Redefining physicians' role in assisted dying.

Department of Orthopedic Surgery, Brigham and Women's Hospital, and Division of Medical Ethics, Harvard Medical School, Boston, USA.
New England Journal of Medicine (Impact Factor: 54.42). 07/2012; 367(2):97-9. DOI: 10.1056/NEJMp1205283
Source: PubMed
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    ABSTRACT: Introduction or backgroundThe public assumes that if euthanasia and assisted suicide were to be legalized they would be carried out by physicians.Sources of dataIn furthering critical analysis, we supplement the discourse in the ethics and palliative care literature with that from medical education and evolving jurisprudence.Areas of agreementBoth proponents and opponents agree that the values of respect for human life and for individuals' autonomy are relevant to the debate.Areas of controversyAdvocates of euthanasia and assisted suicide give priority to the right to personal autonomy and avoid discussions of harmful impacts of these practices on medicine, law and society. Opponents give priority to respect for life and identify such harmful effects. These both require euthanasia to remain legally prohibited.Growing pointsProposals are emerging that if society legalizes euthanasia it should not be mandated to physicians.Areas timely for developing researchThe impact of characterizing euthanasia as 'medical treatment' on physicians' professional identity and on the institutions of medicine and law should be examined in jurisdictions where assisted suicide and euthanasia have been de-criminalized.
    British Medical Bulletin 03/2013; · 4.36 Impact Factor
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    ABSTRACT: Abiraterone acetate is the first second-line hormonal agent proven to improve survival in metastatic castration-resistant prostate cancer. It selectively inhibits cytochrome P450 17 (CYP17) α-hydroxylase and cytochrome17,20 (C17,20)-lyase, which are enzymes critical for androgen synthesis. Abiraterone acetate was initially approved in the United States in 2011 after demonstrating a 4-month survival benefit in docetaxel-refractory metastatic prostate cancer. The FDA recently expanded its indication for use in the pre-chemotherapy setting after it elicited significant delays in disease progression and a strong trend for increased overall survival in phase III studies. Ongoing investigations of abiraterone are evaluating its efficacy in earlier disease states, exploring its synergy in combination with other therapeutic agents, and assessing the necessity for administration of concurrent steroids and gonadal suppression. The identification and development of predictive biomarkers will optimize the incorporation of abiraterone into the management of advanced prostate cancer.
    Advances in Therapy 08/2013; · 2.44 Impact Factor
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    The Permanente journal 01/2012; 16(2):75-6; author reply 75-7.


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May 15, 2014