Bmj Usa

Minerva

BMJ 2003; 327 doi: http://dx.doi.org/10.1136/bmj.327.7425.E258 (Published 20 November 2003) Cite this as: BMJ 2003;327:258

How humane are our medical practices regarding dying people? An American study of the perspectives of relatives of patients dying in the intensive care unit found that 83% were satisfied with the care that their loved ones received. But this contrasts greatly with a Canadian study published in 1997, which found that a high proportion of relatives wanted “comfort care” rather than intervention. One easy explanation could be cultural: American patients may want more active treatment even at the risk of discomfort ().

As Jehovah's Witnesses usually abstain from receiving transfusions of blood or blood products, they might be more likely to die after major trauma than patients from other religious denominations. But surprisingly, a retrospective cohort study conducted in one trauma center found that after age, sex, race, and severity and type of injury were controlled for, Jehovah's Witnesses were not at any significant disadvantage (Journal of Trauma 2003;54: 967-972).

Since 1983 the American Cancer Society has recommended that mammographic screening for breast cancer should begin at the age of 40. The society's latest update continues with essentially the same advice (CA: A Cancer Journal for Clinicians 2003;53: 141-169). A review in its journal (138-140) acknowledges the difficulty of finding evidence to support the policy. It …

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