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3 October 2000 Annals of Internal Medicine Tip Sheet

Annals of Internal Medicineis published by the American College of Physicians-American Society of Internal Medicine (ACP-ASIM), an organization of more than 115,000 physicians trained in internal medicine. The following highlights are not intended to substitute for articles as sources of information. For an embargoed fax of an article, call 1-800-523-1546, ext. 2656 or 215-351-2656. Full content of the issue is available on the Internet at on October 3, 2000.

Cancer Doctors Attitudes and Practices Regarding Euthanasia and Assisted Suicide Influenced by Training, Time, and Health Care Resources

A study of 3,299 U.S. oncologists attitudes on euthanasia and physician-assisted suicide found that 22 percent supported use of physician-assisted suicide for terminally ill patients with unremitting pain and 6.5 percent supported euthanasia (Article, p. 527). Euthanasia is generally defined as a one person painlessly ending the life of another person with an incurable disease at the sick person's request. Physician-assisted suicide involves the doctor providing assistance, usually prescribing drugs, so that the patient can end his own life.

About 70 percent of the physicians surveyed had received requests for euthanasia or physician-assisted suicide; the majority of requests were not fulfilled. Some 3.7 percent had performed euthanasia and 10.8 percent had been involved in physician-assisted suicide. Factors affecting the physicians attitudes and practices included having sufficient time to talk to dying patients about end-of-life care issues, having received adequate training in end-of-life care, and ability to get adequate care for dying patients.

Common Water Pill May Increase Bone Density

Hydrochlorothiazide, an inexpensive diuretic available for decades and widely used to control hypertension, preserved bone density at the hip and spine over a three-year period when compared to placebo, according to a study of 309 healthy older adults (Article, p. 516). The benefit was modest, but the treatment was well-tolerated. The authors note that the inexpensive thiazide diuretics have a good, long-term safety profile, so hydrochlorothiazide should be considered in programs to prevent osteoporosis.

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