EMBARGOED FOR RELEASE UNTIL 5 P.M., EST, TUESDAY, MARCH 31, 1998
April 1, 1998, Tip Sheet
Annals of Internal Medicine is published by the American College of Physicians (ACP), an organization of more than 100,000 physicians trained in internal medicine. For a copy of an article, call 1-800-523-1546, ext. 2656 or 215-351-2656. Articles will be on the Internet at www.acponline.org on April 1.
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Ticlopidine Linked to Rare Blood Disease
Use of the blood thinner ticlopidine may be associated with a rare and serious circulatory disease that affects the brain and kidneys, thrombotic thrombocytopenic purpura (TTP). (Brief Communication, p. 541.) Researchers reviewed 60 cases of TTP that occurred in patients taking the drug. Authors say physicians should prescribe the drug cautiously and inform patients about the possible consequences.
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Internal Medicine Experts Explore the Physician-Assisted Suicide Debate
Analyzing data on end-of-life care and physician-assisted suicide, well-known internists describe seven characteristics of end-of-life care in the U.S. and seven principles of care of dying patients on which, they say, both sides of the physician-assisted suicide debate can agree. (Medicine and Public Issues, p. 552.) They say that the debate must not distract from improving care for dying patients and their families, "who could be better served by improved access to and delivery of palliative care."
Authors compare terminal dehydration (patients voluntarily forgoing food and water) and physician-assisted suicide and find that terminal dehydration, accompanied by palliative care, gives patients an alternative to physician-assisted suicide. (Perspectives, p. 559.)
An editorial on the Oregon effort to legalize physician-assisted suicide says the debate spurred major improvements in Oregon's end-of-life-care, such as fewer hospital deaths and more hospice care. (Editorial, p. 567.) The author calls physician-assisted suicide "a coercive choice" for the uninsured and notes that lobbyists for and against Oregon's assisted suicide initiative spent $4.6 million in advertising -- "enough money to fund access to hospice for every dying Oregonian for three years."
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Annals Editor Concludes Two-Part Series on Medicine and Commerce
Annals Editor says that medicine, as an art as well as a science, is a gift from physician to patient, not a commodity to be sold. (Editorial, p. 572.) Managed care is "destroying medicine's network of gift relationships, providing a second major source of professional anger and anxiety," he says.
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ACP Issues Fourth Edition of Ethics Manual
(See separate news release.)
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