practices of physicians.
When Law and Ethics Collide – Why Physicians Participate in Executions – An NEJM Perspective Article
A. Gawande, NEJM, March 23 2006, Vol 354 (12)
Execution by lethal injection presents an ethical dilemma for physicians: in order for lethal injections to occur effectively and smoothly, the presence of doctors and nurses is necessary, but does this participation violate the medical code of ethics? The quandary only grows as physicians are required to attend executions by state laws. How should the medical community approach physician participation?
Who is at Greatest Risk for Receiving Poor-Quality Health Care? – An NEJM Special Article
S. M. Asch et al., NEJM, March 16 2006, Vol 354 (11)
Differences in health in different societal groups are often attributed to differences in health care delivery, but the problems might be more fundamental and larger in scope. This study showed that disparities between groups are relatively small compared to the gaps between the needed and received level of care in each population group.
A Potential Decline in Life Expectancy in the United States in the 21st Century – An NEJM Original Article
Special Report by S.J. Olshansky et al., NEJM, March 17 2005, Vol 352(11)
New considerations of increasingly prevalent conditions such as obesity and diabetes suggest a possible decline of the projected average lifespan in the future of the United States. These changes in projected lifespan may have many public-policy implications.
