Persistent vegetative state and the decision to withdraw or withhold life support

Article Abstract:

Patients who have extensive brain damage and are in a state of chronic unconsciousness for more than a few weeks are considered to be in a persistent vegetative state (PVS). While body functions may continue with the help of life support equipment, the patient is mentally unaware. The decision of when to withdraw life support measures for these patients has become a controversial issue that has been debated publicly and in the courts. Several judges have allowed family members to refuse or to end life support measures when there was no reasonable hope of recovery. While the legal considerations are important, the ultimate responsibility rests with the physician, who must decide when there is virtually no chance of recovery for the patient. The physician must help the family decide what form of treatment is in the best interest of the patient. In this report, the American Medical Association provides a definition of permanent unconsciousness and clinical criteria for diagnosing PVS. Patients with PVS are typically awake, but not aware; they may open their eyes, smile briefly, and make unintelligible sounds. They may respond to loud noises, but make no purposeful movements or meaningful communication. The higher brain functions involved in pain perception are lost, therefore the patient does not suffer if breathing or feeding equipment is removed. Determining what the patient would have wanted may be a means of avoiding litigation or ethical dilemmas. The legal history of this issue also suggests that in cases where the physician and caretakers agree on a course of action, legal repercussions are quite unlikely. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Laws, regulations and rules, Ethical aspects, Euthanasia, Medical ethics, Right to refuse treatment, Right to die, Treatment refusal, Coma, Coma (Medicine)

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Breast cancer screening guidelines agreed on by AMA, other medically related organizations

Article Abstract:

Eleven medical organizations including the American Medical Association (AMA) recommend that women who do not have signs of breast cancer begin having mammograms at age 40 in order to detect breast cancer in its early stages. The recommendations state that women should undergo annual clinical breast evaluation and mammograms at least every other year. Women 50 years of age and older should receive both clinical breast examination and screening mammography on an annual basis. Screening women in the 40 to 49 year old age group is expected to have a significant effect on the rate of early diagnosis of breast cancer. The American College of Obstetricians and Gynecologists further suggests that women between 35 and 39 years of age perform regular breast self-examination and obtain a single baseline mammogram between ages 35 and 39 years.

Usage, Diagnosis, Medical examination, Cancer, Medical screening, Health screening, Mammography, Breast, Cancer diagnosis

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Guidelines for AMA Web Sites

Article Abstract:

Guidelines developed by the American Medical Association for designing a health or medical Web site are presented. The association will use these guidelines to develop its own Web sites and encourages others to use them as well. Extensive guidance is given for developing and ensuring high-quality content, creating useful links and navigation aids, finding appropriate sponsors and displaying ads, and ensuring the confidentiality of any information provided by users, including financial information supplied during an e-commerce transaction.

Web sites (World Wide Web), Web sites

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