Some months ago, the receptionist in my clinic handed me a registered letter. The name of the sender seemed familiar. “Dear Sir,” the letter read. “Please be advised that this letter serves as official notice that I am considering a potential claim against you in a medical Malpractice claim in regard to my husband. . . .” I stood, stunned. My white coat, which held the daily tools of my profession — my list of patients, the Sanford antibiotic manual, a black stethoscope — felt extraordinarily heavy. (Washington Post)

Tens of millions of people in low and middle income countries would be pushed below the poverty line by buying common but vital medicines which are already unaffordable to hundreds of millions more, a study has found. (Reuters)

Brazilians endlessly repeat the old saw that the world thinks of only three things when it thinks of Brazil: samba, carnivale and football. But its healthcare industry would like to add a fourth–surgery. As part of Brazil’s efforts to leverage both the tourists and the infrastructure investments expected in the wake of the 2014 World Cup and 2016 Summer Olympics in Rio, the country hosted its first medical tourism conference last week in São Paulo. (Fast Company)

The American Journal of Bioethics (Volume 10, Issue 8, 2010) is now available by subscription only.

Articles include:

• “Patient Willingness to be Seen by Physician Assistants, Nurse Practitioners, and Residents in the Emergency Department: Does the Presumption of Assent Have an Empirical Basis?” by Gregory L. Larkin and Roderick S. Hooker, 1-10.
• “Striking the Right Balance in Research Ethics and Regulation” by Franklin G. Miller, 65.

The Obama administration is rewriting new rules on medical privacy after an outpouring of criticism from consumer groups and members of Congress who say the rules do not adequately protect the rights of patients. (New York Times)

Faced with mounting debt and looming costs from the new federal health-care law, many local governments are leaving the hospital business, shedding public facilities that can be the caregiver of last resort. (Wall Street Journal)

Bioethics (Volume 24, Issue 7, September 2010) is now available by subscription only.

Articles Include:

• “Reproductive Tourism and the Quest for Global Gender Justice” by Anne Donchin, 323-332.
• “Care Ethics and the Global Practice of Commercial Surrogacy” by Jennifer A. Parks, 333–340.
• “Revisiting Child-Based Objections to Commercial Surrogacy” by Jason K.M. Hanna, 341-347.
• “Surrogacy: Donor Conception Regulation in Japan” by Yukari Semba, Chiungfang Chang, Hyunsoo Hong, Ayako Kamisato, Minori Kokado, and Kaori Muto, 348-357.
• “The Ethics of Intercountry Adoption: Why It Matters To Healthcare Providers and Bioethicists” by Sarah Jones, 358-364.
• “The Limits of Intimate Citizenship: Reproduction of Difference in Flemish-Ethiopian ‘Adoption Cultures’” by Katrien De Graeve, 265-372.

Cambridge Quarterly of Healthcare Ethics (Volume 19, Issue 4, October 2010) is now available by subscription only.

Articles include:

• “Should Empathic Development Be a Priority in Biomedical Ethics Teaching?  A Critical Perspective” by Bruce Maxwell and Eric Racine, 433-445.
• “Teaching Military Medical Ethics: Another Look at Dual Loyalty and Triage” by Michael L. Gross, 458-464.
• “The Unique Nature of Clinical Ethics in Allied Health Pediatrics: Implications for Ethics Education” by Clare Delany and Merle Spriggs and Craig L. Fry and Lynn Gillam, 471-480.
• “What Health Science Student Learn from Playing a Standardized Patient in an Ethics Course” by Amy Haddad, 481-487.
• “Medical Student Attitudes about Bioethics” by Cheryl C. MacPherson and Robert M. Veatch, 488-496.
• “Rual Heathcare Ethics: No Longer the Forgotten Quarter” by William Nelson and Mary Ann Greene and Alan West, 510-517.
• “The Humanities and the Future of Bioethics Education” by Joseph J. Fins, 518-521.

Earlier this summer a friend revealed that for the last nine years she has been a patient in a concierge, or boutique, primary care practice. For $350 each month, she is guaranteed around-the-clock access to her doctor, appointments within 24 hours of calling, longer office visits and the kind of personalized attention and care coordination she felt was missing with all her previous doctors. (New York Times)

Ruben Betancourt died on May 29, 2009. Last week, a New Jersey appellate court declined to rule on the heated dispute that had broken out between his family and a North Jersey hospital over stopping his medical care prior to his death. (Philadelphia Inquirer)

The American public bought into the specialist mystique, partly thanks to stories in the media about miracle cures that could only be provided by the right medical expert. Family doctors, general internists and pediatricians started to look a little inadequate. (Atlanta Journal-Constitution)

True or false: The new health care law will cut Medicare benefits for seniors. It will slash Medicare payments to doctors. It will ration health care. (USA Today)

NEJM (Volume 363, Number 2, July 8, 2010) is now available by subscription only.

Articles Include:

• “The SGR for Physician Payment - An Indispensable Abomination” by H.J. Aaron.
• “Implementing Health Care Reform - Why Medicare Matters” by R.A. Berenson, 101-103.
• “The Independent Payment Advisory Board” by T.S. Jost, 103-105.
• “Identifying and Eliminating the Roadblocks to Comparative-Effectiveness Research” by D.F. Martin, M.G. Maguire, and S.L. Fine, 105-107.
• “Limbal Stem-Cell Therapy and Long-Term Corneal Regeneration” by P. Rama and Others, 147-155.
• “Genomic Medicine: Genomewide Association Studies and Assessment of the Risk of Disease” by T.A. Manollo, 166-176.
• “Toward More Uniform Conflict Disclosures - The Updated ICMJE Conflict of Interest Reporting Form” by J.M. Drazen and Others, 188-189.
• “Individual Genomes on the Horizon” by D. Watkins and C. Gallant, 195-196.

Tina Follett and her husband Patrick are in Panama on a two-week all-expenses paid trip. But Tina isn’t on vacation. She’s there to get surgery. The Folletts are among a growing number of Americans whose company health plans now include a medical travel option. (CNN)

As hospitals struggle to integrate electronic medical records, some have already instituted electronic drug ordering systems to help reduce prescription errors. But not all so-called computerized provider order entry (CPOE) systems are specially tuned to different patient populations. And while some can catch potentially dangerous drug-drug interactions for individuals, only one has been alerting providers when they are ordering something that could be dangerous for seniors. (Scientific American)

Every medical study ever conducted has concluded that 100 percent of all Americans will eventually die. This comes as no great surprise, but the amount of money being spent at the very end of people’s lives probably will. (CBS News)

Developing World Bioethics (Volume 10, Issue 2, 2010) is now available by subscription only.

Articles Include:

• “The Future of Bioethics” by Udo Schüklenk, ii-iii.
• “Reproductive Tourism in Argentina: Clinic Accreditation and its Implications for Consumers, Health Professionals and Policy Makers” by Elsie Smith, Jason Behrmann, Carolina Martin, and Bryn Williams-Jones, 59-69.
• “Curriculum Guide for Research Ethics Workshops for Countries in the Middle East” by Henry Silverman, Babiker Ahmed, Samar Ajeilet, Sumaia Al-Fadil, Suhail Al-Amad, Hadir El-Dessouky, Ibrahim El-Gendy, Mohamed El-Guindi, Mustafa El-Nimeiri, Rana Muzaffar, and Azza Saleh, 70-77.
• “Access to Treatment in HIV Prevention Trials: Perspectives from a South African Community” by Nicola Barsdorf, Suzanne Maman, Nancy Kass, and Catherine Slack, 78-87.
• “Training Needs Assessment in Research Ethics Evaluation Among Research Ethics Committee Members in Three African Countries: Cameroon, Mali, and Tanzania” by Jêrôme Ateudjieu, John Willians, Marie Hirtle, Cédric Baume, Joyce Ikingura, Alassane Niaré, and Dominique Sprumont, 88-98.
• “From Medical Rationing to Rationalizing the Use of Human Resources for AIDS Care and Treatment in Africa: A Case for Task Shifting” by Jessica Price and Agnes Binagwaho, 99-103.
• “You Can Use My Name; You Don’t Have to Steal My Story - A Critique of Anonymity in Indigenous Studies” by Anna-Lydia Svalastog and Stefan Eriksson, 104-110.

Book Reviews Include:

• “Bioethics and Armed Conflict: Moral Dilemmas of Medicine and War - By Michael L. Gross” by Deanne-Peter Baker, 113.
• “When Experiments Travel: Clinical Trials and the Global Search for Human Subjects - By Adriana Petryna” by Stuart Rennie, 114-115.

NEJM (Volume 363, Number 3, July 15, 2010) is now available by subscription only.

Articles Include:

• “Facing the Wild West of Health Care Reform - Donal Berwick, Pioneer” by J.K. Iglehart.
• “Disclosing Industry Relationships - Toward an Improved Federal Research Policy” by E.G. Campbell and D.E. Zinner.
• “The Renaissance in HIV Vaccine Development - Future Directions” by W.C. Koff and S.F. Berkley.
• “The Havasupai Indian Tribe Case - Lessons for Research Involving Stored Biologic Samples” by M.M. Mello and L.E. Wolf, 204-207.
• “Becoming a Physician: The Case for Primary Care - A Medical Student’s Perspective” by I. Ganguli, 207-209.
• “Case 21-2010L A Request for Retrieval of Oocytes from a 36-Year-Old Woman with Anoxic Brain Injury” by D.M. Greer, A.K. Styer, T.L. Toth, C.P. Kindregan, and J.M. Romero, 27-283.
• “Drug Management of Obesity - Efficacy versus Safety” by A. Astrup, 288-290.
• “Trajectories of Disability in the Last Year of Life,” 294-295.
• “Advance Directives and Surrogate Decision Making Before Death,” 295-296.

8TH Annual Quandaries in Health Care Conference
“A Need to Confess?: Writing About the Healthcare Experience”
September 30 – October 2, 2010
The Given Institute of the University of Colorado
Aspen, Colorado

Quandaries in Health Care is an annual conference series in which keynote discussants, guest faculty and conference participants gather at the Given Institute in Aspen, Colorado, for two and one-half days of large and small group discussions revolving around a single theme.  This year’s theme explores the literary trend among healthcare professionals to publish narratives which reveal the pressures faced and felt by them, often by focusing upon breaches in expectations as well as the shame, guilt and anxiety that such breaches evoke.

The keynote discussants will examine the appropriateness and possible effects of such “confessional” writing, including the effects it may have on patients, the professions, and the connection between professionals and the communities they serve.

For more information or to register

Archives of Internal Medicine (Volume 170, Number 14, July 26, 2010) is now available by subscription only.

• “Racial Differences in Admissions to High-Quality Hospitals for Coronary Heart Disease” by Ioana Popescu,  Brahmajee K. Nallamothu, Mary S. Vaughan-Sarrazin, and Peter Cram, 1209-1215.
• “Geographic Variation in Carotid Revascularization Among Medicare Beneficiaries, 2003-2006″ by Manesh R. Patel, Melissa A. Greiner, Lisa D. DiMartino, Kevin A. Schulman, Pamela W. Duncan, David B. Matchar, and Lesley H. Curtis, 1218-1225.
  
• “National Quality Forum Performance Measures for HIV/AIDS Care: The Department of Veterans Affairs’ Experience” by Lisa I. Backus, Derek B. Boothroyd, Barbara R. Phillips, Pamela S. Belperio, James P. Halloran, Ronald O. Valdiserri, and Larry A. Mole, 1239-1246.
• “Receipt of High-Quality Coronary Heart Disease Care in the United States All About Being Black or White: Comment on ‘Racial Differences in Admissions to High-Quality Hospitals for Coronary Heart Disease’” by Michelle A. Albert 1216-1217.
• “The Good, the Bad, and the About-to-Get Ugly: National Trends in Carotid Revascularization: Comment on ‘Geographic Variation in Carotid Revascularization Among Medicare Beneficiaries, 2003-2006″ by Ethan A. Halm, 1225-1227.
• “Physicians’ and Nurses’ Experiences With Continuous Palliative Sedation in the Netherlands” by Siebe J. Swart, Tijn Brinkkemper, Judith A. C. Rietjens, Marco H. Blanker, Lia van Zuylen, Miel Ribbe, Wouter W. A. Zuurmond, Agnes van der Heide, and Roberto S. G. M. Perez, 1271-1274.
• “Medical Decision Making at the Individual Patient Level” by Claudia Caroline Dobler and Guy Barrington Marks, 1275.
• “Time Spent on Clinical Documentation: Is Technology a Help or a Hindrance?” by Jacob A. Doll and Vineet Arora, 1276.
  

JAMA (Volume 304, Number 4, July 28, 2010) is now available by subscription only.

Articles Include:

• “Reducing Diagnostic Error Through Medical Home-Based Primary Care Reform” by Hardeep Singh and Mark Graber, 463-464.
• “Medical Leadership in an Increasingly Complex World” by Robert H. Brook, 465-466.
• “Miracles, Choices, and Justice: Tragedy of the Future Commons” by David B. Reuben, 467-468.
• “Patient-Centered Care and Informed Consent” by James E. Gottesman, 409-410.
• FDA Targets Antibiotic Use in Livestock” by Bridget M. Kuehn, 396.